View source for Compulsory Vaccination - The Hampshire County Times

''Compulsory Vaccination'' is a letter written by [[Arthur Conan Doyle]] first published in [[The Hampshire County Times]] (Portsmouth) on 27 july 1887.


== Compulsory Vaccination ==

Sir, — Colonel Wintle's second letter appears to me to contain a Jumble of statistics and quotations, some of which do not affect the question at all, while others tell dead against the cause which he is championing. If there is such a consensus of testimony that there was a marked diminution of pock-marked faces between the years 1815 and 1835, is it not a fact that these are the very years when the fruits of Jenner's discovery might be expected to show itself upon the rising generation? Colonel Wintle's argument appears to be that it was a mere coincidence that the disease should begin to diminish ;it the very time when the new treatment was adopted by a considerable section of the public. The medical profession holds that it was cause and effect — an explanation which has been amply borne out by subsequent experience.

The Colonel seems to think that because we still suffer from occasional epidemics of smallpox that proves the system of vaccination to be a failure. On the contrary, the most clinching argument in its favour is furnished by these very epidemics, for when their results come to be tabulated they show with startling clearness the difference in the mortality between those who have and have not been vaccinated. The unvaccinated not only contract the disease more readily, but it attacks them in a far more virulent form. The Sheffield case recorded by "Common Sense" is a remarkable and recent example of this well-known fact. The protection afforded by vaccination is in exact proportion to the thoroughness of the original inoculation. I suppose the most determined anti-vaccinationist would hardly venture to suggest that the statistics of hospitals are cooked in order to annihilate their particular fad. Here are Marson's tabulated results of the cases treated at the Smallpox Hospital during twenty years, and if Colonel Wintle can ignore them, I am puzzled to know what evidence would be accepted by him as conclusive. A glance at the subjoined table will show that there is a most exact correspondence between the degree of vaccination and the degree of mortality:—

of those with 4 vaccine marks ......... 5 per cent died<br>
of those with 3 vaccine marks ......... 1.9<br>
of those with 2 vaccine marks ......... 4. 7<br>
of those with 1 vaccine marks ......... 7.7<br>
With none, but professing to have been vaccinated ......... 23.3<br>
Non-vaccinated patients  ......... 37

Here it will be seen that the death-rate varies from less than one in a hundred among the well-vaccinated to the enormous mortality of 37 per cent. among Colonel Wintle's followers. These figures, remember, are taken from no single outbreak, where phenomenal conditions might prevail, but they represent a steady average drawn from twenty years of London smallpox. I might quote other corroborative tables of statistics, but I feel that if the foregoing fails to convince no other evidence is likely to succeed. Colonel Wintle remarks that London and Liverpool are more afflicted by smallpox than any other towns and deduces from that an argument against vaccination. The reason for the prevalence of the disease is of course that they have a larger floating population than any other English city and that therefore it is more difficult to enforce the vaccination acts. With all the zeal in the world a public vaccinator cannot eliminate smallpox in a large port with a constant influx of foreigners and seamen.

Anti-vaccinationists harp upon vaccine being a poison. Of course it is a poison. So is opium, digitalis, and arsenic, though they are three of the most valuable drugs in the pharmacopaeia. The whole science of medicine is by the use of a mild poison to counteract a deadly one. The virus of rabies is a poison, but Pasteur has managed to turn it to account in the treatment of hydrophobia.

As to fatal cases following vaccination, medical men are keenly alive to the necessity of using the purest lymph, and no candid enquirer can deny that some deplorable cases have resulted in the past from the neglect of this point. Such incidents are as painful as they are rare. Every care is now used to exclude a possibility of a strumous or syphilitic taint being communicated, these being the only constitutional diseases which have been ever known to be conferred. As I said in my previous letter, there are some children who will fester and inflame if they are picked with a pin, and these occasionally have their hereditary weakness brought out by the vaccination. Such stray cases, however, even if we allowed Colonel Wintle's extreme estimate of one a week, bear an infinitesimal proportion to the total amount of good done. At present if a child  dies of any cause within a certain time of its vaccination the anti-vaccinators are ready to put it down as cause and effect. Convulsions, whether arising from worms, or teething, or brain irritation, are all ascribed to the pernicious effect of what the literature of the league terms "that filthy rite."

In conclusion, there is no reason why Colonel Wintle should not hold his own private opinion upon the matter. But he undertakes a vast responsibility when, in the face of the overwhelming testimony of those who are brought most closely into contact with disease, he incites others, through the public press, to follow the same course and take their chance of infection in defiance of hospital statistics. Only the possession of an extremely strong case  can justify a man in opposing medical men upon a medical point,  and this is of all points the one which should be most cautiously approached, as the welfare of the whole community s at stake. Should I put forward some positive and dogmatic views upon the rifling of guns or the trajectory of a shell, Colonel Wintle, as an artillerist, would be justified in demanding that I should produce some good reasons for the faith which was in me. The tendency of the scientific world, if we may judge from the work not only of Pasteur and Koch, but also of Burdon-Sanderson, Toussaint, and others, lies more and more in the direction of preventive methods of inoculation to check zymotic disease. In opposing that tendency Colonel Wintle, however much he may persuade himself to the contrary, is really opposing progress and lending himself to thee propagation of error.

To anyone who wishes to know exactly the evidence upon Which the practice of vaccination is based I should recommend "The Facts about Vaccination," published by the National Health Society, 44, Berners-street, London.

A. CONAN DOYLE, M.D.,

Bush Villa, Southsea



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