was so large a factor in his professional

success.

In 1886, after his marriage to Ada Byron Armstrong, of Doylestown, he removed to Canton, Ohio. Here a serious illness, the foundation for which had been laid in his arduous country practice, made the more difficult the struggle for professional recognition in a community hostile to the homeopathic school. Homeopathy had never been aggressively represented in Canton and little attention was at first paid the new doctor, but when with returning health success began to favor him, he was subjected to the usual harassments and ridicule. He resolutely ignored these petty professional annoyances and applied himself so strenuously to winning success that his sign "Homeopathic Physician" soon became the star of promise for the sick throughout the county. His ability was soon recognized by his brother practitioners, and his advice as consultant was eagerly sought. True to his liberal spirit he was generous with all his colleagues, both with applause and service, and remembering his own early struggles, he became the friend and helper of all young practitioners, regardless of affiliation.

He was a prominent member of the Eastern Ohio Homeopathic Society, of the Ohio State Homeopathic Society and of the American Institute of Homeopathy, as well as a member of the Board of Censors and president of the Alumni Association of the Cleveland Homeopathic Medical College.

He was also prominent in the public and social life of his city, where his genial smile and pleasant address won for him the friendship of every one. His interest in young men drew from him much time and thought in endeavors to better their condition and he was for many years trustee of the Young Men's Christian Association and at the time of his death its honored president.

He was the ideal type of the general practitioner. Fertile in expedients, his papers before the various societies of which he was an enthusiastic member were always heralded with interest, and were

sure to be pregnant with valuable and practical information. He was not only the family physician but the family friend and adviser. His ministrations to the "mind diseased" were as successful as his treatment of the suffering body.

In spite of the almost incessant demands upon his time, he was strenuous in his endeavor to keep pace with the rapid progress of his profession. Ambition to achieve greater things was ever active and at the time of his death he had matured plans for and was actively engaged in preparation for a wider sphere of usefulness.

Cut off in his prime, with his chiefest work undone, we can but feel that his life was all too short; but measured by his achievements, by his place in the hearts of the people, by the good deeds and noble sacrifices which were his, his life was full and well done."- Vale.-A. B. S.

WHAT CONSTITUTES SUCCESSFUL
VACCINATION?

In another column we publish a letter from one of our alumni in which he makes some startling statements regarding the efficacy of recent vaccination in the prevention of smallpox. We do not wish to throw any discredit upon his record of these cases, but inasmuch as his experience has been so much at variance with that of others who have had extensive opportunities of observation we feel that his statements should not go without some comment.

We believe that a great many of the ideas held by anti-vaccinationists regarding the non-efficacy of vaccination are based upon a false conception of what constitutes a successful vaccination. There is no doubt but that a large proportion of cases supposed to be successfully vaccinated have only had the sores from the scarifications and are still susceptible to smallpox. A most convincing article upon this subject was read by Spalding, General Medical Inspector Department of Health, Chicago, at the last meeting of the American Medical Association. He says:

"There are doctors, and good ones, too, who have had so little experience with

vaccination that they do not know what constitutes a successful vaccination. I visited a neighboring town where a reputable physician of unquestioned ability told me he had a case of what he believed to be smallpox in a child he had vaccinated six weeks previous with a typical result. With the doctor I visited the child, found smallpox present, but absolutely no evidence of vaccination. There had been a scarification -too deep and too large--a black scab and a sore, but no vesicle, no febrile re-action and no scar. Had not some one who knows a vaccination seen this child the story would have been published to the world that a child had smallpox who had been vaccinated six weeks before the attack-a circumstance that never occurred and never will occur. Within a year there have been cases of smallpox reported by doctors as having occurred in persons after a recent vaccination. I am perfectly satisfied in my own mind that such cases are either chicken-pox, mistaken for smallpox, or more frequently the supposed postvaccinal victims are not vaccinated at all, but have sore scarifications which are mistaken for and put down as vaccinations."

Spalding also calls attention to another fruitful source of error made in the consideration of this question, viz.: the recording as vaccinated those persons who were vaccinated after exposure to smallpox. The cases referred to in the letter of Dr. Simson would come under this head. Under such conditions Spalding says that one will never get a typical vaccination scar and that it is perpetuating the old errors of the anti-vaccinationists to classify them as successful vaccinations.

A successful vaccination, according to the above author, may be known by "the presence of vesiculation, umbilication, pustulation, mild and limited inflammatory area with febrile reaction. In about twenty days from the beginning of the vesicle the resulting scab comes off. This leaves a characteristic scar unlike that produced by any other agency. This refers to a typical result only. We must look with suspicion on any vaccination lacking these characteristics."

Regarding the susceptibility of persons to vaccination and the permanency of protection resulting from successful vaccination, the above author says:

"No person is insusceptible to vaccina

tion.

That is, vaccinia can be induced at least once in every person. I have known eight, ten, and in one instance - in the practice of the late Dr. Garrott of the Chicago Health Department thirteen attempts to be made before a successful result was attained. Had Dr. Garrott stopped at the twelfth attempt the child would have been considered insusceptible. It is mischievous and untrue to teach that there is such a thing as insusceptibility to vaccinia.

"In some persons one vaccination will protect for a life-time, but in many cases the protective influence will be partly lost in from five to thirty years. It will protect against death from smallpox long after it has ceased to protect from smallpox. It is not claimed now that one vaccination gives immunity from smallpox for life, though it often does. In most persons two vaccinations are all that will take, once in childhood and once in later life. Py experience it has been found that there are comparatively few people in whom vaccination will take more than twice in the course of a lifetime."

He believes, and his belief is based upon careful investigation since 1893, that "vaccination is more certainly protective against smallpox than the figures of most of the records we get will warrant. The fault of most of these records is that they are based on the statement of the patient that he has been vaccinated. An examination of the arm will disprove this statement in a majority of instances. The records are often made by a nurse who accepts the patient's word as fact. Anyone who has had experience with smallpox knows how unreliable the patient's statements are. Ask a hundred patients if they are vaccinated and nearly every one will say yes. Examine their arms and tell them you see no mark, and they will reply that they were vaccinated but that it did not take. Of course, this is no vaccination at all. To most persons a vaccination and an attempt at vaccination is the same thing. People say they have been vaccinated whether the operation is successful or not. Had we not examined the arms of the 591 cases of smallpox in the Chicago Isolation Hospital, but taken the word of the patient for the vaccinal status, more than half of them would have been recorded as vaccinated."

He says: “I do not hesitate to say that vaccination repeated till the susceptibility to vaccine is exhausted is an absolute protection against smallpox. This is the protection given the employes in the Chicago Health Department while they are hand

ling and nursing the sick and burying the dead from smallpox, and in no instance has any of these thus employed contracted smallpox. This is the protection given the 3,200 policemen of Chicago, who, next to the employes in the health department, are the most exposed to smallpox of any class in the city. No case of smallpox has occurred among the policemen of Chicago in the ten years I have been in the health department. Vaccination on entering the school, and again seven years later, is the protection from smallpox given the 265,000 school children of Chicago, and in ten years but seven cases of smallpox have occurred among the school children, and all of these children were in school with a false certificate of vaccination. In one instance last year a child in school with a false certificate attended school two weeks while he had a mild form of smallpox and but one child in the school took the disease, and this child also was in school with a false certificate. No vaccinated school child in the Chicago schools has had smallpox during the last ten years, though Chicago suffered a severe epidemic of smallpox in 1894 and 1895, and has had a mild, almost continuous epidemic of the disease for the past three years. During the last two years more than 600 medical students have been permitted to enter the Chicago Isolation Hospital for the purpose of studying smallpox at the bedside, where they were thoroughly exposed to the disease in all forms and stages. Not one of these students contracted the disease. Before permitted to enter the hospital each student was required to have a vaccination, and if the vaccination was more than a few months old, three revaccinations.

I offer

the experience of these students as proof that vaccination with revaccination gives absolute protection from smallpox. I never saw nor heard of the vaccinated members of a family having smallpox while the unvaccinated members of a family escaped the disease. Scores of times I have sent all the unvaccinated members of a family to the hospital sick with smallpox while all other members of the same family who were vaccinated escaped the disease. This is not an uncommon occurrence. I never have seen a case of smallpox in a person who has had a typical vaccination within nine years, though I am aware that it sometimes occurs.

We do not see how such statements as these can be cast aside as worthless. Vaccination does protect from smallpox and the dangers from it are mil. While no official report has yet been made regarding the cases which have occurred in Cleveland during the past summer, yet it is stated by those conversant with the facts that none of the cases have showed a typical vaccination scar. During the past ninety days there have been in this city more than 200,000 vaccinations and without a single bad result to life or limb. One case of tetanus resulted in a vaccinated person, but the history of the case showed that the boy was perfectly well until he went in bathing and afterwards rolled and played in the sand, tearing off the scab and exposing the ulcerated area to tetanic infection from the soil.

THE VALUE OF VACCINATION IN PREVENTING AND SUPPRESSING SMALLPOX.*

By Dr. Peter Brice, Ex-President of the American
Public Health Association and President of the
Provincial Board of Health, Dominion
of Canada.

Mr. President and Gentlemen:

I accept as an honor to the great American Public Health Association and to the Committee on Vaccination, of which I am chairman, the invitation extended to me to

Read at the September meeting of the Cleveland Homeopathic Medical Society.

address so notable a gathering as that which is present this evening. The old proverb, "One touch of nature makes the whole world kin," is amply illustrated by the fact that, associated with the profession whose duty it is especially to care for the health and welfare of the people, are representatives of the most important commercial and business interests of the great manufacturing city of Cleveland. It is difficult for us to imagine that in the very year 1796 in which Dr. Edward Jenner performed his crucial experiment in vac