SIMON’S DEFENCE AND HAMERNIK’S JUDGMENT.
An attack on Vaccination like that delivered by John Gibbs had
to be met, and Mr. John Simon, Medical Officer to the Board of
Health, was selected for the purpose. The answer appeared in
1857 in a quarto blue-book entitled _Papers relating to the
History and Practice of Vaccination_,[288] 83 pages consisting
of a defence of Vaccination, and 188 pages of illustrative and
corroborative documents. Oddly enough the treatise of Mr. Gibb is
never once mentioned, whilst the order of defence is obviously
marshalled in front of his positions. The reason for this reserve
was double: first, it was considered unadvisable to magnify or
advertise so dangerous an antagonist; and second, it is considered
unprofessional to discuss a medical question with one who is not in
medical orders.
In reviewing Mr. Simon’s defence we are constantly reminded of
Mill’s observation, that a doctrine is never truly judged until
it is judged in its best form; and of Coleridge’s caution, that
an adversary’s bad arguments are no evidence of the goodness of
our own. It lay in the nature of things that many absurd and
trumpery objections should be advanced against vaccination, but
to cite and sneer at them was neither to appreciate nor to refute
the objections that were valid. Had Simon been less scornful and
less loftily disposed, condescending to deal with his antagonist
verbatim, he might have proved no more successful, but he would
have had at least the praise of judicial intention.
After the custom of the eulogists of vaccination, Mr. Simon opened
with a chapter on “Smallpox before the Discovery of Vaccination,”
consisting of terrible tales of the ravages of the disease among
Mexicans, Indians, Greenlanders, Icelanders, Siberians, Hottentots,
etc., as if disbelievers in vaccination were under any obligation
to dispute them. It is not denied that smallpox may be a deadly
epidemic: the contention is that vaccination would not abate its
deadliness. At the same time, when terrible tales are told of
the devastations of smallpox, it is but fair to press for proofs
of their authenticity. Travellers and historians occasionally
prefer the excitement of wonder to adherence to matter-of-fact.
When, for instance, Mr. Simon gravely relates that “in Mexico 3½
millions were suddenly smitten down, leaving none to bury them,”
it is permissible to inquire who was responsible for the Mexican
census in the days of Cortez, and who counted the unburied dead?
Further, it is idle to attach importance to isolated statements
about smallpox, as if smallpox were an independent destroyer of
mankind. It is a member of a group of destroyers, and its activity
is usually coincident with a correspondent dormancy among its
associates. Until the complete vital statistics of a community are
in evidence, it is vain to assert whom smallpox present has slain,
or absent has saved. It is the prevalence of death, and not the
mode of death, that is the critical question.
Again, when the familiar list of great folk who died of smallpox
in Europe in the 17th and 18th centuries is run over, the remark
occurs, that considering the habits and habitations of the said
great folk, their fate was in nowise surprising. Those who believe
that smallpox is generated in unwholesome conditions of life are
not to be confounded by facts that illustrate their contention.
And the like is to be said of the equally familiar tale of London
smallpox. It was to be expected that citizens housed and fed
as Londoners were housed and fed should have been plagued with
smallpox and its congeners. What is denied is that vaccination
could have saved them from smallpox, or reduced their death-rate,
their conditions of life remaining the same.
The extravagant exhibition of the horrors of smallpox is the
customary preliminary to the presentation of Jenner as the saviour
from them; and the part of showman in this respect was fulfilled
with more than ordinary abandon by Simon, who thus depicted the
situation and the rescue--
Medicine baffled and helpless! For millions of our race in after
times the continued raging of that pitiless plague! A drearier
picture could scarcely have saddened mankind.
That this despair was not lasting is due to the genius of an
English surgeon; and the close of the 18th Century, which had
much to darken it, will be remembered till the end of human
history for the greatest physical good ever yet given by science
to the world.
Then followed the Jennerian legend, related in highly fabulous
form with sundry extensions from Simon’s private fancy. It is
sufficient to reassert that Jenner did not introduce cowpox. On
the contrary, he rejected cowpox for horsegrease cowpox; and such
was his prescription because he knew from the evidence of his
neighbourhood that cowpox afforded no protection from smallpox.
It is true that when Pearson discredited horsegrease cowpox,
and recommended cowpox, Jenner dropped his prescription, and
put himself forward as the discoverer of cowpox; but it is also
true that in subsequent years he resumed his original position,
and indeed dispensed with the cow altogether, and, like Sacco of
Milan and De Carro of Vienna, used and diffused horsegrease or
horsepox neat, describing the equine virus as “the true and genuine
life-preserving fluid.” Of all this, however, Simon was either
ignorant, or preferred to say nothing. He, too, dropped cowpox as a
disease of the cow. Referring to a conjecture by Jenner that cowpox
was “smallpox in a milder form,” he maintained that the conjecture
had been verified by Gassner in 1801; by Thiele in 1836; by Ceely
in 1839; and commercially by Badcock of Brighton in 1840. Again
and again Badcock derived fresh stocks of vaccine virus from cows
artificially infected with smallpox; having vaccinated with such
virus more than 14,000 persons, and having furnished supplies of it
to more than 400 medical practitioners--
It has been made matter of almost familiar experiment that the
infection of Smallpox may, by inoculation, be communicated
from Man to Cow; that its result is an eruption of vesicles
presenting the physical characters of Cowpox; that the lymph from
these vesicles, if implanted in the skin of the human subject,
produces the ordinary local phenomena of Vaccination; that the
person so vaccinated diffuses no atmospheric infection; that the
lymph generated by him may be transferred, with reproductive
powers, to other unprotected persons; and that, on the conclusion
of this artificial disorder, _neither renewed Vaccination,
nor inoculation with Smallpox, nor the closest contact and
cohabitation with smallpox patients, will occasion him to betray
any remnant of susceptibility to infection_. (P. xiv.)
Thus were the discredited claims of Jenner revived and reasserted
for a new variety of virus--for smallpox inoculated on the cow!
Even revaccination was pronounced impossible, and logically; for
revaccination implies susceptibility to infection. It was idle,
however, to shelter this new development under Jenner’s authority.
When Jenner said that cowpox was smallpox in milder form, he meant
in process the reverse of Simon’s interpretation. He meant that
smallpox came to man from the horse through the cow; and not that
the cow contracted smallpox from man. Showing his nephew a horse
with greasy heels, he said, “There is the source of smallpox.”[289]
When the stock of cowpox for vaccination ran low, Jenner feared
it might be difficult to enlarge the supply. Why? Because farmers
exercised such precaution, since they learnt that cowpox was
derived from horsegrease, that the disease among cows had become
well nigh extinct. Possibly Jenner was mistaken: possibly cowpox
originated in smallpox: but what Simon described as “settled” in
1857 exists to this day in vehement dispute. Simon’s prescription
was practically a fresh discovery--a new departure in vaccination.
It recalls the practice of the variolators who took virus for
timid patients from healthy subjects inoculated with mild smallpox;
the supposition being that the virulence of the mild pox was
meliorated in them, they playing the part that Ceely and Badcock
assigned to the cow. Thus when Dimsdale variolated the Empress
Catharine, it was with smallpox mitigated in the person of a strong
young man. Had Dimsdale substituted a cow for a man, he would not
only have anticipated Jenner, but the later revelation and practice
of Ceely and Badcock--“the greatest physical good ever given by
science to the world.”
Simon next went on to describe “Smallpox since the Use of
Vaccination,” concerning which these observations may suffice--
1st--Smallpox was abating over Europe prior to the introduction
of vaccination, notwithstanding the stimulation of the disease by
variolation.
2nd--The discredit cast upon variolation by vaccination threw
smallpox out of culture, and to that extent abated smallpox.
3rd--It was absurd to ascribe the decline of smallpox to
vaccination in countries where only a part of the people were
vaccinated; and usually, as in England, a part least liable to
smallpox.
These considerations, sufficiently developed in preceding chapters,
nullify the conclusion, supported by elaborate statistical tables,
that vaccination was the cause of the decline in smallpox. The
asserted cause was incommensurate with the effect.
Another remark remains, namely, that all vaccination was taken by
Simon for effective vaccination, except where smallpox followed,
and then suspicion was thrown on the virus or the time and mode
of its administration. But under his own definition of virus,
namely, smallpox inoculated on the cow, the greater part, if
not the whole, of the vaccinations accomplished were with virus
altogether diverse--with cowpox that owed nothing to smallpox,
with equine cowpox, with horsepox, and much else known only to
omniscience. Yet it was to these heterogeneous inoculations,
modified inscrutably in transit from patient to patient, that the
subsidence of smallpox was attributed! In a word, whatever was
anywhere or by anybody _called_ vaccination, served, according to
Simon, to exterminate smallpox. Where shall we find an epithet for
such crass assurance, with neither science or common-sense to lend
it the gloss of probability!
The succeeding chapter, “Alleged Drawbacks from the Advantages of
Vaccination, and alleged Dangers of its Practice,” was as abusive
as unfair. It is admitted that much nonsense has been written
against vaccination, and, if the pot may call the kettle black,
much more nonsense has been circulated in its favour. Vaccination
was recommended for the improvement of health and the complexion,
for the cure of skin diseases, for the Plague, for whooping-cough,
for rot in sheep, and for distemper in dogs--Jenner himself
vaccinating the King’s staghounds. But to what purpose such
recrimination? The prime charge against vaccination is, that it
is a disease which neither averts or mitigates smallpox; and the
second is, that it frequently excites and sometimes conveys other
diseases.
Simon waxed eloquent on the absurdity of referring the origin of
certain scrofulous affections to vaccination, whilst describing
such affections as notorious sequences of smallpox; but where
was the absurdity if vaccination was (as he held) a mild form
of smallpox?--the mild disease serving equally as a ferment or
excitant of evil humours. In his furious contempt he forgot his
science and logic, and implicitly conceded all for which rational
adversaries of vaccination contended.
In the same reckless vein he asked, “Is properly performed
vaccination an absolutely inoffensive proceeding?” and answered--
Not at all, nor does it pretend to be so. The very meaning of
the thing is, that it shall artificially and designedly produce
a transient and trifling indisposition; that for some days the
infant shall be uncomfortable with a sore arm and a slight
irritation of the adjacent axillary glands, and a perceptible
amount of general feverishness. (P. lx.)
Here we agree, and here disagree--agree as to the disease, disagree
as to the determination of its limits. First, the virus is in
quality indefinite; and second, the recipient of the virus is a
complex of qualities indefinite; so that, as Dr. Mead observed,
when smallpox was used for inoculation, “it is more material into
what kind of body it be infused, than out of what it is taken.”
As pathologists freely allow, it is impossible to predicate the
transformations of organic poisons in the animal frame. A vigorous
infant may throw off the virus, designated vaccine, and suffer no
apparent harm, but the same virus may operate very differently in
contact with debility and disease; so that, in the words of James,
we have to say, “Behold how great a matter a little fire kindleth!”
The conditions of vaccination are essentially those of hazard; the
issues are those of a game of chance; the result at the best being
a risk for naught.
Simon, too, was positive as to the impossibility of the
invaccination of syphilis--a fact no longer in question, save as
to the degree of frequency. And here, also, in his recklessness he
forgot consistency, saying--
When a child is born with the heritage of syphilis (a very
frequent incident, if its parents have been suffering from that
infection) the characteristic symptoms do not appear till some
weeks after birth; and then the scandal discloses itself. (P.
lxvi.)
Just so; and before disclosure the child is vaccinated, and serving
as vaccinifer, the latent syphilis is inoculated and diffused.
Vaccination, according to Simon, was easy--“The mere manual trick
is learnt from a minute’s teaching and an hour’s practice.”
Difficulty begins in the selection of proper subjects for the
rite, for which none are qualified, save the healthy; and for the
recognition of health a trained eye is wanted--
If sickly children are vaccinated, children breeding other
disorders, children having skin disease, children teething and
the like, the results must be at least unsatisfactory, and
possibly dangerous. (P. lxii.)
If such children are exempted from vaccination, how can vaccination
ever approach universality? And when universal vaccination is
effected, as it is frequently effected, how can it fail to be
attended with “results, at least unsatisfactory, and possibly
dangerous”?
More difficult than the selection of subjects is the selection of
virus for the rite; and the manifold dangers and the requisite
precautions were thus specified--
Especially as regards the quality of vaccine lymph, the careless
or uneducated vaccinator is using a dangerous weapon. It is only
during part of the course of a vaccine vesicle that its lymph
is suitable for further vaccinations: for after a given moment,
at which the contents of the vesicle possess their maximum of
simple contagiousness, they tend more and more toward the quality
of common inflammatory products; and matter now taken from the
vesicle is no longer the simple agent of a specific infection,
but has less efficiency for its real purpose, and is specially
able to produce other undesired results.
A danger of somewhat similar kind is that of taking lymph from
vesicles which already have been accidentally ruptured, or where
from any other cause, local or constitutional, their specific
fluid is likely to have been modified by common irritative
processes.
The danger of taking matter from irritated vesicles, and from
vesicles at too advanced a period of their course, is one which
circumstances render frequent; and there is reason to believe
that, in at least a very large proportion of those cases where
abnormal effects have resulted from so-called vaccination, it has
been the employment of this ambiguous irritative matter which has
occasioned the mischief and scandal.
Still more critical changes occur in lymph when removed from the
body, unless appropriate means be taken to preserve it; for,
under the influence of air and moisture, it tends, like other
dead organic matter, to putrid decomposition; and inoculation
with it, when thus changing, can hardly be more useful or less
dangerous than a casual scratch inflicted in the dissecting room.
(P. lxii.)
No one who considers this limitation of vaccination to the
healthy, and these prescriptions as to the collection and
exhibition of “lymph,” can fail to see that the charges of injury
and death brought against the common practice were allowed and
accounted for--were, indeed, the unavoidable associates of that
practice. Vaccination, as described by Simon, was an ideal
operation--impracticable on any ordinary terms. His contention and
his approbation were reserved for “properly-performed vaccination”
on a healthy child, with innocuous virus, the proof of each
condition being discovered in the result. If unsatisfactory or
injurious, or deadly, then the vaccination could not have been
“properly performed”--either the child was unhealthy, or the virus
was at fault.
Nor can we wonder that the people, having experience of the
uselessness and misery of the virulent practice should, undismayed
by the terror of smallpox, decline its observance; nor that those
who made gain thereby should, distrusting their power to prevail by
reason, invoke legislation to enforce the imposture, calling in the
policeman to support the doctor, as of old the soldier supported
the priest.
Still further to sustain his case, Simon addressed the following
Circular of Questions to upwards of 500 medical men--
I.--_Have you any doubt that successful Vaccination confers on
persons subject to its influence a very large exemption from
attacks of Smallpox, and almost absolute security against death
by that disease?_
II.--_Have you any reason to believe or suspect that vaccinated
persons, in being rendered less susceptible of Smallpox, become
more susceptible of any other infective disease, or of phthisis;
or that their health is in any other way disadvantageously
affected?_
III.--_Have you any reason to believe or suspect that lymph, from
a true Jennerian vesicle, has ever been a vehicle of syphilitic,
scrofulous, or other constitutional infection to the vaccinated
person; or that unintentional inoculation with some other
disease, instead of the proposed Vaccination, has occurred in the
hands of a duly educated medical practitioner?_
IV.--_Do you (assuming due provisions to exist for a skilful
performance of the operation) recommend that, except for special
reasons in individual cases, Vaccination should be universally
performed at early periods of life?_
Whilst these questions were framed to draw the answers required,
yet, however modified, the tenor of the returns would have been
much the same. We might confidently predict uniform replies, if a
circular were addressed to 500 clergymen soliciting their judgment
as to the disendowment of the Church, to 500 Nonconformist divines
as to the benefit of hearing sermons, to 500 military men as to
the expediency of an imminent war, to 500 naval officers as to an
enlargement of the navy, or to 500 publicans as to the justice of
local option. Nor is there sense in attributing value to testimony
to be had on demand by the yard. It is brought forth as of course,
and to expect otherwise is to expect what is contrary to nature.
It will be said, “Do you really mean that medical men defend
vaccination because it pays?” In no other sense, I reply, than
as clergymen or publicans defend their vested interests. Medical
men among themselves make no secret of their pecuniary interest
in vaccination, as any one may see who reads their journals; and
Simon’s advocacy culminated in a demand for more liberal pay, as
the only guarantee for “properly-performed vaccination.”
We may view the matter in another light. Suppose a circular had
been addressed to 500 medical men fifty years ago, as to the
utility of bleeding, or blistering, or salivation, would not the
tenor of the answers have been equally uniform with Simon’s in
favour of vaccination? Where are these practices now? But suppose
any one of them had obtained legislative sanction and endowment,
can we doubt that it would have survived to this day, certified as
salutary and harmless by the gross of the medical profession? Let
us clear our minds of cant. The assumption that men’s convictions
(I except the moral aristocracy) are not controlled by their
selfish interests (often enough the reverse of their true ones) is
cant.
Among those interrogated was Dr. Joseph Hamernik of Prague,
whose developed answers form a paper which, by reason of the
independence, acumen and philosophy displayed, constitutes the
distinction of Simon’s collection of documents.
First, Hamernik inquired whether cowpox and smallpox had any
relation to each other, deciding that they were diverse and
independent diseases. Vaccinated persons may be attacked with
smallpox during the development of the cowpox vesicle, or a few
days after the drying-up of the same. When inoculation is made with
a mixture of cowpox and smallpox, there ensue a vaccine vesicle on
the site of the puncture and a variolous eruption over the body. In
fact, it is not uncommon to find cowpox and smallpox flourishing
simultaneously on the same individual. Under some conditions,
the one disease appears to stifle the other. Thus a powerful
epidemic of smallpox will prevent the development of cowpox,
illustrating the Hippocratic aphorism, _Duobus doloribus simul
obortis--vehementior obscurat alterum_, exactly as happens when
other diseases simultaneously invade the human organism. Again, in
well-marked epidemics, cowpox does not protect from smallpox, even
after repeated vaccinations. Under stress of such experience, the
confidence in such vaccination was much shaken in England during
the epidemics of 1825 and 1838. Vaccination was likewise found
useless in the epidemics of Paris in 1825 and Marseilles in 1828.
“Nor can revaccination achieve what vaccination cannot,” said Dr.
Brown of Musselburgh. The revaccinated die of smallpox like other
people, as is proved by the official returns of the armies of
Wurtemburg and Prussia--
Revaccinations among civilians in Bohemia are extremely rare,
and hence I am unable to cite many cases. I only saw two persons
who had been revaccinated die at the Prague Hospital--a Russian
officer in the guards, and a physician from Bremen.
There is no validity in the statement that epidemics of
Smallpox are arrested and made milder by rapid Vaccination and
Revaccination; unless medical men could test the accuracy of
their verdict, as lawyers do, by a new trial. Until they can do
so, we must admit that there are cases and epidemics of Smallpox
light and severe. It was so before Vaccination was heard of, and
is likely so to continue longer than Vaccination will endure.
Second, turning to the examination of the characters of smallpox
before and after vaccination, he observed--
If Vaccination really possessed the properties ascribed to it, a
change must long ere this have taken place in the character of
Smallpox, both of the sporadic and epidemic kind. Smallpox has
been minutely described by pathologists before Vaccination was
introduced, and in such a manner that one would think they had
seen the disease in the wards of our hospitals. Indeed the best
pathologists of our time, who have paid special attention to
Smallpox, agree that they could add nothing to the descriptions
of Rhazes (who died at Bagdad A.D. 930), of Sydenham, 1675, of
Richard Mead, 1754, and of John Huxham, 1764. Mead admits a light
and severe Smallpox, and Huxham observed such slight epidemics
that no fever appeared in the whole course of the disease. At
present, pathologists would hardly class such cases with _Variola
Vera_; they would, perhaps, call them _Variola Modificata_; or
let them figure in their tables as _Varioloid_ and proofs of the
good results of Vaccination.
It may be that in former centuries Smallpox assumed more
frequently the malignant or hæmorrhagic type; but this
circumstance can in nowise be explained by the intervention of
Vaccination. Even as many individuals of the animal and vegetable
kingdoms have disappeared, so also have great changes taken place
in the number and severity of diseases. When scurvy, putrid
fevers, dysentery, etc., were commoner, Smallpox was likely to
be more malignant: so much was due to the prevalent poverty and
scarcity throughout Europe. Pauperism, want and hunger, are
always characterised by a proportionate frequency, gravity and
diffusion of various diseases.
Then, too, much of the mortality of smallpox in former times was
attributable to maltreatment; and Hamernik illustrated what was
possible under good treatment, by adducing his own experience when
the smallpox wards in Prague were under his care. “The recoveries
were, very speedy, and the deaths less than five per cent.”
Third, he held that the doctrine of Jenner was opposed to
recognised pathological principles. Observation has taught us
that two severe diseases cannot affect an individual at the same
time. Thus typhus cannot go on with scarlet fever or smallpox, nor
tuberculous with cancerous disease. The rule, however, only holds
good with diseases that affect the whole organism. It does not
apply to trifling or local affections, to which latter category
cowpox belongs. The best marked diseases pursue their course
contemporaneously with cowpox; and the scars of the punctures
through which it has been inoculated have no more influence in
averting smallpox than any similar scars resulting from analogous
cutaneous lesion--
I consider it as a general pathological law that morbid actions
which have entirely run their course can have absolutely no
influence whatever upon the subsequent pathological reactions of
the individual. Hence it is possible to suffer repeatedly from
smallpox, scarlet fever, typhus, pneumonia, tubercular disease,
etc. Nay, Smallpox has been observed five different times upon
the same patient. Keeping these incontestable facts in view,
it becomes a matter of indifference what was Jenner’s doctrine
relative to Cowpox, whether identical with Smallpox, or whether
antagonistic to Smallpox or anything else. Nor can Variolation be
advocated, if we pay attention to the same pathological law. A
variolous attack, when once passed away, has no more influence,
as regards future events, than any other disease. The reason why
many escape Smallpox altogether, why some have it twice, why the
inoculation of the disease has sometimes no effect, or why some
can inhale its effluvia with impunity, is entirely concealed from
us. As Cowpox is a disease foreign to man, it is particularly for
graziers that further investigations can be interesting.
In answer to the Second Question, whether vaccinated persons, being
less susceptible to smallpox, become more susceptible of any other
infective disease, or of phthisis, Hamernik answered that the
interrogation implied what, for reasons given, he disputed, namely,
that the vaccinated were less liable to smallpox--
The assumption is perfectly gratuitous. Epidemics of Smallpox
occur at widely varying periods, with different degrees of
intensity, prevalence, and duration. The Vaccinated and the
Unvaccinated suffer in every epidemic; and the influence of
Vaccination cannot be determined from the character and progress
of the disease in individual cases.
I am aware that the beneficial influence of Vaccination is
inferred from the registers of public vaccinators; but I freely
confess I consider these books as perfectly valueless; and I may
add that the most intelligent of the gentlemen who keep them
fully concur in my opinion. In this country we know full well
how vaccinators are situated; and that little confidence can be
placed in them is generally acknowledged.
To the Third Question, whether syphilitic, scrofulous, and other
constitutional affections are communicable in vaccination, Hamernik
answered with regret in the affirmative. It was true that the
contrary opinion was written at large. Taupin testified that he had
taken virus from children suffering from typhus, scarlet fever,
measles, smallpox, itch, inflammation of the brain, the lungs and
the intestines; from chorea, epilepsy, scrofula, tuberculosis, and
ring-worm, and no harm had resulted to the vaccinated; and Launauzy
agrees with Taupin, that it is mere prejudice and groundless to
suppose that cowpox taken, from unhealthy children can inflict any
hurt--
On this head, it will be sufficient for me to remark that to
arrive at a knowledge of the amount of mischief such doctrine has
brought upon mankind, it would be necessary to learn how much the
promulgators gained by their unlimited favour for Vaccination.
Professor Waller, of Prague, has proved that syphilis may be
inoculated by means of a patient’s blood; and as blood is often
drawn with the virus of vaccination, no doubt can exist as to the
possibility of doing in this manner a vast amount of mischief.
Monteggio taught at Milan in 1814, that when a syphilitic child
is vaccinated, the result is a vesicle containing both kinds of
virus; and Carioli expressed the same opinion in 1821. Marcolini
relates that, on 16th June, 1814, ten children were vaccinated from
a syphilitic infant, who died at the end of a few months, and five
of the ten children syphilised from her.
In answer to the Fourth Question, whether vaccination should be
universally performed at early periods of life? Hamernik replied,
that he obviously could not recommend a practice which put health,
and even life itself, in jeopardy for no certain advantage. Any
efficient examination of virus was impracticable. Vaccinators may
set to work with zeal and care, but their energy soon cools, and
they settle into perfunctory routine. Government should assume
a passive attitude toward vaccination; or if people _will_ be
vaccinated, something might be done to minimise the danger. If the
practice is assigned to salaried functionaries, they are sure to
create evidence to justify and perpetuate their official existence.
Left to common option--
Vaccinations would every year become fewer, until at last
we should read with astonishment in old newspapers how much
attention was once paid to the practice.
Whilst the majority of Simon’s correspondents conjured up arguments
for vaccination, their facts, apart from their rhetoric, conveyed
much that was instructive. For instance, a register was produced
of the deaths in Christ’s Hospital, London, for the century,
1751-1850. The boys in that charity boarding-school numbered about
550; and in twenty-five years, 1751-75, there died of smallpox 22,
and in twenty-five years, 1776-1800, there died 9. In the fifty
succeeding years, 1801-50, there died 1, and he in 1820. Thereon
we are asked to recognise the efficacy of vaccination! But what
reduced the mortality from 22 in 1751-75 to 9 in 1776-1800? And if
550 boys in the centre of London, in the flux of constant coming
and going, escaped with so few fatalities from smallpox, what comes
of the asserted omnipresence and havoc of the disease in London
before the introduction of vaccination? Across the street from
Christ’s Hospital stands Newgate, which, during the same years, was
haunted with jail fever; which fever was gradually suppressed, and
by what charm? Certainly by no rite analogous to vaccination. Why,
then, should we be required to admit an agency in the reduction
of smallpox which played no part in the reduction of a cognate
disease? In times when smallpox was frequent in Christ’s Hospital,
about as little regard was paid to stench and ventilation as in the
prison over the way. In later years a more wholesome atmosphere
prevailed, and concurrently the diet of the scholars was altered
and improved--changes in themselves as sufficient to account for
the disappearance of smallpox from the school as for typhus from
the jail.
The like indifference to variations of circumstance vitiated
throughout the generalisations of Simon and his correspondents.
Assuming that the conditions of life and the characters of disease
remained unaltered, smallpox was treated as uninfluenced by aught
but vaccination. It needs no words to condemn such procedure as
radically unsound; and men, otherwise sane, only persist in it
as they persist in similar hallucinations. Even the matter of
vaccination they left undefined, or differently defined. Whatever
was called vaccination was taken for vaccination, and the reduction
of smallpox ascribed to it. In Jenner’s hands it was first
horsegrease cowpox, then cowpox, and lastly horsepox. According to
Simon true vaccination was effected with smallpox inoculated on
the cow. Which, we demand, was the virus that wrought the numerous
miracles we are summoned to believe? Is it indeed true that there
is nothing certain about vaccination save the vaccinator’s fee? Is
it that, as in other thaumaturgical performances, virtue resides
in the performer, described by Simon as “the duly educated medical
practitioner?” Is it argued that vaccination is a species of
incantation, and that it matters little what is the vehicle of
the rite, its efficacy being dependent on the credentials of the
administrator? Or that what is believed to be good against smallpox
_is_ good against smallpox, the charm consisting in the faith
wherewith it is received?
The belief in vaccination and its proofs is much akin to the belief
in witchcraft and its proofs. To argue about witchcraft, and to
answer its proofs, was to become a sort of partner in the delusion.
Deliverance lay in the unqualified denial of the imposture; and
from that firm ground difficulty was solved and the inexplicable
disappeared. As soon as the position of absolute disbelief is
taken up, the plausibilities in favour of vaccination resolve
themselves into the element of phantasy, so powerful and yet so
evanescent. The arts of its advocates then become manifest with all
the dodges, conscious and unconscious, whereby the light of truth
is shut out, and the gloom requisite for visions provided. The
story of vaccination is the story of many other impostures which
have bewildered and afflicted mankind, and the study of one is the
revelation of others.
FOOTNOTES:
[288] _Papers relating to the History and Practice of Vaccination._
Addressed to the President of the General Board of Health, and
presented to both Houses of Parliament by command of Her Majesty.
London, 1857. Pp. lxxxiii. and 188.
[289] Baron’s _Life of Jenner_, vol. i., p. 135.