JOHN BIRCH.
It is part of the Jennerian legend that the introduction of
vaccination was resisted by prejudice, fury and fanaticism, and
that the practice made its way by sheer force of its proven
efficacy. The statement is widely at variance with facts.
Vaccination was accepted with instant acclamation by the medical
profession, the royal family, and the public as an infallible
and harmless preventive of smallpox; and the subsequent course
of experience was to disprove alike its harmlessness and
infallibility. That in some cases vaccination was encountered with
absurdity and violence lay in the nature of things, even as it
was advocated with absurdity, violence and prevarication. It is
always easy to raise a laugh by the exhibition of the extravagance
of either side in a hot dispute, but to what purpose? It would
have been no cause for surprise if some had been moved to scorn
by the facile credulity with which Jenner’s magical prescription
was so rashly accepted, but the world to which he appealed had no
scientific acquaintance with the laws of health, and it was in
nowise marvellous that, convinced of the prophylaxy of inoculated
smallpox, they should have been overcome by the plausibility of
inoculated cowpox. Yet were not all overcome, nor were all who
resisted the popular craze furious. There was John Birch, for
example, surgeon to St. Thomas’s Hospital, who with calmness and
cogency steadily protested against the introduction of “the new
disease styled cowpox;” and we may read his letters and pamphlets
and fail to note a fiery epithet or unkindly imputation. People who
talk as if all who opposed Jenner were steeped in ignorance and
perversity can know nothing of John Birch.
Although satisfied with variolous inoculation, he had no objection
to vaccination in itself. He thought it fair that experiments with
cowpox should be tried, and the verdict of experience submitted
to; but he complained that experience was anticipated and success
proclaimed ere it was possible for the truth to be known, whilst
every objector was overwhelmed with abuse. As an illustration
of the unwarrantable persuasion that prevailed in favour of the
new practice before there was time to justify it, Birch mentions
that at the anniversary dinner at Guy’s Hospital in 1802, he was
surprised to find the usual business set aside to secure signatures
to Jenner’s petition for a vote of money from Parliament, and that
after dinner toasts, songs, and compliments in honour of Vaccinia
were the order of the day. Booksellers, he relates, declined to
publish anything against vaccination, and editors of newspapers and
magazines would not suffer a word to appear to its disparagement.
Even the Post Office carried the cowpox and correspondence of
the Royal Jennerian Society gratis until the collapse of the
concern in 1806. Those who resorted to doctors and hospitals for
inoculation with smallpox got cowpox instead in spite of assertions
to the contrary. Church vied with chapel in recommending the new
practice. The Archbishop of Canterbury was called upon to issue
a letter directing the clergy to recommend vaccination from the
pulpit, but, with the wariness of office, sent his chaplain to
Birch to hear the other side, and the chaplain retired with the
judicious observation, “His Grace must not commit the Church.” Many
clergymen, however, not only preached vaccination, but practised it
with restless assiduity. Erasmus Darwin was not without hope that
baptism and vaccination might be associated. He wrote to Jenner
from Derby, 24th February, 1802--
As by the testimony of innumerable instances, the Vaccine Disease
is so favourable to young children, in a little time it may occur
that the christening and vaccination of children may always be
performed on the same day.
_The Vaccine Disease so favourable to young children!_ The
assertion affords a vivid glimpse of the prevalent enchantment.
“The idea of connecting religious services with vaccination,” says
Baron, “had occurred to several individuals in this country as well
as on the Continent.”[160]
I viewed with indignant scorn [wrote Birch], the ungenerous
artifice adopted by the Jennerian Society of sticking up in
every Station House, in the Vestries of fanatical Chapels, and
in Sunday Schools, that false _Comparative View of the effects
of Smallpox and Cowpox_ representing to the gaping multitude
a frightful picture of Inoculation with the supposed misery
attendant on it; and exhibiting representations equally false and
exaggerated of the blessings of Vaccination.
The women were not behind the clergy in diffusing vaccine
salvation. They were Jenner’s most devoted allies. He took pains
to teach ladies to operate with “a light hand” so as not to draw
blood, and boasted that one of his pupils had ten thousand patients
to her credit, rescued from the terror and peril of smallpox!
As Birch observed, it was not a question of medicine or of surgery
that he and others had to deal with, but an outburst of enthusiasm
in which the methods and arguments of science were swept heedlessly
away. Any testimony to the credit of vaccination was accepted
with alacrity, whilst the facts to its discredit were denied or
explained away. This recklessness of procedure was most painfully
manifest in the conduct of the Committee of the House of Commons
which sat on Jenner’s first petition for money in 1802--
The number of witnesses in support of the application [wrote
Birch] was 40, but out of the forty 28 spoke from mere hearsay,
and not from knowledge acquired in practice; while the three who
spoke against it were heard impatiently, though they corroborated
their evidence with proofs.
Birch wished to know what cowpox was. Jenner had said it was
derived from horsegrease, but “that origin is proved to be
erroneous, and is now given up, even by his best friends. On all
hands it is admitted,” Birch continued, “that it is not a disease
of the cow, but communicated to the cow by the milker. No cow that
is allowed to suckle her own calf ever has the complaint.” What,
then, is the disease in the milker? asked Birch. Is it smallpox?
Is it _lues venerea_? Is it itch? A man came to St. Thomas’s
Hospital from an adjacent dairy with a hand and arm covered with
ulcerations. He said several of the milkers and the cows’ teats
were affected in the same way, and he was told they had got cowpox.
Birch called one of his country pupils and asked him what was wrong
with the man. “It is itch--rank itch,” was his reply. A box of
Jackson’s ointment for the itch was given to him, and at the end
of a week he reappeared at the Hospital cured. If cowpox be itch,
argued Birch--
Then if a patient be inoculated with the disorder, though it
may suspend the capacity for Smallpox for a season in the
constitution, it will ultimately prove no security--
Which was to say, that it was not probable that smallpox and itch
could occur together, and that a person inoculated with itch would
pass through the variolous test successfully. In this connection we
may recall the fact that Jenner found it impossible to vaccinate a
regiment at Colchester, the men with their women and children all
being afflicted with itch.
Still farther to complicate the mystery of cowpox, Jenner began
to describe it as genuine and spurious, but which was the one and
which was the other he left in bewildering uncertainty. Said Birch--
Though Dr. Jenner could not tell us what Cowpox was, he soon came
forward to inform us that it was of two sorts--the one genuine
and harmless, the other spurious and hurtful.
_Spurious_ Cowpox is a term I do not admit of. I know of no such
thing as _spurious_ Smallpox, _spurious_ Measles, _spurious_ Lues
Venerea, _spurious_ Scrofula.
Birch’s objection to spurious cowpox was forcible, but what in
the innocence of his heart he took for a blunder was proved out
of Jenner’s own mouth to be a deliberate dodge in 1807. Pressed
by the Committee of the College of Physicians to explain what he
meant by Spurious Cowpox, he had to own that he knew nothing of
such a malady, and that he had only meant to describe irregular
effects of cowpox on the arms of the vaccinated! In other words,
when vaccination turned out badly, he had found it convenient to
ascribe the disaster to spurious vaccine! The policy revealed in
this shameless avowal was cynically justified by Dr. Maunsell, who,
in a well known volume, wrote--
The term _imperfect_ or _Spurious_ Vaccination is frequently to
be met with in books, and has been the cause of no small degree
of confusion in practice, although, at the same time, _it has
frequently afforded the practitioner an excellent asylum against
the storms now and then arising out of failures in the protective
power of the vaccine disease_.[161]
From out the muddle as to the origin of cowpox and its genuine and
spurious varieties, Birch demanded, What had Jenner discovered? It
is not that cowpox prevents smallpox; for that has been asserted by
dairy-folk for generations, and has been disregarded by physicians
because proved to be untrue. What then is it? Let him define his
discovery that we may know how to respect it. Let him explain why
it is forbidden to inoculate direct from the cow. Is genuine cowpox
invisible and to be taken on trust? Or is the disease so virulent
on its first communication that it has to be meliorated in the body
of some victim ere it is fit for public use? Birch asked these
questions as we continue to ask What is cowpox? Is it a disease
of the cow? Or is it communicated to the cow by man or by horse?
However definite the answers, the contradictions are equally
definite, and the authorities equally trustworthy.
Practical men answered for Jenner, as they presume to answer at
this day, “Whatever may be the origin of cowpox, we know that
vaccination is harmless, and that it prevents smallpox; and more we
neither demand nor care to inquire.” The credulity and conceit of
such practical men is that stupidity against which, says Goethe,
even the gods are powerless. It was practical men who “on the mere
show of reason” accepted vaccination before it could be tested, and
on most superficial evidence, said Birch--
Recommended Dr. Jenner to the munificence of Parliament for a
discovery in practice which was never to prove fatal; which was
to excite no new humours or disorders in the constitution; which
was to be, not only a perfect security against Smallpox, but
would, if universally adopted, prevent its recurrence for ever.
The harmlessness of the practice was soon belied--
It gave rise [wrote Birch] to new and painful disorders. It was
sometimes followed by itchy eruptions; sometimes by singular
ulcerations; and sometimes by glandular swellings of a nature
wholly distinct from scrofula, or any other known glandular
disease. Eruptions of the skin are most frequent, and may be
heard of in every parish of London; and whether Vaccination shall
be called the Cow Evil, or the Jennerian Evil, posterity will
have to determine.
The non-fatality of the practice was also speedily confuted. The
disorders it excited caused numerous deaths--from erysipelas
especially. It was then said, as it continues to be said to
this day, “Yes, but it was not vaccination, but erysipelas the
patient died of”--a form of words that seems to satisfy many minds
accounted rational. Birch mentioned three or four cases of death
resulting from vaccination, and adds--
These cases were as favourably palliated and ingeniously excused
as they could be; but it is admitted _that each patient was
punctured by a lancet infected with what is called Cowpox; each
arm so punctured became inflamed and ulcerated, and each patient
died_.
The Variolous Test, used so unscrupulously to win converts to
vaccination, was proved by the Inoculators to be untrustworthy.
They had no difficulty in variolating the vaccinated. When it was
discovered that vaccination was no guard against smallpox, many
of the vaccinated resorted to inoculation with smallpox, and they
“took” as readily as did their unvaccinated acquaintance. Five in
one family, the Hignells of Cheltenham, vaccinated by Jenner were
variolated by Mr. Freeman, and smallpox resulted in the ordinary
course. Nothing indeed became plainer than that the vaunted
Variolous Test was a mere conjuring trick, and the more judicious
vaccinators ceased to refer to it.
The promise that the vaccinated would remain for ever secure from
smallpox Birch had no difficulty with. Londoners vaccinated by the
most approved operators caught smallpox, and died precisely as
did the unvaccinated. “Every post,” said Birch in 1804, “brings
me accounts of the failures of vaccination.” As the failures
multiplied, so did the excuses. There was the prime excuse of
genuine and spurious cowpox. If vaccination failed, it could only
be through the inadvertent use of spurious vaccine. Jenner had
taught that one puncture was all-sufficient for protection, but
as one was not found effective, it was asserted that two or three
were requisite for absolute safety. Many, it was alleged, had been
imperfectly operated upon, and the practice of the women and clergy
and other busybodies was thrown into discredit, although at the
outset their services and testimonies had been blazoned abroad as
indisputable; but Birch made this conclusive answer--
It cannot be meant to class Mr. Wachsel, Apothecary to the
Smallpox Hospital, or Mr. Bing, the Accoucheur, among ignorant
and equivocal practitioners; and yet from the patients vaccinated
by these two persons I could bring instance of more failures,
more deaths, and more diseases than have occurred in the practice
of any other two persons who have come within my knowledge.
Many, moreover, who had been vaccinated by Jenner fell victims to
the disease, and he was so pestered with awkward questions, says
Birch, “that to avoid the perplexing appeals that were made to him
daily, and the messages that were perpetually sent requiring him
to visit untoward cases, he retired from London.” Subsequently he
had to forsake Cheltenham for the same reason. The convictions of
quackery were too numerous for his endurance.
Having proved that vaccination did not prevent smallpox, whilst
it was a frequent cause of illness and death, Birch held up to
derision the fine promises wherewith its advocates had beguiled the
people--
Were an architect to undertake to build an edifice which should
be firm in its foundation; all its rooms wind and water tight;
and such as might be inhabited with perfect security; if, before
the edifice were well finished, the foundations were discovered
to be rotten; and if in less than seven years, several apartments
had fallen in and killed those who occupied them, while in a
great number of rooms, the wind or rain was continually beating
in, could I be blamed for declaring that the architect had
broken his contract, and that the edifice ought no longer to be
inhabited? Certainly not. Why then am I to be told that I am
acting perversely when I remonstrate against the practice of
Cowpox? for such an edifice as I have described, so rotten in its
foundations, so ill built, so ruinous, is Vaccination.
Those who take success as the test of truth may say that Birch
was unsuccessful in his contention; but he was not unsuccessful.
Vaccination in London was discredited, and the imposture abated,
as the report of the College of Surgeons in 1807 attests. Where
retained, it was not so much as a preventive as a mitigator of
smallpox, its advocates being content to occupy the safe position
that it made milder a disease the severity of which was unknown.
Birch died in 1815. His sister reprinted his papers against
vaccination (from which have come my citations[162]), and erected
a monument to his memory in St. Margaret’s, Rood Lane, Fenchurch
Street, the inscription on which is noteworthy.
SACRED
To the Memory of
JOHN BIRCH, _Esquire_,
Many years an eminent Surgeon of this Metropolis;
who died on the 3rd February, 1815,
Aged 69 Years,
and whose earthly remains lie deposited under the Pulpit and Desk.
_In his professional Character,
As humane as he was skilful,
He permitted not the daily sight of wounds and sores,
Afflictions and wretchedness of every kind,
To blunt the edge of his natural feelings,
For the sufferings of his Fellow creatures:
But, contemning a too hasty reliance on vaunted Theories,
Sparing of the Knife--abhorring unnecessary Torture--
A foe to wanton, cruel, or dangerous experiment,
Averse from rash operation, and the destruction of parts,
Redeemable by patient and judicious care--
He erected for himself a high and distinguished reputation,
On the solid, and only secure Basis of
ENLIGHTENED EXPERIENCE:
Stimulated throughout Life by a wise and Christian-like
Ambition, to_ cure, _not_ maim--preserve, _and not destroy_.
_Mankind is indebted to him
For a more intimate acquaintance with the powers
Of MEDICAL ELECTRICITY;
By his own ingenious and improved application of which
He performed many remarkable and almost unhoped-for cures.
But the Practice of COW-POXING,
Which first became general in his Day,
Undaunted by the overwhelming influence of
Power and Prejudice, and the voice of Nations,
He uniformly, and until Death, perseveringly opposed;
Conscientiously believing it to be a_ Public Infatuation,
_Fraught with peril of the most mischievous consequences to Mankind.
Whether right or wrong, Time will most surely determine:--
MAN’S MERE OPINIONS MUST EVER BE LIABLE TO ERROR;
BUT BY THE MOTIVES THAT SWAY HIS HEART
SHALL HE ALONE BE JUDGED._
To perpetuate the remembrance of Qualities so excellent,
PENELOPE BIRCH,
His affectionate and only surviving Sister,
Hath raised this Monument:
Not out of a worldly and vain-glorious
_Pride of Affinity_;
But in order to hand down an Example worthy of Imitation
To succeeding Ages.
Jenner recognised Birch as a dangerous antagonist, and behaved
toward him with his usual meanness. Writing from Berkeley, 11th
October, 1812, to Moore in London, where smallpox was prevalent, he
observed--
I have not heard lately whether the fury of the Smallpox
is abated in town. I trust it is. Had I power to exercise
vaccination as I liked, in one fortnight this dismal work
of death should entirely cease. What a sad wicked fellow is
that Birch! Moseley I hear nothing of now, but Birch is still
employing his agents to spread the pestilence.[163]
Birch a sad wicked fellow employing agents to spread pestilence in
London, whilst the good Jenner, capable of arresting the dismal
work of death, sat impotent at Berkeley! Comment is superfluous.
Quack, malicious and impudent, is written at large.
FOOTNOTES:
[160] _Life of Jenner_, vol. i. p. 541.
[161] _A Practical Treatise on the Management and Diseases of
Children._ By Richard T. Evanson, M.D., and Henry Maunsell, M.D.,
Professors in the Royal College of Surgeons, Ireland. Dublin, 1838.
[162] _An Appeal to the Public on the Hazard and Peril of
Vaccination, otherwise Cowpox, by the late_ JOHN BIRCH, ESQ.,
_together with his Serious Reasons for uniformly objecting to
Vaccination: and other Tracts by the same Author._ 3rd Edition.
London, 1817.
[163] Baron’s _Life of Jenner_, vol. ii., p. 382.