THE PROTECTIVE POWER OF VACCINATION.

577 Service there were forty candidates." Dr. Hall then discussed the respective advantages of the different services, and pointed out that there was ample scope for scientific workers in the department of public health. After reading the Hippocratic oath in extenso, he concluded his address as follows :-" The enlightened morality of the oath, and the admirable rules laid down in it for the conduct of the geons within the first two years, so as to leave two whole medical man towards his patient, leave little to be desired, years for the practical part of their studies. He also in- and if you only act up to the spirit of this document, over sisted upon the importance of students having a clear under- two thousand years old, you will attain, if not wealth, at all standing as to what degrees or diplomas they intend taking. events the respect and esteem of all with whom you come in "Much time is lost and inconvenience caused by the student contact, and a happy hereafter." discovering, after he has started on his career, that he requires a degree in medicine, or that the Fellowship of the College of Surgeons will be necessary. When you are once launched into practice it will be almost impossible for you THE PROTECTIVE POWER OF VACCINATION. to obtain a British medical degree (unless you be over forty), To the Editor of THE LANCET. as all the universities except the London require residence, SIR,-In your last issue, under the above heading, you and the curriculum of the latter puts that out of the questo the importance of inoculating vaccinated persons refer tion."" Dr. Hall was distinctly in favour of enforcing attendance at lectures ; he considered that lectures could lay with variolous virus to furnish undeniable evidence of the stress on the more important points, and that in such a proprotection afforded by vaccinia against variola. This has gressive science as medicine attendance at lectures was the been done, as you know, over and over again, especially only feasible way for students to keep abreast with the daily increase of knowledge. He advocated the plan of taking during the earlier years of this century ; and if such a test short notes at lectures, to be amplified at night. In speak- would convince " anti-vaccinationists," or would inspire coning of the necessity of thoroughness, he said : " If you begin fidence in vaccination among those hesitating as to its your medical career with an inaccurate knowledge of the efficacy, I would refer them to the literature on vaccination sciences on which medicine is based be sure that you will and small-pox issued in Dr. Jenner’s time, in which they never practise your profession with anything like satisfacwill find scores of experiments recorded like those suggested tion to yourself or advantage to your patients. At the best Dr. by Cory and Dr. Mitchell. Those opposed to vaccinayou will be little better than empirics. " Of equal importance with the mental training is the tion who will not listen to reason need no further notice ; necessity of seeing that the physical needs of the body re- but others, who have perhaps thought and read more on the ceive their due share of attention." In speaking on this subject-who at all events are amenable to conviction-will subject Dr. Hall drew attention to the demands upon a say, inoculated variola is a very different disease from conmedical man’s energy and decision, and to the importance of tagious small-pox, and is indeed, so mild a form that it was good health, unless the doctor is himself to fall a victim two employed for many years as a prophylactic against contagious the very disease he was called upon to treat. As a means of variola. This brings me to record an instance which preserving health regular exercise was highly praised, and occurred to me some years ago, and no doubt many such students were advised as much as possible to make their experiences have to other general practitioners, though they recreations such as would take them into the open air, and have not published them. A few years since, when smallto avoid the billiard-room. In speaking of purity of life, pox was raging here, I was notified of a certain case in a Dr. Hall said :"If your purview is limited to this world house in Birkenhead ; and, as public vaccinator there, I only it is worth your while to lead a moral life. Infringe- visited the house to offer its inmates the advantages of vaccination and revaccination, and thus to stamp out what ments of the moral law are frequently visited, as, alas ! will too often have an opportunity of seeing, by immediate might have initiated an epidemic. I found the subject of punishment, and by what I consider as more awful a punish- small-pox to be a tramp’s child, living with its mother in the ment, which in certain cases is shared by innocent victims. attics. With this patient I had nothing to do ; but on Ruined health, early death, or premature old age, to say inquiry I learned there lived in this house two other families, nothing of the misery and wretchedness communicated or consisting each of a father, a mother, and half a dozen transmitted to those nearest and dearest, have been in many children. Of the children only one was under six months instances the lot of youth who commenced life with bright old, and accordingly the only subject for compulsory vaccinaprospects; so " true is the apostolic saying,’The wages of tion. The mother readily agreed to its being vaccinated. sin is death.’ The other children bore marks of successful vaccination After a few words of caution as to the choice of friends and during infancy. Of subjects suitable for revaccination (that on the means of keeping out of the way of temptation by is, persons over twelve years old who had not been successbeing always busy, Dr. Hall proceeded to discuss the fully revaccinated previously) there were only the parents. different openings possible to the medical man. He assumed Therefore I arranged to visit the house again when the men that the majority of his hearers were destined for general would be at home, and on offering both husbands and wives practice, and he told them that with fair education, good revaccination, warning them that if they did not accept rehealth, and tact, they might rest content that they would vaccination they would be attacked by variola, the women earn for themselves a living, and in many cases a very agreed and were revaccinated, the men " trusted to Provicomfortable one. He strongly advised those who were dence." Father, mother, and children of each family slept intended for general practice to go as assistants for a time in the same room, several of them together in the same bed. before starting on their own account, so as to learn some- On that day week, as predicted, the mothers and the infant thing of the requirements of general practice. He then spoke, showed vaccinia, the fathers showed variola. They conof different modes of starting in practice. Those who were, tinued to sleep together but no more cases of small-pox anxious to see something of the world before settling down occurred in this house. The original source of variola was had a wide field of choice-i, e., there were travelling appoint- removed to hospital. Here is an undeniable instance of conments to be had or surgeoncies in the mercantile or emigra- tagious variola being prevented by vaccination from attacktion services. For those who wished for work of a still more ing children of various ages and adults, while it found permanent character, the three branches of Her Majesty’s victims sleeping in the same bed. T ntTt Oir trnnra triil%r service were open-viz., the Army Medical Department, the Indian Medical and the Naval Services. "Ten years P. M. BRAIDWOOD. ago and less the Indian Medical Service was the only one which attracted good men; the two other services THE THIRLMERE WATER SCHEME.—The hearing of were literally starved. But of late years, owing to the increased pay and improved regulations, there has been this case has at last terminated, and the arbitrator will, it is a keen competition for all these services. For instance, at expected, make his award on the 30th inst. The owner of the last examination, held in August, there were ten the property required by the Corporation of Manchester vacancies for the army and thirty candidates, the same demands a sum variously assessed at £75,000, and £93,000, number of vacancies for the navy and twenty candidates, whereas the Corporation consider .620,000 a sufficient whereas for the eight vacancies in the Indian Medical equivalent for the property.

acquire the habit of doing things in a casual manner, which is destructive to anything like thoroughness."He therefore advised that only the minimum amount of attention required by the regulations of the College of Surgeons should be devoted to surgery until the primary examinations had been passed. He urged all students to make an effort to pass the first examination of the Royal Colleges of Physicians and Sur-

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