To the Editor:—
The opponents of vaccination in England and in the United States are circulating the statistics of smallpox in Japan in recent years with a view to discrediting the prophylactic effect of vaccination in that country. They point out that Japan, which is supposed to be a thoroughly vaccinated country, has had, in the twenty years from 1889 to 1908, 171,500 cases of smallpox, and that in 1908 there were 18,139 cases. If the inhabitants of Japan were all thoroughly well vaccinated, these figures would seriously challenge the effectiveness of vaccination as a preventive measure against smallpox. There is, however, information at hand to show that a very large number of Japanese subjects have not been successfully vaccinated, and this information comes to us from an unimpeachable and authentic source. Dr. T. Amako, director of the Municipal Hospital for Infectious Diseases in Kobe, Japan, has recently published an