THE PRESENT VACCINATION LAW for Scotland is defective, securing, as it does adequate protection only for children under the age of six months, and ignoring the rest of  the population - a proportion of whom it leaves as obnoxious to the ravages of small-pox as were the inhabitants of Puynipet some fifteen years ago.* Vaccination, as it is, leaves us a prey to the not infrequent invasion of small-pox; vaccination, as it might be, would banish the disease for ever from the land.

Until  the Compulsory Vaccination Act for Scotland became law some five years ago, the protective measure has been imperfectly applied in Scotland.

The practitioner was seldom afforded an opportunity of ascertaining for himself the result of vaccination. Also there was the difficulty for the country practitioner of keeping up his supply of efficient lymph. Often half a year or more elapsed without his being ever called on to vaccinate.

The greater number of recipients, besides, did not come under the notice of the regular practitioner at all, but were dealt with by the midwife, a canny friend, or the father, or mother, armed with clasp-knife or darning needle. I remember one amateur vaccinator of great local repute, a “surgeon to old shoes,” the weapon of whose anti-varioloid warfare was his awl.

 Matter belonging to any stage of vaccinia, or even the scrapings from the moistened under-surface of the effete crust, after it had dropped off from the arm, served the purpose; and when the produce of this rude husbandry was a pimple or sore of any description, it sufficed. In not a few cases, protection from small-pox was never involved in any way.

As for revaccination, except by the more intelligent class of patients it was seldom acceded to when proposed, and still more rarely applied for. A law providing only for the vaccination of children, left many individuals absolutely or probably without protection.

In the unvaccinated subjects of attack, the malady ran its course with all its wonted severity and fatality. On the other hand, I have never met with small-pox, even among the attendants on those affected with it, and others much exposed to its contagion, in any case in which vaccination (or revaccination) was of more recent date than ten years preceding the period of exposure; and, keeping in view the pre-eminent activity of the varioloid poison, I believe we shall not err in ascribing such escapes, as a rule, to the protective agency of cow-pox.

The need for universal vaccination

A thorough general vaccination or revaccination of all unprotected members of the community, of whatever age, should be made imperative by law.

I suggested and advocated, although in vain, in The Scotsman newspaper, the adoption of a measure of this kind, when our present Vaccination Act was in preparation by the then Lord Advocate. Various objections were urged at the time in opposition to my views.

The proposed measure was pronounced unnecessary, in as much as a general vaccination of infants would be found sufficient to secure for the entire population the necessary protection from small-pox.

Such extended compulsion, it was farther held, was inexpedient, as involving an undue interference with the liberty of the subject. With all respect for my ‘free-born Briton,’ if his pigsty, his untrapped cesspool, his open or unflushed drain, so much as stink in the public nostrils, legal compulsion is brought to bear on him for the abatement of the nuisance; why, then, should state interference be withheld when called for to prevent him from keeping his body in readiness of the reception and the transmission to those around him of a surpassingly loathsome and deadly disease?

*In 1854 the population of Puynipet, a Pacific island, was about 5,000, but in that year an English captain left on the island one of his crew suffering from small-pox. The natives stole the sick man’s clothes and other effects, thereby catching small-pox. Above 3,000 of the 5,000 perished from the disease.

“The greater number of recipients were dealt with by the midwife, a canny friend, or the father, or mother, armed with clasp-knife or darning needle. I remember one amateur vaccinator, a “surgeon to old shoes,” the weapon of whose anti-varioloid warfare was his awl”

“With all respect for my free-born Briton, if his pigsty, his untrapped cesspool, his open or unflushed drain, so much as stink in the public nostrils, legal compulsion is brought to bear on him for the abatement of the nuisance. Why, then, should state interference be withheld when called for to prevent him from keeping his body in readiness of the reception and the transmission to those around him of a surpassingly loathsome and deadly disease?”