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VACCINATION AND INFANTILE SYPHILIS.
404 in the Metropolitan Asylum and the London Fever Hospitals at the end of last week was 822, against numbers increasing in the preceding seven weeks from 559 to 779; 90 cases were admitted to these hospitals during the week, against 124 and 98 in the previous two weeks. The deaths referred to diseases of the respiratory organs in London, which had been 182 and 149 in the preceding two weeks, rose again to 162 last week, but were 26 below the corrected
patients
Correspondence. "Audi alteram
partem."
VACCINATION AND INFANTILE SYPHILIS. To the Editors of THE LANCET. average. The causes of 79, or 22 per cent., of the deaths SIRS,-Returning with Dr. Creighton from his interesting in the twenty-eight towns last week were not certified excursus into the laws of evidence, the Maybrick trial, &c.,
either by a registered medical practitioner or by a coroner. All the causes of death were duly certified in Norwich, Wolverhampton, Blackburn, and Cardiff; the largest proportions of uncertified deaths were registered in Newcastleupon-Tyne, Liverpool, Bristol, and Halifax.
to our starting-place, I have to point out that the subject of my letter was " the argument derivable from Scotch registration statistics regarding the relationship between vaccination and infantile syphilis, and Dr. Creighton’s connexion therewith." He had stated that he had " established " the argument in question, and I showed, as I believe, that his assertion rested on very insufficient ground, and I further HEALTH OF SCOTCH TOWNS. this as a warning to his readers-who might not be The annual rate of mortality in the eight Scotch towns, urged as I had been in this case, to turn to the original able, which had increased from 17’9 to 18’6 per 1000 in the pre- documents-of the too great facility with which it was ceding three weeks, declined again to 17’8 in the week end- possible for him to come to a finding on the subject. We seem ing August 17th; this rate was 1’4 below the mean rate to be at one as to what his ground actually was, and this during the same week in the twenty-eight large English being so, his reiterationof its sufficiency only of course emphatowns. The rates in these Scotch towns ranged last week sises my opinion that he isapttobuildontoo slender a foundafrom 11-6 and 14’0 in Aberdeen and Greenock to 20’7 in and leaves the issue clear for those who care to judge. tion, Glasgow and 26’9 in Perth. The 455 deaths in the eight He states, quite truly, that in addition to the Scotch towns showed a decline of 20 from the number in the prehe had other reasons for his views on infantile vious week, and included 43 which were referred to diarrhoea, statistics, That without saying. It was not, however, syphilis. 2t!. to whooping-cough, 10 to measles, 7 to diphtheria, 6 to with his other goes that I elected to deal, but only arguments and not "fever" (principally enteric), one either to small-pox with the particular statistical argument in question, and oûr scarlet fever; in all, 87 deaths resulted from these princitherefore 1 did not dream of inserting, as he thinks I should pal zymotic diseases, against 77 and 107 in the preceding have done, a quotation as to his opinions on congenital two weeks. These 87 deaths were equal to an annual rate of 3’4 per 1000, which was 1’0 below the mean rate from syphilis. Whether the indication which I gave would be prothe same diseases in the twenty-eight English towns. The visional or would of course depend on whether deaths referred to diarrhoea, which had been 39 and 57 in or not the permanent reader would take the pains to extend his the previous two weeks, declined to 43 last week, but exwith the subject, either through consulting ceeded by 23 the number in the corresponding week of last acquaintance the authorities at first hand, or, more easily though less year. The 21 fatal cases of whooping-cough showed a satisfactorily, through such criticism as may the decline of 3 from the number in the preceding week, and Journal or elsewhere. But, as we may Edinburqh IJIedical included 12 in Glasgow, 4 in Paisley, and 3 in Dundee. take it for granted that many readers will do neither, then The deaths from measles, which had been 8 and 10 in the unquestionably I desired and do desire that, carrying away previous two weeks, were again ]last week, of which 4 with them the fact that vaccination is opposed by one man occurred in Glasgow, 3 in Aberdeen, and 3 in Leith. The of standing in the profession, they should at the same time ‘:7 fatal cases of diphtheria corresponded with the number in carry away the other fact (as I hold it to be) that the man the preceding week, and included 3 in Edinburgh, 2 in in is liable to base his statements on insufficient question Glasgow, and 2 in Dundee. The 6 deaths attributed to evidence. This Dr. Creighton calls "a vague and com"fever" showed a decline of one from the number in the prehensive innuendo." The term does not seem to me to be preceding week, and included 2 in Edinburgh. The deaths applicable. referred to the principal diseases of the respiratory organs, The Doctor mentions, as a difference between us, that which had been 60 in each of the previous two weeks, were while I had transcribed the Scotch into my book, he .57 last week, and corresponded with the number in the had transcribed them only into his figures note-book. That, I take The causes of 36, or nearly 8 per same week of last year. it, was unfortunate, for though they owe much of their value cent., of the deaths registered in the eight towns during to comparisons which he has not made-one being with the week were not certified. English figures of which he was not cognisant,-if he had put even the Scotch figures into his book, they would have served in great measure to counteract the pageful of figures, HEALTH OF DUBLIN. Thedeath-rate in Dublin, which had been 20and 24’8 constituting an oft-repeated argument against vaccination, which in his discussion of the matter he did insert. Indeed, per 1000 in the preceding two weeks, declined to 24’4 in the week ending Aug. 17th. During the first seven weeks it is not easy to see why, in his desire to protect vaccination of the current quarter the death-rate in the city averaged from unjust assault, he should have omitted the former (as 22’4 per 1000, the mean rate during the same period being pedantic ?), while he found a place not only for the latter, 1’7’7 in London and 16-1 in Edinburgh. The 165 deaths in but for another table showing how the registrations from Dublin showed a decline of 3 from the number in the vaccinal erysipelas had increased during the past thirty On his part, as a defender of vaccination against the receding week; they included 25 which were referred to years. "alarmist teaching" of anti-vaccination writersl on this 4 to whooping-cough, 3 to "fever," 1 to measles, 9. to diphtheria, and not one either to small-pox or to subject, the omission was surely a tactical blunder. I am, Sirs, yours sincerely, scarlet fever. Thus the deaths from these principal JOHN C. MCVAIL. 1889. 19th, Aug. had in which been 15 and 25 the diseases, previous zymotic further ,two weeks, rose to 34 last week ; they were equal THE USE OF ROBURITE IN MINES. to an annual rate of 5 0 per 1000, the rate from the same diseases being 3’0 in London and 2-2 in Edinburgh. The To the Editors of THE LANCET. deaths referred to diarrhoea, which had been 8 and 17 in trust to your sense of fairness to allow me space SlRS,--I the preceding two weeks, further rose to 25 last week. to reply to an annotation under the above heading in your The four fatal cases of whooping-cough corresponded with of July 20th. issue ’the number in the previous week. The deaths from "fever" 1. In the first place, let us eliminate from considerathose .-exceeded those recorded in any recent week, while tion the unfortunate accident at Gathurst which you from measles showed a further decline. The deaths of infants showed a marked increase, while those of elderly refer to " as proving beyond doubt that roburite is a very poisonous compound," since it hid nothing whatever persons were below those recorded in the preceding week. do with the use of the explosive in mines. It was Three inquest cases and 4 deaths from violence were regis- to at the inquest that the poor man died from the proved tered ; and 40, or nearly one-fourth, of the deaths occurred in public institutions. The causes of 22, or more than 13 effects upon a weak heart of getting into a closed shaft or 1 THE per cent., of the deaths in the city were not certified. LANCET, Dec. 1st, 1888.
appear in
diarrhoea,
JOHN
patients
Correspondence. "Audi alteram
partem."
VACCINATION AND INFANTILE SYPHILIS. To the Editors of THE LANCET. average. The causes of 79, or 22 per cent., of the deaths SIRS,-Returning with Dr. Creighton from his interesting in the twenty-eight towns last week were not certified excursus into the laws of evidence, the Maybrick trial, &c.,
either by a registered medical practitioner or by a coroner. All the causes of death were duly certified in Norwich, Wolverhampton, Blackburn, and Cardiff; the largest proportions of uncertified deaths were registered in Newcastleupon-Tyne, Liverpool, Bristol, and Halifax.
to our starting-place, I have to point out that the subject of my letter was " the argument derivable from Scotch registration statistics regarding the relationship between vaccination and infantile syphilis, and Dr. Creighton’s connexion therewith." He had stated that he had " established " the argument in question, and I showed, as I believe, that his assertion rested on very insufficient ground, and I further HEALTH OF SCOTCH TOWNS. this as a warning to his readers-who might not be The annual rate of mortality in the eight Scotch towns, urged as I had been in this case, to turn to the original able, which had increased from 17’9 to 18’6 per 1000 in the pre- documents-of the too great facility with which it was ceding three weeks, declined again to 17’8 in the week end- possible for him to come to a finding on the subject. We seem ing August 17th; this rate was 1’4 below the mean rate to be at one as to what his ground actually was, and this during the same week in the twenty-eight large English being so, his reiterationof its sufficiency only of course emphatowns. The rates in these Scotch towns ranged last week sises my opinion that he isapttobuildontoo slender a foundafrom 11-6 and 14’0 in Aberdeen and Greenock to 20’7 in and leaves the issue clear for those who care to judge. tion, Glasgow and 26’9 in Perth. The 455 deaths in the eight He states, quite truly, that in addition to the Scotch towns showed a decline of 20 from the number in the prehe had other reasons for his views on infantile vious week, and included 43 which were referred to diarrhoea, statistics, That without saying. It was not, however, syphilis. 2t!. to whooping-cough, 10 to measles, 7 to diphtheria, 6 to with his other goes that I elected to deal, but only arguments and not "fever" (principally enteric), one either to small-pox with the particular statistical argument in question, and oûr scarlet fever; in all, 87 deaths resulted from these princitherefore 1 did not dream of inserting, as he thinks I should pal zymotic diseases, against 77 and 107 in the preceding have done, a quotation as to his opinions on congenital two weeks. These 87 deaths were equal to an annual rate of 3’4 per 1000, which was 1’0 below the mean rate from syphilis. Whether the indication which I gave would be prothe same diseases in the twenty-eight English towns. The visional or would of course depend on whether deaths referred to diarrhoea, which had been 39 and 57 in or not the permanent reader would take the pains to extend his the previous two weeks, declined to 43 last week, but exwith the subject, either through consulting ceeded by 23 the number in the corresponding week of last acquaintance the authorities at first hand, or, more easily though less year. The 21 fatal cases of whooping-cough showed a satisfactorily, through such criticism as may the decline of 3 from the number in the preceding week, and Journal or elsewhere. But, as we may Edinburqh IJIedical included 12 in Glasgow, 4 in Paisley, and 3 in Dundee. take it for granted that many readers will do neither, then The deaths from measles, which had been 8 and 10 in the unquestionably I desired and do desire that, carrying away previous two weeks, were again ]last week, of which 4 with them the fact that vaccination is opposed by one man occurred in Glasgow, 3 in Aberdeen, and 3 in Leith. The of standing in the profession, they should at the same time ‘:7 fatal cases of diphtheria corresponded with the number in carry away the other fact (as I hold it to be) that the man the preceding week, and included 3 in Edinburgh, 2 in in is liable to base his statements on insufficient question Glasgow, and 2 in Dundee. The 6 deaths attributed to evidence. This Dr. Creighton calls "a vague and com"fever" showed a decline of one from the number in the prehensive innuendo." The term does not seem to me to be preceding week, and included 2 in Edinburgh. The deaths applicable. referred to the principal diseases of the respiratory organs, The Doctor mentions, as a difference between us, that which had been 60 in each of the previous two weeks, were while I had transcribed the Scotch into my book, he .57 last week, and corresponded with the number in the had transcribed them only into his figures note-book. That, I take The causes of 36, or nearly 8 per same week of last year. it, was unfortunate, for though they owe much of their value cent., of the deaths registered in the eight towns during to comparisons which he has not made-one being with the week were not certified. English figures of which he was not cognisant,-if he had put even the Scotch figures into his book, they would have served in great measure to counteract the pageful of figures, HEALTH OF DUBLIN. Thedeath-rate in Dublin, which had been 20and 24’8 constituting an oft-repeated argument against vaccination, which in his discussion of the matter he did insert. Indeed, per 1000 in the preceding two weeks, declined to 24’4 in the week ending Aug. 17th. During the first seven weeks it is not easy to see why, in his desire to protect vaccination of the current quarter the death-rate in the city averaged from unjust assault, he should have omitted the former (as 22’4 per 1000, the mean rate during the same period being pedantic ?), while he found a place not only for the latter, 1’7’7 in London and 16-1 in Edinburgh. The 165 deaths in but for another table showing how the registrations from Dublin showed a decline of 3 from the number in the vaccinal erysipelas had increased during the past thirty On his part, as a defender of vaccination against the receding week; they included 25 which were referred to years. "alarmist teaching" of anti-vaccination writersl on this 4 to whooping-cough, 3 to "fever," 1 to measles, 9. to diphtheria, and not one either to small-pox or to subject, the omission was surely a tactical blunder. I am, Sirs, yours sincerely, scarlet fever. Thus the deaths from these principal JOHN C. MCVAIL. 1889. 19th, Aug. had in which been 15 and 25 the diseases, previous zymotic further ,two weeks, rose to 34 last week ; they were equal THE USE OF ROBURITE IN MINES. to an annual rate of 5 0 per 1000, the rate from the same diseases being 3’0 in London and 2-2 in Edinburgh. The To the Editors of THE LANCET. deaths referred to diarrhoea, which had been 8 and 17 in trust to your sense of fairness to allow me space SlRS,--I the preceding two weeks, further rose to 25 last week. to reply to an annotation under the above heading in your The four fatal cases of whooping-cough corresponded with of July 20th. issue ’the number in the previous week. The deaths from "fever" 1. In the first place, let us eliminate from considerathose .-exceeded those recorded in any recent week, while tion the unfortunate accident at Gathurst which you from measles showed a further decline. The deaths of infants showed a marked increase, while those of elderly refer to " as proving beyond doubt that roburite is a very poisonous compound," since it hid nothing whatever persons were below those recorded in the preceding week. do with the use of the explosive in mines. It was Three inquest cases and 4 deaths from violence were regis- to at the inquest that the poor man died from the proved tered ; and 40, or nearly one-fourth, of the deaths occurred in public institutions. The causes of 22, or more than 13 effects upon a weak heart of getting into a closed shaft or 1 THE per cent., of the deaths in the city were not certified. LANCET, Dec. 1st, 1888.
appear in
diarrhoea,
JOHN