year being about 20 per cent. In the London Foundling Hospital, where the children are provided with wet-nurses, the deaths are 22 per cent. during the first five years, and of these 10 per cent. only die during the first year; but it should be recollected that a child is rarely admitted before the third month, and that it is during the first three months of life that the mortality is greatest. In large manufacturing towns and cities the number of infants reared by hand is greatest, and the deaths are also much the greatest; and the proportions of the survivors that become scrofulous is also the

or not until puberty, or even not until after this epoch. They are among the most influential causes of the distemper, especially when acting more or less in combination, as often observed respecting some of them. It is generally difficult to determine the influence of each, or even of several of them, when operating either coetaneously or in succession, particularly when the constitution presents an hereditary_taint, and in this case those causes are the most efficient in developing this taint into open or manifest disease. The milk of the nurse, especially if she be circumstanced or addicted as just mentioned (29), or if her health be such, ow-greatest. In London, the number of infants ing either to natural delicacy of constitution or to disease, as to render her milk insufficient, innutritious, or unhealthy, is a most influential cause of debility and disease of the infant, this disease assuming more frequently the form of internal or external scrofula, than any other. In connexion with suckling of the infant, there are several causes which often concur in the production of the morbid effect; the most influential of these are the articles of food given to the infant either supplemental of the milk of the nurse, or during and after weaning, and the state of the air which the child breathes by night as well as by day.

thus reared who die during the first year is three or four times as many as those who die from among those similarly reared in the country.

As

32. While very much of the mortality, and of the disease of the survivors, of those reared by hand, is to be imputed to this cause, much also should be referred to the kind of food which is substituted for the milk of the mother, to the air which the infant breathes, and to the other circumstances by which it is surrounded. respects the kind of food which is thus substituted, it may be stated that, in manufacturing towns, where the married women employed in 31. A. The food and drink which are best the factories rear their infants by hand, little adapted to the infant, before it has got several attention is paid to the nature of the food, and teeth, is the milk of a healthy mother or nurse; few of the children survive the first or second and in as far as a departure from this food takes year, most of the survivors becoming scrofuplace, so far will the development of scrofula lous or tuberculous. Mr. PHILLIPS justly rebe risked. When the mother is incapable of marks, that there are two things to be noted in suckling, or her milk is unhealthy or insuffi- respect of children thus circumstanced, viz., cient, a healthy nurse is required; and if she can- the nature of the food and the manner of taknot be obtained, then the best means of feeding ing it. The food, even if it be milk, instead of the infant should be adopted. In the various being drawn directly from the mother, has probcircumstances in which children are brought ably been obtained some time before from a up, it is very difficult to determine the share of purely herbiferous animal- the cow, between injury which may be imputed solely either to the milk of which and that of human milk the nature and amount of their food, or to the there is a very considerable difference, that of state of the air which they breathe, or to the the former containing more than twice as much other influences which surround them. M. BE- casein, and much less butter and sugar of milk. NOISTON DE CHATANNEUF states, that of infants Moreover, in towns the milk of cows is often nursed by their mothers in Paris, 18 per cent. unwholesome, especially to infants, owing to die in the first year, and that of those suckled the confinement of and modes of feeding these by strangers, 29 per cent die in the same time. animals, and not unfrequently to tubercular disDoubtless much of this mortality is to be im-ease developed in them by these causes. The puted to other causes, as to the close unhealthy same author justly adds, that the mode of takair of a large city, as well as to those connecting the food exercises an important influence ed with the food of infancy. Both in towns and on the health of the infant. By the act of suckcountry districts, healthy wet-nurses cannot being, a certain quantity of saliva is pressed into obtained, owing to the circumstances of the majority of those requiring them; and artificial feeding becomes their only resource. This feeding, independently of the many unfavourable influences which concur with it, fails of furnishing an appropriate nourishment; and, consequently, a very large proportion of the infants who are subjected to this mode of rearing die in their first year; and of those who live, many become the subjects of internal or external scrofula. Mr. PHILLIPS has adduced a series of statistical details, illustrating the deaths during infancy of the inmates of several infant institutions, where the children are brought up by hand; and in these the deaths in the first year appear to vary from upward of 80 to 50 per cent. In Lyons, a crowded manufacturing town, where the infants are suckled, the mortality in the first year was 33 per cent., the ordinary mortality at Lyons during the first

the mouth, and is mixed with the milk, so as to render its digestion easier. Indeed, this is essential to good digestion in infants. Moveover, the act of sucking is an exertion which can be made only for a certain time, and hence overdistention of the stomach is prevented; while, when fed by hand, the risk of over-feeding is often run, by the anxiety of the nurse, and harm from this is not unfrequent.

[Much of the milk consumed in our large cities is formed from the slop of grain distilleries, the cows yielding it being confined in close, filthy, and ill-ventilated stables. Such milk is found to contain but a small quantity of butter, of a whiter colour than natural, and associated with more curd and whey than that obtained from other milk. The milk globules are less abundant than in good milk, and of smaller size. Such milk, also, contains a larger quantity of epithelial-cells, some distinctly granular, and

others higher-coloured, than pure and healthy | longed, as it often is in manufacturing towns, milk. The sale of such milk should be prohib- the evils must be so much the greater. Mr. ited by law. The nature of fermentation and PHILLIPS states, that in the larger factory towns distillation is to abstract from the grain all the the deaths from tuberculous and scrofulous disfecula and sugar, the principles that are more eases are as 1 to 31 of the total deaths during particularly convertible into milk and butter, the first year of life, while in the metropolis they leaving the nitrogenized compounds, and also are as 1 to 42. During the whole of life they the casein and earthy matter, nearly untouch- are 1 to 5-6 in the factory districts, and 1 to 6.4 ed; hence the increased quantity of ashes, and in the metropolis. According to the experience also of casein, the nitrogenized compound in of Friendly Societies, he adds, the expectation milk, while the sugar and butter are below the of life in rural districts at 30 is 38 4 years, and usual standard. Animals thus confined become in cities 32 8 years. Of the total population diseased, tuberculous and scrofulous, and there living at the age of ten, one half will have discan be little doubt that the use of such milk appeared in cities before the age of 62, and in tends to develop these diseases in the human towns before 65; while in rural districts half subject. It is a well-known fact, that a much the population will attain nearly 69 years. The larger proportion of the children of the poor in greater longevity of the latter, or the less prev. our large cities are affected with scrofula than alence of scrofula, is not to be imputed to the of the same class in the country; and though food only, even granting this be more nutritious breathing impure air may be one of the causes, and more appropriate, for the former may pos we believe that the use of diseased milk is still sess the greater advantages in this respect; bu more efficient in producing the disease. An to the air, ventilation, exercise, &c., enjoyed by extensive dispensary practice of several years those residing in country districts. furnished a multitude of facts in support of this belief.]

33. In the greatest number of instances, instead of milk, gruel with a little milk, sopped bread, or flour, or other farinaceous substances, are used. This food is assimilated with difficulty, and readily gives rise to acidity, flatulence, and irritation of the digestive mucous surface, with all the consequent evils of insufficient secretion and excretion. and impaired nutrition. Mr. PHILLIPS justly remarks, that these evils are made evident by the following facts: "In Lancashire and the West Riding of York, the deaths in the first year of life are to the total deaths as 1 to 39; while in Devon and Wilts they are one to 64! Now it is in the great factory towns, which are found in Lancashire, Cheshire, and Yorkshire, that the system of bringing up the child by hand is most commonly practiced, and where its evils are most apparent; first in the great destruction of infant life, and, failing that, in the development of scrofula. It is not that the mother has no milk, but that in such places she is enabled to make what she considers a more profitable use of her time than by staying at home and nursing her child. Her infant may be suckled at early morn, and again in the evening; possibly, too, at the middle of the day; but whatever food it may require at the intervening periods, if furnished at all, is afforded in the shape of the crudest and most inappropriate substances, and restlessness is known, in many places, to be habitually repressed by GODFREY'S Cordial." But the mothers are not solely the guilty parties in these circumstances. The fathers are often so drunken and dissolute as to provide little or no food for their families, and the mothers are therefore obliged to be employed in the factories to provide for the wants of their children, entertaining at the same time but little desire to add to their number, or to devote much care on those which require it the most.

35. Dr. BARON HOWARD gives a just but mel ancholy description of the character of many of the operatives in large towns. "A large pro portion of those who regularly receive high wages are constantly in a state of the greates poverty, and often bordering on actual starva tion; their houses are almost destitute of fur. niture, comfortless, and uncleanly; too often damp, cold, and ill ventilated. Their families are ill fed, scantily clothed, and badly lodged. They live much on innutritious and indigestible food, and often use articles of bad quality, or such as are rendered unwholesome by adulteration, or by being kept too long. They are extremely intemperate in their habits, and, instead of purchasing wholesome food and proper clothing, the greater part of their wages is often expended by anticipation at the public house. The effect of the intoxicating liquids they consume is of course to produce a temporary excitement of the whole system, which is succeeded by a corresponding depression; they lose all relish for plain, nutritious food, and their appetites can be stimulated only by something savoury and piquant. This kind of diet does not afford sufficient nourishment to repair the losses the body is continually sustaining; great langour and debility are the consequences; for the removal of which stimulants are again had recourse to, and thus an alternately excited and depressed state of the system is kept up. By this mode of life, too, the digestive organs become impaired, and the function of digestion is so feebly and imperfectly performed, that even much less nutrition is extracted from the indigestible and impoverished diet they use than would be the case if the digestive organs were in a healthy condition." This writer adds, that "scrofula, in all its varied forms, may be mentioned as one of the commonest diseases prevalent among the destitute poor, and which frequently originate in deficiency of food." There can be no doubt of the 34. The digestion of infants is rapid, and as justness of the conclusion at which Mr. PHILthe quantity of food taken at a time is small, it LIPS arrives from his researches, namely, "that is necessary that, during the first month, the in- in Great Britain scrofula is least prevalent terval of feeding should not exceed from one where children and others are best fed; and and a half to three hours. If, in addition to in- although I by no means assume that the imappropriate food, the intervals between the pe-munity is entirely owing to better feeding, beriods of administering it be much more pro- cause where much attention is bestowed on

the food it is hardly likely that other means a number of persons or animals, without the of maintaining health will be neglected; yet I requisite renewal; or by these several causes would submit, as a fair deduction from the fore- conjoined. In a very large proportion of the going evidence, that food exercises a more im-houses in manufacturing and other towns, as portant influence than any other agent in the production of scrofula."-(Op. cit., p. 175.)

36. (a) What influence has particular kinds of food in causing scrofula and tubercles? This question has been differently, but not satisfactorily answered. Several articles of diet have been accused of producing this effect, and to certain of these I have adverted above ( 28). HALLER was among the first to mention the opinion of the prevalence of this distemper being caused by the use of potatoes. The use of these, as the staple article of food in Ireland, where scrofula is more prevalent, and the value of life is less than in England, tends to show that they may be concerned in producing these effects; but it ought not to be overlooked that they afford insufficient nourishment, and that there are other causes in operation. Mr. PHILLIPS believes that those who live almost exclusively on vegetable food in this country are less robust, and exhibit a greater tendency to scrofula, than those who subsist on an admixture of animal and vegetable food; and he considers that our own rural population, as well as that of Scotland and Ireland, bear out the assertion. "But, although it has been shown that insufficient and improper food, however associated, may lay a foundation for that disease, we have, in truth, no conclusive proof that any particular article of food directly tends to the production of scrofula."

well as in many in country districts, the waterclosets, drains, and sewers are so imperfectly constructed as to admit of the evolution of the foul air from the exuviæ, &c., of the inhabitants, not only around, but even within their dwellings, so that they who reside in those houses are constantly breathing an air loaded with the vapours arising from the decomposition of their own excretions, which remain collected under, or close to, or even within, their apartments. These sources of contamination have been fully exposed in the article PESTILENCES-PROTECTION FROM (§ 9, et seq.)

39. C. Next in importance to this source is the congregation of numbers in a close or insuffi ciently ventilated place, more especially in a close sleeping apartment. Among the most prevalent causes of scrofula and tubercles, especially in the present state of society and manners, there are perhaps none more influential than congregating children and young persons in boarding and large schools, where they are often scantily fed, and through the greater part of the day restricted in air and exercise; confined in a school-room often insufficiently or improperly warmed, and improperly ventilated, in order to economize fuel; subjected to premature mental exertion, or to cramming modes of instruction; and packed into sleeping apartments insufficiently ventilated, and much too small for the number confined in them. It is a common practice in boarding-schools, in large towns, to put from six to twenty children or young persons in the same sleeping apartment; and the

having a bed assigned to each, contented with the arrangement. Many such apartments even have not, during night, any ventilation, excepting what takes place by the fire-place, both the doors and windows being closed; and so foul does the air become by the morning, that it is sickening to a healthy person entering the chamber, so completely is it loaded with the emanations resulting from the insensible and sensible perspiration, and from having been repeatedly respired.

37. (b) The drink or beverage used by infants and children has no mean influence in favouring the development of scrofula, and of tubercles at a more advanced age. Among the low-parents are, from ignorance, or the delusion of er classes, especially in large and manufacturing towns, the frequent recourse to anodynes and carminatives, containing narcotics, sedatives, &c., in order to procure sleep or quiet for infants and young children, and to allay their wants, cravings of appetite, and irritations of temper, is of itself no mean cause of their weakness of constitution, of imperfect development of both mind and body, of scrofulous and tubercular formations, and of various other diseases, as they advance to puberty and manhood. The not infrequent practice, among the lowest and 40. This self-contamination of the air is often most abandoned classes, of giving spirituons only supplemental of the contaminations deand other intoxicating liquors to their children rived from other sources, especially from such -of causing their infant offspring to partake of as have been just mentioned; and which, althe noxious beverages in which they are them- though injurious in many private seminaries, selves indulging is productive of effects, in the are even still more so in many large institutions innocent victims, of a similar kind to those just and charities, owing to the congregation of greatstated. The vices of the parent are, in the pres- er numbers, particularly in sleeping apartments, ent state of society, not merely passively prop-to ill-regulated diet-tables, to insufficient exeragated in the offspring to even the third and fourth generation but are not infrequently most actively and feloniously extended, at the most tender and helpless periods of existence, to those for whom the ties of nature should be most intimate and indissoluble.

38. B. Contaminated states of the atmosphere are often not less influential than the nature and quantity of the food in causing scrofula and tubercles, and frequently they are the chief causes. The air may be contaminated by exhalations from drains, sess-pools, sewers, and water-closets; or by stagnation or insufficient renewal; or by being respired frequently or by

cise in the open air at a period of life which requires air and exercise for the healthy development of the frame, and to the over-exertion of the mind to the neglect of healthy pastimes and amusements. This cause is especially productive of the more internal forms of scrofula, and particularly of tubercles of the lungs, and is the more iufluential as being in continued operation during the periods of the growth and development of the frame. These congregations of young persons, especially during the age of puberty-at the period of sexual evolution, when instinctive impulses are too strong for the control of the weakly-exerted dictates of reason,

often lead to practices which tend—and tend more than any other cause, especially at such early periods of life-to exhaust the powers of life, to impair and vitiate nutrition, and to favour the production of the several forms of the distemper now being considered. This mode of life, at this early age, as well as several others to which the lowest and even the highest, are often subjected-the one from misery and necessity, the other from ignorance, vanity, and excessive care-is not infrequently rendered still more injurious by the want of due exposure to the sun and air.

|

on these topics depends upon the limitation of the term scrofula, or the extension of it to the senses already stated (§ 4, et seq.). That confinement in prisons, in poor-houses, in asylums, in charitable institutions for education or reformation, in factories, &c., will occasion some form or other of scrofula, more especially tubercular deposits in internal organs, cannot be gainsayed with truth, although this morbid effect may be manifested in so few as to almost justify the denial of its existence, especially where a sufficiency of wholesome food, exercise in the open air, due light, ventilation, and sunshine are enjoyed. But where these are more or less wanting, and especially where there are overcrowding, particularly in sleeping chambers; low ranges of temperature, conjoined with dampness; contaminated states of the air; depression of spirits or anxiety of mind, &c., the morbid effects will soon become manifest, and frequently in the forms constituting those now under consideration. Most of the causes al

41. Exhalations from privies, sess-pools, drains, and sewers, especially in large institutions, manufactories, and towns, occasion this as well as other states of constitutional disease; and to these are often added the emanations from burying-places. Among the poor, the influence of cold, often conjoined with humidity, and with over-crowding and insufficient ventilation; the exhalations from the soil, and from the animal and vegetable matters which are undergoing de-ready considered have been numerically and composition in or upon the soil; living in damp, cold cellars and apartments on the ground floor, insufficiently drained and ventilated; and want of light and sunshine, are causes which aid the operation of hereditary predisposition, and of deficient or improper food.

statistically investigated by Mr. PHILLIPS, who has thrown much light upon several of them; but, in the extended sense in which I have viewed the subject-not solely with reference to external scrofula, nor to childhood, but with regard to both the external and internal distemper, as observed at all periods of life-I believe that several causes, which he views as possess

ing of more consideration and elucidation than they have hitherto received. There can be no doubt that, in the several circumstances just enumerated, and in the different classes, positions, and employments of life, certain causes are more influential in some of these than in

rest; and that, where several causes are in simultaneous action, it is difficult to estimate the relative value of each; but, nevertheless, whatever cause has the effect of lowering the powers of life, of impairing assimilation, nutrition, and strength, will, in a considerable proportion of those thus affected, give rise to tuberculous deposits, particularly if an hereditary predisposition or constitution already exists, and will reenforce or determine the action of other agents in developing this mischief.

42. Children and young persons subjected to the causes now mentioned become delicate or sickly. The vital endowment and the structur-ed of little or no influence, are actually deserval development of the several organs and textures are impaired or arrested in their progress. Like plants growing excluded from the sun and wind, their vessels often extend rapidly in the direction of their axis; but the parietes of the vessels and their lateral branches are thinly or weakly formed, are surrounded by a lax cellu-others-in one class or occupation than in the lar tissue or parenchyma, and both the organic nerves and the animal fibres are imperfectly constituted. The formative processes seem arrested before they are completed. The circulating fluids present a superabundance of the serous and albuminous constituents, and a deficiency of fibrin and of red globules. While the blood is defective in its crasis, the blood-vessels are impaired in their tone, and the veinous and lymphatic systems are more manifestly or more prominently developed. This condition of the frame often proceeds, as shown above, from the 44. D. May scrofula and tubercles be communiparent or parents. In many cases it is acquired cated by contact or inoculation? (a) ARETÆUS bein early life from various causes, especially from lieved in the communicability of scrofula, and those now mentioned, as insufficient or improper considered it dangerous to live in the same room food, breathing an impure or self-contaminated with scrofulous persons. BAUMES, CHAUMETON, air, a cold and humid atmosphere, or dark, cold, and others, have entertained the belief of the and damp apartments, cellars, &c., the crowding transmission of the disease to infants suckled of numbers in ill-ventilated places, and particu- by scrofulous nurses. BORDEU, no mean authorlarly in sleeping apartments, premature sexuality, states that young healthy women have marindulgences, and solitary vices which waste or exhaust nervous and vital power, and consequently impair the digestive and nutritive processes, at the periods of life when due assimilation and nutrition are most required; and, while these causes often generate this state of frame, they produce, in various parts, textures, and organs, but particularly in the lungs, the deposit of tubercular matter.

43. There are other causes or circumstances influencing the constitution of young persons which have been viewed by some, and denied by others, to be concerned in the production of scrofula; but much of the difference of opinion

ried scrofulous men, and have become so themselves. BAUDELOCQUE, however, remarks that in the "Hôpital des Enfans" there are 150 beds occupied by scrofulous patients, but that he has never observed any thing that occasioned a suspicion of contagion. Mr PHILLIPS says that he never heard of a single instance of the communication of the disease by contagion in the several institutions which he has visited. PINEL and Richerand have furnished a similar testimony.

45. (b) Inoculation of scrofulous matter was practiced by HEBREARD on dogs, but no sign scrofulous infection was observed. LEPE

TIER tried similar experiments without effect; | tubercular matter may become partially resolved and Mr. PHILLIPS states that LEPELLETIER, GOODLAD, and KORTUM applied scrofulous pus to the wounds made for vaccination, and also to wounds made without reference to vaccination, but that scrofula was not produced, although the vaccination succeeded when the vaccine lymph was introduced with the scrofulous pus. Such experiments are most unwarrantable, and even criminal.

and absorbed, the cretaceous or mineral parts of the deposit only remaining, has been proved to take place, but the exact circumstances in which it does take place have been very insufficiently ascertained. RILLIET and BARTHEZ believe that small-pox more especially, scarlatina, and typhoid fever, tend to favour this resolution. That scrofulous and tubercular affections have increased since the introduction of vaccination 46. There may be but little risk of infection is undoubted; and that the dangers from the from cases of scrofula, when the disease is seat-inoculation of small-pox, under due manageed externally. But I believe that there is some ment and care in preventing the occurrence of reason for believing tubercular disease of the the non-inoculated disease, were actually few, lungs, in the second and third stages, by no although remarkably exaggerated, are also cermeans devoid of risk to healthy persons, who tain; so that, balancing the results from the inmay frequently inhale the breath of persons introduction of the one and from the suppression either of these stages of the malady, or may of the other, it is very difficult to say that husleep in the same bed, or even live in the same manity or society has gained any thing by these room, if small or ill ventilated, with persons measures. thus diseased. It should not be permitted for a sickly or scrofulous child, or even for any one with pulmonary tubercles or with open scrofulous sores, to sleep in the same bed with a healthy child or person, however confidently several writers may assert the non-communicability of this distemper; for, although this may be true in ordinary circumstances, those which I have just mentioned may favour the occurrence of very different effects.

47. (c) May pus from a scrofulous person, although not derived from a scrofulous ulcer, communicate the malady? It has been supposed that leucorrhoea in scrofulous females, and that vaccination, or variolous inoculation, from a scrofulous child, will communicate scrofula to persons of a sound constitution. Several writers have favoured the affirmative of this question, but their facts are false, and their reasoning inconclusive. Mr. PHILLIPS remarks, that "an important question is raised by RILLIET and BARTHEZ with reference to the influence of small-pox and scrofula. We have seen that DE HAEN and ROWLEY were of opinion that the inoculation of small-pox had a tendency to excite in the system the development of scrofula; while RILLIET and BARTHEZ state that, in any of the variolous cases they have observed, the eruptive fever has not been terminated by tuberculization. They believe it to be proved that small-pox and tubercular disease are of different natures, and mutually repel each other; that since the use of vaccination tubercular diseases had become more frequent; that those children who die without having had small-pox are more frequently tubercular than otherwise; and that of those vaccinated a greater number are disposed to tubercles than of those who have not been vaccinated. They, however, guard themselves from assigning vaccination as a cause of tubercles; all they have been able to observe is, that a greater number of vaccinated children die with than without tubercles. The only preeise evidence they furnish for the opinion is the following: Of 208 vaccinated children, 138 died tubercular, 70 non-tubercular. Of 95 children who died without having been vaccinated, 30 were tubercular, 65 not so" (p. 149).

48. These results certainly agree with my own observations, and confirm an opinion I have long entertained respecting the comparative effects of vaccination and small-pox upon the prevalence of scrofula. That scrofulous and

[This statement of our author, before it can be fully admitted, must be sustained by a more extensive collection and analysis of facts than has yet been presented. The observations of RILLIET and BARTHEZ have not, so far as we can learn, been confirmed by the experience of others whose attention has been turned to this subject. Our own belief is, that scrofula and tubercularis were far more common and fatal before the practice of inoculation or vaccination was introduced than they have been since. The thousands who were subjected annually to the royal touch for the cure of scrofula, shows very conclusively that the disease was by no means infrequent; while the ill-constructed habitations, the wretched diet, the neglect of personal and domestic cleanliness, and the total ignorance and disregard of sanitary observances and the laws of health, predisposed all classes of the community to this malady. We cannot, then, but regard vaccination as the greatest blessing ever conferred by science upon humanity, and JENNER as one of the greatest benefactors of the race.]

49. E. May other diseases occasion serofula and tubercles? As already shown, it cannot be doubted that vaccination favours the prevalence of the several forms of scrofula; but it is not evident how this result is produced. Can it be occasioned by the inoculation of a virus, which, although productive of a local effect, causes a certain taint of the constitution which is not prevented or removed by its elimination in the form of pustules on the external surface? According to this view, vaccination may be, in many instances, the introduction of a poison or virus, which slowly and silently contaminates the frame, without being maturated and thrown out on the surface, while small-pox has a very different effect, owing to the free suppuration of the pustules, and the elimination thereby of the morbid material or virus from the system. Besides vaccination, inflammations, measles, hooping-cough, &c., have been supposed to favour the production of scrofula; but there is not sufficient evidence to prove this occurrence, farther than that all diseases which lower vital power and resistance will more or less aid the operation of the more efficient causes of this distemper. Notwithstanding the laudation bestowed upon vaccination, I believe that, as the lapse of time allows the fact to be more fully demonstrated, it will be found to be a not unfruitful source of