By H. B. Anderson
226 West 47th Street
                      New York
PRICE $1.00

226 W. 47th STREET, NEW YORK, N. Y.

Copyright 1929
H. B. Anderson
Manufactured in the United States of America

This book has been prepared especially for the busy
man or woman to read.
The entire story is contained in the headlines while
the proof is given in light face type.
It is not necessary, therefore, to read the light face
type except where questions arise regarding the accuracy
of any assertion contained in the headlines, in which
case the facts are readily available.
This book points out the fallacy of community vacci-
nation, involving compulsory measures, but does not at-
tempt to advise anyone whether he should or should not
be vaccinated for his own protection.
The data contained herein is compiled entirely from
board of health bulletins, medical journals and other
authoritative publications.
It represents findings and concessions of the most out-
standing advocates of vaccination. Hence, the data is of
a most conservative character which understates, rather
than overstates, the actual facts.
Nevertheless, the findings here given, revealing the im-
position and enormity of the outrage of the vaccination
requirement, are of a most startling character.
No institutions have wider facilities for acquainting
themselves with the facts referred to in this book than
federal, state and local boards of health. Why then, do
they continue the policy of showing frankness in discuss-
ing vaccination in technical publications and pursue the
policy of assuring the public in the press, on the radio
and on the public platform that vaccination is harmless
and that it constitutes a sure protection against small-

Health boards know the truth of the facts contained
herein. They also know the strength of the political
medical machine which is ever striving to prevent in-
formation of this kind from reaching the public. But
what they apparently fail to take into consideration is
that information may be suppressed for a time, but
eventually avenues are opened up for bringing the facts
to the public.
We appeal to all friends of free speech, to all friends
of a free press, and to all friends of medical liberty to
assist in acquainting the public with the facts contained
in this publication.
Compulsory vaccination as used in this book has refer-
ence to making vaccination a requirement by denying
education, food, or employment to persons not vaccinated.
The exercise of force to compel vaccination would subject
the physician or health officer to possible damages for
assault upon the body. (See Journal American Medical
Association, December 6, 1924, p. 1865). Hence it was
not considered necessary to discuss forcible inoculation.
Grateful appreciation is extended by the author to
Reverend William Whitehead of Bryn Athyn, Pennsyl-
vania for his invaluable assistance in compiling and
assembling the data contained in this publication.
The Reverend Whitehead collaborated with the writer
in the early stages of this treatise and the book would
have been published under joint authorship except for
Mr. Whitehead's absence abroad which necessitated its
completion by the writer.
Reverend William Whitehead is Professor of History
and Head of the History Department, Academy of the
New Church, Bryn Athyn, Pennsylvania.
Note:—All bold face type used in the quotations in
this publication are ours.

In Very Few States Is Vaccination Compulsory By
Law and Of the States Which Have Had Such a
Requirement One After Another Have Enacted
Legislation to Make This Form of Treatment Op-
England Has Repudiated Compulsory Vaccination
By the Acts of 1898 and 1907 Providing for a Con-
science Clause.
Holland Has Suspended Its Vaccination Require-
ment Because of Cases of Serious Illness Following
Australia Has Repudiated Compulsory Vaccina-
The Vaccination Law In Germany Is Breaking
Opposition to Compulsory Vaccination Is So Over-
whelming That an Increasing Number of Medical,
Public Health and School Authorities Are Finding
Fault With the Vaccination Requirement.
The London, Lancet, England's Leading Medical
Journal, Raises the Question of the Desirability
of Abandoning Universal Vaccination As a Public
Health Measure.

Parental Right to Determine Form of Treatment
For Children Is Fundamentally Sound.
Compulsory Vaccination Is un-American.
Typical Instances of Attempts By Advocates of
Compulsory Vaccination to Withhold Education,
Employment or Food From Persons As a Means of
Forcing Them to Be Vaccinated.
Physicians Do Not Want Compulsion For Them-
Organized Regular or Allopathic Physicians and
Vaccine Companies Have a Commercial Interest
In Making It Appear That Compulsory Vaccina-
tion Is Necessary.
Two Health Boards Are Officially Engaged In the
Business of Manufacturing, Creating a Demand
For and Selling Vaccines and Serums.
Medical Politics Stands In the Way of An Im-
partial Consideration of Vaccination Laws.
Facts Showing That Organized Medicine Has the
Machinery For Popularizing Vaccination Regard-
less of Its Merits or Demerits.
Extortion By Terrorism.
The United States Public Health Service Concedes
That Unvaccinated Persons May Be Exposed to
Smallpox Without Contracting It and That Small-
pox of a Fatal Character May Occur In Persons
With a Fairly Good Vaccination History.
Organized Physicians Were Just As Sure That the
Inoculation of People With Smallpox Was a Good
Thing As They Now Are That Vaccination Is
Necessary But Smallpox Inoculation Resulted In

Actually Spreading the Disease and Was Made a
Penal Offence In England In 1840.
Jenner, the So-called Discoverer of Vaccination,
Was Just As Sure That a Single Vaccination
Would Protect For Life As Organized Medicine
Today Is That Vaccination Affords Temporary
Protection Against Smallpox.
Smallpox Has Gone the Way of Cholera and Other
Filth Diseases Before the Onward March of Sani-
tation and Improved Living Conditions.
Smallpox Is Only One of Several Diseases Which
Have Shown a Substantial Reduction.
There Has Been No Increase In Smallpox Follow-
ing the Repeal of the Vaccination Requirement in
Maine and a Number of Other States.
In England Smallpox Mortality Has Greatly De-
clined Following Virtual Repeal Of Vaccination
Requirement By Passage of Acts of 1898 and 1907
Providing For a "Conscience Clause" As Shown
By the Following Tables. No Other Country Has
Given Vaccination So Good a Tryout As England.
Here Are the Facts.
Smallpox Record of United States Where Vacci-
nation Is Optional For Most Part Compares
Favorably With That of Italy, Japan and the
Philippines, Each of Which Make Vaccination
and Revaccination Compulsory.
Unvaccinated Australia Free From Smallpox.
The Case Reports of Alleged Smallpox In the
United States And England, About Which Advo-
cates Of Compulsion Are Seeking to Create So
Much Alarm, Are the Result of a Practice In
These Countries Of Reporting a Variety of Mild
Complaints As Actual Cases Of Smallpox Whereas
In Other Countries They Would Be Designated As

"Alastrim," "Cuban Itch," "Chickenpox" or Under
Some Other Name.
Fallacy of Statistics Comparing Smallpox Cases
Among the Vaccinated And Unvaccinated.
The Misuse of Statistics.
How Statistics May Be Interpreted to Mean Any-
thing the Advocates of Vaccines Want Them to
The Menace of Wholesale Serumization.
Serum Craze Has Now Reached the Stage Where
Persons Are Being Inoculated With Preparations
Ranging From Extracts Of Newspapers to Dan-
druff, Blonde and Brunette Hair and House Dust.
More Than 10,000 Soldiers Were Made Sick By
Articles In Medical Journals Refer to Lockjaw
(or Tetanus) Following Vaccination As Always
to Be Feared and An Ever-Present Possibility.
Bibliography Of Articles In Medical and Public
Health Journals Referring to Cases Of Lockjaw
(or Tetanus) Following Vaccination.
Specific Cases Of Fatalities Following Vaccina-
tion. The Following News Items Are Typical Of
the Clippings Received Each Year Prior to the
Opening Of the Schools. Health Boards In the
United States Are Not Required to Make Public
the Actual Number of Such Cases Which Occur.
Hence, While One News Item May Over-Empha-
size the Part Played By Vaccination the Majority
of Cases Would Not Be Reported At All.

Says Deaths From Vaccination Outnumber Those
From Smallpox.
Disclosures of Serious Illness and Fatalities Re-
sulting From Vaccination Contained in the
Reports of Two Official Investigations Just
New and Startling Dangers.—Recent Reports Of
Cases of Encephalitis Following Vaccination.
Medical Authorities Concede That Vaccination
May Light Up Or Transmit Various Diseases.
Epidemics Of Foot-and-Mouth Disease Of 1902
and 1908 Among Cattle Traced By United States
Department Of Agriculture to Vaccine Virus.
How Vaccine Virus Is Prepared.—Method Used
In England; Method Recommended by Dr. Park.
No Physician Or Health Officer Can Be Absolutely
Certain That Any Batch Of Vaccine Virus Is Free
From Impurities.

This book is dedicated to the late
Mr. John Pitcairn of Bryn Athyn,
Pennsylvania who was one of the most
outstanding opponents of compulsory-
vaccination in the United States.


"Will a nonimmunized person contract smallpox
if exposed to the disease? By no means uniformly.
Exposure to smallpox, especially to the milder
forms, without contracting the disease frequently
occurs and is no definite evidence of immunity.
The number of cases of smallpox among the unpro-
tected persons in contact with patients suffering
from the disease is very much less than 100 per
cent. . . .
"The purpuric, uniformly fatal, form of smallpox
is the most difficult to prevent by vaccination, and
cases of this form, without a true smallpox erup-
tion, may occur in persons with a fairly good vacci-
nation history ..." Extracts from article by Sur-
geon J. P. Leake, published in "Public Health
Reports," the weekly bulletin of the United States
Public Health Service, January 28, 1927.
The Vaccination Requirement Is Strenuously Op-
posed by an Enlightened Public Sentiment Within
and Without the Medical Profession: It is un-
American and is Sponsored by Class Interests
Which Would Profit Financially by the Retention
of this Legislation.

(Note:—Only nine states have laws making this form of
treatment a requirement for admission to the public schools:
the District of Columbia, Maryland, Massachusetts, New
Hampshire, New Mexico, New York (in cities of the first
and second classes only), Pennsylvania, Rhode Island and
South Carolina. Vaccination of children during infancy is
required by law in Kentucky and Maryland. It is optional
with local authorities whether or not they shall require vac-
cination for admission to the public schools in Connecticut,
Georgia, New Jersey, North Carolina, Ohio and Oregon. In
the absence of legislation specifically authorizing State or
local authorities to make vaccination a requirement for ad-
mission to the public schools, the state or local boards of
health in Arkansas, Kentucky, and a few other states have
attempted to require vaccination by means of health board
regulations. This action has been upheld by the courts in
some states but in most cases the exclusion of unvaccinated
children from the public schools, except during times of epi-
demic, without specific authority from the legislature, has
been held illegal. H. B. A.)

Extract from Public Health Bulletin No. 52 by J. W.
Kerr, issued by the United States Public Health Service,
January 1912.
"The provisions relative to vaccination in the United
States are many and varied. In very few States is this
prophylactic measure at all compulsory by law.
some it can be made a provision of state-wide application
at the discretion of the State board of health. In others,
the majority, its adoption is optional with the local health
authorities. Still in others, rules of the State board of
health require its practice, and in several, its obligatory
enforcement is absolutely forbidden.
"As to the practical enforcement of the existing provi-
sions, no opinion can be expressed. Health authorities of
various States admit that, owing to general apathy or
lack of funds, vaccination is seldom systematically en-
forced, except perhaps in the case of school children."
Compulsory Vaccination Prohibited in Four States.
From Supplement No. 60 to the Public Health Reports
entitled, "Smallpox Vaccination Laws, Regulations, and
Court Decisions," issued by the United States Public
Health Service, 1927.
"Compulsory vaccination prohibited.—In four States,
Arizona, Minnesota, North Dakota, and Utah, there are
statutory provisions against compulsory vaccination.
"The Arizona law provides that no minor child shall be
subjected to compulsory vaccination without the consent
of the child's parent or guardian. This law, however,
has a proviso prohibiting the school attendance in a
school district of unvaccinated children when a smallpox
epidemic prevails in such district.
"In Minnesota the statute reads, 'no rule of the State
board [of health] or of any public board or officer shall
at any time compel the vaccination of a child, or shall
exclude, except during epidemics of smallpox and when
approved by the local board of education, a child from

the public schools for the reason that such child has not
been vaccinated.'
"The North Dakota law forbids making any form of
vaccination or inoculation a condition precedent for the
admission of any person to any public or private school
or college, or for the exercise of any right, the perform-
ance of any duty, or the enjoyment of any privilege, by
any person.
"By the Utah" law it is made unlawful for any board of
health, board of education, or any other public board to
compel the vaccination of any person, or to make vacci-
nation a condition precedent to school attendance.
"Compelling vaccination by physical force.—A pro-
vision of the South Dakota statutes makes it unlawful
for any board, physician, or person to compel another by
the use of physical force to submit to vaccination."
Arizona Repealed Law by Referendum Vote.
Prior to the year 1918 Arizona had the following com-
pulsory vaccination law:
"Sec. 28. Each parent or guardian having the care,
custody or control of any minor or other person shall
cause such minor or other person to be vaccinated.
"Sec. 35. * * * Any person who fails to comply with
or violates any of the provisions of this act * * * shall
be guilty of a misdemeanor, and upon conviction thereof
shall be punished by a fine of not less than ten nor more
than fifty dollars, or by imprisonment in the county jail
not exceeding thirty days, or by both.—(Acts of 1903,
ch. 65)."
In 1918 the following law was passed by referendum
"Section 1. Children, compulsory vaccination prohib-
ited; school attendance during smallpox epidemic.—No
minor child shall be subjected to compulsory vaccination
without the consent of the parent or guardian having the
care, custody, or control of such minor: Provided, how-
ever, That no minor child shall be permitted to attend

any public school in any school district in the State of
Arizona during the period in which a smallpox epidemic
may be prevalent in said school district unless said minor
child shall have first been vaccinated.
"Sec. 2. Repeal.—That paragraph 4396, chapter 1,
title 41, of the Revised Statutes of Arizona, 1913, civil
code, be, and the same is hereby, repealed.— (Initiative
measure approved by voters November 5, 1918; effective
December 5, 1918)."
North Dakota Abolished Law in 1919.
Prior to the year 1919 North Dakota had the following
law for the control of smallpox:
"279. Each parent or guardian having the care, cus-
tody or control of any minor or other person shall cause
such minor or other person to be vaccinated.
"9038. Every person who wilfully violates any provi-
sion of the health laws * * * is punishable by imprison-
ment in a county jail not exceeding one year, or by a fine
not exceeding two thousand dollars, or both.—(Revised
Codes, 1905)."
The following law abolishing compulsory vaccination
in North Dakota was passed by the North Dakota Legis-
lature and approved February 14, 1919:
"Sec. 425al. Vaccination not to be made a condition
precedent..—No form of vaccination or inoculation shall
hereafter be made a condition precedent, in this State,
for the admission to any public or private school or col-
lege, of any person, or for the exercise of any right, the
performance of any duty, or the enjoyment of any privi-
lege by any person.
"425a2. Repeal..—Section 425 of the Compiled Laws of
North Dakota is hereby repealed, as well as are all acts
and parts of acts in conflict with the provisions of this
act—(1913-1925 Supplement to 1913 Compiled Laws)."
California Repealed Law in 1921.
Two acts were passed by the California legislature be-
fore the vaccination law in California was completely

abolished. In 1911 the requirement that children be vac-
cinated for admission to the public schools was modified
in such a manner as to exempt children who presented a
signed statement from the parent requesting that the
child be permitted to attend school without vaccination.
In 1921 another act was passed which repealed the vac-
cination requirement altogether. It provides as follows:
"Section 1. Smallpox, control; vaccination rules, adop-
tion.—The control of smallpox shall be under the direc-
tion of the State board of health, and no rule or regula-
tion on the subject of vaccination shall be adopted by
school or local health authorities. (Section 2 repeals ch.
134, acts of 1911.) —(Acts of 1921, ch. 370)."
Maine Abolished Law in 1921.
The State of Maine had, until the year 1921, a law
authorizing superintending school committees to require
vaccination. for admission to the public schools. It pro-
vided as follows:
"Section 35. Superintending school committees shall—
VII. Exclude, if they deem it expedient, any person not
vaccinated, although otherwise entitled to admission.—
(Rev. Stats. 1903, ch. 15)."
In 1921 this law was amended so as to make vaccina-
tion optional with parents, regardless of the wishes of
the superintending school committees. The law as
amended reads as follows:
"Sec. 38 (as amended by ch. 41, acts of 1921). Ex-
clusion of unvaccinated persons from school.—Superin-
tending school committees shall perform the following
V. Exclude, if they deem it expedient, any person not
vaccinated, although otherwise entitled to admission, un-
less a parent or guardian of such person shall present
a signed statement that such parent or guardian is op-
posed to vaccination, in which event such person may
only be excluded in the event of an epidemic of smallpox.
— (Revised Statutes, 1916, ch. 16)."

Massachusetts Abolished Compulsory Vaccination of
Infants in 1908.
Extract from a Communication by Mr. Henry D. Nunn
in the Boston, (Mass.) Post,
January 22, 1924.
"The first compulsory vaccination law was passed by
Massachusetts in 1855. It required that every infant
must be vaccinated before reaching the age of two years;
that no child should be admitted to any public school un-
less vaccinated; that all inmates of public institutions
must be vaccinated; that the employees of all manufac-
turing corporations must be vaccinated as a prerequisite
to employment and to cap the climax, everyone must be
vaccinated every five years. What was the result? In
the 20 years following the enactment of this law there
were 4221 deaths from smallpox in Massachusetts. The
protection afforded by this law did not highly recom-
mend itself to the people, and in time it was pretty much
ignored, so that finally in 1908 the infant vaccination
requirement was repealed without protest by anybody
and without any bad results."
Copy of ordinance passed by the Chicago City Council
January 13, 1926.
"The Board of Health shall pass no rule or regulation
which shall compel any person to submit to vaccination,
or injection of any virus, or medication, against his will
or without his consent, or, in the case of a minor or other
person under disability, the consent of his or her parent,
guardian, or conservator, and nothing in this ordinance
contained, or in any other ordinance heretofore passed
and in force in this city, shall be construed to authorize
or empower any person or officer to so vaccinate, inject,
or medicate, without such consent, or to authorize or em-
power the said board of health to adopt any rule or regu-

lation requiring or authorizing any such vaccination, in-
jection or medication."
A measure was also passed by referendum vote of the
people in Colorado Springs several years ago making vac-
cination optional in that city.
This Action Came As a Result of the Findings of The
Royal Commission on Vaccination in 1898 Which Con-
ducted the Most Exhaustive Investigation That Has
Ever Been Made on This Subject.
Extracts from book by C. Killick Milliard, M.D., entitled,
"The Vaccination Question In the Light of Modern
Experience," 1914, directing attention to the repudiation
of compulsory vaccination in England and the findings
of the Royal Commission on Vaccination in favor of a
modification of the vaccination law.
p. 1. "The Vaccination Question undoubtedly consti-
tutes one of the most remarkable controversies of the age.
In many ways it is unique. Beginning in the early days
of last century when vaccination was first introduced, it
only became a popular question when vaccination was
made compulsory in 1853. It attained its most acute
phase after the Vaccination Act of 1872, which, passed
with the object of securing the more efficient enforce-
ment of the Vaccination Laws by the appointment of
Vaccination Officers, may be regarded as representing the
high-water mark of compulsion. Since the Vaccination
Act of 1898 with the note-worthy Conscience Clause, and
still more since the Act of 1907 permitting the father to
make a statutory declaration before a Justice of the
Peace in place of having to go into Court, real compul-
sion has been very largely abolished. * * *

p. 27. "The Royal Commission on Vaccination
certainly represents by far the most exhaustive inquiry
ever held in connection with the subject of vaccination
and constitutes a landmark in the history of our subject.
It was, indeed, one of the most remarkable inquiries ever
held in connection with any subject. Appointed in the
year 1889, the Final Report was not published until 1898,
seven years later. This delay is not surprising, consider-
ing the enormous volume of evidence recorded. The Com-
missioners held 136 meetings, and examined 187 wit-
nesses. In addition, they caused important investigations
to be made for their assistance. The examination of cer-
tain individual witnesses occupied several whole days.
The total number of questions put and answered was over
18,000. Some idea of the mere bulk of the reports issued
is obtained from the fact that the five principal reports,
consisting of closely printed matter, together with the
eight bulky appendices, weigh altogether over 14 lb.
avoirdupois! The Commissioners, under the able chair-
manship of Lord Herschell, certainly did their work with
commendable thoroughness, and their reports constitute
a veritable storehouse of facts relating to vaccination;
but, unfortunately, much valuable evidence is virtually
buried in this great mass of material. * * *
p. 38. "Reference 5. The Question of Compulsion.—
As regards the important question of compulsion, the
Commissioners recommended a modified and much less
stringent form of compulsion by recognizing and
exempting the 'Conscientious Objector' on certain con-
Two of those who signed the Majority Report,
however, dissented from this concession; but, on the other
hand, two other Commissioners joined the Minority Com-
missioners in objecting to the retention of the principle
of compulsion in any form. There were thus two in
favor of unrelaxed compulsion; seven in favor of a
greatly modified and reduced form of compulsion; and
four in favor of compulsion being abandoned altogether.

It would only have required the transfer of three votes,
therefore, to have secured a majority in favor of the en-
tire abolition of compulsion." * * *
Extracts from item entitled, "Vaccination In Holland,"
translated from the Dutch official document suspending
vaccination for one year, and published in the "Vacci-
nation Inquirer" April 2nd, 1928.
"Vaccination against smallpox is not compulsory in
Holland. By the Infectious Diseases Act, however, it has
been laid down as a rule that teachers and pupils are not
allowed to enter a school unless they have been vaccinated
against smallpox, in a prescribed manner and with lymph
prepared in laboratories approved of by the State. * * *
"In 1923 and following years, cases of encephalitis
after vaccination have occurred. As in most cases this
encephalitis has shown itself 10 to 13 days after vacci-
nation, one has been led to suppose that there must be
some connection between vaccination and the divergence
of the central nerve system as stated from the diagnosis.
"One could therefore not maintain any longer that
vaccination against smallpox has to be considered as
entirely harmless, although the danger may be said to
be very slight.
"Comparing the possible harm caused by vaccination,
the risk of smallpox cases is in this country considered
greater, if the indirect compulsion to be vaccinated should
be entirely abolished.
"The Government, with a view to the present danger
of causing encephalitis after vaccination, for which
there are no decisive remedies yet, have thought it ex-
pedient to suspend the indirect compulsion for one year.

It is hoped that during that period, by means of official
scientific investigations and searches, the cause of the
complication may be discovered, so that measures can be
taken to prevent it.
"Should this step have no satisfactory result after one
year, then it will be for the Government, either to extend
the suspension for another year, or if the danger of en-
cephalitis is considered less than a threatened smallpox
epidemic, to revert to the old regime.
"In political circles there is a strong current to retain
the indirect compulsion of vaccination, even when ad-
mitting that some risk is attached to vaccination. After
a year the Government will take a decision as to the
future. When in some community a case of smallpox is
reported, teachers and pupils, who are not vaccinated,
are prevented from attending school until all danger of
the disease spreading has disappeared.
"At present the work of investigation into the nature
of the post-vaccination encephalitis is rigorously pushed
on, not only in Holland itself, but also in conjunction with
foreign governments, institutions and persons.
"The Hague, February, 1928."
The complete repudiation of compulsory vaccination in
Australia and the small number of persons vaccinated
is shown by the following extracts from the article in
"Public Health Reports," August 14, 1925, page 1691:
"In 1909 compulsory vaccination was in force only in
the States of Victoria and Western Australia. In 1911 a
'conscientious objection' clause was inserted in the health
act of Western Australia and in that of Victoria in 1919.
in South Australia an act to suspend compulsory vacci-
nation was passed in 1917.

"New South Wales has never had any statutory provi-
sion for compulsory vaccination, but public vaccinators
are appointed and receive a fee for each vaccination per-
formed and reported. In this State, excepting for the
years 1913-1917 (period of smallpox outbreak), the vac-
cinations per 100 births varied from 0.02 to 0.7. In 1913
the proportion was 19.5 and in 1914, it was 12.4.
"Infantile vaccination in Victoria continued up to 1919.
From 1909 to 1919 the vaccinations in Victoria varied
between 69 and 44 per 100 births; but in 1920, the year
in which the 'conscientious objection' clause went into
effect, they dropped to 12 and in 1923 to 6.
"The compulsory vaccination provision of the health
act of Queensland has never been proclaimed and vacci-
nation has been voluntary. As medical practitioners do
not notify vaccinations, no exact data on the proportion
of the population vaccinated are available.
"Compulsory vaccination in South Australia practically
ended in 1901 by the inclusion of a 'conscientious objec-
tion' clause, and was abolished by an act of 1917. The
number of vaccinations per 100 births dropped from 14.7
in 1909 to an annual average of 5 for the years 1918-1922.
No vaccinations were reported in 1923.
"In 1909 a bill revising the compulsory vaccination act
of 1878 failed of passage in Western Australia, in which
year it was stated that 'only about 10 per cent. of those
born in recent years in Western Australia had been vac-
cinated.' In the health act of 1911 a 'conscientious ob-
jection' clause was adopted.
"In Tasmania, under the vaccination act of 1898, all
infants are nominally required to be vaccinated before
the age of 12 months unless either (a) a statutory
declaration of conscientious objection is made, or (b) a
medical certificate of unfitness is received. No informa-
tion regarding vaccination in recent years is available for
Tasmania. No cases of smallpox occurred in Tasmania
during the period 1903-1923.

"For practical purposes, it is stated, the Common-
wealth, as a whole, has been unprotected by vaccination
during the period under study; and at the present time
some concern is expressed because of this fact. It is diffi-
cult to estimate the proportion of vaccinated persons,
even in terms of infantile vaccination, without any con-
sideration of the revaccination necessary to insure im-
munity. In the first volume of this study it was esti-
mated that in 1910 about 30 per cent of all persons in
Australia had been vaccinated, and the best estimate from
all figures available places the present proportion at about
the same figure."
Extract from communication in the Journal of the
American Medical Association, January 30, 1926, from
its Berlin Correspondent.
"Since the introduction of compulsory vaccination by
federal enactment back in the seventies of last century,
there has been constant agitation in favor of either re-
pealing or modifying the law.
Some of the opponents
hold that the law is superfluous and useless; others think
that vaccination should be compulsory only when an epi-
demic is threatened. Both parties make use of the plea
that they are conscientious objectors, especially since in
England conscientious scruples are recognized as an ex-
cuse for noncompliance with the law. . . . Professor Grot-
jahn, who occupies the chair of hygiene at the University
of Berlin and who has performed meritorious service, is
in favor of the admission of conscientious objections as
a valid excuse for failing to comply with the compulsory
vaccination law."

Special to The Christian Science Monitor.
THE HAGUE—The suspension of the legal enforce-
ment of vaccination in Holland, temporarily for one year,
is having a marked influence abroad. In Prussia, where
this law was just enforced, the state Minister of Public
Health recently issued a decree stating that vaccination
would for some months not be enforced in territories
where cases of encephalitis had appeared.
The reason for this decision, as stated by the Prussian
Minister, was that in Holland after vaccination, and ap-
parently as a result of it, this disease had occurred or
had taken a more serious form.
The medical editor of De Nieuwe Rotterdamsche Cour-
ant, writing on this subject in a recent issue, states that
evidently the Prussian Minister had followed the advice
of four medical professors who had investigated this
matter in Holland. He points to the importance of this
decision as taking place in the country where the legal
enforcement of vaccination had its most staunch and
numerous supporters in the past.—
From the Christian Science Monitor, April 18, 1928.

Declaration by Dr. Wm. F. King, State Commissioner of
Health of Indiana in Public Health Bulletin No. 149
issued by the United States Public Health Service, 1925.
p. 53. "I know of nothing that causes more useless
antagonism and more difficulty and trouble to the health
department than the more or less grand-stand orders
issued by health departments requiring the vaccination
of school children whenever a few cases of smallpox
I have never been able to see wherein a health
department is justified in issuing an order requiring the
vaccination of school children as a measure to control
an outbreak of smallpox when the adult portion of the
community is at the same time permitted to go and come
as they may please. It seems to me that if a health de-
partment is to be consistent it should issue an order ap-
plying to every unvaccinated person regardless of age,
and not be continually attempting to show an authority
over the school children of the community, who, as a rule,
are.less responsible for the spread of the disease."
Declaration by Dr. John E. Monger, State Health Com-
missioner of Ohio, in the monthly bulletin of the Indiana
State Board of Health, December, 1927.
"We are not German. We are not English. We are
Americans, and you simply cannot tell an American that
he must do thus and so. If you do, he will not do it just
to show you he is an American. The history of compul-
sory vaccination shows this . . . America has it in spots,
and it fails."

Declaration by Dr. Walter N. Dickie, Secretary of the
California State Board of Health, as published in the
bulletin of the Public School Protective League, Los
Angeles, California, May, 1923.
"There is no doubt that many doctors in the medical
profession would like a strict compulsory vaccination law
for California, but the tendency now is to accept the
undeniable rights of the individual to choose
for himself
and for his children that particular mode of treatment
which in his judgment will best promote health and
Copy of editorial published in the weekly bulletin of the
California State Board of Health, January 6, 1923.
"There is apparently some confusion and misunder-
standing relative to the present status of smallpox control
in California. Smallpox is now controlled under the
regulations of the State Board of Health, the same as
other communicable diseases. There is no special legis-
lation with regard to smallpox, with the exception of
Chapter 370 of the 1921 Statutes, which repeals the old
Vaccination Act of 1911, and provides that no rule or
regulation on the subject of vaccination shall be adopted
by school or local health boards.
"This measure does away with the cumbersome and
unpopular Vaccination Act which provided for the ex-
clusion of all unvaccinated persons from attendance
upon the school whenever smallpox existed within the
school district.
"The complex conditions which arose in connection
with this act led to many embarrassing and difficult situ-
ations. Under the present law the regulations of the
State Board of Health provide a uniform method of regu-
lation and thus the possibilities for confusion and mis-
understanding should be eliminated."

Extract from editorial in the California State Journal
of Medicine, February 1921, advocating the passage of
the bill which resulted in the repeal of the vaccination
law in California.
"Senate Bill 408 is an act to repeal the general vacci-
nation act for public and private schools. This act has
been the source of confusion and useless
expense. It
does not seem practical of administration without much
friction. The law requires that a child must be vacci-
nated or present a conscientious objector's card before
he or she can be admitted to school. Many children whose
parents recognized the efficacy of vaccination presented
objector's cards and thereby created false statistics and
increased the work and expense of City and State health
departments. The establishment of exclusive districts
for unvaccinated children created more work and ex-
pense. The repeal of the law will in no way interfere
with the present powers of health officers."
Declaration by Dr. W. J. Breeding, Director, Division of
Health Education, and E. A. Lane, Epidemiologist, Ten-
nessee State Department of Health, in an article pub-
lished in "Public Health Reports," July 23, 1926.
"Although the percentage of persons vaccinated in
Tennessee is extremely low, it is believed that the State
law empowering local boards to enact such vaccination
measures as may be deemed necessary for the protection
of the public is adequate for the time being. A State
compulsory vaccination law, unenforceable in rural sec-
tions, might stir up such opposition as to hinder other
health programs."

Extract from communication by former Commissioner
of Education, Andrew S. Draper, to the President of the
Board of Education, Olean, New York, January 24,1912,
published in the Ninth Annual Report of the Education
Department, State of New York, for the School Year
Ending July 31, 1912, in which he pointed out that there
was a discrepancy between the law requiring that chil-
dren receive an education and the law requiring them to
be vaccinated, and that it was the duty of the legislature
to correct this discrepancy.
"While the health law declares that all children ad-
mitted to the schools must be vaccinated, and therefore
would exclude children who are not, the Education Law
requires that all children of school age shall be required
to attend the schools. In other words, there is an incon-
sistency between the provisions of the health law and
those of the Education Law bearing upon this subject
Both of these statutes cannot be strictly enforced. It is
a matter of common knowledge and it is within my
official knowledge that the health law requiring all
children to be vaccinated as a condition to their admis-
sion to the schools is not strictly enforced, for the suffi-
cient reason that it is not enforceable in the absence of
a real menace to the health of the school; and it is more
than doubtful if the Legislature, in an act concerning
public health alone, actually intended to limit the in-
herent American right of attendance upon the free
schools to those who would yield that freedom of judg-
ment concerning their physical health or its treatment,
which they might have to do if required to be vaccinated.
To say the very least, there are natural rights held
sacred by our political system which are either not to be
invaded at all or only when absolutely necessary to
protect society and give safety to the institutions of the

Declaration by Dr. William Brady, in a syndicated arti-
cle published in the Ohio State Journal, Columbus,
Ohio, October 21, 1923.
"Although I like this comfortable feeling of being well
vaccinated, still I should vote
a positive no on any propo-
sition of compulsory vaccination for any group of people
or even for all the people.
I should vote no on any
proposition which, through interlocking ordinances,
would make vaccination virtually compulsory—such as
the compulsory school attendance law and the law which
permits the authorities to exclude children not properly
vaccinated. . .
"Compulsory vaccination is an institution which a com-
munity, and particularly, the health guardians of the
community, should be ashamed to countenance today. It
is tantamount to a confession that the community is back-
ward and unenlightened upon the elementary principles
of hygiene and sanitation. . .
"Anything resembling compulsory vaccination seems
out of joint with the times. I am my brother's keeper
only with his consent. Any citizen should have the right
to suit his own taste in his choice of religions, healers
and health insurance, provided his preference in such
matters does not endanger or encroach upon the rights of
his neighbors. If vaccination is as efficacious as we
believe it to be then those of us who do believe in it are
reasonably well protected and therefore we cannot be
endangered by those who are not vaccinated."
Declaration by "American Medicine" in an editorial
March, 1914,
"The growing opposition to vaccination is a matter of
grave concern. This new movement ... is not the il-
logical and absurd anti-vaccinationist crusade, but is the
conviction on the part of very intelligent men, that it is
useless to protect against an infection which they may
never encounter......This attitude is not confined to

laymen, but is taken by those leading men in the medical
profession who postpone vaccination of their own kith
and kin until the last moment. Two world renowned men
have confessed to us that they have had their children
vaccinated only in obedience to public opinion in and out
of the profession. The worst of the matter is that the
profession as a whole uses exactly the same arguments
in advising patients not to take any other prophylactic
until the necessity arises—anti-toxin of diphtheria, for
instance. Doubtless we could immunize everyone against
plague and cholera, but what's the use if plague and
cholera never come here? So we hear men saying that
there is not one chance in a million of their children be-
ing infected with smallpox, but that there is far more
chance of a pus infection or tetanus from the vaccine."
Startling Admissions Contained in an Editorial of the
London, Lancet, January 29, 1927, page 239.
"Failure to control smallpox in the North of England
has brought the policy of universal pseudo-compulsory
vaccination of infants into further disrepute.....
"It is a mistake to suppose that all the opposition is
due to lack of imagination or crankiness.
"Vaccination at the age of six months inflicts an in-
fectious disease on the child at a time when its digestive
mechanism is being rapidly modified, and many reason-
able people, although convinced that vaccination will
prevent smallpox, think that the advantages of immun-
ity do not outweigh the disadvantages of its production.
* * * * * *

"There is enough sense in the opinion .... to make
universal and full vaccination of infants (as theoretically
enforced by Parliament) impracticable in this country
at the present time.....
"All that happens is that WHEN AN EPIDEMIC OF
success depending partly on his personality and partly
on whether the disease itself seems dangerous to the
people of the district. This is an unsatisfactory way
of meeting" smallpox in a civilized community, and it is
time that the alternatives were fully discussed.
"The first alternative is to let smallpox take its course,
offering vaccination to those who prefer it....
"The second alternative is to modify our methods of
vaccinating infants, so that sensible people will have no
reason to fear and dislike them.....
"The next, or third, alternative is to abandon univer-
sal vaccination altogether in favor of the effective treat-
ment of contacts in the face of an epidemic.....
"It is likely that even if compulsory vaccination of
infants were sacrificed, Parliament would still be unwill-
ing to give power to the Ministry of Health to make
vaccination compulsory within 'an infected area.'
"Criticism might be lessened, however, if such vac-
cination aimed at conferring only brief and temporary
immunity, and it is theoretically possible to check the
progress of an epidemic by using an antigen producing
symptoms so far negligible that popular prejudice would
soon fade away. . . . The measure would be reserved for
contacts only. For them however, it must be compulsory
to be effective.
'It may be that we have not yet achieved sufficient
accuracy in vaccine standardization or in measuring in-
dividual response to enable us to estimate either the dose
or the probable amount and duration of any immunity
which might thus be conferred."

Extracts From Presidential Address By Dr. J. W.
Carr Before the Medical Society of London, Pub-
lished in The Lancet (London) October 13, 1928,
p. 753.
"Another difficulty to be faced under the rule of
a medical bureaucracy would be that if once any
official procedure were established by law it would
be a long and difficult process to get any alteration
made to suit different circumstances.
"Take, for instance, the case of vaccination
against small-pox. Are we adapting ourselves to
the marked changes in type of that disease which
have developed during the last few years? At pres-
ent the one endeavour of our medical hierarchy is
to get the maximal number of people vaccinated and
protected as completely as possible. Let it be grant-
ed at once that vaccination does (for a certain num-
ber of years) protect against small-pox, the ques-
tion which arises is whether the present form of
small-pox is worth being protected against. Sup-
posing some vaccine were discovered which, for a
certain number of years, entirely prevented chicken-
pox or mumps, would anyone seriously suggest its
universal use? I doubt it, yet both these diseases
are responsible for no inconsiderable inconvenience
and loss of time during school-life, and for the last
ten years chicken-pox has been credited with from
40 to 83 deaths, and mumps with from 14 to 41
deaths annually in England and Wales. Is the pre-
sent form of small-pox really more serious than
chicken-pox? I have no personal acquaintance with
it, but so far as I can gather, it very rarely gives
rise to pitting and hardly makes those suffering from
it feel ill—not so ill as vaccination often does.

"An exceedingly mild form of small-pox has now
been epidemic in this country for several years;
ought we not seriously to consider whether a dis-
ease which causes such slight constitutional dis-
turbance, such an almost inappreciable number of
deaths, and so few—if any—after-results, really
calls for the elaborate and most expensive system
of hospital isolation which we maintain for it, es-
pecially as we are told that in some districts it is
considered preferable to have a pleasant three
weeks in hospital with small-pox than to suffer
from vaccination at home. Also, if the disease is
really not more serious than chicken-pox, let us
treat it accordingly and not try to prevent it by
giving another disease which may cause as much,
or more, constitutional disturbance, and in some
cases as long, or even a longer period of incapacity
for work.
"The results of vaccinia are not absolutely neg-
ligible and, unfortunately, whilst the number of
deaths from small-pox is now certainly much over-
stated, there is a possibility that those from vac-
cinia may be understated. Moreover, it is now rec-
ognized that in a certain number of cases recently
the vaccination of children previously perfectly
healthy has been followed by an obscure condition
of encephalomyelitis which not uncommonly proves

Extract from inaugural address of former Governor
Percival P. Baxter of Maine, January 4, 1923.
"It is fundamental that each person is entitled to
choose his own school of medicine or of treatment just
as he may choose his politics or religion."
The Proposition That Parents Should Determine the
Form of Treatment For Their Children is Laid Down in
Numerous State and Federal Laws, of Which the Follow-
ing Are a Few Examples.
Copy of provision contained in the Federal "Maternity
and Infancy Act," approved November 24, 1921.
"Nothing in this Act shall be construed as limiting
the power of a parent or guardian or person standing
in loco parentis to determine what treatment or correc-
tion shall be provided for a child or the agency or agen-
cies to be employed for such purpose."
Copy of Section 577-c amending the education law in
New York State, effective April 17, 1926.
"Whenever affected by the requirements of this article,
the teacher, janitor or other person so affected and in
the case of a child, the parent or guardian of such child
shall have the right to determine the form or manner of
treatment or remedial care to be prescribed or applied,
but the treatment or remedial care must be in accordance
with and as allowed under article eight of the public
health law, known as 'The Medical Practice Act.' "

Copy of Amendment to the School Law of the State of
"Provided that no pupil or minor shall be compelled
to submit to medical examination or treatment under
authority of this section whose parent or guardian ob-
jects to the same. Such objection shall be made by a
written and signed statement delivered to the pupil's
teacher or to any person who might conduct such exam-
ination or treatment in the absence of such objection."
Declaration by Dr. Frederick R. Green, former Secre-
tary, Council on Health and Public Instruction, Ameri-
can Medical Association, in an address before the Utah
State Medical Association, September 30, 1914, and re-
printed by the American Medical Association from
North West Medicine, December, 1914 and January, 1915.
"Another error into which we have fallen as a pro-
fession is the tendency to regard the medical profession
as a divinely authorized class, whose sacred and dis-
tinctive function is the protection of the people either
with or without their consent.
It is difficult to under-
stand on what rational basis such a belief can rest in a
scientific profession like ours. The medical profession
is recruited from the same class as that which furnishes
the lawyers, judges, ministers, teachers and business men
of our country. The men who go into medicine are
neither wiser, more unselfish, more upright or more in-
fallible in their judgment than those who make up any
other class of professional men. Why should we regard
ourselves as of superior mold, or why expect our opinions
or views to be accepted on any different basis from those
of other men of equal intelligence, except in so far as we
are able to justify our judgment?
Yet too often medical
organizations, as well as individual physicians, have

taken the position that they were the courts of last re-
sort; that it was their special function to dictate the
terms of public health legislation, and that it was the
duty of the public to accept their decisions and acquiesce
in their judgment."
Extract from Presidential Address by W. S. Thayer,
M. D. Before the Annual Meeting of the American
Medical Association, June 12, 1928, Published in the
Journal of the American Medical Association, June 16,
"In the broader matters of public health the public has
the same right, after seeking what advice it will, to take
just what action it chooses. It is our privilege to be in
a position where individually and collectively we are es-
pecially qualified to advise the public in these matters.
This privilege implies a heavy responsibility. We must
seek to direct the public toward sane and efficient action.
But we must remember that neither as individuals nor
as an association have we the right to demand that the
public accept our views.
"As an association we are placed in a peculiarly deli-
cate position. Do what we will we shall be accused by
those who disagree with us of selfishness, of attempting
to protect our own personal interests, of using our power
as an organization to oppress others. We must be exceed-
ingly careful to see that such reproaches are wholly un-
justified. We must not expect that we can go our way
without adapting ourselves to circumstances beyond our
immediate control. A well balanced life is one long com-
promise. We must compromise as best we can with ex-
isting conditions while we seek to direct events toward
that which we think the wisest course. We cannot stop
the general tendencies of the day by violence or heated
opposition. The late King Canute was not successful in
controlling the rising tide."

Declaration by the Journal of the American Medical
Association in an Editorial, February 15, 1919.
"It is not the function of the medical profession to
maintain lobbies or to endeavor to secure public health
measures by political methods.
The true function of the
medical profession is to advise the people, to show them
how to protect themselves. The doctor's mission is to be
a teacher and not a political manipulator. The responsi-
bility for public health conditions must rest with the
people and not with any special class or profession. The
sooner these general principles are recognized, the better
it will be for the medical profession and for public health
Extract from the "Declaration of Independence," made
by the Original Thirteen United States of America, on
July 4, 1776.
"We hold these truths to be self-evident, that all men
are created equal, that they are endowed, by their Crea-
tor, with certain inalienable rights, that among these are
life, liberty, and the pursuit of happiness. That to secure
these rights, governments are instituted among men, de-
riving their just powers from the consent of the gov-
erned, that whenever any form of government becomes
destructive of these ends, it is the right of the people to
alter or to abolish it, and to institute new government,
laying its foundation on such principles, and organizing
its powers in such form as to them shall seem most likely
to effect their safety and happiness."
Extracts from the Constitution of the United States of
"We, the people of the United States, in order to form
a more perfect union, establish justice, insure domestic

tranquillity, provide for the common defense, promote
the general welfare, and secure the blessings of liberty
to ourselves and our posterity, do ordain and establish
this constitution for the United States of America."
Amendments to the Constitution of the United States.
Article I—"Congress shall make no law respecting an
establishment of religion, or prohibiting the free exer-
cise thereof, or abridging the freedom of speech or of
the press, or the right of the people peaceably to assem-
ble, and to petition the government for a redress of
grievances. . . .
Article IV—"The right of the people to be secure in
their persons, houses, paper and effects, against unrea-
sonable searches and seizures shall not be violated; and
no warrants shall issue but upon probable cause, sup-
ported by oath or affirmation, and particularly describing
the place to be searched, and the persons or things to be
seized. . ..
Article V—"No person shall. ... be deprived of life,
liberty or property, without due process of law; nor shall
private property be taken for public use without just
compensation. . . .
Article XIII—Section 1—"Neither slavery nor invol-
untary servitude, except as a punishment for crime,
whereof the party shall have been duly convicted, shall
exist within the United States, or any place subject to
their jurisdiction. . . .
Article XIV—Section 1—"All persons born or natur-
alized in the United States, and subject to the jurisdic-
tion thereof, are citizens of the United States and of the
state wherein they reside. No state shall make or enforce
any law which shall abridge the privileges or immunities
of citizens of the United States; nor shall any state de-
prive any person of life, liberty or property, without due
process of law, nor deny to any person within its juris-
diction the equal protection of the laws."

Copy of editorial from the St. Louis (Mo.) Star, May
24, 1926.
"Be Vaccinated or Get Fired.
"A new form of compulsory vaccination has come to
light in that vaccination has begun of about 1200 em-
ployes of the Chicago & Eastern Illinois Railroad, and
it is announced that employes who refuse to be vacci-
nated will be the first laid off when forces are reduced.
It is hard to conceive of a big successful corporation
taking such a narrow-minded action. Vaccination num-
bers among its opponents hundreds and thousands of
laymen and many doctors of unquestioned standing. It
is bad enough for School Boards and other civic agen-
cies to force those that do not believe in vaccination to
submit to it, but for a private corporation to take upon
itself such duties is incompatible with the American idea
of liberty.
"Recommendations" by Dr. C. C. Pierce, Senior Surgeon,
U. S. Public Health Service, while investigating an epi-
demic of smallpox in St. Paul and Minneapolis in 1925,
published in the Minneapolis Morning Tribune and Even-
ing Tribune, January 14, 1925.
"(1) That the boards of education of the Twin Cities
require all teachers, employees and pupils of the public
schools to be vaccinated or exclude them.
"(2) That all employment agencies refuse to register
applicants unless vaccinated.
"(3) That all merchants be requested to have all em-
ployees vaccinated.

"(4) That all hotels and lodging houses have all em-
ployees vaccinated.
"(5) That the Salvation Army, Union City Mission
and other shelters and lodging houses refuse to feed or
lodge persons not vaccinated.
"(6) That all hospitals refuse to admit visitors not
"(7) That all newspapers be urged to join in a pub-
licity campaign to attain prompt 100 percent vaccina-
Extracts from discussion at a conference of health
officers at Lansing, Michigan, December 12, 1923, pub-
lished in "Public Health," April, 1924 issued by the
Michigan Department of Health.
"Dr. Slemons: . . . 'The children in our schools are
given slips—you will find one of them in the exhibit, in
the auditorium—notifying the parents that the child is
not vaccinated. While the slip does not exactly demand
vaccination, as you will find upon reading it, most people
think that it does and by using it we get a very high per-
centage of vaccinations because our people have gotten
to believe that this is compulsory.'
*    * *
'. ,. ,. On any slight pretense of exposure we demand
vaccination. How far do we go? We go just as far as
we can.'
*    * *
'By taking advantage of any secondary exposure you
will be able to keep 100 per cent of the children in your
schools vaccinated. Here is a point that we have found
extremely beneficial—we penalize the non-vaccinated per-
son every opportunity we get.
I mean by this that any
non-vaccinated person exposed to smallpox is looked upon
as a potential case of smallpox and that person goes home
and stays there for sixteen days, while a direct exposure

when vaccinated gets every consideration, and at the end
of a seventy-two hour period goes back to the public.
It has a very wholesome effect.'
                                  * * *
"Dr. Godfrey: 'In our city unvaccinated children even
though they are not exposed to contagious disease, can-
not come to school until they are vaccinated.
'Unvaccinated children are turned over to the school
board, and excluded from school and then as soon as the
records show that they are not in attendance at school
they are arrested for non-attendance. In other words,
we get them going and coming.'
* * *
"Dr. Town: 'Penalize the fellow who refuses to co-
operate, you will find this is pretty good medicine.
'In Jackson we have not gone into any factory or school
and put on a program of vaccination unless pretty
definite report of exposure has come in, because when
we do go we go the limit, and interpret 'exposure' in its
loosest term.
We have railroad shops where we vac-
cinated 1500 men as soon as it was reported that one
man had worked five days with an eruption. We inter-
preted this as wholesale exposure, and secured authority
from their Detroit office to do the work. Incidentally,
we were very glad to have their regularly employed
physician and surgeon handle the vaccinations.' "
Extract from syndicated article by Harris Dickson,
published in Savannah (Ga.) News, June 14, 1927.
"A drag net, drawn at random through the flooded
area, catches queer fish. The Baton Rouge haul recently
pulled in eighteen members of a certain small sect who
refused to be vaccinated or take the typhoid serum, be-
cause, they insisted, it was against their religion. Sur-
geons attempted to persuade them.
" 'Do this for your own protection, as well as for the
safety of a generous city that shelters you.'

"Not much. Altruistic arguments never touched them.
" 'Well,' the Red Cross man was trying not to become
a very cross man, 'Does your religion forbid you to eat?'
"Eat? Free rations? Oh, dear, no. Breakfast, dinner
and supper constitute Articles One, Two, Three of their
creed. They believe in substantial food.
"'Fine!' the Red Cross official snapped, 'From now on
your meal tickets are cancelled until you can show your
vaccination scars.'"

Extract from a copyrighted dispatch from Mexico City,
to the Observer Dispatch and the Chicago Daily News,
published in Utica, N. Y. Dispatch, April 22, 1926, re-
ferring to the cancellation by 130 members of the Dallas
Chamber of Commerce of their trips to Mexico rather
than submit to vaccination.
"Nearly 100 American medical men who were expected
in Mexico at the end of April after a conference in
Dallas have fared better than the commerce body. Ar-
rangements have been made for allowing them to enter
the republic without vaccination."
Copy of an editorial in the "New York Medical Week,"
June 16, 1923, in which the physician is told that he must
"woo" and "court" the germ to find vacation peace.
"The decisive onset of warm weather calls a halt to
the strenuous activities of colder days for the doctor.
It is the signal for rest, and in the delights of fishing
tackle and golf ball the medical man can find relief and
solace for the harassing memories of the winter's strain.
"It is true that the warm days of summer often bring
a heat a little too extreme for comfort but, if we do not
bear up well under them, it is a consolation to remember
that neither do the microbes. And the nocturnal silence
of the telephone lends such harmony to the music of the
"We might append weighty warnings of the need for
care and hygienic vigilance in the pursuit of rustic
pleasure, but according to Surgeon-General Cummins'
counsels this will never do for the doctor's summer.
Following out the official law of paradoxes, it is only
by wooing the microbe and courting the germ that the

medico will find vacation peace. What food for contem-
plation on the dangers of medical life!"
Medical Society Official Announces that Less than
Fifteen Percent are Prospects for Smallpox But One
Hundred Percent Are Prospects for Vaccination.
Declaration by Dr. Mather Pfeiffenberger of Alton,
Illinois, formerly President of the Illinois State Medical
Society, in an address before a joint meeting of the
Second Annual Health Officers Conference and the
Sangamon County Medical Society, Springfield, Decem-
ber 3, 1926, as reported in "Illinois Health News" for
January, 1927.
"Prevention practiced to its utmost will create more
work for the physician and not diminish it, for the full-
time health officer will be educating his community con-
stantly. There will be more vaccination, more immuniz-
ing, more consulting and use of the physician. His
services will be increased many fold.
* * * *
"I am informed that epidemic and endemic infections
cause only 12% of all deaths and that this percentage
is declining very rapidly. Less than 15% of all children
would ever get diphtheria even under epidemic condi-
tions, while 100% are prospects for toxin-antitoxin. The
percentage who would ever get smallpox, under present
time conditions, is even less; but 100% are prospects for
Scarlet fever will soon come in for its 100%
also, as it may for measles, judging from the reports on
that disease. Typhoid fever is disappearing, due to sani-
tation, but vaccination should be used when the indi-
vidual travels into unknown territory and countries."

This is the Image of Page 35. The Recognized text follows the image.

Marked Photographic Reprint of Page
From The Journal of The Michigan State Medical society,
August, 1988.
528                                    MICHIGAN'S DEPARTMENT OF HEALTH                  Jour. M.S.M.S.
GUY L. KIEFER, M. D., Commissioner             
of all other costs, an average of $50,000
per case the income from this source would
be $250,000. The increase in physicians
income from diphtheria would be from one-
quarter to three-quarters of a million dol-
lars, if we would immunize all children
against this disease soon after they are six
months of age, instead of waiting until
they are stricken with the disease and thenJ
treating them.
Some maternity hospitals are vaccinat-
. ing with vaccine virus all babies born in
their institutions. Babies under ten days
old very seldom have any general reaction
and the immunity usually lasts for the
whole lifetime of the individual. It is
estimated that. one-third of all births in
this state occur in hospitals. If all hos-
pitals were to establish this rule as part of
their regular procedure, it would mean an
addition of 30,000 immunized people in the
state each year and an additional income
of at. least $60,000 to the physicians or
When the 100,000 people born every
year in Michigan are vaccinated against
smallpox at birth, the income to the phy-
sicians would approximate $200,000. The
500 cases of smallpox that occur every
year, treated at an average of $50.00_per
case, bring physicians $25,0000. Thus the
physicians, by adopting the practice of
vaccination at birth, would increase their
income by nearly $200,000.
We have taken diphtheria and smallpox
as_example's of_the economic advantage of.
immunization, but the same conditions
apply to other diseases and to other public
health measures.
With persistent educational work by the
physicians and the Micnigan..Department
of Healthy these immunization programs
will succeed in reducing the number of
these preventable diseases and increasing
the earning of the physicians who actively
sponsor this modern tvpe of.practice.
Summer restarts, and their proper sani-
tary supervision, have come to be a topic of
perennial interest to everyone concerned
with the public health. The increasing
tendency to migrate during the warm
weather—and the modern facility of mi-
At a recent meeting of physicians the
suggestion was made that if various im-
munization programs sponsored by various
public health agencies were carried to their
logical conclusion it would have the effect
of curtailing the amount of medical prac-
tice available to physicians. In this con-
nection there are several well established
facts to be kept in mind.
No immunization program yet proposed
in Michigan has been made sufficiently
complete to reduce the sickness or death
rate of the state as a whole. Local im-
munization in towns, schools or institu-
tions have been the direct cause of the to-
tal absence of smallpox and diphtheria in
these restricted areas. The county medi-
cal societies of four counties sponsored the
immunization of all the school children of
their respective counties. The result was
a reduction of one-half the diphtheria
deaths. In spite of the years of demon-
stration of the effectiveness of vaccine vi-
rus, over 500 cases of smallpox occur an-
nually in this state; it is plain to see that
the complete elimination of any of these
diseases from this state is not an end near
at hand.
The making of people immune to disease
is the field of the private practitioner of
medicine. Only in cases of indigency,
emergency or for the demonstration of its
value to the public is it sound policy for
public health departments to do this work.
Therefore, when this desirable state of im-
munity is conferred upon people it will be
the direct result of the services of their
own physicians.
Let us see, then, what the cold figures
concerning this type of practice show.
In this state there are 100,000 people
born annually. They are practically all
susceptible to diphtheria from the moment
they are born. They are highly susceptible
from the age of six months until they are
immunized. If these infants were all im-
munized, and for this service the physi-
cians received from $5.00 to $10.00 pet-
case, the net income would be from $500,-
000 to $1,000,000. Michigan has 5,000
cases of diphtheria annually. If the physi-
cians received for their services, exclusive

Mr. Draper Says in Many Cases Physicians Become In-
terested in Enforcement of Law Because of the Fees.
Declaration by Andrew S. Draper, former Commissioner
of Education, in his fifth annual report of the New York
State Education Department, for the year ending July
31, 1908.
"In many cases physicians become interested in the
strict enforcement of the law because of the fees result-
ing therefrom.
In some school districts a physician is
appointed by the trustees and the entire expense of vac-
cinating the children is borne by the district. In many
others, parents are requested to have their children
vaccinated and a physician is appointed who vaccinates
those children only whose parents do not provide for
their vaccination. In any event all the children are
vaccinated and provision is made for prompt payment
for such service. In the more populous districts the
medical fees resulting from vaccination are an important
It is not claimed that physicians as a rule are
governed in this matter by a mercenary motive. On the
contrary in the great majority of cases their action in
urging vaccination emanates from their professional
knowledge of the subject and their desire to render a
distinct service to the people of the community in which
they live. However, this mercenary motive has been the
controlling factor in a sufficient number of cases which
have come to the attention of this Department to justify
the above assertion."
Copy of a Washington dispatch published in the New
York Evening World, October 31, 1924, announcing adop-
tion of fee schedule for vaccination, ranging from two
to twenty-five dollars per person.
"Washington, Oct. 31—A scale of minimum and maxi-
mum fees for almost every ill a physician or surgeon is
ever called upon to treat has been fixed by the Medical
Society of the District of Columbia.

"Minimum fees range from $2.00 for a minor office
consultation or a word of advice over the telephone to
$300 for certain major operations. Maximum fees for
similar service range from $10 to $5,000.
"An example is the fee for a smallpox vaccination,
where a minimum of $2, and a maximum of $25.00 is
General visits range from $3 to $25, and the
removal of an appendix may cost from $100 to $5,000."
[Note:—It is significant to note that the above schedule
fixing a minimum fee of $2.00 and a maximum fee of
$25.00 was adopted during the latter part of the year
1924 and in the early part of the following year an ex-
tensive vaccination campaign was carried on in Washing-
ton, D. C. for the alleged prevention of smallpox.—
H. B. A.]
Dr. Rankin Tells Physicians to Think of the Business
the Physicians Receive in Keeping Up the Vaccination
Declaration by Dr. W. S. Rankin while Secretary of the
North Carolina State Board of Health, as reported in
the Journal of the American Medical Association,
November 4, 1922.
"Last year we inoculated 70,000 persons against
typhoid fever, and 1,000 children between 6 and 12 years
of age against diphtheria. The county commissioner paid
the local practitioners 25 cents for each complete inocula-
tion and that was $20,000 which went to the profession
last year which otherwise would not have been received.
"The work of the medical profession with the state
board of health does not stop when that $20,000 is paid.
It goes
on. In the dispensaries which were conducted
in Union County, N. C, with 35,000 people, the physi-
cians vaccinated 10,000 people in a campaign of five
weeks. That was $2,500 paid to twenty physicians-
only $125 each, but think of the effect on the business
of the profession in keeping up that work. It goes on."

Extract from editorial in the Boston Medical and Surgi-
cal Journal, September 17, 1925, in which it takes the
position that vaccinations and inoculations are necessary
for the young physician to have a practice that will be
considered successful.
"The young physician who believes that his life work
will consist in a daily round of house to house visits,
watching the course of typhoid fever, of pneumonia and
of inoperable cancer, is making a grave mistake. If he
is to keep abreast of the times and enjoy a practice that
will be considered successful his duties will consist of
vaccinations and inoculations, periodic health examina-
tions and advice as to hygiene, diet and the maintenance
of health."
Extract from article by C. S. Nelson, M. D., entitled
"Proper Relationship Between the State Department of
Health, and the Medical Profession," published in the
Illinois Medical Journal, March 1928.
I feel that it would be out of place to attempt to dis-
cuss preventive medicine from a monetary standpoint,
for physicians as a rule have never been considered a
mercenary profession. Otherwise they never would have,
as in the past, fallen in line so readily and given their
cooperation toward preventive medicine that has had
such wonderful results in the past quarter of a century.
If, however, this thought should ever enter the mind of
any physician, stop and consider what it would mean to
you, if the present health propaganda and the prevention
of preventable diseases should be universally adopted—
annual physical examinations, vaccination against small-
pox, diphtheria and I think in the near future, scarlet
fever and measles. Would it not appear to you that the
revenue from this source would far exceed the remuner-
ation received from the comparatively few diseases
treated that would naturally occur in the families of
your clientele? And besides it would be much more

Extract from an editorial in the Journal of the Ameri-
can Medical Association, February 14, 1920.
"The danger of commercialized therapeutics has been
enormously increased by the introduction of biologic
products. These substances offer a rich field for the
commercially minded, first, because of the remarkable
results which seem to have followed the use of certain
products of this type; second, because the field is new
and the mode of action of these substances not readily
understood and, third—and most important—because,
by the very nature of the problems involved, few physi-
cians are well informed concerning them."
Item from the Journal of the American Medical Associa-
tion, February 18, 1905.
"The Downfall of Therapeutics.—The following edi-
torial from American Medicine shows clearly the present
status of therapeutics and materia medica: 'Before the
development of the natural sciences placed medicine as
an art among the applied sciences, therapeutics was the
most important branch of medical study and practice.
Among the medical sects the same observation holds true
at the present time. During the last half century medical
progress, however, the pursuit of exact medical knowl-
edge, has led students chiefly into surgery, diagnosis,
pathology and bacteriology. Definite knowledge of the
intimate reactions of the metabolic processes of our
bodies with foreign agents introduced as drugs is just
coming into sight with the growth of the new science
of pharmacology, and so necessarily therapeutics at
present lags behind. All of which is new to no one who
sees, and is introduced simply to draw attention to an
unfortunate practical result of this state of affairs.
For some years progress in materia medica and thera-

peutics has seemed almost to lie in the hands of lay
manufacturers. With their new compounds and their
disguised old ones, the drug makers have kept the ma-
teria medica expanding at an alarming rate.
This con-
dition is by no means wholly to be deplored, as the
pharmaceutists have contributed much to the comfort of
physician and patient. However, the tremendous pre-
ponderance of commercialism in recent therapeutic prog-
ress has brought with it some ill conditions. Money-
making attracts the unscrupulous, and the medical pro-
fession has difficulty in separating the wheat from the
Any good new laboratory product of therapeutic
value is immediately imitated or attacked. There de-
velops intense feeling between foreign and domestic
manufacturers, and all the while the poor doctor, as the
bone of contention, is overwhelmed with "literature" and
"medical journals" (sic) and agents. Contradictions
multiply until mercury and quinin appear to be about the
only agents of whose qualities the physician may feel
reasonably sure! The prize—the patronage of the pro-
fession—being of great commercial value, many subter-
fuges are employed by some to enable them to share in
it. Official positions in medical bodies at times are sought,
and at other times are appropriated by not too nice
strategy. Medical journals are subsidized and new ones
are published. A number of makers pay a regular
stipend secretly to complaisant doctors here and there
over the country, who, in return, are expected to read
"useful" papers and at every possible turn to uphold the
wares of the benefactor.
Thus it comes that therapeu-
tics has reached its present low estate. Scientific physi-
cians give their time to diagnosis and pathology, and
limit themselves to simplest measures of treatment.
Others make a diagnosis and then choose the remedy that
the maker says is best for that condition. Many among
us who love the study of means to alleviate suffering have
endeavored faithfully to recreate professional interest in

pure therapeutics, but the combat with intrenched wealth
and monopoly is an unequal one in the face of general
professional lethargy. But hope is not to be abandoned.' "
Extract from "Public Health Reports," May 29, 1925,
giving a list of the products which the Bureau of
Laboratories of the New York City Department of
Health in 1925 was licensed to sell.
"Diphtheria antitoxin; tetanus antitoxin; antimenin-
gococcic serum; antipneumococcic serum; normal horse
serum; vaccine virus; rabies vaccine (Pasteur); tuber-
culin old; and bacterial vaccines made from gonococcus,
paratyphoid bacillus A, paratyphoid bacillus B, pertussis
bacillus, pneumococcus, staphylococcus albus, staphylococ-
cus aureus, streptococcus, and typhoid bacillus; diph-
theria toxin-antitoxin mixture; diphtheria toxin for
Schick test."
[Note:—The cash receipts of the New York City Depart-
ment of Health from its "Sales of Virus" in 1924
amounted to $16,051.98 and its receipts from "Sales of
Antitoxin" amounted to $53,277.41, making a total of
$69,329.39, as brought out in the Annual Report of the
New York City Department of Health for the year 1924.
—H. B. A.]
Extract from article in "Public Health Reports," May
29, 1925, giving a list of the products which the Massa-
chusetts Department of Health in 1925 was licensed to
"Diphtheria antitoxin; antimeningococcus serum; anti-
pneumococcus serum; vaccine virus; bacterial vaccines
made from paratyphoid bacillus A, paratyphoid bacillus
B, and typhoid bacillus; diphtheria toxin-antitoxin mix-
ture; diphtheria toxin for Schick test."

Extract from address by Dr. W. A. Evans, formerly
Commissioner of Health of Chicago, published in the
Journal of the American Medical Association, September
16, 1911.
"As I see it, the wise thing far the medical profession
to do is to get right into and man every great health
movement; man health departments, tuberculosis socie-
ties, child and infant welfare societies, housing societies,
etc. The future of the profession depends on keeping
matters so that when the public mind thinks of these
things, it automatically thinks of physicians, and not of
sociologists or sanitary engineers. The profession can-
not afford to have these places occupied by others than
medical men."
Copy of resolution adopted by the staff of the North
Carolina State Board of Health, and published in The
Survey, New York, September 15, 1922.
"It is a fundamental purpose of this staff to seek to
enlarge and deepen the interest of the medical profession
in public health work to the end that the profession in
all public matters may assume the initiative and have
the chief credit for whatever there is of achievement in
disease prevention and health promotion."
Dr. Woodward Tells How He Succeeded in Lining Up the
President of the Massachusetts Senate.
Declaration by Dr. Samuel B. Woodward in a Paper
Published in the Boston Medical and S
urgical Journal,
September 15, 1921.
"The so-called vaccination bills are, in common with
most health bills, referred to the Committee on Public

Health, and the composition of this Committee is of the
utmost importance, for the legislature is naturally prone
to follow its recommendations. It is, therefore, import-
ant to get in touch with the President of the Senate and
the Speaker of the House, in whose hands the appoint-
ments to this, as to every committee lie, and this, during
my three years as your President, I always did, finding
understanding and cooperation in my endeavor to have
men with medically sane minds, the majority appointees.
The reason for this cooperation was not, however, al-
ways a desire for the improvement of health conditions
in the Commonwealth.
"In 1919, a gentleman who afterwards became rather
conspicuous as a candidate for State Treasurer, on ac-
count of the similarity of his name with that of the
present occupant of the office, was the ranking Senator
on the Committee of Public Health. Unsuccessful efforts
had been made by your legislative committee to prevent
his re-election. He was a pronounced anti-vaccinationist
and anti all good health measures, yet courtesy would
have made him chairman of his committee. The Presi-
dent of the Senate, however, told me that he would ap-
point as chairman, any Senator endorsed by the physi-
cians of the State, and he kept his word.
"My successor in office, Dr. Worcester, was much cha-
grined a year later when he failed to obtain what he
desired from the same gentlemen, and may be interested
to know why I may have succeeded while he failed. The
Senator in question was connected with a Boston bank.
I am connected with a bank in Worcester and went to
him provided with a letter of introduction from the
President of one of the largest banks in Boston.
"Country banks maintain deposits in city banks, and
some two months after our interview, the President of
the Massachusetts Senate appeared in Worcester and
suggested that I should use his bank as my bank of

"I believe Dr. Worcester is not a banker. It may be
unnecessary to say that no change in financial arrange-
ments was made by me.
"But there are members of the legislature who are
greatly interested in public health and who give, or at any
rate gave me, good advice and abundant cooperation. It
may be, and probably is, invidious to mention names in
this connection, but if one wishes to find a legislator who
from the time of his first election has consistently and
always supported your legislative committee, he need not
wander far from the chair of the present speaker of the
house of representatives."
Declaration by Dr. Moore of Cadillac, Michigan in a Dis-
cussion of Medical Legislation, Published in the Journal
of the Michigan State Medical Society, June 1928, p. 428.
"I think it is within the power of every physician to
make a friend of his Senator and Representative. It is
done in business, and it is done socially. Get him out
and take him on a fishing trip or a hunting trip, or get
him into a poker game. Get under his skin. Don't let
him know what you are doing when you are talking to
him, but get him so full of it that he is just all for you.
"I think it is a good suggestion for every physician
and County Secretary to take home to the local societies
to cultivate the acquaintance of the Senators and Kepre-
sentatives and then your problems will be solved. You
have to do it on the banks of a stream or in a hunting
camp or in a club room or a noonday luncheon club or
some such place as that where you can get right next
to the fellow."

Extracts from an article by John B. Hawes, 2nd, M. D.,
published in the Boston Medical and Surgical Journal,
October 7, 1920, giving a summary of the replies to a
questionnaire he had sent to the Secretaries of the State
Medical Societies.
"New York: The State Medical Society has a legisla-
tive committee which for many years has been very
efficient. It does not limit itself to attending hearings,
but acts by personal interviews with the legislators. The
New York County Medical Society also has a legislative
committee, acting in unison with the State Society. For
several years, the President of the State Society has
taken an active hand in the legislative work. New York
has adopted the principle of personal interviews and in-
fluence with the Legislature. They also ascertain who
is the family or personal physician of each Legislator.
"North Carolina: The committee, however, selects one
doctor in each county who can be called upon to confer
with, write or wire his representative or senator in the
General Assembly. There are 100 counties, and the
Association has been able to turn in a telegram to the
senators and representatives in the General Assembly
from more than 75 per cent of these counties on a given
morning. This has been of distinct influence.
* * * *
"Pennsylvania: The President of the Society has a
desk in the Department of Public Health at the State
House. He is in harmony with this department. He is
closely affiliated with the medical members of the House
and Senate, and attends committee meetings, not as a
lobbyist, but simply as an advisor. He lets it be under-
stood that he represents 11,500 physicians in Pennsyl-
vania. The results depend largely upon the personality
of the president of the society. Pennsylvania is to be
congratulated in having as the president of its State
Medical Society a man who can devote so much time and
who is able to exert so much influence as is apparently
the case here."

Declaration by Dr. William H. Park, Director of Labora-
tories, New York City Department of Health, at a
Federal Hearing on a bill to regulate the Sale of Viruses,
March 24, 1924.
"I remember meeting a physician who was, I thought,
doing some very disreputable things, and I asked him why
he did it, and he said it was the economic urge that caused
him to do it. The economic urge does change our opin-
ions, and we all know the advertising of a business is
very apt to be an art in itself, and the advertiser may
have very little knowledge of the thing.
"I remember some time ago I was asked to make a
vaccine for a certain party, years ago, and I told him
I did not have the facilities. He said:
"I don't care at all whether you have the facilities or
not, because I can advertise the sale of the product, and
even if you give me stone dust, if you will put your name
on it, I can sell it."
Extract from editorial in New York State Journal of
Medicine, June 1, 1928.
"The task of educating the people along medical lines
would be hopeless if it had been done entirely by physi-
cians ; but fortunately the medical profession has the aid
of the departments of health, the public schools, and lay
to such an extent that health education
is invoked as justifying organized sports and the promo-
tion of artificial beauty and comeliness.
* * * *
"The essential element in public health and popular
health education is publicity, especially through the news-

papers. Physicians formerly avoided publicity, and even
made their codes of ethics demand its suppression, be-
cause it was used By quacks for their personal gain.
The physicians now recognize two kinds of publicity:
1, that of the individual doctors, and 2, that of the scien-
tific movements which the doctors represent.
* * * *
"The medical society is a collection of individual
doctors, one of whom writes and speaks for all the others.
It is the individual doctors rather than the organizations
that speak or write.
"Lay organizations engaged in public health work are
not subject to the strict code of ethics of the medical
profession, but they depend on wide publicity for their
very existence. They must show results in order to hold
the support of the people who patronize them and the
money givers who support them. They must transmute
information of their activities into emotion and action
on the part of their followers. They live by means of
publicity of their aims and actions."
Extract from an editorial in the Journal of the Ameri-
can Medical Association, May 5, 1928.
"The Bureau of Health and Public Instruction is reach-
ing a tremendous public through radio lectures, health
talks and direct correspondence. Much of its effort dur-
ing the past year has been devoted to the promotion of
periodic physical examination. Of special significance
is its cooperation with the National Education Associa-
tion in bringing health education directly to children in
the schools. The great philosopher Leibnitz said that he
could change the nature of the world if permitted to
educate the children for two years."

Extract from Editorial in the New York State Journal
of Medicine, May 15, 1928.
"Arousing favorable public opinion toward the scien-
tific work of the doctors is the peculiar field of lay health
"The practice of public health and civic medicine re-
quires a combination of three conditions:
"1. Scientific knowledge made available by a few re-
search workers.
"2. Physicians ready to apply the knowledge.
"3. People ready to receive it.
"A movement in public health starts from a center of
discovery and spreads through a community in ever-
widening waves.
The center is usually a research labora-
tory where the discoveries, such as toxin-antitoxin and
insulin are developed. As the waves advance they
diminish in intensity. While the research worker is
familiar with all the phases of the subject, the family
physician needs to be familiar with only the application
of the product or method; while the layman needs to
know only that it exists, and is valuable as a health
measure and is available at the office of physicians.
"The speed of propagation of waves of medical knowl-
edge from a center is usually in direct proportion to the
need of a community. Physicians apply a preventive
measure according to the demand which the people make
for it. A case of smallpox, for example, speeds up the
distribution of knowledge of vaccination, and a desire
for its application as a preventive measure; but the de-
mand for the procedure often changes to opposition when
the epidemic passes by.
"The function of a lay organization is to create a
demand for public health where none has previously
existed. It seeks to transform knowledge into strong
desire and finally into action."

How the Milwaukee Health Board Caused City to Be-
come Panic-Stricken in Order to Promote a Dangerous
and Questionable Vaccine.
Health Official Tells How He Used Fright and Pres-
sure to Have People Vaccinated.
Declaration by Dr. John P. Koehler, Commissioner of
Health of Milwaukee, Wisconsin, in an article in The
"Wisconsin Medical Journal, November, 1925.
"Since people cannot be vaccinated against their will,
the biggest job of a health department has always been,
and always will be, to persuade the unprotected people
to get vaccinated. This we attempted to do in three ways:
first, by education; second, by fright; and third, by
"We dislike very much to mention fright and pressure,
yet they accomplish more than education, because they
work faster than education, which is normally a slow
*         *         *
"During the months of March and April we tried edu-
cation, and vaccinated only 62,000. During May we made
use of fright and pressure, and vaccinated 223,000 people.
"Our educational program consisted of warnings in
the daily papers, smallpox posters on the streets, in
stores and factories, special smallpox bulletins for all
large places of employment, and special letters to all
large employers from the health department and the
association of commerce, calling their attention to a
threatening smallpox epidemic. The radio was also
made use of in this work.
"As the conditions grew worse, we felt justified in
using stronger measures. We had some good pictures
taken of patients suffering from the confluent type of

smallpox, and had posters, showing these pictures, dis-
tributed all over the city.
The moving picture theaters
cooperated at this time by issuing warnings on the
"The newspapers published daily the names and ad-
dresses of people dying from smallpox. A second letter
was sent to all factories, stores, and other places of busi-
ness, informing them of a rapidly approaching smallpox
epidemic, and advising them to have their employees vac-
cinated immediately, and thereby prevent a serious
financial loss to the city, which might occur if a real
epidemic developed.
"At this time the department was vaccinating thou-
sands of people daily, but there were still too many who
could neither be educated nor frightened into vaccina-
tion. Cases and deaths each amounted to a considerable
number, and we now felt justified in using all of the
power a health officer has, and if that was not enough,
to get more.
"We sent out a third letter to all employers requesting
them to have all of their employees vaccinated and at
the same time informing them that if a smallpox case
developed in their place of employment in the future
we would consider their place of business a menace to
the health of the community and very likely place the
entire establishment under quarantine until it could be
cleaned up and made safe for the public. Putting this
responsibility on the employer drove in thousands of
anti-vaccinationists who could better afford to get vacci-
nated than lose their jobs. All employers co-operated
very bravely with this last request, although in a few
instances it was necessary to lay off old, reliable and
valuable employees."

There is no relation between the vaccination re-
quirement and the presence or absence of smallpox.

Extracts from Article by Surgeon J. P. Leake, Published
in "Public Health Reports," the Weekly Bulletin of the
United States Public Health Service, January 28, 1927.
"Will a nonimmunized person contract smallpox if
exposed to the disease? By no means uniformly.
posure to smallpox, especially to the milder forms, with-
out contracting the disease frequently occurs and is no
definite evidence of immunity. The number of cases of
smallpox among the unprotected persons in contact with
patients suffering from the disease is very much less than
100 per cent. . . .
"Though smallpox is unquestionably many times more
frequent in the unvaccinated than in those who have had
even a single vaccination, it is believed that neither the
vaccination history nor the presence of scars should be
given diagnostic weight. The unreliability of such a
criterion is especially evident in virulent outbreaks of
the disease. . . .
"The purpuric, uniformly fatal, form of smallpox is
the most difficult to prevent by vaccination, and cases of
this form, without a true smallpox eruption, may occur
in persons with a fairly good vaccination history. . .
"The mildness of the form of smallpox commonest at
present is one reason for endeavoring to make preventive
vaccination as harmless and as mild as possible. ....
"Cases, and even fatalities, occur in every severe epi-
demic among persons who were vaccinated in good time
but with vaccine found, too late, to be of insufficient
potency; such cases and fatalities also occur among per-
sons thought to be protected by successful vaccination
performed years previously."

Extract from the Minority Report by Dr. W. J. Collins
and Mr. J. Allanson Picton, of the Royal Commission
on Vaccination, August, 1896 Calling Attention to a
Resolution Passed by the Royal College of Physicians
of London in 1754 Defending Smallpox Inoculation.
"In 1746 an inoculation hospital was started in London,
and in most of the large provincial towns the new prac-
tice was encouraged by the clergy, as well as the lead-
ing medical practitioners, 'and in 1754 the Royal College
of Physicians of London pronounced its authoritative
sanction of what was no longer a speculative novelty.'

The resolution of the college was: 'The College, having
been informed that false reports concerning the success
of inoculation in England have been published in foreign
countries, think proper to declare their sentiments in
the following manner, viz: That the arguments which at
the commencement of this practice were urged against
it have been refuted by experience; that it is now held
by the English in greater esteem, and practiced among
them more extensively than ever it was before; and that
the College thinks it to be highly salutary to the human
race.' From this date to the end of the century inocula-
tion was widely diffused, though to varying degrees, in
different districts; the practice doubtless paved the way
for the later acceptance of vaccination. The latter came
to replace the former method, and by the Act of 1840,
sec. 8, the practice of inoculation became a penal offence.

"Inoculation is still practiced in India, in many places,
and in association with religious observances, in honor
of Sitla, the goddess of smallpox."
Extract from book entitled "Smallpox and Vaccination"
by Benjamin White, Ph.D., Director of the Division of
Biologic Laboratories, Department of Public Health of
Massachusetts, in Which He States that Inoculated Per-
sons Frequently Served to Spread the Disease to Others,

p. 28. "Inoculation, or variolation, consisted in trans-
ferring matter from a true smallpox pustule to the
abraded skin of the person to be protected. This pro-
cedure usually produced a mild form of the disease,
which, anticipated and controlled, was preferable to a
fortuitous and virulent attack, but it had serious disad-
vantages. Infections other than smallpox were trans-
mitted along with the variolous matter. Further, the
induced disease was true smallpox, and, therefore, in-
oculated persons frequently served to spread the disease
to others. Then, too, the infection sometimes ran a
typical and fatal course."
Extract from Article by Dr. J. H. Dempster in the Jour-
nal of the Michigan State Medical Society, July, 1926.
"The method of prevention of smallpox that prevailed
up to Jenner's time was that of 'inoculation,' the effects
of which were often as bad as the disease itself.
procedure consisted in producing in the person an arti-
ficial attack of smallpox, and seeing the patient safely
through the infection. Several doctors became noted for
their skill in inoculation and the operation became a sort
of specialty with them. The operation of inoculation was
attended by risks through the danger of introducing
other infective agents into the system. The only advan-
tage of this old method of prevention consisted in the
fact that the patient could select the time and place when
he wished to have smallpox, but there was no guarantee
that the induced disease might prove less dangerous than
that accidentally acquired."

Extract from the Minority Report by Dr. W. J. Collins
and Mr. J. Allanson Picton, of the Royal Commission on
Vaccination, Calling Attention to the Persistence of
Edward Jenner in maintaining that a Single Vaccination
Offered Protection Against Smallpox For Life:
"Jenner's first writing on the cowpox was a com-
munication intended for the Royal Society in 1797, the
original of which, it would appear, exists in manuscript
in the library of the Royal College of Surgeons. The
communication was not printed in the Philosophical
Transactions, but was returned to Jenner, and, with addi-
tions, was published in 1798 as 'An inquiry into the
causes and effects of the Variolae Vaccinae.' The original
paper asserted that 'matter of various kinds when ab-
sorbed into the system may produce effects in some
degree similar; but what renders the cowpox virus so
extremely singular is, that the person who has been thus
affected is for ever after secure from the infection of
the smallpox; neither exposure to the variolous effluvia
nor the insertion of the matter into the skin producing
this malady.'
* * * *
"Cases in which smallpox had occurred after cowpox
had frequently been pressed upon Jenner's attention
(Gregory's 'Eruptive Fevers,' p. 208), and in his third
publication in 1801 Jenner thus alludes to these objec-
tors: 'Some there are who suppose the security from
smallpox obtained through the cowpox will be of a tem-
porary nature only. This supposition is refuted, not
only by analogy with respect to the habits of diseases

of a similar nature, but by incontrovertible facts, which
appear in great number against it.' ...
In his petition
to the House of Commons he states that he had dis-
covered that 'the cowpox admits of being inoculated on
the human frame with the most perfect ease and safety,
and is attended with the singularly beneficial effect of
rendering through life the persons so inoculated per-
fectly secure from the infection of the smallpox.' (Baron.
1., 490)."
Extracts from Book Entitled "The Vaccination Ques-
tion" by Dr. C. Killick Millard, Medical Officer of Health
for Leicester, England, Issued in 1914, Directing Atten-
tion to the Decline in Smallpox Along With the Plague,
Cholera and Typhus.
p. viii. Preface. "For forty years, corresponding
roughly with the advent of the 'sanitary era,' smallpox
has gradually but steadily been leaving this country
For the past ten years the disease has
ceased to have any appreciable effect upon our mortality
statistics. For most of that period it has been entirely
absent except for a few isolated outbreaks here and there.
It is reasonable to believe that with the perfecting and
more general adoption of modern methods of control and
with improved sanitation (using the term in its widest
sense) smallpox will be as completely banished from this
country as has been the case with plague, cholera, or
typhus fever. Accompanying this decline in smallpox
there has been a notable diminution during the past
decade in the amount of infantile vaccination. This fall-

ing off in vaccination is steadily increasing and is be-
coming very widespread.
*             *             *             *
p. 185. "Undoubtedly, many have a genuine fear that
if smallpox once succeeded in obtaining a foothold in an
unvaccinated community it would spread 'with, a rapidity
of which we have in recent times had no experience.'
I realize that any one who suggests that this view is
unduly alarmist incurs a certain measure of responsi-
bility, and I believe that this reflection has hitherto de-
terred those who might otherwise have been inclined to
express a more sanguine view. Personally, having been
Medical Officer of Health for thirteen years in a town
which, for practical purposes, may be regarded as un-
vaccinated; living and moving, as I do, amongst a child
population 90 per cent of which is unvaccinated, I feel
unable to subscribe to this pessimistic view. I believe
that the sanitary condition of the country has been so
greatly improved, and alternative measures for dealing
with smallpox have been so highly evolved, that we shall
never revert to the state of things which existed in the
days before vaccination was discovered."
Extracts from Article by Dr. C. V. Craster, Health Of-
ficer, Newark, N. J. In the American Journal of Public
Health, May, 1925, Contrasting The Insanitary Condi-
tions of the 19th Century With the Present High Stand-
ards of Living.
"The onset of the industrial era in Europe, and in
America too, changed to an immense degree the general
living conditions of the populations. As a result of
economic demands for factory labor and also the lure of
better wages, a continuous drift of population took place
from the rural districts to the towns.
"This would not have been important as a national
change had the cities been able to absorb and accommo-
date the vast army of employed. As it was, the cities
were without sufficient dwellings and such as they had

were without a water supply, without sewerage, with-
out even an available or clean food supply to provide for
the new citizens. These conditions brought about in the
vast majority of city dwellings in America and abroad
during the middle of the nineteenth century overcrowd-
ing, indescribable filth and generally a miserable living
standard among the families of the poor. Disease and
every kind of infection ran riot, finding ideal conditions
in the foul homes and in the emaciated and under-
nourished bodies of unfortunate victims.
"Speaking of the living conditions in the tenement
buildings of the City of London in the 19th century
Simon said: 'There are some places where the mortality
is yet high, where in fact the cloud of death is always
hanging, where the vitality of the people is seriously
sapped and where disease makes an easy conquest. It
is not enough that these places are the continuous haunts
of such endemic maladies as phthisis, fever, and other
putrid classes, but often they become seats of stronger
"A parallel to this situation existed at the same time
in the City of New York, where in 1864, according to
the City Inspector, 6,000 families comprising 18,000 in-
dividuals were living in underground cellars. . . .
"It was evident that although routine enforcement of
such old established methods as isolation and quarantine
were administration methods of some value in the con-
trol of epidemics, they would in the end be useless as
mere gestures unless there was possible an improvement
in the actual living conditions of the people. The de-
mand for reform brought about the great national efforts
to insure a good water supply for cities and the pro-
vision of adequate sewerage and refuse collection sys-
tems, as well as a general improvement in the type of
city dwelling used by the worker.

"The greater number of epidemic diseases which swept
over enormous continental areas were strictly diseases
where possibilities of spread were directly questions of
environment. This class would include smallpox, yellow
fever, dysentery, typhoid fever, bubonic plague, cholera,
malaria, typhus fever, meningitis and tuberculosis.
of these with the exception of tuberculosis have ceased
to be widely prevalent except in countries where famine,
destitution and filth exist as a result of war or economic
The Following is a Photographic Copy of Chart by
Statistician's Department, The Prudential Insurance
Company of America, Showing Comparative Reduction
in Mortality from Scarlet Fever, Diphtheria and Croup,
Whooping Cough and Measles.
Comparative Reduction in Mortality from Measles
Click here for larger view of graph above.

Table Showing the Number of Cases and Fatalities from
Smallpox in Maine Before and After the Year 1921
When the Law Authorizing Superintending School Com-
mittees to Exclude Unvaccinated Children Was Virtually
Repealed by Passage of "Conscience Clause."
Year                                Cases                 Deaths
1920..........                   256                      0
1921..........                    96                      0
1922..........                    85                      0
1923..........                   118                      2
1924..........                    19                      0
1925..........                      1                      0
1926..........                    12                      0
1927..........                      1                      0
Extract from Communication by the Late Mr. Henry
D. Nunn, in the Boston, Mass. Post, January 22, 1924
Directing Attention to the Repeal of the Vaccination
Requirement of Infants in 1908. (It still requires vac-
cination for admission to Public Schools).

"The first compulsory vaccination law was passed by
Massachusetts in 1855. It required that every infant
must be vaccinated before reaching the age of two years;
that no child should be admitted to any public school un-
less vaccinated; that all inmates of public institutions
must be vaccinated; that the employes of all manufactur-
ing corporations must be vaccinated as a prerequisite to
employment and to cap the climax, everyone must be vac-
cinated every five years. What was the result? In the

20 years following the enactment of this law there were
4221 deaths from smallpox in Massachusetts. The pro-
tection afforded by this law did not highly recommend
itself to the people, and in time it was pretty much
ignored, so that finally in 1908 the infant vaccination
requirement was repealed without protest by anybody
and without any bad results."
Table Showing Number of Cases and Deaths from Small-
pox in Arizona Following Repeal of Vaccination Re-
quirement by Referendum Vote in December, 1918.
Year                                 Cases                 Deaths
1919..........                     69                      0
1920..........                   172                      5
1921..........                   192                      4
1922..........                   468                   134
1923..........                   100                    26
1924..........                   160                    20
1925..........                   117                      1
1926..........                     18                      6
1927..........                     10                      0
Table Showing Number of Cases and Fatalities From
Smallpox in North Dakota Since 1919 When the Law
to Require the Vaccination of Minors Was Repealed.
Year                                 Cases Deaths
1920..........                   533                      0
1921..........                 1777                      2
1922..........                   657                      2
1923..........                   444                      2
1924..........                   575                      1
1925..........                   204                      7
1926..........                   276                      0
1927..........                   208                      0

Table Showing Number of Cases and Fatalities from
Smallpox in California Since 1921 when the Vaccination
Law Was Entirely Repealed.
                                Cases                 Deaths
1921..........                 5581                    21
1922..........                 2129                    20
1923..........                 2025                      1
1924..........                 9445                    56
1925..........                 4921                    58
1926..........                 2794                  236
1927..........                   984                      5
Percentage of Births Vaccinated
and Number
of Smallpox Deaths Registered.
of Births
of Births

1880. .
Average per annum
of Births
of Births
Totals___ 4,365
Average per annum
67.9 436
Percent of Births

1921..........                   38.3                    5
Totals........................... 122
Average per annum 43.4                   12
Commenting on the above statistics, the "National Anti-
Vaccination League," of London, England, remarks:—
"So in the 10 years 1872-1881 when an average of
85.5% of the births were vaccinated, we had an average
of 3,708 Smallpox Deaths every year. In 1882-1891,
when an average of 82.1% of the births were vaccinated,
we had an average of 923 Smallpox Deaths every year.
In 1892-1901, when the vaccinations had declined to an
average of 67.9% of the births, the Smallpox Deaths
dropped to an average of 436 per annum. In 1902-1911,
when the average number of vaccinations was 67.6% of
the births, the Smallpox deaths averaged 395 per annum,
but in 1912-1921, when the vaccinations had dropped to
43.4% of the births, there was an average of only 12
Smallpox Deaths per annum.
"How can any person who claims to understand statis-
tics and to have a logical brain declare that it is vaccina-
tion that has stamped out Smallpox, in the face of the
above official figures?"
(Note:—A discussion of the alleged increase in cases
in England during recent years is given on pages 73-79).
Declaration by United States Census Bureau in "Mor-
tality Statistics," 1917.

p. 28. "It has been many years since smallpox was the

cause of high mortality, and data are now presented only
to show how few deaths have been due to this disease in
recent years."
Table Showing the Number of Fatalities from Smallpox
in the United States During the Years 1902 to 1927
1927 (40 States)
(The number of fatalities from smallpox fades into in-
significance when it is realized that the total number of
fatalities from all diseases in the United States amount

to more than a million per year and the number of per-
sons killed by automobiles amount to approximately six-
teen thousand per year.)
Extracts from an Article by S. Kitasato, M.D., Director,
Institute for Research in Infectious Diseases, Tokyo,
Japan, Published in the Journal of the American Medi-
cal Association, March 25, 1911, Directing Attention to
Outbreaks of Smallpox in Japan and its Vigorous Vac-
cination Laws.
"One of the greatest epidemics of smallpox during the
past forty years broke out in 1885 and lasted three years,
with 125,315 cases and 31,960 deaths. The epidemic be-
gan to decline in 1888. It reappeared in 1892 and again
lasted three years. During this second outbreak 88,095
cases were recorded, of which 23,603 patients died. The
third outbreak extended over two years, 1896-1897, with
52,650 cases and 15,664 deaths. During the next ten
years, a few cases were imported from China every now
and then, without any ensuing serious outbreak. Since
1900, the cases in the whole empire were remarkably
few, until in 1907, when the disease reappeared at Kobe.
This caused an uncommonly severe epidemic, which
spread all through the empire. It began to die out in the
spring of 1908. During this fourth epidemic 19,101 cases
and 6,273 deaths were reported.
This outbreak, however,
completely subsided by July of the same year, without
any trace left.
* * *
"In 1874 the first vaccination law was enacted, and in
1876 the regulations for the prevention of smallpox were
promulgated, which provided for compulsory vaccina-
tion. In 1885 a revised law concerning vaccination was
enacted. It comprised all the data included in the for-
mer two regulations. It provided that every baby should
be vaccinated within the first year of its age, and revac-
cinated every five or seven years. The violation of this

regulation was punished with a fine not less than 5 and
not exceeding 50 sen (or approximately from 2-1/2 to 25
cents in U. S. currency). It was in the same year, just
after the enactment of these regulations, that the great
epidemic broke out which is mentioned above. This
regulation remained unchanged during twenty-four
years; a new revision took effect in the year 1909. This
new law provides that each new-born baby shall be vac-
cinated within ninety days after birth and before June
of the next year. Revaccination shall be made at the
tenth year from birth (including the year in which the
child was born). If either the primary or the secondary
vaccination is unsuccessful, the child shall be revacci-
nated before December of the next year."
Copy of Communication by the Citizens Medical Refer-
ence Bureau Addressed to Dr. Hugh S. Cumming, Sur-
geon General of the United States Public Health Service,
May 25, 1927, Directing Attention to a Severe Epidemic
of Smallpox in Italy Where Vaccination and Revaccina-
tion Are Compulsory.
"We fail to find a comprehensive discussion of the dis-
astrous epidemic of smallpox in Italy in any of the issues
of 'Public Health Reports' or in any of the annual re-
ports issued by your Department.
"We find that in 1912 there was an average mortality
from smallpox in Italy of 9.5 per 100,000 persons. In
1918 there was a mortality of 2.6 per 100,000; in 1919
it rose to 45.4; in 1920 it was 30.3 and in 1921 it was 3.7
per 100,000 persons. This means that in Italy in 1919
there were 18,213 fatalities from smallpox as compared
to only 358 fatalities in the United States, and in 1920
there were 12,155 fatalities in Italy as compared to only
508 fatalities in the United States.
"In view of the fact that the mortality from smallpox
in the United States has been less than one per 100,000

persons during each year for the past 20 years or more,
and in view of the fact that the bulletins issued by the
League of Nations, publications issued by health boards
throughout the country, and publications issued by the
various medical societies have done so much to picture
the United States as being a smallpox plague center,
when the very reverse is true, it is disappointing to say
the least that your Department which is so closely in
touch with the statistics throughout the world has failed
to bring out the facts with regard to smallpox in Italy.
"I am sure you will agree that the record of the
United States, which for the most part does not make
vaccination compulsory, is very remarkable when com-
pared with the record of Italy where the laws provide
for compulsory vaccination of all infants below one year
of age, and for the revaccination of children before they
reach the age of 12 years. The brief reference to small-
pox in Italy in your 1920 annual report does not reveal
either the actual number of fatalities or cases of small-
pox in Italy.
"Will you kindly advise if you contemplate issuing a
report in the near future dealing with the epidemics of
smallpox in vaccinated and revaccinated Italy?"
(Note:—Over a year has elapsed since the above com-
munication was forwarded to the United States Public
Health Service, and more than seven years have elapsed
since the disastrous smallpox epidemic in Italy, and yet
no medical or public health journal in the United States,
to our knowledge, has yet published a comprehensive dis-
cussion of the facts about this epidemic in Italy. H. B. A.)

Disastrous Epidemic of Smallpox in the Philippine Is-
lands in 1918 and 1919 Where Vaccination and Revaccin-
ation Are Compulsory.
Table Showing Number of Vaccinations and the Number
of Fatalities From Smallpox During the Ten Years,
(The total population of the Philippine Islands is only
approximately ten million persons.)
No. of Deaths
No. of Vaccinations
From Smallpox
Total of
10 years
Extracts from Communication by the Philippine Health
Service to the Citizens Medical Reference Bureau, Sep-
tember 25, 1922, denying the charge raised in the United
States as an explanation for the large number of fatal-
ities from smallpox in the Philippines that vaccination
measures were in the hands of inefficient Filipino man-
"We admit that our sanitary inspectors have not been
infallible; yet, our consciences are clear that since we had
assumed the full responsibility of the health administra-
tion, our sanitary personnel have been performing their
duties to the best of their ability.
* * *

"Regarding the question of general administration, any
scientific man would admit that three or four years ob-
servation is not enough to justify a criticism of success
or failure. Experiments either technical or administra-
tive, require a considerable length of time to prove cer-
tain definite conclusions and results. And even at pres-
ent, statistical facts indicate that, under similar existing
conditions and circumstances, the American and Filipino
Health Administrations in the Islands, as far as the re-
straint of smallpox is concerned, show no great discrep-
ancy. In fact, it should be recalled that way back in 1911,
1912 and 1913, i. e., during the American Health Admin-
istration, there have been similar outbreaks of smallpox,
particularly in Southern Islands and among the non-
Christian population of Mindanao and Sulu. It should
not also be lost sight of that, from the beginning of
health administration in the Islands, the personnel of
the vaccinating parties who have been partly, if not in
toto, instrumental in checking such epidemics, have all
been Filipinos."
Extracts from the Report of the Chief of the Division
of Sanitation, City of Manila, in the Annual Report of
the Philippine Health Service for 1920, in Which the
Excuse is Offered That the Hundreds of Thousands of
Yearly Vaccinations in Manila Proved a Failure Because
Infants Under One Year of Age Had Been Allowed to
Escape Compulsory Vaccination.
"From the time in which the smallpox was practically
eradicated in the city of Manila to the year 1918 (about
9 years) in which the epidemic reappeared certainly in
one of its severest forms, hundred after hundred of
thousands of people were yearly vaccinated and revac-
cinated with the most unfortunate result that the 1918
epidemic looks prima facie as a flagrant failure of the
classic immunization towards future epidemics.
"Obviously, the epidemic moment called for a revision
of the classic methods of vaccination, and it was through

a painstaking study and consideration of our records as
compared with the situation that the fact was plainly
disclosed that our hundred of thousands of yearly vac-
cinations were nothing but a fruitless attempt since a
very important group of such population was overlooked
and in fact unwisely spared in the immunization scheme.
Through a combination of circumstances among which
had gained undue prominence the country-wide fear of
accepting antivariolic vaccination for children of less
than six months to one year age, there was thus formed
an aggregate numerous group of unprotected people, too
hardly, if at all possible, to trace and identify after
months or years have elapsed since first seen when nearly
new-born. Just on the occasion of the 1918 epidemic,
cases were on records of children of 40 to 43 days of age
who contracted, and certainly died from, virulent (con-
fluent) smallpox. It was then the moment for a general
alarm, and rush orders were accordingly issued for the
'immediate compulsory vaccination of all children from
not less than 30 days age on, or earlier, if the children's
family so desire.'"
Extract from Service Publication Number 29, Issued by
the Australia Department of Health, 1925, Stating That
for Practical Purposes Australia is Unvaccinated.
P. 109. "Consideration of the extent to which vaccina-
tion has been carried out in the several States during
this period indicates that for practical purposes the
Australian community is, as a whole, unprotected by
vaccination. It is difficult to assess the proportion of
vaccinated persons in the community, even in terms of
infantile vaccination, without any consideration of the
revacciraations necessary to ensure a more complete im-
munity. In the previous volume, page 132, an approxi-

mate estimation was given that, in 1910, some 30 per cent,
of all persons in Australia had been vaccinated."
Table Showing Number of Cases and Fatalities from
Smallpox in Australia During the Fifteen Year Period
Cases of
New South Wales
(In 3 of
these cases
was only a
contributing cause.)
South Australia
Western Australia
The Extremely Mild Character of the So-called Cases
of Smallpox in Australia During the Fifteen Year Period
1909-1923 May be Gained from the Following Extracts
from Service Publication Number 29 Issued by the
Australia Department of Health, 1925, Referring to the
Onset of the Epidemic Among Employees in a Factory
in Sydney, Australia.
"The precedent illness, in all the cases, appeared to
have been of a very mild type, and while some of the
girls had stayed away from business for a few days, some
had not considered it necessary to do so at all. Not more
than two of the girls affected had consulted a medical
practitioner, and in those cases they stated they had
been told that there was nothing much the matter.

Further inquiries elicited that the first case had occurred
on or about 25th April, at which date a girl, E. D.,.aged
22, had been attacked by 'influenza.' Three days later
she developed a 'pimply' rash on the face. She had been
absent from work for a week, and had returned to duty
feeling well before the eruption appeared,"

Extract from Annual Report of the United States Public
Health Service for the Fiscal Year 1924, Referring to
Smallpox as Being Much Better Reported Here Than
in Other Countries.
p. 5. "Reports of 149,550 cases [of smallpox] with
22,346 deaths were received during the year. The fact
that more than one-fifth of the cases reported occurred
in the United States should not be taken to mean that
this disease is more prevalent here than anywhere else,
but that it is much better reported in the United States
than in most other countries."
Table Showing Number of Alleged Cases of Smallpox in
the United States by Years from 1919 to 1927, Inclusive.
1927 (40 States and
D. of C.)

Extracts from London Letter to the Journal of the
American Medical Association, Published in the Journal,
June 30, 1928, Showing the Alarm Being Created There
Over an Alleged Increase of "A Mild Form of Smallpox."
"The report of the smallpox and vaccination committee
of the League of Nations draws attention to the remark-
able decrease in smallpox in European countries during
recent years. To this England and Wales offer the sole
exception, owing to the increasing prevalence of a mild
form of smallpox, from which, however, the mortality
is almost negligible.....The alarming increase in small-
pox in England was emphasized by Major G. S. Parkin-
son of the army medical corps, in an address at the public
health conference recently held in London. He gave the
following figures: 1918, 63 cases; 1921, 336; 1927, more
than 9,000."
United States Public Health Service in "Public Health
Reports," December 9, 1921 Recommended Reporting
Cases of So-called "Cuban Itch," "Philippine Itch,"
"Alastrim," etc. as Actual Cases of Smallpox, as shown
by the Following Extracts.
"It should be borne in mind that while alastrim, from
a scientific viewpoint, may possibly be a separate disease
entity, it has all the public health aspects of smallpox
and, in the present state of our knowledge of its exact
classification, should always be reported and combated as
"Synonyms. Varioloid-varicella, amaas, Kaffir milk-
pox, Sanaga smallpox, West Indian modified smallpox,
pseudo smallpox, weisse pocken.
* * *
"It is probable that the so-called 'Cuban Itch' and
'Philippine Itch' observed after the War with Spain, the
mild form of smallpox prevalent in America, and alas-
trim are identical."

Doctors Unable to Distinguish Between So-called
"Smallpox" and "Poison-Ivy" as Brought Out in the Fol-
lowing Extracts from an Editorial in the New York
Times, July 1, 1926.
"This Smallpox Was Poison Ivy.—From Peekskill
comes the report that the smallpox 'scare' recently re-
ported at the National Guard camp was due to a number
of serious cases of ivy poisoning.
The doctors must have
been able to distinguish between the effects of poison ivy
and incipient smallpox, but the story is another indica-
tion that the poison ivy season is already at its height."
Extracts from an Article by Assistant Surgeon-General
John W. Trask of the United States Public Health Serv-
ice, in "Public Health Reports," June 23, 1911, in Which
He Directs Attention to the Extreme Mildness and the
Small Number of Deaths from Smallpox in the United
"One of the most notable features of the smallpox
which has been more or less prevalent in the United
States for at least ten years is its extreme mildness and
the small number of deaths which it has caused. In 1909
the combined states from which complete reports were
received had 19,534 cases with 92 deaths, which was a
mortality rate of 0.471 for each 100 cases. In 1910 the
rate was considerably higher, but still remarkably low
when compared with the rates reported from other coun-
* * *
"That the community is protected by vaccination may
be true for certain localities, but that the protection thus
afforded is general can hardly be maintained. Japan as
a nation is probably as well or better protected by
vaccination than is the United States, and yet in 1907-
1903 there was an outbreak of smallpox in Japan in
which 19,101 cases were reported with 6,273 deaths.
Vaccination did not there modify the type of the disease
to that found in America. * * * *

"If the non-virulence of the disease in this country is
due to protection by vaccination it would be expected
that the mild cases would be found only in those so pro-
tected. This may be assumed from the limited informa-
tion available not to be the case. Records of the vacci-
nation history of all patients would undoubtedly add
much to our knowledge of the subject.
"That the type of the disease as seen in the United
States is due to the protective value of vaccination is
shown not to be true for certain localities in which out-
breaks of the virulent form of the disease have been re-
ported. These outbreaks have occurred at widely separ-
ated points extending from Virginia and South Carolina
in 1909 to Michigan, Oklahoma, Texas and Oregon in
1910. . . ."
Extracts from Service Publication Number 29, Issued
by the Department of Health of Australia, 1925 Stating
That There is a Division of Opinion Among Health
Authorities as to Whether the Mild Type of So-called
Smallpox Is or Is Not A Distinct Disease.
p. 20. "The striking feature of the world course of
smallpox, during the period under review, has been the
epidemic extension in many countries of an exceptionally
benign form of the disease. Throughout the historical
records that relate to smallpox, there has been noted by
such observers as Rhazes, van Swieten, Sydenham, and
Jenner, the occasional appearance of a form of smallpox
so mild that fatal results were rarely heard of, and the
eruption was only occasionally confluent. Since 1898,
however, particular attention has been focussed on the
continuance of a benign type of the disease in many
countries and on its spread to, and extension and endemic
establishment in, other countries. Naturally, in each out-
break of this type of disease there has been considerable
diversity of opinion as regards diagnosis when the dis-
ease first appeared. The specific identity of the disease
in each outbreak in its relationship to typical variola has

been freely questioned, and the nomenclature adopted
has resulted in a new and confused nosology—'alastrim,'
'amaas,' 'varioloid,' 'variola-varicella/ 'para-variola,' and
'mild smallpox' as distinct from 'variola vera,' 'classical'
or 'Asiatic smallpox.' With the continuance of the mild
type or types of disease, and the accumulation of clini-
cal, epidemiological and laboratory records, there have
developed two schools of opinion which have been called
by Professor Jorge the 'unicists' and 'dualists'—the uni-
cists desire to see in alastrim merely an expression of
variola; the dualists persist in believing it a species sui
generis, autonomous and independent.'"
Extract from Article on "Smallpox" in the 1925 Supple-
ment to The New International Encyclopedia, Vol. II,
pp. 1217-1218 Referring to Alastrim as Being Distinct
from the Severe Type.
"Smallpox. During the 10 years 1914-24, much infor-
mation was gained about this affection. The conviction
is growing that there are different strains of the disease,
one of which is naturally mild and the other severe.
Should this dualistic view obtain a permanent foothold
many peculiarities of the disease may be explained. A
severe type of disease may, of course, have its virulence
modified and appear alternately in mild or severe form;
but there may be a mild form which is never severe
under any circumstances. This appears to be the case
with the alastrim of the West Indies, which is believed
to be the same as the mild smallpox of western Africa,
from which it was originally derived.
The latter has
long been regarded as distinct from the severe smallpox
of eastern Africa. The severity of the latter, as of other
virulent strains of the disease in the tropics, makes it
difficult to control by vaccination, to which must be added
the great difficulty of obtaining fresh virus, and the dif-
ficulty of enforcing vaccination decrees in primitive com-

Extract from Lecture by Dr. Charles V. Chapin, Super-
intendent of Health, Providence, R. I., Extracts from
Which Were Published in "Public Health Reports,"
December 24, 1926.
"That vaccinia is derived from smallpox by animal
passage we know.
That varicella is another offshoot
from smallpox is highly probable. That the mild type
of smallpox sometimes called alastrim, or amaas, is
another cleavage seems clear. That the two strains are
closely related is shown by complement fixation tests, by
animal inoculation, and by the immunity against both
produced by vaccinia. Nevertheless the two types differ
clinically in a marked degree and to some extent in
immunity relations and in animal reactions.
"The history of the appearance and dispersion of the
mild type of smallpox shows that it is not to be explained
by changes in the host caused by vaccination, or other-
It is not possible that it is due to climate or any
telluric, or cosmic, or mystic epidemic influence. The
theory that the disease is mild because the smallpox germ
has parted company with a virulent streptococcus seems
highly improbable. The simple and wholly adequate
theory is that in Florida or in Africa the smallpox germ
some thirty years ago, suddenly underwent a change,
or mutation, just as many other species of plants and
animals, high and low, are constantly doing."
Extract from an Article Published in The Canadian
Medical Association Journal, April, 1928.
"The history of medicine teaches us that most infec-
tious diseases gradually change their character from one
generation to another. The terrible plagues of the
Middle Ages are in many cases unrecognizable from
descriptions which have come down to us. Diseases re-
garded at one time as almost inevitably fatal become
comparatively benign, while others become progressively
more virulent. The factors concerned in this change are

largely unknown; whether it is due to a change in the
customs and habits of mankind, to a gradual immuniza-
tion of the population, or to an alteration in the exciting
organism is uncertain.
(Note: As long as medical text books and medical jour-
nals continue to advise physicians and students to regard
a recent vaccination as a sign that any disease having
the appearance of smallpox is probably some other dis-
ease, the voluminous statistics compiled by health boards
comparing the number of cases of smallpox among the
vaccinated and the unvaccinated are worthless.
following citations are given to show that it is the ac-
cepted practice among physicians to practically rule out
smallpox as a possibility whenever the patient has been
recently vaccinated:)
Extract from Article Entitled "Smallpox—Its Differen-
tial Diagnosis," by Archibald L. Hoyne, M.D., Read Be-
fore the Northwest Branch, Chicago Medical Society,
and Published in the Illinois Medical Journal, June, 1923.
"In examining a case of suspected smallpox, close ob-
servation is of the utmost importance. If the patient
shows evidence of a typical vaccination scar of compara-
tively recent date, variola may be almost absolutely ruled
In a book entitled "Modern Medicine," by William Osier,
M.D, Volume 1, p. 853, William T. Councilman, M.D.,
refers to the differential diagnosis of chickenpox and
smallpox and mentions the following as the first dif-
ferential point.

"The vaccinal condition of the patient."

(1) Health Departments tell physicians to look for the
vaccination soar as of first consideration in deciding whether
a case is or is not smallpox, as in reproduction given below.
(2) Then whan the statistics are compiled these same
Health Departments announce to the world No Smallpox Among the
Persons Successfully Vaccinated!
From The Journal of the Michigan State Medical Society.
March, 1927
                            health department                                         181

An illustration of how statistics are being used by vac-
cinationists to make it appear that compulsory vaccina-
tion is necessary and that vaccine virus is not to blame
for the fatalities following vaccination is illustrated by
an article by W. W. Keen, M.D., entitled, "Smallpox—A
National Disgrace," published in "The American Review
of Reviews," February, 1927.
In parallel columns below we give extracts from the
article by Dr. Keen and facts which he omitted to men-
tion and which would have shown the fallacy of the con-
clusions which he sought to bring before his readers:
Facts Omitted in Article
by Dr. Keen.
Dr. Keen does not ex-
plain that what appears to
the reader unfamiliar with
smallpox statistics as an
alarming increase in fatali-
ties of 628 per cent was
simply the usual fluctuation
that takes place from one
year to the next between
one hundred to less than a
thousand fatalities.
He does not mention that
this is a remarkably low
death rate, so low in fact,
that the United States Cen-
sus Bureau in its 1917 re-
port of "Mortality Statis-
tics" declares that smallpox
data is now given "only to
show how few deaths have
Statements by Dr. Keen.
"Surgeon-General Cum-
ming, head of the Public
Health Service, in his re-
port for June 30, 1925
stated that the increase in
the number of cases of
smallpox in the previous
calendar year was 75 per
cent., and of deaths from
smallpox was 628 per cent.,
over the year 1923!

Statements By Dr. Keen
"Approximately one-fifth
of all the cases in the world
in 1923-24 occurred in the
United States. India with
its 319,000,000 people
headed the list; then came
the United States with 55,-
538 cases.
Facts Omitted By Dr.
Keen (Cont.)
been due to this disease in
recent years."
Also Dr. Keen does not
mention to what extent
these fatalities were due
mainly or in part to other
diseases from which the pa-
tient had been ill.
Dr. Keen does not inform
his readers that the United
States Public Health Serv-
ice in "Public Health Re-
ports," December 9, 1921,
recommended reporting all
cases of "Cuban itch,"
"Philippine itch," alastrim,
and a long list of com-
plaints diagnosed in other
countries under a variety
of names as smallpox.
He does not tell his read-
ers that because of lack of
uniformity in diagnosis a
record of thirty or fifty
thousand cases may mean
nothing more than that
number of cases of chicken-
pox, nor does he mention
as stated in the Annual Re-
port of the U. S. Public
Health Service, 1924, that
the number of cases in this
country should not be taken
to mean that the disease is
more prevalent here than

Statements By Dr. Keen
Facts Omitted By Dr.
Keen (Cont.)
anywhere else, but that it
is much better reported in
the United States than in
most other countries.
Dr. Keen does not men-
tion as brought out in an
article entitled "Alastrim"
in "Public Health Reports,"
December 9, 1921 that "It
is probable that the so-
called 'Cuban-itch' and
'Philippine itch' observed
after the War with Spain,
the mild form of smallpox
prevalent in America, and
alastrim are identical."
Also when Dr. Keen tries
to make it appear that 350,-
000 persons have been
pock-marked and some
blinded for life his state-
ment is shown to be falla-
cious by the description of
the mild smallpox found in
the United States in the ar-
ticle in "Public Health Re-
ports" above referred to
wherein it is brought out
that "the skin is smooth,
with scarcely a trace of
pitting or scarring" and
that "Usually the progress
of the disease is uneventful,
without complications or
sequelae." It also brings
out that "Throughout its
"Smallpox not only kills
many of its victims, but
with very few exceptions
all who escape death are
horribly disfigured by the
pockmarking or 'pitting' of
the face, and a considerable
percentage are also blinded.
Smallpox is especially a dis-
ease of childhood. The pock-
marking and blinding are
therefore for life.
"The 'Statistics of Noti-
fiable Diseases' for 114
countries, issued by the
Health Organization of the
League of Nations, for
1925, shows that in the
United States for the seven
years from 1919 to 1925, in-
clusive, there were reported

Statements By Dr. Keen
409,649 cases of smallpox.
The number of deaths is
not given. Though the epi-
demic has usually been
mild, and therefore the
number of deaths probably
not large, yet certainly
more than 350,000 persons
have been pock-marked and
some blinded for life."
* * * *
"In the seventeenth cen-
tury Bernouilli estimated
that in Europe alone 60,-
000,000 people died of
*             *             *            *
"The Franco - Prussian
War, 1870-1871: In the
German army, 4,835 cases
of smallpox developed, with
276 deaths. In the French
army, much smaller than
the German, there were
125,000 cases and 23,470
deaths—i. e. in the French
army there were 26 times
as many cases and 86 times
as many deaths as in the
German army. (How ser-
ious was the loss of mili-
tary efficiency of the
French army, through the
neglect of vaccination!)
The reason for this impres-
sive difference in these two
Facts Omitted By Dr.
Keen (Cont.)
course the disease is ex-
ceedingly mild, and except
for the pains of onset and
maturation, the patient ex-
periences relatively little
discomfort. There is no
delirium, and patients are
not really very ill and re-
tain their appetites."
The estimate of fatalities
from smallpox in the
seventeenth century may
have been exaggerated a
hundred times. However,
in giving out this estimate
Dr. Keen says nothing
about the insanitary condi-
tions in the seventeenth
The statistics used by Dr.
Keen with reference to the
Franco-Prussian war were
used by the London Lancet,
one of the leading medical
magazines of the world, in
its issue June 1, 1901 but
in its issue June 8, 1901 it
published a communication
by Alexander Paul direct-
ing attention to the fallacy
of the statistics used and
appended thereto the fol-
lowing foot-note:
"The figures escaped our

Statements By Dr. Keen
armies is that vaccination
was widely practiced in
Germany though it was not
enforced by law until 1874,
when it was made compul-
*    * * *
"After the Great War,
from 1919-1921, there were
about 300 cases of smallpox
annually in England and
Wales. In 1923 the number
rose to 2,485, and in 1924
to 3,765. During 1925 there
was a further increase to
5,365 cases.. . Today there
is great concern in England
on account of the increas-
ing smallpox.
*    * * *
"In 1918 (in the Philip-
pine Islands) Death began
to reap his harvest, and by
1921 there had been 130,-
264 cases and 74,369 deaths
from smallpox—the most
terrible epidemic in modern
times. Coincident with the
new administration of Gen-
eral Wood, in 1921, vacci-
nation was again thorough-
ly reestablished, and by
1923 the scourge of small-
pox was ended."
Facts Omitted By Dr.
Keen (Cont.)
attention. We regret to
have published them as
their falsity has been es-
Now after the lapse of
twenty-six years the same
erroneous statistics appear
in the article by Dr. Keen.
Dr. Keen fails to mention
that in England the aver-
age number of fatalities
from smallpox during the
past fifteen years has been
less than fifty per year.
Also Dr. Keen fails to
contrast the remarkable
record in England where
vaccination has been made
optional and where the
majority of the population
is unvaccinated with the
record of Italy where vacci-
nation and revaccination is
In Italy there were 18,213
fatalities from smallpox in
1919, 12,155 fatalities in
1920 and 1,484 fatalities
from smallpox in 1921.
Official reports from the
Philippine Health Service
show that a general vacci-
nation of the population
was carried out during the
years 1905 and 1910. Also

Statements By Dr. Keen
Facts Omitted By Dr.
Keen (Cont.)
during the ten years from
1911 to 1920, there were
24,436,889 vaccinations
The Philippine Health
Service in a communication
addressed to the Citizens
Medical Reference Bureau,
dated Manila, September
25, 1922, said: "We admit
that our sanitary inspectors
have not been infallible;
yet our consciences are clear
that since we had assumed
the full responsibility of
the health administration,
our sanitary personnel have
been performing their
duties to the best of their
The epidemic had come
and gone before General
Wood had reached the Is-
lands as shown by the fact
that the number of fatali-
ties had dropped from 47,-
368 in 1919 to 7,194 in
Dr. Keen does not men-
tion the fact that there are
a number of eastern states
such as Maine and Ver-
mont, where vaccination is
not made a requirement,
where geographical condi-
"In California, from
1919 to 1924, there were
26,651 cases of smallpox.
In Massachusetts, by con-
trast, there were in the
same years only 126 cases.
* * * *
"The very short, upper
line represents 688 deaths
from smallpox in the four

Statements By Dr. Keen
states of New York, New
Jersey, Connecticut and
Maryland, which enforce
vaccination laws. The long
line represents 9137 deaths
—thirteen times as many—
in the two states of Wash-
ington and Oregon, which
have only one-fourth the
population of the four
states in the first group.
Facts Omitted By Dr.
Keen (Cont.)
tions are more nearly the
same as Massachusetts, and
whose absence of smallpox
compares favorably with
Massachusetts or any other
state where it is a require-
Dr. Keen fails to men-
tion that Oregon has the
same kind of law making it
optional with local authori-
ties whether or not they
shall require vaccination as
Connecticut and New Jer-
sey. New York only re-
quires it in cities of the first
and second classes. Hence,
the comparison is not based
upon a group having one
kind of law and another
group having a different
law. Maryland is the only
one out of the six states
mentioned which makes
vaccination a requirement
throughout the state.
Dr. Keen fails to mention
that the Michigan Depart-
ment of Health recom-
mends that "The absence of
any history of having had
smallpox or a successful
vaccination within the past
five years" be regarded by
"What the Detroit Health
Department Found After
the 1924 Epidemic.
"(Of those successfully
vaccinated within five
years, not one contracted
* * * *

Facts Omitted By Dr.
Keen (Cont.)
physicians and health offi-
cers as one of the primary
aids in the diagnosis of
smallpox. (See Journal of
the Michigan State Medical
Society, March, 1927.)
Quite naturally there
would be no cases of small-
pox among the recently
vaccinated if physicians are
advised to look to see
whether or not the patient
has been recently vacci-
nated before they diagnose
the case.
Dr. Keen does not men-
tion the fact as brought out
by Dr. M. J. Eosenau in the
Journal of the American
Medical Association, Janu-
ary 22, 1910 that "It would
be ideal if the government
could guarantee the purity
and potency of each pack-
age, but to do so would re-
quire more than supervi-
sion—it would almost mean
government ownership."
Dr. Keen simply leaves
the reader to infer that the
government does guarantee
the purity of the vaccine.
Also Dr. Keen makes no
mention of the many ar-
ticles like that contained in
Statements By Dr. Keen
"Since 1902 the manufac-
ture of vaccine lymph has
been under Government
control. Every lot of vac-
cine is tested before any
can be sold___There have
been 41 cases of lockjaw in
many millions of vaccina-
tions. The most thorough
examination in each case
has shown that the germ of
lockjaw did not exist in the
vaccine lymph."

Statements By Dr. Keen Facts Omitted By Dr.
                            Keen (Cont.)
the Journal of Infectious
Diseases, November, 1927
that the utmost care and
the best scientific supervi-
sion does not preclude the
chance of serious conse-
quence due to contaminat-
ing bacteria and that the
tetanus organism is an op-
portunist in any wound and
that tetanus following vac-
cination is always to be
(Note:—On the strength of such misleading and er-
roneous use of statistics as that referred to above Dr.
Keen draws the conclusion that "The experience of cen-
turies and the common sense of every community should
insist on universal vaccination." The article by Dr. Keen
is typical of the nation-wide propaganda in favor of
compulsory vaccination appearing in newspapers and
popular magazines, which for the most part these news-
papers and magazines allow to go uncorrected. H. B. A.)
Extract from Paris Letter in the Journal of the Amer-
ican Medical Association, April 16, 1927.
"Dr Dequidt, formerly head of the Service central du
controle in the ministry of public health but who is now
the manager of an independent special journal, the
Mouvement sanitaire, writes that health statistics as at
present published are not fully reliable. While the law

of 1902 demands that the exact causes of deaths be regis-
tered, the number of deaths from 'unknown causes' im-
mediately increased. From 1911 to 1921, between 5 and
6 per cent of the deaths were declared to be due to un-
known causes. In 1925, the percentage increased to 26.7.
However, in about fifteen departments of France the
percentage is above 50, and in the department of la Cor-
reze it is nearly 70. Such figures render the statistics
of these departments practically useless.
In a depart-
ment adjacent to Paris, the mortality from pulmonary
tuberculosis has fallen in five years from fifteen to ten
per 10,000 inhabitants, which amounts to a decrease of
83 per cent from the general average for France. But,
at the same time, the number of deaths, in that same
department, from unknown causes has increased from
5 per cent to 40 per cent. The question is, How many
deaths from tuberculosis may be included in that figure?
One of the most important services that the Office na-
tional d'hygiene sociale, recently created, will render will
be the establishment of uniform statistics in the depart-
ments of France. At the present time, statistics may be
made to say anything that one wants them to say."
Extract from Article in the Statistical Bulletin of the
Metropolitan Life Insurance Company, September, 1928:
A certain statistical office was making a study of the
effect of the great influenza pandemic of 1918 upon the
mortality from puerperal conditions in the United States
and in England and Wales. In the former the figures
show a rise from 6.6 deaths from puerperal causes, per
1,000 live births, in 1917, to 9.2 in 1918; in the latter,
there actually appeared to have been a slight decline,
namely, from 3.9 in 1917 to 3.8 in 1918. On the face
of these figures, the investigator would have to conclude
that while influenza was the cause of a big increase in
the mortality of pregnant and parturient women in the
United States, such was not the case in England. What

actually happened was that in the United States all
deaths, in which the return showed both influenza and
any puerperal cause, were charged to the latter, whereas
in England they were charged to the former.
As the United States Public Health Service Advocates
Seventeen Visits to the Physician's Office for Inocula-
tions as an Alleged Temporary Protection Against Four
Diseases, Would a Hundred Visits and a Hundred Inocu-
lations Be Necessary for Protection Against All the
Contagious Diseases When Vaccines or Serums for All
of Them Have Been Discovered and How Often Would
These Hundred Inoculations Have to Be Repeated; How
Would Anyone Know When the So-called Immunity Had
Disappeared, and Would Any Human Being Be Able to
Submit to Such Experimentation and Survive? These
Are Questions Which Should Be Given Serious Con-
sideration Before Making Vaccination a Requirement.
Copy of Communication by J. P. Leake, M.D., U. S.
Public Health Service, Published in the Journal of the
American Medical Association, January 28, 1928, giving
a schedule of seventeen visits to the doctor's office for
inoculations as an alleged temporary protection against
four diseases.
"To the Editor:—The problem offered by the query
from Pennsylvania (The Journal, January 7, p. 51) rela-
tive to immunization of nurses is an interesting one in
practical immunology, and in part, at least, is not infre-
quently presented to the physician. Carrying out the
same general order as that given in The Journal, and
with the same number of visits to the physician (seven-
teen) , the following scheme would serve to give the most

favorable days for observation and for reading the vari-
ous reactions:
"Day zero: Schick test on the right upper arm and
control on the left upper arm, using the flexor surface
2 inches above the fold of the elbow.
"Day 2: (Two days later) : Smallpox vaccination on
the left upper arm over the insertion of the deltoid
muscle (not on the leg).
"Day 3: Dick test on the right forearm, control on the
left forearm, using the flexor surfaces at the junctures
of the upper and middle thirds.
"Day 4: Reading and recording of measurements of
the reactions to the Dick and Schick tests and smallpox
vaccination. If the Dick test is positive, the first dose
for scarlet fever immunization is given in the upper part
of the right arm.
"Day 11: Reading and recording the reaction to
smallpox vaccination; also recording the date of the maxi-
mum diameter or redness as observed by the person vac-
cinated. The second dose for scarlet fever immunization
is given in the upper part of the right arm.
"Day 18: Third dose for scarlet fever immunization
in the upper part of the right arm.
"Day 25: Fourth dose for scarlet fever immunization,
in the upper part of the right arm. By this time, if the
insertion was small and the area kept dry, the smallpox
vaccination site should be entirely healed and the crust
off, even with primary vaccinia.
"Day 28: First dose of typhoid vaccine, in the upper
part of the left arm, below the site of the smallpox vac-
"Day 32: Last scarlet fever dose, in the upper part of
the right arm.
"Day 35: Second dose, typhoid vaccine, in the upper
part of the left arm.
"Day 39: First dose of diphtheria immunization (if
the Schick test was positive) in the upper part of the
right arm.

"Day 42: Last dose of typhoid vaccine, in the upper
part of the left arm.
"Day 46: Second dose of diphtheria immunization, in
the upper part of the right arm.
"Day 52: Second Dick test and control, in the right
and left forearms.
"Day 53: Reading and recording of the Dick test.
Last dose of diphtheria immunization, in the upper part
of the right arm.
"Seven months after the first Schick test, the second
Schick is given. It is read four days later.
"In case this course of treatment is judged to be over-
strenuous, and some of the immunizations are accord-
ingly omitted, the succeeding dates would be advanced.
Of the different immunizations, that against smallpox
is the most efficacious and should under no circumstances
be omitted for nurses entering training. Purpuric variola
can easily enter the wards of hospitals undiagnosed, and
has given rise to fatalities in the nursing corps more
frequently than appears in the literature. By allowing
adequate observation of the reactions, opportunity should
also be given the vaccinating physician to see that his
smallpox vaccine is of full potency; i.e., giving vaccinoid
(four to seven day maximum) in at least 50 per cent
of those vaccinated over ten years before, and a reaction
of immunity (one to three day maximum) or typical
vaccinia (eight to fourteen day maximum) in all the re-
mainder. A small series of successful primary vaccina-
tions, though commonly so taken, is not sufficient evi-
dence of full potency of a vaccine if reactions of immunity
are to be observed.
"J. P. Leake, M.D., Washington, D. C.
"Surgeon, U. S. Public Health Service."

Copy of an Article by Maximilian A. Ramirez and Fred
Wise in the Medical Journal and Record, June 6, 1928.
"Interesting Cases of Protein Sensitization
"Cases Reported by Dr. Ramirez
"Case I.—A boy, aged fourteen, gave a history of re-
current attacks of asthma for the past five years. He
was free of symptoms during the interval between at-
tacks and was also free during most of the winter months.
Symptoms had been more marked from spring to late
autumn. His mother had hay fever when a child, but
had not had any symptoms during the past few years.
One uncle had asthma and hay fever.
"Careful investigation revealed the fact that this boy's
symptoms came on whenever he went to a farm in the
country, and that during his visit at the farm he in-
variably slept in the same bed with an uncle (not the
uncle having asthma). Thorough testing with a large
variety of epidermal, food, and pollen extracts, gave a
negative result in every case. However, a strongly posi-
tive reaction was obtained by testing with an extract
of dandruff obtained from the uncle with whom this boy
slept at the farm. It is interesting to note that extracts
of hair gave only a very small reaction
"This patient's symptoms completely disappeared by
having him avoid close contact with this uncle. He had
only had one or two slight attacks of asthma during the
past year associated with an acute bronchitis.
"Case II.—The patient, a female, aged forty-six, com-
plained of attacks of severe sneezing and itching of the

eyes every morning, lasting for fifteen or twenty minutes.
There was no difficulty in breathing and there were no
symptoms of asthma or hay fever at any other time.
"Investigation revealed that this patient had breakfast
in bed every morning, after which she read the morn-
ing paper, and that invariably the attacks of sneezing
would come on immediately upon opening the newspaper.
An extract of newspaper was prepared for me by the
Arlington Chemical Company of Yonkers, N. Y., and
tests by both the scratch and intradermal methods gave
a strongly positive reaction
. This patient's symptoms
completely disappeared upon removing exposure to news-
paper at that time.
"It was interesting to note that reading at other times
of the day would cause a slight attack, but not the severe
symptoms that were produced during early morning
exposure. This patient was given a long series of treat-
ments against extracts of newspaper, and was suffi-
ciently protected so that she could read the paper in the
morning as was her usual custom. Protection lasted for
about six months and then symptoms started returning
and she is now receiving another series of inoculations.
"In arriving at the conclusion that newspaper or
printer's ink was the cause of this patient's symptoms,
we must add that symptoms could be produced and
stopped by allowing morning contact and eliminating
morning contact with the newspaper. Some extract was
prepared of the paper before it had gone to press and
also of printer's ink. Skin tests with these two separate
extracts were both negative.
"Sufficient work has not been done on this type of sen-
sitization to justify particular comment other than the
report of an extremely interesting clinical history. I
have recently been told of two other cases of sensitization
to newspaper, therefore, it seems worth while calling this
type of sensitization to general notice.

"Case Reported by Dr. Wise and Dr. Ramirez
"Case.—A. R., male, aged thirty-six, complained of
periodical swelling of the face lasting from one to two
days, simulating the appearance of angioneurotic edema.
Local treatments with lotions and X-ray were of no avail.
Thorough testing with various proteins and investiga-
tion along sensitization lines proved beyond peradven-
ture of a doubt that this patient was hypersensitive to
brunette human hair. Skin test with an extract of bru-
nette hair gave a strongly positive reaction. A skin test
with blonde human hair proved negative. It was possible
to show that if this man avoided contact with brunettes,
he was free of symptoms and his symptoms returned
upon exposure to brunette hair, particularly, to one per-
son. We have been unable to attempt immunization with
extract of brunette hair in this case as the patient had
refused further treatment."

Photographic Reproduction of Article in the Journal of
the American Medical Association, November 7, 1925,
Recommending the Preparation by Physicians of Prod-
ucts for Inoculation Prepared from House Dust, Street
Dust, Glue, etc.
The Propaganda for Reform
In This Department Appear Reports of The Journal's
Bureau of Investigation, of the Council on Pharmacy and
Chemistry and of the Association Laboratory, Together
with Other General Material of an Informative Nature
FOR N. N. R.
Report of the Council on Pharmacy and Chemistry
The Council has authorized publication of the following
                                        W. A. Puckner, Secretary.
Among the allergic protein preparations of E. R. Squibb
& Sons, offered as a means of determining specific hypersen-
sitiveness, are the following: Horse Dung Allergen-Squibb,
Stated to be the protein from the dung of the horse; House
Dust Allergen-Squibb, stated to be the protein from ordi-
nary house dust; Le Page's Glue Allergen-Squibb, the protein
isolated from "Le Page's Glue"; Street Dust Allergen-Squibb,
stated to be the protein from ordinary street dust.
The composition of house dust varies with the contents of
different houses and with their location; therefore the protein
obtained from house dust must vary widely. Similarly, the
composition of street dust is dependent on the material that
goes to make up the dust on streets in different localities.
Le Page's Glue is a product of unstandardized composition;
hence there is no guarantee the protein isolated from
Le Page's glue is uniform. As the composition of horse dung,
house dust, glue and street dust is indefinite, it is irrational
to test the hypersensitivity of a patient by means of a stock
preparation; instead, an extract should be prepared, from
material which is likely to correspond with that to which
the patient is sensitive.
In consideration of their indefinite composition, the Council
finds Horse Dung Allergen-Squibb, House ,Dust Allergen-
Squibb, Le, Page's Glue Allergen-Squibb. and Street Dust
Allergen-Squibb unacceptable for New and Nonofficial

The Vaccination Requirement, Involving as It
Does, Wholesale Inoculation of the Population or
an Important Part Thereof, Constitutes A More
Serious Menace to Public Health Than Smallpox.
"With the greatest care . . . certain risks are
present, and so it is unwise for the physician to
force the operation upon those who are unwilling,
or to give assurances of absolute harmlessness."
—George Dock, M.D., in the chapter on "Vaccina-
tion," in "Modern Medicine," by Sir William Osier,
M.D., 1913 edition, Vol. 1, p. 848.
The Report of the Surgeon General of the Army, 1919,
Vol. 1, p. XXXVIII, gives the number of Admissions to
Hospitals during the year 1918 on account of vaccinia,
the disease caused by vaccination, as 10,830.
The Report of the Surgeon General of the Army, 1918
gives the number of Admissions to Hospitals during the
year 1917 on account of vaccinia and typhoid vaccination
combined as 19,608.

Extract from Article by Stanley Thomas, from the La-
boratory of Bacteriology, Lehigh University, Bethlehem,
Pennsylvania, Published in the Journal of Infectious
Diseases, November, 1927.
"The dangers involved in its use [vaccine virus], how-
ever, cannot be denied. Its preparation, while conducted
with the utmost care and under the best scientific super-
vision does not preclude the chance of serious conse-
quence due to contaminating bacteria. The staphylococ-
cus present in the ordinary commercial vaccine virus (in
spite of the glycerol and phenol preservative) may not
be in itself pathogenic but by aiding anaerobic conditions
it certainly can, and does, prepare a favorable field for
the growth and toxin development of the tetanus bacillus.
Although not in the vaccine itself, this organism is an
opportunist in any wound, and tetanus following vac-
cination is always to be feared.
* * *
"Recently it has been observed in Holland, Switzerland
and elsewhere that the incidence of poliomyelitis and
encephalitis apparently increased following vaccination
against smallpox.
In the light of Levaditi's work show-
ing the similarity between the virus of vaccinia and that
of encephalitis and as some doubt as to the safety of
the neuro-vaccine has been suggested by Camus, Brunet
and others, considerable skepticism would probably have
to be overcome by its users. Proof of the safety of any
product rests with its proponents. In the recent past
syphilis has received considerable attention as a possible
congener of vaccination. Papers by Winkler, Kolb,
Krapelin and Plant, and others have controverted this
theory and the same line of arguments may be used in

defence of neurovaccine if it should prove to be an ef-
ficacious prophylactic against smallpox."
Extract from Editorial in the Journal of the American
Medical Association, May 12, 1928.
"Among the excuses that are offered against com-
pulsory vaccination is the alleged occurrence of post-
vaccination tetanus. True, tetanus has been transmitted
by infected vaccine. However, extensive tests at the
Hygienic Laboratory of the U. S. Public Health Service
have failed to demonstrate the presence of the organism
in modern commercial vaccine. The tetanus bacillus was
detected more than a decade ago on 'bone point' scari-
fiers by McCoy and Bengtson; and this organism has also
been found on bunion pads that were used as vaccina-
tion dressings. The examination of other commercial
dressings, of needles, of capillary tubes, and of mild anti-
septics occasionally used on vaccination lesions has failed
to reveal the presence of B. tetani. Consequently the
government experts conclude that the occasional cases
of postvaccination tetanus which are not explainable on
the basis of the two positive observations mentioned must
be due to the presence of the specific organism at the local
site at the time of vaccination, or to its subsequent intro-
"The ever present possibility of accidental contamina-
tion because of the ubiquity of the tetanus bacillus calls
for continued vigilance."
Extract from Editorial in the New York Medical Jour-
nal, December 11, 1915, Referring to Vaccination Wounds
as Unduly Prone to Tetanus.
"Tragic events, especially if preventable in any degree,
which jeopardize a procedure of such vast importance,
should receive most earnest attention. Tetanus follow-
ing vaccination is an event of just this character. All
available evidence, both clinical and experimental, justi-
fies the belief that infections of this kind are not due to
the vaccine virus per se, but occur subsequently, and are

attributable to later contaminations of the vaccination
wound. In all justice, however, it must be admitted that
experience also teaches, despite all contrary evidence,
that vaccination wounds, at least in children of certain
ages, are unduly prone to such infections. The reasons
are not apparent."
Extract from Editorial Entitled "Pure Vaccine Virus"
in the New York Medical Journal, New York, July 17,
p. 149. "The next step, after cleansing the patient,
was the investigation of the virus. It was found that
bacteria of many sorts were present constantly. The
attempt was then made to decrease the number, and ex-
periments showed that mixing the virus with concen-
trated glycerine and keeping it in the refrigerator for
two or three months caused a great reduction. The
spores that might be present, however, were not affected,
while the activity of the virus was impaired considerably.
This method of preparation, nevertheless, is what is com-
monly employed today; infections are not numerous, but
the percentage of 'takes' may not be as great."
Armstrong, Charles: Tetanus Following Vaccination
Against Smallpox and Its Prevention, "Public Health Re-
ports" December 16, 1927. (Refers to 98 cases of tetanus
following vaccination "over a period of several years.")
Armstrong, Charles: Tetanus Following the Use of
Bunion Pads as a Vaccination Dressing, "Public Health
Reports" June 26, 1925. (Refers to 11 cases of tetanus
following vaccination, of which 9 cases were fatal).
Sir William Osier, M.D. in "Principles and Practice of
Medicine," 1924 Edition. Dr. Osier says: "McFarland

collected 95 cases, practically all American. Sixty-three
occurred in 1901, a majority of which could be traced
to one source of supply, in which R. W. Wilson demon-
strated the tetanus bacillus. Most of the cases occurred
about Philadelphia. Since that date very few cases have
been reported. The occurrence of this complication em-
phasizes the necessity of the most scrupulous care in the
preparation of the virus, as the tetanus bacillus is almost
constantly present in the intestines of cattle."
Anderson, John F.: Post-Vaccination Tetanus, "Public
Health Reports," July 16, 1915.
Photographic extract from a page advertisement published in
numerous medical and public health journals including the follow-
ing: American Medicine, August,
1927; Medical Review of Re-
views, August,
1927; American Journal of Public Health, Septem-
1927; Medical Journal and Record, August 17, 1927; The Jour-
nal Lancet, August
15, 1927 and September 1, 1927; The Canadian
Medical Association Journal, September,
1927, and The Journal of
the American Osteopathic Association, September,
yield to this
WHERE the vesicles inflame and
deep excavated ulcers result.
The bad arm does not manifest until
after "the take," so that the antiseptic

News Item from the Scranton (Pa.) Times, September
25, 1928.
Wilkes-Barre, Sept. 25 (AP).—Mary Woytkwycz, six,
died at a local hospital last night of lockjaw. The little
girl started to school on Sept. 4 and was vaccinated by a
physician. Infection followed and on Friday her jaws
locked. Several hundred thousand units of tetanus anti-
toxin serum were used in efforts to save the child.
News Item from the Washington (Pa.) Observer, Sep-
tember 26, 1928.
York, Sept. 25.—Lockjaw, said to have developed from
vaccination, today caused the second death of a child in
York county in the last 36 hours.
Fairy Crone, 6, of York, died today, while Clair Draw-
baugh, 7, of Dover, near here died late Sunday.
Both children had recently entered school and were
vaccinated in compliance with the law. Tetanus set in
suddenly in both cases and the children were in serious
condition when physicians were called.
It was said no investigation is planned.

Marked Photographic Reprint of Extracts From Death
Certificate of Dorothy Schmoyer, Allentown, Pa., Who
Died July 27, 1927 As a Result of Vaccination Prepara-
tory to Attending School.

News Item from the Philadelphia Record, July 28, 1927.
Allentown, Pa. July 27—Dorothy, 5-year-oid daughter
of David Schmoyer, of Alburtis, died in the Allentown
Hospital today of tetanus. She was admitted yesterday
and, although surgeons made every effort to save the
child's life, their efforts were in vain. The little girl
was vaccinated several days ago, preparatory to attend-
ing school in the fall.
(Note:—The death certificate of Dorothy Schmoyer
specifically mentions Vaccination as a contributory cause
of death. H. B. A.)
News Item from the Scranton Republican (Pa.), October
5, 1927.
Wilkes-Barre, Pa. Oct. 4. (AP).—Frank Shukowski,
[Franciszek Szumowski] aged 7, of Georgetown, a sub-
urb, died at a hospital tonight of lockjaw. The boy was
indirectly a victim of a vaccination. He was vaccinated
three weeks ago to enable him to go to school. Last week
in playing with other boys, the scab was knocked off
and the wound became infected and tetanus set in.
(Note:—The death certificate of Franciszek Szumowski
gives Tetanus as the cause of death. No contributory
cause is mentioned. H. B. A.)
News Item from the Philadelphia Record (Pa.), Novem-
ber 3, 1927.
Death Follows Vaccination. Special to "the Record."
Allentown, Pa. Nov. 2.—Margaret, 6-year-old daughter
of John Montgomery, died today at the Allentown Hospi-
tal of lockjaw.
(Note:—The cause of death of Margaret Montgomery as
stated in the death certificate was "Tetanus—Contribu-
tory—Vaccination Against Smallpox."—H. B. A.)
News Item from the Newburgh, N. Y. News, July 7, 1926.
Peekskill, July 7—Geraldine Creamer, aged 4 years,
daughter of John and Mary Quinn Creamer, died in
Peekskill Hospital from lockjaw. The girl had been vac-
cinated on June 20 and it is believed that the lockjaw

germs entered the body through a vaccination wound
while she was playing in the garden soil in the rear of
her home, 611 John Street.
List of Fatalities Following Vaccination Contained in a
Review of "Pittsburgh's Vaccination Scourge of 1924"
Embodying the Results of a Special Investigation Un-
dertaken by the "Pittsburgh Health Club."
Arthur Santoro, age five years, 1509 Belasco Avenue,
(Beechview), Pittsburgh, Pa., vaccinated at school Octo-
ber 1, 1924, died October 17, 1924.
Blanche Jarmalowski, age ten months, 2741 Mulberry
Street, Pittsburgh, Pa., vaccinated July 14, 1924, died
July 31, 1924.
Minnie A. Hill, 1000 Greenfield Avenue, Pittsburgh,
Pa., vaccinated at the Court House Clinic, July 23, 1924,
died August 8, 1924.
Agnes Bik, age two years and five months, 955 Herron
Avenue, Pittsburgh, Pa., vaccinated about June 25, 1924,
at Montefiore Hospital, died August 24, 1924.
Helen Schamming, age seven years, Grant Street
(Wall) Pittsburgh, Pa., vaccinated about July 15, 1924,
died August 16, 1924.
Antoinette Oleniacz, age one year and six months, 5112
Carnegie Avenue, Pittsburgh, Pa., vaccinated July 10,
1924, died July 28, 1924.
Hilda Fleishauer, age twelve years, 1564 Westmore-
land Street, Pittsburgh, Pa., revaccinated July 9, 1924,
died August 5, 1924.
Mary Florence McGovern, age three years and eight
months, 529 North Euclid Avenue, Pittsburgh, Pa., vac-
cinated July 21, 1924, at Lincoln School, died August 23,
Ten months-old son, Victor, of Mrs. Robert Kozlowski,
3114 Brereton Avenue, Pittsburgh, Pa., died July 22,
Alice Welsh, age nineteen years, 2411 Westmar Street,
North Side Pittsburgh, Pa., vaccinated July 8, 1924, died
July 14, 1924.

Extract from Article Entitled "The 1924 Smallpox and
Vaccination Situation in the City of Pittsburgh" by R. G.
Burns, M.D., Superintendent Bureau of Infectious Dis-
eases and T. F. Moore, M.D., School Physician, Published
in the Pittsburgh Medical Bulletin, Issued by the Alle-
gheny County Medical Society, August 8, 1925:
"With so many vaccinations being performed on peo-
ple living and working in places where the sanitary con-
ditions are far from good, and who have practically no
knowledge of personal hygiene, it is to be noted that
very few serious and fatal secondary infections happened;
three probable and a fourth possible case of this kind
did occur.
Rumors of all kinds came into the Depart-
ment of Public Health with claims of very many deaths
due to vaccination, and in all cases a thorough investiga-
tion was made by a physician, and, except as stated, these
rumors were found to be false."
Extract from a Pamphlet Entitled "Vaccination Results
in New York State in 1914 Being a Study of Forty-nine
Cases With Portraits and Certain Conclusions," by
James A. Loyster, Cazenovia, N. Y., in Memory of His
Son Lewis Freeborn Loyster Who Died September 21,
1914, as a Sequence of Vaccination.
p. 36-37. "As a result of the investigation of over fifty
vaccination disasters and the almost constant study of
vaccination literature for several months, it seems that
the following conclusions are warranted and should be
frankly stated:
"(1) Vaccination has been the cause, directly or indi-
rectly, of the death of at least fifty children in New York
state in 1914. The record herewith printed gives only

the cases occurring in rural or suburban districts.
Neither the time nor means were at hand to make a can-
vass of the cities. While only 27 fatalities are here re-
corded, some of which are not clearly proven, it is be-
lieved that were the figures from the cities obtainable
possible errors in the list would be more than offset and
enough reported to swell the total to the number given.
"(2) In addition to the deaths an appalling trail of
illness has followed vaccination. It has been entirely be-
yond the scope of this publication to print even a partial
record of these cases.
"(3) The cost in illness and destruction of child life
is entirely out of proportion to the amount of protection
against smallpox that is attained or needed. There were
but three deaths from smallpox in the entire state, includ-
ing Greater New York, in 1914. In one rural district
twenty miles in diameter, where four children died from
vaccination, there has not been a single case of smallpox
within the memory of any person now living."
Extract from Book Entitled, "The Vaccination Ques-
tion," by C. Killick Millard, M.D., Medical Officer of
Health for Leicester, England, 1914.
p. 22. "It cannot be denied that vaccination causes,
in the aggregate, very considerable injury to health,
most of it only temporary, but some permanent. It is
true that the deaths certified as due to vaccination are
less numerous now than they used to be, but some deaths
still occur every year. . . . During the last decade the
deaths from vaccinia have several times outnumbered
those from smallpox, whilst if we have regard to the
amount of ill-health caused by the two diseases (and
putting aside for the moment the question of the alleged
effect of vaccination in lessening smallpox) it looks as

if vaccinia were becoming, so far as the community is
concerned, the more serious disease of the two . . . . "
Report of Committee on Vaccination in England Com-
pares the Dangers from Vaccination to Dangers from
Extracts from Report of the Committee on Vaccination
Presented by the Minister of Health to Parliament by
Command of His Majesty, July, 1928.
p. 87.
'If London be excluded, the prevailing type of small-
pox in England and Wales has been mild since the be-
ginning of the century. Witnesses have appeared before
the Committee who have held that there are now two
distinct types of smallpox—the mild and the severe.

The Committee are not in a position to determine whether
or not these types constitute separate entities, or are
merely variations of one disease, or if the mild type and
the severe may. become transformed the one into the
other. Whether or not these forms of smallpox are
simply variants or are separate entities, there is universal
agreement that recent successful vaccination protects
against both. Witnesses affirmed that the bodily dis-
turbance and discomfort produced by the vaccination
of an adult is as great, if not greater, than the disturb-
ance and discomfort produced by an attack of smallpox
of the mild type.
"The deaths from smallpox and from vaccinia as given
in the Registrar-General's Returns during the last 10
years have been as follows:—

Number of Deaths from
Year                                Smallpox Vaccinia
1926...........                    18                    1
1925...........                      9                    3
1924...........                     13                    1
1923...........                      7                    8
1922...........                    27                    4
1921...........                      5                    3
1920...........                    30                    9
1919...........                    28                    1
1918...........                      2                    3
1917...........                      3                    6
"It is also true, as hereinafter recorded, that 93 cases
of post-vaccinal nervous disease with 51 deaths have
been reported in this country between November, 1922,
and the end of September, 1927, during which period
approximately 2,000,000 vaccinations and revaccinations
were performed at the cost of the rates; that 124 cases
with 38 deaths have been reported from Holland between
1923 and August, 1927, and that a few similar cases have
been reported in other countries. Nine English cases
and one Dutch were under one year of age."
Extracts from the Report of the Commission on Small-
pox and Vaccination of the Health Organization of the
League of Nations, Geneva, August 27, 1928.
"5 The post-vaccinal encephalitis with which we are
dealing has become a problem of itself mainly in conse-
quence of the events of the last few years in the Nether-
lands and England and Wales. In each of these coun-
tries the cases which have occurred have been sufficiently

numerous and similar to require them to be considered
collectively. Their occurrence has led to the realization
that a new, or at least a previously unsuspected or un-
recognized, risk attaches to the practice of vaccination.
This risk, when taken at its maximum value, is only
minute in proportion to the vast numbers of normal vac-
cinations to which the cases of post-vaccinal encephalitis
correspond, and it is easy to exaggerate its importance.
Nevertheless, it is one whose existence, in these two coun-
tries at any rate, has to be recognised, and its meaning-
considered. In fact, it has in the Netherlands been con-
sidered of sufficient gravity to cause the temporary sus-
pension of the administrative measures by which the
vaccination of children is secured, while in England the
subject has already received the attention of two expert
Committees appointed by the Ministry of Health, the
second of which (the Rolleston Committee) has now pre-
sented a comprehensive report, embodying the informa-
tion and conclusions arrived at by the first or Andrewes
Committee, whose work was described to this Commis-
sion in 1926.
"6. In the Netherlands, 139 cases of disease of the
central nervous system following vaccination were de-
scribed during 1923 to 1927, of which 41 died. In Eng-
land and Wales, taking the arbitrary periods dealt with
respectively by the Andrewes and Rolleston Committees,
62 cases with 36 deaths occurred between November 14th,
1922, and November 1st, 1923, while a further group of
40 cases occurred between January 1st, 1926, and
September 30th, 1927. Of these 40 cases, however, 15
were excluded by the Rolleston Committee on account of
their doubtful nature, leaving for consideration 25 cases,
of which 12 died, in the second period. The two com-
bined, on this basis, gave a total of 87, of which 48 were
fatal, for England and Wales during the two periods
under investigation by these Committees.

"17. Conclusions: The facts and considerations which
have been before the Smallpox and Vaccination Commis-
sion at its present session seem to permit the following
"(a) The foremost of these is the rarity of cases of
post-vaccinal encephalitis, even in the countries specially
affected, by contrast with the number of vaccinations.
We are in fact concerned with a minimal proportion of
"(b) Apparently the matter is not one in which mere
coincidence between vaccination and encephalitis can be
invoked; in other words, we are not dealing with a merely
fortuitous occurrence.
"(c) In our present state of knowledge we must con-
clude that post-vaccinal encephalitis is a different dis-
ease from encephalitis lethargica. The conditions under
which post-vaccinal encephalitis has manifested itself in
the Netherlands and in England and Wales tend to show
that children between 3 and 13 years of age are par-
ticularly susceptible, whilst infancy and adult ages are
almost wholly exempt. All observations point to the con-
clusion that the appearance of encephalitis is not con-
nected either with particular strains of lymph or with
particular accidents of lymph preparation.
" (d) Passing to the aetiologico-pathological side of the
problem, it would appear in our present state of knowl-
edge that the virus of vaccinia of itself cannot be con-
sidered responsible for the supervention of encephalitis.
Rather it has to be supposed that some unknown factor
exists—perhaps bacterial or a filter-passing virus, or a
latent virus—which, by means of a reciprocal reaction,
determines the occurrence of the accidents in question."

Extract from Report of J. A. Putto, M.D., of the Nether-
lands in the International Health Year Book, 1925,
Issued by the Health Organization of the League of
p. 354. "Post-vaccinal Encephalitis. As in 1924, a cer-
tain number of cases of post-vaccinal encephalitis were
registered in 1925. Dr. van Bouwdijk Bastiaanse was
the first to draw attention to the existence of this disease
in the Netherlands. He submitted the results of his in-
vestigation to the Department of Public Health. He was
then instructed, together with Dr. Terburgh, the Inspec-
tor-General of Public Health, and Dr. Bijl, the head of
the Bacteriological Section of the Central Public Health
Laboratory, to undertake an exhaustive enquiry, the re-
sults of which were discussed at the Conference held
early in January, 1926 at The Hague, under the chair-
manship of Professor Ricardo Jorge. On the advice of
Dr. van Bouwdijk Bastiaanse, the English methods were
adopted in 1926, and Professor Aldershoff, M.D., Direc-
tor of the State Serological Institute, prepared a serum
for use in cases of post-vaccinal encephalitis."
Extract from Article on, "Smallpox and Vaccination,"
in The New International Year Book for 1926.
"Beginning some time in 1925, physicians in Holland,
Germany and Switzerland reported to the proper health
authorities that scattered cases of cerebral disease had
developed during the first week after vaccination, and
that contaminated lymph could not be accused. The total
number was not large, not over fifty, and was scattered
over a very wide area. ... Little chance was given for
a study of the disease. Medical societies and health

boards began an investigation in the affected localities,
and, pending reports, orders were issued to dilute the
lymph considerably more than usual and to refrain, for
the time being, from vaccinating all ailing and delicate
"Thus far, no reports on these cases seem to have
been made in the countries but in April, 1926, the atten-
tion of the ministry of health of Great Britain was called
to the subject. Although no cases had been reported
for that country, an investigation of past records was
ordered. The report of this investigation is found in the
Lancet for September 4. All deaths following vaccina-
tion were subjected to inquiry for years back. It was
found that during the past 14 years 7 such cases had
come to light in Great Britain. These are reported in
full in the British Journal of Experimental Pathology
for October. ... A crucial point was the possibility that
this affection may complicate smallpox; in such case there
is the greater likelihood of it as a result of vaccina-
tion. . ..
"For the past ten years, lethargic encephalitis, or
'Sleeping sickness,' has appeared in most of the coun-
tries of the world, and is practically a new disease. This,
in the opinion of many, indicates a lowered resistance of
the brain tissues to certain infections. If the brain of
civilized man is becoming more vulnerable in this respect,
it may throw a little light on these cases."
Extract from Communication by Netherlands Corres-
pondent, Journal of the American Medical Association,
January 22, 1927.
"Postvaccinal Encephalitis"
"The publication of the reports of several cases in
which encephalitis is alleged to have been the result of
smallpox vaccination has aroused considerable interest.
The statistics of 1924 and 1925 make reference to thirty-
five cases, fifteen of which resulted fatally. It should be

emphasized that these thirty-five cases developed out of
a total of more than 250,000 vaccinations, which makes
the percentage of cases very small indeed. Nevertheless,
the observations prove that vaccination is not absolutely
without danger and furnish arguments to those who op-
pose making it obligatory. Dr. Terburgh, the general
inspector of public health, has addressed a circular to
the medical profession requesting that information be
sent to him in regard to any untoward consequences of
smallpox vaccination be they never so slight, in order
that statistics may be secured that will be valuable in
connection with this question which is of great import-
ance for social medicine."
Extracts from London Letter to the American Medical
Association, Published in the Journal of the American
Medical Association, August 25, 1928.
"In the Section of Pathology and Bacteriology, Pro-
fessor Mclntosh called attention to the fact that clinical
accounts of smallpox contain frequent references to the
appearance of symptoms which suggest involvement of
the nervous system. In recent years a new type of en-
cephalitis had been observed in relation to vaccination.
Professor Turnbull had noticed the occurrence of this
particular type so long ago as 1912. Altogether, some
hundreds of similar cases had now been reported in
Postvaccinal encephalitis bore a constant rela-
tion to vaccination, as regards both time and place. The
condition manifested itself on the average from ten to
fourteen days after vaccination as headache, delirium
paresis, and ultimately coma and death in fatal cases.
Some doubt had existed whether or not the condition
was vaccinal in origin. Professor Mclntosh thought that
the vaccine virus was the causal agent, and presented
a body of evidence in favor of this view."

Extract from "A Layman's Handbook of Medicine," by
C. Cabot, M.D., 1916.
p. 403. "Certain things ought to be said about vac-
cination, because questions are often raised as to the
dangers of the process, arid as to the degree of protec-
tion which it gives. In the first place, the reason that
the antivaccinationists' propaganda gets so much power
is that people are afraid of having some disease put into
their blood. I suppose the disease that they are afraid of
is syphilis. I do not know of any well-authenticated case
where a person has had a syphilitic lesion on the site of
a vaccination, but one cannot deny the possibility of such
a lesion provided vaccination were done with criminal
carelessness. The other thing that bothers people is
the fact that vaccination sores get septic, sometimes when
the vaccination is clumsily done, and sometimes when
it is correctly done. We need not necessarily blame the
doctor because the patient has a bad arm. In spite of
all precautions, if the patient is in bad condition, any
break in the skin may become septic."
Extract from Article by H. E. Hasseltine, Published in
"Public Health Reports," the Weekly Bulletin of the
United States Public Health Service, January 5, 1923:
"After observing this small series of cases, one can-
not escape the conviction that vaccinia had something
to do with the appearance of the leprous manifestations
in the successfully vaccinated cases. This phenomenon
may also explain some of the opinions held by the older
Hawaiian laity, that in many cases vaccination was the
cause, or at least the exciting cause, of leprosy. During
the days of arm-to-arm vaccination the possibility of the
spread of leprosy by this procedure must be admitted.
It is more probable, however, that the vaccination served
to bring to light latent or unrecognized leprosy."

Extracts from Book Entitled "The Principles and Prac-
tice of Medicine" by The Late Sir William Osier, M.D.,
Fellow of the Royal College of Physicians, London;
Regius Professor of Medicine, Oxford University; Hon-
orary Professor of Medicine, Johns Hopkins University,
Baltimore; Formerly Professor of the Institute of Medi-
cine, McGill University, Montreal, and Professor of
Clinical Medicine in the University of Pennsylvania,
Philadelphia, and Thomas McCrae, M.D., Professor of
Medicine, Jefferson Medical College, Philadelphia; Phy-
sician to the Jefferson and Pennsylvania Hospitals,
Philadelphia, and Formerly Associate Professor of
Medicine, Johns Hopkins University, Ninth Edition, 1924.
p. 338. "Generalized Vaccinia.—It is not uncommon
to see vesicles in the vicinity of the primary sore. Less
common is a true generalized pustular rash, developing
in different parts of the body, often beginning about the
wrists and on the back. The secondary pocks may con-
tinue to make their appearance for five or six weeks
after vaccination. In children the disease may prove
fatal. They may be most abundant on the vaccinated
limb, and occur usually about the eighth to the tenth
"(c) Complications.—In unhealthy subjects, or as a
result of uncleanliness, or sometimes injury, the vesicles
inflame and deep excavated ulcers result. Sloughing and
deep cellulitis may follow. In debilitated children there
may be a purpuric rash with this. Acland thus arranges
the dates at which the possible eruptions and complica-
tions may be looked for:
"1. During the first three days: Erythema, urticaria;
vesicular and bullous eruptions; invaccinated erysipelas.
"2. After the third day and until the pock reaches
maturity; Urticaria; lichen urticatus, erythema multi-
forme; accidental erysipelas.
"3. About the end of the first week: Generalized vac-
cinia; impetigo; vaccinal ulceration; glandular abscess;
septic infections; gangrene."

Declaration by the late Senator Dolliver, of Iowa, in
the United States Senate, February 25, 1909.
"The Department of Agriculture in its effort to sup-
press the foot-and-mouth disease traced that disease to
virus imported into the United States by our manu-
facturing chemists and sold to our people. The investi-
gations revealed that this virus, used upon calves in the
District of Columbia, communicated the foot-and-mouth
disease to them.
The investigations also showed that
these diseases are almost universal in the countries of
Europe, in Asia, Japan, the Philippine Islands, and in
practically all the countries from which we import our
medical viruses, including the vaccine for smallpox and
kindred diseases."
Copy of Conclusions Contained in Circular 147, Issued
by the Bureau of Animal Industry of the United States
Department of Agriculture, June 16, 1909, Giving the
Findings of Drs. John R. Mohler and Milton J. Rosenau
in an Investigation Conducted by them of "The Origin
of the 1908 Outbreak of Foot-and-Mouth Disease in the
United States."
"(1) The recent outbreak of foot-and-mouth disease
in this country started from some calves used to propa-
gate vaccine virus.
" (2) The vaccine virus used on these calves has been
proved to contain the infection of foot-and-mouth disease.
"(3) The outbreaks of foot-and-mouth disease in
1902-3 probably had a similar origin.
" (4) It is probable that the foot-and-mouth infection
got into the vaccine virus in some foreign country where
the disease prevailed, and was introduced into the United

States through the importation of this contaminated
"(5) The symbiosis between the infections of vac-
cinia and foot-and-mouth disease is especially interesting.
Animals vaccinated with the mixed virus, as a rule, show
only the lesions of one of these diseases, namely, vaccinia;
nevertheless the infectious principle of foot-and-mouth
disease remains in the vaccinal eruption."
Extract from "Farmers' Bulletin" No. 666, by John R.
Mohler, V. M.D., Assistant Chief, Bureau of Animal
Industry, in an Article Entitled "Foot-And-Mouth
Disease," published by the United States Department of
Agriculture, April 22, 1915.
p. 15. "Foot-and-mouth disease is primarily and
principally a disease of cattle; secondarily and casually,
a disease of man. ...
It is doubtful whether the dis-
ease can be transmitted to man by cutaneous or subcu-
taneous inoculation, though it is probable that the infec-
tion may be communicated if the virus directly enters
the blood through wounds of any kind....
The symptoms
in man resemble those observed in animals."
Extract from "Epidemiology and Public Health," Vol-
ume 1, 1922, by Dr. Victor C. Vaughan, former President
of the American Medical Association.
p. 199. "At the present time the bovine virus is used
in most countries. However, Shera, writing in 1918,
gives the following method for the preparation of vac-
cine employed in England.
" 'Female calves from two to four months old are taken.
They are sometimes tested with tuberculin and always
kept under observation for a few days, then clipped and
thoroughly cleansed. The belly is completely shaved and

prepared as for operation. About 100 small scarifica-
tions are now made under strict asepsis. Slight bleed-
ing occurs, which is mopped up. The virus, which is
obtained from a human case and preserved on sterile
bone "slips," is inoculated on each area. The lesions
are allowed to dry. Sterile gauze then covers the lesions.
The animals are kept clean, excreta being promptly re-
moved. The animal must not kick itself. Within 48
hours a reaction occurs, and the animal is killed after
six days. Strict asepsis, as for operation, is observed.
The field of papules is cleansed and curetted. After
curettage serum exudes. "Slips" are charged with this,
and the pulpy exudate is made up thus:
Glycerin                               50%
Water                                  49%
Phenol                                   1%
"The glycerin pulp is left standing three to four
weeks, as it is always infected with bacteria. At the
end of this time these should have undergone dissolution.
The pulp is then triturated and put up in capillary tubes.
The vaccine is tested bacteriologically and not put up
till sterile. Also it is tested for tetanus and its potency
estimated by the type of vesicle it produces.' "
Extract from "Epidemiology and Public Health," Vol-
ume 1, 1922, by Dr. Victor C. Vaughan, former President
of the American Medical Association.
p. 199. "According to Park, the most reliable seed
Virus is what he calls the human-calf-rabbit virus. Crusts
from healthy children are collected on the nineteenth
day after vaccination and worked into an emulsion with
sterile water. With this material an area of about six
inches square on the prepared abdomen of a calf is inocu-

lated, while the remainder is planted with the ordinary-
vaccine. The virus from the limited space is separately-
collected and after being glycerinated is diluted with
12-1/2 parts of a normal salt solution and planted on the
properly prepared, shaved skin of the backs of rabbits.
The pulp from the rabbit vaccination is used for vac-
cinating calves. Usually within 24 hours after vaccina-
tion the scratches become pink, within another day
slightly raised and papular, and within from four to six
days typical vaccinia vesicles are developed. In remov-
ing the material the scarified surface is washed with
warm water and soap and then thoroughly with sterile
water. The crusts are carefully picked off with sterile
forceps and the contents of the vesicles removed with
a curette. The mass of material thus obtained is placed in
sterile beakers or tubes and treated with a mixture of
water, glycerin, and carbolic acid, as given above in the
English formula. According to Park, one calf should
yield about ten grams of pulp—enough to vaccinate about
1,500 people. The efficiency of the virus is determined
by inoculation on the shaved backs of rabbits. Dilu-
tions of the virus, 1 to 10 and 1 to 100, are made, and a
proper virus should produce vesicles on the rabbit in a
dilution of 1 to 500 at least. The number of bacteria in
the glycerinated preparation can be determined by the
plate method. Usually, practically all bacteria disap-
pear from the glycerinated preparation within a month.
However, in all instances white mice should be inocu-
lated in order to prove the absence of the tetanus

Declaration by Dr. M. J. Rosenau in an article entitled
"The Federal Control of Serums, Vaccines, Etc." in the
Journal of the American Medical Association, January
22, 1910.
p. 249. "The government does not guarantee that each
vaccine point or each package of antitoxin will produce
its full therapeutic effect and be free from all danger.
This would be impracticable with the extent and variety
of the business in biologic products now carried on in
this country and abroad. It would be ideal if the govern-
ment could guarantee the purity and potency of each
package, but to do so would require more than super-
vision—it would almost mean government ownership."
Copy of item entitled "Bacteria in Vaccine" published in
the Encyclopedia Americana, Volume 27, stating that
all vaccine virus contains many varieties of bacteria,
some of these may be pathogenic, but the majority are
"The many investigations made of the bacteria found
in both the humanized and bovine virus are almost con-
clusive that they are in no wise connected with the spe-
cific cause of vaccinia. All vaccine virus contains many
varieties of bacteria, some of these may be pathogenic,
but the majority are harmless.
Their origin may be
from several sources from an antecedent virus, from the
skin, from the alimentary tract of the vaccinated animal
and from external contamination. Bovine virus usually

contains the pus organisms, the staphylococcus aureus
and albus, the streptococcus and in rare instances the
tetanus bacillus. A vaccine virus may contain a great
number of bacteria and yet be harmless; on the other
hand only a few of the pathogenic varieties, and may
cause serious consequences. As a rule the number of
bacteria may be taken as an index of impurity result-
ing either from a faulty preparation, or not subjected
long enough to the action of the glycerine. Any treat-
ment to which the vaccine tissues are subjected, with
a view to freeing it from the extraneous bacteria, in-
fluences its potency to a more or less degree. If glycer-
ine be added, the number will gradually diminish. So
in order to obtain the best results it usually follows that
there arrives a time when such virus is free of bacteria,
or nearly so, and when its potency is very little impaired.
The Japanese have discovered that vaccine virus to
which glycerine has been added, can be made to with-
stand considerable quantities of pure carbolic acid and
in such strength as to kill the extraneous bacteria, and
to do so without materially impairing its potency. Fur-
ther, the vaccine virus can be produced bacteria free in
certain animals, such as the male rabbit and calves, as
has been suggested by Noguchi, but as yet this is in the
experimental stage.
"The preservation of the virus in a highly potent state
is all important, it is quite sensitive to heat; the hot
weather of the summer months causes it to deteriorate
rapidly. Low temperatures on the other hand preserve
it, and particularly is this so if the temperature is be-
low the freezing point. Elgin of this country was first
to discover this fact, which was confirmed by Green of
England. Vaccine virus when subjected to very low
temperatures and maintained, thus with but little varia-
tion will remain potent for months, even as much as two

Declaration by Dr. William Brady, in a syndicated
article in the Ohio State Journal, Columbus, Ohio,
October 21, 1923.
"No one knows what vaccinia is, whether a 'take' gives
the subject cowpox or a modified form of smallpox. No
one knows whether cowpox is a distinct disease or
smallpox modified by passing through the animal. No-
body has discovered the germ or organism, which we
believe causes smallpox. Nobody has isolated a specific
germ or organism from the virus employed for vaccina-
tion. No one can be absolutely certain that the virus
employed for vaccination will not convey to the subject
vaccinated some accidental infection as well as vaccinia."

Education Law, Conflict With 18
Employment, Vaccination A
Requirement for......29, 50
Encephalitis .10, 14, 99, 110-115
Encyclopedia Americana ... 122
England......8, 20, 22, 53, 56
......62-64, 74, 108,109, 119
Evans, Dr. W. A.......... 42
Fees for Vaccination .36, 37, 38
Food, Vaccination a Require-
ment for............... 32
Foot and Mouth Disease.. .118
Franco-Prussian War..... 84
Freedom......15-20, 24-28, 33
Georgia .................. 2
Germany...........13, 14, 113
Germs, Doctors to Court and
Woo ................... 33
Green, Dr. Frederick R. .. 25
Hawes, John B., M.D....... 45
Holland........10, 99, 110-115
Hoyne, Archibald, M.D..... 79
Illinois Health News....... 34
Illinois Medical Journal .38, 79
Indiana................15, 25
Italy ..................67, 85
Japan .................66, 75
Jenner, Edward........... 55
Journal of the American
Medical Association .....
........27, 39, 47, 100, 115
Journal of Infectious Dis-
eases .................. 99
American Medicine........ 19
Arizona ..............3, 4, 61
Arkansas ................ 2
Australia.......11, 71, 72, 76
Baxter, Governor Percival
P ......................24
Boston Medical & Surgical
Journal..............38, 45
Brady, Dr. Wm.......19, 124
Breeding, Dr. W. J........17
Cabot, Richard C, M.D___116
California...........5, 16, 62
Canadian Medical Associa-
tion Journal............ 78
Cards to Parents, Mislead-
ing Wording Of......... 30
Carr, Dr. J. W............ 22
Chapin, Dr. Charles V.....78
Chicago.................. 7
Coercion, Examples of .. .29-32
Commercialism Behind Vac-
cination Requirement . .34-41
Connecticut .............. 2
Constitution, U. S......... 28
Craster, Dr. C. V.......... 57
Declaration of Independence 27
Department of Agriculture,
U. S................118-119
Dickie, Dr. Walter N....... 16
Diphtheria .........34, 35, 59
District of Columbia...... 2
Dolliver, Senator..........118
Draper, Andrew S.......18, 36
Dust Preparations ......94-97

Keen, W. W., M.D..........  81
Kentucky.................    2
Kerr, J. W................    3
King, Dr. Wm. F...........  15
Koehler, Dr. John P........  49
Lancet (London) .......... 20
League of Nations.....110-111
Leake, Surgeon, J. P.. .1, 52, 91
Loyster, James A..........107
Mclntosh, Professor.......115
Maine ..................6, 60
Maryland ................ 2
Massachusetts.....2, 7, 42, 60
Massachusetts Department
of Health............... 41
Maternity and Infancy Act 24
Medical Journal and Record 94
Medical Politics.. .25-27, 42-48
Metropolitan Life Insurance
Mexico, Waives Vaccination
Requirement for Physi-
cians ................... 33
Michigan................. 44
Michigan Department of
Health ...... 30, 35, 80, 87
Millard, C. Killick___8, 56, 108
Milwaukee Health Board... 49
Minnesota................ 3
Monger, Dr. John E........ 15
Moore, Dr................44
National Anti-Vaccination
League................. 64
National Education Ass'n.. 47
Nelson, C. S., M.D......... 38
New Hampshire .......... 2
New International Encyclo-
pedia .................. 77
New International Year
New Jersey.............. 2
New Mexico.............. 2
New York ...............
___2, 18, 24, 36, 45, 105, 107
New York City .......... 58
New York City, Department
of Health............41, 46
New York Medical Journal
New York Medical Week... 33
New York State Journal of
Medicine.............46, 48
Newark, N. J............. 57
Newspaper Publicity ...46, 50
North Carolina .........2, 45
North Carolina State Board
of Health............37, 42
North Dakota.........3, 5, 61
Ohio ...................2, 15
Oregon .................. 2
Osier, William. .79, 98, 101, 117
Park, Dr. Wm. H.......... 46
Pennsylvania___2, 45, 103-107
Pfeiffenberger, Dr. Mather. 34
Philippine Islands ... 69-71, 85
Pierce, Dr. C. C............ 29
Pittsburgh Health Club___106
Poison Ivy ...............75
Propaganda, Medical ... .46-51
Rankin, Dr. W. S.......... 37
Red Cross................ 32
Religion, Disregard for ... 31
Rhode Island ............. 2
Rosenau, Dr. M. J........122
Royal Commission on Vacci-
nation ............8, 53, 55
Serumization, Wholesale. .91-97
Smallpox Inoculation___53-54
Smallpox, Mildness of.....

United States, Smallpox In
.........20, 51, 64-65, 73-78
Utah..................... 3
U. S. Public Health Service
..............1, 3, 15, 29 51,
......52, 67, 74, 91, 101, 116
Vaccination, Dangers Of...
................20, 23, 98-124
Vaccination, Laws Relating
Vaccination, Uncertainty Of
................1, 21, 52-88
Vaccine Virus, Preparation
of .................119-121
Vaughan, Dr. Victor . .119, 120
White, Benjamin, Ph. D___ 54
Woodward, Dr. Samuel B... 42
Smallpox, No Uniformity in
Diagnosis of .........73-79
Smallpox, Status Of......
...............20, 51, 56-87
Soldiers Made Sick By Vac-
cination ................ 98
South Carolina ........... 2
South Dakota ............ 4
Statistics, Fallacy Of___79-90
Switzerland ..............113
Tennessee ................ 17
Terrorism, Extortion By...
Tetanus Following Vaccina-
tion .................99-109
Thayer, Dr. W. S.......... 26
Trask, Dr. John W........ 75

State Medicine A Menace to
State Medicine A Menace To Democracy is the title of a
128-page book by H. B. Anderson which presents a disinter-
ested analysis of erroneous principles of public health policy.
It explains the seeming paradox that the larger the appro-
priations for alleged public health work become the more
attention is diverted from sound public health activities and
the more the enjoyment of "life, liberty and the pursuit of hap-
piness" is being taken away from the American people.
The book is based upon a painstaking study of the most im-
portant official documents and periodicals issued by health de-
partments, leading medical and sociological organizations and
other publications bearing on the subject of public health.
Issued by
Citizens Medical Reference Bureau
226 West 47th Street, New York City
Price $1.00 per copy bound in cloth
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Subscribe to the Monthly
The Bulletins and News Letters Issued by the
Citizens Medical Reference Bureau Contain Important
Facts Revealing the Fallacy Behind, and the Enormity
of the Outrage of Measures for the Compulsory Med-
ical Supervision of Everybody.
Two Bulletins and a News Letter are Issued
each month.
Send $1.00 for Six Months'
Trial Subscription
226 West 47th Street
                           New York City
State Medicine A Menace to
State Medicine A Menace To Democracy is the title of a
128-page book by H. B. Anderson which presents a disinter-
ested analysis of erroneous principles of public health policy.
It explains the seeming paradox that the larger the ap-
propriations for alleged public health work become the more
attention is diverted from sound public health activities and
the more the enjoyment of "life liberty and the pursuit of
happiness" is being taken away from the American people.
The book is based upon a painstaking study of the most
important official documents and periodicals issued by health
departments, leading medical and sociological organizations
and other publications bearing on the subject of public health.
Issued by
226 West 47th Street
                           New York City
Price $1.00 per copy bound in cloth