of deaths among primary vaccinations was one in 14,159, and the Commissioners think that for the years 1886-91 it was not substantially different. In Scotland, during the years 1883-90, the proportion was one in 38,872, the difference probably being due to the fact that in Scotland vaccination is performed within the first six months instead of the first three of life, and the majority of children are vaccinated in their own homes. Even assuming, therefore, that all the deaths certified as being connected with vaccination are so connected-which is not the case- the risk to life is very slight.

As regards the possible transmission of disease, it is true that deaths from syphilis have increased during the last twenty years among infants under one year of age. But the statistics show that the bulk of the fatality from the disease falls within the first three months of life, a fact which appears to suggest that it is mostly unvaccinated children who die of it. With regard to erysipelas, that is a disease which largely affects children independently of vaccination, and the Commissioners think the evidence conclusive that there has not been in the last forty years a substantial increase in mortality from erysipelas due to vaccination. It is undeniable, however, that erysipelas does sometimes occur after vaccination, as it does after the most trivial scratches or abrasions; but it is equally certain that attacks of erysipelas are often attributed to vaccination when in reality the one event has only accidentally followed the other. The same thing may be said of skin eruptions; I have myself known vaccination to be postponed for some reason, and the child has within a few days developed a skin affection which would unquestionably have been thought to be the consequence of vaccination had that been performed.

For my own part, having seen much of the effects of vaccination as a general practitioner, and having had exceptional opportunities during nearly twenty years of seeing affections of various kinds supposed to have been caused by it, in the out-patient department of a large London hospital, I can only state my belief that the injurious consequences fairly attributable to vaccination are few in number, and mostly insignificant in nature. Such as they are, they are almost entirely preventible with proper care. On this point the Commissioners make recommendations which if adopted would make the risk of vaccination practically a negligible quantity.

The existing law as to vaccination is based on the hypothesis that it is an efficient means of protection against small-pox. To the medical profession this is not an hypothesis, but a fact established by larger and more decisive evidence than any other in the whole range of therapeutics. It is significant that of the three medical men in this country, whom I may call the scientific heresiarchs in this matter, two are not, and have not for many years, if ever, been general practitioners; while the third is engaged in a special line of

practice in which opportunities of observing the effects of vaccination must be extremely rare. Their objections are founded largely on theoretical considerations which can have little or no weight with those who know the facts from personal observation. The belief of the medical profession in the efficacy of vaccination is fully shared by the Commissioners, only a minority of whom are medical men. Their Report, in fact, justifies in the strongest possible manner the truth of the doctrine on which it is based. It is to be regretted, therefore, that they should have made certain recommendations as to the carrying out of the law, which go far to stultify their own conclusions on the evidence before them. They recommend what amounts to a practical abolition of compulsion. Parents who object to vaccination are to be allowed to follow the dictates of their conscience in the matter. This (not to speak it profanely) seems to me mere foolishness. Many parents feel compelled by what they call their conscience to use strict discipline in bringing up their children, but the law shows no regard for their conscience when the discipline exceeds a certain limit. The Peculiar People have a conscientious objection to medical treatment of any kind, but the law does not, therefore, hold them guiltless if their children die for the want of it. Children are not the chattels of their parents; they are also the property of the State, and the parent's liberty of action as regards his child needs to be limited not only in the interest of the child, but in that of the nation. I therefore consider it in the highest undesirable that the Legislature should give effect to this recommendation, even in the modified form proposed by Mr. Jonathan Hutchinson and Sir W. Guyer Hunter. The opposition to vaccination comes, after all, from a minority which is numerically small; and whatever may be the case as regards other matters, where the public health is concerned a minority has no rights. Vaccination, if it is to do its full measure of good to the community, must be not merely compulsory' but compelled. The recommendation of the Commissioners that penalties for nonconformity should be abolished, is only a concession to democracy, which regards medical science with suspicion and dislike; and it is to be feared that it will lead to disastrous consequences for the coming generation if Government does not show itself wiser than the Commissioners.

On the evidence submitted to them, and on their own conclusions after careful sifting of that evidence, their only logical course would have been to recommend compulsory re-vaccination of all children at the age of ten or thereabouts. But if it is too much to ask that re-vaccination should be made compulsory, at least we may ask that it shall be encouraged by the State and by society in every posssible way. It should be insisted on as a regular condition of admission to every branch of the public service. It should be made a condition of passing beyond a certain standard in all

Board Schools; of admission to training ships, reformatories and homes and teaching establishments of all kinds under public control, to all public schools, to the local examinations of the universities, and to the preliminary examinations for the professions. The French Government has just ordered that all persons wishing to enter as medical students in Paris must first be re-vaccinated. This precaution might, with the greatest advantage to the public as well as to individuals, be extended to all professions where a regular apprenticeship is required. It would be well also if it were adopted by railway companies, ship-builders, gas and water companies, owners of factories and warehouses, and all large employers of labour, and by authorities of schools. In fact, a system of rewards for re-vaccination might be established, and it is conceivable that in this way public opinion might be educated to such a degree that it would come to be deemed as disgraceful to be unre-vaccinated as it is now thought to be unwashed.

If the State concerns itself with vaccination at all, it is incumbent on it to exercise strict vigilance over its performance. At present, it must be admitted, it is too often imperfectly performed. I am inclined to think that it would be better to entrust the duty altogether to public vaccinators, who should seek out the persons to be vaccinated at their own homes, and whose work should be under Government inspection. I think also it is the clear duty of the State to make itself responsible for the supply as well as for the use of pure lymph. That there is room for reform in the way vaccination is now carried out, at least in England, is clearly shown by the evidence before the Commissioners; and the Report will have done something to compensate for its evil effects in other ways if it leads to a more efficient and a more careful performance of the operation.

Isolation, which is the substitute proposed for vaccination by the dissentients, is most useful as an ally, but it could not stand alone as a means of protection, for the simple reason that when any strain on the machinery came it would inevitably break down, as it did at Leicester in 1893. Compulsory isolation' on any large scale would be far more resisted than vaccination, and if enforced, would be sure to lead sooner or later to the revolt of the rate-payer. In fact, the 'conscience' of recalcitrant parents would be at least as much outraged by isolation as by vaccination, and its enforcement would only lead to the development of a new kind of martyr.'

To sum up I would retain the element of compulsion in full force as far as primary vaccination is concerned, but I would make martyrdom' less cheap. Instead of repeated penalties, I would impose one fine sufficiently substantial to act as a deterrent. In case of persistent disobedience I would go the length of temporary disfranchisement, a penalty which is not too great for an act of bad citizenship.

Re-vaccination should, as already said, be promoted by a system of rewards.

After all, the question of vaccination is one that chiefly concerns the people itself. The medical profession, if it looked at the matter from a purely selfish point of view, would certainly take no trouble to promote a practice which is directly injurious to its material interests. Doctors know how to protect themselves and those dear to them, and if only men and women were in question, they might be content to let them enjoy the freedom which, as Dr. Gregory wrote many years ago, every Englishman values so greatly, of doing what is foolish and wrong, and going to the devil his own way.'

But the young, young children, O my brothers!

For the sake of these helpless ones I would earnestly plead that there should be no relaxation of the existing law.

MALCOLM MORRIS.

A SHINTO FUNERAL

AMONG the advisers who in this generation have surrounded the throne of Japan there have been none more valued by both Emperor and people, none who, by wise counsels and devoted loyalty, have contributed more to raise the ancient empire to the position which it occupies to-day, than Prince Taruhito Arisugawa, whose death caused universal mourning throughout the land.

A man of high principle, and steadfast, upright, honest character, he joined to the ardent patriotism which is a Japanese characteristic a warm personal affection for the Emperor; and by his caution and wisdom he was a constant influence for good in all state affairs. A prince of the blood, but by birth no nearer than a fourth cousin of the Emperor, the Japanese custom of adoption gave him the position of uncle to the latter, and he was, whether by birth or by reason of this adoption is uncertain, heir presumptive to the throne next in succession to the crown prince.

When, at the beginning of the war with China, Hiroshima was fixed on as the headquarters of the army, he accompanied the Emperor thither, and, as chief of the general staff, was ever in his place at the counsels of war, and working indefatigably for the success of the plans which his wisdom did so much to formulate.

If we reckon, as we surely must do, among the brave men who have given their lives for their country those whom disease has stricken down while they were leading armies to victory, Prince Arisugawa's name must be included in the number. The staff at Hiroshima, following in that the example set them by the Emperor, have kept constantly before their minds the hardships and privations endured by the troops, and have regulated their own lives by a standard which they have striven to approximate to that which is possible for their soldiers.

Prince Arisugawa was sixty-one; not an old man, but still past the age when such exertions and privations can be undergone with impunity, and there appears to be no doubt that when, in December, he was attacked by typhoid fever, the strain to which his constitution