to be published in the religious press or in village papers, where it would meet the uninformed and ignorant reader, it might do some harm, but surely it is not worth any one's time to answer such stuff in the pages of the Medico-Legal Journal. I return you the paper at once, so that if you have any mind to submit it to someone else to respond to, there may be less delay. For my own part I have been hindered so much by other duties, that I am far in arrears in the preparation of my annual report of the State Board of Health. My college work is on also at present and I cannot for some weeks to come spare the time the importance of the subject demands to make a suitable reply. Very respectfully, C. S. LINDSLEY. George B. Fowler, M. D., Health Commissioner of New York City, replied to the question as follows in a letter to the Secretary: Clark Bell, Esq., 39 Broadway, New York City: My Dear Sir:-Your communication of the 30th, relative to my replying to a prospective paper before the Medico-Legal Society, by Dr. M. R. Leverson, in which he assails "compulsory vaccination," is at hand. This Board is not in favor of "compulsory vaccination," and never has been. It is acting under the State laws when it assists the Board of Education in securing the vaccination of pupils and teachers. So thoroughly has this co-operation been carried out that in the last ten years, during which three epidemics of smallpox have occurred in this city, not a single pupil or teacher connected with the public schools has been reported to this Department as suffering with smallpox. The reason the Board of Health does not believe in compulsory vaccination is because it is believed that such a statute would result in antagonism to the work, which would defeat the object it has always secured in the way of gratuitous and voluntary vaccination, and the comparative immunity from smallpox for which this city is noted. I therefore do not see any reason why I should defend the position that Dr. Leverson proposes to take in this paper. Yours very truly, GEO. B. FOWLER, Commissioner. Dr. Moreau Morris, M. D., Health Department, New York City, replied as follows: Clark Bell, Esq., Secretary of the Medico-Legal Society: Dear Sir:-To the question, "Compulsory Vaccination, should it be enforced by the law?" I would respectfully answer, that for a general State law, negatively, but for local purposes in cities or villages having a population of 1000 or over, where large congregations of school children especially congregate, there should be compulsory vaccination as a precedent to school admission. The experience of other countries and in this city in suppressing the spread of smallpox, by carefully selected vaccine virus introduced into the human system by proper antiseptic means, seems to set the seal of its legitimacy for public policy and universal protection beyond all question. The public protection is paramount to any and all private interests. Respectfully yours, MOREAU MORRIS, M. D., 109 East 73rd Street, N. Y. Prof. Eugene Foster, Dean of the Faculty of the College of Georgia, replied as follows: Mr. Clark Bell, N. Y. Medico-Legal Society, No. 39 Broadway, N.Y. My Dear Sir:-Pray pardon my failure to earlier make reply to your letters of Sept. 28th and Oct. 1st, great press of business together with several absences from the city has prevented earlier attention to the matter. I very sincerely appreciate the compliment extended in asking me to submit a paper on Vaccination to be read on the 3rd Wednesday of November in reply to one to be presented by Dr. Montague R. Leverson. I could not do justice to the subject of Vaccination in a "short paper." I have written exhaustively upon this subject in my article on "The Statistic Evidences of the Value of Vaccination" which was presented at the Jenner Centennial at the recent meeting of the American Medical Association in Atlanta. This paper you will find in a series of articles which were published in the Journal of the American Medical Association. If this paper does not produce sufficient evidence to satisfy a reasoning man as to the safety and efficiency of vaccination I could not consent to waste time in arguing the question with him. In my positions on the question of vaccination, I am sustained by almost every reputable medical man in the civilized world. I do not attemp: to argue the good policy of compulsory vaccination; this is a question entirely separate and distinct from its efficiency and safety, and many of the best members of the medical profession seriously doubt if indeed they are not actually opposed to compulsory vaccination. I have had the article above referred to reprinted, and will in a short time send you a copy of it if you desire me to do so. I very greatly regret that I did not know that the copy of the Berlin Report of the Consul General referred to by you was not preserved by me, that is, the original received from Surgeon General Sternberg, was included among the manuscript turned over to the printer with the balance of my article read at the Jenner Centennial. I will be very glad to have you send me Dr. Leverson's article as promised in yours of October 1st, for the reason that I do not now receive the transactions of the Medico-Legal Society as I formerly did. I am Very truly yours, EUGENE FOSTER. Col. W. P. Prentice, counsel for the health authority, replied as follows: Clark Bell, Esq.: Dear Sir:-I have the honor to acknowledge your letter of the 2nd inst., with its invitation "to prepare," for the meeting of the Medico-Legal Society on November 18th, my "views" upon the following theme," Conceding the utility and value of vaccination as a preventative, should it be made compulsory by law?" There cannot now be said to be any open question subject to concession in the first clause of your theme, in my opinion; but as the Register of Scotland reported in 1874, "there is but little of that unreasonable opposition to the practice of vaccination" remaining, and the recent report of the Parliamentary Commission of England, of which Lord Herschell was the chairman, following similar reports in Germany and other States, closes the discussion for the present, exhibiting the impracticability of opposition. This result adds strength to the argument for the indirect methods of securing vaccination. I have elsewhere in my book on "Police Powers" discussed this question more at large, and have given reference to many cases, including those which have maintained a personal liberty where the public health was not directly endangered. At page 132 this statement was made, "Compulsory vaccination has been instituted in several countries, and by the laws in several States in respect to minors. City ordinances regulate it, but the indirect method of excluding children not vaccinated from schools and factories, or in case of immigrants, insisting upon quarantine, and the offer of free vaccination, with the constant supervision of the health officers, are more effective." This opinion I still maintain, and in common with many others, have not ceased to regret the unwise proceedings which have been occasionally undertaken in defense of health and sanitary laws, weakening their proper force. The Court of Appeals' decision in 1895, Matter of Smith (146 N. Y., 68), brings up the sound rule to govern such cases, viz.: that, "where a right to restrain the citizen in his personal liberty, or to interfere with his pursuit of a lawful avocation, is claimed to sustain the claim, it must appear very clearly, not only that the right has been conferred by law, but that the facts existing justify its exercise. The validity of the law is not so much called into question as the right to enforce its provisions," the opinion says, and again uses words which I would adopt. "T think no one will dispute the right of the Legislature to enact such measures as will protect all persons from the impending calamity of a pestilence, and to vest in local authorities such comprehensive powers as will enable them to act competently and effectively." Little can be added to the lesson of this judgment, and I believe we have at present sufficient laws, if they are duly administered and properly enforced. I remain with great respect, Yours truly, W. P. PRENTICE. Sir Frederick Bateman, of Norwich, England writes: Clark Eell, Esq.: My Dear Sir:—You ask my views on compulsory vaccination. It so happens that this question has much engaged my attention, and I send you a pamphlet in which at page 5 you will see my mature views on this subject. With kind regards, Yours faithfully, FREDERICK BATEMAN. The pamphlet referred to is the annual report of the Asylum Union for 1895, by Sir Frederick Bateman, which cannot, for want of space, be given, but the summary will be of great interest, which is as follows: I hold that any individual who from his obstinacy declines to avail himself of the protective influence of vaccination, and thus risks not only his own life, but that of his innocent neighbor, is just as much liable, or ought to be, to punishment by law as he who knocks his neighbor down, or picks his pocket; and I maintain it is a wicked crime for persons in the broad daylight of the nineteenth century, from obstinacy or ignorance, to abstain from being vaccinated and from having their families similarly protected. As hypothesis and mere opinion have but little influence, I wish to support these remarks by some documentary evidence in reference to the results of vaccination. During a period of 16 years. 5.797 cases of smallpox were admitted into the Smallpox Hospital, at Highgate. Of this number, 2,654 or nearly one-half were unprotected by vaccination; of these, 996 died, being 35 per cew. Now just mark the reverse; of those properly vaccinated-and I lay great stress on the word "properly," because otherwise these statistics might be pulled to pieces-just under one per cent. died; so here you have 353 per cent. dying, of the unvacemated, and less than one per cent. of the vaccinated. The latest scientific views as to the value of vaccination may thus be summarised. 1st. Vaccination properly performed in infancy, affords an almost complete protection against smallpox up to the period of puberty: but it is important to bear in mind that vaccination is a surgical operation, and should be performed in a satisfactory and careful manner; for many of the supposed failures are in reality due to the careless way in which the operation has been undertaken. 2nd. That in the few instances in which vaccination may fail to impart absolute protection against the smallpox, it nevertheless, in the majority of instances, modifies the course of the disease, and renders it less fatal, as was strikingly exemplified in the outbreak at Hackford. 3rd. That at puberty, re-vaccination is strongly to be recom mended, and that, as a rule, such re-vaccinated persons may be regarded as permanently protected, although in an epidemic of smallpox, it may be a wise precautionary measure to submit them. again to the process of vaccination. The importance of the subject, and the fact of the recent outbreak of smallpox in this Union, must be my excuse for dwelling at such length on the efficacy of vaccination. The arguments for the necessity of it have been much strengthened by the remarkable discoveries recently made in connection with bacteriology and the antitoxin treatment of disease, discoveries which have been hailed with acclamation in all parts of the civilized world; and I unhesitatingly and emphatically assert that Sanitary Authorities will be neglecting their duty, in the face of all this, if they do not resolutely and unflinchingly put into operation the compulsory clauses of the Vaccination Acts. C. S. Lindsley, M. D., Secretary of the State Board of Health of Connecticut, replied as follows: Clark Bell, Esq.: Dear Sir-In your courteous invitation to me, on September Ist., to prepare a paper "In support of Vaccination," there is not a word about "compulsory." In your favor of September 10th, you speak of my proposed paper, " defending compulsory vaccination." Defending vaccination and defending compulsory vaccination are two quite different things. I am not an advocate of compulsory vaccination. I am positively opposed to it. But wholly on the ground of expediency. The people of this country are too thoroughly imbued with a sense of personal independence to submit patiently to personal compulsion. The attempt would excite hostility to vaccination that does not exist at present, and would hinder rather than promote the cause of vaccination. I have received this morning another notice with an invitation, which I regret to say I shall not be able to accept by reason of other engagements. Lack of time obliges me to reply briefly to your numerous questions although they cover enough for a small volume. I will answer them as you have numbered them. Q.(1). Ans. Sometimes humanized and sometimes bovine virus. O. (2). Ans. No. Q. (3). Ans. From a previously vaccinated calf, and originally from a cow or heifer with vaccine discase. Q. (4). Ans. In most states there is no legalized supervision. 2. (5). Ans. My only security is the known care and precaution which are observed by the best producers: except when I use humanized lymph, and then my own personal knowledge of the health of the subject from which it is taken. Very respectfully, C. S. LINDSLEY. |