GOLDSON AND BROWN.
William Goldson, member of the London College of Surgeons,
practising at Portsea, published a pamphlet in 1804[164] wherein
he set forth a number of instances within his own experience of
smallpox following vaccination by infection or inoculation. He did
not turn against vaccination, but suggested that its prophylaxy
might neither be so certain nor so enduring as at first asserted.
Vaccination, he pointed out, had been carried into practice on a
wave of enthusiasm, and it was not unreasonable to expect that
on closer acquaintance some of the claims made for it should be
subject to modification. Indeed so much was already admitted; for
failures had led to the discrimination of spurious from genuine
cowpox, and to the issue of new instructions as to the period of
taking vaccine, “on which point, it was now said, depended the
whole success of the operation.” Thus what was originally set
forth as an operation for which any novice was competent, had
developed into one of considerable delicacy with serious liability
to miscarriage. Goldson, therefore, had fair reason to believe
that his own observations and suggestions would meet with candid
consideration, and, if verified, serve for general guidance in the
practice of vaccination.
It is unnecessary to recite Goldson’s cases. Interesting at the
time, they are now commonplace. He found that inoculation with
smallpox was possible at an interval after vaccination, and that
infection with smallpox was equally possible under the like
circumstances. One case is noteworthy for its connection with
Jenner. A seaman, named Clarke, was successfully vaccinated on 4th
November, 1800, and, returning from a voyage to the West Indies was
put to the variolous test on 24th March, 1802, when he sickened
with smallpox and was sent to Haslar. To prove that his malady was
really smallpox, several persons were variolated from him. The
Committee of the House of Commons was sitting on Jenner’s first
claim for public money, and Goldson wrote to Jenner to come to
Haslar and see Clarke for himself; but Jenner was too astute to
cumber himself with difficulties at a time when so much cash was in
question. The case was mentioned to the Committee, but was treated
as of no moment in presence of what they were pleased to regard as
overwhelming evidence as to the perpetual virtue of vaccination.
Goldson’s was a modest pamphlet--conjectural rather than
demonstrative. He ventured to think it was possible that the
efficacy of vaccine might be weakened by transmission from arm to
arm, and that security might be restored by reversion to the cow--
The casual Cowpox is produced by virus immediately from the
animal; while the inoculated disease is the effect of _new
matter_ generated by the action of the other on the human
subject. Whether that _new matter_ be possessed of the power to
produce the same _permanent_ properties as the _parent_ virus,
time alone can decide.
He likewise suggested that horsegrease might be inoculated on
the nipple of the milch mare, and the virus used for equination.
These and other points were advanced with a philosophic grace
that ought to have commanded respect; but, on the contrary, his
pamphlet was received with a howl of fury, and its author denounced
as an ill-conditioned fellow--ignorant, prejudiced, pig-headed.
It was safer to be pronounced anti-vaccinist than a vaccinator
and harbour doubt as to any article of the Jennerian faith. Ring
plied his bludgeon over the heretic, and Jenner wrote of him
with malicious insolence--“All his reasoning is erroneous;” “his
arrogance is increased by attention;” “he obstinately holds a veil
before his eyes, and will not behold the vaccine light;” “one
might as well contend with a blind man on the nature of a prism;”
and so on. Goldson’s offence was that he laid his finger on some
of the weaker points of vaccination; that his sight was too keen,
and his reasoning too cogent. At this day the questions between
him and Jenner are decided by vaccinators themselves in Goldson’s
favour.[165]
Perhaps the most able attack on the practice of vaccination was
delivered by Thomas Brown, surgeon, Musselburgh; and it is much to
be regretted that his book, published in Edinburgh in 1809,[166]
is so little known at this day. Brown had accepted vaccination,
carried away, he admitted, by the common enthusiasm, and the
unqualified audacity with which its claims were asserted--
The practice was introduced and recommended to the public by
its Author as a perfect antidote and security against Smallpox
without any exception or reserve, and capable of banishing
Variola from the catalogue of human misery. I have no hesitation
in confessing that I became an early convert and advocate of the
new practice; and it is now eight years and a-half since I have
uniformly advised and practised Vaccination, in which period
I may safely say, I have vaccinated upwards of twelve hundred
patients, and have only inoculated three at the positive request
of parents. This course I persevered in until the present time,
notwithstanding I met with several instances where it appeared
to fail in giving security; some about three years after the
introduction of the practice; a few more about two years ago; and
those which make part of the present volume within the last six
months.
An epidemic, in which his own perfectly vaccinated patients fell
victims to smallpox, at last opened his eyes to the delusion in
which he was walking, and to the perversity with which he and
others had resisted the light of truth--
I am convinced from what has passed under my own observation
for the last three or four years, that we have been _all_
guilty of rejecting evidence that deserved more attention, in
consequence of the strong prepossessions which existed, from the
very persuasive proof of Vaccination resisting inoculation and
exposure to infection, and from our judgments being goaded and
overpowered with the _positive_ and _arbitrary_ opinions of its
abettors. I am now perfectly satisfied, from my mind being under
the influence of prejudice and blind to the impression of the
fairest evidence, that the last time Smallpox was prevalent, I
rejected and explained away many cases which were entitled to
the most serious attention, and showed myself as _violent_ and
_unreasonable_ a partisan as any of my brethren in propagating
a practice, which I have now little doubt we must ere long
surrender at discretion.
When Brown first saw the vaccinated prostrate with smallpox, he
concluded that there must have been some mistake about their
vaccination; “for after Vaccination it was impossible to contract
Smallpox;” but the evidence of his senses gradually overcame the
phantasy imposed upon him, and like an honest man he proclaimed his
error, and verified the experiences whereby he had been reluctantly
corrected. He set forth with all particulars forty-eight cases of
smallpox following vaccination within his own immediate cognizance,
and though aware of many cases outside that cognizance, he limited
himself to what he could attest with personal assurance. He knew
he would be told that the vaccinations had been imperfect, or that
what he took for smallpox was some other eruption--
It is strenuously contended [said Brown] by nearly every
author, and by almost every practitioner, that Vaccination is a
perfect antidote against Smallpox, if the disease be properly
communicated; and Dr. Jenner and his relative, Mr. G. Jenner,
positively assert, that they have had not one instance of
failure in their own practice. They all therefore, and without
hesitation, refer the whole series of failures that have been
brought forward to the sweeping power of imperfect Vaccination,
or to the blindness and stupidity of the medical practitioner who
cannot distinguish between Smallpox and Chickenpox, a rash, or
bug-bites.
Nor did Brown rest satisfied with proving that vaccination did
not prevent smallpox. He also showed the fallacy of the variolous
test. He adduced twelve cases in which vaccinated persons had been
variolated as if they had never been vaccinated. Also four cases in
which vaccination and variolation were effected simultaneously, the
diseases running their courses concurrently, proving there was no
antagonism between them; and since they could occur together, what
reason was left for supposing that one might not succeed the other?
Having found liberty in the truth, he reverted to Jenner’s
writings, and reading them with opened eyes, he was not slow
to detect and to demonstrate the laxity of statement, the
contradictions, and absurdities with which they were pervaded. No
reply was attempted: no reply, indeed, was possible. The surgeons
of the Edinburgh Vaccine Institution issued _An Examination of Mr.
Brown’s Opinions and Statements_,[167] but they merely carped over
non-essential details, and left the main issues wholly unaffected.
What they had to show was that Brown’s patients were either
unvaccinated, or had not had smallpox; and unable to do this, they
were unable to do anything.
Brown remained victor. He did not overthrow vaccination, nor
restore variolation, but he did make an end in Scotland of
confidence in vaccination as an omnipotent safeguard against
smallpox. The rite continued to be practised on humbler terms:
“it did no harm”: even Mr. Brown allowed that it might keep off
smallpox for a time: and “there was reason to believe that it
tended to make the disease milder when it did occur.” Thirty
years after his first publication, in 1842, Brown reaffirmed his
position in a series of letters[168] to Dr. George Gregory, a
sympathetic friend, and advised a return to variolation in view
of “the acknowledged defects of the Jennerian practice”--a dismal
alternative. But it is in vain to expect any man to be _much_ in
advance of his time: it suffices for honourable distinction that
he _be_ in advance. When Brown commenced practice, smallpox and
other fevers were regarded as inevitable as storms and earthquakes,
and the knowledge with which we are now so familiar, that they
are engendered in foul habits and habitations, was for practical
purposes unknown. Our reproach is, that knowing so much better, we
surrender ourselves to a superstitious observance conceived in days
of darkness.
FOOTNOTES:
[164] _Cases of Smallpox subsequent to Vaccination, with Facts
and Observations read before the Medical Society at Portsmouth,
29th March, 1804: addressed to the Directors of the Vaccine
Institution._ By William Goldson. Portsea, 1884.
[165] Baron’s _Life of Jenner_, vol. ii. pp. 338, 346, 348.
[166] _An Inquiry into the Anti-Variolous Power of Vaccination;
in which from the state of the Phenomena and the Occurrence of a
great variety of Cases, the most Serious Doubts are suggested of
the Efficacy of the Whole Practice, and its Powers at best proved
to be only temporary. From which also will appear the Necessity
of and the proper period for again submitting to Inoculation with
Variolous Virus._ By Thomas Brown, Surgeon, Musselburgh. Edinburgh,
1809. Pp. 307.
[167] _Report of the Surgeons of the Edinburgh Vaccine Institution,
containing an Examination of the Opinions and Statements of Mr.
Brown of Musselburgh on Vaccination._ Edinburgh, 1809.
[168] _An Investigation of the Present Unsatisfactory and Defective
State of Vaccination, and the Several Expedients proposed for
removing the now Acknowledged Defects of the Jennerian practice.
In a Series of Letters addressed to Dr. George Gregory, Physician
to the Smallpox and Vaccination Hospital, London; which also are
intended as an Answer to the Queries of the Academy of Science in
Paris, proposed as the subject of a Prize Essay._ By Thomas Brown,
formerly Medical Practitioner in Musselburgh. Edinburgh, 1842, pp.
139.