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Business Data Analysis
SCH-MGMT 650

STATISTICS FOR MANAGERS

USING Microsoft Excel
David M. Levine David F. Stephan
Timothy C. Krehbiel Mark L. Berenson

Custom Edition for

UMASS-Amherst
Professor Robert Nakosteen

Taken from:

Statistics for Managers: Using Microsoft Excel, Fifth Edition

by David M. Levine, David F. Stephan, Timothy C. Krehbiel, and Mark L. Berenson
Cover photo taken by Lauren Labrecque.

Taken from:

Statistics for Managers: Using Microsoft Excel, Fifth Edition

by David M. Levine, David F. Stephan, Timothy C. Krehbiel, and Mark L. Berenson
Copyright 2008, 2005, 2002, 1999, 1997 by Pearson Education, Inc.
Published by Prentice Hall
Upper Saddle River, New Jersey 07458

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 To our wives,
Marilyn L., Mary N., Patti K., and Rhoda B.,

and to our children

Sharyn, Mark, Ed, Rudy, Rhonda, Kathy, and Lori
 ABOUT THE AUTHORS
The textbook authors
meet to discuss statis-
tics at Shea Stadium for
a Mets v. Phillies game.
Shown left to right,
Mark Berenson, David
Stephan, David Levine,
Tim Krehbiel.

David M. Levine is Professor Emeritus of Statistics and Computer Information Systems at

Bernard M. Baruch College (City University of New York). He received B.B.A. and M.B.A.
degrees in Statistics from City College of New York and a Ph.D. degree from New York
University in Industrial Engineering and Operations Research. He is nationally recognized as a
leading innovator in statistics education and is the co-author of 14 books including such best
selling statistics textbooks as Statistics for Managers using Microsoft Excel, Basic Business
Statistics: Concepts and Applications, Business Statistics: A First Course, and Applied
Statistics for Engineers and Scientists using Microsoft Excel and Minitab.

He also recently wrote Even You Can Learn Statistics and Statistics for Six Sigma Green Belts
published by Financial Times-Prentice-Hall. He is coauthor of Six Sigma for Green Belts and
Champions and Design for Six Sigma for Green Belts and Champions, also published by
Financial Times-Prentice-Hall, and Quality Management Third Ed., McGraw-Hill-Irwin
(2005). He is also the author of Video Review of Statistics and Video Review of Probability,
both published by Video Aided Instruction. He has published articles in various journals
including Psychometrika, The American Statistician, Communications in Statistics,
Multivariate Behavioral Research, Journal of Systems Management, Quality Progress, and The
American Anthropologist and given numerous talks at Decision Sciences, American Statistical
Association, and Making Statistics More Effective in Schools of Business conferences. While
at Baruch College, Dr. Levine received several awards for outstanding teaching and curriculum
development.

David F. Stephan is an instructional designer and lecturer who pioneered the teaching of
spreadsheet applications to business school students in the 1980 s. He has over 20 years experi-
ence teaching at Baruch College, where he developed the first personal computing lab to sup-
port statistics and information systems studies and was twice nominated for his excellence
in teaching. He is also proud to have been the lead designer and assistant project director of a
U.S. Department of Education FIPSE project that brought interactive, multimedia learning to
Baruch College.

Today, David focuses on developing materials that help users make better use of the informa-
tion analysis tools on their computer desktops and is a co-author, with David M. Levine, of
Even You Can Learn Statistics.

vi
 About the Authors vii

Timothy C. Krehbiel is Professor of Decision Sciences and Management Information

Systems at the Richard T. Farmer School of Business at Miami University in Oxford, Ohio. He
teaches undergraduate and graduate courses in business statistics. In 1996 he received the pres-
tigious Instructional Innovation Award from the Decision Sciences Institute. In 2000 he
received the Richard T. Farmer School of Business Administration Effective Educator Award.
He also received a Teaching Excellence Award from the MBA class of 2000.

Krehbiel s research interests span many areas of business and applied statistics. His work
appears in numerous journals including Quality Management Journal, Ecological Economics,
International Journal of Production Research, Journal of Marketing Management,
Communications in Statistics, Decision Sciences Journal of Innovative Education, Journal of
Education for Business, Marketing Education Review, and Teaching Statistics. He is a co-
author of three statistics textbooks published by Prentice Hall: Business Statistics: A First
Course, Basic Business Statistics, and Statistics for Managers Using Microsoft Excel. Krehbiel
is also a co-author of the book Sustainability Perspectives in Business and Resources.

Krehbiel graduated summa cum laude with a B.A. in history from McPherson College in 1983,
and earned an M.S. (1987) and Ph.D. (1990) in statistics from the University of Wyoming.

Mark L. Berenson is Professor of Management and Information Systems at Montclair State

University (Montclair, New Jersey) and also Professor Emeritus of Statistics and Computer
Information Systems at Bernard M. Baruch College (City University of New York). He cur-
rently teaches graduate and undergraduate courses in statistics and in operations management
in the School of Business and an undergraduate course in international justice and human
rights that he co-developed in the College of Humanities and Social Sciences.

Berenson received a B.A. in economic statistics and an M.B.A. in business statistics from City
College of New York and a Ph.D. in business from the City University of New York.

Berenson s research has been published in Decision Sciences Journal of Innovative Education,
Review of Business Research, The American Statistician, Communications in Statistics,
Psychometrika, Educational and Psychological Measurement, Journal of Management
Sciences and Applied Cybernetics, Research Quarterly, Stats Magazine, The New York
Statistician, Journal of Health Administration Education, Journal of Behavioral Medicine, and
Journal of Surgical Oncology. His invited articles have appeared in The Encyclopedia of
Measurement & Statistics and in Encyclopedia of Statistical Sciences. He is co-author of
11 statistics texts published by Prentice Hall, including Statistics for Managers using Microsoft
Excel, Basic Business Statistics: Concepts and Applications, and Business Statistics: A First
Course.

Over the years, Berenson has received several awards for teaching and for innovative contribu-
tions to statistics education. In 2005 he was the first recipient of The Catherine A. Becker
Service for Educational Excellence Award at Montclair State University.
BRIEF CONTENTS
Preface xix
1 INTRODUCTION AND DATA COLLECTION 1
2 PRESENTING DATA IN TABLES AND CHARTS 31
3 NUMERICAL DESCRIPTIVE MEASURES 95
4 BASIC PROBABILITY 147
5 SOME IMPORTANT DISCRETE PROBABILITY DISTRIBUTIONS 179
6 THE NORMAL DISTRIBUTION AND OTHER CONTINUOUS DISTRIBUTIONS 217
7 SAMPLING AND SAMPLING DISTRIBUTIONS 251
8 CONFIDENCE INTERVAL ESTIMATION 283
9 FUNDAMENTALS OF HYPOTHESIS TESTING: ONE-SAMPLE TESTS 327
10 SIMPLE LINEAR REGRESSION 369
11 INTRODUCTION TO MULTIPLE REGRESSION 429
Appendices A-F 471
Self-Test Solutions and Answers to Selected Even-Numbered Problems 513
Index 535

CD-ROM TOPICS

4.5 COUNTING RULES CD4-1

5.6 USING THE POISSON DISTRIBUTION TO APPROXIMATE THE BINOMIAL DISTRIBUTION CD5-1
6.6 THE NORMAL APPROXIMATION TO THE BINOMIAL DISTRIBUTION CD6-1
7.6 SAMPLING FROM FINITE POPULATIONS CD7-1
8.7 ESTIMATION AND SAMPLE SIZE DETERMINATION FOR FINITE POPULATIONS CD8-1
9.7 THE POWER OF A TEST CD9-1

ix
CONTENTS
Preface xix

1 INTRODUCTION AND DATA COLLECTION 1

1.1 Why Learn Statistics 2
1.2 Statistics for Managers 2
How This Text is Organized 3
Using Statistics @ Good Tunes 4
1.3 Basic Vocabulary of Statistics 4
1.4 Data Collection 6
1.5 Types of Variables 8
Levels of Measurement and Measurement Scales 9
1.6 Microsoft Excel Worksheets 11
Worksheet Cells 11
Designing Effective Worksheets 12
Summary 13
Key Terms 13
Chapter Review Problems 14
End-of-Chapter Cases 15
Learning with the Web Cases 16
References 17
Excel Companion to Chapter 1 18
Key Terms 30

2 PRESENTING DATA IN TABLES AND CHARTS 31

Using Statistics @ Choice Is Yours, Part I 32
2.1 Tables and Charts for Categorical Data 32
The Summary Table 33
The Bar Chart 33
The Pie Chart 34
The Pareto Diagram 35
2.2 Organizing Numerical Data 40
The Ordered Array 41
The Stem-and-Leaf Display 41
2.3 Tables and Charts for Numerical Data 44
The Frequency Distribution 44
The Relative Frequency Distribution and the Percentage Distribution 46
The Cumulative Distribution 47
The Histogram 48
The Polygon 50
The Cumulative Percentage Polygon (Ogive) 51
2.4 Cross Tabulations 54
The Contingency Table 55
The Side-by-Side Bar Chart 56
xi
xii Contents

2.5 Scatter Plots and Time-Series Plots 58

The Scatter Plot 58
The Time-Series Plot 59
2.6 Misusing Graphs and Ethical Issues 62
Microsoft Excel Graphs 64
Summary 66
Key Terms 66
Chapter Review Problems 67
Managing the Springville Herald 73
Web Case 74
References 74
Excel Companion to Chapter 2 75

3 NUMERICAL DESCRIPTIVE MEASURES 95

Using Statistics @ Choice Is Yours, Part II 96
3.1 Measures of Central Tendency 96
The Mean 97
The Median 99
The Mode 100
Quartiles 101
The Geometric Mean 103
3.2 Variation and Shape 105
The Range 105
The Interquartile Range 106
The Variance and the Standard Deviation 106
The Coefficient of Variation 110
Z Scores 111
Shape 112
Visual Explorations: Exploring Descriptive Statistics 113
Microsoft Excel Descriptive Statistics Results 114
3.3 Numerical Descriptive Measures for a Population 118
The Population Mean 118
The Population Variance and Standard Deviation 119
The Empirical Rule 120
The Chebyshev Rule 120
3.4 Exploratory Data Analysis 122
The Five-Number Summary 123
The Box-and-Whisker Plot 124
3.5 The Covariance and the Coefficient of Correlation 127
The Covariance 127
The Coefficient of Correlation 128
3.6 Pitfalls in Numerical Descriptive Measures and Ethical Issues 133
Ethical Issues 133
Summary 134
Key Equations 134
Key Terms 135
Chapter Review Problems 135

Statistics for Managers Using Microsoft Excel, Fifth Edition, by David M. Levine, Mark L. Berenson, and Timothy C. Krehbiel. Published by Prentice Hall.
Copyright 2008 by Pearson Education, Inc.
 Contents xiii

Managing the Springville Herald 142

Web Case 142
References 142
Excel Companion to Chapter 3 143

4 BASIC PROBABILITY 147

Using Statistics @ The Consumer Electronics Company 148
4.1 Basic Probability Concepts 149
Events and Sample Spaces 150
Contingency Tables 151
Simple (Marginal) Probability 151
Joint Probability 152
General Addition Rule 154
4.2 Conditional Probability 157
Computing Conditional Probabilities 157
Decision Trees 159
Statistical Independence 161
Multiplication Rules 162
Marginal Probability Using the General Multiplication Rule 163
4.3 Bayes Theorem 166
4.4 Ethical Issues and Probability 171
4.5 (CD-ROM Topic) Counting Rules 172
Summary 172
Key Equations 172
Key Terms 172
Chapter Review Problems 173
Web Case 176
References 176
Excel Companion to Chapter 4 177

5 SOME IMPORTANT DISCRETE PROBABILITY

DISTRIBUTIONS 179
Using Statistics @ Saxon Home Improvement 180
5.1 The Probability Distribution for a Discrete Random Variable 180
Expected Value of a Discrete Random Variable 181
Variance and Standard Deviation of a Discrete Random Variable 182
5.2 Covariance and Its Application in Finance 184
Covariance 184
Expected Value, Variance, and Standard Deviation of the Sum
of Two Random Variables 186
Portfolio Expected Return and Portfolio Risk 186
5.3 Binomial Distribution 189
5.4 Poisson Distribution 197
5.5 Hypergeometric Distribution 201
5.6 (CD-ROM Topic) Using the Poisson Distribution to Approximate
the Binomial Distribution 204
Summary 204
Key Equations 204

Statistics for Managers Using Microsoft Excel, Fifth Edition, by David M. Levine, Mark L. Berenson, and Timothy C. Krehbiel. Published by Prentice Hall.
Copyright 2008 by Pearson Education, Inc.
xiv Contents

Key Terms 205

Chapter Review Problems 206
Managing the Springville Herald 209
Web Case 209
References 210
Excel Companion to Chapter 5 211

6 THE NORMAL DISTRIBUTION AND OTHER

CONTINUOUS DISTRIBUTIONS 217
Using Statistics @ OurCampus! 218
6.1 Continuous Probability Distributions 218
6.2 The Normal Distribution 219
Visual Explorations: Exploring the Normal Distribution 229
6.3 Evaluating Normality 234
Comparing Data Characteristics to Theoretical Properties 234
Constructing the Normal Probability Plot 236
6.4 The Uniform Distribution 238
6.5 The Exponential Distribution 241
6.6 (CD-ROM Topic) The Normal Approximation to the Binomial
Distribution 243
Summary 243
Key Equations 243
Key Terms 243
Chapter Review Problems 244
Managing the Springville Herald 246
Web Case 246
References 246
Excel Companion to Chapter 6 247

7 SAMPLING AND SAMPLING DISTRIBUTIONS 251

Using Statistics @ Oxford Cereals 252
7.1 Types of Sampling Methods 252
Simple Random Samples 253
Systematic Samples 256
Stratified Samples 256
Cluster Samples 257
7.2 Evaluating Survey Worthiness 258
Survey Error 259
Ethical Issues 260
7.3 Sampling Distributions 261
7.4 Sampling Distribution of the Mean 262
The Unbiased Property of the Sample Mean 262
Standard Error of the Mean 264
Sampling from Normally Distributed Populations 265
Sampling from Non-Normally Distributed Populations
The Central Limit Theorem 268
Visual Explorations: Exploring Sampling Distributions 270
7.5 Sampling Distribution of the Proportion 272

Statistics for Managers Using Microsoft Excel, Fifth Edition, by David M. Levine, Mark L. Berenson, and Timothy C. Krehbiel. Published by Prentice Hall.
Copyright 2008 by Pearson Education, Inc.
 Contents xv

7.6 (CD-ROM Topic) Sampling From Finite Populations 275

Summary 275
Key Equations 276
Key Terms 276
Chapter Review Problems 276
Managing the Springville Herald 279
Web Case 279
References 280
Excel Companion to Chapter 7 281

8 CONFIDENCE INTERVAL ESTIMATION 283

Using Statistics @ Saxon Home Improvement 284
8.1 Confidence Interval Estimation for the Mean (* Known) 285
8.2 Confidence Interval Estimation for the Mean (* Unknown) 290
Student s t Distribution 290
Properties of the t Distribution 290
The Concept of Degrees of Freedom 291
The Confidence Interval Statement 292
8.3 Confidence Interval Estimation for the Proportion 296
8.4 Determining Sample Size 299
Sample Size Determination for the Mean 300
Sample Size Determination for the Proportion 302
8.5 Applications of Confidence Interval Estimation in Auditing 306
Estimating the Population Total Amount 307
Difference Estimation 308
One-Sided Confidence Interval Estimation of the Rate of Noncompliance
with Internal Controls 311
8.6 Confidence Interval Estimation and Ethical Issues 313
8.7 (CD-ROM Topic) Estimation and Sample Size Determination
for Finite Populations 314
Summary 314
Key Equations 314
Key Terms 315
Chapter Review Problems 315
Managing the Springville Herald 320
Web Case 321
References 321
Excel Companion to Chapter 8 322

9 FUNDAMENTALS OF HYPOTHESIS TESTING:

ONE-SAMPLE TESTS 327
Using Statistics @ Oxford Cereals, Part II 328
9.1 Hypothesis-Testing Methodology 328
The Null and Alternative Hypotheses 328
The Critical Value of the Test Statistic 330
Regions of Rejection and Nonrejection 330
Risks in Decision Making Using Hypothesis-Testing Methodology 331

Statistics for Managers Using Microsoft Excel, Fifth Edition, by David M. Levine, Mark L. Berenson, and Timothy C. Krehbiel. Published by Prentice Hall.
Copyright 2008 by Pearson Education, Inc.
Other documents randomly have
different content
said, variolation was well known to be no sure defence against
smallpox, why should people be offended when smallpox in like
manner occasionally followed vaccination? Why, indeed! but then the
promise ran—“The human frame when once it has felt the influence
of genuine cowpox, is never afterwards, at any period of its
existence, assailable by smallpox.” In a letter to his friend Moore in
1810, Jenner said, “Cases of smallpox after inoculation are
innumerable.” And again, “Thousands might be collected; for every
parish in the kingdom can give its case.” And he asked another
correspondent, Dunning, in 1805, “Is it possible that any one can be
so absurd as to argue on the impossibility of smallpox after
vaccination!” And this from Jenner, who had deceived the nation in
1802 with the assurance that, “inoculated cowpox was attended with
the singularly beneficial effect of rendering through life the person
so inoculated perfectly secure from the infection of smallpox”!
Such was Jenner; such his inconsistency; and such the admissions
he was driven to make under stress of failures many and manifest.

SMALLPOX MADE MILDER.

As vaccination failed to afford the protection originally guaranteed,
various explanations were devised to enable those who had talked
too loftily to eat humble pie without painful observation. One of the
commonest excuses was that if vaccination did not prevent smallpox
it made it milder: and inasmuch as no one knew, or could know, how
severe any attack of smallpox would have been without vaccination,
it was an assertion as indisputable as the reverse—namely, that
vaccination not only made smallpox severer, but frequently induced
the disease. There are many assertions with which there is no
reckoning, for it would require omniscience to check them. Let us
beware of such assertions. Let us neither make them, nor suffer
ourselves to be imposed upon by them.

PUNCTURES, ONE OR SEVERAL.

Another excuse was advanced in the report of the National
Vaccine Establishment in 1814. It was said the failures in vaccination
appeared to result from the practice Of making only one puncture
for the insertion of virus. One puncture ineffective! Why, if one
puncture were ineffective, how were the early miracles of
vaccination to be accounted for, all of which had been effected by
means of single punctures?

MR. RIGBY’S PROTEST.

There was in those days a surgeon of eminence in Norwich,
Edward Rigby, and he at once entered his protest against the novel
doctrine. Writing to the Medical and Physical Journal of August,
1814, he said, “No physiological reason is assigned for this, and I
believe it would be difficult to prove that a single perfect vesicle,
which goes through the usual stages and exhibits the characteristic
appearances of this singular disease, can be less the effect of a
constitutional affection than any given number would be.... It cannot
surely be doubted that a single perfect vesicle affords as complete
security against Variola as any indefinite number; and, if so, there
would seem to be an obvious objection to unnecessarily multiplying
the vesicles, which in all cases go through a high degree of
inflammation, are often attended with painful tumefaction and even
suppuration in the axilla, and, if exposed in the later stages to any
act of violence, are apt to assume a very disagreeable ulceration,
more especially as young children, now the principal subjects of
vaccination, are most liable to suffer in this way.” Rigby had the
better side of the argument. As he observed, no physiological reason
was assigned for the recommendation of plural punctures; nor was
any such reason ever assigned. It is the rationale of vaccination that
a virus is injected into the system which begets a fever equivalent to
an attack of smallpox; and as smallpox rarely recurs in a lifetime, it
is hoped that Nature may graciously recognise the substitute for the
reality. Organic poisons such as vaccine operate like fire or ferment.
Quantity is of no account. So that the fever be kindled, excess is
waste. A scratch at a dissection is as deadly as a gash. One bite of a
mad dog is as likely to beget hydrophobia as a dozen. The sting of a
cobra may be almost invisible, but the puncture is enough for death.
Sir James Paget says of vaccine virus that “inserted once, in almost
infinitely small quantity, yet by multiplying itself, or otherwise
affecting all the blood, it alters it once for all.”
Such is the rationale of vaccination, and if I were a vaccinator, I
should hold the position assumed by Rigby, and maintain that one
puncture is as effective as a dozen, inasmuch as with one it is
possible to excite that fever which is the essential of vaccination;
adding, in Rigby’s words, that as one puncture is in all cases
attended with a high degree of inflammation, and often with painful
tumefaction, and even suppuration in the arm-pits, which in case of
violence are apt to pass into very disagreeable ulceration, especially
in young children, it is most undesirable to increase the number of
such dangerous wounds.

MR. (MARKS) MARSON.

I do not know that the condemnation of single punctures at that
time, seventy years ago, had much effect. Two punctures became
common, chiefly to guard against the possible failure of one. It is of
late years that the resort to many punctures has become
fashionable. Mr. Robert Lowe, now Lord Sherbrooke, in the House of
Commons in 1861 spoke of “the beautiful discovery which had been
made, that the security of vaccination may be almost indefinitely
increased by multiplying the number of punctures”! The chief author
of this remarkable discovery was Mr. Marson, for many years
surgeon of the Smallpox Hospital at Highgate. He estimated the
efficacy of vaccination by marks, and made so much of marks that I
usually think of him as Marks Marson. He said—“A good vaccination
is when persons have been vaccinated in four or more places leaving
good cicatrices. I define a good cicatrix in this way: a good vaccine
cicatrix may be described as distinct, foveated, dotted, or indented,
in some instances radiated, and having a well, or tolerably well,
defined edge. An indifferent cicatrix is indistinct, smooth, without
indentation, and with an irregular or ill-defined edge. When I find
that a person has been vaccinated in at least four places, leaving
good marks of the kind which I have described, that person
invariably, or almost invariably, has smallpox in a very mild form.”
Reading a statement like this, we revert to the rationale of
vaccination, and ask what can marks have to do with its efficacy?
Remember, Marson offered no explanation of his statement. He was
satisfied to say thus and thus have I observed, and you may take my
word for it. But in science we take no man’s word. We must see, or,
like Trelawney’s Cornishmen, we must know the reason why. Marson
appeared before the House of Commons’ Vaccination Committee in
1871, and set forth his marks doctrine with all the qualifications and
inconsistencies which characterise the victim of a fad in contact with
facts which his fad fails to include or account for.

MR. WHEELER’S RESEARCHES.

Fatal cases of smallpox are confluent cases, and in confluent cases
vaccination marks rarely show up so as to answer to Marson’s
description of marks distinct, foveated, dotted, or indented, with a
well, or tolerably well-defined edge. And in this matter our acute and
industrious friend, Mr. Alexander Wheeler, has explored the records
of the Smallpox Hospitals, and proved that vaccination marks many
or vaccination marks few have no influence whatever on the
character or issue of smallpox. As Mr. Wheeler shows, the
classification of smallpox into discrete and confluent is the only clue
to the right estimation of the fatality of the disease. Smallpox in the
discrete form, that is, when the pustules are distinct and separate, is
not dangerous when uncomplicated with other disease, the
overwhelming majority of patients recovering, vaccinated or
unvaccinated. The contest between life and death is waged among
the confluent cases, where the pustules are so close that they run
together; and it is on these confluent cases, and the conditions and
antecedents of the sufferers, that attention should be concentrated.
There is a third form of smallpox, the malignant, chiefly confined to
persons of irregular life, which is almost invariably fatal, and, as
vaccinators themselves allow, vaccination in malignant smallpox
affords no odds to its victims.
 MR. ROBINSON’S OPINION.
Nevertheless, as Mr. Enoch Robinson has pointed out, there is
something to be said for what Marson called good vaccination
marks. The bit of reality that constitutes the basis of the marks
illusion is this, that a well-formed vaccine cicatrix represents a strong
vitality with vigorous healing power; whilst an ill-formed cicatrix
represents a contrary habit of body; and, pari passu, those who heal
well under vaccination stand likely to make the best recoveries in the
event of smallpox. Good marks are simply notes of good
constitutions, and the rest follows. Aught beyond is mere medical
rubbish, on a par with faith in omens and divination in tea-cups.

CRUELTY OF MARKING.
Vaccination, in whatever form, is bad, but this faith in marks
aggravates its cruelty. Mr. Claremont, vaccinator for St. Pancras,
operates on infants by the thousand, and inflicts on each four marks.
At a recent inquest on an infant, the victim of his handiwork, I heard
him say, “The mothers nearly always protest.” Of course they do.
What kind of mothers would they be if they did not protest! Apart
from the venom, the shock to an infant’s life from such wounds is
very serious. Mr. Young was called the other day to see a dying
infant vaccinated by this Claremont. Previous to vaccination it was
perfectly healthy, but never afterwards. From the time of the
operation it fell under a blight. “In its coffin,” said Mr. Young, “it lay
like a child’s doll—the poor babe had wasted away.”
I was glad to see in the Times about a year ago a letter from Dr.
Allnatt of Cheltenham protesting against the cruelty of vaccination as
practised upon the children of the poor. He recalled the days when
he was a pupil of Dr. Walker, in 1825-26, and his instructions were to
dip the point of the lancet into the fresh lymph, and insert it tenderly
without drawing blood, under the cutis of the forearm, and protect
the wound with a slight compress. “But the case is altered now,” he
says. “Some of the vaccinators use real instruments of torture. Ivory
points are driven into the flesh, and wounds ensue which become
erysipelatous, and in the delicate constitutions of weakly children
fatal.”
The case is altered now, says Dr. Allnatt; but why is the case
altered now? Why, because, under the old terms vaccination was
more and more seen to be no defence against smallpox; and to
preserve the rite, and the gains from the rite, the marks doctrine
was invented, or, rather, revived, and hailed as a sort of revelation
from heaven.

REVACCINATION INTRODUCED.
When vaccination was seen to be no preventive of smallpox, it
was conjectured that it might require renewal, a suggestion which
distressed Jenner exceedingly. It was calculated, he said, “to do
unspeakable mischief,” depriving his discovery “of more than half its
virtues.” But as experience continued to belie the claim made for
vaccination as a permanent defence, it was natural that those
interested in its performance should endeavour to retrieve its waning
credit. Thus revaccination began to be practised. Between 1830 and
1835 there were 13,861 revaccinations effected in the army of
Wurtemburg. Dr. Holland (subsequently Sir Henry) after recording
the accumulating proofs of the futility of vaccination in 1839,
recommended revaccination as a probable resource, and the
recommendation gradually acquired authority. The London Medical
Gazette in 1844 boldly proclaimed, “Revaccinate, revaccinate!” But
so late as 1851 the National Vaccine Establishment protested against
the innovation, saying, “The restriction of the protective power of
vaccination to any age, or to any term of years, is an hypothesis
contradicted by experience and wholly unsupported by analogy.”
Whatever the experience, however, and whatever the analogy, there
was the indisputable fact, that vaccination in most unimpeachable
form did not avert smallpox, and that if the public faith and the
public money were to be retained, some fresh artifice was essential.
It was hard to surrender the original claim of the equivalence of
vaccination to smallpox; but it needs must when the devil drives;
and so it has come to be admitted that Jenner was mistaken, and
the vaccine rite to be effectual must be renewed.

VACCINISATION.
Dr. Colin expresses what is now the common medical opinion in
saying, “We must not stop at a single vaccination. We must establish
the firm conviction in the public mind, that vaccine prophylaxy is
only real and complete when periodically renewed;” and Dr.
Warlomont, chief of Belgian vaccinators, goes yet further in advising
and practising what he calls Vaccinisation; which is, that every
subject of the rite be vaccinated again and again until vesicles cease
to respond to the insertion of virus. Then, and then only, can the
victim be guaranteed from smallpox! Such are the shifts to which
vaccinators have been reduced. If their insurance were valid, the
premium would exceed the principal, whilst there is no reason to
believe the new security is a whit better than the old. In these
frantic prescriptions we see the quackery in its death-throes.

ABSURDITY OF REVACCINATION.
As for revaccination keeping off smallpox, it is absurd, and ought
to be known for absurd. The chief incidence of smallpox is among
the young, in whom it cannot be pretended that the influence of
primary vaccination is exhausted. The subjects of revaccination are
passing, or have passed out of the smallpox age; and as the
statistics of the army and navy prove, our soldiers and sailors are no
more exempt from smallpox than the unrevaccinated civil population
of corresponding years. In this matter, the old words stand true,
Populus vult decipi; decipiatur.

THE REDUCTION OF SMALLPOX.

From whatever side regarded, the original and successive claims
made for vaccination are seen to have broken down; but a practice
endowed and enforced as a poll-tax for the benefit of the medical
profession is not lightly surrendered. Instead a variety of defences,
more or less ingenious, are thrown out.
 I.—One of these is the reduction of smallpox. It is said, “Smallpox
was once a common disease, and is now a comparatively rare one—
How are we to account for this improvement otherwise than by the
introduction of vaccination?”
The answer is, that smallpox was declining before vaccination was
introduced, and that, too, in spite of the extensive culture of the
disease by variolation; and the decline continued during the first part
of the present century whilst as yet nine-tenths of the people were
unvaccinated. Several diseases once common have abated or
disappeared; and why should we attribute to an incommensurate
cause a similar abatement in smallpox? Leprosy, once extensively
prevalent in England, has disappeared. Why? It died out gradually;
but suppose some rite, analogous to vaccination, had been brought
into vogue contemporaneously with its decline, would not the rite
have had the credit, and would not its practitioners have called the
world to witness the success of their prescription?

HAS VACCINATION SAVED LIFE?

II.—In the same line of defence, we have the claim made for an
extraordinary salvation of human life. Thus Sir Spencer Wells in a
recent speech observed, “Jenner is immortal as a benefactor of
mankind. It may not be generally known, but it is true, that Jenner
has saved, is now saving, and will continue to save in all coming
ages, more lives in one generation than were destroyed in all the
wars of Napoleon.”
The answer to such a statement is to call for proof of the lives
saved. There is no proof. At the close of last century, 20 per cent. of
the mortality of Glasgow was due to smallpox. Smallpox abated, but
did mortality abate? Not in the least. Dr. Robert Watt in 1813
recorded the fact with amazement over it. And what was true of
Glasgow was true of other cities and other populations. There may
be a cessation of smallpox, but (unless the result of sanitary
improvement) the work of death is merely transferred to cognate
agencies. There is no saving of life. What was a mystery to Watt is
less of a mystery since the development of sanitary science. Zymotic
disease in its various forms is a definite evolution from definite
insanitary conditions. It is not affected by medical repression, nor by
the spontaneous substitution of one variety of fever for another. In
the words of Dr. Farr, “To save people from smallpox is not enough
whilst exposed to other forms of disease. Thus in a garden where
the flowers are neglected, to keep off thistle-down merely leaves the
ground open to the world of surrounding weeds.” To lower the
zymotic death-rate it is necessary to reduce the conditions in which
zymotic disease is generated. Citing Dr. Farr once more, “To operate
on mortality, protection against every one of the fatal zymotic
diseases is required; otherwise the suppression of one disease-
element opens the way for others.” Dr. Watt and Dr. Farr alike
believed that vaccination stopped smallpox, and alike realised that
the disappearance of smallpox was accompanied with no saving of
life. Sir Spencer Wells is of a contrary opinion, which he shares with
a number of people who prefer the free, play of the prejudiced
imagination to the sobriety of exact information.

WHO ARE THE UNVACCINATED?

III.—Then we are asked to believe that though vaccination may
not keep off smallpox, it makes it milder, and in proof we are
entertained with low rates of mortality among the vaccinated and
high rates among the unvaccinated.
We reply, to make a fair comparison between the vaccinated and
the unvaccinated, it would be necessary to compare class with class,
physique with physique, age with age. In other words, the subjects
of smallpox should be constitutionally equal, their difference being
limited to vaccination present or vaccination absent. So much is
obvious.
But when or where has such comparison been even attempted?
Nor would it be easily practicable: for the vaccinated comprise the
best portion of the community, physically; but who are the
unvaccinated? They are the waifs and strays of civilisation, the
offspring of the miserable and the vagrant, who, without fixed
domicile, escape the attention of the vaccination officer. These,
whatever their ailment, whether measles, pneumonia, diarrhœa,
would exhibit a higher rate of mortality than the vaccinated; but
would it therefore be safe to argue that vaccination was not only
good against smallpox, but against measles, pneumonia, and
diarrhœa? Yet it is these, the lowest physically and most neglected
of the population, who drift into smallpox hospitals, who are
exhibited as fearful examples of the neglect of vaccination. It might
be added, they are unbaptised as well as unvaccinated, and
probably the one defect may be as prejudicial as the other.

UNVACCINATED DEATH-RATES.
Our contention does not end here. Such is the prejudice in favour
of vaccination that a bad case of smallpox is assumed to be an
unvaccinated case. Over and over again has it been proved that
vaccinated patients dead of smallpox have been registered as
unvaccinated, their death being taken as evidence of the absence of
the saving rite. Again in severe smallpox, when vaccination marks
are invisible, the sufferer is frequently set down as unvaccinated. Dr.
Russell, of the Glasgow Hospital, relates that patients entered as
unvaccinated, showed excellent marks when detained for
convalescence. Had they died, they would have gone to swell the
ranks of fearful examples.
It is thus that the high death-rates of the unvaccinated are
accounted for, the framers of hospital reports appearing to vie with
each other in extravagance. We are continually adjured in the
newspapers to confess our folly and repent, because 40 or 60 or 80
per cent. of the unvaccinated have perished in this or that hospital
because unvaccinated. To us such statistics have fraud written on
their face, and the more they are sworn to, the more unscrupulous
do their vendors reveal themselves. When all were unvaccinated last
century, the hospital death-rate of smallpox ranged about 18 per
cent. Now we are asked to believe that death-rate has doubled,
trebled, quadrupled, and for no other reason apparently than to
make for the glory of vaccination.

NURSES EXEMPT FROM SMALLPOX.

IV.—It is further said that nurses in smallpox hospitals never
contract smallpox because they are revaccinated.
To establish this assertion, it would be necessary to prove that
prior to the introduction of vaccination, or rather of revaccination, it
was common for nurses to fall victims to the disease. The attempt is
not made, and wisely, for failure would be conspicuous. Jenner never
recommended vaccination as a protective for nurses. Their general
immunity, along with that of physicians, is noted throughout our
older medical literature; nor is the reason far to seek. Smallpox is
predominantly an affection of the young, and it is no more surprising
that a nurse should be proof against it than that she should be proof
against measles, whooping cough, or scarlet fever. Nurses
occasionally incur these maladies, and they occasionally incur
smallpox.
If revaccination preserves nurses from smallpox, to which they are
exposed in the intensest form, it should much more preserve
soldiers, sailors, policemen and postmen, whose exposure is
incomparably less intense; yet these servants of the state (as
already observed) are as liable to smallpox as their unrevaccinated
fellow citizens of correspondent ages.
To speak plainly, the selection of a vocation so arduous and
repulsive, marks off a smallpox nurse as unimpressionable, and little
apt to catch anything. Smallpox, too, is like tobacco: custom fortifies
the constitution against its immediate effects. If the atmosphere of a
smallpox hospital is endured for a fortnight, it is likely to continue
endurable. On the other hand, if a volunteer sickens on probation,
she is not reckoned among nurses. Lastly, many nurses have entered
hospitals as patients, and have accepted service in default of other
occupation. On these grounds, the nurse argument breaks down
irretrievably. At first sight, it seems something, but on scrutiny it
proves nothing.

POCK-MARKED FACES.
V.—Another favourite argument for vaccination is the
disappearance of pock-marked faces. People say when they were
young such faces were common, whilst now they are rare; and
demand, What can have wrought the change if not vaccination?
A medical man at a public meeting tried to dispose of some
statistics adverse to vaccination by saying that statistics could be
made to prove anything; and presently went on to relate that when
his mother was a girl every third person she met was pock-marked.
She had told him so repeatedly, and there was no doubt about her
accuracy. Thus statistics in general were untrustworthy, but his
mother’s statistic was unquestionable.
We need not hesitate to allow that when smallpox was common
and cultivated pock-marked faces were more numerous: but we
must not forget that whether a patient is marked or not marked is
very much a matter of treatment. Many at this day pass through
smallpox, and severe smallpox, and escape unmarked, simply
because those who have care of them observe certain precautions.
It was different in former times. The treatment of smallpox was
atrocious. The sick-room was made pestiferous by the exclusion of
air and the maintenance of high temperature. The patient sweltered
under bed-clothes. He was neither allowed to wash nor change his
linen. He was drenched with physic and stimulants. In hospitals,
patients were stuck two or three in a bed, and stewed together. If,
under such circumstances, the sick were restored to life pock-
marked, what wonder! Patients who were fortunate enough to be
sufficiently let alone, stood the best chance of recovery.
Besides smallpox was not equally diffused. In some places it was
endemic; in others it appeared at intervals; and in others it was
hardly known. The smallpox death-rate of Glasgow was double that
of London; and we may therefore infer that pock-marked faces were
twice as numerous in Glasgow as in London. Hence when
recollections are appealed to, they should be localised. What might
be true of one population might be grossly untrue of another.
It has been observed that smallpox was falling off toward the
close of last century, and the decline accelerated in the present
century, irrespective of vaccination. An excellent illustration of this
reduction of smallpox is furnished by the reports of the National
Vaccine Establishment for 1822, 1825, and 1837, where the
disappearance of pock-marked faces from London is triumphantly
recorded and claimed as a result of vaccination. In 1831 Dr. Epps,
director of the Royal Jennerian Society, made the like observation
and the like claim, saying, “Seldom are persons now seen blind from
smallpox. Seldom is the pitted and disfigured face now beheld;”
adding, “but seldom do mankind inquire for the cause. It is
vaccination. It is vaccination which preserves the soft and rounded
cheek of innocence, and the still more captivating form of female
loveliness.” Inasmuch as not ten per cent. of the population were
vaccinated in 1831, the claim made for vaccination was absurd,
whilst the disappearance of pock-marked faces was sufficiently
explicable by the reduced prevalence of smallpox.
Where then is the argument for vaccination from the
disappearance of pock-marked faces? When anyone under seventy
proceeds to recite the legend, “There is no use in arguing against
vaccination, for when I was young every third or fourth person was
pock-marked,” etc., etc., the effect is droll. It shows how prone we
are to fancy we have seen what we think we ought to have seen.
Droller still it is when striplings of five-and-twenty and thirty profess
the same experience—“When I was a lad,” and so forth and so forth.
There is matter for reflection as well as for laughter in the
hallucination.
Nevertheless, if pock-marked faces are not so common as they
must have been a century ago, they are by no means rare; and if
the argument for vaccination were valid, the pock-marked would be
unvaccinated. But are they? Those who will take pains to inquire will
find that almost invariably they have been vaccinated, and some of
them repeatedly, the vaccination having as it were induced the
smallpox.

VACCINIA A REAL DISEASE.

Thus far we have chiefly dealt with vaccination as if its fault were
limited to failure to prevent smallpox; but vaccination is more than
an ineffective incantation. It is the induction of an acute specific
disease. The prime note of vaccination is erysipelas. “The cowpox
inflammation,” said Jenner, “is always of the erysipelatous kind.” He
held that cowpox unattended with erysipelas was “incapable of
producing any specific effect on the human constitution.” If it is
supposed that Jenner is antiquated, we may refer to a distinguished
contemporary. Mr. John Simon replying to the question, “Whether
properly performed vaccination is an absolutely inoffensive
proceeding?” answers decisively, “Not at all; nor does it pretend to
be so.” The rationale of vaccination is that it communicates a mild
variety of smallpox, and that with a little of the devil we buy off the
entire devil. Dr. Ballard, Medical Officer to the Local Government
Board, in his treatise, Vaccination: its Value and Alleged Dangers,
says, “Vaccination is not a thing to be trifled with, or to be made
light of; it is not to be undertaken thoughtlessly, or without due
consideration of the patient, his mode of life, and the circumstances
of season and of place. Surgeon and patient should both carry in
their minds the regulating thought, that the one is engaged in
communicating, the other in receiving into his system, a real disease
—as truly a disease as smallpox or measles; a disease which, mild
and gentle as its progress may usually be, yet, nevertheless, now
and then, like every other exanthematous malady, asserts its
character by an unusual exhibition of virulence.”

VACCINAL FATALITIES.
Here we have Vaccinia defined as disease with precautions for its
safe reception; yet withal it is allowed it may assert itself with
virulence. But where do we find any precautions exercised in the
vaccination of the poor?—that is to say, of the vast majority.
Precautions are not only disregarded, they are unknown, they are
impracticable. Infants of all sorts and conditions are operated on as
recklessly as sheep are marked. Whether they live or die is matter of
official indifference, whilst each is warrant for an official fee. Sir
Joseph Pease, speaking in the House of Commons, said, “The
President of the Local Government Board cannot deny that children
die under the operation of the Vaccination Acts in a wholesale way.”
Vaccination conveys an acute specific disease (having a definite
course to run like smallpox or other fever) which, whether by
careless treatment, or superinduced, or latent disease, is frequently
attended with serious and fatal issues. Hence it is that vaccination is
dreaded and detested by the poor on whom it is inflicted without
parley or mitigation; in itself a bearer of illness, it is likewise a cruel
aggravation of weakness and illness. When the poor complain that
their children are injured or slain by vaccination, they are officially
informed they are mistaken. Dr. Stevens, a well-known familiar of
the vaccination office, says he has seen more vaccination than any
man, and has yet to witness the least injury from the practice.
Variolators used to say the same of their practice until vaccinators
arose and convicted them of lying. Coroner Lankester held that
vaccination was not a cause of death “recognised by law,” and was
therefore an impossible cause. Such prevarication is mockery. True it
is that, if a child dies of vaccination, it dies of erysipelas, or pyœmia,
or diarrhœa, and it is easy enough to ignore the primary cause and
assert the secondary; but I would ask, How else can death ensue
from vaccination than by erysipelas, pyœmia, diarrhœa, or similar
sequelæ? If vaccination kills a child, how otherwise could it kill? Even
should death occur directly from surgical shock, it would be said, the
child did not die of vaccination, but from lack of vigour to sustain a
trivial operation. The Sangrado of the Stevens pattern is never
without a shuffle.

VACCINIA MODIFIED IN ITS RECIPIENTS.

 It is usual at coroners’ inquests on vaccination fatalities to produce
children vaccinated at the same time from the same vaccinifer, and
to assert that inasmuch as they have made good recoveries, it is
impossible that the virus was at fault, and that something else than
vaccination must have been the cause of death. The argument often
impresses a jury, but it is grossly fallacious. Suppose a mad dog bit
six men, and that five escaped injury beyond their wounds and
fright, and that one died of rabies, would the escape of the five
prove that the death of the sixth was unconnected with the dog? Or
suppose an equal potion of gin were administered to six infants, one
of whom died and five recovered, would the recovery of the five
prove that gin did not kill the sixth? Mr. Stoker writes to the
newspapers that he vaccinated twelve other persons with the virus
he used for Miss Ellen Terry, and that as no untoward symptoms
appeared in the twelve, therefore Miss Terry’s whitlow had no
connection with her vaccination—and this in spite of the untoward
symptoms falling due at the very time that vaccination accounted for
them! Any reasons are good for those disposed to be convinced, and
who have settled it in their minds that vaccination is invariably
harmless.
No doubt there is virus used for vaccination that is virulent beyond
other virus, as there is virus that is comparatively innocuous; but, as
Dr. Mead observed more than a century ago, “It is more material
into what kind of body smallpox is infused than out of what it is
taken.” The same virus that one constitution may throw off with little
effort, may induce disease and death in another. Dr. Joseph Jones,
president of the Louisiana Board of Health, relates that “In many
cases occurring in the Confederate Army, the deleterious effects of
vaccination were clearly referable to the condition of the forces, and
the constitution of the blood of the patients; for it was observed in a
number of instances that the same lymph from a healthy infant
inoculated upon different individuals produced different result’s
corresponding to the state of the system; in those who were well fed
and robust, producing no ill-effects, whilst in the soldiers who had
been subjected to incessant fatigue, exposure, and poor diet, the
gravest results followed.”
Some constitutions are peculiarly liable to injury from vaccine
virus, just as some constitutions cannot endure drugs that others
receive without inconvenience. Thus it is that fatalities from
vaccination are frequent in certain families. Of these, neither the law
nor medical men condescend to take account. Parents often plead in
vain for exemption from the rite on the ground that they have
already had children injured or slain by its performance; the brutal
and unscientific argument running, “How can vaccination hurt your
children when it does not hurt other people’s children?”

VACCINIA PLUS OTHER DISEASE.

Nor is the case against vaccination yet complete. The virus used is
not only Vaccinia, but more than Vaccinia; for it is impossible to
propagate virus from child to child without taking up other qualities.
This was clearly foreseen by the variolators when vaccination was
introduced—they making it a point to take smallpox for inoculation
from known and sound subjects. They maintained that cowpox
transferred indiscriminately from arm to arm must acquire and
convey constitutional taints; and their prognostication was speedily
and grievously fulfilled in the item of syphilis. Notwithstanding, the
fact was furiously contested. It was said that parents used
vaccination as a screen for their own wickedness; and assertion
alternated with denial even to our own day. At last the conflict is at
an end. The evidence has grown too multitudinous and deadly for
evasion. The invaccination of syphilis is admitted, and any question
is reserved for the degree of frequency. Some are pleased to
describe the risk as infinitesimal, but their pleasure stands for
nothing but itself. Deeds are expressive beyond words. The wide
resort to animal vaccination on the Continent and in the United
States has but one interpretation. Doctors and patients do not
abandon what is easy for what is troublesome, nor incur the risk of
the communication of bovine disorders unless under the influence of
over-mastering terror.
 STATISTICAL EVIDENCE OF EXTRA DISEASE.
Relations of individual experience may be disregarded as
untrustworthy, but the broad evidence of national statistics conveys
authoritative lessons. Vaccination in England was made compulsory
in 1853, stringently so in 1867, and systematically extended to the
entire population. If therefore it were true that vaccination often
communicates more than Vaccinia, and that it aggravates existent
and excites latent disease, the proof must be manifest in the
statistics of the Registrar-General. Thus argued Mr. C. H. Hopwood,
and accordingly he moved in the House of Commons successively for
three Returns, published as follows—Vaccination, Mortality, No. 433,
1877; Mortality (General and Infant), No. 76, 1880; and Deaths
(England and Wales), No. 392, 1880.
These Returns, charged with curious and authentic information,
are little known, and have been treated with significant silence by
the press. Obscurantism is not confined to ecclesiastics. Our valiant
journalists who mock at the Index Expurgatorius, and abhor the
Russian censorship, are in their little way as ready to act the same
part in favour of established prejudice. If facts adverse to the public
confidence in vaccination are revealed, it is considered no more than
decent to keep them out of sight.
What then is the evidence of Mr. Hopwood’s Returns? Briefly this:
they clearly illustrate that vaccination does produce, intensify, excite
and inoculate disease whose issue is death. The record of infant
mortality from fifteen specified diseases related to vaccination stands
thus—
Prior to Vaccination Act—1847-53—
Infants died, 1847, 62,619
Out of a population of
17,927,609.
Vaccination Obligatory—1854-67—
Infants died, 1854, 73,000
Do. 1867, 92,827
 Out of a population of
20,066,224.
Vaccination Enforced—1868-75—
Infants died, 1868, 96,282
Do. 1875, 106,173
Out of a population of
22,712,266.
Thus, while the population of England and Wales had increased
from 18 to 23 millions, the deaths of infants from fifteen diseases
had risen from 63,000 to 106,000. Had the mortality kept pace with
the population, the deaths in 1875 would only have been 80,000;
that is to say, in 1875 there perished in England 26,000 infants who
would have lived had vaccination remained as little in vogue as in
1847! The result though startling in the gross is precisely what might
have been predicted. The infancy of a country cannot be
systematically diseased, that is vaccinated, without exciting and
aggravating other maladies, and thereby enlarging the harvest of
death.

VACCINIA AGGRAVATES DISEASE.

The asserted connection of vaccination with other ailments, such
as bronchitis, sometimes gives occasion to ignorant ridicule.
“Bronchitis,” says Sir Lyon Playfair, “has about the same relation to
vaccination as the Goodwin Sands have to Tenterden Steeple.” The
answer is that the debility produced by vaccination predisposes to
affections of the respiratory organs. The human body does not
consist of isolated compartments, but is an organised whole,
sympathetic in all its parts and functions. Erysipelas, as we have
seen, is the primary symptom of inoculated Vaccinia, and diarrhœa
is its commonest sequence; and given erysipelas and diarrhœa,
what vigour may remain to assist and throw off other ailments? It is
not said that certain maladies are communicated by vaccination, but
that vaccination contributes to their fatality. An infant that would
have survived bronchitis dies of bronchitis and vaccination; dies of
teething and vaccination; dies of convulsions and vaccination; dies of
whooping-cough and vaccination; and so on. Again disease kindles
disease, and many a child might outgrow congenital scrofula or
phthisis if the latent disorder were not roused by vaccination. For
these reasons no doubt need be entertained that were vaccination
abolished, the event would be immediately signalised by an
extraordinary fall in infant mortality.

ORIGIN OF COMPULSORY VACCINATION.

If vaccination were a voluntary superstition, its prevalence would
be sufficiently deplorable; but when we think of it as inflicted on the
nation, and pressed on those who know it for an injurious imposture,
language is apt to arise which it is expedient to repress. It may be
asked how it came to pass that legislation was ever compromised
with a medical prescription, and the answer is not a reassuring one.
The initial error was the endowment in 1808 of the National Vaccine
Establishment, and the provision of vaccination fees in 1840 out of
the poor rate. For the enforcement of vaccination, there never was
any popular demand—never the slightest. The public had, however,
learnt from sanitarians that a large part of the sickness from which
they suffered did not come of fate, but was preventible; and under
this novel persuasion the vast expenditure on sanitary works during
the past fifty years has been cheerfully incurred. Availing themselves
of this favourable disposition in the public mind toward projects in
the name of health, certain medical place-hunters operating as the
Epidemiological Society contrived to gain the ear of Government and
to pass a compulsory Vaccination Act in 1853. The politicians who
lent themselves to this transaction disowned any knowledge of
vaccination. They acted, they said, under medical advice, and ran
the bill through Parliament with little resistance. The Act did not
personally concern M.P.’s. If they happened to believe in vaccination,
their children received the rite with all recognised precautions. Its
enforced application by contract at 1s. or 1s. 6d. per head was
reserved for the unenfranchised and unconsulted multitude; whilst
the administration of the Act provided place and pay for its ingenious
promoters.

RESISTANCE, INFLEXIBLE RESISTANCE.

When an oppressive law is enacted, by whatever strategy or
however corruptly, its repeal is no easy matter. The oppressors have
won the nine points of possession. The antagonists of the
Vaccination Acts nevertheless possess a certain advantage. Some
bad laws can only be denounced as it were from a distance; but
vaccination touches every household, and can be fought wherever a
child is claimed as a victim for the rite.
We abhor the rite. We detest it as an imposture. We dread it as a
danger. We refuse it on any terms. We encourage, we justify, we
insist on the duty of rejection. Our contention extends and prospers.
In various parts of the country resistance has been rewarded with
success. The evil law has been broken down. Freedom has been
recovered and freedom is enjoyed. In other parts the struggle for
liberty proceeds, and as it proceeds, light is diffused and courage
evoked for enlarged resistance. Elsewhere there are vindictive and
cruel prosecutions, chiefly of humble folk. “Respected ratepayers,” to
whom the law is objectionable and its penalties trivial annoyances,
are discreetly passed over. Hard, however, is the lot of poor men,
who for love of their children affront the dull animosity and
ignorance of English Philistines whether as guardians or as
magistrates on the bench of injustice. Shortly co-operation for
defence and insurance against fines will enable the feeblest and
most fearful to maintain his integrity and encounter his pursuers
with undaunted front. Parliament, as our statesmen allow, is deaf to
the aggrieved until they make themselves intolerable, and to raise
ourselves to that pitch must be our end and aim.

COMPULSORY EDUCATION AND VACCINATION.

Many good people are distressed over the operation of this
extraordinary law, and sometimes in their perplexity adventure for
excuse, “Surely since we compel parents to educate their children, it
cannot be wrong to compel them to have their children vaccinated.”
We answer, education is compulsory so far as it is outside
conscience. Compulsion is designed to overcome parental
indifference and selfishness: where it confronts serious convictions it
is arrested. By general consent the most important part of education
is religion; and religion is precisely that part of education which is
exempted from compulsion. The law does not even enforce some
form of religion, so that parents who regard religion as superfluous
may not be aggrieved.
What therefore the opponents of vaccination demand is, that the
respect thus accorded to the religious conscience be extended to the
scientific conscience—to those who are convinced that vaccination
does not prevent smallpox or is an injurious practice. Even allowing
it to be a harmless ceremony, resistance would be justifiable. It
would be in vain to console a Baptist, forced to convey his child to
the parish font, with the assurance that a few drops of water could
do no harm. It is not in human nature to submit to the indignity of
imposture; and to thousands of Englishmen vaccination is a cruel
and degrading imposture, and to punish them for their loyalty to
what they think right is every whit as tyrannical as it was for
Catholics to persecute Protestants, and Protestants Catholics, and
Catholics and Protestants Jews. There is no difference in the terms
of intolerance; and there is no difference in the spirit with which this
latter-day tyranny is confronted, and that spirit with which religious
liberty was vindicated and won.

CONDITIONS OF THE CONFLICT.

To some eyes the conflict is not only arduous; it is hopeless; but
we are of a different mind. The conflict may prove even less arduous
than it appears; and for these reasons. The law as it stands is
perfunctorily defended. No politician answers for it without
reluctance. Many allow that a serious mistake was made when
legislation was enacted for medical advantage at medical dictation.
The Gladstone government proposed to abolish repeated penalties.
The central authorities at the Local Government Board make no
secret of the insuperable difficulties which attend the administration
of the law. They advise concession to its resolute adversaries. They
do not reinstate the law where it has broken down. Legislation thus
discredited is sure to collapse under broader pressure. The medical
support is still weaker; and is chiefly confined to those who
represent the trade element of the profession—men who would
defend any abuse however flagrant if established and lucrative. It is
the custom to laud the immortal Jenner and the salvation he
wrought, but these are words of an old song. Those who have
penetrated to the inception of the Jennerian rite; who know the
absolute promise by which it prevailed and its absolute failure; who
have followed its successive transformations and varieties with their
respective injuries and fatalities; who are aware of the Babel of
confusion and contradiction in which its venal practitioners are
involved—these we say recognise how impossible it is for vaccination
to be brought under discussion and survive. It is this consciousness
which accounts for the reserve of the more prudent order of medical
men. They excuse their acquiescence in the delusion (after the
manner of ecclesiastics) by the exigencies of professional loyalty;
and by the supposition that the harm of the practice is exaggerated,
whilst it serves for the consolation of the vulgar. It is for such
reasons that we consider the conflict less arduous than it appears.
The fortifications are undermined; the bulwarks are rotten through
and through. Over all, we place our confidence in the omnipotent
favour of the truth. Goliath, mighty and vaunting, is evermore laid
low by a smooth stone shapen in the waters of verity.

A WORD FOR THE AUTHOR.

The Story of this Great Delusion, I have tried to tell concisely,
keeping close to matter-of-fact, and with some exceptions adhering
to English experience. When we venture abroad, we are apt to fall
into inaccuracies and draw unwarrantable conclusions. I am told my
animus is too pronounced, and that I should have done better had I
adopted a more judicial tone. Ah well! we should always have done
differently had we done differently. It seems to me a man does best
when he is most truly himself; and I question whether I should have
improved my case had I tried to conceal my real mind in order to
make a more startling show of it at the close.

L’ENVOI.
Lastly, a word to those who are accustomed to dismiss opponents
of vaccination as fools and fanatics. It is related of Sydney Smith
that calling on Lord Melbourne one morning, he found his lordship in
an evil temper and cursing at large. Smith, urgent about his own
affairs, at last observed that they should take everything for damned
and proceed to business. For like reason I would suggest that the
familiar tirade of fool and fanatic be taken as spoken, and that we
proceed to discuss vaccination and compulsory vaccination on their
merits.

DR. GARTH WILKINSON’S CATECHISM.

Q. When Whooping-Cough is not rife, what is that due to?
A. Nature.
Q. When Scarlatina is not rife, what is that due to?
A. Nature.
Q. When Cholera is not rife, what is that due to?
A. Nature.
Q. When Smallpox is not rife, what is that due to?
A. Vaccination.
Q. When other diseases in the course of time have become mild or died
out, what is that due to?
A. Nature.
Q. And when Smallpox has become mild or died out, what is that due
to?
A. Vaccination.
 S ancho P anza .-I beg of your Worship that you would let your wound be
dressed, for a great deal of blood comes from that ear: and I have some
lint, and a little white ointment, here in my wallet.
D on Q uixote .—All this would have been needless had I recollected to
make a vial of the balsam of Fierebras; for with one single drop of that,
we might have saved both time and medicine.
S ancho P anza .—What vial, and what balsam is that?
D on Q uixote .—It is a balsam, the receipt of which I hold in memory; and
having it, there is no fear of death, nor that any wound will be fatal:
therefore, when I shall have made it, and given it to thee, all thou wilt
have to do, when thou seest me in some battle cleft asunder (as it
frequently happens) is, to take up fair and softly that part of my body
which shall fall to the ground, and with the greatest nicety, before the
blood is congealed, place it upon the other half that shall remain in the
saddle, taking especial care to make them tally exactly and justly. Then
shalt thou give me two draughts only of the balsam aforesaid, and
instantly wilt thou see me become sounder than an apple.
S ancho P anza .—If this be so, I renounce from henceforward the
government of the promised island; and only desire, in payment of my
many and good services, that your Worship will give me the receipt of this
extraordinary liquor; for I daresay it will anywhere fetch more than two
reals an ounce; and I want no more to pass this life with credit and
comfort. But first, I should be glad to know whether the making of it will
cost much?
D on Q uixote .—For less than three reals thou mayest make nine pints.
S ancho P anza .—Sinner that I am! Why does your Worship delay making
and showing it to me?
D on Q uixote .—Peace, friend, for I intend to teach thee greater secrets,
and to do thee greater kindnesses: but at present, let us set about the
cure; for my ear pains me more than I could wish.
 PART I.—VARIOLOUS INOCULATION.

CHAPTER I.

COTTON MATHER AND ZABDIEL BOYLSTON.

To the Turks we owe little, and in the little is included the practice of
inducing smallpox artificially. The practice was first brought under
English attention by Emanuel Timoni in a letter, dated
Constantinople, December, 1713, communicated to the Royal Society
by Dr. Woodward, and published in the Society’s Transactions for
1714.[1] About the same time, Pylarini, Venetian consul at Smyrna,
described the practice in a Latin pamphlet printed at Venice, 1715,[2]
and reproduced in the Philosophical Transactions for 1716. Mr.
Kennedy, an English surgeon, who had visited Turkey, also reported
the practice under the designation of “Engrafting the Smallpox.”[3]
Timoni was a Greek physician, who had studied at Oxford and
Padua, and then established himself in Constantinople. He described
“smallpox by incision” as having been practised in Constantinople for
forty years, and that it had been found uniformly successful in
warding off smallpox as naturally developed. The variolous matter
was usually taken from healthy boys suffering from the spontaneous
disease, and was applied to persons of all ages and temperaments,
causing them no more than temporary and trifling inconvenience.
The only preparation requisite for incision was abstinence from flesh
and broth for twenty or twenty-five days.
It so happened that when Woodward read Timoni’s letter to the
Royal Society, he at the same time produced a selection from the
correspondence of Cotton Mather of Boston, Massachusetts—a
curious jumble of facts and fancies. Mather had been elected a
Fellow of the Society, and the selections from his correspondence,
and Timoni’s letter appeared in the same number of the
Transactions, No. 338, 1714.
Cotton Mather is one of the marvels of biography—a choice
specimen of Puritanism developed without check. He was a man of
boundless energy and incessant industry, of intense piety and
unlimited self-confidence; and thus, without hesitation, he set
himself to extirpate witchcraft, shrinking from no atrocity, until the
frightful Salem tragedy of 1692 shocked the colony into mercy and
common-sense.
Mather was just the sort of character to be impressed with
Timoni’s description of the short and easy way with smallpox; and he
who had hanged warlocks and witches with sublime assurance, was
not likely to have scruples about inoculating the community when
inwardly satisfied it was for the public good. The audacity and
tyranny of conscientious conceit are proverbial. He had, however, to
exercise patience in awaiting an opportunity to test the Turkish
remedy, for there had been no smallpox in Boston for nineteen years
—a fact worth noting by those who imagine smallpox was an
omnipresent ailment until the advent of Edward Jenner. In 1721 a
serious outbreak occurred, the deaths rising in October to 100 a
week in a population of 15,000. Mather convoked a meeting of
physicians, and laid before them the new prescription, but they
would not listen to it. Dr. Boylston, however, was persuaded, and
inoculated two of his slaves, and then his sons, aged five and six;
whereon he was summoned before the justices and severely
reprimanded. Undeterred by the State, and supported by the
Church, he persevered, and by the end of September had inoculated
80, and by the middle of December, 250.
His custom was to make a couple of incisions in the arms, into
which bits of lint dipped in pox-matter were inserted. At the end of
twenty-four hours the lint was withdrawn, and the wounds dressed
with warm cabbage leaves. On the seventh day the patient sickened
and pustules appeared, sometimes few, sometimes hundreds.
Mather and Boylston maintained it was a most wholesome operation,
for after it “feeble, crazy, consumptive people, grew hearty, and got
rid of their former maladies.”[4] To be poxed was to be rejuvenated.
Cotton Mather’s own account of the Boston experiment is worth
reading. He wrote—
March 10th, 172 12 .
The distemper hath lately visited and ransacked the City of Boston; and
in little more than half a year, of more than 5000 persons that have
undergone it, near 900 have died. But how many lives might have been
saved if our unhappy physicians had not poisoned and bewitched our
people with a blind rage that it has appeared very like a Satanick
Possession against the method of relief and safety in the way of the
smallpox inoculated!
I have prevailed with one physician (and for it I have had bloody
attempts made upon my life by some of our Energumens) to introduce the
practice; and the experiment has been made upon almost 300 Objects in
our neighbourhood, young and old (from one year to seventy), weak and
strong, male and female, white and black, in midsummer, autumn, and
winter, and it succeeds to admiration!
I cannot learn that one has died of it; though the experiment has been
made under various and marvellous disadvantages. Five or six have died
upon it, or after it, but from other diseases or accidents; chiefly from
having taken infection in the common way by inspiration before it could be
given in this way by transplantation.
Dr. Leigh, in his Natural History of Lancashire , counts it an occurrence
worth relating, that there were some catts known to catch the smallpox,
and pass regularly through the state of it, and then to die. We have had
among us the very same occurrence.
It was generally observed and complained that the pigeon-houses of the
City continued unfruitful, and the pigeons did not hatch or lay as they
 used to do all the while that the smallpox was in its epidemical progress:
and it is very strongly affirmed that our dunghill fowl felt much of the like
effect upon them.
We have many among us who have been visited with the Plague in
other countries many years ago, who have never been arrested with
smallpox after it, though they have been exposed as much as any other
people to it; whence the belief now begins to prevail among us, that they
who have had the Plague will never have the smallpox after it.

Considering the developed evidence that awaits us as to the

character and results of inoculation, it would be superfluous to
discuss this singular report, but we may remark the consummate
audacity with which Mather assumes and maintains his position.
What a masterly touch of the quack have we in these words—
I cannot learn that one has died of it. Five or six have died upon it, or
after it, but from other diseases or accidents; chiefly from having taken
infection in the common way by inspiration before it could be given in the
way of transplantation.

We can readily understand how the hand that could give so adroit
a turn to awkward disasters could in other days frame irresistible
indictments for witchcraft.
The precise truth as to the extent of the Boston epidemic is far
from easy to ascertain: it was the temptation of the inoculators to
magnify the numbers of the afflicted and of their antagonists to
minimise. Thus we read—
At a meeting by publick authority in the Town House of Boston, before
His Majesty’s Justices of the Peace and the Select Men; the practitioners
of physic and surgery being called before them, concerning Inoculation,
agreed to the following conclusion:—
A Resolve upon a debate held by the physicians of Boston concerning
inoculating the Smallpox on the 21st day of July, 1721.
It appears by numerous instances, that it has proved the death of many
persons soon after the operation, and brought distempers upon many
others which have in the end proved deadly to ’em.
That the natural tendency of infusing such malignant filth in the mass of
blood is to corrupt and putrefy it, and if there be not a sufficient discharge
 of that malignity by the place of incision, or elsewhere, it lays a
foundation for many dangerous diseases.
That the operation tends to spread and continue the infection in a place
longer than it might otherwise be.
That the continuing the operation among us is likely to prove of most
dangerous consequence.
The number of persons, men, women, and children, that have died of
smallpox at Boston from the middle of April last (being brought here then
by the Saltertuda’s Fleet) to the 23rd of this instant July (being the hottest
and worst season of the year to have any distemper in) are, viz. —2 men,
strangers, 3 men, 3 young men, 2 women, 4 children, 1 negro man, and 1
Indian woman, 17 in all; and of those that have had it, some are well
recovered, and others in a hopeful and fair way of recovery.
By the S elect M en of the T own of B oston .

Dr. Fleuart of Boston wrote to London that of 70 inoculated, 14 or

15 had died; and that at Roxbury, where there was no smallpox, 5
inoculated had died.[5]
Conflicting as are the testimonies, we must allow much to the
natural aversion from an operation, not only novel, but disgusting;
but taking the best that could be claimed for the new practice by an
enthusiastic advocate, the benefit was trifling when seriously
scrutinised. Dr. Boylston visited London after the Boston epidemic,
and finding inoculation in high vogue he published an Account of the
Smallpox inoculated in New England.[6] George I. and the Prince and
Princess of Wales had taken Inoculation under their august
patronage, and Boylston with loyal fervour burst forth—
Shall not physicians and surgeons recommend and bring it into greater
esteem and practice, and save (under God) thousands and tens of
thousands by it; and make further improvements in it; and set more
vigorously about it when they consider their great Pattern and Example for
it, namely, the greatest and wisest of Kings, their royal highnesses the
Prince and Princess at the head of it; and that it has been used upon their
Royal Issue with great success?

Boylston in his Account recites his cases with, we think, general

veracity. He performed 244 inoculations, and says, “there were in
the towns near Boston about 36 persons more inoculated, which all
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