Dissolving Illusions
Vaccination in Italy (June 21, 1899)

Charles Ruata, M. D., Professor of Hygiene and of Materia Medica in the University of Perugia, “Vaccinationin Italy”, The New York Medical Journal, July 22 1899, pp. 188-189
To the Editor of the New York Medical Journal:
SIR: In his presidential address to the American Medical Association, Dr. Joseph M. Mathews had thegoodness to call mad people, misguided people those who have no the good luck to be among the believers in thepreventative power of vaccination against small-pox. It is not surprising to hear such language from fanatics; in fact
it is most common to see ignorant men make use of similar vulgar expressions; but it seems to me almost incrediblethat the president of such a powerful association as the American Medical Association in his address showed himself
so enthusiastic in his belief as to forget that respect which is due to his colleagues who do not have the same blindfaith.
It may be that we antivaccinationists are “mad” and “misguided”, but I feel that we are far more correct inour expressions, although we do not believe, but are quite sure, that vaccination is one of the most wonderful andmost harmful mistakes into which the medical profession has ever fallen. I can assure you that if I am a madman,
my madness is very contagious, because all my pupils for several years have become as mad as I am, so that several
thousands of medical men in Italy are suffering now with the same kind of madness.
One of the most prominent characteristics of madness is shown in illusions and hallucinations which areaccepted as fundamental truths. Now, let us see what are the main facts about vaccination and small-pox in Italy:
Italy is one of the best vaccinated countries in the world, if not the best of all, and we can prove thatmathematically.
All our young men, with not many exceptions, at the age of twenty years must spend three years in thearmy, where a regulation prescribes that they must be directly vaccinated. The official statistics of our army,
published yearly, say that from 1885 to 1897 the recruits who were found never to have been vaccinated before wereless than 1.5 per cent., the largest number being 2.1 per cent. In 1893, and the smallest 0.9 per cent. in 1892. Thismeans in the clearest way, that our nation twenty years before 1885 was yet vaccinated in the proportion of 98.5 percent. Notwithstanding, the epidemics that we have had of small-pox have been something so frightful that nothing
could equal them before the invention of vaccination. To say that during the year 1887 we had 16,249 deaths fromsmall-pox, 18,110 in the year 1888, and 13,413 in 1889 (our population is 30,000,000) is too little to give a faintidea of the ravages produced by small-pox, as these 18,110 deaths in 1888, etc., did not happen in the best educatedregions of our country, but only in the most ignorant parts, where our population live just as they lived a century ago– that is, the mountainous parts of Sardinia, Sicily, Calabria, etc. Among the great number of little epidemics which
produced the 18,110 deaths mentioned, I will only note the following: Badolato, with a population of 3,800, had
1,200 cases of small-pox; Guardavalle had 2,300 cases with a population of 3,500; St. Caterina del Jonio had 1,200cases (population 2,700); Capistrano had 450 cases (population 2,500). All these villages are in Calabria. InSardinia the little village of Laerru had 150 cases of small-pox in one month (population, 800); Perfugas, too, in one
month had 541 cases (population, 1,400); Ottana had 79 deaths from small-pox (population, 1,000), and the deaths
were 51 at Lei (population, 414). In Sicily 440 deaths were registered at Noto (population, 18,100), 200 at Ferla(population, 4,500), 570 at Sortino (population, 9,000), 135 at San Cono (population, 1,600), and 2,100 deaths atVittoria (population, 2,600)! Can you cite anything worse before the invention of vaccination? And, the populationof these villages is perfectly vaccinated, as I have proved already, not only, but I obtained from the local authorities
a declaration that vaccination has been performed twice a year in the most satisfactory manner for many years past.
Vaccinationists were not puzzled by these facts, and with the greatest certainty they asserted that thisenormous number of deaths was due to want of revaccination. Happily, in Italy we are able to prove thatrevaccination has not the least preventative power. I only give a few figures: During the sixteen years 1882-’97 ourarmy had 1,273 cases of small-pox, with 31 deaths; 692 cases, with 17 deaths, happened in soldiers vaccinated withgood result, and 581 cases, with 14 deaths, happened in soldiers vaccinated with bad result. This means that of a1

Dissolving Illusions
Vaccination in Italy (June 21, 1899)

hundred cases of small-pox, fifty-four were in persons vaccinated with good result, and only forty-six in thosevaccinated with bad result, and that the death-rate among those vaccinated with good results was 2.45 per cent. andonly 2.40 per cent. in those vaccinated with bad result.
Vaccinationists say that when vaccination does not “take” the operation must be repeated, because no resultmeans no protection given. Now, we see that soldiers not protected because vaccination did not “take” were less,attacked by small-pox than those duly protected by the good result of their revaccination; and that the death-rate inthose vaccinated with good result was greater than among those in whom vaccination did not “take”.
Our vaccinationists did not lose their extraordinary courage before these facts, and they objected that they
could be accounted for by considering that during the years before 1890 vaccination was not well performed. I can
not understand this objection, but accepted it, and have limited my analysis to the last six years, during which theonly lymph used in all our army has been animal lymph, exclusively furnished by the government institute for theproduction of animal lymph. The results are the following: The total number of our soldiers during these five years
was 1,234,025, of which 783,605 were vaccinated with good result, and 450,420 with no result. In the first cases ofsmall-pox were 153 – that is, 1.95 to very 10,000 soldiers, while in other the number of cases was only 45 – that is,
0.99 cases to every 10,000 soldiers. The “duly protected” soldiers were attacked by small-pox in a proportion
double that among the “unprotected” soldiers.
As you see, these are official statements, extremely trustworthy, because the official statistics were made ina country where and at a time when no one thought that it was possible to raise a doubt against the dogma ofvaccination. In our country we have no league against vaccination, and every father thinks that vaccination is one of
his first duties; for these reasons no bias could exist against vaccination in making these statistics. I could continue
for a long while to quote similar facts, but I wish to call your attention only to the two following ones: During thethree most terrible years of epidemics that we have had in Italy lately (1887, 1888, and 1889) the death-rate fromsmall-pox among our people of the same age as the soldiers (twenty, twenty-one, and twenty-two years) has been 21
per 100,000, and it was 27.7 during the worst year (1888). In our army the same death-rate during nine years (1867’75) has been 20 per 100,000, and it was 61.3 during the worst year (1871).
In consequence of our young men being obliged to spend three years in the army, it happens that after theage of twenty years men are by far better vaccinated than women, and, if vaccination did prevent, after the age oftwenty small-pox should kill fewer men than women. But in fact just the reverse has happened. I give here thestatistics of the three years 1887, 1888, and 1889 as the ones of greatest epidemics, but all the other years give thesame results:
1887

Deaths1888

1889

Totals

Men

Women

Men

Women

Men

Women

Men

Women

Before the ageof twenty

5,997

5,983

7,349

7,353

5,625

5,631

18,972

18,968After the ageof twenty

2,459

1,810

1,990

1,418

1,295

863

5,749

4,091

After these facts I would most respectfully ask Dr. Joseph M. Mathews if he can show that in considering
them I have lost my mind. At any rate, I do not consider it correct for a medical man to make use of such language
against other medical men, however few, who have the only fault of considering facts as they are, and not as one
wishes they should be.
The progress of knowledge has for its principal base truth and freedom, and I hope that in the name of truth
and freedom you will publish these observations, badly expressed in a language that is not my own, in your mostesteemed journal.

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