CHAPTER I.

TRANSCRIBER’S NOTE

Italic text is denoted by _underscores_.

Footnote anchors are denoted by [number], and the footnotes have

been placed at the end of each Chapter.

Some minor changes to the text are noted at the end of the book.

THE STORY

OF

A GREAT DELUSION.

[Illustration: EDWARD JENNER.

_From the statue by Monteverde._]

THE STORY

OF

A GREAT DELUSION

IN A SERIES OF MATTER-OF-FACT CHAPTERS.

BY WILLIAM WHITE.

All the world assenting, and continually repeating and

reverberating, there soon comes that singular phenomenon, which the

Germans call Swarmery, or the “Gathering of Men in Swarms,” and

what prodigies they are in the habit of doing and believing, when

thrown into that miraculous condition....

Singular, in the case of human swarms, with what perfection of

unanimity and quasi-religious conviction the stupidest absurdities

can be received as axioms of Euclid, nay as articles of faith,

which you are not only to believe, unless malignantly insane, but

are (if you have any honour or morality) to push into practice, and

without delay see _done_, if your soul would live!--THOMAS CARLYLE.

LONDON:

E. W. ALLEN, 4 AVE MARIA LANE.

1885.

GLASGOW:

HAY NISBET AND CO., PRINTERS,

STOCKWELL STREET.

CONTENTS.

INTRODUCTION. PAGE

Prefatory, ix

Variolation, x

The Precursor of Vaccination, xi

Immediate Triumph of Vaccination, xii

Jenner’s Procedure, xiii

Horsegrease Cowpox, xiv

Rejection of Jenner’s Prescription, xiv

Jenner’s Transformation, xv

Horsegrease Cowpox kept out of Sight, xvi

Spurious Cowpox, xvi

Horse Virus Vindicated, xvii

Which shall it be? xviii

Smallpox Cowpox, xix

Condemnation of Smallpox Cowpox, xx

Cowpox Revived, xxi

A Cowpox Charlatan, xxii

A Decorous Unanimity, xxiii

Jenner’s Successive Disclaimers, xxiv

Smallpox made milder, xxvi

Punctures, one or several, xxvi

Mr. Rigby’s Protest, xxvi

Mr. (Marks) Marson, xxviii

Mr. Alexander Wheeler’s Researches, xxix

Mr. Enoch Robinson’s Opinion, xxx

Cruelty of Marking, xxx

Revaccination Introduced, xxxi

Vaccinisation, xxxii

Absurdity of Revaccination, xxxii

The Reduction of Smallpox, xxxiii

Has Vaccination saved Life? xxxiii

Who are the Unvaccinated? xxxiv

Unvaccinated Death-rates, xxxv

Nurses exempt from Smallpox, xxxvi

Pock-marked Faces, xxxvii

Vaccinia a real Disease, xxxix

Vaccinal Fatalities, xl

Vaccinia Modified in its Recipients, xli

Vaccinia _plus_ other Disease, xlii

Statistical Evidence of extra Disease, xliii

Vaccinia aggravates Disease, xlv

Origin of Compulsory Vaccination, xlv

Resistance, Inflexible Resistance, xlvi

Compulsory Education and Vaccination, xlvii

Conditions of the Conflict, xlviii

A Word for the Author, xlix

L’Envoi, l

Dr. Garth Wilkinson’s Catechism, l

I.--VARIOLATION.

CHAPTER I.--Cotton Mather and Zabdiel Boylston, 1

II.--Lady Mary Wortley Montagu, 8

III.--Maitland’s Experiments, 12

IV.--The First Opponents of Inoculation, 21

V.--Collapse of Inoculation, 29

VI.--Revival of Inoculation, 36

VII.--Triumph of Inoculation, 45

VIII.--Inoculation Abroad, 56

IX.--Inoculation superseded and suppressed, 66

X.--As to the Prevalence of Smallpox in the 18th

Century, 76

II.--VACCINATION.

CHAPTER I.--Jenner’s Earlier Years, 91

II.--Jenner’s _Inquiry_, 1798, 103

III.--Jenner in 1798, 127

IV.--Pearson’s _Inquiry_, 136

V.--Woodville, Pearson, and Jenner, 145

VI.--Jenner’s _Further Observations_, 152

VII.--Operations in London, 1800, 159

VIII.--Triumph of the New Inoculation, 171

IX.--A Dishonourable Transformation, 177

X.--Jenner before Parliament, 1802, 183

XI.--Pearson’s _Examination_, 197

XII.--Observations on the Position in 1802, 208

XIII.--The Royal Jennerian Society, 218

XIV.--Application to Parliament for Jenner’s Relief,

1806, 230

XV.--Report of the Royal College of Physicians, 235

XVI.--Jenner Relieved, 1807, 243

XVII.--Vaccination Established and Endowed, 250

XVIII.--Horsegrease as a source of Vaccine, 259

XIX.--John Birch, 274

XX.--Goldson and Brown, 283

XXI.--Moseley, Rowley and Squirrel, 289

XXII.--William Cobbett, 303

XXIII.--The Grosvenor Case, 317

XXIV.--Dr. John Walker, 322

XXV.--Jenner’s Later Writings, 333

XXVI.--Baron’s Life of Jenner, 349

XXVII.--The Medical Position in 1823, 363

XXVIII.--Introduction of Vaccination to the United

States, 370

XXIX.--Introduction of Vaccination to India and

the East, 383

XXX.--Diffusion of Vaccination throughout Europe, 395

XXXI.--Sweden, Denmark and Iceland, 408

XXXII.--Newcastle Smallpox: a Common Story, 424

XXXIII.--The Norwich Epidemic--1819, 431

XXXIV.--Smallpox Displaced and Replaced: Dr. Watt’s

Discovery.--Glasgow, 1813, 439

XXXV.--The National Vaccine Establishment--1808-40, 453

XXXVI.--The National Vaccine Establishment--1841-50, 470

XXXVII.--Vaccination Enforced--1853, 477

XXXVIII.--Universal Compulsion Demanded--1855, 491

XXXIX.--John Gibbs’s Letter--1855, 500

XL.--Simon’s Defence and Hamernik’s Judgment, 510

XLI.--Compulsion Intensified--1861 and 1867, 526

XLII.--The Gathering Movement, 1867-70, 540

XLIII.--House of Commons Committee, 1871, 552

XLIV.--The Struggle for Freedom, 573

NOTES--Origin of the Term Vaccination, 229

_Vaccination a Statistical Question_, 596

INDEX, 597

ILLUSTRATIONS.

Edward Jenner from Statue by Monteverde, FRONTISPIECE.

John Gibbs, 508

INTRODUCTION.

PREFATORY.

There are few matters among educated people upon which opinion is

so absolute and so ill-informed as vaccination. They will tell you

it has stopped smallpox and does no harm, and if you venture to

question either assertion you are set down as an abettor of “those

ignorant and fanatical anti-vaccinators.” If undeterred you inquire

when smallpox was stopped, and which is the harmless variety of

vaccination, you will probably be told that these are medical

questions, whilst the facts are indisputable; the answer running in

the line of Old Kaspar’s to Little Peterkin, inquisitive as to the

good of Blenheim--

Why that I cannot tell, said he,

But ’twas a famous victory.

I am not complaining of this attitude of mind. We all accept more

or less on bare authority. In the multiplicity and unsearchableness

of knowledge, it is unavoidable. Some years ago a venerable friend

urged me to write against vaccination, which, he said, was working

endless mischief to the public health. He would have the book

published, and provide whatever was requisite for my satisfaction.

I pleaded prior engagements, and turned the conversation, thinking

how sad it was that one so good, and, in other respects, so

enlightened should be subject to so strange an illusion--I, then,

taking vaccination on trust as one of the numerous blessings

conferred upon mankind in the course of the present century.

I am therefore disposed to make large allowance for the credulous

attitude of the public toward vaccination whilst at the same

time insisting on its correction; and for this reason especially,

that vaccination is no longer a matter of private concern. We are

free to entertain what notions we please, but if we proceed to

enforce them on unbelievers, we cannot complain if we are required

to answer for our aggression or encounter rough usage. Enforced

by the law of England, vaccination is related to the life and

intelligence of every citizen, and it is consequently vain to claim

for it exemption from vulgar discussion. Apart from its compulsory

infliction, vaccination might be and remain an esoteric rite, the

very mystery of mysteries; but with compulsion the privilege of

sanctity is impossible.

VARIOLATION.

It has been said that beliefs and observances in themselves most

irrational wear a different aspect when viewed in the light of

their origin and history. It is so with vaccination. Had it

come upon the world as we know it, with failure and disaster,

equivocation and apology, rejection would have been inevitable; but

when we turn to the past we discover that our _damnosa hæreditas_

has a tradition that goes far to account for, if not to excuse, the

folly which remains.

Vaccination was the successor of Inoculation (or, more precisely,

Variolation), entering into a possession already acquired in the

human mind.

It had been observed from of old that some forms of disease rarely

recur in the same person in a lifetime; and thus when scarlet

fever, or measles, or smallpox broke out in a family, it was

considered prudent to let the disease have its course, and thereby

obtain immunity from fear of future infection.

It was this confidence, that smallpox once undergone was finally

disposed of, that was the justification of the practice of

inoculating the disease when introduced from the East in the

first quarter of last century. Inasmuch, it was argued, as none

can have smallpox more than once, why not induce it artificially,

and pass through the illness at a convenient season? But Nature,

though compliant, does not always accept the course we ingeniously

prescribe for her. Smallpox as naturally developed (so to speak) is

a crisis of impurity in the blood, and if the requisite conditions

are absent, it cannot be adequately excited. Hence variolation

was an uncertain and hazardous operation. It took with some and

was indistinguishable from an attack of ordinary smallpox; it

took partially, or not at all with others; and the operation was

frequently followed by malaise, disorders of the skin, and grave

constitutional derangements. Nor were the variolated secure from

smallpox. They occasionally had smallpox with their neighbours,

and then it was said, “There must have been some mistake about the

inoculation; for it is impossible that anyone can be successfully

inoculated and have smallpox.” Further, the variolated, while

labouring under the induced malady, conveyed the disease to their

attendants and visitors; and thus smallpox was propagated by the

means intended to avert it.

THE PRECURSOR OF VACCINATION.

At the close of last century, variolation had become the custom

of the upper and middle classes of England. The trouble and the

peril were disliked, but were accepted in the name of duty. The

variolation of their children was an anxiety that weighed like

lead on the hearts of affectionate parents; and glad and grateful

they were when the operation was accomplished without serious

mishap. Patients designed for variolation were dieted, purged,

and bled; and smallpox from sufferers of sound constitution was

diligently inquired for. Mild smallpox was in great demand and

was propagated from arm to arm. When Dr. Dimsdale operated on the

Empress Catharine he did not venture to convey smallpox direct to

the imperial person. He looked out a case of “benign smallpox” with

which he inoculated a strong young man, and from the young man the

Empress. Unless we realise the inconveniences, the uncertainties,

the disasters and the horrors of the practice of variolation,

albeit minimised, excused and denied by its professors, we can

never understand the enthusiasm with which vaccination was received

as its substitute. The promise conveyed in vaccination was a relief

inexpressible, bearing with it a show of reason that was well nigh

irresistible. The argument ran thus: No one can have smallpox

twice, and the mildest attack is as protective from subsequent

attack as the severest. Therefore it is that in inoculation with

smallpox we find security. But inoculation with smallpox is an

uncertain operation with dangerous issues. Here, however, in cowpox

is discovered a mild variety of smallpox, which may be inoculated

with perfect ease, and with no possibility of harm. And inasmuch

as the mildest smallpox is as preventive of future smallpox as the

severest, it follows that this gentle cowpox must serve as a full

equivalent for smallpox itself.

IMMEDIATE TRIUMPH OF VACCINATION.

It was in this plausible shape that vaccination had an immediate

triumph. The way was made straight for it and every difficulty

removed by the existing practice of variolation. Dr. W. B.

Carpenter says that vaccination was more strenuously resisted

at the beginning of the century than it is at this day. He is

completely mistaken. Vaccination came upon a generation prepared

for it--which saw in it a prescription in full accord with

common-sense. The entire medical profession, with a few exceptions,

the King, Queen and court, were converted straight off, and

parliament and society followed suit. It was, I confess, a natural

development of opinion; and we need have little doubt that had we

lived in those days we should have found ourselves shouting with

the genteel mob. The limited resistance offered to vaccination

was not based on physiological or sanitary science: such science

did not then exist. It was the resistance of variolators who

were satisfied with the established practice and resented its

disturbance; professing at the same time immeasurable horror at the

profanation to humanity by infection with bovine disease. Whilst

we have no reason to identify ourselves with that resistance,

we have to recognise the service rendered by the variolators in

observing the results of vaccination--the persistency with which

they traced and exposed its failure to prevent smallpox and the

injuries and deaths it caused. So far as the maintenance of

variolous inoculation was concerned, they fought a losing battle;

but they drove the vaccinators from post to post (cursed while they

did so as malignant false witnesses possessed of the devil) and at

last compelled the admission that their infallible preventive could

not be guaranteed to prevent, but only to make smallpox milder--a

safe assertion because unverifiable, as disputable as indisputable

in particular instances.

JENNER’S PROCEDURE.

About the matter of this prophylactic there was from the first a

curious confusion which continues to this day.

Jenner was a country doctor at Berkeley in Gloucestershire, a dairy

country, where the maids believed that if they caught cowpox in

milking they could never afterwards catch smallpox. Jenner when a

young man was inclined to accept the dairymaids’ faith; but when

he discussed it with his medical acquaintance, they ridiculed him.

They said, “We know that such is the dairymaids’ faith, but we also

know that it is untrue; for we know dairymaids who have had cowpox,

and afterwards had smallpox notwithstanding their cowpox.” Jenner

was convinced and said no more about cowpox.

To this point let me draw special attention. No man knew better

than Jenner that cowpox as cowpox was no preventive of smallpox.

Toward middle-life he had what he conceived to be a happy thought.

Cowpox as cowpox he had dismissed as impracticable; but there was

a variety of cowpox which he resolved to recommend.

Cows in Gloucestershire were milked by men as well as by women; and

men would sometimes milk cows with hands foul from dressing the

heels of horses afflicted with what was called _grease_. With this

_grease_ they infected the cows, and the pox which followed was

pronounced by Jenner to have all the virtue against smallpox which

the dairymaids claimed for cowpox.

HORSEGREASE COWPOX.

According to Jenner, then, the dairymaids were right, and they were

wrong. They were right when the pox they caught was derived from

the horse through the cow; they were wrong when the pox they caught

originated on the cow without the horse. He thus discriminated a

double pox--cowpox of no efficacy against smallpox, and horsegrease

cowpox of sure efficacy.

Further, in this connection, it is to be observed, that farriers

believed that when they got poisoned in handling horses with greasy

heels, they too, like the dairymaids, were safe from smallpox.

It is not therefore for cowpox, but for horsegrease cowpox that

Jenner is answerable. In cowpox he had not, and could have no faith.

In 1798 Jenner published his famous _Inquiry_, a treatise much more

spoken of than read, wherein he distinctly set forth the origin of

his chosen prophylactic. It was _not_, I repeat, cowpox: _it was

horsegrease cowpox_. He carefully discriminated it from spontaneous

cowpox, which, he said, had no protective virtue, being attended

with no inflammation and erysipelas, the essential sequences of

inoculation with effective virus.

REJECTION OF JENNER’S PRESCRIPTION.

I have said that the world gave a cordial and unhesitating welcome

to Jenner’s revelation, but the observation requires a startling

qualification. Jenner’s revelation as conveyed in his _Inquiry_

was summarily and ignominiously rejected--was absolutely rejected.

I wish to emphasise this point. Jenner published his _Inquiry_ in

order to recommend horsegrease cowpox, and what I have to say is,

that the public declined to have anything to do with horsegrease

cowpox. The origin of cowpox in horsegrease was scouted as an

intolerable origin. It was disgusting. Why a diseased secretion

from horses’ heels should be more repulsive than a similar

secretion from cows’ teats was not explained; but, as we all know,

there is no accounting for tastes. Various attempts were made to

verify Jenner’s prescription by inoculating cows with horsegrease,

but they ended in failure--fortunately, it was said, in failure;

for as Dr. Pearson (chief among primitive vaccinators) observed,

“The very name of horsegrease was like to have damned the whole

thing.” What did Jenner do under these circumstances? Did he

confront the public and assert the efficacy of horsegrease cowpox?

Not he. He wanted money. He saw how the wind was blowing. He said

not another word about horsegrease cowpox; and as the public

were eager at any price to escape from the nuisance of smallpox

inoculation, and disposed to substitute cowpox as a harmless

substitute, why then he resolved to go in for cowpox, and pose as

its discoverer and promoter.

JENNER’S TRANSFORMATION.

I am not making what is called a constructive charge against

Jenner, but simply setting forth plain, undeniable matter-of-fact.

I ask any one in doubt as to what I say to read Jenner’s _Inquiry_,

published in 1798, the prescription of which is horsegrease cowpox,

and the condemnation of cowpox. Turn then to his petition for

largess, addressed to the House of Commons in 1802, and what do we

find? Not one word about horsegrease cowpox, but this audacious

assertion:--

“That your Petitioner has discovered that a disease which

occasionally exists in a particular form among cattle, known by

name of Cowpox, admits of being inoculated on the human frame

with the most perfect ease and safety, and is attended with the

singularly beneficial effect of rendering through life the person

so inoculated perfectly secure from the infection of Smallpox.”

Why, that was not Jenner’s discovery! It was the notion of the

dairymaids, and, so far as concerned spontaneous cowpox, was known

by Jenner to be untrue. Yet, strange to say, the claim was in a

measure allowed by the House of Commons, and £10,000 awarded to the

imposter, and subsequently £20,000 in 1807.

HORSEGREASE COWPOX KEPT OUT OF SIGHT.

As evidence of how completely Jenner’s prescription of horsegrease

cowpox was put out of sight, I may refer to the treatise of Dr.

Willan _On Vaccine Inoculation_, published in 1806, wherein

all that was thought important concerning the new practice was

set forth; and although Jenner was freely cited, yet neither

horsegrease nor horsegrease cowpox was referred to from the

first page to the last. Instead, cowpox, after the fancy of the

dairymaids, was exalted as the true prophylactic, apparently

without a suspicion of its questionable character.

As I have said, Jenner not only offered no resistance to this

amazing transformation, but conformed to it, and assumed the issue

as his own. Since the public preferred cowpox to horsegrease

cowpox, he saw no reason why he should object, especially as the

same foolish public lusted after some one to worship for their

deliverance from the plague of variolation. The world resounded

with praises of the immortal Jenner, the saviour of mankind from

smallpox. Enveloped in the smoke of such incense, it is scarcely

surprising that the idol came to believe that his worshippers knew

him better than he did himself.

SPURIOUS COWPOX.

The promise of vaccination, its absolute security and harmlessness,

was speedily belied. The vaccinated caught smallpox; they fell

sick after the operation; they were afflicted with eruptions and

swellings; they died. These mishaps were at first denied--stoutly

denied; and when denial was no longer possible, it was attempted

to explain them away. The cowpox used could not have been genuine

cowpox, but spurious; and for awhile spurious cowpox did yeoman’s

service in the way of apology; but by-and-by the excuse began to

work more harm than good. Mishaps were so numerous that people

became afraid of this omnipresent spurious cowpox, and to ask what

it was, and how it could be avoided. How can there be spurious

pox? Whoever heard of spurious disease? Milkmen vend spurious

milk, grocers spurious sugar, smashers spurious coin; but surely

cows are not to be numbered with such malefactors as producers

of spurious pox! The thing was absurd on its face, and absurd

it proved. When Jenner was under examination by a committee of

the College of Physicians in 1806, he was pressed hard for a

definition of spurious cowpox, when he “owned up.” He knew nothing

of spurious cowpox. The words had been employed, not to describe

any irregularity on the part of the cow, but certain irregularities

in the action of cowpox on the part of the vaccinated: which was

to say that when the vaccinated recovered creditably and did not

catch smallpox, the cowpox was genuine; but when the sequences were

otherwise, why then it was spurious! Ingenious and convenient, was

it not?

HORSE VIRUS VINDICATED.

Reverting to Jenner’s suppression of the origin of cowpox in

horsegrease, it may be suggested that he had changed his mind: but

he had not changed his mind. As observed, various attempts were

made to inoculate cows with horsegrease, and that these attempts

were failures; but subsequent attempts were successful. Tanner,

a veterinarian, of Rockhampton, Gloucestershire, succeeded to

Jenner’s complete satisfaction. Dr. Loy of Whitby dispensed with

the cow altogether, and inoculated with horsegrease, or horsepox,

producing vesicles identical with those of cowpox. The great

success, however, in this line was reserved for Sacco of Milan.

From the hand of a coachman poisoned with horsegrease he inoculated

nine children, and from the virus thus engendered operated on every

side. Writing to Jenner in 1803, Sacco said--“It is now admitted

and settled that grease is the cause of vaccine, and we cannot too

soon alter the designation to equine.” De Carro of Vienna received

this equine from Sacco, and used it so freely and successfully

among the Viennese, that, in his own words, it became impossible to

say which of the citizens were equinated and which vaccinated.

What did Jenner make of these confirmations? He was adjudged

mistaken in asserting that the cowpox good against smallpox was

derived from horsegrease. Did he appeal with triumph to the

evidence of Sacco, and say, “You thought me wrong, but see, I was

right!” Not he. He kept silence. He consented to be treated as in

error. He stood by and allowed cowpox to be used in which he had

no confidence whatever. Nay more. He consented to be rewarded and

honoured as the discoverer of a pox (which he did not discover) in

which he was without faith, and had at the outset of his career

expressly rejected and condemned. He recognised that it was

expedient that the connection between horsegrease and cowpox should

be denied. He had his bill to settle with the English people, and

it was not for him to make difficulties. When, however, he had

obtained all he could expect from public favour, and had got clear

of London and the oppression of its savants, why then he resumed

the expression of his original opinion; and still further, like

Sacco of Milan, he dispensed with the cow, and inoculated straight

from the horse. He supplied the National Vaccine Establishment with

horse virus; he sent it to Edinburgh; he distributed it among his

medical acquaintances; he described it as “the true and genuine

life-preserving fluid.” What more need I say? Such was Jenner; such

were his tactics; and whoever assumes his defence will assume a

task in which he is not to be envied.

WHICH SHALL IT BE?

Jenner died in 1823, and at that date three kinds of virus were in

use; first, cowpox from horsegrease or horsepox; second, cowpox;

third, horsepox. These of course were subject to inscrutable

modification in transmission from arm to arm: it is the distinct

sources we have to recognise. A patient intent on vaccination might

have said to himself, Which shall it be? Shall I be cowpoxed? or,

shall I be horsepoxed? or, shall I be horsepoxed cowpoxed? How such

an inquirer would have been answered had he set his perplexity

before his medical adviser, I can only conjecture. Probably he

would have been rebuked for his intrusion into matters outside

his province. The little girl who quenched the scepticism of her

comrade with the dictum, “It is so, for ma says so; and if it isn’t

so, it is so, if ma says so,” illustrates the manner of rebuff

administered to those who pry into professional mysteries. It is

for you to pay and for us to think is a formula by no means limited

to ecclesiastics.

SMALLPOX COWPOX.

Jenner was pleased to describe cowpox as a mild form of smallpox;

but for what reason, outside his pleasure, he did not explain.

Nevertheless the suggestion has borne fruit. When virus has fallen

short, it has been asked, Why, if cowpox be mild smallpox, should

not cows be inoculated with smallpox, and a crop of virus be

raised? Various such attempts have been made, in which Mr. Badcock

of Brighton has been especially distinguished. Mr. John Simon,

writing in 1857, said, “Mr. Badcock, from 1840 to the present time,

has again and again derived fresh stocks of vaccine lymph from cows

artificially infected by him; having vaccinated with such lymph

more than 14,000 persons, and having forwarded supplies of it to

more than 400 medical practitioners.” When it is remembered that

virus for half a dozen or more vaccinations is taken from a single

arm, and that this process of reproduction is repeated every week,

some idea may be formed of the extent to which this smallpox cowpox

has been diffused over the country.

The original assertion that vaccination conferred life-long

immunity from smallpox was unwillingly abandoned under stress

of experience, until no respectable practitioner pretended that

the rite afforded more than a partial or temporary security. In

promotion of smallpox cowpox, however, Jenner’s most extravagant

claims were revived. In Mr. Simon’s words, for the recipient of

smallpox cowpox, “Neither renewed vaccination, nor inoculation with

smallpox, nor the closest contact and co-habitation with smallpox

patients, will occasion him to betray any remnant of susceptibility

to infection.” Untrue even of variolation, it is unnecessary to

controvert such a figment: it suffices to place it on record.

The hypothesis was, that smallpox inoculated on the cow lost

somewhat of its virulence; but if so, why should not such cowpox

inoculated on man resume its virulence? We are apt to forget that

the nature of things is not controlled by our wishes, and that

our interest in the conversion of smallpox into cowpox, and its

maintenance as cowpox, is no warrant for fulfilment. I may also

remark that though smallpox cowpox has entered so largely into

currency, there is no evidence to what extent it has displaced

the preceding issues of horsegrease cowpox, cowpox and horsepox.

So far as we know, they are all existent in the common blood,

indistinguishable, the stronger surviving, the weaker dying out:

nobody knows, nor can know.

CONDEMNATION OF SMALLPOX COWPOX.

That smallpox cowpox is in any sense cowpox is, however, widely

disputed, much confidence being placed in the researches of the

Lyons Commission in 1855, presided over by M. Chaveau. This

Commission, says Dr. Charles Cameron, “proved incontestably that

smallpox can no more be converted into cowpox by passing it

through a cow than by stunting an oak it can be converted into a

gooseberry bush.” Cowpox, it is held, is a disease of the cow, with

no relation to smallpox. The vesicles of each may be apparently

identical, as are the vesicles excited by the application of tartar

emetic; but that is no proof of essential identity. According to

Dr. George Wyld, “Smallpox inoculation of the heifer produces not

vaccinia, but a modified smallpox, capable of spreading smallpox

among human beings by infection;” and Dr. Cameron boldly attributes

the recent increase of smallpox to the use of smallpox cowpox for

vaccination.

Nor is Dr. Cameron singular in this opinion. Some time ago, the

Galway Guardians ran short of virus for vaccination, when it was

proposed to inoculate a calf with smallpox. As soon as the Local

Government Board in Dublin became aware of the project, it was

forbidden. Why? Here is the deliverance of the Secretary--“Because

smallpox virus taken from the calf would communicate that

disease to the human subject, and be thereby a fertile source of

propagating the disease; and would, moreover, render the operator

liable to prosecution under the Act prohibiting inoculation with

smallpox.” Thus the virus current in England, and credited with

miraculous virtue by Simon, is denounced as dangerous and its use

unlawful in Ireland!

COWPOX REVIVED.

The constant disasters of vaccination, the certain and suspected

communication of human diseases with the virus propagated from arm

to arm, have induced a wide resort to cowpox under the designation

of “animal vaccination,” in contempt of the fact that disease in

cattle is as rife as among men, and inoculable. Still the dread of

the invaccination of syphilis is so intense, and so justifiable,

that other risks are encountered if that may be avoided.

This cowpox is commended as “pure lymph from the calf,” a sweet

periphrase with a savour of Daphne and Chloe, of Flora and the

country green--a periphrase used in craft or ignorance, “pure

lymph” being as incapable of producing vaccinia as pure milk or

pure saliva. The prescription takes us back to Jenner’s time

and Jenner’s procedure. As has been said, the Gloucestershire

dairymaids believed that after cowpox they were safe from smallpox,

and that Jenner was much impressed with their belief until he

discovered that it was untrue. Had he found it true, he might

have advertised the prophylactic thirty years in advance of the

publication of his _Inquiry_; but if anything was certain, this

was certain, that cowpox did not avert smallpox. Satisfied that

cowpox _per se_ was of no avail against smallpox, he defined a

variety of cowpox generated by the application of horsegrease, to

which he was pleased to ascribe sovereign efficacy. Why, I ask,

did he discriminate and prescribe that variety of cowpox if cowpox

_per se_ was effective? The question answers itself. I will not

say the cowpoxers treat Jenner’s evidence with disrespect; for

such is their ignorance, that I question if they are aware of

its existence; moreover, that which is undesirable to know, is

instinctively avoided and kept out of sight. They recommend their

“lymph” as wonderfully mild, being attended with no erysipelas, the

pest of arm-to-arm vaccination--a description that tallies exactly

with Jenner’s of impotent cowpox. “The pustules,” says Jenner, “are

of a much milder nature” than those of horsegrease cowpox. “_No

erysipelas attends them_, and they are incapable of producing any

specific effect on the human constitution.”

A COWPOX CHARLATAN.

Yet, incredible as it may appear, it is with the praise of this

impotent cowpox, attended with no erysipelas, that the public

have been deafened, and for which the most extravagant assertions

are made. Dr. Martin, one of the chief producers and vendors of

the article, appeared at the British Medical Association in 1881,

saying, “I am called upon at times, at the very shortest notice,

to vaccinate whole cities; and when I left America, I had just

completed the vaccination of the city of New Haven. The custom

is to send for me, or my son, wherever smallpox breaks out, with

orders to vaccinate at once the entire population of the city,

town, or neighbourhood. It is done immediately, the result being

that an epidemic is completely stopped in a week.”

Thus spoke the charlatan, with the acquiescence of the medical

assembly. When churchmen deplore the scepticism of the age, and

the decay of faith, it is to be observed that the habit of mind is

limited to certain modes of opinion, and that in general we are

as credulous as ever. Human nature in its structure is curiously

immutable. Wherein is the advantage to disbelieve in witchcraft and

to believe that epidemics of smallpox can be stopped with cowpox?

A DECOROUS UNANIMITY.

Such are the leading varieties of virus used for

vaccination--starting with Jenner’s horsegrease cowpox, then

cowpox, then horsepox, then smallpox cowpox, and finishing with

cowpox revived; each of them inscrutably modified in transit

from child to child and from beast to beast. We are continually

hearing of miracles wrought by vaccination in the past and

present--especially the past, at home and abroad--especially

abroad, the assumption being that vaccination is, and has been,

everywhere the same. On the contrary, the condition precedent to

serious consideration of any vaccine miracle is a definition of

the variety of vaccination practised. It is, we admit, convenient

for the administrators of the rite that it should pass for

uniform, however multiform; for the practice has become a great

and lucrative business--a world-wide poll-tax; and whatever the

internal differences of the priesthood, it is their obvious

interest to exhibit a decorous unanimity in presence of their

customers. Hence the uneasiness recently excited by indiscreet

advocates of “pure lymph from the calf” has been judiciously

allayed, not by resistance, but by concession and damnation with

faint praise; the commercial instinct dictating caution, for if the

public did get behind the professional screen, and discovered the

mysteries of pox, what might not befall the craft of vaccination!

JENNER’S SUCCESSIVE DISCLAIMERS.

The story of vaccination is a story of failures, and as each

failure has become manifest, it has been more or less artfully

apologised for.

Much is given to assurance. People like infallible prescriptions.

They prefer an unequivocal lie to an equivocal answer. This

adventurers understand, and discourse accordingly. Hence when

Jenner solicited Parliament for largess, he did so in no doubtful

terms. He boldly declared that cowpox was “inoculated on the human

frame with the most perfect ease and safety,” and was “attended

with the singularly beneficial effect of rendering through life

the person so inoculated perfectly secure from the infection of

smallpox.” Again he said, “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.”

It is needless to point out that Jenner was without warrant for his

assertions. His experience did not cover more than a few years;

and he could not, therefore, know that his specific would secure

its subjects from smallpox for life. He believed, or affected to

believe, his own assurance, and assurance being infectious, it

widely spread. The inoculation of cowpox became fashionable among

busybodies, male and female. Ladies especially were numbered among

Jenner’s favourites and experts, operating, as he described, “with

a light hand.” Cobbett relates, “Gentlemen and ladies made the

beastly commodity a pocket companion; and if a cottager’s child

were seen by them on a common (in Hampshire at least), and did not

quickly take to its heels, it was certain to carry off more or less

of the disease of the cow.”

It so happened that prior to the introduction of vaccination, a

marked decline in the prevalence of smallpox had set in, and for

the continuance of this decline the vaccinators took credit. “See,”

they cried, “see what _we_ are doing!” But they failed to observe

that the decline prevailed among millions who did not participate

in the cowpox salvation. Soon, however, cases of smallpox among

the vaccinated began to be reported. At first they were denied.

They were impossible. When the evidence became too strong for

contradiction, it was said, “There must have been some mistake

about the vaccination; for it is incredible that any one can be

properly vaccinated and have smallpox: 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.” Either some

carelessness on the part of the vaccinator, or some defect in the

cowpox served for a while to reassure the faithful; but ultimately

these reassurances utterly broke down. Persons vaccinated by Jenner

himself caught smallpox and died of smallpox. Then said Jenner, “I

never pretended that vaccination was more than equivalent to an

attack of smallpox, and smallpox after smallpox is far from being

a rare phenomenon; indeed, there are hundreds of cases on record,

and inquiry is continually bringing fresh ones to light.” True;

very true; but what then of the assurance and prediction under

which £30,000 of the people’s money had been pocketed--“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”? Nay, more; Jenner descended even lower. He not only

likened vaccination to smallpox, but to variolation, that is to

the former practice of inoculation with smallpox; and as, he

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.

* * * * *

SANCHO PANZA.-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.

DON QUIXOTE.--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.

SANCHO PANZA.--What vial, and what balsam is that?

DON QUIXOTE.--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.

SANCHO PANZA.--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?

DON QUIXOTE.--For less than three reals thou mayest make nine

pints.

SANCHO PANZA.--Sinner that I am! Why does your Worship delay

making and showing it to me?

DON QUIXOTE.--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, 1721/2.

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 SELECT MEN OF THE TOWN OF BOSTON.

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 did well; namely, by Dr. Roby about 11, and by Dr. Thomson

about 25, which, together with my 244, make up the number of 280;

out of which number died only 6 persons, notwithstanding all the

difficulties the practice laboured under.”

Beyond measure extraordinary was the bland assurance wherewith

Boylston, in common with Mather and others, assumed and argued

that the 280 inoculated had been thereby delivered from the plague

of smallpox and death. Accepting the improbable supposition that

the 280 were a fair average of 15,000 Bostonians, of whom one-third

took smallpox, we have to abstract two-thirds of the 280, or 186

as superfluously inoculated, leaving 93 saved from smallpox. If we

then inquire how many of these were saved from death, and resort to

Boylston’s statistics, who says,--

In 1721 and beginning of 1722 there were in Boston 5759 persons

who had smallpox in the natural way, out of which number died

844; so that the proportion that die of natural smallpox appears

to be one in six, or between that of six and seven--[7]

We find the number no more than 15, from which, if we deduct the

6 who died under his hand, his trophies are reduced to 9, to save

whom he put 280 into serious sickness and jeopardy--so serious

indeed in some instances (as appears from his own notes) that there

was slight reason to prefer inoculated to spontaneous smallpox.

Viewed thus in his own light--a light most favourable, how vain,

not to say impudent, was such boasting as this--

Now, if there be any one that can find a faithful account or

history of any other method or practice that has carried such a

number of all ages, sexes, constitutions, and colours, and in

the worst seasons of the year, through the smallpox; or indeed

through any other acute distemper with better success, then I

will alter my opinion of this; and until then, I shall value

and esteem this method of inoculating the smallpox as the most

beneficial and successful that ever was discovered to, and

practised by mankind in this world.[8]

And, gaining courage through his own noise, he went yet farther,

and proclaimed that smallpox was tamed and subdued--

It is, and shall be acknowledged, to the praise and glory of God,

that whereas a most wild, cruel, fierce and violent distemper,

and which has destroyed millions of lives, is now (by that happy

discovery made of its transplantation) become tractable, safe and

gentle.[9]

In the knowledge of the emptiness of this bounce, it may seem

malicious to withdraw it from forgetfulness; but it serves to point

the truth that human nature in 1726 was much the same as human

nature at this day, and that the same arts of audacious assertion

and rowdy rhetoric were in practice then as now. Indeed, whoever

is sufficiently wicked to presume on the natural trustfulness of

mankind, and will lie loud enough and long enough, may attain an

appalling success--as our story, alas! will prove.

One thing goes to Boylston’s credit: he did not propose to make

poxing universal--to poison and sicken everybody, and inflict

certain injury to avert future and uncertain danger from a few. He

proposed to reserve inoculation for emergencies--

When the smallpox left Boston, inoculation ceased; and when

it shall please Providence to send and spread that distemper

among us again, may inoculation revive, be better received, and

continued a blessing in preserving many from misery, corruption

and death.

The narratives of Mather and Boylston are of special importance

because we have in them the true lineage of inoculation as

introduced from the eastern to the western world. Boylston tells us

that when smallpox appeared in Boston--

Dr. Mather, in compassion to the lives of the people, transcribed

from the _Philosophical Transactions_ of the Royal Society the

accounts sent them by Dr. Timonius and Pylarinus of inoculating

the smallpox in the Levant, and sent them to the practitioners of

the town for their consideration thereon.[10]

For some inscrutable reason the true position of Cotton Mather in

the history of inoculation is continually overlooked or mis-stated.

For instance, in Mather’s biography in the excellent _English

Cyclopædia_, it is said that he derived his information and impulse

from the letters of Lady Mary Wortley Montagu; a statement repeated

in the memoirs of that lady, which is entirely fabulous.

FOOTNOTES:

[1] _Philosophical Transactions_, No. 338, 1714.

[2] _Nova et Tuta Variolas Excitandi per Transplantationem

Methodus._ Jacob Pylarinum. Venet. 1715. Reprinted in

_Philosophical Transactions_, No. 347, 1716.

[3] _An Essay on External Remedies._ By P. Kennedy. London, 1715.

[4] _Philosophical Transactions_, Vol. xxxii. p. 35.

[5] _Letter to Dr. Jurin by Isaac Massey._ London, 1723.

[6] _An Historical Account of the Smallpox inoculated in New

England upon all sorts of persons, Whites, Blacks, and of all Ages

and Constitutions._ By Zabdiel Boylston. London, 1726.

[7] _An Historical Account_, p. 39.

[8] _Ibid._ p. 38.

[9] _Ibid._ p. 46.

[10] _An Historical Account_, p. 1.

CHAPTER II.

LADY MARY WORTLEY MONTAGU.

“As for History,” said the Duke of Marlborough, “I know that it

is false;” and whoever has occasion to enter minutely into any

historical question will be apt to concur with the Duke. Happening

to refer to Walter Bagehot’s essay on Lady Mary Wortley Montagu, I

found this passage--

She brought from Turkey the notion of inoculation. Like most

improvers, she was roughly spoken to. Medical men were angry

because the practice was not in their books, and conservative

men were cross at the agony of a new idea. Religious people

considered it wicked to have a disease which Providence did not

think fit to send you; and simple people “did not like to make

themselves ill of their own accord.” She triumphed, however, over

all obstacles; inoculation, being really found to lengthen life

and save complexions, before long became general.[11]

Now Bagehot loved accuracy and abhorred credulity; and yet in

these lines, delivered with as much confidence as a column of the

multiplication table, there are exhibited about as much inaccuracy

and credulity as could be packed into the space. Let us see what

Lady Mary really did in the matter of inoculation.

Mr. Wortley Montagu was appointed ambassador to the Porte, and set

out for Constantinople in the autumn of 1716 accompanied by his

wife, then in her twenty-seventh year. The Ottoman Empire was in

those days powerful and proud, disdaining to send representatives

to Christian Courts, and receiving ambassadors as commercial

agents, or as bearers of homage from their respective sovereigns.

The English ambassador reached his destination early in 1717, and

ere a month had passed, and ere Lady Mary had time to look around

and appreciate the strange world into which she had entered, with

sprightly audacity she wrote as follows to her friend Miss Sarah

Chiswell--

I am going to tell you a thing that I am sure will make you wish

yourself here. The smallpox, so fatal, and so general amongst us,

is here entirely harmless by the invention of _ingrafting_, which

is the term they give it. There is a set of old women who make

it their business to perform the operation every autumn, in the

month of September, when the great heat is abated. People send to

one another to know if any of their family has a mind to have the

smallpox: they make parties for this purpose, and when they are

met (commonly fifteen or sixteen together) the old woman comes

with a nut-shell full of the matter of the best sort of smallpox,

and asks what veins you please to have opened. She immediately

rips open that you offer to her with a large needle (which gives

you no more pain than a common scratch), and puts into the vein

as much venom as can lie upon the head of her needle, and after

binds up the little wound with a hollow bit of shell; and in

this manner opens four or five veins. The Grecians have commonly

the superstition of opening one in the middle of the forehead,

in each arm, and on the breast, to mark the sign of the cross;

but this has a very ill effect, all these wounds leaving little

scars, and is not done by those that are not superstitious, who

choose to have them in the legs, or that part of the arm that is

concealed. The children or young patients play together all the

rest of the day, and are in perfect health to the eighth. Then

the fever begins to seize them, and they keep their beds two

days, very seldom three. They have very rarely above twenty or

thirty [pustules] in their faces, which never mark; and in eight

days’ time they are as well as before their illness. Where they

are wounded, there remain running sores during the distemper,

which I don’t doubt is a great relief to it. Every year thousands

undergo this operation; and the French ambassador says pleasantly

that they take the smallpox here by way of diversion, as they

take the waters in other countries. There is no example of any

one that has died in it; and you may believe I am very well

satisfied of the safety of the experiment, since I intend to try

it on my dear little son.

I am patriot enough to take pains to bring this useful invention

into fashion in England; and I should not fail to write to

some of our doctors very particularly about it, if I knew any

one of them that I thought had virtue enough to destroy such a

considerable branch of their revenue for the good of mankind. But

that distemper is too beneficial to them not to expose to all

their resentment the hardy wight that should undertake to put an

end to it. Perhaps, if I live to return, I may, however, have

courage to war with them. Upon this occasion admire the heroism

in the heart of your friend.

In this letter there was material for a smallpox idyl--nothing

easier, nothing surer, “smallpox made entirely harmless.” But idyls

are deceptive; their paradisiacal effects are obtained by the

sedulous exclusion of whatever is otherwise. About the time that

Lady Mary was romancing so triumphantly to Miss Sarah Chiswell she

despatched this note to her husband--

Sunday, 23rd March, 1717-18.

The boy[12] was engrafted last Tuesday, and is at this time

singing and playing, and very impatient for his supper. I pray

God my next may give as good an account of him.... I cannot

engraft the girl; her nurse has not had the smallpox.

Why should the engrafting of the infant have been hindered because

the nurse had not had smallpox? The answer to the question reveals

a peril concealed from Miss Sarah Chiswell. Because the engrafted

child would probably have communicated unmitigated smallpox to the

nurse. Why not then engraft nurse and child? Because they would

have sickened together, and mother Mary did not care to incur the

risk. There was no danger, she said; none whatever, only a pleasant

diversion; nevertheless she preferred discretion to her own voluble

assurance.

In History we have always to suspect the picturesque, for mankind

have a fatal preference for handsome error over uncomely fact; and

Lady Mary Wortley Montagu as mother of English inoculation, and

derivatively of vaccination, is ever so much more graceful than

dull Timoni and Pylarini in the _Philosophical Transactions_, or

Cotton Mather in New England. Few condescend to inquire whether

Lady Mary, as primary inoculator, was acting independently, or

whether she had advisers and prompters. “All of her self and by

her self” is the heroic representation--“a woman’s wit against the

world;” and judgment surrenders to fancy, as is the way with myths

ancient and modern.

But it so happens that what in itself ought to be incredible--that

a young Englishwoman should suddenly adopt the strange practice of

a strange people--is demonstrably incredible. Lady Mary did not

act alone. She had for counsellor and director, Charles Maitland,

the physician to the embassy, who, familiar with the fame of

inoculation, was glad to observe its practice experimentally.

Maitland writes--

In the year 1717, when I had the honour to attend the English

Ambassador and his family at Constantinople, I had a fair

opportunity fully to inform myself _of what I had long before

heard_, namely, the famous practice of transplanting, or raising

the smallpox by inoculation.[13]

Here we may note, too, that Maitland was aware that inoculation did

not originate in Turkey. He says--

Whilst universally practised all over Turkey for three-score

years past, it has been known in other parts of the East, a

hundred, or, for aught we know, some hundreds of years before.[14]

It was Maitland who managed the inoculation of young Montagu, and

he thus described the operation--

About this time, the Ambassador’s ingenious lady resolved to

submit her only son to it, a very hopeful boy of about six years

of age. She first of all ordered me to find out a fit subject

to take the matter from, and then sent for an old Greek woman

who had practised this way a great many years. After a good deal

of trouble and pains, I found a proper subject, and then the

good woman went to work; but so awkwardly by the shaking of her

hand, and put the child to so much torture with her blunt and

rusty needle, that I pitied his cries, who had ever been of such

spirit and courage that hardly anything of pain could make him

cry before; and, therefore, inoculated the other arm with my own

instrument, and with so little pain to him that he did not in

the least complain of it. The operation took in both arms, and

succeeded perfectly well.... He had about an hundred pox all upon

his body. This operation was performed at Pera in the month of

March, 1717.

That is to say, almost simultaneously with the Ambassador’s arrival

in Turkey.

The embassy returned to England in 1718, after a residence

of little over a year in Constantinople. The dates are worth

observation; for whilst it appears that the doctor and the lady

were in common resolved to recommend the practice of inoculation to

their countrymen, the dates prove with what inexperience and levity

they assumed the grave responsibility. If quackery be assertion

in absence of knowledge or of evidence, then we may accurately

stigmatise Maitland and Montagu a couple of quacks. But so far as

concerns Maitland we may go farther, for he expressly tells us--

I was assured and saw with my eyes that the smallpox is rather

more malignant and epidemic in the Turkish dominions than with

us; insomuch that, as some have affirmed, one-half, or at least

one-third part of the diseased, at certain times, do die of it;

and they that escape are terribly disfigured by it.[15]

Yet this same Maitland, who thus testified of the impotence of

inoculation to mitigate and restrain smallpox in Turkey, came

to England ready to assert its power to mitigate and restrain!

It is difficult to find words of due severity for such impudent

inconsistency. We shall see, however, in the course of this

wonderful story, how every rule of evidence may be defied in the

matter of smallpox, and how it is possible to shut one’s eyes and

prophesy in the name of science, and have noise and hardihood

accepted for veracity.

FOOTNOTES:

[11] _Literary Studies_, Vol. i. p. 248.

[12] Born in Yorkshire, 1713.

[13] _Account of Inoculating for Smallpox._ London, 1722.

[14] _A Short Account of Inoculation._ London, 1723.

[15] _Account of Inoculating for Smallpox_, p. 4.

CHAPTER III.

MAITLAND’S EXPERIMENTS.

Lady Mary Wortley Montagu returned to England in 1718, but not

until 1721 did she fulfil her intention of making war on the

doctors, and incurring their resentment for the good of mankind.

In the spring of 1721 she commenced action in earnest by the

inoculation of her daughter--the infant that it was considered

unsafe to “engraft” when at Pera in 1718. In Maitland’s words--

The noble Lady sent for me last April, and when I came, she

told me she was now resolved to have her daughter inoculated,

and desired me forthwith to find out matter for the purpose. I

pleaded for a delay of a week or two, the weather being then cold

and wet. I also prayed, that any two physicians whom she thought

fit, might be called, not only to consult the health and safety

of the child, but likewise to be eye witnesses of the practice,

and contribute to the credit and reputation of it. This was at

first denied me, it might be out of a design to keep it secret,

or lest it should come to nothing.

In the meantime having found proper matter, I engrafted the child

in both arms, after the usual manner. She continued easy and well

till the tenth night, when she was observed to be a little hot

and feverish. An ancient apothecary in the neighbourhood being

then called, prudently advised not to give the child medicine,

assuring the parents there was no danger, and that the heat would

quickly abate, which accordingly it did, and the smallpox began

next morning to appear. Three learned physicians of the college

were admitted, one after another, to visit the young lady; they

are all gentlemen of honour, and will on all occasions declare,

as they have done hitherto, that they saw Miss Wortley playing

about the room, cheerful and well, with the smallpox raised

upon her; and that in a few days after she perfectly recovered

of them. Several ladies, and other persons of distinction, also

visited this young patient, and can attest the truth of this fact.

One of the learned physicians who had visited Miss Wortley,

having some years since fully informed himself of this method

of practice, and being thoroughly satisfied of the safety and

reasonableness of it, at length resolved to try it in his own

family; he had formerly lost some children in a very malignant

kind of the smallpox, and therefore advised me to lose no time to

engraft the only son he had left. The boy (who was not quite six

years of age) being of a pretty warm and sanguine complexion, the

Doctor ordered about five ounces of blood to be taken from him;

and then, in ten days after, having found matter which he liked,

I inoculated him in both arms. This was performed the 11th of

May, 1721.

The learned physician here referred to was Dr. Keith, and the

facility wherewith he adopted the novel practice supplies an

instructive commentary on Lady Mary’s anticipation of the

resentment of “the profession”--her first imitator coming from

the ranks of the dreaded self-seeking obstructives. Furthermore,

we have to observe how different is Maitland’s account from the

heroic myth current of “the one woman confronting the prejudice and

ill-will of the world.” Even Lady Louisa Stuart, who made it her

business to correct many misconceptions as to her grandmother’s

career, writes--

Only the higher motive of hoping to save numberless lives could

have given Lady Mary courage to resolve upon bringing home the

discovery. For what an arduous, what a fearful, and, we may add,

what a thankless enterprise it was, nobody is now in the least

aware. Those who have heard her applauded for it ever since

they were born, and have also seen how joyfully vaccination was

welcomed in their own days, may naturally conclude that when once

the experiment had been made, and had been proved successful,

she could have nothing to do but to sit down triumphant, and

receive the thanks and blessings of her countrymen. But it was

far otherwise.... Lady Mary protested that in four or five years

immediately succeeding her arrival at home, she seldom passed a

day without repenting of her patriotic undertaking; and she vowed

that she never would have attempted it, if she had foreseen the

vexation, the persecution, and even the obloquy it brought upon

her. The clamours raised against the practice, and of course

against her, were beyond belief. _The facility rose in arms to a

man_, foretelling failure and the most disastrous consequences;

the clergy descanted from their pulpits on the impiety of thus

seeking to take events out of the hand of Providence; the common

people were taught to look at her as an unnatural mother,

who had risked the lives of her own children.... We now read

in grave medical biography that the discovery was instantly

hailed, and the method adopted, by the principal members of the

profession.... But what said Lady Mary of the actual fact and

actual time? Why, that _the four great physicians deputed by

Government to watch the progress of her daughter’s inoculation_,

betrayed not only such incredulity as to its success, but such

an unwillingness to have it succeed, such an evident spirit of

rancour and malignity, that she never cared to leave the child

alone with them one second, lest it should in some secret way

suffer from their interference.[16]

Thus is History written! An apothecary and three doctors, selected

by the Wortleys at discretion, and admitted singly to view a

private experiment, are converted into “four great physicians

deputed by Government,” rancorous and dangerous! Thus are myths

generated!

Lady Mary was a woman of mark in society, fashionable and literary,

and her exploit was naturally the talk of the town. Among her

friends was Caroline, Princess of Wales, a lady of more than

ordinary strength of mind and intelligence, with a taste for

theology and philosophy, the patron of Butler, and his sympathetic

student. It has been said, “There never was a clever woman that

was not a quack;” and Princess Caroline was an illustration of

its truth. The new remedy for smallpox caught her fancy, and she

determined to put it to the test. She begged of George I. that

six felons should be pardoned on condition of their submission

to inoculation, and the King was pleased to comply with the

extraordinary request. Maitland was then called upon to exhibit his

skill, but he hesitated to act as hangman’s substitute; whereon

Sir Hans Sloane, the court physician, was appealed to. Sir Hans

held counsel with Dr. Terry of Enfield, who had practised physic in

Constantinople, and knew something of inoculation; and fortified

with Terry’s assurance, he was enabled to overcome Maitland’s

scruples, real or affected. Accordingly, on the 9th of August,

1721, writes Maitland--

I performed the operation of inoculating the smallpox on six

condemned criminals at Newgate in presence of several eminent

physicians, surgeons, and others. The names of the criminals

were--

1. MARY NORTH, Aged 36 years

2. ANNE TOMPION, ” 25 ”

3. ELIZABETH HARRISON, ” 19 ”

4. JOHN CAWTHERY, ” 25 ”

5. JOHN ALCOCK, ” 20 ”

6. RICHARD EVANS, ” 19 ”

On Wednesday morning, 9th August, he made incisions in both arms

and the right legs of the six. Thursday passed and Friday passed

without any indications of constitutional disturbance, and,

despairing of success, he obtained fresh pox on Saturday from

Christ’s Hospital, and repeated the inoculation in new incisions

in the arms of five of them. He had no matter left for Evans,

who, it appeared, had had smallpox in September, 1720, and who

therefore escaped hanging unwarrantably. The disease now “took,”

and progressed satisfactorily. Says Maitland--

One day Mr. Cook, an eminent Turkey merchant, having seen the

persons engrafted in Newgate, and having fully considered their

incisions and eruptions, he openly declared they were the very

same as he had observed in Turkey, having seen a great many

instances; and that we might be assured they would never again be

infected with smallpox.

Dr. Mead suggested another experiment--that cotton dipped in pox

should be inserted in the nostrils; and a young woman sentenced

to death received her life on condition of submitting to the

operation. Here we have Mead’s own account of the transaction--

A learned author has given an account of the practice of sowing

smallpox, as they call it, known to the Chinese above three

hundred years, which is this. They take the skins of some of the

dried pustules, which are fallen from the body, and put them into

a porcelain bottle, stopping the mouth of it very close with wax.

When they have a mind to infect any one, they make up three or

four of these skins, putting between them with one grain of musk

into a tent with cotton, which they put up the nostrils.

I myself have had an opportunity of making an experiment to

this purpose. For, when in the year 1721, by order of his

Sacred Majesty, both for the sake of his own family, and of

his subjects, a trial was to be made upon seven condemned

malefactors, whether or not the smallpox could safely be

communicated by inoculation; I easily obtained leave to make the

Chinese experiment in one of them. There was among those who were

chosen out to undergo the operation, a young girl of eighteen

years of age. I put into her nostrils a tent, wetted with matter

taken out of ripe pustules. The event answered: for she, in like

manner with the others, who were infected by incisions made in

the skin, fell sick, and recovered; but suffered much more than

they did, being, immediately after the poison was received into

the nose, miserably tormented with sharp pains in her head, and a

fever, which never left her till the eruption of the pustules.[17]

Finally, says Maitland--

On the 6th of September they were all dismissed to their several

counties and habitations. The thing has been successful on all

the five, far beyond my expectation, considering their age, habit

of body, and circumstances; and it has perfectly answered Dr.

Timoni’s account of the practice, and also the experience of all

who have seen it in Turkey.[18]

So Maitland asserted, but others were of a different opinion.

Dr. Wagstaffe, who visited the patients in Newgate regularly,

maintained in a letter addressed to Dr. Freind--

Upon the whole, Sir, in the cases mentioned, there was nothing

like the smallpox, either in symptoms, appearances, advance of

the pustules, or the course of the distemper. And it would puzzle

any one to conceive how it is possible that smallpox can ever be

prevented by inoculation. With the exception of one of the men,

the girl who had cotton dipped in matter thrust up her nostrils,

had as fair a smallpox as any in the place.[19]

Sir Hans Sloane and Dr. Steigertahl, physician to the King, to

test the matter farther, “joined purses,” and had one of the women

inoculated in Newgate sent to Hertford, where smallpox of a severe

form was prevalent, to lie in bed with smallpox patients. This she

did with impunity; but it was reasonably objected that many who

were not inoculated did so likewise and escaped without harm.

The Newgate experiment, of course, caused great excitement, and

induced many repetitions in town and country. The Princess of Wales

was especially alive to the importance of “the great discovery;”

and for her additional satisfaction, six charity children,

belonging to the parish of St. James, were inoculated; and all but

one “took” and did well; the exception being due to the craft of

the child, who, for the sake of the reward, concealed the fact of

having had smallpox.

Upon these trials, and several others in private families

[wrote Sir Hans Sloane], the Princess of Wales sent for me to

ask my opinion of the inoculation of the Princesses. I told Her

Royal Highness, that by what appeared in the several essays, it

seemed to be a method to secure people from the great dangers

attending smallpox in the natural way. That preparations by diet

and necessary precautions being taken, made the practice very

desirable; but that not being certain of the consequences which

might happen, I would not persuade nor advise the making trials

upon patients of such importance to the public. The Princess then

asked me if I would dissuade her from it: to which I made answer

that I would not, in a matter so likely to be of such advantage.

Her reply was, that she was then resolved to have it done, and

ordered me to go to the King, who commanded me to wait upon him

on the occasion. I told his Majesty my opinion, that it was

impossible to be certain, but that raising such a commotion in

the blood there might happen dangerous accidents not foreseen:

but he replied that such might and had happened to persons who

had lost their lives by bleeding in a pleurisy, and taking physic

in any distemper, let never so much care be taken. I told his

Majesty that I thought this to be the same case, and the matter

was concluded upon, and succeeded as usual, without any danger

during the operation, or the least ill symptom or disorder

since.[20]

The Princess Amelia, aged eleven, and Caroline, aged nine, were

therefore inoculated on the 19th of April, 1722.

Let us return to Maitland, whose triumph for the moment appeared

complete, and with it his assurance. To his detractors he professed

boldly--

I could bring a great many cases of persons inoculated in Turkey

to prove _the constant and certain success of the practice_; in

all which I have never seen any miscarriage, except in one, which

was wholly due to the rashness and inadvertence of a surgeon at

Constantinople.

Is it not a matter of the greatest importance for us to know

how to prevent the mighty contagion of the smallpox, and how to

preserve our children from the violent attacks and fatal effects

of it?

To divine Maitland’s character--to determine how far he was

deceiver or deceived is not easy. He obviously made professions in

vast excess of his knowledge. One of his contemporaries writes--

I remember Mr. Maitland at Child’s Coffee House, when the

experiment was just begun at Newgate, was as confident and

positive of the success and security proposed by inoculation as

if he had had twenty years experience without any miscarriage,

which made those who heard him justly suspect he was more

concerned for the employ than for the success of it.[21]

He had not the proper craft of this conscious rogue, for alongside

his assertions of absolute competence and safety, he set forth such

confessions of ignorance and disaster, that one is impelled to

pronounce him a purblind enthusiast. For example, take this case,

which he published without apparently any sense of its scope--

_2nd October, 1721._--After due preparation of the body, I

engrafted Mary Batt, an infant of two years and a half old,

daughter of Thomas Batt, a Quaker, living at Temple, within three

miles of Hertford. The red spots and flushings appeared on her

face and neck the fourth day; and she kept playing about well

till the seventh or eighth, when she became a little heavy and

thirsty, with a fuller and quicker pulse; then the pustules came

out fresh and full, and the incisions discharged a thick and well

digested matter. She had not above twenty in all upon her; they

continued about three or four days, then dried away and fell off,

and the child recovered perfectly.

Thus far all was well; _but what happened afterwards was, I must

own, not a little surprising to me, not having seen or observed

anything like it before_. The case was in short this. Six of

Mr. Batt’s domestic servants, namely, four men and two maids,

who all in their turns were wont to hug and caress this child

whilst under the operation, and the pustules were out upon her,

never suspected them to be catching, _nor indeed did I_, were

all seized with the right natural smallpox, of several and very

different kinds; for some had the round distinct sort, some the

small continued, and others the confluent; all of ’em had a great

many, but especially the last, with the usual bad symptoms,

_and very narrowly escaped_. But they all (God be thanked) did

well (_except one maid_, that would not be governed under the

distemper, _who died of it_,) and now enjoy a perfect state of

health.[22]

Thus at the outset, smallpox and death were the products of

inoculation--the peril to be averted was incurred and multiplied.

Yet the man who thus records his own infamous ignorance, had the

impudence in the same pages to assert--

_The practice prudently managed, is always safe and useful, and

the issue ever certain and salutary._[23]

Words are wasted on such reckless folly: we perceive how true

is Carlyle’s observation, “Stupidity intellectual always means

stupidity moral, as you will, with surprise or not, discover if you

look.”

Before leaving Maitland, we may take another leaf from his

experience. He writes--

_12th October, 1721._--I inoculated Joseph and Benjamin, sons of

William Heath, of Hertford; the first of about seven, and the

second three years of age; both with the same matter and at the

same time: the last had a gentle and favourable kind; but the

first, namely, Joseph, being a fat, foul, gluttonous boy, who

would not be confined to the rules and directions I had strictly

charged his mother withal, as to diet and keeping warm, was taken

very ill before the eruption, and after it had a great load of

the continued small kind, but at last recovered and did well.

What a mighty difference is here to be observed between those two

boys! The reason of it seems to be plainly this: the younger, who

had the favourable kind, was of a clean habit, moderate appetite,

and easily governed during the whole process. The elder was not

only of a gross foul constitution, but likewise had a voracious

appetite, always eating and filling his belly with the coarsest

food--as cheese, fat country pudding, cold boiled beef, and the

like, which I saw myself as I came in by chance the third day

after the operation; nor was there any care taken to restrain or

keep him within doors in cold, windy, frosty weather; he once

wet his feet in water--insomuch that had he taken the smallpox

by infection, the world could not have saved his life. Hence it

appears how necessary it is to cleanse thoroughly foul habits

before the operation, and, withal, to keep patients to a very

strict regimen under it.[24]

Verily, as Cobbett said, quackery is never without a shuffle. As we

shall see, inoculation came to require a preparatory course of very

strict regimen--so strict as to be impracticable for the rank and

file of the world; but the practice was at first commended without

any such conditions. What said Maitland’s patron, Lady Mary, in her

famous letter from Adrianople?--

The smallpox, so fatal and so general amongst us, is here

entirely harmless by the invention of _ingrafting_.... Every year

thousands undergo its operation; and the French ambassador says

pleasantly that they take the smallpox here by way of diversion,

as they take waters in other countries. There is no example of

anyone that has died in it.

It was under cover of such seductive assurances that inoculation

was introduced to England, and established in perversity and

quackery.

FOOTNOTES:

[16] _Letters and Works of Lady Mary Wortley Montagu._ Vol. i. pp.

88-90. Ed. 1861.

[17] _On Smallpox and Measles._ By Dr. Mead. London, 1747.

[18] _Mr. Maitland’s Account of Inoculating the Smallpox._ 2nd. ed.

London, 1723.

[19] _A Letter to Dr. Freind showing the Danger and Uncertainty of

Inoculating the Smallpox._ By W. Wagstaffe, M.D. London, 1722.

[20] _An Account of Inoculation by Sir Hans Sloane, Bart., given

to Mr. Ranby to be published_, 1736. _Philosophical Transactions_,

Vol. xlix. p. 516.

[21] Isaac Massey to Sir Hans Sloane, 1722.

[22] Maitland’s _Account_, p. 27.

[23] _Ibid._ p. 33.

[24] Maitland’s _Account_, p. 27.

CHAPTER IV.

THE FIRST OPPONENTS OF INOCULATION.

As we have seen, it is part of the legend that the introduction of

inoculation was fanatically resisted by physicians, clergy, and

mob; but the resistance was neither fanatical nor extensive, and is

chiefly the invention of the romancing biographers who represent

Lady Mary Wortley Montagu as a heroine and martyr of science. To do

that shrewd and brilliant woman justice, she made no pretence to

the character imputed to her, and in her copious correspondence,

there is not a hint of annoyance on the score of her patronage

of the Turkish modification of smallpox. On the contrary, it

would appear that inoculation brought her a large share of that

veiled notoriety in which she had sincere pleasure. Writing to the

Countess of Mar in 1723, she says--

Lady Byng has inoculated both her children, and since that

experiment has not had any ill effect, the whole town are doing

the same thing; and I am so much pulled about, and solicited to

visit people, that I am forced to run into the country to hide

myself.[25]

Lady Mary understood her countrymen thoroughly, and, thirty years

after her exploits in inoculation, she wrote to Mr. Wortley Montagu

as follows--

BRESCIA, 24th April, 1748.

I find Tar Water succeeded to Ward’s Drop. ’Tis possible, by

this time, that some other quackery has taken place of that.

The English are easier than any other nation infatuated by the

prospect of universal medicines, nor is there any country in the

world where the doctors raise such immense fortunes. I attribute

it to the fund of credulity which is in all mankind. We have

no longer faith in miracles and relics, and therefore with the

same fury run after recipes and physicians. The same money which

three hundred years ago was given for the health of the soul is

now given for the health of the body, and by the same sort of

people--women and half-witted men.[26]

Those who fancy there could be any wide or effective resistance

to inoculation in 1721 misapprehend the conditions of the time.

There was no scientific knowledge of the laws of health; diseases

were generally regarded as mysterious dispensations of Providence

over which the sufferers had little control; and a great part

of medicine was a combination of absurdity with nastiness. It

would not be difficult to compile a series of recipes from the

pharmacopœia of that day which would alternately excite amusement,

surprise, and disgust, and to describe medical practice from which

it is marvellous that ever patient escaped alive; but so much must

pass without saying. Suffice it to assert, that to inoculation

there was little material for opposition, rational or irrational;

and that what we might think the natural horror of transfusing the

filth of smallpox into the blood of health, was neutralised by the

currency of a multitude of popular remedies which seemed to owe

their fascination to their outrageous and loathsome characteristics.

Moreover, as the dates prove, the interval was brief between the

introduction of inoculation and its authoritative acceptance. The

girl Montagu was privately inoculated in April, 1721, Dr. Keith’s

boy on the 11th of May, the Newgate experiment took place on the

9th of August, a variety of experiments followed, and lastly

the Princesses Amelia and Caroline were inoculated on the 19th

of April, 1722--sharp work for one year. There was not time for

opposition. The citadel of social approval was carried with a rush.

As a contemporary observed--

I could not but take notice with what united force and zeal the

practice was pushed on upon the life and reputation it received

from its admission to the Royal Palace; all pens and weekly

papers at work to recommend and publish it; and it was rightly

judged, then or never was the time; and had it not been for some

unlucky miscarriages, the Inoculators would have had the best

chance for full practice and full pockets that ever fell into the

hands of so small a set of men.[27]

The royal approval was assiduously worked, and there were not

wanting hints that to question the goodness of inoculation was

equivalent to disloyalty; and thus we find the Rev. E. Massey

protesting in a letter to Mr. Maitland--

I wish the Doctor more candour toward those who differ from him

than to insinuate that they are guilty of high treason, and a

better argument for this practice than the cry, Inoculation! and

King George for ever![28]

Bad reasons are often advanced against bad policy, and whilst it is

probable that some silly things were uttered against inoculation,

yet I think every candid mind would be impressed with the

moderation of Maitland’s chief adversaries. There was Isaac Massey,

for instance, apothecary to Christ’s Hospital, who published

several pamphlets in opposition, wherein candour and good sense are

throughout conspicuous. He defined--

Inoculation as an art of giving the smallpox to persons in

health, who might otherwise have lived many years, and perhaps

to a very old age without it, whereby some unhappily come to an

untimely death.[29]

He objected to the exaggerated dangers of smallpox wherewith the

Inoculators operated on the public fears, and appealed to his own

experience in Christ’s Hospital--

Where there are generally near 600 children, the nurseries at

Ware and Hertford constantly filling the places of those who go

off. It hath sometimes happened that great numbers have been down

of the smallpox, and ’tis but seldom that the House is free, or

not long so: yet I daresay, and Sir Hans Sloane, I presume, will

say so too, that in twenty years there have not died above five

or six at most of the distemper, and in the last eight years

there died but one.[30]

So lightly did he regard the peril of smallpox to the young that he

delivered this challenge--

Suppose that twenty-five Bluecoat Hospital boys at a medium, one

year with another, taken ill of the smallpox.

Suppose we likewise, that the Inoculators take out of the several

wards, yearly, as they find them, twenty-five boys, which are

inoculated.

Quere, What the difference of success? I solemnly protest that if

this could be put in practice, I would lay two to one against the

inoculated.

For, as I have said before, we have lost but one smallpox patient

these nine years [writing in 1723] although 1800 children have

been in the House during that time, and I declare to have met

with no unequal success in other families amongst children about

the same ages (that is between 8 and 15) where I have been

concerned, and I doubt not but many of the Learned Faculty, as

well as some others of my profession, can say as much from their

own experience and observation.[31]

To appreciate Massey’s contention on this point, we have to

remember that smallpox is the designation of a disease of many

degrees of intensity; a consideration which Dr. Wagstaffe, another

opponent of inoculation, thus enforced--

There is scarcely, I believe, so great a difference between any

two distempers in the world, as between the best and worse sort

of smallpox, in respect to the dangers which attend them.... So

true is that common observation, that there is one sort in which

a nurse cannot kill, and another which even a physician can never

cure.[32]

Of course the Bills of Mortality were appealed to in evidence of

the extent and fatality of smallpox; and as it is matter of common

belief that prior to inoculation and Jenner (there is always a

haze about the date) people were mown down with smallpox, it may

be worth while reviving the table of relative mortality in London

during the first twenty-two years of the 18th century.

Burials from all Diseases. From Smallpox.

1701 20,471 1095

1702 19,481 311

1703 20,720 898

1704 22,684 1501

1705 22,097 1095

1706 19,847 721

1707 21,600 1078

1708 21,291 1687

1709 21,800 1024

1710 24,620 3138

1711 19,833 915

1712 21,198 1943

1713 21,057 1614

1714 26,569 2810

1715 22,232 1057

1716 24,436 2427

1717 23,446 2211

1718 26,523 1884

1719 28,347 3229

1720 25,454 1440

1721 26,142 2375

1722 25,750 2167

------- ------

505,598 36,620

By these tables [wrote Dr. Jurin] it appears that upwards of 7

per cent., or somewhat more than a fourteenth part of mankind,

die of the smallpox; and consequently the hazard of dying of that

distemper, to every individual born into the world, is at least

that of 1 in 14.[33]

This large induction from London to universal mankind is

noteworthy, because, as we shall see, it came to be often made,

and involved a serious fallacy; for unless universal mankind

dwelt in conditions similar to Londoners, it was idle to infer a

common rate of disease and mortality. The population of London in

1701 was estimated at about 500,000 (there was no exact census),

rising to about 600,000 in 1720. It was closely packed and lodged

over cess-pools; the water supply was insufficient, and there was

no effective drainage. The vast multitude was disposed, as if by

design, for the generation and propagation of zymotic disease,

and specially smallpox. Little attention was paid to personal

cleanliness, and still less to ventilation, to light, to exercise.

The condition of a large urban community a century ago is almost

inconceivable at the present day. Londoners were then only slowly

and blindly rising out of those modes of existence which made the

Plague of 1665, and other plagues, possible. Hence we need not be

astonished that smallpox was a common and persistent affliction;

but it was less prevalent and less deadly than it is the custom

to assert; and had the disease not been attended with injury to

feminine beauty, there might have been no more fuss made about it

than about any other form of eruptive fever.

It has also to be observed, that smallpox as a cause of death was

probably much exaggerated in the Bills of Mortality; for as Isaac

Massey pointed out--

These Bills are founded on the ignorance or skill of old women,

who are the searchers in every parish, and their reports (very

often what they are bid to say) must necessarily be very

erroneous. Many distempers which prove mortal, are mistaken

for the smallpox, namely, scarlet and malignant fevers with

eruptions, swinepox, measles, St. Anthony’s fire, and such like

appearances, which if they destroy in three or four days (as

frequently happeneth) the distemper can only be guessed at, yet

is generally put down by the searchers as smallpox, especially if

they are told the deceased never had them.[34]

Massey, in the same spirit of good sense, objected to

generalisations about smallpox from the Bills of Mortality, as if

all who died were slain by the disease and by nothing else.

There ought to be no comparison [he said] between sick people,

well regimented with diet and medicine, and those who have no

assistance, or scarcely the necessaries of life.

The miserable poor and parish children make up a great part, at

least one-half of the Bills of Mortality; to confirm this I have

examined several yearly bills, and I find that the out-parishes

generally bury more than the ninety-seven parishes within the

walls, and the parish of Stepney singly, very near as many as the

City of London yearly; this sufficiently shows what little help

and care are taken of the poor sick, which so much abound in all

those places.[35]

Of course there lurks a fallacy in all statistics of disease

wherein conditions of life are not discriminated. Whether patients

survive or die from any zymotic ailment depends upon their breed,

their circumstances, their habits, and their medical treatment

and nursing--all essential particulars, yet difficult to define

and register on a large scale. It would appear that in sound

constitutions, and with fair treatment, smallpox in 1721 was by no

means deadly, whilst in bad constitutions, and with exposure and

neglect, it was extensively fatal. Yet of these differences, little

account was taken by the Inoculators, and the malady was measured

and discussed as though it were something uniform like water or

gold. Massey in one year had 49 cases of smallpox and one death;

in Stepney an equal number of cases might have shown a mortality

of 20 or 30 per cent.; whilst Dr. Nettleton reported that of 1245

cases in Halifax and adjacent towns in Yorkshire, there died 270,

or about 22 per cent.[36]

One of Massey’s fears in relation to inoculation was the risk of

poisoning the blood with more than smallpox. He was not disinclined

to experiment with “duly prepared children infected with smallpox

by inspiration,” for then--

They will run no hazard of being infected by a leprous, venereal,

or scrofulous taint that may, for aught we know, be transplanted

by inoculation.[37]

Massey’s prescience has been woefully verified; is indeed under

perpetual verification in the pollution and destruction of

multitudes of infants. The notion that virus with a complex of

qualities can be transferred from one body to another, and operate

with the single quality the operator is pleased to favour, is a

notion that might pass muster in a manual of magic or folk-lore,

but which never can have any warrant in human physiology.

Of course the chief strength of the opponents of inoculation (ere

experience gave them stronger ground) lay in the assertion of the

folly of incurring a certain injury for an uncertain advantage.

Whatever the risk of smallpox to those who have it, yet large

numbers, it was argued, pass through life untouched; and why should

they make themselves sick, and risk their lives in order to obtain

a superfluous security![38]

The frequent assertion that the clergy thundered against

inoculation is untrue and invented for effect. The Rev. Edmund

Massey, Lecturer of St. Alban, Wood Street, did preach a sermon

against the new practice, and a fair sermon it was, according to

the standard of sermons. Maitland published some remarks on the

sermon, to which Massey rejoined; and if I select a passage from

the rejoinder it will prove, better than any description, that

the divine was more than a match for the surgeon. Said Massey to

Maitland--

Inoculation, in your sense, is an engraftment of a corrupted body

into a sound one; an attempt to give a man a disease, who is in

perfect health, which disease may prove mortal.

This I said was tempting Providence.

To which you reply, It resembles that of a person who leaps

out of a window for fear of fire; and surely that can never be

reckoned a mistrust of Providence.

No, certainly, Sir, if his house be really on fire, and the

stairs burnt. ’Tis the only probable way of safety left; and if

the leap should kill him, the action could neither be called

sinful or imprudent. But what should we say to a man, who jumped

out of the window when his house was not a-fire, only to try

what he might perhaps be forced to do hereafter? This mad action

exactly hits the case between us. For if my house be not on fire,

that is, if I am in no apparent danger, what need I jump out at

the window? What occasion is there to inoculate me?

To carry on your own allegory, I would ask you, Sir, what human

or divine authority you have to set a man’s house on fire, that

is, put a man who is in perfect health in danger of his life by a

fit of illness? His own consent is not sufficient, because he has

no more lawful power over his own life or health than you have,

to put either of them in hazard.[39]

In short, nothing can be more unfounded than the assumption in

literature, popular and professional, that Maitland and Montagu

were confronted by a crowd of howling fanatics over whom they

triumphed as light over darkness. Marvellous is the imbecility

wherewith biographers and historians reproduce the fables of any

inventive predecessor.

I shall now proceed to show that the practice of inoculation

introduced by Cotton Mather to New England, and by Maitland to

England, collapsed in a few years under stress of the mischiefs and

fatalities which attended it; that it was revived in a subsequent

generation; that it proved a curse wherever practised; and that

finally it was abandoned with execration in the Western world.

FOOTNOTES:

[25] _Letters and Works of Lady M. W. Montagu_, Vol. i. p. 468,

edition 1861.

[26] _Ibid._ Vol. ii. p. 161.

[27] _A Short and Plain Account of Inoculation._ By Isaac Massey.

London, 1724.

[28] _Letter to Mr. Maitland._ By Edmund Massey. London, 1722.

[29] _A Short and Plain Account of Inoculation_, p. 1.

[30] _Ibid._ p. 21.

[31] _Letter to Dr. Jurin._ By Isaac Massey. London, 1723.

[32] _Letter to Dr. Freind._ By W. Wagstaffe, M.D., F.R.S., one of

the physicians of St. Bartholomew’s Hospital. London, 1722.

[33] _A letter to Caleb Cotsworth, M.D._ By James Jurin, M.D.

London, 1723.

[34] _Letter to Dr. Jurin._ London, 1723.

[35] _Ibid._

[36] _Mr. Maitland’s Account of Inoculating the Smallpox

Vindicated._ London, 1722, p. 20.

[37] _Letter to Dr. Jurin_, p. 12.

[38] Jurin’s _Yearly Account of Inoculation_, p. 13.

[39] _Letter to Mr. Maitland in Vindication of the Sermon against

Inoculation._ London, 1722.

CHAPTER V.

COLLAPSE OF INOCULATION.

We sometimes fetch from afar what is to be found at our own

doors; and thus it was with inoculation. No sooner was the great

Eastern preventive advertised than it was said--Why, it is

nothing more than a practice common in Wales and the Highlands

of Scotland! Perrot Williams, M.D., and Richard Wright, surgeon,

of Haverfordwest, communicated to the Royal Society[40] that the

people in Pembrokeshire had practised inoculation “time out of

mind.” They either scraped the skin thin or pricked it with pins,

and then rubbed in pus from a smallpox patient. This they called

“buying the smallpox,” as it was customary to pay something for

what was fancied to be “good matter.” The Welshmen gave the same

account of the practice as the Turks--there was no danger, no

mishaps, and certain security from smallpox. In Scotland it did not

appear that the skin was scraped, but worsted threads saturated

with pus were tied round the wrists of children to whom it was

desired to communicate the disease.[41]

Dr. Thomas Nettleton, of Halifax, Yorkshire, was an early and

energetic inoculator. He prepared his patients by vomiting,

purging, and bleeding. He disliked Maitland’s small punctures, and

made gashes an inch long--one in the arm and one in the opposite

leg, and inserted bits of cotton steeped in pus, and covered them

up with plaster and rollers. It was his design to produce large

wounds with copious discharges, so that peccant matter might be

freely evacuated. He was well satisfied with his heroic practice,

and a record of his cases was sent to the Royal Society[42]--a

record from which any reader will be apt to conclude that there

was little to choose between Nettleton’s inoculations and smallpox

itself. He made no pretence that inoculation induced a trifling

ailment, but only one less serious than the spontaneous disease,

congratulating himself on having conveyed some sixty inoculated

patients through grave peril; whilst, he wrote--

In Halifax, since the beginning of last winter, 276 have had the

smallpox, and out of that number 43 have died. In Rochdale, a

small neighbouring market town, 177 have had the distemper, and

38 have died. It is to be noted that in this town [Halifax] the

smallpox have been more favourable this season than usual, and in

Leeds they have been more than usually mortal; but upon a medium

there have died nearly 22 out of every 100 in these three towns,

which is about a fifth part of all that have been infected in the

natural way.[43]

English experience quickly made an end of the fiction under cover

of which inoculation had been introduced--that it was attended

with no risk, and might be performed by any old woman. Dr. Jurin,

secretary of the Royal Society, and a steady advocate of the

practice, thus laid down the conditions considered essential to

success--conditions arrived at through stress of suffering and

disaster--

Great care ought to be taken to inoculate none but persons of a

good habit of body, and free, not only from any apparent, but, as

far as can be judged, from any latent disease.

The body, especially if plethoric, ought to be prepared by proper

evacuations--as bleeding, purging, vomiting, etc.--though in many

cases there will be occasion for very little or none of these, it

being sufficient to enjoin a temperate diet and proper regimen.

But this must be left to the judgment of the physician.

The utmost caution ought to be used in the choice of proper

matter to communicate the infection. It should be taken from a

young subject, otherwise perfectly sound and healthful, who has

the smallpox in the most favourable manner. When the pustules are

properly maturated, and just upon the turn, or soon after, two or

three of them should be ripped with a glover’s needle or small

lancet, and a couple of small pledgets of lint or cotton are to

be well moistened with the matter, and immediately put into a

little vial or box, and carried in the warm hand or bosom of the

operator to the house of the person to be inoculated.[44]

The publication of these conditions was little short of a practical

surrender, and the opponents of inoculation were not slow to avail

themselves of the advantage. What had been proclaimed the easy

and universal defence against smallpox proved hedged about with

precautions and preparations for which only health with wealth

was equal. Where was the profit, argued Francis Howgrave, of a

practice which leaves the feeble and delicate and poor to their

fate, which makes the well sick, and wounds those that are whole,

whilst smallpox in the natural way very rarely affects life where

the habit of body and constitution are good.[45] Isaac Massey was

especially indignant over Jurin’s comparison of the mortality of

smallpox with the mortality of inoculation. Jurin reckoned that

out of every 100 who took smallpox, 20 died, whilst only 2 in 100

died from the effects of inoculation. “He forgets,” said Massey,

“that the inoculated are picked lives. If this be fair, Hang fair!”

Massey was right. It was absurd to institute a comparison between

the common smallpox, comprising that of the poor and neglected, and

the well-fed and carefully tended subjects of inoculation. Massey,

too, was strong in his own experience, saying--

I have a list of the names of 32 children, who are all that have

had the smallpox during the last two years [1727] in Christ’s

Hospital, and every one recovered. I have had, besides, 17 or 18

more in my private business, of whom only one died. Here, then,

we have 49 cases of natural smallpox and but 1 death.[46]

Emphatic likewise was his protest against the exaggeration of the

inoculators.

A natural simple smallpox seldom kills, unless under very ill

management, or when some lurking evil that was quiet before is

roused in the fluids and confederated with the pocky ferment.[47]

At this point we may see the judgment and the fears of the English

people had gone against inoculation, and the practice appeared

destined to gradual extinction. According to the inoculators, their

work was thus summarised--

182 inoculations in 1721 and ’22, with 3 deaths.

292 ” in 1723, with 6 deaths.

40 ” in 1724, with 1 death.

Prince Frederick and Prince William were among the inoculated of

1724.

256 inoculations in 1725 and ’26, with 4 deaths.

124 ” in 1727 and ’28, with 3 deaths.

Dr. Scheuchzer, in 1729 tabulated[48] the cases and results of

these years, 1721-28, as follows--

---------------+--------+---------+---------+-------+-------

| No. |Success- | Had | |

Age. |operated|fully in-|imperfect|Did not| Died.

| upon. |oculated.|Smallpox.| take. |

---------------+--------+---------+---------+-------+-------

Under 1 year, | 24 | 24 | 0 | 0 | 2

1 to 2, ” | 34 | 33 | 0 | 1 | 4

2 to 3, ” | 65 | 65 | 0 | 0 | 1

3 to 4, ” | 91 | 88 | 0 | 3 | 1

4 to 5, ” | 65 | 63 | 0 | 2 | 1

5 to 10, ” | 257 | 249 | 3 | 5 | 3

10 to 15, ” | 140 | 131 | 1 | 8 | 1

15 to 20, ” | 104 | 95 | 3 | 6 | 2

20 and upwards,| 110 | 91 | 6 | 13 | 2

Unknown, | 7 | 6 | 0 | 1 | 0

| --- | --- | -- | -- | --

| 897 | 845 | 13 | 39 | 17

---------------+--------+---------+---------+-------+-------

Thus stood the account by the inoculators’ own showing, and it

was by no means a satisfactory balance-sheet. What strikes one

painfully in looking over it, is the vast preponderance of the

young and defenceless (780 out of 897) upon whom the abominable

experiment was tried. “Helplessness which commands the protection

of the brave is the opportunity of the investigating sneak.”

Whilst the inoculators argued laboriously that if some danger

attended artificial smallpox, it was trifling to that attached

to the spontaneous disease (among other obvious replies), it was

maintained that only after much wider experience could it be

known what were the precise effects of inoculation. Inoculation,

as introduced by Maitland in 1721, had proved vastly different

after acquaintance, and there was no telling what remained to be

revealed. As Dr. Wagstaffe observed--

Had it always been slight, gentle, safe, and useful, with all

those alluring epithets bestowed on it; had none had above

a hundred or two hundred pustules, and no one died of it in

the space of several years; and had there been no instance of

any one’s being ever again infected with smallpox who had any

pustules at all, how few soever, raised by inoculation, nobody

would sooner have subscribed to the practice than myself.[49]

The primal promise that the inoculated were thereafter proof

against smallpox was speedily belied, but that difficulty was

disposed of by the assertion that inoculation in such cases must

have been imperfect, for it was impossible for any one to have

smallpox twice. The admission of fatalities from inoculation was

very tardily made; and they were generally referred to some cause

perversely concealed from the inoculator, which, had he known,

would have prevented his operation. Then, the manifest fatalities

were naturally suspected to stand for a larger number sedulously

kept out of sight. As Massey put it--

The ill success of inoculation is very partially and sparingly

given to the world. The operator will not tell it, who lives by

the practice; nor will the relations, to whose authority the

mischief is owing, be fond of revealing that to the public, which

is grief to them in private.[50]

Fortunately for the public, several of the mishaps occurred in

“good society,” and were too conspicuous to be hushed up or

denied. Miss Rigby died eight weeks after inoculation, “miserably

disordered by the operation.” A son of the Duke of Bridgewater

and a son of the Earl of Sunderland likewise perished; and a

servant of Lord Bathurst died of confluent smallpox “consequent on

engraftment.” Such incidents struck terror everywhere, and caused

wise and timid alike to face the ills they knew rather than risk

certain peril for uncertain advantage.

Maitland returned to Scotland, his native country, in 1726,

and, going among his relations in Aberdeenshire, showed off his

skill by inoculating six children. One of them, Adam, son of

William Urquhart of Meldrum, aged 18 months, sickened on the

seventh, and died on the eighth day. There was a great outcry,

and Maitland tried to excuse himself by asserting that Adam was

afflicted with hydrocephalus, which had been improperly concealed

from him. Anyhow, the Aberdeenshire folk were satisfied with

their experience, and recommended “Charlie Maitland to keep

his new-fangled remedy for the English in future.” He was more

fortunate in the west of Scotland, where he “inoculated four

children of a noble family,” who escaped alive. The Scots, however,

were deaf to his persuasions, and he made no headway among them. At

a later date, 1733, inoculation began to be practised in and about

Dumfries, and occasionally elsewhere.

In Ireland little more was effected than in Scotland. It was said

that 25 inoculations took place between 1723 and 1728 with 3

fatalities. Dr. Bryan Robinson inoculated five children in Dublin

in 1725, and was the death of two of them.[51]

Inoculation met with faint acceptance on the Continent. Maitland

went over to Hanover in 1724 and inoculated Prince Frederick and

eight children of Baron de Schulenberg. In France the practice had

been discussed by Dr. Boyer so far back as 1717; and in 1723 the

English experiments were recounted in Paris with much enthusiasm

by Dr. de la Coste, evoking a declaration from the College of

Physicians, “that for the benefit of the public, it was lawful to

make trials of inoculation.” A commencement was about to be made

in the hospitals under the Sanction of the Regent, the Duke of

Orleans, when his death put a stop to the design. Soon after Dr.

Hecquet published _Raisons de Doute contre l’Inoculation_, which,

coupled with bad reports from England, made an end of the project.

If a London journalist had been called upon in 1728 to report upon

Inoculation, he might have written as follows--

Seven years ago the practice was introduced to this country under

powerful auspices. It was confidently averred that anyone might

have his blood infected with the virus of smallpox, that a trifling

ailment would ensue, and that thenceforward he would be secure

from smallpox in the natural form. Experience rapidly belied these

promises. The trifling ailment proved, in many cases, a serious

ailment--so serious that physicians tried to anticipate and

mitigate its severity by a preliminary regimen of bleeding, purging

and vomiting. So exhausting and hazardous is the whole operation,

that only sound and vigorous constitutions are considered fit for

it; and the delicate and feeble, who require protection most, are

advised to submit themselves as of old to the ordinary course of

nature. Moreover, the induced smallpox is occasionally as severe

as the spontaneous; the pustules are multitudinous, and sometimes

confluent, with death for the issue. Fear may exaggerate the risks

of inoculation, but more are believed to have perished than the

inoculators are willing to confess. Again, many are not susceptible

of inoculation, and though the infection fails to operate in their

blood as desired, they do not always escape injury: they find their

health disordered--are rendered sickly and uncomfortable. Worst

of all, what none at first reckoned on, the artificial smallpox

turns out to be infectious, and begets natural smallpox in those

who are with the inoculated. Thus, the very means taken to limit

the disease become a cause of its extension. Smallpox was more

than usually prevalent in Hertford in 1721, and in London in 1724,

and there was fair reason to conjecture that it was extensively

disseminated by inoculation. Lastly, it is doubtful whether even

successful inoculation protects from subsequent smallpox; for it is

maintained that some of the inoculated have already fallen victims

to the natural disorder. In short, the preventive appears to have

so many drawbacks that it is questionable whether it is not worse

than the malady; and it is probable that in a year or two it will

pass into forgetfulness in common with many other remedies as

highly extolled on early and imperfect acquaintance.

So much might have been stated and prognosticated in 1728: how the

prognostic failed to be verified remains to be told.

FOOTNOTES:

[40] _Philosophical Transactions_, No. 375, 1723.

[41] _An Account of Inoculation in Scotland._ By A. Monro. Edin.,

1765.

[42] _Philosophical Transactions_, No. 370, 1722.

[43] Letter from Dr. Nettleton to Dr. Jurin, dated Halifax, 16th

June, 1722.

[44] _An Account of the Success of Inoculating the Smallpox in

Great Britain._ By James Jurin, M.D.

[45] _Reasons Against the Inoculation of the Smallpox._ By Francis

Howgrave, Apothecary. London, 1724.

[46] _Remarks on Dr. Jurin’s Last Yearly Account of the Success of

Inoculation._ By Isaac Massey. London, 1727.

[47] _Ibid._ p. 5.

[48] _An Account of the Success of Inoculating the Smallpox in

Great Britain._ By John Gasper Scheuchzer, M.D. London, 1729.

[49] _Danger and Uncertainty of Inoculating the Smallpox_, p. 64.

[50] Massey’s _Remarks_, p. 18

[51] Scheuchzer and Massey.

CHAPTER VI.

REVIVAL OF INOCULATION.

The practice of inoculation, thus discredited, revived, and not

only revived, but prevailed. The revival was gradual, and may be

said to have acquired definition about 1748, under the powerful

approval of Dr. Mead. In the score of years from 1728 to 1748,

it is not to be imagined that the practice was abandoned: there

were always a few repeating the attempt to have smallpox without

the penalties of smallpox, but success was not conspicuous or

encouraging. Inoculation was introduced to a generation specially

disposed to receive it; and it was only allowed to slip for a time

under the compulsion of manifest disaster. Perhaps there never was

a people with such a taste for dodges in favour of health as the

English of last century: the common intelligence was invested

in quackery. Even Wesley found time to dabble in medicine, and

to compile a volume of prescriptions for his followers, entitled

_Primitive Physic_--a piquant mixture of sense with absurdity

and credulity. Our forefathers had no clear conception of the

connection of physical well-being with physical well-doing,

and many of the essential conditions of health were unknown to

them. Their physical afflictions were regarded as mysterious

dispensations to be endured with resignation or frustrated with

medicines. The same attitude of mind is far from uncommon at the

present day, and many will recollect how, ere sanitary science

attained repute, it was considered profane to assert that typhus

was subject to control, and that cholera might be suppressed;

whilst a drug to subdue either would be heard of with gratitude.

Superstition has rarely had any objection to the apothecary.

An incident passed over in histories, although far more inwardly

characteristic of the mind of the 18th century than a multitude of

the superficialities wherewith their pages are cumbered, is that of

Joanna Stephens and her remedies for the stone. Her cures were so

remarkable and (on evidence) so indisputable, that a general demand

arose for the revelation of her secret for the public benefit.

This revelation Mrs. Stephens agreed to make on receipt of £5000

as compensation; and a subscription was started, to which Fellows

of the Royal Society, physicians, noblemen, bishops, ladies, and

kindly folk of all orders set their names. Such, however, was the

unanimity and anxiety to possess the Stephens secret, that it was

pronounced a national concern, and Parliament was invoked to supply

the requisite funds; whereon an Act was passed “for providing a

reward to Joanna Stephens upon a proper discovery to be made by her

of the medicines prepared by her for the cure of the stone.” The

discovery was duly disclosed to appointed trustees, one of whom was

Archbishop of Canterbury, and the £5000 was paid over in 1739; and

here we have the heads of the precious revelation--

My medicines are a Powder, a Decoction, and a Pill.

The Powder consists of egg-shells and snails, both calcined.

The Decoction is made by boiling camomile, fennel, parsley, and

burdock leaves (together with a ball, which consists of soap,

swine’s cresses burnt to a blackness, and honey) in water.

The Pills consist of snails calcined, wild carrot seeds, burdock

seeds, ashen keys, hips and hawes, all burnt to a blackness, soap

and honey.

JOANNA STEPHENS.

16th June, 1739.

The public were apparently satisfied with the purchase, but

with the usual levity of credulity forgot Mrs. Stephens and her

marvellous cures in the pursuit of fresh nostrums. Fashions in

medicine are on a par with fashions in dress, and have only

occasional reference to the permanence and veracity of nature.

The revival of inoculation in England was stimulated by reports

from abroad. For instance, in the _Gentleman’s Magazine_ it was

stated that in 1737 there were inoculated in Philadelphia--

Men and Women, 32

Children under twelve, 64

Negroes, 32

and that out of the 128 only one Negro died. Again, in the same

magazine for 1738 we read--

In Barbados in March last there were upwards of 3000 persons

down in the smallpox, where inoculation is practised with great

success.

Such reports, whilst secure from examination, were none the

less effective over the public imagination. There was a report

published by Dr. Mead in 1747, which derived great credit from his

endorsement, and which continues to be cited to the present day

as proof for inoculation, but which is a model of convenient and

circumstantial vagueness worthy of Defoe. Thus Mead’s story runs--

The following relation was communicated to me by a gentleman

of great credit. He was a merchant at St. Christopher’s in the

West Indies, and in the making of sugar employed a great number

of slaves. In one year, when the smallpox raged with more than

ordinary violence in the neighbouring islands, with his own hands

he inoculated three hundred of them, from five to sixty years

of age, with such success, that not one of them died, though

most of them were negroes. And whereas all the Americans suffer

this distemper in a most terrible manner, yet experience shows,

that it is much more dangerous when it attacks the natives of

Africa.[52]

Mead held positions which later and more exact inquiry rendered

untenable. He would not allow that the pus of smallpox could

communicate any disease but smallpox, _if_ taken from a proper

subject--a condition that required supernatural assistance to

fulfil. He maintained that inoculation generated true smallpox,

and that as no one could have smallpox twice, therefore no one

could have smallpox after inoculation, and that reports to the

contrary were not credible. It now goes without saying that in this

contention Mead was at fault, but at the time his confidence was

not inexcusable; and whilst defending and recommending inoculation,

he made admissions which fully justified those who resisted and

condemned his counsels. Let us not forget that the following

passage was published in 1747, and was the fruit of six-and-twenty

years of experience in the best London practice. Thus Mead wrote--

It ought not to be omitted, that boils and swellings under

the ears and in the arm-pits arise more frequently after the

distemper procured by art than after that which comes of its own

accord; for this reason, as I suppose, that the venomous matter

is pushed forward with less force, which disadvantages Nature

makes amends for in this way.

Therefore all possible means are to be used to ripen such tumours

of whatever kind they are: if this cannot be done, they must be

opened by incision; and when all the matter is drawn out, the

body must be purged by proper medicines, which are to be oftener

repeated in this than in the natural disease.[53]

How just are the judgments of Divine Order! These boils, swellings,

and tumours, were the sequences of the violated harmony of the

body--of the faithless anticipation, the meddling and muddling with

its processes.

An extensive series of inoculations took place in 1742-45 in the

south of England. Smallpox was prevalent in Winchester and adjacent

towns, and Dr. Langrish operated freely on whoever resorted to

him. In Portsmouth, Chichester, Guildford, Petersfield, and

Winchester, it was said that at least 2,000 were poxed, and that

only two pregnant women perished, who, as usual, “were inoculated

contrary to the advice of their physician.” The ill results, wrote

Bishop Maddox, “were only such as might reasonably be supposed to

have been worse had those operated on had smallpox in the natural

way”--such being the euphemism wherewith boils, tumours, and other

sequelæ were accounted for.

The reviving favour for inoculation was indicated in this paragraph

from the newspapers of 13th April, in 1744--

Fourteen children, three years old, having been inoculated for

the smallpox in the Foundling Hospital, Hatton Garden, all with

good success, the Governors have resolved to have all their

children inoculated at the same age.

An important movement was made in 1746 with the opening of a

Smallpox Hospital in Cold Bath Fields at which “the benefit of

inoculation” was offered to the poor. At first those who applied

were taken into the house, and nursed through their self-inflicted

illness, but the proximity of the veritable smallpox, the regimen,

and the seclusion were sufficient to deter applicants: those,

however, who have a hobby to ride grow reckless in presence of

obstacles, and by-and-by inoculation was offered to all comers, who

were dismissed to recover and diffuse infection in their own homes.

With the revival of inoculation there was a revival of the

controversy as to its lawfulness theologically. Dr. Isaac Maddox,

Bishop of Worcester, preached a sermon on behalf of the Smallpox

Hospital in St. Andrew’s, Holborn, on 5th March, 1752,[54] which

excited considerable attention. He showed the necessity for

such an hospital for the poor and forsaken of the great city--a

necessity incontestable. He mentioned (and the remark supplies a

curious note on the hygiene of the time) that ventilators were

to be introduced, and it was expected that the access of fresh

air might benefit the patients. The return of the Hospital for

1752 showed 344 admissions, with 262 recoveries, and 82 deaths--a

proportion that does not contrast disadvantageously with 19th

century hospitals, fortified with sanitary appliances. During

the same year 112 inoculations were effected at the Hospital.

The Bishop had been assured by three eminent surgeons that they

had inoculated 1500 persons with only 3 fatalities, one of them

(Sergeant Ranby) having accomplished one thousand without a mishap.

The practice was without doubt lawful, for it averted a dangerous

disease, and some risk was inseparable from all methods of cure.

The practice had already done much to lessen smallpox, and, as it

became commoner, it would do more. The result of the sermon was a

subscription of £809 for the charity at the subsequent dinner in

the Drapers’ Hall.

The Bishop was singularly at fault in his ascription of diminished

mortality to inoculation, for, in 1752, smallpox was more than

unusually rife in the Metropolis, and its prevalence was not

unreasonably attributed to infection from the inoculated. In 1751

the deaths from smallpox in London were 998; they rose to 3538 in

1752; declined to 774 in 1753; and rose to 2359 in 1754.

Dr. Doddridge lent his powerful influence in favour of inoculation;

and, considering the unqualified assertions of medical men as

to its benefits and harmlessness, it cannot be said he was

blameworthy. The audacious assurance with which many of them bore

down opposition overcame the simple-minded, who argued as if the

world were constituted after the pattern of their own innocent

hearts. That smallpox frequently followed inoculation is now known

beyond dispute, and yet Dr. Kirkpatrick wrote--

I have heard myself a great many rumours of the inoculated being

naturally infected afterwards, which upon examination proved just

as many lies.[55]

How could women and divines resist such evidence?

A voluble antagonist of inoculation was the Rev. Theodore Delafaye

of Canterbury. He preached a sermon in that city on the 3rd of

June, 1753, from the text, “Let us do evil that good may come”

(Rom. iii. 8), and published it under the title of _Inoculation an

Indefensible Practice_. He was in turn attacked by the inoculators,

and in 1754 issued _A Vindication_ of 200 pages, in which he

returned more than he received with vigour rather than discretion.

His conclusion was--

Inoculation I maintain to be, in a religious and moral view,

a self-destructive, inhuman, and impious machination, and in

a physical one an unreasonable, unnatural, unlawful, most

hazardous, ineffectual, fruitless, uncertain, unnecessary device;

in a word, a practice which nature recoils at, which reason

opposes, and which religion condemns.

We sometimes read that inoculation was denounced as Atheism, and

we are expected to reprobate or to smile at the bigotry; and,

whilst we may not approve of the stigma, we may at the same time

recognise the honest sense in which it might be affixed. Some who

spoke of inoculation as Atheistic felt more vividly than they

could otherwise describe, that it was an infraction of the deeper

sanctity of Nature, where man’s hand cannot enter and prosper, and

that those who made the attempt could have no proper sense of Him

in whom they lived, and moved, and had their being. Moreover, if we

are to admit that they who thus expressed themselves are blameable

for excessive vehemence, what are we to say of the more numerous

party who did not hesitate to pronounce inoculation a discovery

effected in the human mind by God himself? If it was reasonable to

speak of the practice as Theistic, why should it be fanatical to

assert the contrary, and maintain that it involved a negation of

Divine Providence? Dr. Kirkpatrick, with the sycophancy which was

the custom of his age, praised George II. for “the benevolent, and

even celestial disposition,” which induced him to patronise “the

wonderful and probably Heaven-descended practice of inoculation;”

and extolled “its equal simplicity and success” as demonstrating

“to a reflective mind the goodness of Providence in making what may

be so often necessary, so easily accomplished.”[56] It would not

be difficult to cite scores of confessions of gratitude to God for

inoculation, but to what purpose?

What we think good we necessarily ascribe to God; and we do well;

but much that we think good is otherwise, or is only partially

good; and what then? Why, we are undeceived and corrected by

experience. We put our notion of what is good to the test of

practice, and God answers us in the event--justifies, amends, or

confounds us. Thus with inoculation. It was fair that those who

thought it good should refer it to God, and thank him for it; and

it was equally fair that those who thought it bad should say it

was none of his--that it was at variance with his order, and a

discredit to the intelligence of those who imputed it to Him. How

was the issue to be determined? Only by God himself. And how would

He speak? In the results of experience wherein his will would

become manifest beyond equivocation.

In 1754 inoculation obtained full recognition from the London

College of Physicians. It was declared “that experience had refuted

the arguments urged against the practice; that it was now more

extensively employed in England than ever; and that it was highly

beneficial to mankind.” The fence of hesitation was thrown down,

and to be inoculated became the distinction of all who wished to

be numbered with the enlightened and prudent. That the Circassians

were famous for their beauty, and that they practised inoculation,

was a staple argument, and an irresistible, with a multitude of

Englishwomen. Opposition was chiefly confined to the lower orders,

who objected to have the inoculated at large among them, and in

some places threatened to demolish the houses where inoculation

was performed.[57] Occasionally a medical practitioner acquired

reputation as an inoculator, and was resorted to by patients from a

distance, and his operations were not regarded with much favour by

his neighbours. Thus the physicians and surgeons of Newbury, Berks,

were compelled by their townsmen to promise to inoculate no one who

had not resided in Newbury at least two years.

The new practice created much business, and its distribution

excited some jealousy. Physicians complained that surgeons

inoculated without their assistance, and surgeons that apothecaries

did so likewise. Dr. Kirkpatrick laid down the rule that every

rightly conducted inoculation involved the employment of physician,

surgeon, and apothecary--the physician to prepare and prescribe

for the patient, the surgeon to cut, infuse, and dress, and the

apothecary to make up the medicines. Some, however, dispensed

with all three, and effected their own inoculations. A boy poxed

fourteen of his school-fellows in sport, and amateur inoculators,

male and female, multiplied. As an example of amateur procedure,

Dr. Kirkpatrick relates that a gentleman of Kent sent his servant,

Silvanus, a young man, to Mrs. Chapman, at Heathfield, to be

inoculated. He had to ride thirteen miles, and arrived hot and

fatigued at the house of the inoculatrix. As he had taken his

preparatory physic at his master’s, Mrs. Chapman desired him to get

ready at once for the operation, which he begged her to defer as

he was in such a heat. She replied that he must be inoculated that

very day, Tuesday, or remain until the following week, for Tuesday

was her lucky day. The poor fellow allowed himself to be persuaded,

and was then and there inoculated: severe smallpox ensued, and he

died.[58]

Thus was inoculation revived and established, and smallpox with

it--established and diffused.

FOOTNOTES:

[52] _Medical Works of Dr. Mead_, Vol. ii. p. 146. Edinburgh ed.,

1765.

[53] _Ibid._ p. 149.

[54] _A Sermon before the Governors of the Smallpox Hospital._

Isaiah lviii. 7. London, 1752; second ed., 1753.

[55] _An Analysis of Inoculation_, 2nd ed. 1761, p. 145.

[56] _Analysis of Inoculation_, p. 348.

[57] _Gentleman’s Magazine_, March, 1753.

[58] Kirkpatrick’s _Analysis of Inoculation_, p. 359.

CHAPTER VII.

TRIUMPH OF INOCULATION.

It having come to pass, according to the boast of Dr. Kirkpatrick,

that inoculation was regarded as “the most salutary practice

ever discovered for restraining a very loathsome and destroying

disorder, which it had nearly expunged from the catalogue of mortal

diseases,” it was the aim of physicians and patients to reduce the

trouble and hazard of the operation to the lowest terms possible.

In the words of Dr. Jenner, “There was bleeding till the blood was

thin, purging till the body was wasted to a skeleton, and starving

on vegetable diet to keep it so;” and practitioners who promised to

mitigate these rigours, placed themselves in the line of popularity

and prosperity.

Among distinguished easy inoculators was a family named

Sutton--“the Suttons” being a familiar name a century ago. Dr.

Robert Sutton practised surgery and pharmacy at Debenham, in

Suffolk, and went into inoculation with such energy that between

1757 and 1767 he operated on 2514 patients. His son, Robert, set up

as inoculator at Bury St. Edmunds, where he did a large business;

but a second son, Daniel, was the genius of the household. He had

been acting as assistant to Mr. Bumstead at Oxford, and returned

to his father in 1763 enthusiastic over a new plan of inoculation

whereby the time of preparation was to be shortened, whilst the

patients were to live in the open air. Old Sutton showed no favour

for the projected innovation, whereon Daniel opened an inoculating

house on his own account at Ingatestone, in Essex, advertising

himself as inoculator on a new, safe, and sure method. The

speculation answered. In 1764 he took 2000 guineas, and in 1765 his

receipts were £6300. His fame spread throughout the country, and so

many resorted to him that lodgings were scarcely to be had in and

around Ingatestone. His practice in Kent was also extensive, and he

was obliged to employ assistants. To crown his enterprise, he kept

a parson--the Rev. Robert Houlton, to puff his skill and success.

According to Houlton, the business of Daniel Sutton during three

years was as follows--

Inoculated in 1764, 1629

” 1765, 4347

” 1766, 7816

------

13,792

to which number was added 6000 inoculated by Sutton’s assistants,

making a total of 20,000, without, said Houlton, a single death.[59]

Sutton was denounced as a quack, and if to reserve as one’s own,

and to traffic in what is proclaimed to be for the common advantage

of mankind, constitutes a quack, Sutton was one. Nevertheless, he

was successful, and his success begot so much jealousy that he was

indicted at the Chelmsford quarter sessions, but acquitted with the

thanks of the grand jury for the lesson he had taught the Faculty.

Much ingenuity was exercised in ferreting out Sutton’s secret. His

secret, so far as it was anything, was an open one; and supposing

it necessary to infect men’s blood with variolous pus, and then

to operate for their recovery, there would be much to say for

Sutton’s procedure. His patients were obliged to go through a

strict preparatory regimen for a fortnight, during which every

kind of animal food, with the exception of milk, and all fermented

liquors and spices were forbidden. Fruit of all sorts was allowed,

unless on days when purges were taken. In the course of a fortnight

a powder was thrice administered at bed-time, and a dose of salts

on the succeeding morning. When the days of preparation were

accomplished, the patient was taken to the inoculating house, where

in the public room was found an array of people in various stages

of smallpox. From one of these sufferers, the operator selected a

pustule to his mind, opened it with his lancet, and, turning to

the patient to be poxed, raised the cuticle on the outer part of

his arm with the moist lancet, and pressed it down with his finger.

This was the entire operation: no plaster or bandage was applied:

and from that moment the patient was pronounced proof against

smallpox, even if he should lie in bed with one suffering from the

disease. Of course there remained the variolous affection to be

dealt with. The regimen of preparation was continued unchanged, and

a pill was taken nightly until the fever came on. None were allowed

to rest in bed, except for sleep, but had to walk abroad and enjoy

fresh air, even in winter weather. If a patient was too sick to go

alone, he was supported by attendants; and when the fever was at

its height, he was encouraged to drink copiously of cold water.

Much more was attributed to Sutton’s pills and powders than to

his regimen, and these were no more than preparations of antimony

and mercury, with which practitioners of all orders were only

too familiar. Sutton, however, contrived to maintain his mystery

until he had no longer occasion for it, and lived to recognise

a successor in Jenner. He removed to London in 1767 in hope of

enlarging his income, but like many other provincial celebrities,

discovered that he had better have remained where he shone without

rivals and detractors.

The Sutton regimen, so far as it might be described as “cool,”

came into general favour, whilst what was called the hot regimen

of warm rooms, bed, and cordials was correspondingly discredited.

Contrasting the two methods, Sir George Baker, writing in 1771,

observed--

I found that in the counties of Norfolk, Suffolk, and Essex, many

thousands of people of all ages and constitutions, and some of

them with every apparent disadvantage, had been inoculated with

general good success; whereas at Blandford, in Dorset, out of 384

who were inoculated, 13 actually died, and many others narrowly

escaped with their lives from confluent smallpox.[60]

A famous inoculator was Dr. Thomas Dimsdale of Hertford, a Quaker

of easy principles. He published in 1766 a treatise entitled _The

Present Method of Inoculating for the Smallpox_--an exposition of

the most approved practice of the time, which, by one of those

curious felicities of circumstance, conferred on him a European

reputation; and in 1781, _Tracts on Inoculation_--a record of his

opinions and adventures at home and abroad.

Dimsdale desired to universalise inoculation, but with

circumspection. He recommended that the inhabitants of a suitable

district should be dealt with as a whole and at once. That the

names of all should be taken, and on a certain day that everyone,

who had not had smallpox, should be inoculated. That the district

should then continue in quarantine for about three weeks, at the

end of which the danger and the fear of smallpox would cease, until

an unpolluted generation should afresh accumulate. The project was

not mere dreaming. Dimsdale was a man of influence and energy, and

effected several complete inoculations of villages and parishes in

Hertfordshire according to his plan. In later years, he combined

banking with medicine, and the firm of Dimsdale, Fowler, and Co. of

Cornhill originated with him and perpetuates his name.

Dimsdale’s practice lay chiefly among the upper classes, to whom he

made matters very comfortable. As he wrote--

I do not enjoin any restriction in respect to diet, nor direct

any medicines to be taken before the time of operation by such as

appear to be in a proper state of health.[61]

He was satisfied with administering a powder on the evening of

the day on which a patient was inoculated, consisting of calomel,

tartar emetic, and crabs’ claws.

Whilst labouring to popularise inoculation, Dimsdale was strongly

opposed to the trade therein passing to unauthorised hands--simple,

safe, and salutary though he asserted it to be. Thus he averred--

The mischiefs arising from the practice of inoculation by the

illiterate and ignorant are beyond conception.[62]

How illiteracy should affect inoculation, he left to conjecture.

He apparently forgot that the practice was derived from people who

made no pretence to literature, and whose efficiency and success

were, moreover, set forth as warrant and encouragement for English

imitation.

In 1775 a Society was formed for General Inoculation, and an

hospital was opened for the purpose at Battle Bridge, on the site

of what is now the Great Northern Railway station, King’s Cross.

Dr. Lettsom, a popular Quaker physician, issued an appeal on behalf

of the enterprise, and having invoked Dr. Dimsdale’s approval,

a lively controversy ensued between the brethren--personal

rather than profitable. Dimsdale disapproved of indiscriminate

inoculation: he was ready to inoculate the whole world, but

systematically, and under strict safe-guards. He pointed out that

whatever might be the advantage to the individual, unless the

inoculated patient was rigorously secluded, he would diffuse the

disease from which he sought to be delivered, and that the price

of his life might be the destruction of many. Dimsdale’s warnings

were, however, slightly regarded, and inoculation was pursued with

criminal recklessness. As Pascal observes, of all the faculties

given to man, the most awful in its consequences is the power of

standing amid a number of facts, and seeing such as we please to

see, and being blind to the rest.

Specially remarkable in connection with the smallpox of

last century was the exaggerated terror expressed for it by

professional inoculators, and the little real terror manifested

by the multitude. It was by no means the most fatal of diseases,

nor was it a large factor in the common mortality. Wherever we

test the matter by unbiased contemporary evidence, we find the

outcry factitious: the dreadful and desolating malady from which

Jenner delivered his country is merely a fiction continued by

the vaccinators from the inoculators. For proof let us turn to

the evidence of Dr. Alexander Monro, Professor of Medicine and

Anatomy in the University of Edinburgh. The Faculty of Medicine in

Paris had appointed a commission to inquire into the advantages

of inoculation, which in the course of duty applied to Monro,

who in response produced and published in 1765 _An Account of

the Inoculation of Smallpox in Scotland_. He reported that from

the introduction of the practice by Maitland in 1726, there had

been 5554 inoculations effected in Scotland with 72 fatalities;

that is to say about 140 annually with deaths 1 in 78, according

to the confession of the inoculators themselves. Monro further

stated that the practice was disliked in Scotland as “a tempting

of Providence,” an unwarrantable risk of life for an uncertain

advantage. Our present interest, however, is in the statistics of

deaths from smallpox in Edinburgh for a series of twenty years thus

adduced by Monro.

Burials From

from all Smallpox.

Diseases.

1744 1345 167

1745 1463 141

1746 1712[63] 128

1747 1200 71

1748 1286 167

1749 1132 192

1750 1038 64

1751 1241 109

1752 1187 147

1753 1105 70

------ ----

12,709 1256

1754 1215 104

1755 1187 89

1756 1316 126

1757 1267 113

1758 1001 52

1759 1136 232

1760 1123 66

1761 903 6

1762 1305 274

1763 1160 123

------ ----

11,613 1185

Here we have a piece of valid experience with every advantage to

the smallpox terrorist: for Edinburgh last century was a city

contrived as if for the generation and perpetuation of smallpox.

The population of 55,000 was lodged thickly in flats, in houses

of many storeys, closely built in lanes and courts--a population

densely compacted as any in Europe, with arrangements for

cleanliness indescribable, at this day perhaps incredible. Yet

in conditions so propitious to smallpox, we see before us the

total outcome during a series of twenty years; and reprehensible

as the result may appear to contemporary sanitarians, who hold,

and rightly hold, that all zymotic diseases are preventible, yet

it affected Monro with no anxiety or dismay: nor does the rate

of mortality of old Edinburgh contrast unfavourably with that of

the modern city. The case of Edinburgh, however, serves to show

that in all cases when we hear of the ravages of smallpox before

Jenner appeared as deliverer, our policy is to insist firmly upon

the production of special and adequate evidence: it is monstrous

that the assertions of common quacks, whether inoculators or

vaccinators, should pass into tradition and be accepted as

unquestionable verity.

We have, moreover, to observe that the mortality from smallpox in

Edinburgh was infantile mortality: for as Monro testified--

The inhabitants of Scotland generally have the smallpox in their

infancy or childhood; very few adults being seen in this disease.

Whether this is owing to any particular constitution of the air,

or of the people, or to the disease not being so much dreaded as

to cause any to fly from the place where it is, or to the great

intercourse which must be among the inhabitants of the towns, of

which several, nay, many families enter to their houses by one

common stair, while in the villages the peasants are generally

assistant to their neighbours of whose family any is sick, it is

not now necessary to inquire.

Not only were the habits of the people contributory to the

diffusion of eruptive disorders, but likewise their food, of which

oatmeal was the staple, whilst vegetables were few, fruit rare,

and tea unknown. Hence many maladies had free course; and as Dean

Ramsay relates, a girl on her arrival at Mrs. Betty Muirheid’s

boarding-school in the Trongate, Glasgow, when asked whether she

had had smallpox, replied, “Yes, mem, I’ve had the sma’pox, the

nirls [measles], the blabs [nettle-rash], the scaw [itch], the

kink-host [whooping-cough], the fever, the branks [mumps], and the

worm [toothache].”

* * * * *

A last word as to Lady Mary Wortley Montagu. After a residence

of twenty years in Italy, she returned to England to die, 21st

August, 1762. On the west side of the north door in Lichfield

Cathedral, there is a female figure, in marble, leaning on an urn

inscribed M. W. M. The inscription runs--

SACRED TO THE MEMORY OF

THE RIGHT HONOURABLE

LADY MARY WORTLEY MONTAGU,

WHO HAPPILY INTRODUCED, FROM TURKEY,

INTO THIS COUNTRY,

THE SALUTARY ART OF INOCULATING THE SMALLPOX.

CONVINCED OF ITS EFFICACY,

SHE FIRST TRIED IT WITH SUCCESS

ON HER OWN CHILDREN,

AND THEN RECOMMENDED THE PRACTICE OF IT TO

HER FELLOW-CITIZENS.

THUS, BY HER EXAMPLE AND ADVICE,

WE HAVE SOFTENED THE VIRULENCE, AND

ESCAPED THE DANGER, OF THIS MALIGNANT DISEASE.

TO PERPETUATE THE MEMORY OF SUCH BENEVOLENCE,

AND TO EXPRESS HER GRATITUDE

FOR THE BENEFIT SHE HERSELF RECEIVED FROM

THIS ALLEVIATING ART,

THIS MONUMENT IS ERECTED BY

HENRIETTA INGE,

RELICT OF THEODORE WILLIAM INGE, ESQ.,

AND DAUGHTER OF SIR JOHN WROTTESLEY, BART.,

IN THE YEAR OF OUR LORD,

MDCCLXXXIX.

Whilst we do not resort to epitaphs for truth, we may discover in

them what was taken for truth, or what was wished to be taken for

truth. We have in the foregoing epitaph the legend which has caught

the popular fancy, and which is likely to survive corrections

innumerable. It is the custom of mankind to identify a common

movement with some prominent or picturesque figure in the movement,

and to suppress the rest. The practice is convenient, but it taints

all history with fable.

* * * * *

It may be said that the practice of inoculation met with no

active resistance in England during the last thirty years of last

century. How widely and deeply it extended it would be difficult to

determine. The probability is, that the mass of the population was

untouched, and that inoculation was limited to the upper and middle

classes, and to the lower so far as they came under the immediate

influence of those above them. We have, perhaps, an index to the

condition of affairs in Dr. Wm. Buchan’s _Domestic Medicine_, first

published in 1769, which ran through eighteen editions, amounting

to 80,000 copies, in the author’s life-time. It is not uncommon to

refer contemptuously to Buchan, but his work was the production

of a man of vigorous good sense with faith in the good sense of

his readers--a book creditable to the author and to the people who

appreciated him.

Buchan was an inoculator, a zealous advocate of inoculation, and

earnestly laboured to universalise the practice. In the _Domestic

Medicine_, ed. 1797, he wrote--

No discovery can be of general utility while the practice of it

is kept in the hands of a few. Had Inoculation been practised by

the same kind of operators in our country as in the countries

from which we derived it, it had long ago been universal. The

fears, the jealousies, the prejudices, and the opposite interests

of the Faculty are, and ever will be, the most effectual

obstacles to the progress of any salutary discovery. Hence it is

that Inoculation never became in any manner general in England

till taken up by men not bred to physic.

Consistently with this opinion, Buchan strongly advocated domestic

practice, saying--

They know very little of the matter, who impute the success of

modern inoculators to any superior skill, either in preparing the

patient or communicating the disease. Some of them, indeed, from

a sordid desire of engrossing the whole practice to themselves,

pretend to have extraordinary secrets or nostrums for preparing

persons for inoculation, which never fail of success. But this is

only a pretence calculated to blind the ignorant and inattentive.

Common-sense and prudence alone are sufficient both in the

choice of the subject and management of the operation. Whoever

is possessed of these may perform this office for his children

whenever he finds it convenient, _provided they be in a good

state of health_.

This statement is not the result of theory, but of observation.

Though few physicians have had more opportunities of trying

inoculation in all its different forms, so little appears to me

to depend on those generally reckoned important circumstances,

of preparing the body, communicating the infection by this or

the other method, etc., that, for several years past, I have

persuaded parents and nurses to perform the entire operation

themselves.

I have known many instances of mothers inoculating their

children, and never so much as heard of one bad consequence.

Common mechanics often, to my knowledge, perform the operation

with as good success as physicians.

Having described the ordinary method of inoculation by incision

with a lancet dipped in pus, he goes on to say--

If fresh matter be applied long enough to the skin, there is no

occasion for any wound at all. Let a bit of thread, about half

an inch long, wet with the matter, be immediately applied to the

arm, midway between the shoulder and the elbow, and covered with

a piece of common sticking-plaster, and kept on for eight or ten

days. This will seldom fail to communicate the disease.

Instead of multiplying arguments to recommend this practice, I

shall beg leave to mention the case of my own son, at the time

an only child. After giving him two gentle purges, I ordered the

nurse to take a bit of thread which had been previously wet with

fresh matter from a pock, and to lay it upon his arm, covering it

with a piece of sticking-plaster. This remained on six or seven

days, until it was rubbed off by accident. At the usual time

smallpox made their appearance, and were exceedingly favourable.

Surely this, which is all that is generally necessary, may be

done without any skill in medicine.

Thus was smallpox made easy!

Buchan appealed to the clergy for co-operation as inoculators--

The persons to whom we would chiefly recommend the performance

of this operation are the clergy. Most of them know something

of medicine. Almost all of them bleed, and can order a purge,

which are all the qualifications necessary for the practice of

inoculation.

And as propagandists--

No set of men have it so much in their power to render the

practice of inoculation general as the clergy, the greatest

opposition to it still arising from some scruples of conscience,

which they alone can remove. I would recommend them not only to

endeavour to remove the religious objections which weak minds

have to this salutary practice, but to enjoin it as a duty, and

to point out the danger of neglecting to make use of a means

which Providence has put in our power for saving the lives of our

offspring. Surely such parents as wilfully neglect the means of

saving their children’s lives are as guilty as those who put them

to death.

How familiar have vaccinators rendered this line of adjuration! If

you do not comply with our prescription, and your children catch

smallpox, then are you their murderers.

Here is another passage from Buchan, which with equal accuracy

might apply to Vaccination--is indeed what is perpetually asserted

to be the truth concerning Vaccination--

As the Smallpox is now become an epidemical disease in most

parts of the known world, no other choice remains but to

render the malady as mild as possible. This is the only manner

of extirpation now left in our power; and though it may seem

paradoxical, the artificial method of communicating the disease,

could it be rendered universal, would amount to nearly the same

thing as rooting it out. It is a matter of small consequence

whether a disease be entirely extirpated, or rendered so mild as

neither to destroy life nor hurt the constitution; but that this

may be done by Inoculation, does not now admit of a doubt. The

numbers who die under Inoculation hardly deserve to be named.

In the natural way, one in four or five generally dies; but by

Inoculation not one of a thousand. Nay, some can boast of having

inoculated ten thousand without the loss of a single patient.

In this deliverance, Buchan did not lie, nor did he speak

for himself alone, but expressed the medical opinion of his

time, precisely as a physician of to-day testifies concerning

Vaccination. Yet we all know that Buchan was completely at fault,

and substituted what he wished to be true for what was true.

I cannot leave Buchan without a few words in his favour, for,

according to his lights, he was a worthy fellow, and the words

shall be his own. He wrote--

I am old enough to remember the time when the success of

Inoculation was supposed to be entirely owing to the preparation

of the body, as it was called; but I am convinced that such

preparation always has done, and still does, more harm than good.

_The body cannot be better prepared to meet a disease, than by

being in good health._ Medicine may cure a disease, but it cannot

mend good health. When a person enjoys the blessing of health, he

ought never to meddle with medicine on any account whatever.

No: nor with half an inch of thread dipped in pox.

FOOTNOTES:

[59] _Sermon preached at Ingatestone, 12th October, 1766, in

defence of Inoculation, with App. on the present state of

Inoculation._ Lond., 1767.

[60] _Medical Transactions_, vol. ii. art. xix.

[61] _Tracts on Inoculation_, p. 126.

[62] _Ibid._ p. 107.

[63] Monro accounts for the excessive mortality of this year by the

presence of regiments in Edinburgh after the suppression of the

rebellion of 1745.

CHAPTER VIII.

INOCULATION ABROAD.

Before proceeding to relate how Inoculation was superseded and

ultimately suppressed in England, it may be expedient to make some

notes on the prevalence of the practice in other lands.

And first in New England where, as we have seen, Cotton Mather had

precedence in subjecting the reports of eastern inoculation to the

test of western practice. Mather and his coadjutor, Boylston, did

not propose to make inoculation habitual, but to reserve it for

use in epidemics. Sometimes years elapsed in New England without

smallpox: there were no dense urban populations to constitute

seats of zymotic disease: and to provide perpetually against

what was occasional was obviously unnecessary. Nevertheless the

colonists shared the common disposition of the time for pottering

in remedies, and their slaves afforded convenient opportunities for

experiments in which temerity had the sanction of beneficence. With

the Whites, cleanliness, ventilation, drainage, and pure water,

were conditions of accident rather than of providence, but with the

Blacks life was that of the stye, and the consequences in smallpox

were thought to be sufficiently accounted for by the assertion

that Negroes were constitutionally pre-disposed to that disorder.

Wherefore the Blacks from Boston to the Spanish Main were from time

to time remorselessly inoculated, and all of them who afterwards

escaped smallpox had their immunity ascribed to their inoculation.

Jonathan Edwards, the prince of Calvinistic divines, was killed by

inoculation. There was an epidemic of smallpox in New Jersey, and,

for security, Edwards was inoculated. The result was the generation

of smallpox in a severe form, of which he died, 22nd March, 1758,

in his 54th year. In search of a superfluous safety was he slain.

A man of the age of Edwards had little to fear from smallpox; for

the disease, in the vast majority, was an affection of the young,

concerning which, as having attained middle life, Edwards might

have maintained comparative indifference.

The colonists usually ascribed any outbreak of smallpox to

importation by shipping from Europe, if not manifestly, then

covertly; for, it was held that smallpox could never be evolved

spontaneously. Great pains were therefore taken to isolate

patients, and Boston and other sea-ports had hospitals erected

on sites remote from habitation, from which a flag was displayed

whenever occupied by the sick. A physician who visited an hospital

was required to take off his wig, to change his shoes, and to put

on a gown which hung from his neck to his ankles; and, when he came

out, to wash his hands, and be fumigated with frankincense. In

setting forth these precautions, Professor Waterhouse of Cambridge,

Massachusetts, observed in a letter to Dr. Haygarth of Chester--

I cannot believe them altogether unnecessary. Our towns are

small, our houses scattered, most of them having a garden between

them, so that we have been able to trace the action of contagion.

We have tried many experiments with smallpox in New England, and

persuade ourselves that we have some pretensions of knowing more

of that disease than you in Europe.

During the war with England, smallpox broke out in the American

army, and inoculation was so freely resorted to that scarcely a

man escaped the lancet. Washington had his New England soldiers

inoculated at Cambridge in 1776, and it was difficult to find men

to keep guard over the sick; that is to say, men who had passed

through smallpox and were not considered liable to infection,

a curious evidence of the rarity of the natural disease in the

communities from which the army had been recruited.[64]

Cotton Mather’s triumph over Boston was complete--complete beyond

his intention; for it came to be as thoroughly inoculated as any

town in these days is vaccinated. Dr. Waterhouse, writing on 28th

October, 1788, said--

We find that in 1752 there were but 170 persons liable to

smallpox in Boston, and in 1754, when there was a general

inoculation in the town, I question whether there was a quarter

of that number that did not receive the infection _viâ naturæ vel

artis_. In the years 1776, ’77, and ’78 they inoculated pretty

freely throughout the State. Two days ago, I was at the review

of part of the militia of the county of Suffolk, and of 520 men,

I scarcely think there were a hundred above twenty-five years of

age that had not passed through smallpox by means of inoculation;

and of 2000 reviewed a week or two before, in the county of

Middlesex, there was not a greater proportion of the same age

liable to take the disease. Since 1764 the dread of smallpox has

lessened considerably; and since 1778 we meet the disorder with

as little fear as any people you can mention.

In another letter, dated 15th October, 1787, the Doctor said--

I do not believe there is at present a single person infected by

smallpox in all the four New England Governments, that is, not

one in a million of people.[65]

However it may have been elsewhere, inoculation was conducted in

Boston with a formality and deliberation that might have satisfied

Dimsdale himself. There was an inoculation hospital erected on

Sewell’s Point, which juts into Charles River, remote by a mile and

a half from the common road, and situated in pleasant grounds with

trees and walks. Three weeks were devoted to inoculation and the

subsequent sickness, and before dismissal, wrote Dr. Waterhouse--

The patients are washed all over in soap suds, then rubbed with

brandy, and lastly washed in vinegar; they put on fresh clothes,

and bury those they wore during their stay in the hospital.

But even then they are smoked and fumigated with sulphur in

the smoke-house, which is about twice the size of a common

sentry-box. This smoke-house has a hole in its side for the

patient to put his head out of during the operation. Although

this seems formidable on paper, yet patients submit cheerfully,

and with no slight merriment.

There are perhaps 150 under inoculation at present at Sewell’s

Point, not one of them paupers. They are principally children,

perhaps thirty or forty of them of the first people in the

commonwealth. The charge for the whole process is 8 dollars,

or 36s. sterling, including every expense from incision to

dismission. In some places they inoculate for half that sum. You

must conceive the whole business conducted with a good deal of

gaiety, where a patient, when ill, is as apt to be pitied as if

sea-sick with a sailing party. The established system of mirth

and good humour contributes not a little to the welfare of the

patients.

It is a curious story, and stands in broad contrast to the rough

and ready practice of Turkey, and of many inoculators in England

and elsewhere. Dr. Waterhouse adds--

There were a considerable number of persons in Boston to whom

smallpox could not be communicated by inoculation. In some the

operation was repeated two, three, and four times with fresh

matter. Several of these have had the disease severely since in

the natural way, and some have died of it.

France was slow to accept inoculation. After its introduction in

1723, about thirty years elapsed without any serious movement

in its favour, when Voltaire, Diderot, and their set began to

recommend the practice, which had the merit of being English and

disliked by those who held change and improvement in aversion. La

Condamine read an eloquent paper on the advantages of inoculation

before the Academy of Sciences; and Turgot, the ardent and

sagacious lover of his kind, procured the inoculation of a child

in Paris, 1st April, 1755; which was followed on 14th May by a

young man, named Chastellux, submitting himself to the operation

in the interest of the common welfare. Then Dr. Hosty was sent to

London to investigate and report, and on his return issued these

statements--

1. That out of 463 cases inoculated in the London Hospital, only

one had been unsuccessful; whereas in the Smallpox Hospital

nearly one in four had died.

2. That Mr. Ranby, principal surgeon to his majesty, had

inoculated 1600 persons, and Mr. Bell 903, without the loss of

one.

3. That to form a just comparison between the fatality of

natural and artificial smallpox, it is only necessary to visit

the London Smallpox Hospital and then the Inoculation Hospital:

the difference between the two is so remarkable that the most

incredulous must be convinced.

4. Lastly, with respect to the asserted insemination of other

diseases with inoculated smallpox: no instance of the kind has

ever been produced. Persons have been inoculated with variolous

matter taken from patients afflicted with venereal disease, yet

they have received no infection save that of smallpox only.

It would be superfluous to deal with the fallacies involved in

these statements: they served to satisfy those who were disposed

to be satisfied, and inoculation became the fashion among the

scientific and enlightened. Dr. Tronchin, a well-known inoculator,

was summoned from Geneva to Paris in 1756 to operate upon the

children of the Duke of Orleans, and his success was pronounced

decisive. Nevertheless inoculation did not extend beyond people

of leisure and culture, and in 1763 an outbreak of smallpox in

Paris made an end of the practice. An inquiry was instituted by

the authorities, and the evidence left no doubt that the epidemic

had been diffused, if it did not originate, with the artificially

poxed; and inoculation was thenceforth prohibited in Paris. Any

citizen who was resolved to have the induced disease had to retire

to country quarters.

Here we may observe that the confidence of the inoculator was

grounded on the assumption that whoever had once passed through

smallpox, whether natural or artificial, could never again

contract the disease. Nevertheless the inoculated did contract the

disease, and the disaster was uniformly accounted for as due to

some imperfection in the inoculation. There were also instances

of smallpox after smallpox, but these, too, were discredited;

the first smallpox could not have been smallpox, but chickenpox,

measles, or some other eruptive disorder. There was a conspicuous

confutation of these evasions in the case of Louis XV. He had

smallpox unquestionably in his 14th year, and of unquestionable

smallpox he died in 1774 in his 64th year. Notwithstanding, the

assertion was perpetuated that there was no possibility of smallpox

after smallpox, and it was only when it became necessary to

maintain the credit of vaccination that the facts were admitted;

and in this form--Smallpox after vaccination is no more common or

extraordinary than smallpox after smallpox--a falsehood on the back

of a former falsehood.

We have seen under what safeguards inoculation was practised in

Boston, and now we shall turn to Geneva and discover how all the

American precautions were set at naught in that city with apparent

impunity. The details are from a letter of the Council of Geneva,

dated 24th December, 1791, addressed to Dr. Haygarth in answer to

his inquiries and suggestions. Des Gouttes, secretary to the Geneva

Syndic, wrote--

I.--The Republic of Geneva contains about 35,000 inhabitants, of

whom 26,000 dwell in the city, and 9,000 in the adjacent country.

II.--The city is of small extent, and ill adapted to so large

a population; and its extension is not easy on account of the

fortifications wherewith it is surrounded. There are little more

than 1200 houses in the city, which are built in many storeys of

many apartments like the ancient part of Edinburgh, each house

sheltering on an average twenty-one inhabitants.

III.--A great part of the population consists of strangers, not

only because most of our servants and labourers are natives of

other countries, but because Geneva being a frontier city, girt

about by Savoy, Switzerland, and France, and situated on the

highways of intercourse between these states, travellers are

always coming and going.

IV.--Notwithstanding this continual resort of strangers within

our walls, an epidemic of smallpox is of almost regular

occurrence every five years; and between the epidemics it

frequently happens that we have no natural smallpox whatever,

either in the city or its vicinity.

V.--Inoculation began to be practised here in 1751, since which

date we have inoculated a very large number of children annually,

and with such marked success that the deaths have but slightly

exceeded 1 in 300. Although we have often had to inoculate with

pus brought from a distance at times when there was no smallpox

to be found in the city, and although children so inoculated have

gone freely into the streets, walks, and other public places,

before, during, and after the eruption, we have never observed

that they were sources of contagion, nor that they produced any

intermediate epidemic, nor that they accelerated the return of

the periodical epidemic.

VI.--Lastly, our citizens enjoy a republican constitution which

requires us to pay most scrupulous regard to the liberty of every

individual. No coercive measures to hinder the introduction or

communication of smallpox are here practicable; and we believe we

ought to limit our action to advice, and to simple precautions of

police, which must not, nor even seem to be, oppressive to the

citizens.

This glimpse into old Geneva is not only instructive as concerns

inoculation, but it is another exposure of the monstrous fable

that represents European cities as decimated with smallpox until

Jenner’s advent as saviour--a fable that vanishes like smoke

whenever brought into contact with matter-of-fact.

Inoculation was introduced to Rome and Florence during a severe

epidemic in 1754; and attention being drawn to the remedy, it was

discovered that the Italian peasantry had long practised voluntary

smallpox just as did the peasantry of Wales and the Highlands of

Scotland. In Spain, inoculation made little headway: in the words

of Moore--

Some inoculations were effected in a few trading cities, which

held communication with England; but these efforts were of short

duration, and from the distinguished inaction of the Spaniards,

inoculation was soon relinquished; and no other country in Europe

has suffered so little from smallpox.[66]

In Holland and Denmark inoculation acquired a certain vogue among

the upper classes, and in Germany the like was true to a less

extent. In Sweden inoculation was encouraged by the Court, and

Dr. Schultz was deputed to visit the London Hospital. His report

was so favourable that in 1755 inoculation houses were opened in

several parts of the kingdom, and the benefits of the practice were

commemorated by a medal in 1757--a curious trophy of illusion under

prepossession.

Perhaps the most notable event in the story of inoculation was

its introduction into Russia: how it was brought about is thus

described by Mr. Morley--

As soon as Catharine came into power (1762), she at once applied

herself to make friends in this powerful region [French letters

and philosophy]. It was a matter of course that she should begin

with the omnipotent monarch at Ferney. Graceful verses from

Voltaire were as indispensable an ornament to a crowned head

as a diadem, and Catharine answered with compliments that were

perhaps more sincere than his verses. She wonders how she can

repay him for a bundle of books that he had sent to her, and

at last bethinks herself that nothing will please the lover of

mankind so much as the introduction of inoculation into the great

Empire; so she sends for Dr. Dimsdale from England, and submits

to the unfamiliar rite in her own sacred person.[67]

One day in the summer of 1768, at his house in Hertford, Dimsdale

received an unexpected message from Pouschin, the Russian minister

in London, to wait upon him; and in his presence he learnt that he

was required to proceed at once to St. Petersburg to inoculate the

Empress. There was of course some hesitation about undertaking so

long a journey, but Pouschin had been authorised to overcome all

obstacles. What would the Doctor require in the way of expenses?

The Doctor discreetly answered that he would leave that to her

Imperial Majesty, whereon Pouschin handed him £1000 to pay his

way to St. Petersburg. Dimsdale summoned his son from his medical

studies in Edinburgh, and the two set off for the North on the 28th

of July.

At St. Petersburg Dimsdale was received with every mark of respect

and liberal hospitality. He was introduced to the Empress, who

was charming and gracious; and he was instructed to make the

requisite preparations for the serious duty before him. He had

to find pus, and to obtain pus he had to lay hands on a suitable

sufferer from smallpox--a task which proved by no means easy.

Having discovered a case to his mind, he had then to overcome an

obstinate objection to the abstraction of virus. He had, at the

same time, to find a couple of healthy young men, who had not had

smallpox, on whom to raise secondary virus, for the Empress could

not be expected to run the risk of smallpox without mitigation.

His first attempt was a complete failure, and he had to report

accordingly to his expectant patient. Catharine heard his report

with philosophical equanimity, and left him to try again. At last

he was successful, and at the palace of Czarscoe Selo on Saturday,

11th October, 1768, the Empress swallowed five grains of mercurial

powder, and late on Sunday evening Dimsdale inoculated her with

fluid matter by one puncture in each arm. She did well. From the

time of the inoculation to the commencement of the eruption, she

walked every day for two or three hours in the open air, and, on

the 1st November, she returned to St. Petersburg “in perfect good

health, to the great joy of the whole city.”[68] The Grand Duke

was inoculated on the 30th October, and by the 22nd November had

“perfectly recovered.”

The Empress having played, the nobility had to follow suit, and

Dimsdale was requested to proceed to Moscow to take them in hand;

but at this time there was a new difficulty. There was said to be

no smallpox in Moscow, and as Dimsdale could not inoculate without

fresh virus, he had to inoculate two girls in St. Petersburg,

designing so to time their disorder that he should arrive with

them in Moscow in prime condition for business. One girl was a

failure, and mishaps and delays on the sledge journey almost made a

failure of the other. He did, however, reach Moscow in time enough

to communicate the requisite infection to fifty patients, and in

Moscow he remained for two months operating and playing the lion.

Then he set off for home, and on his route through St. Petersburg

found Catharine suffering from pleurisy, for which he bled her,

drawing eight ounces of imperial blood. Then came the reckoning. In

substantials he had--

£10,000 down;

£2,000 for travelling expenses;

£500 a year for life, to be paid in net English cash, and

A superb gold snuff-box set with diamonds for Mr. Dimsdale.

In honours he had the appointments of--

Counsellor of State;

Physician to her Imperial Majesty; and

Baron of the Russian Empire with descent of title to his

eldest son.

It was a barbarian’s style of recompense, paid under the eye of

Europe. It cost Catharine nothing, for it is subjects who suffer

for the extravagance of despots.

Dimsdale had plans for the systematic inoculation of Russia, but

they resulted in little. Catharine’s purpose was sufficiently

served in the display she had made; and possibly she came to

consider Dimsdale an appendage of that deceiver Voltaire, whose

busts, that had adorned her saloons and corridors, were by her

orders thrown into the cellars when the French revolution opened

her eyes to the consequences of French philosophy.

In perusing the literature of inoculation, nothing impresses a

reader, enlightened by sanitary science, so much as the manner in

which smallpox was regarded as something like hail or lightning

that might be averted, but could not be prevented. So far, I have

not met with even a hint in that literature that smallpox was

either induced by unwholesome modes of life, or that it could be

avoided by wholesome modes. In conjunction with this blindness

was the amazing assumption of the inoculators, that every one

inoculated was to be placed to their credit as saved from smallpox;

as if (granting inoculation to be prophylactic) smallpox was ever a

universal epidemic, and as if multitudes did not pass through life

without smallpox before inoculation was heard of. The true problem

to be set and solved in all epidemics, whether of influenza or

smallpox, is why some are susceptible and some insusceptible, and

whether it is not practicable so to modify conditions as to carry

over the susceptible to the ranks of the insusceptible.

FOOTNOTES:

[64] Humphries’s _Life of General Putnam_, p. 151.

[65] These letters of Benjamin Waterhouse, M.D., Professor

of Physic at Cambridge, Mass., appear in Haygarth’s _Plan to

Exterminate Smallpox_. London, 1793.

[66] _The History of the Smallpox._ By James Moore. London, 1815.

P. 288.

[67] _Diderot and the Encyclopædists._ By John Morley. Vol. ii. p.

114.

[68] Dimsdale: _Tracts on Inoculation_.

CHAPTER IX.

INOCULATION SUPERSEDED AND SUPPRESSED.

The illusory character of human testimony is graphically

illustrated in the case of inoculation. Suppose an inquirer wished

to ascertain the ratio of deaths to inoculations, he would be

completely bewildered. We have seen what Dr. Buchan wrote--

In the natural way, one in four or five generally dies of

smallpox; but by inoculation not one of a thousand. Nay, some

can boast of having inoculated ten thousand without the loss of

a single patient.

John Birch, an eminent London surgeon, said--

Not one in three hundred dies of inoculation in the general

irregular mode of proceeding, and not one in a thousand among

observant practitioners; and if the inoculated patient die, he

dies of smallpox and of nothing but smallpox.[69]

In the _Edinburgh Review_, October, 1806, we read--

Of those who have smallpox naturally, one is found to die in

six. Of inoculated patients, only one dies in two hundred and

fifty. This at least is Dr. Willan’s calculation; and we are

persuaded that it is very near the truth. In London, where it

ought to be best ascertained, some eminent practitioners have

stated the proportion to be so high as one in the hundred. The

zealous anti-vaccinists have denied it to be greater, under

judicious treatment, than one in a thousand. It cannot be denied,

however, that besides the risk to life, the disease, even under

the mitigated form, has frequently proved an exciting cause

of scrofula and other dreadful distempers, and has often been

attended with blindness and deformity.

In Reynolds’s _System of Medicine_, it is stated by Marson that--

The Smallpox and Inoculation Hospital was founded in London in

1746, and inoculation was continued there until 1822. Dr. Gregory

went carefully over the records of the Hospital for that period

of seventy-six years, and found that only three in a thousand

died of inoculation. The inoculated disease was usually very

mild, but not invariably so.

Scores of such testimonies might be adduced, twitching the

reader from conclusion to conclusion; and in the conflict of

authorities what is to be said? It is true that if we select

what evidence we like, and call it sound, and reject what we

dislike, and call it unsound, we may prove anything; but it is

also true, that if we are to be fettered by evidence we shall

stand paralysed amid contradictions. When men who are competent,

and obviously honest, deliver varying testimony, we are driven

to seek some method of reconciliation; and in this matter of

Inoculation wherein our resort is to books, and about which we

can have no immediate experience, we may derive much light from

the corresponding practice of Vaccination. Thus, what is commoner

than for vaccinators to assert, that never within their sphere of

observation have they witnessed a single case of injury resulting

from Vaccination--not one! Subject any dozen ordinary practitioners

to judicial examination, and they would thus testify with scarcely

a note of variation. On the other hand, take any dozen mothers of

families, especially from among the poor, and they would tell of

illness, disease, and death following the vaccinators’ lancets. The

men are more or less competent and honest, and the women likewise,

and how shall we account for their variance? In the first place,

the men have been drilled from the outset of their profession into

the conviction that Vaccination is absolutely harmless, and if any

disaster follows, it is coincidence, not consequence. Occasionally

a practitioner of more vigorous intelligence than the average, like

Mr. Henry May of Birmingham, sees what the mothers see, but does he

report accordingly? Not at all. In Mr. May’s own words--

A death from Vaccination occurred not long ago in my practice,

and although I had not vaccinated the child, yet in my desire to

preserve Vaccination from reproach, I omitted all mention of it

from my certificate of death.[70]

Mr. May recognised the fact and concealed it: a duller man would

have ascribed the death mechanically to erysipelas or pyœmia.

Indeed, it is a commonplace with medical men, that no child dies

of Vaccination; and hence Vaccination is not an admitted cause of

death; and when the fact is insisted upon, there is no limit to

the hardihood wherewith the truth is crushed down and covered up.

Coroners refuse to hold inquests on children slain by Vaccination,

and Dr. Lankester, as coroner for Middlesex, did not hesitate to

authorise a false certificate of death in order, like Mr. May,

“to preserve Vaccination from reproach.”[71] As for mothers, poor

creatures, few of them have minds of their own, and if only they

were adequately assured that it was for the good of their offspring

that their noses should be slit, they would believe, weep, and

submit.

But it will be pointed out that inoculators of the more reasonable

sort admitted a certain mortality from the practice. It is so; but

the admission was unavoidable. Inoculation communicated smallpox,

and there was no evasion of the fact that occasionally the malady

assumed a severe form, and the patient died. For such mishaps,

however, there were always excuses. The patient was not in a

suitable condition of body; he had been eating improperly; he had

caught cold; and so on. There remained, nevertheless, the sequelæ

of Inoculation, which were just as persistently denied as are those

of Vaccination, although there were always clear-sighted observers

who maintained that it was impossible to infect the blood with a

complex organic virus, and that it should exhaust its effects in

a single and definite issue. We all remember how we used to be

assured with contemptuous emphasis that it was utterly impossible

to communicate Syphilis by Vaccination, and that assertions to

the contrary were the fables of ignorance and malice; yet, we

see that what was fabulous a few years ago, is now accepted as

medical matter-of-fact. Nowhere is scepticism so useful as among

physicians; for whenever they protest most, suspect most.

With the close of the 18th Century, Inoculation with smallpox to

avert smallpox was accepted as sound practice throughout England.

Its safety and efficiency were extolled by medical writers in

terms curiously identical with those applied to Vaccination.

The objectors were few, and for pious rather than physiological

reasons; and the question that exercised practical and benevolent

minds was how to universalise the remedy, which, on account of its

troublesome accompaniments, was chiefly confined to the upper and

middle classes. On this point it may be well to cite the words of

Dr. Haygarth of Chester, who, in a letter to the Council of Health

of Geneva, dated 10th February, 1792, thus sets forth the position

of affairs--

In Chester, and, I believe, in most of the large towns of

England, the casual smallpox is almost constantly present. _All

the children of the middle and higher ranks of our citizens

are inoculated in early infancy._ The populace, very generally

regarding the distemper as inevitable, neither fear nor shun

it; but much more frequently by voluntary and intentional

intercourse, endeavour to catch the casual infection. All the

difficulties of our Smallpox Society in Chester proceeded from

this strange delusion and perversity of disposition. With us

the smallpox is seldom or never heard of except in the Bills of

Mortality; but there its devastation appears dreadful indeed.

The strong objection to Inoculation was, that it diffused the

disease generally which it was supposed to avert individually.

Inoculators tried to minimise and deny the danger, but in vain;

and nothing so contributed to the supersession of the practice by

Vaccination as the expectation of escape from the artificially

propagated disease. How extensive was that propagation, we leave

the writer in the _Edinburgh Review_ of 1806 to describe--

The inoculated smallpox is an infectious disease, and those who

take it naturally from an inoculated patient have it as violently

as if they had been infected from a case of spontaneous disease;

it is to all intents and purposes the natural smallpox again in

them. Now, if it be considered that several hundred thousand

persons have been annually inoculated in these Kingdoms for the

last fifty years, it will be easy to calculate the immense

addition that must have been made in that period to the cases of

actual disease, and the increase of natural smallpox that may be

supposed to have arisen from this constant multiplication of the

sources and centres of infection.

Unless this culture and this traffic in smallpox throughout the

United Kingdom be realised, the potent cause of the immediate and

extravagant success of Vaccination will be left out of reckoning.

When we are harassed, anxious and impatient under some course of

conduct, our ears are open to any promise of relief; and it was

to a generation so afflicted and so receptive that Jenner in 1798

made his revelation of the virtue of cowpox. No more need, said

he, to inoculate with smallpox. Substitute cowpox; and whilst it

will protect as effectually, it will inflict no injury and diffuse

no infection. The revelation was received with acclamation, and

within eighteen months of its delivery (without due experience, and

without any warrant that could pass muster in the severe realm of

science) the leading physicians and surgeons of London subscribed

and published the following manifesto in the newspapers of 1800--

We, the undersigned physicians and surgeons, think it our duty to

declare our opinion, that those persons who have had the Cowpox

are perfectly secure from the infection of the Smallpox, provided

this infection has not been previously communicated.

I do not wish to anticipate the wondrous tale of Jenner--my

present purpose is to show how Inoculation was set aside; and it

suffices to state that cowpox rapidly made an end of inoculation

with smallpox. Indeed, I question whether a revolution in practice

was ever effected with similar facility. Within eight years of

the delivery of Jenner’s revelation, the writer in the _Edinburgh

Review_ of 1806, already cited, was able to testify--

The bitterest enemies of Vaccination will not deny, that

more than nine-tenths of the medical world are decidedly and

zealously in favour of it, and that all their demonstrations

of its dangers and terrors have been insufficient to convert a

single one of their brethren from so damnable and dangerous a

heresy. Testimonies, it may be said, should be weighed, and not

numbered; and in this respect the vaccinators, we are afraid,

will have a splendid and indisputable triumph. We give the

anti-vaccinists all the advantage in our power when we assign

to them a few members of the profession in London; for in the

country at large, we believe, they have not one respectable

practitioner on their side in five hundred. In this great city

and school of medicine [Edinburgh] we are assured, they are

without a single public adherent.

The resistance to Vaccination was almost entirely confined to

the resistance of inoculators, who were too deeply compromised

by their own disloyalty to Nature, to make effective resistance.

They were steadily borne down by the vaccinators, many of whom

had been energetic inoculators, and displayed the usual ardour of

apostates in condemning what they had formerly approved. Indeed,

when we consider how Inoculation was commended for its efficiency

and harmlessness by the same medical authorities who, within a year

or two after Jenner’s appearance, denounced the practice for its

difficulties and dangers, their tergiversation appears little short

of shameless. Dr. Lettsom had been an inoculator, yet on 2nd July,

1805, he felt warranted in writing--

What have not the abettors of Variolous Inoculation to answer

for? To shoot a dozen or two innocent people in the public

streets of London would not be half so injurious as allowing

the murderers to kill the rising generation, the future hope of

the State. Nothing can show the supineness and ignorance of the

Government more than legalising these Variolous Murders.

How far the conquest of the inoculators by the vaccinators had

advanced, appeared in a debate in the House of Commons in 1806,

when Wilberforce urged that Inoculation should be suppressed, or at

least that those who insisted on Inoculation should be compelled

to place their patients in quarantine. Mr. Windham admitted the

scandal of wretched and miserable subjects of Inoculation being

carried about in the streets, but he hesitated to recommend

coercive legislation until persuasion had been fully tried and

had failed. Dr. Matthews, M.P. for Hereford, took occasion at the

same time to run with the hounds. Inoculation, he said, was a

frequent cause of disfigurement and of death in its most awful

form; it was a magazine of the most dreadful evils; a magnifier of

mortality; and a means of introducing scrofula, a more dangerous

and pernicious disorder than smallpox itself--facts which it would

have been more creditable to have proclaimed when Inoculation was

in fashion. It is so easy to kick when a foe has fallen, and where

all are kicking. Human nature is never so despicable as when thus

engaged.

The question of restraining Inoculation came again before the House

of Commons in 1807, when the practice of inoculating out-patients

at the London dispensaries and hospitals was energetically

condemned. “I think that the legislature,” said Mr. Sturges Bourne,

“would be as much justified in taking a measure to prevent this

evil by restraint, as a man would be in snatching a fire-brand out

of the hands of a maniac just as he was going to set fire to a

city.”

No one was more eager to suppress Inoculation by force than Jenner

himself, and in July 1807, he sought an interview with the Premier

for the purpose. In a letter to Dr. Lettsom he thus describes his

mortification--

You will be sorry to hear the result of my interview with the

Minister, Mr. Perceval. I solicited this honour with the sole

view of inquiring whether it was the intention of Government

to give a check to the licentious manner in which Smallpox

Inoculation is at this time conducted in the metropolis. I

instanced the mortality it occasioned in language as forcible

as I could utter, and showed him clearly that it was the great

source from which the pest of smallpox was disseminated through

the country as well as through the town. But, alas! all I said

availed nothing, and the speckled monster is still to have the

liberty that the Smallpox Hospital, the delusions of Moseley, and

the caprices and prejudices of the misguided poor, can possibly

give him. I cannot express to you the chagrin and disappointment

I felt at this interview.

We are not accustomed to regard politicians of Perceval’s order as

favourable to liberty; and yet it is refreshing to remark in even

the Tories of the Georgian age a jealous regard for the personal

freedom of Englishmen, and a hearty contempt for the plausible

quacks who were always contriving to circumscribe it. Perceval was

not opposed to Vaccination, but he would not consent to give it an

illicit advantage over Inoculation. If it were the good thing it

was asserted to be, it might be left to prevail by reason of its

own quality.

Under medical and social pressure, the practice of Inoculation at

public institutions was gradually abandoned. On 5th May, 1808, the

inoculation of out-patients was discontinued at the London Smallpox

Hospital, but not until 20th of June, 1822, did the inoculation of

in-patients cease. In 1816 the Colleges of Surgeons of London and

Dublin pledged themselves against the practice. A formal attempt

at coercive legislation, often called for, was at last made by

the directors of the National Vaccine Establishment. They framed

and promoted a bill, which was introduced to the House of Lords

in 1813 by Lord Boringdon, but it was ignominiously withdrawn in

1814--a choice example of grand-motherly legislation. Among its

provisions was the enactment that whenever an inoculation took

place, the clergyman of the parish should receive notice, and that

red flags should be displayed from the house where the patient lay!

As Earl Stanhope observed, instead of being a measure of humanity,

it would, if passed into law, be one of the most troublesome,

inconvenient, and mischievous ever enacted.

In the discussion on this foolish project, Lord Eldon pointed out

that the common law was already sufficient to arrest the exposure

of sufferers from infectious disease; and acting on the hint the

Vaccine Establishment prosecuted a woman, 27th April, 1815, for

carrying her inoculated child covered with pustules through the

streets of her neighbourhood. Evidence was adduced that she had

thus infected eleven persons with smallpox of whom eight had died.

The Court of King’s Bench pronounced her conduct illegal and

criminal, but as it was the first prosecution for such an offence,

she was let off with a sentence of three months’ imprisonment.

A practice thus banned could not long survive in England, and

by and by a medical man who would consent to inoculate became

a rarity, or was accounted disreputable. Yet there remained

old-fashioned folk who would have nothing to do with cowpox,

and insisted on having genuine human pox for their children and

grandchildren. Hence Dr. Epps writing in 1831 had to say--

There is a class of medical practitioners who inoculate for the

smallpox. Society should utter its voice of moral indignation

against such individuals, who glory in anything by which they can

claim singularity, or by which they can increase their pecuniary

means. Let not society be deceived into any parley with such

practices upon the plea, that parents _will_ have their children

inoculated with the smallpox.[72]

Gradually the inoculating practitioner ceased, and the practice

remained in the hands of “ignorant and unqualified persons, old

women, and itinerant quacks;”[73] and then the end came. An Act of

Parliament was passed in 1840 wherein it was enacted that--

Any person who shall produce or attempt to produce in any person

by inoculation with variolous matter, or by wilful exposure to

variolous matter, or to any matter, article, or thing impregnated

with variolous matter, or wilfully by any other means whatsoever

produce the disease of smallpox in any person in England,

Wales, or Ireland, shall be liable to be proceeded against and

convicted summarily before any two or more justices of the peace

in petty sessions assembled, and for every such offence shall,

upon conviction, be imprisoned in the common gaol or house of

correction for any term not exceeding one month.

The Government did not at first intend to make the prohibition

absolute, but Mr. Wakley insisted that the time had arrived to

suppress the nuisance summarily, and that not a voice would be

raised in opposition. Nor was there any opposition. Mr. Goulburn

expressed some hesitation, but the House was practically unanimous.

Outside the House few regrets were expressed. Dr. George Gregory,

physician of the Smallpox Hospital at St. Pancras, was, however, a

man of philosophic turn, and he did not see the old idol cast down

unmoved.

On 23rd July, 1840 [he wrote], the practice of inoculation, the

introduction of which has conferred immortality on the name of

Lady Mary Wortley Montagu, which had been sanctioned by the

College of Physicians, which had saved the lives of many kings,

queens, and princes, and of thousands of their subjects, during

the greater part of the preceding century, was declared illegal

by the English Parliament, and all offenders were to be sent

to prison, with a good chance of the tread-mill. Such are the

reverses of fortune to which all sublunary things are doomed.[74]

Gregory was not blind to the extravagant claims made for

Vaccination, and evidently had a lurking conviction that all was

not gain in the substitution of the new practice for the old,

saying--

Had not the discovery of Jenner interfered to interrupt its

extension and improvement, Inoculation would have continued to

this day increasing yearly in popularity.[75]

Yet was not Inoculation abolished. Sometimes when we get the devil

out at the door, he presently re-enters by the window; and thus

while Parliament was making an end of Inoculation in one form, it

was reviving in another.

It is to be understood that Jenner’s cowpox, whatever it might

be, was an uncommon and erratic disease, and its discovery and

maintenance difficult. To provide a substitute, cows were from time

to time inoculated with smallpox, and the resulting virus was used

instead of the Jennerian specific. Lest one should be accused of

questionable witness, let us refer to Dr. Seaton’s _Handbook of

Vaccination_. There we read--

Mr. Ceely of Aylesbury in February, 1839, succeeded in inducing

vaccine vesicles on two sturks by inoculation with variolous

lymph, and in thus establishing lymph-stocks, which passed at

once into extensive use, so that, in a few months, more than 2000

children had been vaccinated from them. In December, 1840, Mr.

Badcock succeeded in variolating a cow at Brighton, and deriving

therefrom a stock of genuine vaccine lymph. In this manner he

has raised stocks of vaccine lymph for use on no fewer than

thirty-seven separate occasions. The lymph thus obtained by him

is now largely employed; it has been supplied to many hundreds

of practitioners, and very many thousands of children have

been vaccinated with it. Mr. Ceely’s experiments were repeated

in America in 1852 by Dr. Adams of Waltham, and Dr. Putnam of

Boston, who were able, it is said, to furnish the city and

neighbourhood of Boston with all the vaccine matter used there

since that period.

Again, Sir John Cordy Burrows, a surgeon, speaking as a magistrate,

at Brighton on 5th February, 1876, observed--

The public seem scarcely to understand what Vaccination means.

The vaccine lymph taken from a child is nothing more than what

has passed from a smallpox patient through a cow. In 1856-58 I

took an active part in inoculating seventeen cows with smallpox,

producing in three cases vaccine lymph, and from these the world

has been supplied.

Thus, as asserted, has Inoculation been revived, and Jenner’s

specific set aside. When Dimsdale had Russian nobles to operate

upon, he tried to mollify the smallpox by passing it through

healthy children. Cows have now taken the place of children, and

the virus in its passage from arm to arm may still further be

reduced in virulence, when it does not take up fresh malignities

such as syphilis; but it is inoculation with smallpox all the same.

FOOTNOTES:

[69] _Serious Reasons for Uniformly Objecting to the Practice of

Vaccination._ By John Birch. London, 1806.

[70] _Birmingham Medical Review_, January, 1874.

[71] The facts are set forth in _Vaccination Tracts_, No. 14, p.7.

[72] _Life of John Walker, M.D._ London, 1831, p. 326.

[73] Letter of Poor Law Commissioners, 20th August, 1840.

[74] _Lectures on Eruptive Fevers._ London, 1843, p. 39.

[75] _Ib._, p. 93.

CHAPTER X.

AS TO THE PREVALENCE OF SMALLPOX IN THE 18TH CENTURY.

The exact truth as to the prevalence of smallpox in the 18th

Century is not attainable; vital statistics were undeveloped; and

in the absence of precision the imaginative revel. M.D.’s and

M.P.’s shut their eyes, tilt their noses skyward, and prophesy

concerning the frightful ravages, and the salvation wrought by

the revered and immortal Jenner. Any extravagance, as to the

ravages, or as to the salvation, is accepted as laudable zeal for

humanity. “Decimation” is a favourite word in this connection

without any sense of its definite meaning. “What family before

1800 ever escaped decimation from smallpox?” asks Dr. Granville.

“Smallpox decimated the country in olden times,” says Dr. Chavasse;

“it ravaged like a plague, whilst Inoculation caused the disease

to spread like wild-fire;” adding as a sequence, “Vaccination is

an important cause of our increasing population.” In the same

temper, Lord Chief Justice Cockburn described an unvaccinated

infant as “a centre of contagion;” and as the folly of the great is

intensified in the little, Mr. Bompas, Q.C., informed the electors

of Marylebone, that “a person not vaccinated is like a flaming

fire-brand among the people.” Thus the infants of last century were

“centres of contagion;” the adults were “flaming fire-brands;”

whilst England was “decimated” with smallpox diffused like

wild-fire by inoculation. What a picture of 18th Century England

painted by Rant and illuminated by Delirium!

The tendency of excess on one side is to provoke to excess on

the other, but the extravagance of these popular fables ought to

put us in love with homely matter-of-fact--wherein indeed is the

true extreme of these frantic inventions. What was the extent of

smallpox in England last century is the question. With accuracy,

we do not know. The common estimates (when not evolved from inner

consciousness) are based on the London Bills of Mortality, and

when these Bills are scrutinised we find nothing to justify the

opinion that the community was harassed and devastated by smallpox

over other ailments. In the first place, we have to remark that

the exact population of the metropolis was unknown. Some say it

was 500,000 in 1701, and others 700,000. In 1751 it was generally

reckoned at 750,000, and in 1801 it was said to be 958,863. Then

we have to consider that the increase, whatever it might be, lay

only partially within the Bills of Mortality, for several rising

quarters were outside the boundaries, and there were extensive

exemptions within. Thus, so late as 1818, we find Dr. Burrows

writing--

The parishes of Marylebone, Pancras, Chelsea, Kensington, and

Paddington, now forming an integral part of the metropolis, and

containing a population of 160,000 are not within the Bills of

Mortality, and make no returns. Neither are there any returns

from St. Paul’s Cathedral, Westminster Abbey, the Temple Church,

the Rolls and Lincoln’s Inn Chapels, the Chapter House, the Tower

Church, and various other places of worship of the Established

Church. Besides, neither Dissenters, Papists or Jews who have

burying places of their own, are included in the Bills. Many of

the wealthier classes when they die are removed for interment

into the country; nor do they appear in the Bills.

With omissions so serious, the Bills are obviously worth little as

registers of the number of deaths in any year in London; and when

we inquire how far they may be trusted as indicating the relative

prevalence of certain forms of disease, we find them equally

questionable. Dr. Burrows thus describes the method by which the

causes of death were ascertained--

Diseases as specified in the Bills are a disgrace to the medical

science and civilisation in which as a nation we are acknowledged

pre-eminent; nor can any effective reform take place while the

sources of information are so ignorant and venal as at present.

The information as to the disease of which any person dies is

collected and verified in the following way.--The Churchwardens

of each parish within the Bills of Mortality appoint two old

women to the office of Searchers. These women as soon as they

hear the knell for the dead, repair to the sexton of the parish

to learn the residence of the deceased. They demand admittance

into the house to examine the body in order that they may see

that there is nothing suspicious about it, and _judge_ of what

disease the person died; and _they_ report to the parish clerk.

The regular charge for the performance of this office is 4d.

to each Searcher; but if an extra gratuity be tendered, they

seldom pass the threshold or hall of the house, and are content

with whatever account is given; or should they actually view the

corpse, it is easy to imagine what credit is due to the judgment

they pronounce.[76]

In presence of defects so grave as to the number of the dead, and

of diagnosis so grotesque as to the causes of death, it would

be unwise to argue with any confidence from the data of these

Bills; yet, such as they are, we have nothing else to appeal

to. The variations of mortality from year to year were of wide

irregularity; and whatever influence smallpox might have had, it

does not appear to have had much in magnifying the annual totals.

Let us take a dozen years when smallpox was heaviest from the last

seventy years of the century, and observe its relation to the

entire mortality, and to that from fevers--

Burials from From From

Year. all Diseases. Smallpox. Fevers.

1736 27,581 3014 3361

1740 30,811 2725 4003

1746 28,157 3236 4187

1749 25,516 2625 4458

1752 20,485 3538 2070

1757 21,313 3296 2564

1762 26,326 2743 3742

1763 26,143 3582 3414

1768 23,639 3028 3596

1772 26,053 3992 3207

1781 20,709 3500 2249

1796 19,288 3548 1547

------- ------ ------

296,021 38,827 38,398

Again, let us take twelve years when the death-rate from smallpox

was at its lowest. Here they are--

Burials from From From

Year. all Diseases. Smallpox. Fevers.

1745 21,296 1206 2690

1750 23,727 1229 4294

1751 21,028 998 3219

1753 19,276 774 2292

1773 21,656 1039 3608

1780 20,517 871 2316

1782 17,918 636 2552

1786 20,454 1210 2981

1788 19,697 1101 2769

1795 21,179 1040 1947

1797 17,014 522 1526

1799 18,134 1111 1784

------- ------ ------

241,896 11,737 31,978

We thus see that in twelve years when the death-rate from smallpox

was highest, as many died of fevers as of smallpox; and in twelve

years when the death-rate from smallpox was lowest, there died

thrice as many of fevers as of smallpox. Again, we have to remark,

that, on an average of all the years, smallpox was accountable

for something less than a tenth of the total mortality. Also we

have to note, that the mortality from smallpox was in great part

infant mortality, and that there is reason to believe measles was

extensively confounded with smallpox. The infant mortality was

prodigious. Rarely a year passed in which a fourth of the deaths

was not set down to Convulsions--that is, to babes killed by

improper feeding. In 1772 (the worst smallpox year of the century

when 3,992 died) there were, 6,605 ascribed to Convulsions, the

total mortality being 26,053.

Now I have no wish to minimise the London smallpox of last century,

nor even to set 1797, when 522 died, against 1796, when 3548 died.

I yield to none in detestation of smallpox as a preventible and

therefore disgraceful affliction. Let so much pass for granted;

but do not let us in any access of sanitary fury lose alike eyes

and reason and rave like maniacs. If smallpox was bad, fevers were

worse, and as both had a common origin, why should we make a wanton

and unscientific distinction between them?

That smallpox should have been constantly present in London

throughout last century was in nowise surprising. The citizens

lived in a manner to invite and maintain fevers. I shall refer to

their food and drink presently, and would now call attention to

the fact that they were a stay-at-home generation almost beyond

present-day belief. Cowper did not violate credibility when he

sang--

John Gilpin’s spouse said to her dear,

“Though wedded we have been

These twice ten tedious years, yet we

No holiday have seen.”

They had no ready means of locomotion, and indeed did not think

of fresh air and exercise. An apprentice or maid from the country

entered London and was immured as in a prison. We know how the

lower orders in our own time huddle together like pigs, unless so

far as restrained by lodging-house law, but middle-class Londoners

a century ago utilised their apartments, with more decency perhaps,

but with equal ignorance of the virtue of oxygen. The Londoners

were a densely compacted community, and at night the streets and

lanes of the city were almost as thickly tenanted as a man-of-war,

but without benefit of sea-air. A Quaker told me that he served

his apprenticeship to a grocer in Cheapside between 1786 and 1793,

that the shop was opened at seven in the morning and closed at

ten at night, that he slept under the counter, that his ablutions

were limited to his countenance, and that he never went out except

to meeting on First Days; adding, that he had no sense of being

hardly dealt with; it was the custom of the time, and he was as

his fellows. Memoirs of the 18th century prove that he spoke the

simple truth. Bishop Wilson of Calcutta records that he served in

the house of a silk merchant in Milk Street from 1792 to 1797,

that he was occupied from six or seven in the morning till eight

at night; that there was supper at 8.30, followed by prayers, and

that all went to bed at ten. An apprentice in the same house said

that he never put on his hat for weeks together, and that more

than three years elapsed before his first holiday was granted.

William Cobbett in 1783 got into a lawyer’s office in Gray’s Inn

where, he relates, “I worked like a galley slave from five in

the morning till eight or nine at night, and sometimes all night

long. I never quitted this gloomy recess except on Sundays when

I usually took a walk to St. James’s Park.” Such instances might

be multiplied to any extent; and in short it comes to this, that

the Londoners of last century lived from year to year _in_ their

houses, and had no outdoor exercise. If they were careless about

air, they were equally careless about light, and, but for the cost

of candles, might have disregarded it altogether. Water was chiefly

brought from wells or conduits, and was used sparingly; and it is

needless to add, there were no water-closets. Even in well-ordered

households, stenches were dreadful; and where there were slatterns,

the condition of affairs may be faintly imagined. Horrible

cesspools lay behind or beneath most of the houses, evolving

pestiferous effluvia. Out of doors, the streets were scarcely less

noisome. Rain was the chief scavenger. Swift, in his description

of a City Shower, sets before us as graphically as Hogarth, the

offices of the rain--

Now in contiguous drops the flood comes down

Threatening with deluge this devoted town....

Now from all parts the swelling kennels flow,

And bear their trophies with them as they go:

Filths of all hues and odours seem to tell

What street they sailed from by their sight and smell.

They, as each torrent drives with rapid force,

From Smithfield or St. ’Pulchre’s shape their course,

And in huge confluence joined at Snowhill ridge,

Fall from the conduit prone to Holborn Bridge.

Sweepings from butchers’ stalls, dung, guts, and blood,

Drowned puppies, stinking sprats, all drenched in mud,

Dead cats, and turnip-tops, come tumbling down the flood.

Nor in estimating the sanitary condition of 18th Century London

is the influence of the dead on the living to be forgotten. The

twenty thousand who died annually remained to poison the survivors.

The city grave-yards were places of decomposition rather than of

interment, and an odour of corpses pervaded many neighbourhoods.

Mr. Samuel Gale wrote in 1736--

In the church-yard of St. Paul, Covent Garden, the burials are

so frequent that the place is not capacious enough to contain

decently the crowds of dead, some of whom are not laid above a

foot under the loose earth. The cemetery is surrounded every

way with close buildings; and an acquaintance of mine, whose

apartments look into the churchyard, hath averred to me that

the family have often rose in the night-time and been forced to

burn frankincense and other perfumes to dissipate and break the

contagious vapour. This is an instance of the danger of infection

proceeding from the corrupt effluvia of dead bodies.[77]

Church-goers were subjected to cadaverous influences from the dead

in the yard without and from the dead in the vaults below; and

pious thoughts acquired an indescribable savour of the sepulchre.

Many illnesses originated in church; and families who led

wholesome lives at home were brought into deadly peril when they

turned out on Sundays to public worship.

It is necessary to enter into these details if we would know what

manner of people the Londoners were who suffered from smallpox,

and what sort of place London was wherein they suffered. Londoners

have been taken for the standard of 18th century smallpox, in

forgetfulness of the fact that there did not then exist in England

a town of a hundred thousand inhabitants--perhaps only two or three

of fifty thousand; whilst the rural population bore a far larger

proportion to the urban than is the case at this day. In so far

as the sanitary conditions of Bristol, Norwich, or York resembled

those of London, the analogy between them held good; but to convert

the London rate of smallpox into the common rate of England, of

Europe, and of the world, and to use the appalling result as a

whip of terror wherewith to enforce universal inoculation, and

afterwards vaccination, was sheer absurdity, if not something worse.

Whilst smallpox was always present in London, its appearance in the

country was irregular and usually epidemic. The Bills of Mortality

of towns as large as Northampton were sometimes clear of smallpox

for years. Sir Gilbert Blane, in his advocacy of Vaccination

_versus_ Inoculation, said, that previous to the practice of

inoculation there were many parts of the country where smallpox was

unknown for periods of twenty, thirty, and even forty years. Mr.

Connah, a surgeon of Seaford, Sussex, with a population of 700,

informed Dr. Haygarth in 1782, that one person had died of smallpox

in Seaford about eleven years before, and he could not ascertain

that any other death from the disease had occurred subsequently;

and that there was reason to believe that a like immunity prevailed

throughout the smaller towns and villages of the southern counties.

Wherever we inquire, we are driven to the conclusion that the

prevalence and fatality of smallpox in the 18th century were

grossly exaggerated by quacks and panicmongers. Nor should we

forget in this connection how Professor Waterhouse, of Boston, an

ardent inoculator, had to write in 1787--

I do not believe there is at present a single person infected by

smallpox in all the four New England Governments; that is, not

one in a million of people.

What we have to say of London smallpox during last century is,

that prevalent as it was, our wonder is that it was not more

prevalent; that the disease was bred in the circumstances and

habits of the citizens; and that if it were possible to reproduce

the same conditions, we should reproduce the same smallpox. On the

contrary, say our valiant vaccinators, the same conditions might be

reproduced, but if the citizens were universally and efficiently

vaccinated and re-vaccinated, there would be no smallpox. Thus

we are taught that people may eat and drink as they like, live

in darkness, neglect personal cleanliness, take little exercise,

breathe air polluted by respiration, filth, and putrefaction, and

that whatever disease overtakes them, they will be proof against

smallpox. The promise is deceptive, but it was the promise of

the inoculator, and it is the promise of the vaccinator; and Dr.

Drysdale, describes the practice which warrants the promise as “the

greatest triumph of hygienic science--I repeat, by far the greatest

triumph of positive hygienic science ever made.”[78]

Some share in the fatality of 18th century smallpox must be charged

to the treatment of the disease. What was described as the cool

regimen was no secret, yet its practice appears to have been

limited to few; whilst with the multitude, patients were confined

to close and heated rooms, under heavy bed-clothes, plied with hot

drinks, cordials, and alcohol, and kept in foul linen until killed

or cured. Frequently, when symptoms of smallpox appeared, bleeding,

blistering, and purging were energetically resorted to. If a family

of children were affected, they were commonly stowed away in one

bed, and their skins would stick together with pus and sweat. It

was much the same in hospitals and workhouses. “I have seen above

forty children,” says Dr. Buchan, “cooped up in one apartment, all

the while they had this disease, without any of them being admitted

to breathe the fresh air.” The same course was pursued with other

fevers, and the effluvia of the sick-room was overpowering. Take

this instance from Jenner’s own household. His nephew, Henry, and

a maid-servant, were seized with typhus, and Jenner wrote--

The stench from the poor girl is so great as to fill the house

with putrid vapour; and I shall remove Henry this morning, by

means of a sedan chair, to an adjacent cottage.[79]

Indeed, the cleanliness and ventilation we consider so salutary

were sedulously avoided. Cold air was accounted specially

pernicious, and occasionally when the poor, afflicted with

smallpox, were exposed to the weather, astonishment was expressed

that recovery instead of death was the issue. It is related in

Hutchins’s _History of Dorset_ that Blandford was burnt down in

1731, and several patients in smallpox were laid under the arches

of the bridge as a place of refuge, and, to the general surprise,

all got well, although many had died in their beds before the fire.

John Birch a London surgeon of high repute, writing in 1814, sums

up the case for us on this head in saying--

I consider the natural smallpox a mild disease, and only rendered

malignant by mistakes in nursing, in diet, and in medicine, and

by want of cleanliness, which last is the fomes of hospital

fevers, and all camp and contagious disorders.

It would hardly be too bold to say, that the fatal treatment of

this disease, for two centuries, by warming the chamber, and by

stimulating and heating cordials, was the cause of two-thirds of

the mortality which ensued.[80]

We now come to an interesting question. If the reader refers to

the list of twelve years of greatest smallpox, and to the list of

twelve years of least smallpox in London, it will be observed that

the years of least smallpox predominate in the last quarter of

the century, and this in spite of the diffusion of the disease by

Inoculation. The inoculators when charged with increasing smallpox

appealed to the London Bills of Mortality. “Let us,” they said,

“take the last ninety years of the century, and we shall find that

there died in London of smallpox in the thirty years--

From 1711 to 1740 inclusive 65,383

1741 to 1770 ” 63,308

1771 to 1800 ” 57,268

Here we see, that the number of deaths was greater in the first

thirty years by 2075 than in the second thirty years during which

Inoculation had acquired some stability, and greater by 8115

than in the last thirty years, during which Inoculation was the

established practice of most prudent families.[81] We are therefore

unjustly accused. These figures leave no doubt that smallpox is

decreasing, and we claim that the decrease is due to our practice.”

The decrease was certain, but I cannot allow that it was due to

Inoculation; on the contrary I assume that the decrease would have

been greater but for the culture of the disease by the inoculators.

The fact is extremely distressing to the more rabid vaccinators,

and Dr. Corfield tries to curse it out of existence as “the falsest

of falsehoods;” but there it abides. It is hard for those who

represent Jenner as the saviour of mankind from smallpox to have it

shown that Londoners, at least, were in process of salvation before

his intervention; but facts, alas! are cruelly unkind to theorists,

sentimentalists, and quacks of all sorts. In the words of Dr. Farr--

Smallpox attained its maximum mortality after Inoculation was

introduced. The annual deaths from smallpox from 1760 to 1779

were on an average 2323. In the next twenty years, 1780 to 1799

they declined to 1740. The disease, therefore, began to grow

less fatal before Vaccination was discovered; indicating,

together with the diminution of fevers, the general improvement

of health then taking place.[82]

The decrease of smallpox towards the close of the century, says Dr.

Farr, was due to “the general improvement of health then taking

place;” but to what was that improvement due? No marked improvement

had been effected in the sanitary arrangements of London--why then

this change for the better? My answer is, that a great alteration

was in progress in the popular diet.

Dr. George Cheyne, in his famous _Essay of Health and Long Life_,

published in 1724, says--

There is no chronical distemper whatsoever more universal, more

obstinate, and more fatal in Britain, than the Scurvy taken in

its general extent.

And more than fifty years afterwards, in 1783, we have Dr. Buchan

bearing similar testimony--

The disease most common to this country is the Scurvy. One finds

a dash of it in almost every family, and in some the taint is

very deep.

It is scarcely necessary to cite authority for what was so

generally known and confessed; but in this question of smallpox and

its prevention we have to deal with many who appear to be destitute

of any historic sense; who argue as if what Englishmen are to-day,

they always were; and who contend that as there was more smallpox

in London before Jenner than since Jenner, therefore Jenner must be

the cause of the diminution. It is necessary to condescend to such

feeble folk.

The cause of the general scorbutic habit of the people was widely

recognised by medical men, and Buchan merely repeated their common

opinion in saying--

A disease so general must have a general cause, and there is none

so obvious as the great quantity of animal food devoured by the

natives of this island. As a proof that Scurvy arises from this

cause, we are in possession of no remedy for that disease equal

to the free use of vegetables.[83]

Cheyne said much the same at the earlier date. He complained that

the upper classes gorged themselves with animal food, and slaked

their thirst with wine, “which is now [1724] become common as

water, and the better sort scarce ever dilute their food with any

other liquor.” Beer had the place of wine among the middle and

lower orders. In the words of Buchan--

The English labourer lives chiefly on bread, which being

accompanied with other dry, and often salt food, fires his blood

and excites an unquenchable thirst, so that his perpetual cry is

for drink.

He adds--

If men will live on dry bread, poor cheese, salt butter, broiled

bacon, and such like parching food, they _will_ find their way

to the alehouse--the bane of the lower orders, and the source of

half the beggary in the nation.

Were we to say that the diet of the English for the greater part

of last century consisted of Bread, Beef, and Beer, we should

not go far wrong. The London bread was then, as now, poor stuff;

“spoiled,” says Buchan, “to please the eye, artificially whitened,

yet what most prefer, and the poorer sort will eat no other.”

Whenever it could be obtained, beer was the beverage that went

with bread, and was drank by young and old. Salt beef and mutton,

bacon, salt fish, and butchers’ offal completed the dietary of the

multitude. The feeding of the poor in hard seasons exercised the

beneficent severely, for the baker’s bill often went far to exhaust

the working-man’s earnings.

It was easy to recommend the rich to get rid of their scurvy by

a resort to vegetable food, but to the poor with their obstinate

prejudices, shiftlessness, and ignorance, such a recommendation was

a sort of mockery. Deliverance, however, came in a form recommended

by pleasantness and economy, namely, in the potato. It is true

the tuber had been known long before, but not as an article of

free and ordinary consumption. Toward the middle of the century

it was discovered that potatoes could be grown cheaply in large

quantities, and supply and demand developed together. Women and

children especially rejoiced in the new food, whilst the benevolent

exulted in the liberal accession to the poor man’s fare. It became

a point of duty with Lord and Lady Bountiful to recommend the

culture and consumption of potatoes everywhere; and to see how far

the substitution of potatoes for bread had extended early in the

nineteenth century, we need only refer to the pages of Cobbett,

who denounced the change with unwearied virulence as a degradation

of humanity. Certainly potatoes are inferior to bread in nutritive

value, but in food we have to look for more than mere nutriment;

and the general use of the potato went far to purify and ameliorate

the blood of the English people.

The appearance of the potato as a cheap constituent of common

fare, was an argument wherewith Jenner endeavoured to allay

apprehensions, that, having stopped smallpox, there would soon

be more mouths than food to fill them. To Dunning he wrote, 10th

February, 1805--

I have often urged the following argument when too numerous a

population has been thrown in my teeth, as one of the ill effects

likely to attend vaccination. Who would have thought a century

ago, that providence had in store for us that nutritious and

excellent vegetable, the potato--that ready made loaf, as it

were, which is prepared in higher perfection in the garden of the

cottager than in the highly manured soil of the man of opulence.

And again to Worthington, 25th April, 1810--

What a gift from Heaven was this extraordinary vegetable--a ready

made loaf; reserved, too, till the hour when population, in these

realms at least, began first to increase; and then coming we

scarcely know how. Away with Malthus and his dreary speculations!

The skies are filled with benevolence, and let population

increase how it may, let us not distrust and suppose that men

will ever pick the bones of each other.[84]

Nor was the change in the people’s diet limited to the introduction

of the potato; with it came tea. Of course we know that tea was

drank in England long ere George III. was King, but it was in his

days that tea came into popular use. Here again we may refer to

Buchan, who was strongly opposed to the innovation. He wrote--

It is said the inhabitants of Great Britain consume more tea

than all the other nations of Europe together. The higher ranks

use tea as a luxury, while the lower orders make a diet of it.

The lowest woman in England must have her tea, and the children

generally share it with her. The mischiefs occasioned by tea

arise chiefly from its being substituted for solid food, and had

I time to spare, I think it could not be better employed than

in writing against the destructive drug. Its use will induce a

total change in the constitutions of the people of this country.

Indeed, it has gone a great way towards effecting that evil

already.

What Buchan had not time to do, Cobbett subsequently did, and

some of his most racy patches of vituperation were applied to tea

and tea-drinkers. In Bacon, Bread and Beer, according to Cobbett,

consisted the strength of the English working-man, whilst tea and

potatoes he held in abomination.

To this partial substitution of potatoes and tea for salted animal

food and malt liquor, we may justly attribute the reduction of

the scorbutic habit of the people, and that improvement of health

which were coincident with the close of last century and were

continued into the present. What every student of vital statistics

has to remember is, that conditions have to be identical to yield

identical results. The lives of the majority of the English people

last century, and notably so in London, were hard and sordid to

a degree which in these times is difficult to realise. Their

sanitary conditions have been indicated, and I would now enforce

the observation, that they were ill fed and insufficiently fed;

consequently their diseases were malignant, and smallpox not

unfrequently scarred deeply its scorbutic victims. Wherefore to

run a parallel between the Londoners of the 18th century and the

English of the 19th in the matter of smallpox, and to ascribe

any difference between them to Jenner’s specific, is to display

ignorance that is inexcusable, or craft unscrupulous.

FOOTNOTES:

[76] “On the Uses and Defects of Parish Registers.” By G.M.

Burrows, M.D. In _London Medical Repository_, No. 58, October 1818.

[77] Nichols’s _Illustrations of Literary History_, vol. iv. p. 499.

[78] _The Times_, 23rd Oct. and 4th Dec., 1879.

[79] Baron’s _Life of Jenner_, vol. i. p. 107.

[80] _An Appeal to the Public on Vaccination._ By John Birch.

[81] Dr. Adams in _Medical Journal_, 1810, p. 31. Dr. Gregory in

his treatise on _Eruptive Fevers_, 1843, cites and endorses this

argument.

[82] Article, “Vital Statistics: Epidemics,” in M‘Culloch’s

_Statistical Account of the British Empire_.

[83] _Domestic Medicine._ Chap. lvi. Concerning the Diet of the

Common People.

[84] Baron’s _Life of Jenner_, vol. ii. pp. 348 and 410.

PART II.--VACCINATION.

CHAPTER I.

JENNER’S EARLIER YEARS.

The competent biographer, it is said, must be an admirer of his

subject, for only so far as he sympathises can he understand.

_Tout comprendre c’est tout pardonner._ But I neither propose to

write a Life of Jenner, nor do I believe it essential to insight

to sympathise where compelled to reprobate. In Jenner’s case

we have to deal with an accident rather than with a vigorous

personification of evil. It was his fate to have a happy (or

unhappy) thought, adapted to the humour and practice of his

time, which was immediately caught up and carried to world-wide

issues. In himself, he was as ordinary a character as was ever

thrust into greatness. For the mischief of his thought, some of

his contemporaries were as responsible as himself--some, indeed,

more blameworthy. With Bishop Butler I may ask, “Why may not

whole communities be seized with fits of insanity, as well as

individuals?” and with him aver, “Nothing else can account for a

great part of what we read in history.” The common mind passes at

times into unwholesome conditions, wherein the words of Paul are

exemplified, “For this cause shall God send them a strong delusion,

that they should believe a lie.”

Edward Jenner, the son of a clergyman, was born at Berkeley,

Gloucestershire, on 17th May, 1749. After the usual education of

a youth of his class, he was apprenticed to Mr. Ludlow, surgeon

and apothecary, of Sodbury, near Bristol; and on the completion

of his time (1770) was sent to London, where he resided for two

years with Dr. John Hunter, who increased his means for scientific

inquiry by the reception of pupils, caring much more for his

menagerie at Brompton than for patients, and utilising his pupils

as assistants in his researches. Captain Cook returned from his

first voyage of discovery in 1771, and his collection of specimens

of natural history was assigned to Hunter for arrangement, who set

Jenner to work upon them; and, it is said, he did his duty so well

that he was offered the appointment of naturalist in Cook’s next

expedition. Jenner was, however, eager to commence business as

country surgeon, and in 1772, at the age of 23, he returned to his

native vale, legally qualified by his experience at Sodbury, and

his two years with Hunter, to practise at discretion on the good

folk of Berkeley.

It may be said that Jenner’s was a poor sort of training for

a medical man, but it is to be questioned if he lost much by

his ignorance; for a century ago medical knowledge was largely

absurdity, and practice mischief; and he did best who stood most

frequently helpless in the presence of Nature. Sir Benjamin Brodie

relates how he served when a young man with a general practitioner

near Leicester Square--

His treatment of disease seemed to be very simple. He had in his

shop five large bottles, which were labelled _Mistura Salina_,

_Mistura Cathartica_, _Mistura Astringens_, _Mistura Cinchonæ_,

and another, of which I forget the name, but it was some kind of

white emulsion for coughs; and it seemed to me that out of these

five bottles he prescribed for two-thirds of his patients. I do

not, however, set this down to his discredit; for I have observed

that while young members of the medical profession generally deal

in a great variety of remedies, they commonly discard the greater

number of them as they grow older, until at last their treatment

of diseases becomes almost as simple as that of my Æsculapius of

Little Newport Street.[85]

Hunter’s name is often used as a sort of consecration of Jenner,

but for no obvious reason. Hunter confirmed, if he did not beget

in Jenner a strong liking for natural history; and when Jenner was

settled in the country, he often availed himself of his services

as observer and collector, writing to him for information about

the habits of the cuckoo, the breeding of toads and frogs, and the

sexes of eels; for cuckoos’ stomachs, crows and magpies’ nests, for

bats, hedgehogs, blackbirds, lizards, hares, and fossils; for a

cock salmon, for salmon spawn and fry, for a large porpoise, “for

love or money;” for the arm of a certain patient when he dies;

suggesting horrible experiments on hedgehogs, bats, and dogs, and

describing one of special atrocity upon an ass. The most serious

proposition in their correspondence was that Jenner should come to

London as a teacher of natural history, but Hunter threw out the

suggestion with hesitation, the qualification for the appointment

being 1000 guineas down. Jenner had improved, or supposed he had

improved, the preparation of tartar emetic, and Hunter wrote--

DEAR JENNER,--I am puffing off your tartar as the tartar of all

tartars, and have given it to several physicians to make a trial

of, but as yet have had no account of their success. Had you

not better let a bookseller have it to sell, as Glass of Oxford

did his magnesia? Let it be called Jenner’s Tartar Emetic, or

anybody’s else you please.

Hunter died in 1793, and there is no evidence that Jenner submitted

to his judgment the question of Vaccination, if even we allow that

prior to that date the project had occurred to Jenner himself.

It is certain that he mentioned to Hunter that country folk

believed that to catch cowpox was to be secure from smallpox, and

that Hunter repeated the fact in his conversation and lectures;

but there is no reference to the matter in Hunter’s writing and

correspondence.

It is the habit of Jenner’s admirers to represent him as a patient

investigator to whom a great thought dawned in boyhood, which was

brought forth in the maturity of life. In conformity with this

legend, it is related that when an apprentice at Sodbury, a young

woman came to his master’s surgery, and smallpox being mentioned,

she said, “I cannot take that disease, for I have had cowpox;” and

her observation was pondered in his heart; whereon Dr. Baron, his

biographer, ecstatically launches forth--

Newton had unfolded his doctrine of light and colours before he

was twenty: Bacon wrote his _Temporis Partus Maximus_ before he

attained that age: Montesquieu had sketched his _Spirit of Laws_

at an equally early period of life: and Jenner, when he was still

younger, contemplated the possibility of removing from among the

list of human diseases one of the most mortal that ever scourged

our race. The hope of doing this great good never deserted him,

though he met with many discouragements; his notions having been

treated with scorn and ridicule by some, and with indifference by

almost all.

Against such a paragraph we may write, Sheer romance! Jenner was by

no means reticent, and that the prevention of smallpox was for any

length of time the burden of his soul, nowhere appears. The romance

came into being after date in order to make much of little, and to

justify payment in cash and reputation. For, taking Vaccination

at the utmost, it was a slight advance upon existent knowledge

and practice. In the first place, it was a notorious belief in

many dairy districts, that to contract cowpox was equivalent to

smallpox in averting a subsequent attack of smallpox. In the

second place, inoculation with smallpox was the custom of the

time; and if infection with cowpox prevented smallpox, why should

not inoculation with cowpox do so as effectually as inoculation

with smallpox? The intelligence requisite to reach a conclusion so

obvious was not great, and therefore it was no cause for surprise

that when Jenner’s claim as originator of Vaccination was brought

forward, his priority should be disputed from several quarters; as

by Benjamin Jesty of Yetminster, who inoculated his wife and sons

with cowpox in 1774; by Nash of Shaftesbury; Mrs. Rendall, and

others. Jenner was not insensible to the force of these claims, but

evaded them under the plea that there was cowpox _and_ cowpox, and

that he had discovered and defined the right sort.

In parts of Holstein, too, cowpox was regarded as good against

smallpox, and on more than one occasion was deliberately

employed for the purpose. Plett, a village schoolmaster, near

Kiel, inoculated three children with the disease in 1791, who

were afterwards credited with resisting variolous infection in

consequence of their vaccination.[86]

How thoroughly the asserted prophylaxy of cowpox was known, Jenner

himself was accustomed to bear witness. He was a member of two

clubs, the Medico-Convivial which met at Rodborough, and the

Convivio-Medical which met at Alveston; and he used to bring cowpox

so persistently under discussion, that, he said, he was threatened

with expulsion if he did not desist. “We know,” said the jovial

doctors, “that an attack of cowpox is reputed to prevent smallpox,

but we know that it does not, and that should end the matter.”[87]

In pursuance of the tactics that would represent Vaccination as

the outcome of the labour of many years, we have the following

extraordinary narrative from Baron, Jenner’s biographer--

It was not till 1780 that Jenner was enabled, after much study

and inquiry, to unravel many of the perplexing obscurities and

contradictions with which the question of cowpox was enveloped,

and which had impressed those who knew the traditions of the

country with the opinion that it defied all accurate and

satisfactory elucidation. In the month of May of the year just

mentioned, 1780, he first disclosed his hopes and his fears,

respecting the great object of his pursuit, to his friend Edward

Gardner. By this time _Jenner’s mind had caught a glimpse of

the reputation which awaited him_, but it was still clouded by

doubts and difficulties. He then seemed to feel that it might, in

God’s good providence, _be his lot to stand between the living

and the dead, and that through him a plague might be stayed_. On

the other side, the dread of disappointment, and the probability

of failing to accomplish his purpose, restrained that eagerness

which otherwise would have prompted him prematurely to publish

the result of his inquiries, and thereby, probably, by conveying

insufficient knowledge, blight forever his favourite hope.[88]

Many are the marvellous relations in ancient and modern history,

but in the records of the supernatural it is questionable if there

be anything to match the preceding. Painters depict the runaway

apprentice listening on Highgate Hill to the bells as they pealed,

“Turn again Whittington, twice Lord Mayor of London,” but they

might find a finer subject in the young Gloucestershire surgeon,

aged 31, habited “in blue coat and yellow buttons, buckskins, well

polished jockey boots with handsome silver spurs, a smart whip with

silver handle, and hair done up in a club under a broad-brimmed

hat,”[89] with eye fixed in vision, contemplating his glorious

destiny, through clouds of doubt and difficulty, full twenty years

ahead; standing like another Aaron, censer in hand, between the

living and the dead until the plague was stayed! Verily, if we do

not see miracles, it is because we do not choose to look for them.

The chapter of the wonderful is not exhausted; yet greater things

remain. Says Baron, and recollect the year was 1780 and Jenner aged

31--

Jenner was riding with Gardner, on the road between Gloucester

and Bristol, near Newport, when the conversation passed of which

I have made mention. He went over the natural history of cowpox;

stated his opinion as to the origin of this affection from the

heel of the horse; specified the different sorts of disease which

attacked the milkers when they handled infected cows; dwelt upon

the variety which afforded protection against smallpox; and with

deep and anxious emotion mentioned his hope of being able to

propagate that variety from one human being to another, till he

had disseminated the practice all over the globe, to the total

extinction of smallpox--

Which is to say, that in 1780, Jenner, aged 31, had arrived at the

conclusion which he offered to the world in 1798 at the mature

age of 49; and in the meanwhile allowed mankind to perish from

smallpox, he having their salvation in his hands!

The miraculous conversation, says Baron, was concluded by Jenner in

words to the following effect--

Gardner, I have entrusted a most important matter to you, which

I firmly believe will prove of essential benefit to the human

race. I know you, and should not wish what I have stated to be

brought into conversation; for should anything untoward turn up

in my experiments I should be made, particularly by my medical

brethren, the subject of ridicule--for I am the mark they all

shoot at.[90]

Gardner, Jenner’s friend, who played the part of _alter ego_ in

the asseveration of an early date for Vaccination, was a dealer

in wines and spirits. Charity believeth all things, but even

charity would exhibit a sceptical countenance when what it is

a man’s interest to prove and have placed to his credit, is in

itself improbable; which, if true, might be proved by documents

and witnesses; but which is merely supported by his own word

and that of a friend. Let me repeat, there was never a vestige

of evidence adduced for the revelations of 1780 beyond the bare

assertions of Jenner and Gardner; and further, that they are

radically at variance with the tenor and dates of Jenner’s first

publication--_The Inquiry_ of 1798.

The next date to which we come is 1787, in which year Jenner is

represented as having taken his nephew, George, into a stable to

look at a horse with diseased heels--

“There,” said he, pointing to the horse’s heels, “is the source of

smallpox. I have much to say on that subject, which I hope in due

time to give to the world.”[91]

Baron gives no authority for this anecdote. It is probably

ante-dated six or seven years.

In 1788 Jenner married Catherine Kingscote. In his domestic

relations, he was devotedly affectionate, even uxorious; ready to

defer any duty and to surrender any advantage to the pleasures of

home.

As the phrase ran, Jenner was a good hand at a “copy of verses,”

and one of these, “Signs of Rain,” commencing--

The hollow winds begin to blow,

The clouds look black, the glass is low--

has a place in nearly all poetical collections.

In 1792 Jenner applied to the University of St. Andrews for the

degree of Doctor of Physic. It cost £15, and nothing more.

Hunter used to say to speculative pupils, “Don’t _think_, but

_try_; be patient, be accurate;” and Jenner, in relation to cowpox,

required the advice; for, by his own account, he was content to

_think_ of cowpox for at least a quarter of a century, whilst he

knew by intuition its true origin, its magical efficacy, and future

triumph without any _trial_. His first experiment was made in

November, 1789, upon his son Edward, his first-born, an infant of

eighteen months.

“He was inoculated with cowpox?”

O, no!

“Then with grease from a horse’s heel?”

Not at all!

“With what then?”

Why, with swinepox; and it answered!

The child sickened on the eighth day; a few pustules appeared; they

were late and slow in their progress, and small, but they proved

sufficient. The poor child was then put through what was styled the

Variolous Test: not once or twice, but five or six times at various

intervals, he was inoculated with smallpox without other obvious

effect than local inflammation and erysipelas. Nothing ever claimed

for cowpox turned out more satisfactorily than this experiment with

swinepox--supposing we trust Jenner.

Arguing from the records (and we have nothing else to argue from)

it was not until about 1795 that Jenner turned his attention with

serious purpose to cowpox. This Baron allows, saying--

Many years elapsed before Jenner had an opportunity of completing

his projected experiments in Vaccination, and he encountered

numerous difficulties in carrying on the preliminary part of his

inquiry.[92]

But Baron fails to specify what were the projected experiments, or

the difficulties which hindered their performance. It is a common

nuisance in “sympathetic” biographies to have unlimited drafts made

upon one’s credulity. The evidence of example would go to prove

that Jenner placed his trust in swinepox rather than cowpox, at

least as late as 1789.

In April, 1795, a general inoculation took place at Berkeley on

Dimsdale’s plan; that is to say, all in the district who had not

had smallpox were inoculated with the disease, so that they might

sicken together and do no mischief. Among the Berkeleyans was one

Joseph Merret, who, 1770, had attended horses with greasy heels

and at the same time milked cows, and from the cows had contracted

cowpox. Jenner inoculated him repeatedly with smallpox on this

occasion, but with no effect; whence he concluded that the attack

of cowpox in 1770 had maintained Merret secure from smallpox for

five-and-twenty years.[93]

Jenner’s aim was now directed to demonstrate that the common faith

in cowpox as a defence against smallpox was well-founded; and to do

so it was necessary to clear away two objections--

FIRST, That some who had caught cowpox had subsequently suffered

smallpox.

To which he answered--

Various eruptions occur on the teats of cows, which are confounded

with cowpox, and infect the milkers; and these, I admit, do not

protect from smallpox.

In a letter to Edward Gardner in 1798 he remarked--

The _true_ has many imitations by the _false_ on the cow’s udder

and nipples; and all is called _cowpox_ whether on the cow or

communicated to the human.[94]

SECOND, That some who had contracted true cowpox had nevertheless

fallen victims to smallpox.

To which he answered--

Admitted: but then the milker had not received infection from the

cow at the proper time, but at a stage of the eruption too early or

too late.

If the reader will set these points clearly before him, he will

have the measure of Jenner’s claim. It was a claim to define the

truth there was in a popular belief--not to make an independent

discovery.

Jenner at this juncture had staked his hope on the identification

of horsegrease with cowpox. Yet even in this identification he does

not seem to have been original.

It was a persuasion among the farmers that pox on the cows

was derived from grease on the horse; and that infection with

horsegrease was just as good against smallpox as infection with its

derivative cowpox. The fact, however, of this derivation of cowpox

from horsegrease was contested, but Jenner was positive. Writing in

1794 he said--

At our last meeting our friend treated my discovery of the origin

of cowpox as chimerical. Farther investigation has convinced

me of the truth of my assertion beyond the possibility of a

denial.[95]

Challenged to produce direct evidence that grease from the horse

produced pox in the cow, he met with considerable difficulty, so

that on 2nd August, 1797, he had to write--

The simple experiment of applying the matter from the heel of the

horse, in its proper state, to the nipples of the cows, when they

are in a proper state to be infected by it, is not so easily made

as at first sight may be imagined. After waiting with impatience

for months in my own neighbourhood, without effect, I sent a

messenger to Bristol, in vain, to procure the true virus. I even

procured a young horse, kept him constantly in the stable, and

fed him with beans in order to make his heels swell, but to no

purpose.[96]

In the matter of horsegrease, it is to be observed as Dr. Mason

Good informs us, “that for ages blacksmiths and farriers, who

had been infected with grease, were considered as generally

insusceptible of variolous contagion.”[97] Wherefore, to Jenner is

not to be ascribed the discovery of horsegrease as good against

smallpox; but merely that he held with certain farmers that it was

the cause of cowpox, and one in constitution with cowpox; and thus

endeavoured to combine the tradition of the stable with that of the

dairy.

It was not until 1796 that Jenner made any experiment with

cowpox--up to that date, whatever his visions, he was in Hunter’s

phrase a _thinker_, not a _trier_. On 14th May of that year, he

took matter from the hand of Sarah Nelmes, who had been infected by

her master’s cows, and inserted it by two incisions in the arm of

James Phipps, a child of eight years of age. The boy went through

the disease in a regular manner, and on the 1st July was inoculated

with smallpox without effect, to Jenner’s intense satisfaction. He

communicated the event to Gardner in the following letter--

BERKELEY, 19th July, 1796.

DEAR GARDNER,--As I promised to let you know how I proceeded in

my inquiry into the nature of that singular disease the Cowpox,

and being fully satisfied how much you feel interested in its

success, you will be gratified in hearing that I have at length

accomplished what I have been so long waiting for, the passing of

the Vaccine Virus from one human being to another by the ordinary

mode of inoculation.

A boy of the name of Phipps was inoculated in the arm from the

pustule on the hand of a young woman who was infected by her

master’s cows. Having never seen the disease but in its casual

way before, that is when communicated from the cow to the hand

of the milker, I was astonished at the close resemblance of the

pustules, in some of their stages, to the variolous pustules.

But now listen to the most delightful part of my story. The boy

has since been inoculated for the smallpox, which, as I ventured

to predict, produced no effect. I shall now pursue my experiments

with redoubled ardour.

But the experiments could _not_ be pursued, for, from July, 1796

till the spring of 1798, Cowpox disappeared from the dairies around

Berkeley, and, as we have seen, horsegrease was also unattainable.

Jenner had, however, resolved on publication. Life was advancing;

he had made no mark in the world; and, as he wrote to Gardner--

Added to all my other cares, I am touched hard with the reigning

epidemic--Impecuniosity.

At first he proposed to embody his views in a paper for the Royal

Society, but on second thoughts determined to issue a pamphlet.

Having read his manuscript to Dr. Worthington, Mr. Paytherus, and

Mr. H. Hicks, assembled round the table of Mr. Thomas Westfaling,

at Rudhall, near Ross, Herefordshire, and having secured their

approval, the matter was put to press, and about the end of June,

1798, appeared--

AN

INQUIRY

INTO

THE CAUSES AND EFFECTS

OF THE

VARIOLÆ VACCINÆ,

A DISEASE

DISCOVERED IN SOME OF THE WESTERN COUNTIES OF ENGLAND,

PARTICULARLY

GLOUCESTERSHIRE,

AND KNOWN BY THE NAME OF

THE COW POX.

FOOTNOTES:

[85] _Autobiography of Sir B. C. Brodie_, p. 38.

[86] Simon’s _Papers on Vaccination_, p. xii.

[87] Baron’s _Life of Jenner_, vol. i. pp. 48 and 126.

[88] _Ib._, vol. i. p. 127.

[89] Thus described by Gardner. Baron’s _Life of Jenner_, p. 15.

[90] Baron’s _Life of Jenner_, vol. i., pp. 127-129.

[91] _Ibid._, p. 135.

[92] Baron’s _Life of Jenner_, vol. i., p. 131.

[93] Jenner’s _Inquiry_, case i., p. 9.

[94] Baron’s _Life of Jenner_, vol. i., p. 297.

[95] Baron’s _Life of Jenner_, vol. i, p. 136.

[96] _Ibid._ p. 141.

[97] _Study of Medicine_, vol. iii. p. 59, 3rd ed. London, 1829.