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    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.




CHAPTER II.

JENNER’S _INQUIRY_, 1798.


  The curious tradition among the dairy folk of Gloucestershire,
  that persons who had suffered from Cowpox were thereby rendered
  insusceptible of Smallpox, was made known to Edward Jenner when
  a doctor’s apprentice, _and was never afterwards absent from
  his mind_. Thirty years elapsed before the fruit was borne
  to the public; _but incessantly he thought, and watched, and
  experimented on the subject_, and the work in which at length he
  recorded the incomparable results of his labour may well have
  commanded the confidence of reflecting persons.

  Little would ever be heard of objections to Vaccination, if all
  who undertake the responsibility of its performance, and all who
  feel disposed to resist its adoption, _would but thoroughly study
  that masterpiece of medical induction_, and imitate the patience
  and caution and modesty with which Jenner laid the foundations of
  every statement he advanced.

  In the first _Inquiry into the Causes and Effects of the Variolæ
  Vaccinæ_, Jenner set on a scientific basis the popular belief to
  which I have referred; 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.--_Papers relating to the History and Practice of
  Vaccination._ Pp. xi. and xii. London, 1857.

These are the words of Mr. John Simon, and in them we have the
Jennerian legend with the morsel of fact to the mass of fable
which characterises legendary matter, ancient and modern. The
recommendation to “study thoroughly that master-piece of medical
induction,” Jenner’s _Inquiry_, is a mere flourish of panegyric;
for, as Mr. Simon was well aware, the book had been out of print
for half a century, and was practically inaccessible; whilst
its reproduction has usually been considered undesirable in the
interests of Vaccination, inasmuch as it reveals more than is
expedient for common knowledge. An idol that is good to swear by is
always fortified by a convenient obscurity.

The _Inquiry_ is a quarto of less than seventy pages in large
type, set in broad margins in the grand style of the period,
and illustrated with four coloured plates. There are eight pages
of Introductory Matter, followed by thirty-four pages of Cases,
concluding with twenty-six pages of General Observations.

It is to the Cases as the ground of the argument, that I would
first direct attention. They are twenty-three, and may be thus
assorted--

    13 of Cowpox communicated by accident.

     4 of Horsegrease communicated by accident and inoculated by design.

     6 of Cowpox inoculated by design or transferred from arm-to-arm.

It may be tedious, but I should like to go with the reader over
these Cases, for they are highly instructive. Let us take the first
twelve of Cowpox communicated by accident.


I.--JOSEPH MERRET, Gardener.

In 1770 attended to Horses, milked Cows, and caught Cowpox.
Afterwards his family had Smallpox, but he escaped. In 1795 Jenner
repeatedly inoculated him with Smallpox without effect.


II.--SARAH PORTLOCK, Farm Servant.

In 1771 had Cowpox. In 1792 nursed her child in Smallpox
“conceiving herself secure,” and was at the same time inoculated
with Smallpox in both arms without effect.


III.--JOHN PHILLIPS, Tradesman.

Had Cowpox when nine years old. Was inoculated with Smallpox by
Jenner at the age of 62 without effect.


IV.--MARY BARGE, Farm Servant.

In 1767 had Cowpox. In 1791 was inoculated with Smallpox without
effect. Had also acted as nurse to Smallpox patients without
catching the disease.


V.--MRS. H----, Gentlewoman.

Had Cowpox when very young, contracted by handling dairy utensils.
Was subsequently exposed to Smallpox, “where it was scarcely
possible for her to have escaped;” and in 1778 was inoculated with
Smallpox by Jenner without effect.

       *       *       *       *       *

At this point, I would draw attention to the ages of the persons
set forth in these Cases: they were past middle life when the
susceptibility to Smallpox was either low or extinct. The reason
given by Jenner for their production was that he “wished to show
that the change produced in the constitution by Cowpox is not
affected by time”--a claim which vaccinators at this day surrender,
insisting on the necessity of re-vaccination to maintain “the
benign influence;” but apart from that consideration, there was
nothing extraordinary in resistance to inoculated Smallpox. Without
the intervention of Cowpox, inoculators were constantly meeting
patients who would not “take,” even with repeated attempts, and
especially among elderly people; and some who obstinately resisted
inoculated Smallpox, subsequently contracted the disease in the
ordinary way. So much Jenner himself allowed, saying--

  There are many who from some peculiarity in habit resist the
  common effects of variolous matter inserted into the skin, and in
  consequence are haunted through life with the distressing idea of
  being insecure from subsequent infection. (P. 60.)

Yet he was pleased to refer this well recognised resistance to
variolation in those who had had Cowpox to Cowpox, allowing nothing
for habit of body!


VI.--SARAH WYNNE, Dairymaid.

In 1796 had Cowpox in May, and “in so violent a degree, that she
was confined to her bed, and rendered incapable for several days
of pursuing her ordinary vocation.” On 28th March, 1797, she was
inoculated with Smallpox by Jenner without effect.

Under this Case Jenner observes, that “among our dairy farmers
those who have had Smallpox either escape Cowpox, or are disposed
to have it slightly; and as soon as the complaint shows itself
among cattle, assistants are procured, if possible, who are thus
rendered less susceptible of it, otherwise the business of the
farm could scarcely go forward.” At the farm where Sarah Wynne was
employed, all had had Smallpox except Sarah, and all save Sarah,
escaped.


VII.--WILLIAM RODWAY, Dairyman.

In 1796 had Cowpox. In 1797 was inoculated with Smallpox by Jenner
without effect.

Under Rodway’s Case Jenner showed that the farmers were at fault in
supposing that Smallpox kept off Cowpox. In the dairy where Rodway
was employed, all the milkers had passed through Smallpox, except
Rodway, and all contracted Cowpox; “but there was no comparison
in the severity of the disease as it was felt by them and by
Rodway. While he was confined to bed, they were able, without much
inconvenience, to follow their ordinary business.” Thus Jenner
argued that though Smallpox might not keep off Cowpox, it made
Cowpox milder.


VIII.--ELIZABETH WYNNE, Dairymaid.

In 1759 had Cowpox slightly when 19 years of age. “As the malady
had shown itself in so slight a manner,” observed Jenner, “and as
it had taken place at so distant a period of her life, I was happy
with the opportunity of trying the effects of variolous matter upon
her constitution, and on the 28th of March, 1797, I inoculated her”
without effect. Nevertheless in the following year, 1798, she again
caught Cowpox, having a “large pustulous sore” accompanied with
“general lassitude, shiverings, alternating with heat, coldness of
extremities, and a quick and irregular pulse.”


IX.--WILLIAM SMITH, Farm Servant.

  Although [wrote Jenner as preface to this Case] the Cowpox
  shields the constitution from the Smallpox, and the Smallpox
  proves a protection against its own poison, yet it appears that
  the human body is again and again susceptible of the infectious
  matter of the Cowpox.

In 1780, when attending to Horses with sore heels, Smith
conveyed the equine infection to Cows, “and from the Cows it was
communicated to Smith. In 1791, the Cowpox broke out at another
farm where he then lived as a servant, and he became affected with
it a second time; and in 1794 he was so unfortunate as to catch it
again. The disease was equally as severe the second and third time
as it was on the first.” He was twice inoculated with Smallpox in
1795, and exposed to Smallpox without effect.


X.--SIMON NICHOLS, Farm Servant.

In 1782 was employed in dressing the sore heels of Horses, and at
the same time assisted in milking Cows, thereby infecting them and
generating Smallpox. Changing his situation, he communicated the
disease to other Cows, and was himself severely affected. Some
years afterwards, he was inoculated with Smallpox by Jenner without
effect.


XI.--WILLIAM STINCHCOMB, Farm Servant.

In 1782 had Cowpox severely on the same farm with Nichols. In 1792
he was inoculated with Smallpox along with a large party, but in
his case without result. “During the sickening of some of his
companions, their symptoms so strongly recalled to his mind his
own state when sickening with the Cowpox, that he very pertinently
remarked their striking similarity.”


XII.--HESTER WALKLEY, Farm Servant.

In 1782 had Cowpox when she was attended by Jenner. In 1795 she,
and seven other pauper women of Tortsworth, who also had had
Cowpox, were inoculated with Smallpox by Henry Jenner without
effect. “This state of security proved a fortunate circumstance,”
observed Jenner, “as many of the poor women were at the same time
in a state of pregnancy.” Why then, it might have been asked, did
Henry Jenner try to variolate them?

       *       *       *       *       *

These Twelve Cases illustrate Jenner’s procedure; and those
familiar with scientific methods, and the scrutiny and caution
requisite to arrive at trustworthy physiological data, will
view with some astonishment his free and easy induction. In the
majority of the Cases he was without proof that his subjects had
suffered Cowpox; and the absence of this certainty was the more
remarkable as he knew that the dairy-folk described as Cowpox
several varieties of eruption. The same rural observers who held
that Cowpox averted Smallpox, also held that Smallpox averted
Cowpox; and yet Jenner had to show in Rodway’s Case No. vii., that
they were mistaken; although, granting the thesis that Smallpox
and Cowpox were equivalents and mutually preventive, the rural
faith ought to have stood justified, and Smallpox shown to be good
against Cowpox. Again Jenner allowed that an attack of Cowpox did
not prevent a subsequent attack of Cowpox, saying--

  It is singular to observe that the Cowpox virus, although it
  renders the constitution insusceptible of the variolous, should
  nevertheless leave it unchanged with respect to its own action.

Singular indeed! The observation in presence of the principle
to be established was nothing short of imbecile. If Smallpox
prevented Smallpox, and Cowpox was one with Smallpox, and Cowpox
did not avert Cowpox, how was Cowpox to avert Smallpox? The
insusceptibility of Jenner’s subjects to variolous inoculation was,
as observed, of little account. Resistance to inoculated Smallpox
was of common occurrence, and inoculators practised various dodges
to overcome it. To have made such experiments approximately
conclusive would have required the inoculation with Smallpox of
subjects of corresponding ages and temperaments who had not passed
through Cowpox; and the probability is that the results would not
have been dissimilar.

We must not, however, proceed farther until Cowpox is described;
and for that purpose I cannot do better than cite Jenner verbatim.


JENNER’S DESCRIPTION OF COWPOX.

  Cowpox appears on the nipples of the Cows in the form of
  irregular pustules. At their first appearance they are commonly
  a palish blue, or rather of a colour somewhat approaching to
  livid, and are surrounded by an inflammation. These pustules,
  unless a timely remedy be applied,[98] frequently degenerate into
  phagedenic [spreading] ulcers, which prove extremely troublesome.
  The animals become indisposed, and the secretion of milk is much
  lessened.

  Inflamed spots now begin to appear on different parts of the
  hands of the domestics employed in milking, and sometimes on
  the wrists, which run on to suppuration, first assuming the
  appearance of the small vesications produced by a burn. Most
  commonly they appear about the joints of the fingers, and at
  their extremities; but whatever parts are affected, if the
  situation will admit, these superficial suppurations put on a
  circular form, with their edges more elevated than their centres,
  and of a colour distantly approaching to blue. Absorption takes
  place, and tumours appear in each axilla [arm-pit].

  The system becomes affected, the pulse is quickened; shiverings,
  succeeded by heat, general lassitude and pains about the loins
  and limbs, with vomiting, come on. The head is painful, and the
  patient is now and then even affected with delirium. (P. 3.)

And Jenner might have added, with convulsions.

Having drawn this alarming picture of the effects of Cowpox, he
interposes--

  These symptoms arise principally from the irritation of the
  sores, and not from the primary action of the vaccine virus upon
  the constitution. (P. 5.)

If Cowpox meant all this, some might prefer, at least, the risk
of Smallpox; hence the judicious explanation--the irritation of
the sores, and not the poison in the blood, was the cause of the
distressing symptoms. Jenner went on--

  These symptoms, varying in their degrees of violence, generally
  continue from one day to three or four, leaving ulcerated sores
  about the hands, which, from the sensibility of the parts, are
  very troublesome, and commonly heal slowly, frequently becoming
  phagedenic, like those from whence they sprang. During the
  progress of the disease, the lips, nostrils, eyelids, and other
  parts of the body, are sometimes affected with sores; but these
  evidently arise [How evidently?] from their being heedlessly
  rubbed or scratched with the patient’s infected fingers. (P. 5.)

It was this serious disease, this communicated Cowpox, which
the subjects of the foregoing Cases were assumed to have passed
through; and Jenner, in conformity with the opinion of the dairies,
held that they were thereby rendered proof against Smallpox. Whilst
his Twelve Cases make a show of inquiry, they bear no trace of
extensive or critical research. In the general inoculations then
prevalent, those who had undergone Cowpox were not treated as
protected (as were those who had had Smallpox) but were “cut” with
their neighbours--as, in Case xii., were the eight cowpoxed paupers
of Tortworth. Yet Jenner was at no pains to collect and set forth
the evidence of other Gloucestershire practitioners, who, in the
course of duty, must have known as much of Cowpox as himself, and
might have set scores of Cases alongside his perfunctory dozen.

Having perused Jenner’s description of Cowpox, let us now turn to
his account of its origin.


GENERATION OF COWPOX IN HORSEGREASE.

  There is a disease to which the Horse, from his state of
  domestication, is frequently subject. The Farriers have termed
  it THE GREASE. It is an inflammation and swelling in the heel,
  accompanied in its commencement with small cracks or fissures,
  from which issues a limpid fluid, possessing properties of a
  peculiar kind. This fluid seems capable of generating a disease
  in the human body (after it has undergone the modification I
  shall presently speak of) which bears so strong a resemblance
  to the Smallpox, that I think it highly probable it may be the
  source of that disease.

  In this Dairy Country a great number of Cows are kept, and the
  office of milking is performed indiscriminately by Men and Maid
  Servants. One of the former having been appointed to apply
  dressings to the heels of a Horse affected with the malady I
  have mentioned, and not paying due attention to cleanliness,
  incautiously bears his part in milking the Cows, with some
  particles of the infectious matter adhering to his fingers.
  When this is the case, it frequently happens that a disease is
  communicated to the Cows, and from the Cows to the Dairy-maids,
  which spreads through the farm until most of the cattle and
  domestics feel its unpleasant consequences. This disease has
  obtained the name of THE COWPOX.

  Thus the disease makes its progress from the Horse (as I
  conceive) to the nipples of the Cow, and from the Cow to the
  Human Subject. (Pp. 2 and 6.)

This conception of the origin and progress of the disease was not
Jenner’s specially: he shared it with the farmers to whom it was a
novelty--

  The rise of Cowpox in this country may not have been of very
  remote date, as the practice of milking Cows might formerly have
  been in the hands of women only; which I believe is the case now
  in some other dairy countries; and consequently that the Cows
  might not in former times have been exposed to the contagious
  matter brought by the men servants from the heels of Horses.
  _Indeed a knowledge of the source of infection is new in the
  minds of most of the farmers in this neighbourhood_, but has at
  length produced good consequences; and it seems probable from
  the precautions they are disposed to adopt, that the appearance
  of the Cowpox here may either be entirely extinguished or become
  extremely rare. (P. 56.)

Thus Cowpox was to be extinguished by forbidding milkers to handle
Horses’ greasy heels. Jenner himself tried to produce Cowpox in the
manner described, but without success--

  It is very easy [he wrote] to procure pus from old sores on the
  heels of Horses. This I have often inserted into scratches made
  with a lancet on the sound nipples of Cows, and have seen no
  other effects from it than simple inflammation. (P. 45.)

What was requisite for success, he concluded, was the limpid fluid
from the Horse’s heel at an early stage of the disease, and that it
should be applied to the Cow’s nipples at a certain season--

  The virus from the Horses’ heels is most active at the
  commencement of the disease, even before it has acquired a
  pus-like appearance; indeed I am not confident whether this
  property in the matter does not entirely cease as soon as it is
  secreted in the form of pus. I am induced to think it does cease,
  and that it is the thin darkish-looking fluid only, oozing from
  the newly formed cracks in the heels, similar to what sometimes
  appears from erysipelatous blisters, which gives the disease. Nor
  am I certain that the nipples of the Cows are at all times in a
  state to receive the infection. The appearance of the disease
  in the spring and the early part of the summer, when they are
  disposed to be affected with spontaneous eruptions so much more
  frequently than at other seasons, induces me to think, that the
  virus from the Horse must be received upon them when they are in
  this state in order to produce effects. Experiments, however,
  must determine these points. (P. 45.)

Whilst thus explicit as to what was requisite for the infection of
the Cow by the Horse, Jenner did not succeed in producing Cowpox
from Horsegrease. He had to write--

  The spring of the year 1797, which I intended particularly to
  have devoted to the completion of this investigation, proved from
  its dryness remarkably adverse to my wishes. No Cowpox appeared
  in the neighbourhood; for it most frequently happens that while
  the farmers’ Horses are exposed to the cold rains of spring their
  heels become diseased. (P. 44.)

Yet without proof, he argued as if he had proof, saying--

  With respect to the opinion adduced, that the source of the
  infection is a peculiar morbid matter arising in the Horse,
  although I have not been able to prove it from actual experiments
  conducted immediately under my own eye, yet the evidence I have
  adduced appears sufficient to establish it. (P. 43.)

Evidence adduced! Of evidence there was none. The farmers might
be right in their opinion that Cowpox sprang from Horsegrease,
but opinion was not evidence, nor even such assurance as this of
Jenner’s--

  I feel no room for hesitation respecting the common origin of the
  disease, being well convinced that it never appears among the
  Cows unless they have been milked by some who at the same time
  has the care of a Horse affected with diseased heels. (P. 44.)

But not even to this conviction did he adhere. “It was highly
probable,” he thought, “that not only the heels of the Horse, but
other parts of the body of that animal, are capable of generating
the virus which produces the Cowpox”--

  An extensive inflammation of the erysipelatous kind appeared
  without any apparent cause upon the upper part of the thigh
  of a sucking Colt, the property of Mr. Millet, a farmer at
  Rockhampton, the inflammation continued several weeks, and at
  length terminated in the formation of three or four small
  abscesses. The inflamed parts were fomented, and dressings were
  applied by some of the same persons who were employed in milking
  the Cows. The number of Cows milked was 24, and the whole of them
  had the Cowpox. The milkers, consisting of the farmer’s wife,
  a man and a maid-servant, were infected by the Cows. The man
  servant had previously gone through the Smallpox, and felt but
  little of the Cowpox. The servant maid had some years before been
  infected with the Cowpox; and she also felt it now in a slight
  degree. But the farmer’s wife, who had never gone through either
  Smallpox or Cowpox felt its effects very severely.

  That the disease produced upon the Cows by the Colt, and from
  thence conveyed to those who milked them, was the _True_ and
  not the _Spurious_ Cowpox, there can be scarcely any room for
  suspicion; yet it would have been more completely satisfactory
  had the effects of variolous matter [Inoculation with Smallpox]
  been ascertained on the farmer’s wife; but there was a
  peculiarity in her situation which prevented my making the
  experiment. (P. 62.)

Spurious Cowpox! What was Spurious Cowpox? Here is Jenner’s answer--

  Pustulous sores frequently appear spontaneously on the nipples
  of the Cows, and instances have occurred, though very rarely, of
  the hands of the servants employed in milking being affected with
  sores in consequence, and even of their feeling an indisposition
  from absorption. These pustules are of a much milder nature than
  those which arise from that contagion which constitutes the
  True Cowpox. They are always free from the bluish or livid tint
  so conspicuous in the pustules of that disease. _No erysipelas
  attends them_, nor do they show any phagedenic disposition, as in
  the other case, but quickly terminate in a scab without creating
  any apparent disorder in the Cow. This complaint appears at
  various seasons of the year, but most commonly in the spring,
  when the Cows are first taken from their winter food and fed with
  grass. It is very apt to appear also when they are suckling their
  young. But _this disease is not to be considered as similar in
  any respect to that of which I am treating_, as it is incapable
  of producing any specific effects upon the Human Constitution.
  However, it is of the greatest consequence to point it out here,
  lest the want of discrimination should occasion an idea of
  security from the infection of the Smallpox, which might prove
  delusive. (Pp. 7 and 8.)

Nothing could be more explicit. COWPOX was of two kinds--True and
Spurious. The Spurious consisted of pustular sores which appeared
spontaneously on the nipples of Cows, and was of no avail against
Smallpox: the True Cowpox, on the other hand, was not a disease of
the Cow, but of the Horse transmitted to the Cow.

It is of prime importance to bear this distinction in mind; for
if it is not borne in mind, much that remains to be told must
appear confused or unintelligible. As we have seen, it was the
belief of the dairymaids that if they caught Cowpox they would
never afterwards catch Smallpox. Medical men in practice in
Gloucestershire ridiculed the dairymaids’ belief. They said--

“We know that such is the dairymaids’ faith, but it is mistaken;
for we know dairymaids who have had Cowpox and afterwards had
Smallpox in spite of their Cowpox.”

At this point Jenner intervened, saying--

“Let us distinguish. Eruptions contracted in milking are
indiscriminately described as Cowpox by dairy-folk; but there
is an eruption attended with erysipelas and fever which has all
the virtue they claim for it. This variety of eruption does not
originate on the Cow, but is communicated to the Cow from the
Horse. Thus the dairymaids are right and they are wrong. They are
right when the pox they catch is derived from the Horse through
the Cow: they are wrong when the pox they catch originates on
the Cow without the Horse. In short Cowpox proper is of no avail
against Smallpox. It is Horsegrease Cowpox that is of sovereign
and infallible virtue. Any maid who receives HORSEGREASE COWPOX
into her veins is, as she believes, for ever after secure from the
infection of Smallpox.”

Let us therefore bear in mind that Jenner’s prescription was not
Cowpox but HORSEGREASE COWPOX. It is a point to be insisted upon;
for, as we shall see, it was lost from sight, and kept out of
sight, to the utter confusion of the question.

       *       *       *       *       *

We now come to Jenner’s Cases of Horsegrease--for not only were
farm-folk reputed secure from Smallpox by reason of Cowpox, but
farriers likewise in consequence of infection with Horsegrease.


XIII.--THOMAS PEARCE, son of a Farrier.

In consequence of dressing Horses with sore heels at his father’s
when a lad, had sores on his fingers which suppurated, and
occasioned pretty severe indisposition. Six years afterwards,
Jenner inoculated him repeatedly with Smallpox, but only produced
slight inflammation, and exposed him to the contagion of Smallpox
without effect.

On this Case Jenner observed--

  It is a remarkable fact, and well-known to many, that we are
  frequently foiled in our endeavours to communicate Smallpox by
  inoculation to blacksmiths, who in the country are farriers. They
  often, as in the above instance, either resist the contagion
  entirely, or have the disease anomalously. Shall we not be able
  now to account for this on a rational principle?


XIV.--JAMES COLE, Farmer.

Was infected with Horsegrease in the same way as Pearce. Some years
afterwards was inoculated with Smallpox, but only a few eruptions
appeared on his forehead, which passed away without maturation.


XV.--ABRAHAM RIDDIFORD, Farmer.

Was affected with very painful sores in both hands, tumours in each
arm-pit, and severe and general indisposition, in consequence of
dressing a Mare that had sore heels. He was attended by a surgeon,
who recognising a similarity of the sores upon his hands with
those of Cowpox, and knowing the effect of Cowpox on the human
constitution, assured him that he never need fear Smallpox; but,
twenty years afterwards, he caught the disease, which ran its
regular course.

From these Cases Jenner drew this conclusion--

  Although the absorption of matter from sores on the heels of
  Horses, secures, or nearly secures, the system from variolous
  infection, yet it is possible that this cannot be entirely relied
  upon, until a disease has been generated by morbid matter from
  the Horse on the nipple of the Cow, and passed through that
  medium to the human subject.

Which conclusion he repeated thus--

  The active quality of the virus from the Horse’s heels is greatly
  increased after it has acted on the nipples of the Cow; as it
  rarely happens that the Horse affects his dresser with sores;
  and as rarely that a milkmaid escapes infection when she milks
  infected Cows. (P. 45.)

From this conclusion, Jenner at a subsequent period withdrew.
The virus from the Horse was employed for inoculation without
transmission through the Cow, and with results equally
satisfactory. As we shall find, Jenner used and distributed
Equine Virus neat, which he certified as “the true and genuine
life-preserving fluid.”

So far the Cases set forth described no more than ordinary
Gloucestershire experience; but we now come upon ground regarded as
peculiarly Jennerian.


XVI.--SARAH NELMES, Dairymaid.

In 1796 was infected with Cowpox, receiving the virus on a part of
her hand scratched by a thorn. From the large pustulous sore on
Sarah’s hand Jenner, on the 14th May, inoculated--


XVII.--JAMES PHIPPS, eight years old.

Said Jenner, “The more accurately to observe the progress of the
infection, I selected a healthy boy, about eight years old, for the
purpose of INOCULATION FOR THE COWPOX.” The matter was inserted
into his arm by two incisions, barely penetrating the cutis, each
about half an inch long. The inoculation “took,” and was followed
by a chill, loss of appetite, headache, and restless sleep. On the
1st of July, the poor lad was inoculated with Smallpox, and again
several months afterwards, it is said, without effect.

  Here [wrote Jenner] my researches were interrupted till the
  spring of the year 1798, when, from the wetness of the early
  part of the season, many of the farmers’ Horses were affected
  with sore heels, in consequence of which Cowpox broke out among
  several of our dairies, which afforded me an opportunity of
  making further observations upon the curious disease.

About the latter end of February, 1798, William Haynes and Thomas
Virgoe, having to wash a Mare with sore heels, were infected with
Grease, and described their sensations as much the same as when
they were inoculated with Smallpox. Their infection proved that if
Grease was good against Smallpox, Smallpox was not good against
Grease. Haynes was employed as a milker, and Pox broke out among
his master’s Cows about ten days after he had first assisted in
washing the Mare’s heels.


XVIII.--JOHN BAKER, five years old.

Inoculated, 16th March, 1798, with matter taken from a pustule on
the hand of the aforesaid Thomas Virgoe poisoned with Grease from
the Mare’s heels. “He became ill on the sixth day with symptoms
similar to those excited by Cowpox, and on the eighth was free from
indisposition.”

On this case of Horsegrease inoculation, Jenner observed--

  We have seen that the virus from the Horse is not to be relied
  upon as rendering the system secure from variolous infection,
  but that the matter produced by it on the nipple of the Cow
  is perfectly so. Whether the virus passing from the Horse
  through the human constitution, as in the present instance,
  will produce a similar effect remains to be decided. This would
  have been effected, but the boy was rendered unfit for Smallpox
  Inoculation from having felt the effects of a contagious fever in
  a work-house soon after this experiment was made.

Mark the assumption, “_The virus from the Horse is not to be relied
upon as rendering the system secure from variolous infection, but
the matter produced by it on the nipples of the Cow is perfectly
so!_” Such was Jenner’s method of induction! How could he leave
the question undecided? Why not have waited until little Baker
recovered from his fever? or why not have inoculated another
work-house child with Horsegrease? The true sons of science do not
rush into print in such shameless deshabille.


XIX.--WILLIAM SUMMERS, aged five and a half.

Inoculated 16th March, 1798, from the nipple of one of the Cows
infected with Horsegrease by Haynes. Subsequently inoculated with
Smallpox without effect.


XX.--WILLIAM PEAD, aged eight.

Inoculated, 28th March, from Summers. Subsequently inoculated with
Smallpox without effect.


XXI.--HANNAH EXCELL, aged seven.

And several children and adults were inoculated from the arm of
Pead on 5th April. “The greater part of them sickened on the sixth
day, and were well on the seventh; but in three of the number
a secondary indisposition arose in consequence of an extensive
erysipelatous inflammation which appeared on the inoculated arms.
By the application of mercurial ointment to the inflamed parts (a
treatment recommended under similar circumstances in the inoculated
Smallpox) the complaint subsided without giving much trouble.”

Excell was inoculated in three places on her arm. “This,” said
Jenner, “was not done intentionally, but from the accidental
touch of the lancet, _one puncture being always sufficient_.” The
resulting pustules so much resembled those arising from inoculation
with Smallpox, “that an experienced inoculator would scarcely have
discovered a shade of difference.”


XXII.--FOUR CHILDREN.

On 12th April virus was taken from Hannah Excell and inserted in
the arms of--

    Robert F. Jenner, aged 11 months,
    John Marklove,     ”   18   ”
    Mary Pead,         ”    5 years,
    Mary James,        ”    6   ”

R. F. Jenner did not “take.” The arms of the others inflamed, and
Jenner fearing erysipelas, as in the preceding cases, applied a
caustic of soap and quick-lime to Marklove and James, “which,” he
says, “effectually answered my intention in preventing erysipelas.”
The disease was suffered to take its course in Pead, and no
erysipelas appeared.


XXIII.--JOHN BARGE, aged seven.

Inoculated from Mary Pead, and successfully. Was subsequently
inoculated with Smallpox without effect.

“These experiments,” said Jenner, “afforded me much satisfaction;
they proved that the matter in passing from one human subject
to another, through five gradations, lost none of its original
properties, John Barge being the fifth who received the infection
successively from Wm. Summers, the boy to whom it was communicated
from the Cow.”

       *       *       *       *       *

These are Jenner’s Cases. In them we have his “Masterpiece of
Medical Induction”--the fruit of thirty years of incessant thought,
of watching, and of experiment! Let us carefully observe the
dates. Until 1796, when he operated on Phipps, he never made an
experiment in Horsegrease Cowpox Inoculation; and not until the
middle of March, 1798, a few weeks before going to press with the
_Inquiry_, did he repeat the experiment; and though his later
cases were complicated with erysipelas, he did not stay to dispose
of the difficulty and alarm thereby excited. He got together his
scratch lot of Cases, as if under some over-mastering compulsion,
and consigned the concern, crude and incomplete, to the public.
By-and-by the hasty performance came to be spoken of as the result
of thirty years of incessant thought, of patient research, and of
unwearied labour. It is unnecessary to argue the matter. Whilst
there is nothing too great for the credulity of those who are in
the disposition of belief, yet facts are facts, and there is the
stone-wall of the _Inquiry_ with its authentic details whereon to
crack the skulls of romancers. In Jenner’s story as recited to the
vulgar, we have the advantage of witnessing the development of
myth in the light of our own age under our own eyes.

Taking Jenner’s _Inquiry_ at the utmost, What was it? A suggestion
to substitute Horsegrease Cowpox for Smallpox in inoculation.
That was all. Beyond this there was no point of novelty. Some
have credited Jenner with originating the transfer of virus from
arm to arm; but in this respect he followed the example of many
variolators. There was a mild form of Smallpox occasionally
prevalent in London called “pearly pox,” and Dr. Adams and others
kept it going from patient to patient; and the virus from the body
of a healthy variolated child was in constant request by timid
folk, who fancied the virulence of the original infection might
thereby be abated in transmission.

So much for Jenner’s data. Now for a word or two as to the
speculation that invested his prescription.

He considered that some of the diseases which afflict men are
derived from their domestication of animals, and that thus several
diseases might have a common origin. “For example,” he asked, “Is
it difficult to imagine that measles, scarlet fever, and ulcerous
sore throat with a spotted skin, have all sprung from the same
source?”

About the imagination, there might be little difficulty: the
difficulty lay in the production of proof that any disease in man
was derived from disease in animals, and that disease so derived
was variously manifested. Jenner wished to have it believed that
a variety of Cowpox was generated from Horsegrease, which Cowpox
was the source of Smallpox. He adduced no evidence, however, to
connect outbreaks of Smallpox with Cowpox; nor did he ever suggest
that dairymaids caught Smallpox from Cows, or farriers from
Horses. His identification of Horsegrease Cowpox with Smallpox
was the resemblance of their pustules, and on the ground of this
resemblance he affirmed the equivalence of the diseases. Thus in
describing his first inoculation of Cowpox, that of Phipps from the
hand of Sarah Nelmes on the 14th of May, 1796, he wrote--

  The appearance of the incisions in their progress to a state of
  maturation was much the same as when produced in a similar manner
  by variolous matter. This appearance was in a great measure
  new to me, and I ever shall recollect the pleasing sensations
  it excited; as, from its similarity to the pustule produced by
  variolous inoculation, it incontestably pointed out the close
  connection between the two diseases, and almost anticipated the
  result of my future experiments. (P. 30.)

The similarity of the Cowpox and Smallpox pustules _incontestably
pointed out_ the close connection between the two diseases!
The observation and the conclusion are worth notice, being
characteristic of Jenner’s loose and illogical mind. He was
familiar with Tartar Emetic, and he might have observed that it
produced pustules on the skin exactly like those of Cowpox and
Smallpox; wherefore would it have been fair to argue that the
pustules being alike, their causes were incontestably identical?
Dr. Hamernik of Prague observes--

  Some years ago the theory was brought forward, under the auspices
  of the great alchemistical artist, Hufeland, that Vaccination
  from Tartar Emetic pustules was a perfect substitute for
  Vaccination with Cowpox, and had the same beneficent effect.
  With this I fully agree; and I remark further, that if Tartar
  Emetic pustulation is produced in Cows and Calves, and vaccine
  matter is then taken from them, such Vaccination is also
  perfectly harmless. The most convincing proof of the beneficent
  and identical action of such Vaccination with that of Cowpox, is
  furnished by the fact that it presents pustules similar in size
  and form, therefore, necessarily of identical value.[99]

Having identified Horsegrease Cowpox with Smallpox, by reason of
similarity of pustules, he went on to assert that such Horsegrease
Cowpox was equivalent to Smallpox for inoculation, and was attended
with the like prophylaxy, saying--

  What renders the Cowpox virus so extremely singular is, that
  the person affected with it is forever after secure from the
  infection of the Smallpox; neither exposure to the variolous
  effluvia, nor the insertion of the matter into the skin producing
  this distemper. (P. 7.)

  It is curious also to observe, that the virus, which, with
  respect to its effects, is undetermined and uncertain previously
  to its passing from the Horse through the medium of the Cow,
  should then not only become more active, but should invariably
  and completely possess those specific properties which induce in
  the human constitution symptoms similar to those of the variolous
  fever, and effect in it that peculiar change _which for ever_
  renders it insusceptible of the variolous contagion. (P. 48.)

And so on. The assurance was absolute, and the warrant for the
assurance was the Cases adduced, and the similarity of Horsegrease
Cowpox pustules and Cowpox pustules! But if the pustules were
similar, the effects were not similar. Inoculation with Smallpox
produced Smallpox, mild or otherwise, with pustules few or many;
but inoculation with Horsegrease Cowpox was attended with no
eruption beyond the points of incision--

  It is an excess in the number of pustules which we chiefly dread
  in the Smallpox; but in the Cowpox no pustules appear, nor does
  it seem possible for the contagious matter to produce the disease
  from effluvia; so that a single individual in a family might at
  any time receive it without the risk of infecting the rest, or of
  spreading a distemper that fills a country with terror. (P. 58.)

Very good; but where are we? If similarity of pustule proved the
identity of Smallpox and Horsegrease Cowpox, what did those graver
dissimilarities between the diseases prove? That an objection so
obvious should never have occurred to Jenner indicates the extent
of his logical capacity.

Jenner’s expectation from the issue of the _Inquiry_ had nothing of
the prophetic character described by his enthusiastic biographers.
It is only necessary to peruse its pages and note the dates in
order to perceive the impossibility of the vision of 1780 described
by Baron when Jenner exhibited to Gardner his future glory, and how
he was destined to stand like Aaron between the living and the dead
until the plague was stayed. Alas! how many similar fables may we
entertain because the means of detection are not, as in Jenner’s
case, available.

When Jenner was writing, the English people were committed to
Smallpox Inoculation, or more accurately Smallpox culture, and it
was in competition with Smallpox that he advanced Cowpox. “If
asked,” he said, “whether his investigation be matter of mere
curiosity, or whether it tend to any beneficial purpose,” he
replied by setting forth the draw-backs to the existing practice,
and contrasting them with the advantages of his own.

  Notwithstanding [he wrote] the happy effects of Inoculation, with
  all the improvements the practice has received since its first
  introduction into this country, it not very unfrequently produces
  deformity of the skin, and sometimes, under the best management,
  proves fatal. (P. 57.)

On the contrary, he said--

  I have never known fatal effects arise from the Cowpox, even when
  impressed in the most unfavourable manner, producing extensive
  inflammations and suppurations on the hands; and as it clearly
  appears that this disease leaves the constitution in a state of
  perfect security from the infection of the Smallpox, may we not
  infer that a mode of Inoculation may be introduced preferable to
  that at present adopted, especially among those families, which,
  from previous circumstances, we may judge to be predisposed to
  have the disease unfavourably?

Inoculation was freely charged with exciting scrofula; thus Jenner
observed--

  In constitutions predisposed to scrofula, how frequently we see
  the inoculated Smallpox rouse into activity that distressful
  malady; and the issue does not seem to depend on the manner of
  the inoculation, for it as often occurs in those who receive it
  mildly as in those who receive it severely. (P. 60.)

Happily he had the grace to refrain from the explicit assertion
that Cowpox was exempt from similar hazard; yet with characteristic
inconsistency, was disposed to advance a claim for it as an
expulsive irritant--

  As we have seen [though he never showed] that the constitution
  may at any time be made to feel the febrile attack of Cowpox,
  might it not, in many chronic diseases, be introduced into the
  system, with the probability of affording relief, upon well-known
  physiological principles? (P. 60.)

A reader of the _Inquiry_ in 1798 could never have supposed that it
was an attempt to displace the existing practice of Inoculation.
Nor is there any sign that Jenner at the time contemplated such
an issue. He referred to Variolous Inoculation with respect, and
was satisfied to suggest that in certain cases inoculation with
Horsegrease Cowpox might be substituted with advantage. As to the
permanent existence of Horsegrease Cowpox he was doubtful. Since,
he said, the farmers had traced the infection to the Horse, “the
appearance of the Cowpox may either be entirely extinguished or
become extremely rare.” It may be replied that this behaviour on
the part of Jenner was due to reserve and tact, but the reserve and
tact are invisible. The _Inquiry_ was simply what it appears--a
hasty performance, which, in other hands, developed to more,
far more, than its author contemplated. Subsequently he, and
his friends for him, laid claim to years of research under the
influence of supernatural foresight; but, with the _Inquiry_ before
us, I ask where is the evidence? I take the date, 14th May, 1796,
when Jenner inoculated Phipps from the hand of Sarah Nelmes, as the
time when the project of inoculation with Horsegrease Cowpox began
to assume form, and I maintain that the character, order and dates
of the Cases set forth in the _Inquiry_ plainly show that they were
got together to sustain the conclusion then arrived at. When Mr.
John Simon descants on Jenner’s thirty years of incessant thought,
watching and experimenting which resulted in the production of
that Masterpiece of Medical Induction--_The Inquiry_, the answer
is, Peruse the _Inquiry_, and then say where the fruit of thirty
years of labour is to be found. The assertion is too absurd for
discussion, whatever it may be as an article of faith.

The single point of originality in the _Inquiry_ was the definition
of the disease for which prophylactic efficacy was asserted. The
dairymaids said Cowpox: the farriers said Horsegrease. Jenner
said neither Cowpox nor Horsegrease, but their combination in
Horsegrease Cowpox, which variety of Pox alone ensured life-long
security from Smallpox. We shall see as we proceed how this
position was surrendered and resumed, modified and confused beyond
recognition. Let it suffice at present to say that the note of
Jenner’s _Inquiry_ was HORSEGREASE COWPOX and nothing else. Strike
out HORSEGREASE COWPOX, and the affair is reduced to nonentity.


THE VARIOLOUS TEST.

What was called the Variolous Test worked wonderfully for Jenner;
and as we shall have to refer to it repeatedly, it may be well to
describe and dispose of it at once.

We have seen how the Test was practised in the Cases in the
_Inquiry_. Those who had undergone Cowpox were inoculated with
Smallpox, and as the Smallpox did not “take,” they were assumed
to be proof against that disease. Hence the absolute conclusion
proclaimed _Urbi et Orbi_, that none inoculated with Cowpox could
ever afterwards contract Smallpox.

It was replied, that some who _had_ suffered from Cowpox _had_
contracted Smallpox, and that others _had_ received the disease by
inoculation; to which Jenner’s summary answer was, “There must have
been some mistake about the Cowpox; for no one _can_ have genuine
Cowpox and subsequently incur Smallpox, either by infection or
inoculation.”

Cowpox was inoculated and propagated from arm to arm; and, in proof
that the constitution was fortified against Smallpox, it was common
to inoculate with Smallpox, which usually did not “take”; whereon
the operator exclaimed, “Behold! the patient is insusceptible of
Smallpox _for ever_!”

Such was the Variolous Test. It was to multitudes absolutely
conclusive; and to question its validity was to exhibit a
contentious and unphilosophic disposition.

What shall we now say concerning it?

First, that failures were numerous in Variolous Inoculation apart
from Vaccination, and that it was not supposed that when a patient
did not “take,” he was therefore insusceptible of Smallpox; nor
even when he did “take,” that he was thereby rendered proof against
Smallpox. So many of the successfully inoculated did subsequently
fall victims to Smallpox, that Variolators at the end of last
century were compelled to argue (like Vaccinators at the end of
this) that Variolation was a guard, but not an absolute guard;
and that when it did not altogether avert Smallpox, it modified
and mitigated an attack. The excuse for failure was as artful as
the motive was urgent: Variolation was too good a trade to be
imperilled for lack of a little ingenuity.

Nevertheless, if we make full allowance on the score of frequent
incapacity to receive Variolation, we have yet to explain, on a
candid view of the whole evidence, how it was that in numerous
cases Inoculation with Smallpox was ineffective after Inoculation
with Cowpox.

“What can you urge against the Variolous Test?” was a frequent and
imperious demand.

The explanation in general lay in the fact, that Variolation was
attempted before the complete subsidence of the vaccine fever.
The inoculation with Cowpox had set up a serious constitutional
disturbance, and during that disturbance the Smallpox virus could
not develop its malign energy. Let me show what I mean from the
testimony of Jenner himself.

On 15th March, 1800, the Duke of York requested Jenner to proceed
to Colchester to the 85th Regiment. Jenner was unable to go, and
sent his nephew, George, instead, who had to report a complete
failure. The reason of the failure was, that the entire Regiment,
with women and children, had the itch! Jenner was then driven
to the conclusion which, says Baron, “he adopted and invariably
maintained to the last hour of his life, namely, that any cutaneous
disease, however slight in appearance, was capable of interfering
with the regular course of the Cowpox and of preventing it from
exercising its full protecting influence.”[100]

Just so: and mark how the same logic applies to the Variolous Test,
which “nobody could get over.” If any cutaneous disorder, however
slight, could nullify Cowpox, was it not equally probable that
the cutaneous disorder induced by inoculated Cowpox would nullify
inoculated Smallpox _until the effects of the Cowpox had time to
subside_? When the itch at Colchester was cured, then inoculation
with Cowpox was found to be practicable. Thus worthless was the
Variolous Test on Jenner’s own principle; yet with such evidence
under his eyes and among his fingers, he failed to discern its
significance. Nor apparently did he inquire whether the influence
of Cowpox was perpetuated over specified periods of six months,
nine months, one year, two years, and so on. As trader and
adventurer, it suited him better to be not over inquisitive, and
to avow boldly that his specific conferred life-long immunity from
Smallpox.

Vaccinators at this day rarely refer to the once famous Variolous
Test: to do so would be absurd. The fact of Re-Vaccination, of
Vaccination after Vaccination at short intervals, proves, that
whatever the influence of the operation, it is transient and not
permanent; and the cases of Smallpox after Vaccination, and of
Smallpox in its most malignant forms after Re-Vaccination, as
if induced thereby, leave the Variolous Test, which so widely
impressed and imposed upon our forefathers, an exploded piece of
jugglery.


FOOTNOTES:

[98] Such timely remedies were solutions of sulphate of zinc or
sulphate of copper--a hint for those in quest of antidotes for
Vaccination.

[99] _Remarks on Certain Medical Principles._ London, 1882.

[100] Baron’s _Life of Jenner_, vol. i. p. 380.




CHAPTER III.

JENNER IN 1798.


Jenner, with his wife and daughter, left Berkeley for London on
24th April, 1798, in order to see the _Inquiry_ through the press.
He remained in London until 14th July, and failed, if he tried,
to induce any inoculator to substitute cowpox for smallpox. In
the Jenner legend, it is usual to find some touching remarks on
this trip to town: genius unrecognised: truth turned from every
door: the great soul abiding in patience and courage invincible.
Dates, however, are again merciless. The _Inquiry_ was not in the
booksellers’ hands until the end of June, and, within a fortnight
after publication, Jenner was on his way to Berkeley. There was no
occasion for the virtues specified.

Among Jenner’s acquaintance was Henry Cline, teacher of surgery in
St. Thomas’s Hospital; and with Cline he left some virus in a quill
that he had taken from the arm of Hannah Excell, at Berkeley on 5th
April. Cline had a patient, a child named Richard Weller, with an
affection of the hip-joint, and intending to create an issue by way
of counter-irritation, he inoculated the hip with Excell’s virus,
and thus described the experiment in a letter to Jenner--

    LINCOLN’S INN FIELDS, _2nd August, 1798_.

  The Cowpox experiment has succeeded admirably. The child sickened
  on the seventh day; and the fever, which was moderate, subsided
  on the eleventh day. The inflammation extended to about four
  inches diameter, and then gradually subsided without having been
  attended with pain or other inconvenience. The ulcer was not
  large enough to contain a pea; therefore, I have not converted
  it into an issue as I intended. I have since inoculated him with
  smallpox in three places, which were slightly inflamed on the
  third day, and then subsided.

  Dr. Lister, who was formerly physician to the Smallpox Hospital,
  attended the child with me, and he is convinced that it is not
  possible to give him the smallpox.

  I think the substituting of cowpox poison for the smallpox
  promises to be one of the greatest improvements that has ever
  been made in medicine; for it is not only so safe in itself, but
  also does not endanger others by contagion, in which way the
  smallpox has done infinite mischief. The more I think on the
  subject, the more I am impressed with its importance.

Cline then attempted to vaccinate with virus taken from Weller’s
hip, but failed. He wrote to Jenner--

    LINCOLN’S INN FIELDS, _18th August, 1798_.

  Seven days since I inoculated three children with cowpox matter,
  and I have the mortification of finding that the infection has
  not taken, and I fear I shall be entirely disappointed unless you
  can contrive to send me some fresh matter. I think it might come
  in a quill in a letter, or enclosed in a bit of tin-foil.

Jenner was unable to comply with Cline’s request: he had no cowpox
to transmit: and readers of the _Inquiry_ who addressed to him
similar requests had to submit to similar disappointments, out of
which some suspicion was naturally developed. The recommendation of
a remedy whereof there was no available supply was not a passport
to confidence.

Baron relates, that “Mr. Cline perceiving _at once_ from the
success of his first trial, what incalculable blessings were
connected with the diffusion of the new practice, immediately
advised Jenner to quit the country, and to take a house in
Grosvenor Square, and promised him £10,000 per annum as the result
of his practice; in which opinion Mr. Cline was supported by Sir
W. Farquhar; but that all these splendid prospects of wealth and
distinction could not move Jenner.”[101]

The story is either an invention, or it does little credit to
Cline’s judgment. Jenner had neither the means for a house in
Grosvenor Square, nor was there any likelihood of his earning
£10,000 a year by cowpox. Nevertheless it would appear that at this
juncture some one was advising him to try London (one’s vanity is
never without a prompter), and that Jenner replied--

    CHELTENHAM, _29th September_.

  My perplexity really amounts to agitation. On the one hand,
  unwilling to come to town myself for the sake of practice, and,
  on the other, fearful that the practice I have recommended may
  fall into the hands of those who are incapable of conducting it,
  I am thrown into a state that was not at first perceptible as
  likely to happen to me; for, believe me, I am not callous to all
  the feelings of those wounds which, from misrepresentation, might
  fall on my reputation; on the contrary, no nerves could feel more
  acutely; and they now are actually in a tremor from anticipation.

  How very few are capable of conducting physiological experiments!
  I am fearful that before we thoroughly understand what is cowpox
  matter, and what is not, some confusion may arise, for which I
  shall, unjustly, be made answerable.[102]

If his correspondent had been a man of sense, he might have
replied--

  Why so much ado about nothing! You recommend that horsegrease
  cowpox be substituted for smallpox in cases of inoculation. It is
  a simple prescription, easily determined altogether apart from
  you, and there is no reason why you should work yourself into
  such a flutter.

But Jenner was not the unimpassioned man of science, who can leave
truth to take care of itself, and submit when truth contradicts his
prepossessions. Dr. Ingenhousz, an Anglicised Dutchman (born at
Breda, 1730), with reputation as electrician and chemist, read the
_Inquiry_ with considerable amazement. He was himself an inoculator
of mark, having been selected by the Empress Maria Teresa to
operate upon the imperial family of Austria; and by her had been
rewarded (after the pattern of Catharine of Russia and Dimsdale)
with a pension of £600 a year, and the titles of Aulic Councillor
and Imperial Physician. Naturally, therefore, Ingenhousz had a
lively interest in Jenner’s project, and being on a visit to the
Marquis of Lansdowne at his seat in Wiltshire, addressed him as
follows--

    BOWOOD PARK, _12th October, 1798_.

  As soon as I arrived at Bowood, I thought it my duty to inquire
  concerning the extraordinary doctrines contained in your
  publication, as I knew the cowpox was well known in this county.

  The first gentleman to whom I addressed myself was Mr. Alsop,
  an eminent practitioner at Calne, who made me acquainted with
  Mr. Henry Stiles, a respectable farmer at Whitley, who, thirty
  years ago, bought a cow at a fair, which he found to be infected
  with what he called the cowpox. This cow soon infected the whole
  dairy; and he himself, by milking the infected cow, caught the
  disease which you describe, and that in a very severe way,
  accompanied with pain, stiffness, and swelling of the axillary
  glands. Having recovered from the disease, and all the sores
  dried, he was inoculated with smallpox by Mr. Alsop. The disease
  took place, a great many pox came out, and he communicated the
  infection to his father who died of it.

  This being an incontrovertible fact, cannot fail to make some
  impression on your mind, and excite you to inquire further on
  the subject before you venture finally to decide in favour of a
  doctrine, which may do great mischief should it prove erroneous.

The impression made on Jenner’s mind was simply one of annoyance.
He fell back on the assertion that all was not cowpox that was
supposed to be cowpox, and that Farmer Stiles could not have had
the genuine distemper, or he would not have received smallpox by
inoculation. It did not even occur to him that it was necessary to
investigate and account for the evidence adduced by Ingenhousz,
which was every whit as valid as much of his own. He was content to
protest--

  In the course of my inquiry, not a single instance occurred of
  any one having the disease, either casually or from inoculation,
  who on subsequent exposure to variolous contagion received
  the infection of smallpox.... Should it appear in the present
  instance that I have been led into error, fond as I may appear
  of the offspring of my labours, I had rather strangle it at once
  than suffer it to exist, and do a public injury. At present, I
  have not the most distant doubt that any person, who has once
  felt the influence of perfect cowpox matter, would ever be
  susceptible of that of the smallpox.

Could universal conclusion be deduced from more questionable
premisses? and this, too, by one who had just exclaimed, “How
very few are capable of conducting physiological experiments!”
Always, as we shall see; ungenerous toward those who questioned his
assertions, Jenner wrote to his friend, Gardner--

  This man, Ingenhousz, knows no more of the real nature of
  the cowpox than Master Selwyn does of Greek: yet he is among
  philosophers what Johnson was among the literati, and, by the
  way, not unlike him in figure--

When, in fact, what provoked him was that Ingenhousz knew too
much about cowpox, and had laid his finger on the point of error
at the outset. Inquiry on the part of Ingenhousz brought to light
several other instances of smallpox after cowpox; and Dr. Pulteney
of Blandford reported that Dorsetshire inoculators were familiar
with the one sort of pox after the other sort. Jenner’s constant
answer to such objections was, “Yes; but it could not have been
true cowpox to start with”--a style of argument maintained with
parrot-like persistency when smallpox followed vaccination.
“Ah!” it was said, “there must have been some mistake about the
vaccination; for no one can be thoroughly vaccinated and have
smallpox.”

Looking back on the final years of last century, it is much to be
regretted that more pains were not taken to hold Jenner fast to his
position that smallpox never followed cowpox, and to demonstrate
beyond contention that it was not true. It certainly was not true;
the evidence to that fact was indisputable; but few were disposed
to follow Ingenhousz into the West of England and search for the
requisite proof; and Ingenhousz was cut out of the controversy
by his death at Bowood on 7th September, 1799. Presently Jenner
managed to have the contention shifted from the experience of the
dairies to vaccination from arm to arm and the illusory variolous
test, and the advantage of a decision at the springs of fallacy
was lost. In the general confusion which ensued Jenner came to be
taken for a discoverer, and he posed diligently in the character,
when he was nothing more than the advertiser of the vulgar opinion
of his neighbourhood, with the modification that not Cowpox but
Horsegrease Cowpox was the true and infallible specific. The fact
is so clear, that he was a mere advertiser, that it would not be
worth repetition, were it not so systematically treated as unseen.
How distinctly it was at first recognised appears in a letter of
thanks for a copy of the _Inquiry_ addressed to Jenner by Francis
Knight, a London surgeon, wherein he observed--

    CLIFFORD STREET, _10th September, 1798_.

  I have read your publication with much satisfaction; and, from
  a long residence in the dairy part of Wiltshire, as well as in
  Gloucestershire, I know the facts to be well supported; at least,
  it was a general opinion among the dairymen, that those who
  had received the cowpox were not susceptible of the variolous
  disease. The cowpox pustule is very familiar to my eye, and I am
  quite charmed with the delineation of it in your plates. You have
  opened to the world a very curious field of investigation, and it
  is too interesting a subject to die with the day.[103]

In these remarks of Knight, we have Jenner’s position accurately
defined. He made himself responsible for “the general opinion among
the dairymen”; and had some one at that time shown in perspicuous
and emphatic fashion that the dairymen were wrong, Jenner would
have been summarily disposed of. Vain, however, are such regrets;
and we may find comfort in the reflection that there is an order in
the universe which converts misfortune into means for greater and
rarer good.

Another letter to Jenner from Dr. Hicks contains these remarks--

    BRISTOL, _3rd October, 1798_.

  I wish you had been able to have communicated the cowpox to the
  cow by means of inoculation from a greasy horse’s heel, for your
  work would then have been more complete and satisfactory.

  I do not see that you need hesitate to accept the invitation
  given you to inoculate with the cowpox, convinced as you are that
  it will secure the persons so inoculated from ever being infected
  with the smallpox.

Everlasting security from smallpox! Such was the unqualified
promise, and with how little warrant! In presence of a Socratic
inquirer with his persistent, how do you know? Jenner must have
stood confounded.

A letter to Jenner from Dr. Percival, also contains some remarks
worth notice. He wrote--

    MANCHESTER, _20th November, 1798_.

  The facts you have adduced incontestably prove the existence of
  the cowpox, and its ready communication to the human species.
  But a larger induction is yet necessary to evince that the virus
  of the Variolæ Vaccina renders the person who has been affected
  with it secure during the whole of life from the infection of the
  smallpox.

  Mr. Simmons, an ingenious surgeon of this town, has inoculated
  a human subject with the ichor issuing from what is termed
  the grease in horses; but the fluid introduced, though eight
  punctures were made, neither occasioned inflammation nor
  eruption; yet the same child was soon afterwards inoculated with
  success for the smallpox. Mr. Simmons has now engaged a herd of
  cows, and is busily employed in making such experiments as your
  publication has suggested.

  It is very remarkable, that the cowpox has been hitherto
  unnoticed in Cheshire, which is not less a dairy county than
  Gloucestershire, and where the office of milking is performed
  also by men and maid servants indiscriminately.

The frequent statement that Jenner’s _Inquiry_ was at first
received with indifference is entirely untrue: on the contrary, it
was read with interest from the outset, and the only check he met
was due to his inability to supply the demands of correspondents
for samples of the precious virus. Cowpox was absent for awhile
from the dairies, and great was his relief and delight when toward
the end of 1798 some matter was obtained from a farm at Stonehouse
wherewith on the 27th November he vaccinated the children of his
friend, Henry Hicks of Eastington; “the first gentleman,” says
Baron, “who had the merit of submitting his own children to the new
practice.”

Ere 1798 had passed away, Jenner had secured an energetic ally in
Dr. George Pearson, F.R.S., Physician to St. George’s Hospital,
London.[104] Pearson entered into the cowpox question with his
whole heart, and constituted himself a sort of partner in Jenner’s
project. He wrote to him--

    LEICESTER SQUARE, _8th November, 1798_.

  Your name will live in the memory of mankind, as long as men
  possess gratitude for services and respect for benefactors; and
  if I can but get matter, I am much mistaken if _I do make you
  live for ever_.

And in a more decided strain on 13th November--

  I wish you could secure me matter for inoculation, because,
  depend upon it, a thousand inacurate but imposing cases will be
  published against the specific nature of the disease by persons
  who want to send their names abroad about anything, and who will
  think _you and me_ fair game.

In the same letter he told Jenner what some were saying about the
suggested practice--

  You cannot imagine how fastidious the people are with regard to
  this business of the cowpox. One says that it is very filthy and
  nasty to derive it from the sore heels of horses. Another, that
  we shall introduce the diseases of animals among us, and that we
  have already too many of our own. A third sapient set say, it is
  a strange odd kind of business, and they know not what to think
  of it. All this I hear very quietly, and recollect that a still
  more unfavourable reception was given to inoculation for the
  smallpox.

Such observations were natural and to be expected. Jenner wrote
to Gardner that “brick-bats and hostile weapons of every sort
were flying thick around him,” but they were chiefly imaginary.
His revelation was communicated to a ready world. It was no
revolutionary project, but a seductive modification of existing
practice. Inoculation with smallpox was the order of the day
among all respectable people. The operation was troublesome and
uncertain, perilous to patients and to those in contact with them;
and, when all was done, it afforded no unquestionable security
against the disease it was designed to avert. To a community thus
harassed and anxious, came Jenner with his prescription and his
promise--Substitute cowpox for smallpox and you will escape from
this distress, danger, doubt. You will have a harmless fever
without pustules and without risk of infection, and the security
from smallpox will be absolute and perpetual. What wonder that in
such circumstances Jenner’s message was heard gladly and accepted
with grateful enthusiasm. That he should have encountered some
resistance was inevitable, for what change is ever effected
without opposition and ominous prediction? But the change Jenner
proposed was the slightest of changes with the largest prospects
of advantage. Unless these conditions are borne in mind, we shall
never rightly understand the reception accorded by our forefathers
to inoculation with cowpox.


FOOTNOTES:

[101] Baron’s _Life of Jenner_, vol. i. p. 154.

[102] _Ibid._ p. 155.

[103] Baron’s _Life of Jenner_, vol. i. p. 159.

[104] Born at Rotherham, 1751. Graduated M.D., Edinburgh, and
practised at Doncaster until 1784, when he removed to London.
Died at his house in Hanover Square from a fall down stairs, 9th
November, 1828.




CHAPTER IV.

PEARSON’S _INQUIRY_.


Dr. Pearson’s _Inquiry concerning the History of the Cowpox_[105]
is a remarkable proof of the alacrity and energy with which
Jenner’s project was entertained. As observed, Jenner’s _Inquiry_
was published at the end of June, 1798, and ere six months
were over, in November, 1798, appeared Pearson’s _Inquiry_, a
masterly review of Jenner’s; and not only a review, but a record
of investigation, personal and by correspondence with country
physicians and farmers; the entire work displaying a capacity for
business to which Jenner was wholly unequal.

Cowpox did not come before Pearson as a novelty, nor Jenner in
connection therewith. He relates--

  When I was in company with the late Mr. John Hunter, about
  nine years ago, I heard him communicate the information he had
  received from Dr. Jenner, that in Gloucestershire an infectious
  disorder frequently prevailed among the milch cows, named the
  Cowpox, in which there was an eruption on their teats; that those
  who milked such cows were liable to be affected with pustulous
  eruptions on their hands, which were also called the cowpox; that
  such persons as had undergone this DISEASE COULD NOT BE INFECTED
  BY THE VARIOLOUS POISON; and that as no patient had been known to
  die of the Cowpox, the practice of the inoculation of the poison
  of this disease, to supersede the Smallpox, might be found, on
  experience, to be a great improvement in physic.

  I noted these observations, and constantly related them, when on
  the subject of Smallpox, in every course of lectures which I have
  given since that time. (P. 5.)

The communication of Jenner to Hunter was nothing of a discovery.
There was no secret in the existence of Cowpox, nor in the belief
that inoculation therewith fortified the sufferer against Smallpox.
Dr. Pulteney, of Blandford, informed Pearson that--

  Cowpox is well known in Hampshire, Dorsetshire, Somersetshire,
  and Devonshire. It is not unknown in Leicestershire, and other
  midland counties; but dairymen keep it a secret as much as
  possible, as it is disreputable to the cleanliness of their
  produce. (P. 8.)

In the northern counties and in Wales, Cowpox was either rarely
seen or unknown. In Cheshire, as much of a dairy county as
Gloucestershire, where also men acted as milkers, the disease
was never met with. Where, however, Cowpox was recognised, the
faith in its efficacy against Smallpox appeared to be general,
and inoculators regarded it as a bar to their success. Thus Mr.
Giffard, surgeon, Gillingham, wrote to Pearson, 9th August, 1798--

  Cowpox is more known in Dorsetshire than in most counties. Last
  winter I inoculated three parishes, and some of the subjects
  told me they had had the Cowpox, and that they should not take
  the Smallpox; but I desired to inoculate them, and did so two or
  three times, but without effect. Persons never take the Smallpox
  after they have had the Cowpox. (P. 14.)

At a milk-farm on the Hampstead Road, Pearson found a man who had
often seen Cowpox in Wiltshire and Gloucestershire. He said that--

  He had known many who had had Cowpox, and they never suffered
  from the Smallpox, although it prevailed in their own families.
  To use his own words, they who have had the Cowpox “are hard to
  take the Smallpox.” (P. 29.)

Mr. Rolph, surgeon, Peckham, who had practised in Gloucestershire,
informed Pearson that--

  Cowpox was very frequently epizootic in the dairy-farms in the
  spring.... A great number of instances of the Cowpox in milkers
  had fallen under his observation, but not a single mortal, or
  even dangerous, case occurred. There was not a medical man in
  Gloucestershire, or scarce a dairy-farmer, who did not know
  from his own experience, or that of others, that those who have
  suffered the Cowpox are exempt from the agency of the variolous
  poison. (P. 95.)

Dr. Croft likewise told Pearson--

  That in Staffordshire to his knowledge, the fact had been long
  known of the Cowpox, which prevails in that county, affording an
  exemption of the human subjects from the Smallpox. (P. 35.)

Nor did what was so widely believed escape mention in medical
literature. Thus Dr. Beddoes, in _Queries concerning Inoculation_,
had written in 1795--

  I have learnt from my own observation, and the testimony of
  some old practitioners, that susceptibility to the Smallpox is
  destroyed by the Cowpox, which is a malady more unpleasant than
  dangerous.

And Dr. Adams, in his treatise on _Morbid Poisons_, 1795, observed--

  Cowpox is a disease well known to the dairy-farmers in
  Gloucestershire. What is extraordinary, as far as facts have
  hitherto been ascertained, a person infected with Cowpox is
  rendered insensible to the variolous poison.

And Dr. Woodville in his _History of Inoculation_, 1796, argued--

  It has been conjectured that the Smallpox might have been derived
  from some disease of brute animals; and, if it be true that
  the mange affecting dogs, can communicate a species of itch to
  man; or that a person, having received a certain disorder from
  handling the teats of cows, is thereby rendered insensible to
  variolous infection ever afterwards--then, indeed, the conjecture
  is not improbable.

The belief, moreover, that Cowpox was good against Smallpox, had
tempted several to court the disease. The Rev. Herman Drewe wrote
to Pearson of himself and Mr. Bragge, surgeon, Axminster, 5th July,
1798--

  Mr. Bragge and I endeavoured to try the experiment of inoculating
  with the matter of the Cowpox, but from the scarceness of the
  disease, and unwillingness of patients, we were disappointed. (P.
  39.)

Mr. Dolling of Blandford related that--

  Mr. Justings, of Axminster, inoculated his wife and children
  with matter taken from the teats of a cow that had the Cowpox.
  In about a week afterwards their arms were very much inflamed,
  and the patients were so ill that the medical assistance of Mr.
  Meach, of Cerne, was called for. The patients did well. They were
  afterwards inoculated for the Smallpox by Mr. Trobridge without
  effect. (P. 42.)

Dr. Pulteney of Blandford informed Pearson that--

  A respectable practitioner inoculated seven children for the
  Smallpox, five of whom had been purposely infected with the
  Cowpox by being made to handle the teats and udders of cows
  under the disease, and in consequence contracted the distemper.
  These five, after inoculation for the Smallpox, did not sicken,
  whilst the other two did. (P. 39.)

These cases were examples of many; and if it be asked, why were not
such inoculations repeated, we may take an answer from Mr. Fewster,
surgeon, of Thornbury, who, in a practice of thirty years in
Gloucestershire, inoculated thousands with Smallpox, and had known
“numberless instances of Cowpox.” He wrote, 11th October, 1798--

  In general, I think, Cowpox is a much more severe disease than
  the inoculated Smallpox; nor do I see any great advantage from
  its inoculation. Smallpox inoculation seems to be so well
  understood that there is very little need of a substitute. It is
  curious, however, and may lead to other improvements. (P. 104.)

To show still further how Jenner’s communication was “in the
air” ready for descent. Mr. Downe, surgeon of Bridport, wrote to
Pearson, 1st August, 1798--

  A few years ago when I inoculated a great number for the
  Smallpox, I remarked that I could not by any means infect one
  or two of them; and, on inquiry, I was informed that they had
  previously been infected with the Cowpox. I know that a medical
  man in this part of the country was injured in his practice by
  a prejudice raised unjustly that _he intended to substitute the
  Cowpox for the Smallpox in inoculation_. So great an enemy to
  improvement are the prejudices of the public in the country, that
  I think experiments of importance can only be made in hospitals.
  (P. 10.)

Thus popular scandal anticipated what was called Jenner’s discovery!

Nor was Pearson content simply to inquire of others: he
experimented himself, and put Cowpox to the test a week or so
before the appearance of Jenner’s _Inquiry_. He wrote--

  Happening, on the 14th of June, to be with Mr. Lucas, apothecary,
  on professional business at Mr. Willan’s farm, adjoining the New
  Road, Marylebone, where from 800 to 1000 milch cows are kept, I
  availed myself of the opportunity to make inquiry concerning the
  Cowpox. I was told it was a pretty frequent disease among the
  cows of that farm, especially in winter, and that it was supposed
  to arise from sudden change from poor to rich food. It was also
  well known to the servants, some of whom had been affected with
  the malady from milking the diseased cows. On investigation, I
  found that three of the men-servants, namely, Thomas Edinburgh,
  Thomas Grimshaw, and John Clarke had been affected with the
  Cowpox, but not with the Smallpox. I induced them to be
  inoculated for the Smallpox, and, with the view of ascertaining
  the efficacy of the variolous infection employed, William Kent
  and Thomas East, neither of whom had either the Cowpox or the
  Smallpox, were also inoculated. (P. 14.)

The result conformed to expectation: Edinburgh, Grimshaw, and
Clarke did not take Smallpox, even though inoculation was repeated,
whilst Kent and East did. Pearson set forth his experiments much
more philosophically than Jenner, but his bias was pronounced, and
it blinded him to some obvious considerations; and it is marvellous
how easily we may accumulate details for which we have a fancy.
Summing up the testimonies he had collected, he held that--

  The body of evidence is numerous and respectable, declaring
  that a person who has laboured under the Cowpox fever and local
  eruption, is not susceptible of the Smallpox. It does not appear
  that a single well authenticated contravening instance has fallen
  under observation. But I do not apprehend that accurate and able
  reasoners will consider the fact as completely established,
  though, I doubt not, they will allow that the testimonies now
  produced greatly confirm the probability, and that the cautious
  appropriation of it in practice is warrantable. (P. 64.)

In this summary we perceive the limit and imperfection of Pearson’s
_Inquiry_. Smallpox _did_ follow Cowpox: it was well known that
it did: and Dr. Ingenhousz ascertained the fact as soon as he
looked for it. Moreover Pearson showed himself ignorant of Jenner’s
position, who, recognising the fallacy of the rural superstition,
was compelled to discriminate Cowpox as genuine and spurious--the
genuine being the variety derived from Horsegrease.

Upon Jenner’s assertion that Cowpox was unaltered by transmission
from arm to arm, Pearson remarked, “The fact remained to be
proved.” That Cowpox produced a harmless ailment was not, he
thought, to be hastily assumed. Dr. William Heberden had recently
inoculated 800 poor persons at Hungerford without a mishap, and
1700 had passed through Dr. Woodville’s hands in the current
year (1798) with only two deaths; yet how erroneous would be to
argue that variolous inoculation was harmless from such special
experience!

  Such instances of success can only be attributed to a certain
  favourable epidemic state of the human constitution itself,
  existing at particular times, for the proportion of deaths from
  inoculation is usually much greater, owing, probably, to certain
  unfavourable epidemic states. (P. 67.)

If Cowpox remained unchanged in transmission from arm to arm, it
would be no harmless ailment; for the evidence was distinct that it
was frequently a severe one. For example, Edinburgh told Pearson
that when suffering from Cowpox he had to give up work and go into
an hospital; and Grimshaw that the disease was uncommonly painful,
with swellings in his armpits, sore to the touch; and the servant
at Rhodes’s farm in the Hampstead Road, who had seen much Cowpox in
Wiltshire and Gloucestershire, said the milkers were sometimes so
ill that they had to keep their beds for several days, though none
ever died of the Cowpox fever. If, however, by transmission from
arm to arm, Cowpox became milder, it was not improbable that at the
same time it would lose more or less of its protective efficacy.

Pearson might have seen and added, that resistance to inoculated
Smallpox, when the constitution was in no humour for Smallpox, was
no proof that the same constitution would resist Smallpox when
epidemic, or in condition for the evolution of the disease.

Pearson likewise took objection to Jenner’s evidence (such as it
was) that it was possible to take Cowpox after Cowpox, but not
Smallpox after Cowpox; saying--

  Most of professional men are extremely reluctant in yielding
  assent to this statement. Some, indeed, reject it in the most
  unqualified terms. That Cowpox follows Cowpox appears certain,
  but that Cowpox should avert Smallpox, and not avert itself
  appears incredible. (P. 44.)

Here we see Pearson on the verge of discovery of the illusion, but
with all his training and Yorkshire shrewdness he lost the scent,
and allowed himself to be deceived; and not only deceived, but to
become a prime mover in the deception of the world. Jenner felt the
difficulty and replied--

    CHELTENHAM, _27th September, 1798_.

  MY DEAR SIR,--You may be assured that a person may be repeatedly
  affected, both locally and generally, by the Cowpox, two
  instances of which I have adduced, and have many more in my
  recollection; but, nevertheless, I have some reason to suspect
  that my discriminations have not been, till lately, sufficiently
  nice.... Certain it is, that the skin is always subject to the
  ulcerative effects of the virus; but whether the constitution can
  repeatedly feel the primary effects of it, I have experiments in
  view to determine. (P. 99.)

This passage is commended to those who hold with Mr. John Simon
that Jenner delivered to the world “a Master-piece of Medical
Induction,” the fruit of thirty years of incessant thought,
watching and experiment. It is plain that in 1798 the very elements
of the problem were by him undetermined, and the most obvious
objections unforeseen and unconsidered.

Pearson’s strongest opposition was reserved for the asserted origin
of Cowpox in Horsegrease. He said--

  It has no better support than the coincidence in some instances
  of the two diseases in the same farm in which the same servants
  are employed among the Horses and Cows.

  I have found that in many farms the Cowpox breaks out although no
  new-comer has been introduced to the herd; although the milkers
  do not come in contact with the Horses; although there are no
  greased Horses; and even although there are no Horses kept on the
  farm.

  It appears that the Cowpox does not break out under the most
  favourable circumstances, if it be occasioned by _the Grease_.
  “I have had,” writes Sir Isaac Pennington, Cambridge, 14th
  September, 1798, “Dr. Jenner’s book some weeks, and the
  particulars stated in it are really astonishing. I have made
  inquiries upon the subject at Cottenham and Willingham, in which
  two parishes 3000 milch Cows are kept; also a great many Horses
  of the rough-legged cart kind (much liable to the scratches or
  grease) half the parishes being under the plough, and the men
  much employed in milking. But I cannot find that any pustulous
  eruptions on the teats of the Cows, or on the hands of the
  milkers, have ever been heard of.” (P. 82.)

In the opening of his _Inquiry_, Pearson was good enough to say of
Jenner, “I would not pluck a sprig of laurel from the wreath that
decorates his brow”; but, disputing the origin of genuine Cowpox in
Horsegrease, he might have asked himself, what sprig of laurel he
had left. That Cowpox originated in Horsegrease was not Jenner’s
discovery. As Pearson ascertained in the London milk farms, “There
was such a notion entertained in several parts of the country,
whatever might be its foundation.” (P. 86.) But the definition of
Horsegrease Cowpox as the form of Cowpox that justified the faith
of the country-folk in the power of the disease to avert Smallpox,
was Jenner’s solitary distinction--the principle and motive of
his _Inquiry_, which, to prove fallacious, was to extinguish his
title to regard. Cowpox apart from Horsegrease was clearly taught
by Jenner to have no influence on the constitution, and to be
attended with no erysipelas. “Let me call your attention,” he wrote
to Pearson, 27th September, 1798, “to a similarity between the
Smallpox and the Cowpox when inoculated. The symptoms of absorption
first disturb the system, and, secondly, the system feels the
consequences of the local sores. Exactly so with the Cowpox; and
_as the Cowpox inflammation is always of the erysipelatous kind_,
when it spreads over the skin to any great extent, it produces
symptoms not unlike the confluent Smallpox.” (P. 100.)

Pearson foresaw that if the principle of inoculation with Cowpox
were established it would lead to other applications--

  The Cow Poison appears to alter the human constitution, so as to
  render it insusceptible of a different morbific poison, namely,
  the variolous in producing the Smallpox. This fact is, I believe,
  quite a novelty in physiology and pathology: it indicates a new
  principle in the mode of prophylactic practice. And we now see a
  principle upon which diseases from various other morbific poisons
  may possibly be prevented from taking place, such as the Measles,
  Ulcerous Sore Throat, Hooping Cough, Syphilis, etc., namely, in
  consequence of destroying the excitability of the constitution
  to such poisons by the agency of different, and perhaps less
  hurtful ones. Whether the Cowpox preserves the constitution from
  other morbific poisons, besides the variolous, is an undecided
  question. (P. 79.)

Like Jenner, he also recognised in Cowpox a counter-irritant--a
safe sort of fever that might be used to drive off other diseases--

  If it be true that the same constitution is liable to undergo
  repeatedly the Cowpox, to which distemper no one has fallen a
  victim, practitioners may avail themselves of this means of
  exciting an innocent fever as a remedy of various disorders; it
  being a truth, admitted by men of experience, that fevers are
  occasionally efficacious remedies, especially for inveterate
  chronic maladies, such as Epilepsy, Hysteria, Insanity, St.
  Vitus’s Dance, Tetanus, skin deformities and diseases, etc. (P.
  81.)

Nor was the notion without warrant, for Smallpox itself was
credited with a double action as a generator and exterminator of
disease--

  A disposition to certain diseases, and even diseases themselves,
  are not rarely brought on by the Smallpox; but sometimes also
  dispositions to diseases, and diseases themselves of the most
  inveterate kind are removed by the Smallpox. (P. 77.)

In one respect, Jenner showed himself superior to Pearson, namely,
in offering some explanation of Cowpox. Pearson accepted the
disease on the rural terms--as an eruption on Cows attended with
no serious illness. If in any way such Pox was equivalent to
Smallpox, it was inexplicable that it should be limited to the
udder and teats of milch cattle, and that males, and females not in
milk, should be exempt from infection. A disease so unique wanted
accounting for; but Pearson made no attempt to account for it,
nor gave any sign that he apprehended the difficulty. Jenner, on
the other hand, accounted for Pox on the Cow by referring it to
infection from the Horse conveyed by the milkers, which explanation
Pearson rejected. But in giving Jenner credit for so much, let
it not be for over much. Whilst he ascribed Cowpox to a credible
cause, he did not recognise his advantage and summon gainsayers
to explain how Cowpox, as described by them, could exist without
Bullpox. On the contrary, as we shall see, Jenner submitted to be
silenced on this point for reasons far from creditable.


FOOTNOTE:

[105] _An Inquiry concerning the History of the Cowpox, principally
with a view to supersede and extinguish the Smallpox._ By George
Pearson, M.D., F.R.S., Physician to St. George’s Hospital, etc.
London, 1798, 8vo., pp. 116.




CHAPTER V.

WOODVILLE, PEARSON AND JENNER.


Another early and earnest examiner of Jenner’s _Inquiry_ was Dr.
William Woodville, physician to the London Smallpox and Inoculation
Hospital. He was a Cumberland man, born at Cockermouth, 1752; a
member of the Society of Friends. An ardent botanist, he turned
two acres of the ground around the Hospital at King’s Cross into a
botanic garden, which he maintained at his own expense. He died of
a chronic pulmonary complaint in 1805, and in his last illness had
himself removed from his house in Ely Place to the Hospital for the
sake of the garden and the country air.

Woodville was eager to try cowpox, but Jenner had no supply, nor
could any be had elsewhere. He therefore resorted to horsegrease,
but could make nothing of it. In his own words--

  Conceiving that the distemper might be produced by inoculating
  the nipples of Cows with the matter of the grease of Horses, I
  proceeded to try whether the Cowpox could be actually excited
  in this manner. Numerous experiments were accordingly made upon
  different Cows with the matter of grease, taken in the various
  stages of that disease, but without producing the desired effect.

  Neither were inoculations with this matter, nor with several
  other morbid secretions in the Horse, productive of any effects
  upon the human subject.[106]

Thrice in person did Woodville submit to inoculation with
horsegrease, but in vain. Others in London and elsewhere attempted
to raise pox on cows in the same way without result save
malediction on Jenner for originating such a troublesome quest.

Thus closed 1798 with many anxious to try the new prescription
whenever there was a chance. Early in the new year, there was a
cry in London, ’Tis found! ’tis found! In Harrison’s dairy, Gray’s
Inn Road, close by the Smallpox Hospital, cowpox was discovered,
and thither hastened Woodville, Pearson, Sir Joseph Banks, Sir
William Watson, Dr. Garthshore, Dr. Willan, and other medical men;
and in their presence, on 19th January, Woodville inoculated six
patients with the pox.[107] The eruptions on the cows’ teats were
diligently compared with the description and plates in Jenner’s
_Inquiry_, and pronounced identical. Four-fifths of the 200 cows in
the dairy became affected, those not in milk escaping the disease;
likewise some of the milkers, the first being Sarah Rice, who had
undergone smallpox in childhood--a proof that smallpox did not
prevent cowpox. “At the same time,” wrote Dr. Pearson, “I received
the agreeable intelligence that the disease was also raging in the
largest stock of cows on the New Road, near Paddington, to which no
one could gain admittance but myself.”

With cowpox thus provided in abundance, Pearson and Woodville
set to work--Woodville at his Hospital, and Pearson in private
practice. Be it observed, however, that this London cowpox was not
Jenner’s cowpox. It was not horsegrease cowpox, but the variety
stigmatised by Jenner as spurious. How Pearson and Woodville
pressed forward with their enterprise appears from the following
letter, enclosing cowpox threads, sent by Pearson to two hundred
medical practitioners throughout the United Kingdom--

    LEICESTER SQUARE, _12th March, 1799_.

  Sir,--I hope you will pardon me for taking the liberty to inform
  you (by way of additional evidence to the testimonies I have
  published on the subject of the Cowpox) that upwards of 160
  patients, from two weeks to forty years of age, principally
  infants, have been inoculated since the 20th January last by Dr.
  Woodville and myself, separately....

  Not one mortal case has occurred.

  Not one of the patients has been dangerously ill....

  None of the patients, namely above 60, inoculated with the
  Smallpox, subsequently to the Vaccine Disease, took the
  infection....

  In many of the cases eruptions of the body appeared, some of
  which could not be distinguished from the Smallpox.

  I have sent the matter of Cowpox pustules on the thread enclosed,
  in order, if you approve of the inquiry, to inoculate with it;
  and I entreat you to favour me with the result of your trials:
  but I must trouble you to apply the test of inoculating with
  variolous matter subsequently to the vaccine disorder.

    GEORGE PEARSON, M.D., F.R.S.

  P.S.--I am happy to be able to state that at Berkeley, Dr. Jenner
  has continued his trials of inoculation with vaccine matter sent
  from London with good success.

Jenner was of an indolent disposition, but the part Pearson was
playing stung him to action. His nephew, Rev. G. C. Jenner, wrote
to him from London, and thus roused his jealousy--

    NORFOLK STREET, _11th March, 1799_.

  After what Mr. Paytherus has written to you it will be needless
  for me to say anything to urge the necessity of your coming to
  town to wear the laurels you have gained, or to prevent their
  being placed on the brows of another....

  Dr. Pearson is going to send circular letters to medical
  gentlemen to let them know that he will supply them with Cowpox
  matter upon their application to him, by which means _he_ will be
  the chief person known in the business, and consequently deprive
  you of that merit, or at least a great share of it, which is so
  justly your due. Dr. Pearson gave a public lecture on the Cowpox
  on Saturday, and adopted your opinions, except with regard to the
  probability of the disease originating in Horses’ heels.... All
  your friends agree that _now_ is your time to establish your fame
  and fortune; but if you delay taking a personal active part any
  longer, the opportunity will be lost for ever.--Your affectionate
  nephew, G. C. JENNER.

Jenner at once communicated the alarming intelligence to his friend
Gardner with a sly suggestion for counter-action--

    BERKELEY, _Wednesday_.

  A letter just received from G. Jenner informs me that Dr. Pearson
  on Saturday gave a public lecture on the Cowpox, and that it
  was publicly exhibited at Sir Joseph Banks’s on Sunday evening.
  He has also given out that he will furnish any gentleman at a
  distance with the virus.

  As this is probably done with the view of showing himself as
  the first man in the concern, should not some neatly drawn
  paragraphs appear from time to time in the public prints, by no
  means reflecting on the conduct of P., but just to keep the idea
  publicly alive that P. was not the author of the discovery--I
  mean of Cowpox Inoculation.--Yours truly, E. J.

As human nature exists, it was not extraordinary that Jenner should
feel anxious over the occupation of ground he considered his own;
but at the same time it is obvious, that Pearson had done nothing
wrong, nothing that was not allowable, nothing indeed that was not
praiseworthy. He allowed Jenner full credit for having advertised
the Gloucestershire faith in cowpox, and for the production
of certain evidence for that faith; but he set aside Jenner’s
prescription of horsegrease cowpox, and was making use of a form
of cowpox that Jenner had explicitly condemned. Whilst Jenner,
too, had excited curiosity, he did nothing, or could do nothing,
to satisfy it; and it was idle to expect the world to await his
convenience: nor was Pearson the man to rest content where action
was possible. As he said--

  From the time of the publication of the _Inquiry_ in June, 1798,
  the author contributed no further inoculated cases to the end of
  that year; nor could I do more than investigate the history of
  the Cowpox principally by inquiries among provincial physicians
  and farmers, from whom I was enabled to confirm some of the facts
  in Dr. Jenner’s book, and to render doubtful or disprove others,
  and to bring to light new observations.[108]

Jenner was not slow to respond to his nephew’s summons to London.
He left Berkeley on the 21st of March, and remained in town until
the 11th of June, visiting medical men, asserting his own claims,
and counter-acting the operations of Pearson and Woodville.

In Dr. Pearson’s circular, it will be observed, that he described
inoculation with cowpox as attended with eruptions in some cases,
which could not be distinguished from smallpox. So far as Pearson
and Woodville were concerned, it was an unfortunate statement, and
gave Jenner an advantage over them which he used unsparingly to
their discredit.

Jenner’s claim for inoculation with cowpox was, that it excited a
fever that was not infectious and was without pustular eruptions;
and here was Dr. Pearson setting up as his critic, and Dr.
Woodville assuming to develop his practice, and producing a
disorder that was indistinguishable from smallpox! Such presumption
and ignorance deserved to be hooted.

What was the explanation? Simply this: that Woodville conducted
some of his cowpox inoculations in the variolous atmosphere of his
Hospital, and that he thereby communicated smallpox and cowpox
simultaneously. In a scientific sense, the experience was valuable;
it proved that it was possible to have cowpox and smallpox at the
same time--that neither disease superseded or nullified the other.

Woodville tried to vindicate himself, and in his failure magnified
Jenner’s triumph still further. Yet he had much that was reasonable
to say for himself. For example, he had transmitted to Jenner some
of the virus from one of the first of his cowpox inoculations in
January, and with it Jenner operated on twenty persons, reporting
to Woodville--

    BERKELEY, _February, 1799_.

  The rise, progress, and termination of the pustules created by
  the virus were exactly that of the true Cowpox.

Nevertheless, wrote Woodville--

  This virus which Dr. Jenner declared to be perfectly pure and
  genuine was taken from the arm of an hospital patient who had 310
  pustules, all of which suppurated.

Woodville also argued, that “Cowpox, as casually produced by
milking infected cows, differs considerably from that which is the
effect of inoculation”; which Jenner attested in saying--

  Four or five servants were inoculated at a farm contiguous to
  Berkeley last summer with matter just taken from an infected Cow.
  A little inflammation appeared on all their arms, but died away
  without producing a pustule; yet all these servants caught the
  disease within a month afterwards from milking the infected Cows,
  and some of them had it severely.[109]

Others maintained that the cowpox which saved milkmaids from
smallpox was a much severer affection than that induced by
Jenner’s lancet, and that it was folly to assume their equivalence.
There was force in the argument; for every one then knew how much
the issue of smallpox inoculation depended on the mode of its
performance. The infection when communicated through the skin was
usually much less severe than when communicated by incision; and
Jenner related how a country inoculator, who liked to “cut deep
enough to see a bit of fat,” was the death of his patients on every
side. The human body is of infinite delicacy and complexity, and we
are sure to find ourselves at fault when we deal with its mysteries
according to our crude and inanimate logic. It is by experiment and
not by syllogism that physiological truth is verified.

Whatever might be the perils, immediate or remote, of inoculation
with cowpox, it was not attended with smallpox eruption; and at
last it became manifest to Woodville himself, that the virus he had
used, and the virus he had distributed, which had produced such
eruption, was the virus of smallpox.

After much controversy and many experiments these conclusions were
arrived at--

1. That when a person was inoculated with smallpox and cowpox about
the same time, both inoculations proved effective. There was a
pustular eruption on the skin from the smallpox, and the cowpox
vesicle reached maturity in the usual number of days.

2. These effects took place, without much variation, in all cases
where the interval between the two inoculations did not exceed a
week; but--

3. When the smallpox matter was inserted on the ninth day after
the inoculation with cowpox, its action seemed to be wholly
precluded.[110]

That is to say, for a time--until the influence of the vaccine
fever had worn off. Some fancied that smallpox when inoculated
with cowpox generated a hybrid pox that was more efficacious than
either. There was occasionally some interaction of the diseases,
as of a subdued activity in each, but generally they proceeded
together unaffected, the cowpox maintaining its characteristics in
the midst of a crop of smallpox.

One point of great significance in Woodville’s experience was
overlooked. He inoculated with cowpox in the Smallpox Hospital, and
some of his patients there contracted smallpox, who certainly were
not inoculated with smallpox, either accidentally or by design.
The lesson of this experience was unperceived, and though it has
been repeated again and again, is rarely acknowledged. Vaccination
in presence of smallpox, or in an epidemic of smallpox, is often a
means of inducing the disease it is intended to prevent. It lights
the fire; and when the fire is lighted, it is said, “Ah! it must
have been a-light before.” When we have a mind for an excuse, our
sophistry is usually equal to the requisition.

The New Inoculation, as it was called, grew in favour daily.
Woodville and Pearson did the real work of publicity and
promotion--Pearson especially. Within seven months, January
to August, 1799, they performed 2000 inoculations. In the
_Philosophical Journal_, August, 1799, Pearson observed--

  In Scotland the New Inoculation has not been less successful. Dr.
  Anderson, of Leith, informs me that he has inoculated above 80
  persons; that Dr. Duncan has begun the practice in Edinburgh and
  that it has been introduced in Dundee, Paisley, and Dalkeith.

Nor did Pearson limit his efforts to his native land. He wrote--

  In the course of the same year, 1799, I extended the
  dissemination of the vaccine matter to Germany, for the Princess
  Louisa at Berlin, to Hanover, Vienna, Geneva, Lisbon, Paris, and
  Boston, and into the British Army through Mr. Keats.

Jenner regarded much of this activity with a jealous eye: it did
not sufficiently make for his glory. He was anxious, fretful,
helpless. “It is impossible for me, single-handed, to combat all my
adversaries,” was his whine. “I am beset on all sides with snarling
fellows, and so ignorant withal that they know no more of the
disease they write about than the animals which generate it.” In
order to keep his name to the fore, he published a second pamphlet
in the spring of 1799, in which are several details of biographical
interest.


FOOTNOTES:

[106] _Reports of a Series of Inoculations for the Variolæ Vaccinæ
or Cowpox._ London, 1799.

[107] J. C. Wachsel in _London Medical Repository_, 1819, p. 257.

[108] _Examination of Report of Committee of House of Commons_,
1802.

[109] _Further Observations on the Variolæ Vaccinæ_, 1799.

[110] _On Vaccine Inoculation._ By Robert Willan, M.D. London, 1806.




CHAPTER VI.

JENNER’S _FURTHER OBSERVATIONS_.[111]


This pamphlet appears to have been produced with many pains and
extraordinary apprehensions. Jenner wrote to Gardner, 7th March,
1799--

  Every sentence must be again revised and weighed in the nicest
  balance that human intellect can invent. The eyes of the
  philosophic and medical critic, prejudiced most bitterly against
  the hypothesis, will penetrate its inmost recesses, and discover
  the minutest flaw were it suffered to be present. Language I put
  out of the question: it is the matter I refer to.[112]

These words betray excitement for which there was no warrant; and
when we turn to the treatise that was to be weighed sentence by
sentence in the nicest of balances, it is clearly seen that its
author was a weak-minded creature. It is little more than a gossip
about Cowpox without advance upon the statements of the _Inquiry_.
Indeed, he sets out with the admission--

  Although it has not been in my power to extend the Inquiry into
  the causes and effects of the Variolæ Vaccinæ much beyond its
  original limits, yet, perceiving that it is beginning to excite
  a general spirit of investigation, I think it is of importance,
  without delay, to communicate such facts as have since occurred,
  and to point out the fallacious sources from whence a disease
  resembling the true Variolæ Vaccinæ might arise, with the view
  of preventing those who may inoculate from producing a spurious
  disease; and further, to enforce the precaution suggested in
  the former Treatise on the subject, of subduing the inoculated
  pustule as soon as it has sufficiently produced its influence on
  the constitution. (P. 69.)

Sometimes when it is objected that the evidence adduced in the
_Inquiry_ was hastily collected, meagre and inconclusive, it is
replied, “Yes, but recollect, it was merely a selection, if a poor
one, from the author’s stores”--a reply which Jenner thus renders
nugatory in recording--

  My late publication contains a relation of _most of the facts
  which had come under my own inspection at the time it was
  written_, interspersed with some conjectural observations--(P.
  70)--

Which is exactly what any perspicacious reader would infer from
the cases adduced in the _Inquiry_. They were Jenner’s best and
his all. Meanwhile, as observed, he had been able to do little in
extension of the Inquiry; but if idle and helpless, Dr. Pearson had
been active--

  Since then Dr. George Pearson has established an inquiry into the
  validity of my principal assertion, the result of which cannot
  but be highly flattering to my feelings. It contains [Pearson’s
  _Inquiry_] not a single case which I think can be called an
  exception to the fact I was so firmly impressed with--that the
  Cowpox protects the human body from the Smallpox. (P. 70.)

Here we have a distinct mis-statement. It was not Jenner’s “fact”
that Cowpox protected the human body from Smallpox--that was a
widespread superstition. His contribution to the question was
a definition of the Cowpox effective against Smallpox, namely
Horsegrease Cowpox, other Cowpox being adjudged spurious. Pearson
so far from confirming Jenner’s position, deliberately set it
aside. He not only accepted the rural faith in Cowpox (which Jenner
knew to be unwarrantable), but, when he proceeded to practice,
made use of Cowpox which owed nothing to Horsegrease. If therefore
Pearson’s procedure was “highly flattering” to Jenner’s feelings,
he was either easily pleased, or an adept in dissimulation.

The truth is, the publication of _Further Observations_ was
designed by Jenner to loosen himself from what was definite in
the _Inquiry_, so that he might be able to appropriate whatever
might result from the investigations and experiments then going
on. He had defined prophylactic Cowpox as Horsegrease Cowpox, but
Horsegrease did not meet with favour, nor appear likely to answer;
and it might be expedient to drop it; and thus he described the
ground of his attachment to that form of specific--

  Firstly.--I conceived that Horsegrease was the source of Cowpox
  from observing that where the Cowpox had appeared among the
  dairies here [Berkeley] (unless it could be traced to the
  introduction of an infected cow or servant) it had been preceded
  at the farm by a Horse diseased in the manner described, which
  Horse had been attended by some of the milkers.

  Secondly.--From its being a popular opinion throughout this great
  dairy country, and from its being insisted on by those who here
  attend sick cattle.

  Thirdly.--From the total absence of the disease in those
  countries where the men servants are not employed in the dairies.

  Fourthly.--From having observed that morbid matter generated by
  the Horse frequently communicates, in a casual way, a disease to
  the human subject so like the Cowpox, that in many cases it would
  be difficult to make the distinction between one and the other.

  Fifthly.--From being induced to suppose from experiments, that
  some of those who had been thus affected from the Horse resisted
  the Smallpox.

  Sixthly.--From the progress and general appearance of the pustule
  on the arm of the boy whom I inoculated with matter taken from
  the hand of a man infected by a Horse; and from the similarity to
  the Cowpox of the general constitutional symptoms which followed.
  (P. 91.)

The boy inoculated with secondary Horsegrease was Baker, Case
xviii. of the _Inquiry_. He died of fever in the parish workhouse
before he could be subjected to the variolous test.

Jenner’s drift in the foregoing propositions was obviously to
lighten his responsibility for the advocacy of Horsegrease as
the origin of Cowpox; but in doing so he deprived himself of
any vestige of claim as a discoverer. Cowpox and Horsegrease
as preventives of Smallpox were in common repute; but their
combination as Horsegrease Cowpox was supposed by some to be
Jenner’s peculiar specific. “Not so,” he said. “It is the
popular opinion throughout the country that Cowpox is begotten
of Horsegrease;” and proceeded to justify his prescription by
the popular authority. He produced a letter from Parson Moore of
Chalford Hill to prove how in November, 1797, his Horse had the
Grease, with which his boy-servant infected the Cow, which in turn
infected the lad with Cowpox, although eighteen months before he
had been inoculated, and severely too, with Smallpox; the parson
adding--

  I am firmly of opinion that the disease in the heels of the
  Horse, which was a virulent Grease, was the origin of the
  Servant’s and the Cow’s malady. (P. 94.)

To the objection that attempts to raise Cowpox from Horsegrease
had, so far, proved failures, Jenner replied--

  The experiments published by Mr. Simmons of Manchester and others
  on the subject, with the view of refuting the origin of Cowpox
  in Horsegrease, appear to have but little weight, as even the
  Cowpock Virus itself, when repeatedly introduced into the sound
  nipples of Cows by means of a lancet, was found to produce no
  effect. (P. 93.)

Having reached this point, I would beg the reader to pause and
ask, What was Jenner’s discovery? It was not Cowpox; it was not
Horsegrease; it was not Horsegrease Cowpox; all of which by his
own admission were recognised by those familiar with them as
preventives of Smallpox. What was it then?

Nothing is more conspicuous in the _Further Observations_ than the
condition of ignorance and imbecility they reveal. As we have seen,
critics of the order of Mr. John Simon represent Jenner’s _Inquiry_
as a Masterpiece of Medical Induction, the fruit of thirty years
of incessant thought, observation and experiment; whilst the
patience, the caution, and the modesty of the author are commended
for imitation. Those who have been subjected to Mr. Simon’s homily
cannot but suffer disenchantment when they come face to face with
the facts. Not after his thirty years of asserted research could
Jenner answer the simple question, What is Cowpox? Incredible as it
may appear, the following was his deliverance in presence of the
doubts excited by the discussion of his original communication--

  To what length pustulous diseases of the udder and nipples of the
  Cow may extend, it is not in my power to determine; but certain
  it is, that these parts of the animal are subject to some variety
  of maladies of this nature; and as many of these eruptions
  (probably all of them) are capable of giving a disease to the
  human body, would it not be discreet for those engaged in this
  investigation to suspend controversy and cavil until they can
  ascertain with precision what _is_ and what _is not_ the genuine
  Cowpox? Until experience has determined which is the _true_
  Cowpock, and which is _spurious_, we view our object through a
  mist. (P. 73.)

Consider this declaration after thirty years of incessant thought,
observation and experiment! The Masterpiece of Medical Induction
with the essential fact undetermined! The discovery undiscovered!
And the reputed discoverer sitting ready to appropriate any praise
or profit from the execution by others of his proper business! Was
there ever such an exhibition of self-satisfied futility?

Among the gossip adduced to show that the country folk called
eruptions Cowpox that were not Cowpox, we learn that the affection
induced by Horsegrease was thus designated--

  From the similarity of symptoms, both constitutional and
  local, between the Cowpox and the disease received from the
  morbid matter generated by a Horse, the common people in this
  neighbourhood, by a strange perversion of terms, frequently call
  it the Cowpox. (P. 95.)

Wherefore, he argued, many thus affected may fancy themselves
secure from Smallpox, supposing they have suffered Cowpox, when
they have undergone nothing but Horsegrease; and in the event
of incurring Smallpox, would bring discredit on the virtue of
true Cowpox. How easy it was to confound the two diseases, he
illustrated from the case of William Morris, a servant, aged 32,
who applied to him on 2nd April, 1798--

  His symptoms and the sores on his hands were so exactly like the
  Cowpox, that I pronounced he had taken the distemper from milking
  Cows. He assured me he had not milked a Cow for more than half
  a year, and that his master’s Cows had nothing the matter with
  them. I then asked him if his master had a Greasy Horse, which
  he answered in the affirmative; and further said, that he had
  constantly dressed him twice a day for the last three weeks or
  more, and remarked that the smell of his hands was much like that
  of the Horse’s heels. (P. 97.)

Thus Horsegrease sores so simulated those of Cowpox, or of
Horsegrease Cowpox, as to be indistinguishable from them. At this
time it was Jenner’s opinion that Horsegrease, _per se_, afforded
no protection from Smallpox: it had to pass through the Cow to
acquire its sovereign efficacy. The opinion is noteworthy in view
of its absolute surrender at a later period, when the virus from
the Horse’s heel came to be described by him as “the true and
genuine life preserving fluid,” and was used by him for inoculation
without any reference to the Cow.

One of the aims of _Further Observations_ was “to enforce the
precaution of subduing the inoculated pustule as soon as it had
sufficiently produced its effect on the constitution.” True
Cowpox, according to Jenner, was a serious affection. “The sores
ate into the flesh.” (P. 77.) They were capable of producing
violent effects. They were attended with erysipelas. “They closely
resembled Smallpox of the confluent sort.” (P. 111.) To prolong
such suffering he considered useless, for the virus conferred its
protective influence on the constitution as soon as received--

  The symptoms which (as in the accidental Cowpox) affect the
  patient with severity, are entirely secondary, excited by the
  irritating processes of inflammation and ulceration; and it
  appears to me this singular virus possesses an irritating quality
  of a peculiar kind; but as a single Cowpox pustule is all that is
  necessary to render the variolous virus ineffectual, and as we
  possess the means of allaying the irritation, should any arise,
  it becomes of little or no consequence. (P. 110.)

The means for allaying the irritation were mercurial ointment,
acetate of lead, caustic potash, or any suitable escharotic--

  After the pustule has duly exerted its influence, I should prefer
  the destroying it quickly and effectually to any other mode.
  The term caustic to a tender ear (and I conceive none will feel
  more interested in this Inquiry than the anxious guardians of a
  nursery) may sound harsh and unpleasing, but every solicitude
  that may arise on this account will no longer exist when it is
  understood that the pustule in a state fit to be acted upon is
  then quite superficial, and that it does not occupy the space of
  a silver penny. (P. 104.)

  I would not, however, recommend any application to subdue the
  action of the pustule until convincing proofs had appeared of
  the patient having felt its effects for at least twelve hours.
  No harm indeed could ensue were a longer period to elapse before
  the application was made use of. In short, the pustule should be
  suffered to have as full an effect as it could, consistently with
  the state of the arm. (P. 109.)

Horsegrease annoyed Pearson--it was like to damn the whole thing;
and this treatment of the Cowpox pustule was scarcely less
objectionable to him and to Woodville.[113] It gave the public,
they thought, a sense of the virulence of Cowpox that was wholly
unwarrantable; and they did not stay to consider whether what
Jenner called Cowpox in Gloucestershire and what they called Cowpox
in London were the same virus. Jenner’s virus was Horsegrease
Cowpox; Pearson and Woodville’s was Cowpox; and such being the
case, the diversity of symptoms might have been accounted for.
Anyhow, the difference between Jenner and Pearson and Woodville, as
to a detail so elementary, shows in what an unfinished condition
the Cowpox prescription was shot upon the world, and affords
a curious commentary on the Masterpiece of Medical Induction,
the fruit of thirty years of incessant thought, observation and
experiment. At the same time we have to do Jenner the justice of
allowing that at this date, 1799, he made no pretence to a finished
Masterpiece, but ingenuously ascribed the prevalent uncertainty
to “the present early stage of the Cowpox Inquiry; for early,” he
wrote, “it must be deemed.” (P. 115.) Early it was: not a point
firmly determined: the reverse of what might have been expected
after thirty years of incessant thought, observation and experiment.


FOOTNOTES:

[111] _Further Observations on the Variolæ Vaccinæ._ By Edward
Jenner, M.D., F.R.S. London, 1799. 4to pp. 73. Reprinted with
the third edition of the _Inquiry_ in 1801, to which edition my
references apply.

[112] Baron’s _Life of Jenner_, vol. i. p. 322.

[113] Baron’s _Life of Jenner_, vol. i. p. 315.




CHAPTER VII.

OPERATIONS IN LONDON, 1800.


Dr. Pearson was the chief actor in the formation of--

    _The Institution
    for the Inoculation of the Vaccine Pock,
    Warwick Street, Charing Cross.
    Founded 2nd December, 1799._

In April, 1801, the Institution was removed to a more commodious
house, 5 Golden Square. It was the first establishment of the kind
in the world. In the conspectus of the Institution it was stated--

  Of above 4000 persons who have had the inoculated Cowpock one
  only has died. There is, however, good ground for believing that
  the proportional mortality will be even less than here stated.

  Not a single well-attested instance has been produced among
  more than 2000 inoculated with Cowpock, and subsequently with
  Smallpox, of the Smallpox being taken, although many were exposed
  to the infectious effluvia of that disease. Traditionally the
  fact is established from time immemorial that after Cowpox there
  is no Smallpox.

  It may be fairly affirmed, that the inoculated Cowpock is
  generally a much slighter disease than the inoculated Smallpox;
  and that the proportion of severe cases in the latter is to the
  former as at least ten to one.

  It does not appear the genuine Vaccine Pock can be propagated
  like the Smallpox by effluvia from persons labouring under it.
  Hence if the Vaccine Inoculation should be universally instituted
  in place of the Smallpox, it is reasonable to conclude, that this
  most loathsome and fatal malady will be extinguished; and, like
  the Sweating-Sickness, the Plague, certain forms of leprosy,
  etc., be known in this country only by name.

  It does not appear that the Vaccine Poison, like that of the
  Smallpox, can be conveyed so as to produce the disease indirectly
  from diseased persons, by adhering to clothes, furniture,
  bedding, letters, etc. Hence no danger of its propagation in
  these channels is to be apprehended from the universal practice
  of the inoculation of the Cowpock.

  It has been found that a person, whose constitution has
  distinctly undergone the Vaccine Disease, is in future
  insusceptible of the same disorder. [_Thus re-vaccination was
  treated as impossible._]

  Experience shows, that there is no reason to apprehend the
  smallest chance of deformities of the skin from the Vaccine
  Inoculation.

  The extensive practice of the Vaccine Inoculation in the present
  year, and the accounts of the disease in the casual way do not
  show that any other disease will be excited subsequently.

  A further considerable public benefit expected is, that a stock
  of efficacious Vaccine Matter, _free from contamination by the
  Smallpox_, will by this Institution be preserved for the use of
  the public.

These statements are interesting as showing how early the
rollicking tunes were set to which at this day we are expected
to dance. The last paragraph is noteworthy as a confession
under Pearson’s hand that vaccine poison had got confused with
variolous, and that the mistake would henceforth be avoided.
Jenner maliciously and persistently used this mishap, for which
Woodville was responsible, to discredit Pearson and magnify his
own pretensions; but, as Pearson observed, neither Jenner nor any
one else knew that it was possible to have cowpox and smallpox
simultaneously. The mistake was made, however; and, as is the
function of mistakes, knowledge was enlarged. Pearson’s behaviour
in the matter was as creditable to him as Jenner’s was otherwise.

The Vaccine Pock Institution was organised with a staff of
physicians, surgeons, and apothecaries of the highest London
respectability; and as it was desired to have the benefit
of Jenner’s name (his active co-operation, as a resident in
Gloucestershire, being out of the question) Pearson wrote to him--

    LONDON, _10th December, 1799_.

  We have made some progress in the institution of a charity for
  inoculating the Vaccine Pock. I do not know that I can confer any
  honour on you by proposing you (if I am able) to the directors of
  our establishment, nor do I well know what to propose to you. It
  occurs to me that it might not be disagreeable to you to be an
  extra corresponding physician.

  No expense will be attached to your situation except a guinea a
  year as a subscriber; and indeed I think you ought to be exempt
  from that, as you cannot send any patients: but you may depute
  some proxy in town.

  I confess I was surprised that you neither called nor sent for me
  for the last _two_ months you were in town. However, if it was
  because you were too much occupied, I certainly excuse you.

The invitation was given stiffly, from duty more than inclination.
Pearson knew very well why Jenner, furious with jealousy, had kept
away from him; and he was thus answered--

    BERKELEY, _17th December, 1799_.

  SIR,--I received your letter of the 10th instant, and confess I
  felt surprised at the information it conveys.

  It appears to me somewhat extraordinary that an institution
  formed upon so large a scale, and that has for its object the
  inoculation of the Cowpox, should have been set on foot and
  almost completely organised without my receiving the most distant
  intimation of it. The institution itself cannot, of course, but
  be highly flattering to me, as I am thereby convinced that the
  importance of the fact I imparted is acknowledged by men of the
  first abilities. But at the same time allow me to observe that
  if the Vaccine Inoculation, from unguarded conduct, should sink
  into disrepute (and you must admit, Sir, that in more than one
  instance has its reputation suffered) I alone must bear the
  odium. To you, or any other of the gentlemen whose names you
  mention as filling up the medical departments, it cannot possibly
  attach.

  At the present crisis I feel so sensibly the importance of the
  business that I shall certainly take an early opportunity of
  being in London. For the present I must beg leave to decline the
  _honour_ intended me.--I remain, Sir, your obedient Servant,

    E. JENNER.[114]

Pearson’s reply to this absurd and thoroughly Jennerian letter
does not appear. He might have thanked Jenner for having drawn
his attention to cowpox, and have proceeded to point out that
beyond that service he and his friends owed him nothing, nor in
anywise admitted his guardianship. Their practice was at complete
variance with his teaching. He had prescribed horsegrease cowpox
in which they had no faith, having tried to produce it in vain. On
the other hand, they were operating with cowpox _per se_, which
he had condemned as useless, being attended with no erysipelas
or constitutional effect; and that working with this condemned
cowpox, they found themselves producing a much milder disease, and
were under no necessity of following his advice and destroying
the pustule formed at the point of inoculation with escharotics;
adding, that if they had been bound to his horsegrease and
caustics, they would have made no progress with the public whatever.

Vaccine Inoculation might be good for mankind, but it was to
be something better for Edward Jenner. There was not the least
reason, outside his jealousy and rapacity, why he should not
have congratulated Pearson on his enterprise and promised his
assistance. As to claiming the guardianship of Vaccine Inoculation,
it was preposterous: it had passed wholly beyond his control. It
was Pearson’s complaint that Jenner never did anything useful after
the publication of _The Inquiry_. He left to others the discovery
of virus, and the labour and responsibility of experimenting, and
only appeared on the scene when there was some disaster whereat
he could play the part of superior person, whilst insisting that
all supposed improvements and successes should be assigned to his
credit.

Jenner is all-in-all in the vaccinators’ hagiology, but he holds
the place at the cost of justice to Pearson and Woodville. To prove
that I am not making a fanciful assertion, let me cite unprejudiced
contemporary evidence. Dr. Paterson of Montrose in a communication
to the _Medical and Physical Journal_, dated 25th May, 1801,
observed--

  While we are irresistibly led to join the wondering, the grateful
  throng, in paying the just tribute of applause to Dr. Jenner,
  the immortal discoverer, we must, at the same time, confess how
  much we are indebted to the ingenious and benevolent Dr. Pearson
  for bringing, in such a handsome manner as he did, the business
  before the public; thereby exciting, all at once, a universal,
  an unparalleled quest of investigation, and furnishing, by
  innumerable and satisfactory experiments, a complete confirmation
  of the noble discovery.

Here, we may observe afresh, that Pearson did not confirm Jenner’s
“noble discovery.” On the contrary, his use of cowpox was at
distinct variance with Jenner’s prescription of horsegrease cowpox,
and with his condemnation of cowpox. Jenner, as we shall see,
followed Pearson: Pearson did nothing to confirm Jenner.

Woodville lent his powerful influence as head of the Smallpox
Hospital to establish the New Inoculation. He put Jenner’s
prescription to the test with perfect sincerity and admirable
courage, suffering himself to be thrice inoculated with horsegrease
in order to come at the truth;[115] and only resorted to cowpox
when he found horsegrease cowpox unattainable. Mr. Anthony
Highmore, surgeon, speaking over Woodville’s grave in 1805,
exclaimed--

  Who that have felt the benefits of Vaccination will not teach
  their children, and their children’s children, to bless the name
  of Woodville when they bless the name of Jenner.

Yet Pearson and Woodville, who made the New Inoculation practical
and practicable, were pursued by Jenner with implacable animosity,
stigmatising their mishaps and appropriating their apparent
successes.

To publish a pamphlet for the detraction of Woodville, and if
possible to upset Pearson’s Vaccine Pock Institution, Jenner left
Berkeley for London on 28th January, 1800, taking Bath on his way,
where also a Vaccine Pock Institution was in progress.

Early in 1800 appeared _A Continuation of Facts and Observations
relative to the Variolæ Vaccinæ_--a quarto of 40 pages, Jenner’s
third pamphlet. Like its predecessor, a trumpery collection of
gossip, it was designed to manifest his advantage over Woodville,
who had inadvertently confused cowpox with smallpox in his
inoculations at the Hospital.

First, Jenner expressed satisfaction over the interest of Europe in
Cowpox Inoculation--

  I have the pleasure, too, of seeing that the feeble efforts of a
  few individuals to depreciate the new practice are sinking fast
  into contempt beneath the immense mass of evidence which has
  risen up in support of it.

He then went on to describe the accumulating mass of evidence--

  Upwards of six thousand persons have now been inoculated with
  the virus of Cowpox, and the far greater part of them have
  since been inoculated with that of Smallpox, and exposed to its
  infection in every rational way that could be devised, without
  effect.

“True,” Pearson might have observed, “but who inoculated the
vast majority of the six thousand? Nor were they inoculated with
the horsegrease cowpox you prescribed, but with the cowpox you
condemned.”

The introductory reference to Woodville revealed Jenner’s
disposition and tactics--

  It was very improbable that the investigation of a disease so
  analogous to the Smallpox should go forward without engaging the
  attention of the Physician of the Smallpox Hospital in London.

  Accordingly, Dr. Woodville, who fills that department with so
  much respectability, took an early opportunity of instituting an
  inquiry into the nature of the Cowpox. This inquiry was begun
  in the early part of 1799, and in May, Dr. Woodville published
  the result, which differs essentially from mine in a point of
  much importance. It appears that three-fifths of the patients
  inoculated were affected with eruptions, for the most part so
  perfectly resembling the Smallpox, as not to be distinguished
  from them. On this subject it is necessary that I should make
  some comments.

Woodville, whose experiments were as a hundred to one of his
patronising critic, and informed with purpose too, must have
received this languid commendation of his country acquaintance
with some surprise, if not with fierier sentiment. Jenner as
an investigator was never of much account. Of what constitutes
scientific demonstration, he had little perception. Incapable and
indolent, he nevertheless was ambitious, and had the craft to
appropriate the research of others, and with assurance so ineffable
that even the plundered fell under the persuasion that what he
took was somehow his own. For example, the occurrence of smallpox
and cowpox simultaneously in Woodville’s practice, which he had
not foreseen, nor could any foresee, he first used as a pretext
for lofty reprehension toward Woodville, and then converted into
evidence of his own prescience, saying--

  In my first publication I expressed an opinion that the
  Smallpox and the Cowpox were the same disease under different
  modifications. In this opinion, Dr. Woodville has concurred. The
  axiom of the immortal Hunter, that two diseased actions cannot
  take place at the same time in one and the same part, will not be
  injured by the admission of this theory.

Mark the adroit oblivion and the adroit attachment. It was
horsegrease that he assumed to be the origin of smallpox through
cowpox; and the cowpox used by Woodville was Jenner’s condemned
cowpox, underived from the horse; yet the inconvenient was passed
over, and the convenient assumed!

Possibly cowpox and smallpox are forms of the same disease:
possibly they are not: possibly all diseases are forms of one
disease: possibly they are not: but whatever the fact, Jenner had
not an iota of evidence to adduce for his conjecture that grease
in horses, and pox from that grease in cows, was a modification of
smallpox in men.

As we review these early days of the New Inoculation, nothing so
stirs regret as what appears to have been the wilful shutting
of men’s eyes to facts--to notorious facts. It was well known
in Gloucestershire, that whilst the vulgar supposed that cowpox
prevented smallpox, it did not do so. Indeed, it was under stress
of this knowledge that Jenner rejected cowpox _per se_ for
horsegrease cowpox. In the _Gloucester Journal_ of 9th May, 1799,
Mr. C. Cooke wrote--

  I not only very much doubt that the Cowpox is a permanent
  preventive of Smallpox, but I am confirmed in this opinion by
  occurrences in my own practice, by conversing with many medical
  men on the subject, and by Dr. Beddoes, who writes, “I have a
  case where the Smallpox was taken after the Cowpox had been twice
  gone through.”[116]

Yet in presence of such testimonies, which were neither examined
nor exploded, Jenner prophesied in this strain--

  Some there are who suppose the security from the Smallpox
  obtained through the Cowpox will be of a temporary nature. This
  supposition is refuted, not only by analogy with respect to
  diseases of a similar nature, but by incontrovertible facts,
  which appear in great numbers against it. A person had the
  Cowpox 53 years before the Smallpox was tried upon him, and as
  he completely resisted it, I conceive every reasonable mind must
  be satisfied that he was secure from the disease during the
  intervening time.

Such was the evidence that he thought should satisfy every
reasonable mind! How did he know that the said person had cowpox
53 years before, or had the right sort of cowpox, and in the
right way? Inoculation with smallpox was continually unsuccessful
(without reference to cowpox as cause of failure) and especially
among elderly folk. When, however, there is a disposition to
believe, the most indifferent reasons serve for conviction.

Cowpox and Smallpox, said Jenner, were modifications of the same
disease; and Smallpox, whether contracted or inoculated, was
a well-known excitant of scrofula; and Jenner was inclined to
consider it probable that “the general introduction of the Smallpox
into Europe had been among the most conducive means in exciting
that formidable foe to health.” Then, it might be said, Cowpox as a
modification of Smallpox must be liable to the like objection. “Not
at all!” protested the smooth-spoken adventurer. “The diseases are
the same, but unlike in the excitation of scrofula”--

  Having attentively watched the effects of the Cowpox in this
  respect, I am happy in being able to declare, that the disease
  does not appear to have the least tendency to produce this
  destructive malady.

Considering his limited experience, the asseveration as to the
non-excitation of scrofula was sheer quackery, and of a piece with
the wilder assurance that follows. In 1798 he had set forth cowpox
as a useful alternative to smallpox for inoculation; but in 1800
the claim was thus magnified--

  When scrutiny has taken place, not only among ourselves, but in
  the first professional circles in Europe, and when it has been
  uniformly found in such abundant instances--

  _That the Human Frame when once it has felt the influence of
  the genuine Cowpox is never afterwards, at any period of its
  existence, assailable by the Smallpox_,

  May I not with perfect confidence congratulate my country and
  society at large on their beholding in the mild form of the
  Cowpox, an antidote that is capable of extirpating from the earth
  a disease which is every hour devouring its victims; a disease
  that has ever been considered as the severest scourge of the
  human race!

It is unnecessary to discuss these wild words--it is sufficient to
record them as evidence of what it was possible to assert in the
year 1800--and assert, too, whilst as yet the Cowpox that was to
work the miracle was one thing in the hands of Jenner, and another
in those of Pearson and Woodville!

The pamphlet published, Jenner’s other business in London was to
undermine the institution for Vaccine Pock Inoculation. He went
about insinuating and protesting that its founders and officers
neither knew what was true Variolæ Vaccinæ, nor how to use it;
that not only were they ignorant, but perverse; and that the
immeasurable blessing he had been the means of conveying to mankind
would never be rightly enjoyed until there was an Institution with
Edward Jenner for its guide and director.

In playing this game Jenner had facilities and advantages. No one,
not Pearson himself, contested his position as advertiser of the
New Inoculation, and to the public he was its representative. He
had attempted nothing and had no mishaps to account for: these
attached to Woodville and other credulous and active experimenters.

Moreover he had no awkward information to contend with in those he
addressed--they listened, were informed, were convinced. Jenner’s
conduct at this juncture, in relation to Pearson and Woodville,
has been stigmatised as mean, thankless, despicable. These be hard
words. His tactics were the common tactics of men in whom self-love
is predominant, and we have not the strength for the use of the
appropriate epithets with the frequency that experience requires.

The poor were the chief sufferers from smallpox, and under the name
of the poor Jenner advanced his project. He drew up the following
memorandum, which he submitted to the Earl of Egremont, and
circulated privately--

  PROPOSAL FOR A PUBLIC INSTITUTION FOR VACCINE INOCULATION.

  Having now pursued the inquiry into the nature of the Cowpox to
  so great an extent as to be able positively to declare that those
  who have gone through this mild disease are rendered perfectly
  secure from the contagion of the Smallpox; and being convinced
  from numberless instances that the occupations of the mechanic or
  the labourer will meet with no interruption during its progress,
  and the infected and uninfected may mingle together in the most
  perfect safety, I conceive that an Institution for the Gratuitous
  Inoculation of the lower classes of society in the Metropolis
  would be attended with the most beneficial consequences, and that
  it might be so constituted as to diffuse its benefits throughout
  every part of the British Empire.

    EDWARD JENNER.

  London, 16th March, 1800.

Then followed a scheme of the Institution, including “a Physician
to be appointed to superintend the medical department.”

Whether from Jenner’s practical inefficiency, or because the time
was not ripe, or because those who were more actively interested in
cowpox were satisfied with Pearson’s Institution, the project lay
in abeyance till 1803. He took nothing ostensibly by his intrigue
save the withdrawal of the names of the Duke of York and Lord
Egremont from the patronage of the existing establishment.

Meanwhile Pearson continued to operate with unabated energy, and
his Institution became a recognised centre of inquiry, advice,
and supply. It was designed, as he wrote, “1st, to be useful to
the poor; but it had other objects, to wit, 2ndly, to ascertain
the laws of the new poison for the extinction of smallpox; and
3rdly, to serve as a public office for the supply of the world with
virus until supplies should become unnecessary.” One of the most
flattering applications was received by Pearson from the French
Consulate on 5th April, 1800. In a reply, dated 12th May, signed by
the staff of the Institution, it was said--

  We are not surprised that you have not yet found the disease
  among the cows of France, it being on the whole a rare disease in
  England; nor are we surprised at your want of success with the
  matter sent to you, because from experience we know that it very
  frequently fails, unless used immediately from the subject.

  Vaccine matter may be conveyed in various ways: we have sent it
  to you in three, namely, on threads, on lancets, and on glass.

  If you try the matter sent on thirty patients immediately, we
  think you cannot fail to excite the disease in some of them, and
  then you will please to preserve the succession by inoculation
  as we do in England, having had no fresh matter from the cow
  since January and February of last year, 1799.

The Frenchmen failed again with this virus, but Dr. Woodville soon
after went to Paris, and effected what was desired.

Cow-Pock Dispensaries were opened in various towns throughout
England, Bath and Manchester perhaps having the lead; and an
Address to the Poor was drawn up as a common form to be issued from
such Dispensaries. In a copy of this Address, widely circulated in
and around Manchester in 1800, we read--

  The experience of several years has fully proved that inoculation
  for the Cowpox is _a certain preservative_ against the Smallpox;
  and is, besides, so mild and safe a disorder, when compared with
  the inoculated Smallpox, that it has been generally introduced
  among the better informed and more wealthy inhabitants, both of
  this kingdom and of various parts of Europe.

  Inoculation for the Cowpox has been practised for several years
  [_less than three_] with constant success, in various parts of
  the Kingdom.

  It has never failed to prevent the infection of the natural
  Smallpox.

  It may be communicated with safety to persons of every age
  and sex, and at all times and seasons of the year, with equal
  advantage.

  It does not produce eruptions, which scar and disfigure the face;
  and it is seldom, if ever, attended with any other marks of the
  disease than what appear on the arms from inoculation.

  So far from proving hurtful, delicate and sickly children are
  often improved in health by having passed through this complaint.

  Scarcely any remedies or attendance are required for the Cowpox,
  nor is there any necessity for a course of physic before or after
  the inoculation.

  The prejudices of the poor against inoculation for the Smallpox,
  by which thousands of lives have been annually saved,[117]
  have been often lamented; but if they suffer unjust prejudices
  to prevent their laying hold of the advantages now offered to
  them by the inoculation of the Cowpox, they will neglect the
  performance of a duty they owe to themselves, to their families,
  and to society at large. For surely it is little less than
  criminal to expose their helpless children to the attack of so
  terrible and fatal a malady as Smallpox when it may be readily
  avoided by the inoculation of so mild, simple, and safe a disease
  as that of the Cowpox.

  N.B.--All poor persons, whose affection for their families
  leads them to embrace this favourable opportunity, may have
  their children inoculated for the Cowpox at the Hospital and
  Dispensaries every day in the week (Sunday excepted) throughout
  the year. No time ought to be lost by the poor in freeing their
  families from the apprehension of the Smallpox, _which daily
  increases in frequency and malignity throughout this town_.

This manifesto is an illustration of the unscrupulous and
unwarrantable assertions with which the New Inoculation was
introduced to the world. There is no question that many who were
active in circulating these mendacities did so honestly, justified,
as they thought, by medical authority. What is marvellous is the
survival of the primitive fictions to the present day. It would
seem that when the human mind acquires a certain _set_, something
like a surgical operation is requisite to reverse it.

We shall now see how the New Inoculation obtained this sudden
popularity--a popularity so sudden that opposition had not time to
organise itself. There were protests, and some raillery. In the
_Gentleman’s Magazine_ for August, 1799, we find a correspondent
saying--

  There is a plan to mitigate Smallpox in the human species by
  passing it through a Cow. Now as everyone is not in possession
  of a Cow, I propose to pass it through animals that most people
  possess. I mean Cats; and I shall call it the Catpox. When my
  plan is matured, the ingenious shall hear further concerning it.

And Pearson writing in 1802, when the success of cowpox appeared
secure, observed--

  How the new practice was sneered at by some: how it was
  reprobated as a gross and mischievous imposition: how it was
  stigmatised with the appellation of the Gloucestershire bubble:
  and how the Inquirers were considered by many persons as fit
  candidates for a certain asylum: to say nothing of the villainous
  jests made on the occasion, are recent in our memory.[118]


FOOTNOTES:

[114] Baron’s _Life of Jenner_, vol. i. p. 360.

[115] _Rees’s Cyclopædia_, vol. 38. London, 1819. The writer of the
article himself inoculated Woodville with the Grease.

[116] Mr. Cooke’s letter was reprinted in the _Medical and Physical
Journal_, vol. i. p. 322. London, 1799.

[117] By and by controversy with the Smallpoxers waxed hot, and
then the Cowpoxers averred that thousands of lives were annually
_lost_ by their practice.

[118] _Examination of Report of Committee of House of Commons._
London, 1802.




CHAPTER VIII.

TRIUMPH OF THE NEW INOCULATION.


The House of Hanover has been reproached for indifference to
literature, science and art, but an exception might be asserted on
the score of variolous and vaccine inoculation. It was Caroline,
Princess of Wales, who in 1721 promoted Maitland’s experiments;
and Jenner found none so ready to hear and believe as George
III. and his family. His first convert was the Duke of Clarence,
subsequently William IV. The Duke’s surgeon happened to be Francis
Knight, who had lived in Wilts and Gloucestershire, and was
familiar with the country faith in cowpox, and received Jenner’s
communication with a ready mind. In 1799 Knight was allowed to
operate upon the Duke’s children by Mrs. Jordan, and the fact was
noised abroad and passed to Jenner’s credit. Nor was the Duke’s
service limited to this example. He made Jenner’s acquaintance,
listened to his stories, and became his active partizan. Then the
Duke of York, commander-in-chief of the army, was convinced, and
enforced the new practice to the full extent of his power. He,
moreover, acted as patron of the Vaccine Pock Institution until he
was persuaded that Pearson, its founder, was injurious to Jenner.
On 7th March, 1800, Jenner was presented to George III. at St.
James’s Palace, and delivered _The Inquiry_ bound in crimson to his
majesty, who was pleased to accept the dedication of the second
edition. On the 27th he had an interview with Queen Charlotte,
who conversed about the new specific with all the curiosity of
a grand-motherly quack. The Prince of Wales followed suit; and
Jenner found himself invested with the full effulgence of the royal
favour. It was a magical success; for, consider, not two years had
elapsed since the publication of _The Inquiry_.

Jenner naturally became very popular. He wrote to Mr. Shrapnel--“I
have not yet made half my calls in town, although I fag from
eleven till four;” and, “Pray tell Tierney how rapidly the Cowpox
is marching over the metropolis, and indeed through the whole
island. The death of three children under inoculation with smallpox
will probably give that practice the Brutus-stab.”

With little ability to make and maintain ground, Jenner, like many
feeble folk, had the faculty of converting those he called his
friends to his private advantage. He did not subdue them by will,
but by weakness. Indeed, whoever chooses to observe will often have
to mark with amaze how stronger natures suffer their means and
energies to be appropriated by inferior organisms, and used with
the thanklessness of rightful possession.

John Ring was a remarkable instance of this sort of possession.
He was a surgeon in New Street, Hanover Square, London. In 1799
he entered into correspondence with Jenner, and his interest in
cowpox and its advertiser developed into an enthusiasm without
qualification by weariness or fear. Whatever Jenner asserted he
swore to; whatever charge was brought against the New Inoculation
he denied. He was ready for all comers with such voluble and
hearty vigour that his outrages on propriety were laughed at and
excused as “John Ring’s way.” Among his earlier services was the
preparation of the Testimonial in favour of the New Inoculation
which he carried from house to house and obtained the signature
of nearly every London physician and surgeon of distinction. The
Testimonial was published in the _Medical Review_ and _Medical
Journal_ for July, 1800, and was reprinted in the newspapers. It
ran as follows--

  Many unfounded reports have been circulated, which have a
  tendency to prejudice the public against the Inoculation of the
  Cowpox: 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 future infection
  of the Smallpox, provided the infection has not been previously
  communicated.[119]

  We also declare that the inoculated Cowpox is a much milder and
  safer disease than the inoculated Smallpox.

The first signatures comprised thirty-two physicians and forty
surgeons, and the example being set, others hastened from town and
country to record their adhesion. “I feel proud,” wrote Mr. Witham
in sending his name, “that my little bark may, with others more
illustrious,

                                Attendant sail,
      Pursue the triumph, and partake the gale.”

The Testimonial had great effect on the public mind: to the
majority it was irresistible. As Ring said, “It confounded the
enemies of the new practice”--adding in his characteristic
vernacular, “and it secured the triumph of reason over the scruples
of prejudice and ignorance, and the base manœuvres of sordid and
self-interested men.”[120] Thus early was it discovered that an
opponent of Vaccination was an ignoramus or a rascal. Ring’s easy
arrogance is concisely illustrated in this deliverance--

  It is no want of candour to affirm that those who are hostile to
  Vaccine Inoculation, are total strangers to it; those who are
  doubtful, are almost total strangers to it; and I defy the whole
  world to produce one single instance of a person that has had any
  experience of the disease, who is not a decided friend to the
  practice.[121]

Jenner recognised his thorough-going supporter, and used his
loyalty to strike at Pearson and others who failed to abide in like
subservience. He wrote to a foreign physician--

  The discovery which I had the happiness to announce to the world
  is much indebted to Mr. Ring’s ardent zeal and indefatigable
  exertions for the rapid progress it has made; while some of
  those _who vainly conceived themselves instrumental in promoting
  its adoption_ have in reality from _their ignorance and
  indiscretion_, rather retarded than accelerated its progress.[122]

Wonder is frequently expressed over the rapid conversion of England
and the world to Vaccination, but, as I have before remarked,
wonder is much reduced when we set the circumstances clearly
before us. Inoculation with smallpox to avert smallpox was the
practice of the time, and it was not a universal practice simply
because it was troublesome and dangerous: everybody believed in
the saving rite; and where evaded it was as onerous and perilous
duties are always and everywhere evaded by the indolent and
cowardly. Inoculation with cowpox was introduced to the public
as a substitute for inoculation with smallpox, equally efficient
or more efficient, and neither troublesome nor dangerous. Thus
easy and seductive was the transition from the one practice to
the other. Jenner had no serious battle to fight: the contest
was decided in the years during which inoculation with smallpox
struggled for prevalence. The warfare that subsequently cost
him so much irritation was conducted by the conservatives of
Inoculation, as experience revealed the inefficiency and mischiefs
of Vaccination. Resistance such as is now offered to Vaccination on
physiological grounds there was none, so far as I can discover. It
had apparently occurred to no one that smallpox was a consequence
of the transgression of the laws of health, and was preventible by
submission to those laws. It was imagined that the disease came
by the will of God, or the devil, or by force of fate, and that
to dodge it by medical craft was the utmost that was practicable.
Unless we bear in mind these conditions of the public intelligence,
we shall misapprehend the demeanour of the people who so cordially
welcomed Jenner’s advertisement. It is always a mistake to
criticise the conduct of an earlier generation by the light of a
later. We turn history to ill account when we use it to nourish our
self-complacency; for the probability is that had we lived with our
forefathers, we should have done exactly as they did.

Some will ask, How did it ever come to pass that so many doctors
in 1800 signed Ring’s testimonial certifying that inoculation
with cowpox was a sure and everlasting protection from smallpox
when they had not, and could not have, any experience to warrant
their assertion? True, but they had an illusory experience by which
they were beguiled, namely, the Variolous Test. Hundreds were
inoculated with cowpox and subsequently with smallpox, and were
also exposed to smallpox contagion, and as the disease did not
take, it was concluded it could never take, and that the subjects
of the operation were fortified for ever. The fallacy is now
manifest, but it was by no means manifest in 1800, and all manner
of men received and propagated the fable with energetic sincerity.
It was once admitted that a tub full of water did not overflow when
a fish was slipped into it, and many explanations were current of
the curious phenomenon until a sceptical spirit suggested that the
experiment be tried. A like spirit might have suggested that it was
expedient to wait and see whether cowpox was indeed a perpetual
defence against smallpox, inasmuch as nature had an awkward habit
of confuting prognostications apparently irrefragable.

The ease with which it was asserted cowpox inoculation could be
performed, coupled with its harmlessness, not to say wholesomeness,
and the absolute security it afforded against smallpox, induced
benevolent busybodies to set up as vaccinators all over the
country. What the kindly quack delights in is something cheap and
handy with a touch of mystery and the promise of immeasurable
advantage--conditions which the new practice completely fulfilled.
The memoirs of the time, especially of the Evangelical party,
abound with instances in which this good soul and that good soul
had vaccinated so many hundreds or thousands, delivering them from
the peril of an awful disease. Thus in the _Gentleman’s Magazine_,
for December, 1800, we read--

  Two respectable families near Manchester have within these few
  months inoculated upwards of 800 of the neighbouring poor from
  two months old to twenty years with uniform success. Twenty of
  them were subjected to the variolous test, and all were found
  proof against the disease.

And John Ring relates--

  Dr. Jenner lately met in a large party of fashion a lady of
  Portman Square, who, with another lady, has inoculated 1300 in
  the north of England. The rural swain, when he receives the
  blessing of Jenner’s discovery from such a fair hand, must
  conclude that the Goddess of Health has adopted the practice.[123]

Of course medical practitioners had little favour for this sort
of intrusion into their domain, but Jenner encouraged and boasted
himself in the domestic diffusion of the discovery. By and by
when disasters became common it was found extremely convenient
to ascribe them to these unskilled operators; and ultimately
vaccination was resigned entirely to the legally qualified
practitioner, whose failures are rarely inquired into, and when
proclaimed are, as professional matter of course, explicitly denied.

Jenner after six months of lionising left London on 23rd June,
1800, and on his way home passed through Oxford where he was
introduced to Dr. Marlow, Vice-Chancellor of the University, and
other dignitaries, who subscribed the following testimonial, drawn
up by Sir Christopher Pegge, Reader in Anatomy--

  We, whose names are undersigned, are fully satisfied upon the
  conviction of our own observation, that the Cowpox is not only
  an infinitely milder disease than the Smallpox, but has the
  advantage of not being contagious, and is an effectual remedy
  against the Smallpox.

When a prophet in the country turns out a prophet in London
his country neighbours begin to believe in him; and thus it
was with Jenner. His metropolitan reputation was reflected in
Gloucestershire. Earl Berkeley wrote to the Duke of Beaufort--

  Every father of a family owes the greatest obligation to Dr.
  Jenner for preventing the dreadful effects of the smallpox.

And the sense of this obligation took shape in a service of plate
presented in 1801 and bearing this inscription--

    PRESENTED BY
    THE NOBILITY AND GENTRY OF
    THE COUNTY OF GLOUCESTERSHIRE
    TO THEIR COUNTRYMAN
    EDWARD JENNER, M.D., F.R.S.
    AS A TESTIMONY OF THE HIGH SENSE THEY ENTERTAIN OF THOSE
    EMINENT ABILITIES WHICH DISCOVERED AND THAT
    DISINTERESTED PHILANTHROPY WHICH
    PROMULGATED
    THE VACCINE INOCULATION.


FOOTNOTES:

[119] Meaning thereby, as happened under Woodville at Battle Bridge
Hospital where Smallpox and Cowpox were incurred simultaneously.

[120] _A Treatise on the Cowpox containing the History of Vaccine
Inoculation._ By John Ring. Part i. p. 297. London, 1801.

[121] _Ib._ Part ii. p. 720. London, 1803.

[122] _The Beauties of the Edinburgh Review_, alias _the Stink-Pot
of Literature_. By John Ring. London, 1807. P. 49.

[123] _Treatise on the Cowpox_, p. 520. London, 1801.




CHAPTER IX.

A DISHONOURABLE TRANSFORMATION.


Honour was abundant, but honour is windy fare, and Jenner had an
eye for something more substantial. Among his papers we read--

  While the vaccine discovery was progressive, the joy I felt at
  the prospect before me of being the instrument destined to take
  away from the world one of its greatest calamities, _blended with
  the fond hope of enjoying independence_ and domestic peace and
  happiness, was often so excessive that, in pursuing my favourite
  subject among the meadows, I have sometimes found myself in a
  kind of reverie. It is pleasant to me to recollect that these
  reflections always ended in devout acknowledgments to that Being
  from whom this and all other mercies flow.[124]

But how was the fond hope of enjoying independence to be realised?
The question was discussed by Jenner and his friends, and it was
finally decided to apply to the House of Commons for a reward. But
in order to go to Parliament it was necessary to have a good case,
and Jenner’s case was open to various objections. _The Inquiry_,
published in 1798, was by no means a manual of practice. Its
prescription was Horsegrease Cowpox; but such Cowpox was neither
producible nor accounted tolerable. Cowpox that did not originate
in Horsegrease, Jenner had adjudged spurious; and yet such spurious
Cowpox had been adopted by Pearson and Woodville, and under their
influence had obtained extraordinary popularity. It was therefore
by no means improbable that any claim for cash wherewith to enjoy
independence might be seriously contested. In this strait, what
was to be done? The question was a grave one, and called for a
heroic solution. Resolved therefore, that Horsegrease Cowpox be
dropped, and with it the use of escharotics for the subjugation of
the pustules produced thereby. Absolute silence should thenceforth
be his rule as to Horsegrease. So much for the negative position:
the positive was more difficult. To claim Cowpox as his own, with
the modes of its exhibition devised by Pearson, was an evolution
full of hazard, but unless prepared to surrender “the fond hope of
enjoying independence,” it must be effected. He had advantages.
His name was associated with the new practice: even Pearson had
done him homage: neither the medical profession nor the public were
likely to study the _Inquiry_ critically, or to trouble their heads
over obscure details: Cowpox was to them Cowpox: he had the world’s
ear; and opposition would be set down as the ordinary behaviour of
envy toward success. Anyhow the transformation must be attempted:
otherwise, farewell to dreams of financial independence.

To initiate this transformation, Jenner came to London, and in May,
1801, published a quarto pamphlet of twelve pages, entitled _The
Origin of the Vaccine Inoculation_.

First it was necessary to represent that his investigations had
extended over many years--a fact of which there was no sign in the
_Inquiry_, the evidence indeed being distinctly otherwise; and thus
he shaped his statement--

  My inquiry into the nature of the Cowpox commenced upwards of
  twenty-five years ago. My attention to this singular disease
  was first excited by observing that among those whom in the
  country I was frequently called upon to inoculate, many resisted
  every effort to give them the Smallpox. These patients I found
  had undergone a disease they called the Cowpox, contracted by
  milking Cows affected with a peculiar eruption on their teats.
  On inquiry, it appeared it had been known among the dairies
  from time immemorial, and that a vague opinion prevailed that
  it was a preventive of the Smallpox. This opinion I found was
  comparatively new among them; for all the older farmers declared
  they had no such idea in their early days--a circumstance that
  seemed easily to be accounted for, from my knowing that the
  common people were very rarely inoculated for the Smallpox
  till that practice was rendered general by the improved method
  introduced by the Suttons: so that the working people in the
  dairies were seldom put to the test of the preventive powers of
  the Cowpox.

Jenner’s design in the foregoing statement was manifest. It was to
minimise the faith of the country folk, and to represent that by
his own perspicacity he had discovered the virtue of Cowpox through
his failures to inoculate with Smallpox. The inquiries of Pearson
and others, however, showed conclusively that in many parts of the
south of England, in Ireland, and on the Continent it was believed
that to have suffered from Cowpox was to be secure from Smallpox;
and the belief was entertained altogether independently of failures
to inoculate with Smallpox; just as a similar belief prevailed
among farriers as to the prophylaxy of Horsegrease. The faith
in Cowpox was neither vague, nor new, nor confined to Jenner’s
neighbourhood; and his assertion to the contrary showed with what
hardihood he had undertaken to construct a case in his own favour.

In opposition to the rural faith, medical men maintained that it
was possible to have Smallpox after Cowpox; and surgeons averred
that they had successfully inoculated many who had suffered Cowpox.
Indeed it was indubitable professional testimony to this effect
that compelled Jenner to forsake his first fancy for Cowpox,
and to report the true specific as Horsegrease Cowpox. Having,
however, to sacrifice that discovery, and revert to the Cowpox he
had discredited, a fresh manœuvre was requisite; and thus was it
performed--

  In the course of the investigation I found that some of those
  _who seemed to have undergone the Cowpox_, nevertheless, on
  inoculation with the Smallpox, felt its influence just the same
  as if no disease had been communicated to them by the Cow. This
  occurrence led me to inquire among the medical practitioners in
  the country around me, who all agreed in this sentiment, that
  the Cowpox was not to be relied upon as a certain preventive of
  the Smallpox. This for a while damped, but did not extinguish my
  ardour; for as I proceeded I had the satisfaction to learn that
  the Cow was subject to some varieties of spontaneous eruptions
  upon her teats, that were all capable of communicating sores to
  the hands of the milkers, and that whatever sore was derived
  from the animal was called in the dairy the Cowpox. Thus I
  surmounted a great obstacle, and, in consequence, was led to form
  a distinction between these diseases, one of which only I have
  denominated the _true_, the others the _spurious_ Cowpox, as they
  possess no specific power over the constitution.

Here we have the trick before us at the very point of
transformation. He consulted with medical practitioners, “who
all agreed that Cowpox was not to be relied upon as a certain
preventive of Smallpox.” True. What did he do next? He discovered
that what Cowpox did not prevent, the variety derived from
Horsegrease did. Such was the original revelation of 1798. In 1801
we have a different story, and his quest a different issue. Not
a word about the discovery of the sure preventive in Horsegrease
Cowpox--not one word! Although his ardour was damped by the medical
evidence against Cowpox, he yet prosecuted his inquiry; and to his
satisfaction ascertained that what the milkers called Cowpox was
not always Cowpox, but that any sores whatever derived from the
Cow were so designated. He therefore was led to form a distinction
between the diseases, and to denominate one as _true_ and the
others as _spurious_ Cowpox.

Thus the Horse, the obnoxious Horse, was got rid of, and the
Cow represented as of herself yielding pox, which pox was the
Cowpox that Pearson and Woodville (in contempt of Jenner’s 1798
revelation) had brought into fashion; and which it had become all
essential for Jenner to claim as his own in order to realise his
“fond hope of enjoying independence.”

In this connection the question occurs, Why should “some varieties
of spontaneous eruptions” have been designated _spurious_ Cowpox?
Such eruptions were not Cowpox in any sense. Why then spurious?
That Cows communicated a variety of sores to their milkers,
described by them in common as Cowpox, was an assertion for which
Jenner never adduced any evidence; which, too, (as we shall see)
at a later date he disowned as a misapprehension. Nevertheless
spurious Cowpox got the New Inoculation over many difficulties.
When Smallpox, or any notable mischief, followed Cowpox it was
said, “Ah! the Cowpox must have been spurious; for Smallpox, or
any harm, is impossible after true Cowpox.” People did not stay to
inquire whether spurious Cowpox (that was to say, matter “from a
variety of sores on the Cow,” according to Jenner’s second version)
could be propagated from arm-to-arm, even if taken from the Cow by
mistake. The illusory Variolous Test and the Spurious Cowpox Dodge
worked marvellously for the public deception.

Another point Jenner tried to score at the cost of Pearson and
Woodville. When they began to inoculate they found they had to
ascertain at what period the virus should be taken from the Cow,
and from the arms of the inoculated. Jenner afforded them no
guidance. Writing to John Ring, 1st July, 1801, he confessed--

  In the early part of my inoculations I had not learned to
  discriminate between the efficacy of the virus taken at an early
  and at a late period of the pustule.[125]

Where Jenner had not learned to discriminate, the line became clear
in the course of general practice; and Pearson was especially
explicit as to the right time for taking virus; but to make good
his claim to national consideration, Jenner fancied it necessary
to exhibit himself as complete master of the art of Cowpox
Inoculation, owing nothing to others; and he therefore proceeded to
appropriate the fruit of the common medical experience, assigning
it to a season when he alone was in the field. Referring to his
separation of true from spurious Cowpox, he thus prosecuted his
raid--

  This impediment to my progress was not long removed before
  another, of far greater magnitude in appearance, started up.
  There were not wanting instances to prove that when the true
  Cowpox broke out among the cattle at a dairy, the person who
  had milked an infected animal, and had thereby gone through the
  disease in common with others, was liable to receive the Smallpox
  afterwards. This, like the former obstacle, gave a painful check
  to my fond and aspiring hopes; but reflecting that the operations
  of Nature are generally uniform, and that it was not probable the
  human constitution (having undergone the Cowpox) should in some
  instances be perfectly shielded from the Smallpox, and in many
  others remain unprotected, I resumed my labours with redoubled
  ardour. The result was fortunate; for I now discovered that the
  virus of Cowpox was liable to undergo progressive changes from
  the same cause precisely as that of Smallpox, and that when
  it was applied to the human skin in its degenerated state, it
  would produce the ulcerated effects in as great a degree as when
  it was not decomposed, and sometimes far greater; but having
  lost its _specific properties_, it was incapable of producing
  that change upon the human frame which is requisite to render
  it insusceptible of the variolous contagion: so that it became
  evident a person might milk a Cow one day, and having caught the
  disease, _be for ever secure_; while another person, milking the
  same Cow the next day, might feel the influence of the virus in
  such a way as to produce a sore, or sores, and, in consequence of
  this, might experience an indisposition to a considerable extent;
  yet, as has been observed, the specific quality being lost, the
  constitution would receive no peculiar impression....

  This observation will fully explain the source of those errors
  which have been committed by many inoculators of the Cowpox.
  Conceiving the whole process to be extremely simple, as not to
  admit of a mistake, they have been heedless about the state of
  the Vaccine Virus; and finding it limpid, as part of it will
  be, even in an advanced state of the pustule, they have felt an
  improper confidence, and sometimes mistaken a spurious pustule
  for that which possesses the perfect character.

No one apparently thought it worth while to expose the fictitious
character of these statements, invented by Jenner to justify his
pretensions and to baffle objections. Any careful reader of the
_Inquiry_ of 1798, and the _Origin of Vaccine Inoculation_ of 1801,
cannot fail to perceive the radical inconsistency of the earlier
and later narratives, and how a few hasty experiments enveloped in
unverifiable conjecture and gossip, came to be magnified into years
of arduous research.

He wound up his statement with this flourish and prediction--

  The distrust and scepticism which naturally arose in the minds of
  medical men, on my first announcing so unexpected a discovery,
  has now nearly disappeared. Many hundreds of them from actual
  experience, have given their attestations that the inoculated
  Cowpox proves a perfect security against the Smallpox; and I
  shall probably be within compass if I say thousands are ready to
  follow their example; for the scope that this Inoculation has now
  taken is immense. An hundred thousand persons, upon the smallest
  computation, have been inoculated in these realms. [May, 1801.]
  The numbers who have partaken of its benefits throughout Europe
  and other parts of the globe are incalculable; and it now becomes
  too manifest to admit of controversy, that the annihilation of
  the Smallpox, the most dreadful scourge of the human species,
  must be the final result of this practice.

For the end designed--to establish and exalt a claim with the
purpose of exacting corresponding recompense, the _Origin of the
Vaccine Inoculation_ was an adroitly drawn document: its veracity
is a different matter. A just man, not to say a generous, would
have had some praise for Pearson, Woodville, and others to whom
the extension of the New Inoculation was due; but Jenner was
essentially a mean spirit; and for him to have stated his case
truly would have been to jeopardise “the fond hope of enjoying
independence.”


FOOTNOTES:

[124] Baron’s _Life of Jenner_, vol. i., p. 140.

[125] Baron’s _Life of Jenner_, vol. i., p. 448.




CHAPTER X.

JENNER BEFORE PARLIAMENT, 1802.


Jenner was timid and indolent, and, though eager for reward,
required much prompting to use the means to the end on which his
heart was set. He wrote to Lord Sherborne to speak for him to Prime
Minister Addington; but Sherborne replied, 23rd April, 1801, that
he did not know Addington even by sight. He would however try to
see Mr. Pitt, adding for encouragement and direction--

  If patriot Grattan gets £50,000 for his patriotism, the true
  patriot Jenner deserves more: I am sure not less; and less would
  be perfectly shabby to think of. I perfectly recollect Grattan’s
  business. It was settled among his friends to propose £100,000
  for him, determining to ask enough; and fearing that sum would
  not be granted, one of his particular friends was to get up
  afterwards and propose £50,000, which was immediately granted,
  and he took £47,500 for prompt payment.

Action had to be taken, and on 9th December, 1801, Jenner went to
London to prepare a petition to the House of Commons and to canvass
for support. Even at the last moment, Wilberforce had to warn him,
24th February, 1802, that no time was to be lost, or he would lose
his chance for the year. After prolonged consultation with those
accustomed to such business, the petition was got ready, and on
17th March, 1802, it was presented to the House of Commons.

  The humble Petition of EDWARD JENNER, Doctor of Physic,

    SHEWETH,

  That your Petitioner having discovered that a disease which
  occasionally exists in a particular form among cattle, known by
  the name of the 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
  persons so inoculated perfectly secure from the infection of the
  Smallpox.

  That your Petitioner after a most attentive and laborious
  investigation of the subject, setting aside considerations of
  private and personal advantage, and anxious to promote the
  safety and welfare of his Countrymen and of Mankind in general,
  did not wish to conceal the Discovery he so made of the mode
  of conducting this new species of Inoculation, but immediately
  disclosed the whole to the public; and by communication with
  medical men in all parts of this Kingdom, and in Foreign
  Countries, sedulously endeavoured to spread the knowledge of his
  discovery and the benefit of his labours as widely as possible.

  That in this latter respect the views and wishes of your
  Petitioner have been completely fulfilled; for to his high
  gratification he has to say that this Inoculation is in practice
  throughout a great proportion of the civilised world, and has in
  particular been productive of great advantage to these Kingdoms,
  in consequence of its being introduced, under authority, into the
  Army and Navy.

  That the said Inoculation hath already checked the progress of
  the Smallpox, and from its nature must finally annihilate that
  dreadful disorder.

  That the series of experiments by which this discovery was
  developed and completed have not only occupied a considerable
  portion of your Petitioner’s life, and have not merely been
  a cause of great expense and anxiety to him, but have so
  interrupted him in the ordinary exercise of his profession as
  materially to abridge its pecuniary advantages without their
  being counter balanced by those derived from the new practice.

    Your Petitioner, therefore, with the full persuasion that
    he shall meet with that attention and indulgence of which
    this Honourable House may deem him worthy, humbly prays this
    Honourable House to take the premises into consideration, and
    to grant him such remuneration as to their wisdom shall seem
    meet.

Patriot Grattan asked for £100,000, was awarded £50,000, and took
£47,500: “true patriot Jenner deserves more,” said Lord Sherborne;
but Jenner had not courage for the demand. What, however, was
undefined in cash was made up for in pretension.

As we read Jenner’s petition we note (1) the Discovery; (2) its
Disclosure and Diffusion; (3) the Expense thereby incurred; and (4)
the Prophecies; and under these heads it is to be observed--

1.--It was no discovery of Jenner’s that cowpox was inoculable and
preventive of smallpox. That was a rural superstition. Nor, be
it again repeated, did he ever become responsible for that rural
superstition. Recognising its futility, he deliberately set it
aside, and recommended a disease of the horse, transmitted through
the cow, for inoculation. It was Pearson, who disliking Jenner’s
prescription, brought cowpox into vogue; whereon Jenner, fearing
that he might be cut out of the enterprise, dropped his specific,
adopted the cowpox he had rejected, and claimed Pearson’s work as
the development of his own.

2.--That he disclosed his discovery was true, but it was not
the discovery set forth in the petition. Moreover the merit
of disclosure in such a case is measured by the advantage of
concealment; and what could Jenner have taken by concealment? The
conditions of successful quackery were not present in the secret
practice of inoculation with horsegrease cowpox.

3.--That the discovery occupied a considerable portion of Jenner’s
life, and was attended with great expense and loss of practice, is
answered by reference to his _Inquiry_. With what loss of time,
loss of money, and loss of practice could the series of cases
therein set forth have been attended? And after 1798, he confessed
he was able to achieve little further.

4.--As for the prophecies about the absolute security afforded
by cowpox with the final extermination of smallpox, we may
estimate the worth of such vapouring by the asserted check at
that time, 1801, administered to the disease, when as yet an
insignificant fraction of the population had been subjected to the
New Inoculation, and a fraction, too, least likely to suffer from
smallpox.

Petitions are petitions, and not designed for over-much scrutiny.
In them truth is rarely to be looked for otherwise than warped
to personal ends. The policy of a petition is to claim in excess
with a view to obtain a larger concession. Jenner’s petition was
a more than usually flagrant instance of this policy, with the
disadvantage that much of its untruth passed into currency as
matter of fact.

The Prime Minister, Mr. ADDINGTON (afterwards Viscount Sidmouth),
informed the House that he had taken the King’s pleasure on the
contents of the petition, and that his Majesty recommended it
strongly to the consideration of Parliament. It was referred to a
committee, of which Admiral Berkeley, a zealous believer in Jenner,
was appointed chairman. The points to which the committee chiefly
directed their inquiries were--

I.--The utility of the discovery itself.

II.--The right of the petitioner to the discovery.

III.--The sacrifices of the petitioner in making the discovery.

As an investigation the work of the Committee was illusory. The
points were decided in the petitioner’s favour from the outset.
There was no opposition. Dr. Moseley, Mr. Birch, and Dr. Rowley,
who became active opponents of the New Inoculation, were summoned,
but the matter was new to them; they had not had time to collect
evidence and formulate conclusions: a rite that was to protect for
a lifetime and to annihilate smallpox, announced in 1798, was to be
adjudicated upon in 1802! On the other hand, Jenner’s friends were
influential and active, and used the opportunity to parade their
whole strength in his favour. The medical testimony especially was
unreserved and enthusiastic.

Dr. JAMES SIMS, president of the London Medical Society, laid
before the Committee a unanimous resolution of the Society in
Jenner’s favour. He said he was at first adverse to Vaccine
Inoculation, but his confidence in it was increasing every hour.
It introduced no other disease to the human frame, whilst it made
an end of the possibility of smallpox, a disease that proved fatal
to one in six of those it attacked. He had never heard of Cowpox
before the publication of _The Inquiry_, and regarded the discovery
therein communicated as the most useful ever made in medicine. If
Jenner had kept and traded on his secret, he might have become the
richest man in the kingdom.

Sir GILBERT BLANE related how the New Inoculation had been
introduced to the Navy. He had had the men on board the _Kent_,
man-of-war, inoculated with cowpox, and then with smallpox, and
not one took the latter disease. Of every thousand deaths in the
country, smallpox was accountable for ninety-five. Taking London
as the standard, 45,000 must perish annually from smallpox in the
United Kingdom. As soon as the preventive discovered by Jenner
became universal that large mortality would cease.

Dr. LETTSOM, a popular physician, a member of the Society of
Friends, and an enthusiastic supporter of Jenner, said he had
paid much attention to smallpox statistics. Taking London and
the out-parishes as containing nearly 1,000,000 inhabitants, he
calculated that eight a day, or 3000 annually died of smallpox.
Allowing Great Britain and Ireland to have a population of
12,000,000, that would give a mortality of not less than 36,000 per
annum from smallpox. He had reason to conclude that about 60,000
persons had undergone the New Inoculation up to date. He did not
think that the genuine cowpox when inoculated could ever prove
fatal. Had Jenner kept his remedy secret he might have derived
immense pecuniary profits from it, as did the Suttons by their
improved practice of variolous inoculation.

Asked whether he had known any inoculated with smallpox
subsequently contract smallpox, he replied that he had two
relatives inoculated who afterwards had smallpox, and one of them
died. He had recently attended two families, in each of which
a child inoculated was laid up a year after the operation with
smallpox.

Dr. WOODVILLE, forgiving Jenner’s evil treatment, came, like a
good Friend, to bear witness to the new practice. He had learnt
to prefer vaccine to variolous inoculation at the Hospital. He
had, up to January, 1802, operated with cowpox on 7,500 patients.
About half of them had been subjected to the Variolous Test with
satisfactory results.

Dr. BRADLEY, physician to the Westminster Hospital, said he looked
on Jenner as the author of Vaccine Inoculation, and believed no
medical man doubted it. As accidental inoculation with cowpox was
proved to keep off smallpox for life, it was matter of course that
intentional inoculation would do so also. Not less than 2,000,000
of persons had received Vaccine Inoculation, and he had never known
an instance of any one dying of it. One in 300 died of smallpox
inoculation in England, and not less than one in 150 throughout
the rest of Europe, Asia, Africa and America. Had Jenner settled
in London he might have made £10,000 per annum for the first five
years, and double that sum afterwards.

Sir WALTER FARQUHAR, physician to the Prince of Wales, had told
Jenner that if he had come to London and kept his secret, he would
have ensured him £10,000 a year. He had however divulged his
secret and lost all chance of emolument. His remedy was a permanent
security against smallpox, and had never proved fatal; whilst
variolous inoculation, performed in the best manner, cost one life
in three hundred.

Mr. CLINE, surgeon to St. Thomas’s Hospital, corroborated the
opinion that Jenner could have earned £10,000 a year in London by
means of his secret. As smallpox was the most destructive of all
diseases, its suppression was the greatest discovery ever made in
the practice of physic.

Mr. JOHN GRIFFITHS, surgeon to the Queen’s Household and St.
George’s Hospital, had inoculated upwards of 1500 persons with
cowpox without any untoward symptoms.

Mr. JAMES SIMPSON, surgeon to the Surrey Dispensary, had inoculated
between fifty and sixty without any injury. Considered them
perfectly secure from smallpox. A child of nine months covered with
_crusta lactea_ resisted all the usual remedies, but on the tenth
day after he had inoculated it with cowpox, the crust began to
disappear, and the twelfth day was entirely gone.

Dr. JOSEPH MARSHALL related his experience as a vaccine inoculator
in the Navy and at Gibraltar, Malta, Palermo, Naples, Rome and
Genoa. Everywhere was successful. Believed he had operated on
10,000, and never witnessed any ill consequences whatever. On the
contrary, children in a weak state of health, after passing through
the vaccine infection, began to thrive and become vigorous.

Mr. JOHN ADDINGTON, surgeon, had used Jenner’s remedy since 1799
in eighty-one cases. One third of these he had inoculated with
smallpox, and subjected to every method of infection he could
devise, but found them perfectly proof against the disease.

Dr. SKEY, physician to the Worcester Hospital, testified that
in the spring of 1801 smallpox was epidemic in Worcester. He
inoculated a number of children with cowpox, and none of them took
smallpox although constantly exposed to contagion.

Dr. THORNTON, physician to the Marylebone Dispensary, had
inoculated a patient with cowpox, and afterwards with smallpox at
twelve different times during the past three years without effect.
He had even slept with a person in natural smallpox, who died, but
took no harm. When at Lord Lonsdale’s in the North he had operated
on upwards of a thousand, and had completely satisfied himself, and
all the medical practitioners in that part of England, that cowpox
was a mild disease, hardly deserving the name of a disease. It was
not contagious; it never disfigured the person, never produced
blindness, nor excited other diseases. It was equally safe whether
during the period of pregnancy, or the earliest infancy, or extreme
old age.

Dr. BAILLIE then gave his influential judgment. He thought cowpox
an extremely mild disease, and when a patient had properly
undergone it, he was perfectly secure from the future infection
of smallpox: and further, if Dr. Jenner had not chosen openly and
honourably to explain to the public all he knew upon the subject,
he might have acquired a considerable fortune. In his opinion it
was the most important discovery ever made in medicine.

Mr. DAVID TAYLOR, surgeon of Wootton-under-Edge, had inoculated
about two thousand persons with cowpox without a single
failure, nor had he met with any ulcerations, tumours, or other
diseases following the operation. He knew Jenner’s practice in
Gloucestershire. It was in a very populous neighbourhood where
there was not another physician within sixteen miles. He had
surrendered an income of £600 a year to devote himself to the
public service.

As a final specimen of this medical evidence I may cite Mr. JOHN
RING, the petitioner’s henchman. He considered Jenner the author of
Vaccine Inoculation, a discovery the most valuable and important
ever made by man. It was a perfect and permanent security against
smallpox. He had himself inoculated about 1200, of whom a thousand
had exposed themselves to smallpox infection with impunity.
There was no danger whatever from the New Inoculation unless
from ignorance and neglect. One in every hundred inoculated with
smallpox in London died, owing to the unwholesome atmosphere and
the necessity of operating on children at an improper age. If
Jenner had kept his discovery to himself he might have made £10,000
a year by it; for others had got as much or more by the practice of
physic.

This evidence, better than any secondary description, will enable
the reader to appreciate the prevalent furore as it affected the
leaders of the medical world. At the same time it is to be borne
in mind that the craze was superficial. Any radical change in
conviction or practice is never accomplished thus easily or thus
rapidly. The medical men who bore witness for cowpox had been bred
to inoculation with smallpox, for which cowpox was substituted. The
change was essentially trivial. The trouble, the danger, and the
uncertainty of variolous inoculation were generally recognised,
and when cowpox was recommended as a mild form of smallpox, it was
not difficult to appreciate the asserted advantage: for, as it was
argued, no one can have smallpox twice, and as the mildest attack
of smallpox is as prohibitive of a second attack as the severest,
therefore cowpox (which is smallpox in mild form) must protect as
effectually when inoculated. With logic so admirable, it was in
nowise wonderful that so many were carried away; but unfortunately,
as so often happens, matter-of-fact did not correspond to the
admirable logic.

The DUKE OF CLARENCE testified that he had availed himself of
Jenner’s discovery from the outset. His children, his household and
farm servants were all protected. A postillion positively refused
to be operated on, and eighteen months after he caught smallpox
in the most virulent form. Children who had undergone cowpox were
constantly in the room where the lad lay and suffered no harm.

The EARL OF BERKELEY had his son inoculated with cowpox by Dr.
Jenner at the age of six months. One of his maid-servants took
smallpox and died, and the effluvia during her illness was so
offensive that his servants had to move to another part of the
house. To test the reality of his son’s protection, he sent
for Jenner, and got him to inoculate the boy with pox from the
maid. The child was found to be proof, for the inoculation had
no effect--To illustrate the validity of the Gloucestershire
tradition, he related how a man of 72 in his service had caught
cowpox when a boy of 15 whilst milking, and in consequence always
reckoned himself secure from smallpox, exposing himself to the
disease with complete indifference.

LORD ROUS gave similar evidence. His child had been inoculated with
cowpox at the age of three months, and he was perfectly satisfied
that he could never have smallpox.

Then there were lay practitioners, of whom Jenner’s nephew, the
Rev. G. C. JENNER, may be taken as an example. He bore witness that
he had inoculated 3000 with cowpox without a single unfavourable
case, from the earliest infancy to eighty years of age, and under
circumstances in which it would not be prudent to use variolous
virus; as, for example, children during teething and women in every
stage of pregnancy. Upwards of two hundred of his patients had been
afterwards inoculated with smallpox matter, and an equal number
exposed to variolous effluvia, and in no instance did smallpox
ensue. He was satisfied that as soon as the new practice became
universal, smallpox would be annihilated.

An early date being wanted for “the discovery,” EDWARD GARDNER,
wine and spirit dealer, was brought from Gloucester to affirm that
he had known Jenner for more than twenty-two years, and had been in
the constant habit of hearing his medical opinions and discoveries.
It was in the month of May, 1780, that Jenner first informed him
concerning the nature of cowpox as a sure preventive of smallpox,
and of the theory he had formed on the subject; declaring his
full and perfect confidence that the virus might be continued
in perpetuity from one human being to another until smallpox was
extinguished.

It is needless to stigmatise Gardner’s testimony afresh. It
possibly had its foundation in Jenner discussing the familiar rural
faith in cowpox. Sir EVERARD HOME mentioned to the Committee that
Jenner had brought a drawing to London in 1788 of Variolæ Vaccinæ
as it appeared on the finger of a milker, and had shown it to John
Hunter, who advised him to look further into the matter; but it was
not pretended that he spoke to Hunter of the matured conviction
revealed to Gardner eight years before.

The Committee heard evidence as to the knowledge and use of cowpox
apart from Jenner, and their verdict was given as follows--

  The disorder itself, and its specific property of securing
  against Smallpox infection, _was not a discovery of Dr.
  Jenner’s_; for in various parts of England, in Gloucestershire
  and Devonshire particularly, there was an opinion of that sort
  current among the common people employed in dairies, which
  the observations of the inoculators for the Smallpox tended
  to confirm. It appears not improbable that in some very rare
  instances this knowledge was carried one step farther, and that
  the Cowpox was communicated either by handling the teat, or
  by inoculation from the animal, for the purpose and with the
  intention of securing against the danger of Smallpox; but the
  practice of which Dr. Jenner asserts himself to be the original
  Inventor is, the inoculation from one human being to another, and
  the mode of transferring indefinitely, the vaccine matter without
  any diminution of its specific power, to which it does not appear
  that any person has ever alleged a title.

Thus the Committee disallowed Jenner’s claim, whilst indicating the
only colourable point of novelty, namely, the transfer from arm to
arm of virus. At the same time, it should not be forgotten that
inoculation from arm to arm with “mild kinds of smallpox” was an
existing practice, and there was little merit to speak of in Jenner
doing the same thing with horse or cowpox.

There was no opposition--no devil’s advocate; but it may be held
that Dr. Pearson assumed that office. He was heard with impatience,
and afterwards delivered his mind in _An Examination_, to which we
shall presently refer.

The Report to the House was brought up on the 2nd of June, 1802,
and was conclusive as to the utility of the discovery. Indeed, the
evidence on that head was only cut short because it threatened
to be interminable. The judgment of the Committee reiterated
the common persuasion--“As soon as the New Inoculation becomes
universal, _it must absolutely extinguish_ one of the most
destructive disorders by which the human race has been visited.”

Admiral BERKELEY, chairman of the Committee, commended the Report
to the House. He considered the discovery as unquestionably the
greatest ever made for the preservation of the human species. _It
was proved_ that in the United Kingdom 45,000 perished annually
from smallpox; but throughout the world what was the desolation!
Not a second struck but a victim was sacrificed at the altar of
that most horrible of diseases. He should therefore move that a sum
of not less than £10,000 be granted to the Petitioner, but if the
House thought fit to adopt any larger sum, he should hold himself
free to vote for it. Why, Dr. Jenner’s expenses in postage alone
had been from 25s. to 30s. a day!

Sir HENRY MILDMAY did not think £10,000 at all adequate. Had Jenner
kept his secret he might have made at least £100,000. He moved that
he should have £20,000.

Mr. WINDHAM said the petitioner had surrendered his discovery
to his country, and was therefore entitled to remuneration. The
discovery had been the labour of years and the fruit of extensive
practice.

Sir JAMES SINCLAIR ERSKINE was assured that Jenner had expended
£6000 in the propagation of his discovery, and if he had £10,000,
he would be left with no more than £4000. Besides, he had given up
a practice of £600 a year to benefit his fellow-creatures.

Mr. COURTNEY observed that the evidence showed that 40,000 men
would be annually preserved to the State by the New Inoculation.
These would return £200,000 a year to the Exchequer, and if the
Petitioner had only a tithe of that sum for one year, he was
entitled to £20,000.

Mr. WILBERFORCE stated that Jenner had spent upwards of twenty
years in completing his discovery. He was no adventurer seeking to
push himself before the world. He had already attained to great
celebrity in his profession, and had sacrificed his practice for
the public good. In every view he thought the larger sum ought to
be granted.

Mr. GREY thought £10,000 would be no more than an indemnity for
expenses. He hoped the House would vote for £20,000.

Mr. BANKS said there was no question as to the utility of the
discovery. If he felt more niggardly than other members, it was
because his paramount duty consisted in guarding the public purse.
That purse was a large one, but it was not to be dipped into at
pleasure. The strength of the country lay in economy and sound
finance. He did not see that a case had been made out for so large
a sum as £10,000. The discovery itself might be trusted to pay its
author. He always looked on a Report of a Committee with jealousy,
for it was controlled by the friends of the Petitioner, and there
was no one with sufficient motive to provide the correctives
required in the public interest.

Mr. ADDINGTON, Chancellor of the Exchequer, held that the value of
the discovery was without example, and beyond calculation. So much,
indeed, was not contested. The Petitioner had received the highest
reward in the approbation, the unanimous approbation of the House;
an approbation richly deserved, since it was the result of _the
greatest discovery since the creation of man_. Whatever money the
House might see fit to vote on some future occasion, his present
duty was to recommend the smaller sum of £10,000. In doing so, he
admitted, he surrendered his private inclination to his sense of
public duty. He had, however, the satisfaction in knowing that this
discussion had conferred on Dr. Jenner a reward that would endure
for ever, whilst the comfort of his family would be amply ensured
in the extension of practice that would follow the approbation of
the House.

The question was then put that the words £10,000 do stand part
of the resolution; when the Committee divided--Ayes 59, Noes 56,
Majority 3.

The discussion in the House of Commons shows how wide was the
general craze. Facts and figures were evolved at discretion and
repeated indiscriminately. To rave about Jenner, the saviour from
smallpox, was the mode. It was as if all had consented to go mad
together. Mr. Dunning, a surgeon, otherwise rational, broke into
prophetic fury--

  With pride, with just and national pride, we boast a Newton and
  a Harvey; posterity will boast a Jenner![126]

Considering the value set on “the great discovery,” the award of
£10,000 was not excessive. In the _Medical Journal_ it stands
recorded--

  We have never witnessed a more unanimous and general
  disappointment than that which has been expressed, not only by
  the profession, but by the public at large, at the smallness of
  the remuneration.[127]

On the other hand, it is to be remembered that the times were
dark and hard, cruelly hard, through war and scanty harvests; the
quartern loaf selling at 1s. 11d., a significant index of the
people’s misery.


FOOTNOTES:

[126] _Medical Journal_, January, 1802.

[127] _Ib._ July, 1802.




CHAPTER XI.

PEARSON’S _EXAMINATION_.[128]


A few weeks after the award of £10,000 to Jenner by the House of
Commons, Dr. Pearson published _An Examination_ of the report of
the committee. He did not contest Jenner’s claim to consideration,
but the ground on which it was advanced, and on which it was
conceded; drawing attention to the manner in which the claims set
forth in Jenner’s petition had been reduced to “inoculation from
one human being to another,” whilst a new claim was invented for
him, “to wit, the mode of transferring, indefinitely, the vaccine
matter without any diminution of its specific power.”

What Pearson held, and rightly held, was, that the public
acceptance of the New Inoculation was due to Woodville and himself,
and not to Jenner--

  The Cowpock Inoculation (after Dr. Jenner’s book was published
  in June, 1798, which contained seven or eight cases, the whole
  result of his experience) was not practised by any person that I
  know of, till January, 1799, neither Dr. Jenner, nor any person
  that I could find being in possession of matter; but, in January,
  1799, in consequence of a general inquiry, which I had instituted
  immediately after Jenner’s publication, information was given
  of the Cowpock Disease breaking out in two Cow-stables near
  London, and from these sources Dr. Woodville and myself collected
  matter, by which, in the course of three months, 300 persons (not
  fewer, I think) were inoculated for the Cowpock in addition to
  the seven or eight cases of Dr. Jenner, then the whole stock of
  facts of Inoculation before the public. Besides carrying on the
  Inoculation ourselves in this manner, we disseminated the matter
  throughout the country, in particular to Dr. Jenner himself; and
  especially, I within that time issued a printed letter, directed
  to upwards of two hundred practitioners in different parts of
  the kingdom, containing thread impregnated with the Cowpock
  matter.... By the close of 1799 about 4000 persons had been
  inoculated by Dr. Woodville, myself, and our correspondents.

Pearson also claimed to have cleared away difficulties created by
Jenner’s statements, some of which were most prejudicial to the
public acceptance of the New Inoculation--

  I published experiments of inoculating persons with the Cowpock
  to show that _they could not take the Cowpock after the
  Smallpox_, contrary to Dr. Jenner. Secondly, experiments to
  show that persons could not take the Cowpock who had already
  gone through the Cowpock, also contrary to Dr. Jenner.[129]
  Thirdly, many persons had at this period made experiments to
  show that _the Cowpox did not originate in the grease of Horses’
  heels_, as Dr. Jenner had asserted. In the spring of 1799, a
  second publication appeared from Dr. Jenner recommending caustic
  or escharotics to the inoculated parts in Cowpox, which we
  found wholly unnecessary in practice; and I consider that the
  distinctive characters of the Cowpock were better understood by
  some of us than by Dr. Jenner himself.

One can only say of these statements of Pearson as against Jenner,
that they are simple matters of fact, impugn them whoso list. It is
impossible to controvert Pearson’s assertion--

  That the whole of Jenner’s experience extended to seven or eight
  cases, and a part only of these--namely, four--were from human
  subject to human subject; and not until long after Dr. Woodville
  and myself had published several hundred instances of vaccine
  virus transmitted from arm to arm, had he any experiments to set
  alongside ours.

They had to find out for themselves when to take virus from the
cow, how to preserve it when taken, how to dress inoculated arms,
when to take virus from the arm, and, in short, to do everything
that constitutes the difference between a suggestion and an art.

Pearson, too, as we have seen, had a leading part in the formation
of the first Institution for the Inoculation of the Vaccine Pock,
with which Jenner had not only nothing to do, but _would_ have
nothing to do: concerning which wrote Pearson--

  The Vaccine Inoculation was next considerably established by
  the Cowpock Institution, of which I was one of the founders,
  commencing at the close of 1799; which Institution has been the
  principal office for the supplying the world in general, and the
  Army and Navy in particular, with matter; and where a regular
  register is kept of each of the cases inoculated.

As to Jenner keeping the secret of Cowpox and making a great
fortune out of it, Pearson replied, first, that he had not proved
his remedy; second, that he would have had to persuade the public
to believe in him; and, third, that too much was known about Cowpox
to have made a secret possible. Moreover, the assertion that he
might have earned £10,000 a year and a fortune of £150,000 was
absurd--

  Such a fortune no one ever acquired by physic in this or any
  other country--far exceeding the greatest ever known, those of
  Sir Theodore Mayerne in the first half of the 17th century, and
  of the still greater one of Dr. Ratcliffe in the early part of
  last century.

When it was further said, that experiments in Vaccine Inoculation
had occupied twenty years of Jenner’s life, that they had cost him
£6000, and that he had surrendered a practice of £600 a year in the
populous neighbourhood of Berkeley for the public benefit--he would
not trust himself to characterise the allegations.

His own position, Pearson thus defined--

  I have admitted that Dr. Jenner first set on foot the inquiry
  into the advantages of Vaccine Inoculation; but I apprehend
  that the practice has been established almost entirely by other
  practitioners; and that his new facts, or which I consider to be
  new, have been, in my opinion, disproved by subsequent observers;
  and that in consequence of those facts being disproved, together
  with the very ample experiences of other persons, we owe the
  present extensive practice of the Vaccine Inoculation.

Pearson further indicated on what conditions he would have been
satisfied to see Jenner rewarded--

  A much more dignified and more just ground of claim, and an
  equally favourable one for remuneration, would have been in
  terms denoting that the Petitioner had proposed a new kind of
  Inoculation, and actually furnished some instances of the success
  of it, founded upon facts; of which some were brought to light
  and use, which heretofore had only been locally known to a very
  small number of persons; and others were discoveries of the
  Author: further, that in consequence of considerable subsequent
  investigation, by the Author and others, such a body of evidence
  had been obtained, and such further facts had been discovered, as
  demonstrated the advantages of the new practice.

Whilst willing that Jenner should be rewarded, for Woodville and
for himself, Pearson wanted nothing: he simply maintained that the
judgment of the House of Commons Committee should have recognised
the facts of the situation. He observed--

  I have some authority for stating that the members of the
  Committee _did not unanimously_ think such exclusive claims were
  just. I had some reason to expect that the representation of
  the Committee in their Report would have been such as to have
  satisfied the expectations, not exorbitant, of Dr. Woodville
  and myself; such as would have cost the Petitioner nothing, _to
  wit_, a mere acknowledgment of services. The most unqualified and
  exclusive claims having been decreed, this bounty of course has
  been withheld, either because it was judged to be not owing, or
  from some other motive which I will not name; but it is fitting
  that I disclaim any insinuation of unworthy motives actuating
  those with whom judgment was invested.

Considering the injustice to which Pearson had been subjected,
and the provocation he had received, it is impossible to refrain
from admiration of the serene and impartial temper in which he
composed his _Examination_. Had he sat as judge between Jenner and
himself, he could not have stated the case with greater accuracy
and absence of bias. He fell into no exaggeration; he indulged in
no sarcasm; he descended to no abuse. He set forth the incidents
of the New Inoculation with the imperial simplicity and dignity
of truth. Where others had gone crazed, he preserved some degree
of sanity. He held it to be premature to proclaim the extinction
of Smallpox, or to say with Jenner that reports of failure and
injury from inoculated Cowpox were beneath contempt. It was only
time and experience that could warrant such absolute assertion and
prediction.

It is said that in hurricanes of panic or enthusiasm, wise men go
home and keep quiet until the sky clears, resistance being folly.
For immediate effect resistance may be folly, but the protest of
truth is sometimes imperative, whatever the disposition of the mob.
Pearson took little at the time by his _Examination_: it entered
into far too many details for general apprehension; and it was
convenient to account for his opposition as due to jealousy and
envy. Jenner attempted no reply, and assumed profound disdain. His
silence was judicious, but it was not from disdain.

       *       *       *       *       *

At this day it is easy to see that Pearson as against Jenner
played his part badly, failing to recognise his proper advantage.
Jenner’s prescription in the _Inquiry_ of 1798 was not Cowpox. It
was Horsegrease Cowpox. It was a disease of the horse inoculated on
the cow. Cowpox _per se_ he expressly rejected as useless, having
no specific effect on the human constitution. Pearson and Woodville
entertained Jenner’s prescription in good faith. They tried to
generate pox on the cow with grease from the horse, but did not
succeed. Reluctantly they abandoned Jenner’s prescription, and
resorted to Cowpox.

Whilst Pearson and Woodville were without prejudice against
Horsegrease Cowpox, it was otherwise with the public. The origin of
Cowpox in Horsegrease was voted detestable, and had the origin been
maintained, it is not improbable that the New Inoculation would
have proved abortive.

This difficulty Pearson and Woodville, the chief promoters of
the New Inoculation, cleared away. They had tried Horsegrease;
they considered they had disproved Jenner’s assertion concerning
it; and they were able to assure the public that they inoculated
with Cowpox, and nothing but Cowpox, and had no connection with
Horsegrease whatever. The public were satisfied; and Inoculation
with Cowpox became the rage, fashionable and philanthropic.

What did Jenner do? Did he vindicate his prescription, the fruit of
thirty years of incessant thought, observation and experiment? He
did not. On the contrary he dropped it. He said not another word
about it; and proceeded to claim Cowpox as employed by Pearson and
Woodville as his discovery. In his petition to Parliament there was
no mention of Horsegrease Cowpox; but Cowpox, with “its beneficial
effect of rendering the persons inoculated therewith perfectly
secure through life from the infection of Smallpox,” was set forth
as the result of his most attentive and laborious investigation at
the sacrifice of time, money, and professional advancement. We have
to recollect that Jenner was inspired with what he called “the fond
hope of enjoying independence,” and he was not slow to recognise,
that if he stood by Horsegrease Cowpox his “fond hope” would be
wrecked. The statement may seem incredible, but the fact of the
transformation is manifest at large to any one who will take the
trouble to compare Jenner’s _Inquiry_ of 1798 with his Petition to
the House of Commons in 1802.

Pearson failed to arrest the imposture. He might have said to
Jenner, “Your discovery was not Cowpox: that was well known
to every dairymaid in your neighbourhood. Your prescription
was Horsegrease Cowpox. You condemned Cowpox, which Cowpox has
nevertheless been brought into use by Woodville and me. Keep to
your Horsegrease Cowpox; make what you can of it; and leave us
alone.”

Had Pearson taken this course, he would have fixed Jenner to his
discovery, such as it was, and have clearly defined and established
his own and Woodville’s service in rendering the New Inoculation
practicable and popular. But he failed to draw a firm line between
Woodville and himself and Jenner, and to insist that they were
operating, not only with a different pox, but with a form of pox by
him rejected as useless. Through this default, he enabled Jenner
to intrude into a province that was not his own, and to reap where
he had not sown, and gather where he had not strawed. It is to be
admitted that the facts as stated were all involved in Pearson’s
_Examination_, but they were _involved_, and required picking out
and sharper definition to give them effect. Truth is truth, but
truth to have its rightful influence has to be made plain. It is of
little avail to have a good cause at law if the means are wanting
to place its goodness manifest and paramount over contention to the
contrary.

This, too, may be observed: Pearson was not in condition to offer
the manner of resistance specified. To have turned Jenner’s flank,
it would have been necessary to discredit Cowpox; and Pearson was
committed to Cowpox. Jenner had been familiar from youth with the
dairymaids’ faith in Cowpox. Why then did he not advertise its
virtue? Because it had been proved to him that the dairymaids’
confidence was illusory. His recommendation of Horsegrease Cowpox
attested his distrust in Cowpox. If Pearson had asked himself,
What induced Jenner to set aside Cowpox for Horsegrease Cowpox?
the answer would have revealed to him a whole series of facts
to the discredit of that prophylaxy of which he and Woodville
had constituted themselves advocates. Thus, fettered by his own
prepossession, Pearson was unable to deal effectually with Jenner
without incurring a disenchantment fatal to his own enterprise.

       *       *       *       *       *

When we recognise that Jenner’s prescription was a disease of
the horse communicated to the cow, which Pearson and Woodville
set aside for Cowpox, the controversy as to the originator of
the use of Cowpox for inoculation loses significance. We have to
assert peremptorily that Jenner had no claim to the use of Cowpox
whatever. It is true that he advanced the claim in his _Origin of
the Vaccine Inoculation_ in 1801, and in his Petition to Parliament
in 1802; but those who refer to his _Inquiry_ of 1798 will require
no further proof of his mendacity. That his claim to the use of
Cowpox was entertained can only be ascribed to that indolence,
ineptitude and ignorance on the part of the world whereon quacks
presume and prosper.

It was Pearson and Woodville, I once more repeat, who diffused
and popularised Cowpox; and Pearson’s inquiries left no doubt
that the faith in Cowpox as a preventive of Smallpox was widely
entertained; and that the substitution of Cowpox for Smallpox in
inoculation was a mere question of time and accident. Mr. Downe
of Bridport informed Pearson that a surgeon in his neighbourhood
suffered discredit in practice because it was reported that he
inoculated with Cowpox instead of Smallpox; and the papers of
Mr. Nash, surgeon, of Shaftesbury proved that in 1781 he had the
project of Cowpox Inoculation distinctly before him. The evidence
of Benjamin Jesty, farmer of Downshay in the Isle of Purbeck, has
usually been taken as most conclusive in relation to the immanence
of the New Inoculation in the common mind. Jesty was invited to
London by the conductors of the Original Vaccine Pock Institution,
44 Broad Street, Golden Square; and in August, 1805, they had him
with his wife and two sons under examination. In their report[130]
it is said--

  We think it a matter of justice to Mr. Jesty, and beneficial to
  the public, to attest, that among other facts he has afforded
  decisive evidence of his having vaccinated his wife and two sons,
  Robert and Benjamin, in the year 1774; who were thereby rendered
  insusceptible of the Smallpox, as appears from the frequent
  exposure of all three to that disorder during the course of 31
  years, and from the inoculation of the two sons for the Smallpox
  15 years ago.

It is to be observed that insusceptibility to Smallpox was by
no means infrequent apart from Cowpox; and as fear of Smallpox
predisposes to attack, so, on the other hand, confidence in
security, whether by Cowpox or other charm, would tend to exemption.

Jesty’s reasons for his experiment were thus specified--

  He was led to undertake the novel practice in 1774 to counteract
  the Smallpox, at that time prevalent at Yetminster, from
  knowing the common opinion of the country ever since he was a
  boy (now 60 years ago) that persons who had gone through the
  Cowpock naturally, that is to say by taking it from cows, were
  insusceptible of the Smallpox.

  By himself being incapable of taking the Smallpox, having gone
  through the Cowpock many years before.

  From knowing many individuals who after the Cowpock could not
  have the Smallpox excited.

  From believing that the Cowpock was an affection free from
  danger; and from his opinion that by the Cowpock Inoculation
  he should avoid engrafting various diseases of the human
  constitution, such as “the Evil, madness, lues, and many bad
  humours,” as he called them.

In these reasons we have the Cowpox doctrine as prevalent in
Dorsetshire, which Jesty developed in family practice. The report
proceeds--

  The remarkably vigorous health of Mr. Jesty, his wife, and two
  sons, now 31 years subsequent to the Cowpock, and his own healthy
  appearance, at this time 70 years of age, afford a singularly
  strong proof of the harmlessness of that affection; but the
  public must, with particular interest, hear that during the late
  visit to town, Mr. Robert Jesty submitted publicly to inoculation
  for the Smallpox in the most rigorous manner; and that Mr. Jesty
  also was subjected to the trial of inoculation for the Cowpock
  after the most efficacious mode, without either of them being
  infected.

It is curious how evidence conforms to prepossession. Dr. Pearson
and his associates were persuaded that as no one could have
Smallpox twice, neither could any one have Cowpox twice. Jesty
had Cowpox when young, and when at three score they found him
insusceptible, they took it for granted that re-vaccination was
impossible. Robert Jesty, who had Cowpox thirty-one years before
was at the same time inoculated with Smallpox, and as that likewise
failed to take, the experiment enforced the desired conclusion.

Having turned out so well, praise and portraiture were bestowed on
Jesty--

  The circumstances in which Mr. Jesty purposely instituted the
  Vaccine Pock Inoculation in his own family, namely, without
  any precedent, but merely from reasoning upon the nature of
  the affection among cows, and from knowing its effects in the
  casual way among men, his exemption from the prevailing popular
  prejudices, and his disregard of the clamorous reproaches of his
  neighbours, will entitle him, in our opinion, to the respect
  of the public for his superior strength of mind. Further, his
  conduct in again furnishing such decisive proofs of the permanent
  anti-variolous efficacy of the Cowpock, in the present [1805]
  discontented state of mind in many families, by submitting to
  Inoculation, justly claims at least the gratitude of the country.

  As a testimony of our personal regard, and to commemorate so
  extraordinary a fact as that of preventing the Smallpox by
  inoculating for the Cowpock 31 years ago, at our request, a
  three-quarter length picture of Mr. Jesty is painted by that
  excellent artist, Mr. Sharp, to be preserved at the Original
  Vaccine Pock Institution.

    GEO. PEARSON,   }
    LAW. NIHELL,    } _Physicians_.
    THOS. NELSON,   }

    T. KEATE,       } _Consulting
    T. FOSTER,      } Surgeons_.

    J. C. CARPUE,   }
    J. DORATT,      } _Surgeons_.

    FRAS. RIVERS,   }
    EV. A. BRANDE,  } _Visiting
    PH. DE BRUYN,   } Apothecaries_.

    JOHN HEAVISIDE, }
    THOMAS PAYNE,   } _Treasurers_.

    WILLIAM SANCHO, _Secretary_.

      _6th September, 1805._

In the church-yard of Worth Matravers, Dorset, there is a
grave-stone with this inscription--

    SACRED TO THE MEMORY OF
    BENJAMIN JESTY, OF DOWNSHAY,
    WHO DEPARTED THIS LIFE
    APRIL 16TH, 1816, AGED 79 YEARS.

  He was born at Yetminster, in this County, and was an upright
  honest man, particularly noted for having been the first person
  known that introduced

    THE COWPOX BY INOCULATION,

  and who, from his great strength of mind, made the experiment
  from the Cow on his Wife and two Sons in the year 1774.

Jesty is frequently played off against Jenner, as having
anticipated him, but under a misapprehension. Jesty inoculated
with Cowpox, sharing the dairymaids’ faith that it prevented
Smallpox. Jenner knew that the dairymaids were wrong, and that
Cowpox did not avert Smallpox. What he recommended was Cowpox
produced by Horsegrease. Pearson and Woodville disregarded
Jenner’s recommendation and made use of Cowpox like Jesty, which
substitution Jenner did not resist; and not only did not resist,
but claimed as the fulfilment of his programme! Jenner should never
be suffered to get mixed up with Jesty, and the course of his
procedure be thereby obscured.

I am explicit to iteration because the truth is not recognised
and may be accounted incredible. In another way the facts may be
thrown into relief if we inquire, How would Jenner have fared
had he applied for a patent? Suppose his several publications
were submitted to a patent-agent, In what manner could a tenable
specification be evolved from these materials?

    1798.--_The Inquiry._                    { Prescribes Horsegrease
                                             { Cowpox.

                                             { Slackens off from
                                             { Horsegrease Cowpox;
                                             { ascribes its
    1799.--_Further Observations._           { efficacy to common
    1800.--_Continuation of Observations._   { repute; and recommends
                                             { escharotics to arrest
                                             { its virulence.

                                             { Claim of discovery and
    1801.--_Origin of Vaccine Inoculation._  { use of Cowpox, previously
    1802.--Petition to Parliament.           { condemned as spurious,
                                             { and Horsegrease Cowpox
                                             { dropped.

By no ingenuity could a valid patent be got out of these documents.
If Horsegrease Cowpox were selected as the basis of claim, what
of the repudiation of Cowpox? and if Cowpox, what of Horsegrease
Cowpox? And if Horsegrease Cowpox, what of the ascription of its
virtue to common repute? And if Cowpox, was not the committee
of the House of Commons in 1802 compelled to disallow Jenner’s
claim to the discovery, and to define and limit his merit to the
propagation of its virus from arm to arm? It was, however, Pearson
and Woodville who first propagated Cowpox from arm to arm: Jenner’s
start being made with Horsegrease Cowpox. But allowing him so much
credit, it is nevertheless to be remembered that it was at that
time a frequent practice to inoculate with Smallpox from arm to
arm; and the substitution of Cowpox for Smallpox was a trifle for
which to pay £10,000 and dissolve in ecstasies of admiration.


FOOTNOTES:

[128] _An Examination of the Report of the Committee of the House
of Commons on the Claims of Remuneration for the Vaccine Pock
Inoculation: containing a Statement of the Principal Historical
Facts of the Vaccinia._ By George Pearson, M.D., F.R.S. London,
1802. 8vo. Pp. 196.

[129] Such was the logic, but such was not the fact. If no one
could have Smallpox twice, and if inoculated Cowpox was equivalent
to Smallpox, no one could have Cowpox twice. Such was the argument.
Pearson did not foresee its systematic refutation exemplified in
Re-Vaccination, septennial, triennial, annual.

[130] _Edinburgh Medical and Surgical Journal_, October, 1805. P.
513.




CHAPTER XII.

OBSERVATIONS ON THE POSITION IN 1802.


One of my medical readers observes--

  The House of Commons in 1802 was committed to a variety of
  extravagances, but, allowing for these, you have to account for
  certain evidence that Cowpox had _some_ influence over Smallpox;
  for you surely do not mean to contend that it had _no_ influence
  over that disease, and that the evidence before the Committee was
  a uniform tissue of illusion and delusion.

Put thus, it is as difficult to deal with the objection as it is
to prove a negative. It is not for me to define the influence of
cowpox over smallpox, but for those who believe in its prophylaxy.
I should argue that as ill-health leads to ill-health, and as
corruption breeds corruption, that inoculated cowpox would generate
a habit of body favourable to smallpox, and at the same time tend
to excite and intensify other forms of disease. I would also ask,
What are the extravagances to be allowed for? When these are
determined we may then proceed to discuss what are not extravagant.
It is a common form of evasion to make a general confession
of guilt in order to avoid the pain of specific and explicit
condemnation. It is conceded that the House of Commons in 1802
“committed a variety of extravagances,” and under this appearance
of candour the chief extravagance is implicitly re-asserted and
carried forward, namely, that inoculated cowpox had an influence
adverse to smallpox.

In the “variety of extravagances,” few, I suppose, would hesitate
to include the asserted annual smallpox mortality of the United
Kingdom. Sir Gilbert Blane pronounced it 45,000, while Dr. Lettsom
gave it as 36,000--a wide difference in the play of fancy! Dr.
Lettsom, who claimed to have paid much attention to figures
connected with smallpox, was pleased to convert an extreme London
mortality, namely, 3000, into the ordinary mortality, although in
some years it fell under 1000. Then estimating the population of
London at one million, and the population of the United Kingdom
as twelve millions, he multiplied 3000 by 12, and evoked the
astounding national death-rate of 36,000 annually from smallpox,
all of whom were to be saved by Jenner’s prescription! But whether
he had taken the average or even the lowest metropolitan mortality,
the computation would have remained grossly fallacious. London
overcrowded and pestiferous, was no standard for the general
population, urban or rural; and the assumption was monstrous
that smallpox, a notoriously sporadic disease, was constant and
equally diffused over the land. We are without comprehensive vital
statistics for the time in question, but arguing from the London of
to-day in continual connection with the provinces, to the London
of 1802 in comparative isolation, what do we find? Why, smallpox
prevalent in London with little or no smallpox in the country! In
the _Pall Mall Gazette_ of 31st May, 1878, we read--

  The degree in which the Smallpox epidemic of the last seven years
  has been localised in London is very remarkable. The _Lancet_
  points out that during the week ending 25th May, 51 fatal cases
  were registered in London and its suburban districts, whereas not
  one was recorded in any of the nineteen large provincial towns
  having an aggregate population about equal to that of London.
  Since the beginning of the year the fatal cases of Smallpox
  within fifteen miles of Charing Cross have been 1,134, while but
  8 have occurred in the nineteen other large towns.

We find similar illustrations of the sporadic character of smallpox
wherever we can get at the facts. In 1874 there died in London 735
of smallpox, but not one in Birmingham; 386 in Liverpool, but not
one in Plymouth; 347 in Salford, but not one in Nottingham; 190 in
Manchester, and but 1 in Sheffield; 24 in Bristol and 4 in Leeds;
and so on. What reason is there to believe that what is true of
smallpox within our own experience was otherwise in the experience
of our forefathers?

I said that few would hesitate to include Dr. Lettsom’s 36,000
and Sir Gilbert Blane’s 45,000 among the extravagances of 1802,
but I forgot myself. We have a National Health Society with the
Duke of Westminster for President and all manner of notables,
aristocratic, philanthropic, scientific, and literary, among
its committee and members. Now this Society issues a hand-bill
of advices and warnings relating to smallpox, approved too by
the Local Government Board, and there we find set forth as
unquestionable matter of fact--

  “_Before the introduction of Vaccination Smallpox killed 40,000
  persons yearly in this country._”

We thus see how hard it is for a convenient fable to die, even when
known to be false, and how respectable people will keep repeating
it as long as they fancy it is for good.

Absurd as was the extension of the ratio of London smallpox to the
populations of the United Kingdom, of Europe, and of the world,
the London disease itself afforded little warrant for the extreme
terms of horror and dismay with which it was described. Smallpox
did not increase the death-rate of London: when smallpox was
most prevalent and least prevalent, the total mortality was but
slightly affected. As long as the sanitary conditions of the great
city remained unchanged, fevers replaced smallpox and smallpox
replaced fevers, and whether deaths were from one form of disease
or another, so that the people died the same, what did it matter?
Smallpox when most prevalent was never accountable for much more
than 10 per cent. of the total London mortality, and in some years
for less than 3 per cent.; and it is to be remembered that the
larger portion of that mortality was infantile mortality--smallpox
being in the great majority of cases a disease of the young; none
the less objectionable on that account, but less chargeable than
some other forms of zymotic disease with striking down the adult
bread-winner and enlarging misery and pauperism.

Again, in much of the talk about smallpox, it was assumed that the
disease had no limits--that it was something like fire, and might
spread to any extent if unchecked. But what was there to justify
such an assumption? Assuredly nothing in London experience.
Smallpox was always present in London, waxing and waning under
some unknown law; the deaths rising as high as 3992 in 1772 and
falling as low as 522 in 1797--the extremes of the century. Why
did 4000 never die in any year, or 7000, or 10,000? When a fire
is extinguished, we know it has met with a check; and if smallpox
caused 3992 deaths in 1772 and 522 in 1797, and smallpox be like
fire, there was, we see, a check; and I ask, What was that check?
There may be answers, but none for unreserved acceptance. What
is certain is, that in London smallpox was never an illimitable
affliction. It had limits, and it was only in the rhetoric of
alarmists that it had none.

And the check to the disease (whatever it was) lay in the bodies of
the citizens, and not in their therapeutics. Isolation was rarely
attempted, and in their crowded habitations was impracticable.
Moreover they had not only the smallpox appropriate to their
evil conditions to contend with, but the disease as propagated
and diffused by the inoculators. What we have to say is, that
whilst in the London of last century we behold smallpox endemic
and cultivated, yet in no year did the mortality therefrom exceed
4,000; and further, that with so much to favour and stimulate the
disease it was a diminishing quantity. In the words of Dr. Farr--

  London Smallpox attained its maximum mortality after inoculation
  was introduced, and the disease began to grow less fatal before
  vaccination was discovered.

We shall see as we proceed how the natural check to smallpox
(whatever it was), the immunity of the majority from infection,
and the decline of the disease were all claimed as the blessed
results of Jenner’s prescription; and now-a-days it has passed
into common-place, for which evidence is thought superfluous,
that without that prescription smallpox might have illimitable
extension. If anywhere a variolous epidemic is slight, it is said
that but for vaccination it would have been severe; and if severe,
that its intensity would have been doubled or trebled save for the
action of the same prophylactic. We have a remarkable illustration
of this style of prophecy in the Report of the Select Committee of
the House of Commons upon the Vaccination Act of 1867, dated 23rd
May, 1871, where we read--

  Smallpox unchecked by Vaccination, is one of the most terrible
  and destructive of all diseases as regards the danger of
  infection, the proportion of deaths among those attacked, and the
  permanent injury to the survivors.

  Your Committee believe that if Vaccination had not been general,
  _the epidemic_ [then prevalent] _would have become a pestilence,
  raging with the destructive force of the Plague of the middle
  ages_.

What is beyond evidence is beyond refutation; and the imaginations
of M.P.’s, dull though they be, not unfrequently prevail over their
intelligence.

To set aside the mass of testimony adduced by Jenner’s friends
before the Commons’ Committee in 1802 is sometimes described as
a hopeless undertaking; but the answer to such a boast is, that
experience has nullified the essential part of that testimony, and
that there is little left to account for. No well-informed medical
practitioner now believes what the Committee was led to believe,
that to be inoculated with cowpox was to be secure from smallpox
for life. The security, where still credited, is subject to so many
qualifications that the primitive inoculators with cowpox would
have thought such protection not worth paying for, still less of
exulting over as the greatest discovery ever made in medicine.
Nor would many now admit the validity of the Variolous Test which
then carried conviction with irresistible force. Inoculation with
smallpox was in itself an uncertain operation, and that it should
fail after inoculation with cowpox, ere the poisoning of the
blood had been worked off, was in nowise surprising. The exposure
of vaccinated subjects to smallpox infection was in like manner
deceptive; and it was conveniently forgotten that all manner
of people were exposed to contagion with impunity in the usual
circumstances of life. Taking a year of exceptional smallpox in
London, such as Dr. Lettsom set forth as ordinary, when 18,000 were
affected and 3000 died (that is one in six), there were in the
million of inhabitants 982,000 who escaped. How did they escape?
A multitude must have come into immediate contact with the sick:
How did they remain unscathed? The question is simple, but it is
crucial. If smallpox were like fire, and men, women, and children
like fuel, why did not all burn? Under what prophylaxy did they
abide secure? Again in this connection, we must not lose sight
of the magic of faith. Things being equal, two persons exposed
to smallpox, one confident that he was invulnerable through
vaccination, and the other apprehensive of danger, the chances are,
that the fearful would be attacked whilst the fearless would have
his faith justified in immunity.

In considerations thus obvious it is not difficult to understand
how the testimony delivered to the Committee had a semblance as of
veracious Nature. Any one who has studied the history of remedies,
or the various quackeries within his own observation, will know
how easy it is to conjure up testimony, with asseverations
presumptuous to question, which by-and-by are gradually discredited
and ultimately disappear in forgetfulness. I have, therefore,
no disposition to be hard on the men of 1802. From our vantage
of experience we see how they were led astray, and recognise
the pressure of the influences under which they acted. Moreover
a remedy that bore the promise of relief from the pest of
smallpox inoculation came with strong seduction. What a pest that
inoculation was, how it was loathed, and how it was submitted to
under the persuasion of duty are written at large in the domestic
memoirs of last century. Every mother among the upper and middle
classes was persuaded that it was necessary for her children
to undergo the variolous ordeal--an ordeal that involved the
deliberate introduction of smallpox into her household. It was
hateful, it was intolerable, and yet it had to be endured! The
doctors minimised the risks to the uttermost, but what they really
believed plainly appeared when vaccination presented itself as an
alternative. Then smallpox inoculation was denounced by its former
practitioners with a fervour that contrasted painfully with their
antecedent professions; whilst parents heard with indescribable
satisfaction that absolute life-long security from smallpox was
henceforward insured at the price of a trifling operation attended
by no peril whatever, and with distinct benefit to health. To make
the contrast clear I subjoin copy of a hand-bill that was posted on
walls and circulated by thousands in London and the country at the
time of which I write, 1801-2.


  A TABLE SHEWING THE ADVANTAGES OF VACCINE INOCULATION.

       _The Natural            _The Inoculated           _The Inoculated
         Smallpox._               Smallpox._                Cowpock._

  I. The natural Small-   I. The inoculated       I. The inoculated
  pox is a loathsome,     Smallpox also is        Cowpock scarcely
  infectious, painful,    loathsome, infectious,  deserves the name of
  and fatal disease. It   painful, and sometimes  a disease. It is not
  is confined to no       fatal; and, when        infectious; and, in
  climate, but rages in   partially adopted,      the opinion of the
  every quarter of the    spreads the contagion,  most experienced
  world, and destroys a   and increases the       practitioners has
  tenth part of mankind.  mortality of the        never proved fatal.
                          disease.

  II. Those who survive   II. It sometimes        II. It occasions no
  the ravages of that     occasions the same      other disease. On the
  dreadful distemper,     maladies as the         contrary, it has often
  often survive only to   natural Smallpox.       been known to improve
  be the victims of other                         health, and to remedy
  maladies, or to drag                            those diseases under
  out a miserable                                 which the patient
  existence worse than                            before laboured.
  death.

  III. This cruel and     III. It frequently      III. It leaves behind
  lamentable disorder     leaves behind it the    no blemish, but _a
  leaves behind it pits,  same blemishes and      Blessing_--one of
  scars, and other        deformities as the      the greatest ever
  blemishes and bodily    natural Smallpox,       bestowed on man--_a
  deformities which       which are the more      perfect security
  embitter life.          deplorable as they      against the future
                          are brought on by a     infection of the
                          voluntary act.          Smallpox_.

  From this faithful statement of the advantages attending VACCINE
  INOCULATION, it must appear evident to every unprejudiced person,
  that it is the duty as well as the interest of every parent, of
  every individual, and of every nation, to adopt the practice, and
  to hasten

    THE EXTERMINATION OF THE SMALLPOX.

It was thus that Vaccination was introduced to the English people,
not by men accounted quacks, but by leaders of the medical
profession; and whatever the illusions and mischiefs of the
new practice, we must allow it the credit of discouraging and
ultimately superseding the grosser practice of inoculation with
smallpox. As for the various items in the bill, we have had, and
shall have them before us, and I would only now recall attention
to the initial statement that “Smallpox destroys a tenth part
of mankind.” The summary answer to the statement is that the
number of mankind was unknown, likewise their diseases, and the
proportion in which they were fatal. It was a repetition of Dr.
Lettsom’s unwarrantable extension of a bad year of London smallpox
to the whole earth. Even in an occasional year when upwards of
3000 died in London of smallpox, the total average mortality was
not seriously affected thereby. The deaths, as we have observed,
were merely taken out in smallpox instead of in some other form of
fever. That nothing can permanently reduce the death-rate of any
community save improved sanitary conditions and personal habits was
unrevealed in 1802.

Notwithstanding the exultation over Jenner, “the saviour of the
world from smallpox,” and over “the greatest discovery since the
creation of man,” the suspicion is unavoidable that it was largely
factitious--“from the teeth outwards,” as Carlyle would have said.
The vote of £10,000 to the miraculous benefactor of the human race
was carried by a majority of three in a Parliament to which no
more than 115 members could be whipped up, and neither Pitt or Fox
thought it worth while to be present. Nor was Jenner treated as if
his asserted services to mankind were soberly credited. “Yes,” it
may be said, “the world never recognises its true benefactors;”
but the observation does not apply, for Jenner was profusely
recognised, and received praise from his contemporaries which
posterity hesitates to repeat. Nevertheless the praise, though
profuse, was little more than verbal. Some expressed indignation
at the paltry award of £10,000, and proposed to start a national
subscription, but no one took the initiative, and the national
gratitude was not put to the test. Even the £10,000 was paid
tardily. Writing to a friend on 3rd June, 1804, Jenner had to
relate that--

  The Treasury still withholds the payment of what was voted to me
  two years ago; and now there are new officers, and it may yet be
  very long before a guinea reaches me from that quarter.

When at last the money was paid, nearly £1000 was deducted for
fees, etc.; and, having the repute of the money, he was considered
public property. As Dr. Baron records--

  The people of England seemed to think that the fee-simple of his
  body and mind had been purchased by the TEN THOUSAND POUNDS; and
  many an unjust and ungenerous intimation of this feeling was
  conveyed to him. To a mind like his, this was no small annoyance.
  He was called upon for explanations and opinions by every person
  who thought a direct communication with the Author of Vaccination
  an honour worth seeking, while they might have obtained all the
  information they wanted in his published writings.

So much was matter of course, but Jenner had worse to encounter.
He took the fine talk of his medical and political friends _au
sérieux_, bade farewell to Berkeley, and set up as London physician
in Hertford Street, May Fair. The result we have in his own words--

  Elated and allured by the speech of the Chancellor of the
  Exchequer, I took a house in London for ten years, at a high
  rent, and furnished it; but my first year’s practice convinced
  me of my own temerity and imprudence, and the falsity of the
  Minister’s prediction. My fees fell off both in number and value;
  for, extraordinary to tell, some of those families in which I had
  been before employed, now sent to their own domestic surgeons
  or apothecaries to inoculate their children, alleging that they
  could not think of troubling Dr. Jenner about a thing executed so
  easily as vaccine inoculation. Others, who gave me such fees as I
  thought myself entitled to at the first inoculation, reduced them
  at the second, and sank them still lower at the third.

His fees did not amount to £350 a year, and he presently found
himself nothing the better for the parliamentary grant, and
involved in grave financial difficulties. He wrote to a friend, 2nd
November, 1804--

  The London smoke is apt to cloud our best faculties. I do
  not intend to risk the injury of mine in this way, unless
  occasionally for the transaction of business. The public has not
  the smallest right to require such a sacrifice of me. I have
  received no reward for showing them how to remove one of the
  greatest obstacles to human happiness; but, on the contrary, am
  loaded with a tax of more than £400 a year!

And to another correspondent--

  I have now completely made up my mind respecting London. I have
  done with it, and have again commenced as village doctor. I found
  my purse not equal to the sinking of a £1000 annually (which has
  actually been the case for several successive years) nor the
  gratitude of the public deserving such a sacrifice. How hard
  after what I have done, the toils I have gone through, and the
  anxieties I have endured _in obtaining for the world a greater
  gift than man ever bestowed on the world before_ (excuse this
  burst of egotism), to be thrown by with a bare remuneration of my
  expenses.

It was hard! People who attributed to Jenner the greatest discovery
ever made, the preservation of from 36,000 to 45,000 lives
annually in the United Kingdom, and the salvation of the human
race from smallpox, were indeed entitled to have dealt with him
more handsomely. He had sympathisers and candid friends. “Your
liberality and disinterestedness every one must admire,” wrote Mr.
Benjamin Travers, “but you are sadly deficient in worldly wisdom.
If you had undertaken the extinction of the smallpox yourself, with
coadjutors of your own appointment, I am confident, you might have
put £100,000 in your pocket; and the glory would have been as great
and the benefit to the community the same.” How that £100,000 was
used to tantalise him! and yet, as Dr. Pearson pointed out, never
any one showed on what practicable terms the immense sum could have
been earned by means of cowpox.




CHAPTER XIII.

THE ROYAL JENNERIAN SOCIETY.


Jenner, jealous of Pearson, was anxious to supersede the
Institution for the Inoculation of the Vaccine Pock established
by him in 1799; but Jenner was what Scots call “a feckless
creature,” whose wishes rarely issue in fruit. After his success
in Parliament, he did not remain in London to improve his
opportunities, but retreated to domestic quiet at Berkeley and
Cheltenham. His friends, however, were mindful of him, and Dr.
Hawes, Mr. Addington, surgeon, Benjamin Travers, and Joseph Leaper
met in Queen Street, City, 3rd December, 1802, and resolved
to establish a “JENNERIAN SOCIETY for the Extinction of the
Small-Pox.” Mr. Addington transmitted the resolution of the meeting
to Jenner, saying--

  We look to your direction and assistance, and feel very desirous
  of knowing when it is probable we may have the pleasure of seeing
  you in town.

Joseph Fox of Lombard Street, dentist and enthusiastic promoter of
the new inoculation, also wrote to him, 4th December, soliciting
his co-operation--

  The plan which is in agitation is of the most extensive and
  liberal kind. It is even expected that the Royal countenance
  will be gained; but much depends upon thee. All are looking
  toward thee as the proper person to lay the foundation-stone. It
  would be well if this could be done in the course of the present
  year, particularly as it is the memorable time when the practice
  received parliamentary sanction.

But the ease-loving Jenner was not to be drawn. He wrote to Mr.
Addington from Berkeley, 10th December, 1802--

  Your very obliging letter found me just returned with my wife
  and children to our pleasant home, where I promised myself a few
  weeks of domestic comfort after some years spent in constant
  anxieties.

  This is the pull on one side. On the other is the delightful
  prospect held up to my view of an Establishment for the promotion
  of Universal Vaccine Inoculation--an establishment to which I
  have for years been looking forward with a longing eye.

  I need not go farther into explanation, and shall only say, that
  if it be incompatible with the generous design to suffer me to
  remain here for the time I had allowed myself, I will certainly
  comply with the wishes of my friends and go to town. Yet it must
  be observed that I humbly conceive and ardently hope that my
  presence will not be absolutely necessary. I have written to my
  friend Dr. Lettsom and requested him to have the kindness to be
  (as far as such a thing is admissible) my representative. In his
  judgment on the present occasion I can place every confidence.

The letter describes the man. He did not like to be troubled--not
even when action stood for the advancement of his own glory. As
Pearson observed, “If Vaccination had been left to Jenner, it would
never have come to anything.” Benjamin Travers also wrote to him
at the same time urging the necessity of his presence in London,
but he was put off with similar excuses and with expectations of
assistance from the public purse--

  Government, I have no doubt, will give due support to so just
  and laudable an undertaking. I am warranted in this suggestion
  by a long conversation I had with Mr. Abbott, Speaker of the
  House of Commons, who said that after the investigation of the
  Parliamentary Committee he thought it became a public duty to
  form Institutions for Gratuitous Inoculation.

As Jenner was not to be had, the promoters set to work without him,
and their triumph was complete when at a meeting in the London
Tavern on 17th February, 1803, it was announced that his Majesty
had graciously condescended to become the patron of “THE ROYAL
JENNERIAN SOCIETY for the Extermination of the Smallpox:” that
her Majesty had with great benignity acquiesced in the request to
become patroness: that his Royal Highness the Prince of Wales and
their Royal Highnesses the Duke of York, the Duke of Clarence, and
the Duke of Cumberland, had evinced, in a most flattering manner,
their willingness to accept the office of vice-patrons: that his
Grace the Duke of Bedford had consented to fill the office of
president; and that many prelates, noblemen, and gentlemen of the
highest rank and respectability had agreed to be vice-presidents of
the Society.

The approval of the Prince of Wales was conveyed in a letter
of the Earl of Egremont, over which Baron, Jenner’s biographer
(writing when the Prince had blossomed into George IV.), bursts
into worship in capitals, as follows--

  The gracious and beneficent mind of the Illustrious writer is
  displayed in every line; and the whole is truly characteristic of
  those great qualities which continue to add lustre to his still
  more EXALTED STATION and shed so much of real glory on his REIGN.

Subscriptions flowed in freely. The Corporation of London gave
£500, the East India Company £100, the Duke of Bedford £50, and
guineas ten, five, two and one were contributed with a liberality
that attested the fervour of the common credulity. But it was much
easier to get money than to administer it with a nice adjustment of
means to ends. The Jennerians, too, were over-organised. There were
a Medical Council and a Board of Directors. The Medical Council
consisted of twenty-five Physicians and twenty-two Surgeons of the
first eminence in London, with Jenner for president and Lettsom for
vice-president. Such mechanism could never work, and at the point
where real business was to be transacted, an officer was selected
of extraordinary character.

John Walker was born at Cockermouth in 1759, and was a
school-fellow of Woodville, subsequently physician to the London
Smallpox Hospital. After a rambling career as blacksmith, engraver,
and school-master, he turned his attention to medicine, graduated
at Leyden, associated with French revolutionists in the guise of
a member of the Society of Friends; then accompanied Dr. Marshall
in a vaccinating cruise to the Mediterranean, from whence, after
a variety of adventures in war and weather, he appeared in London
in 1802, habited as a Quaker with a long beard--an apparition in a
clean shaven community. Joseph Fox, the dentist of Lombard Street,
gave him the use of a part of his house, and there, in his own
words, “I set up my VACCINIUM for the glorious cause.” As soon as
the Jennerian Society was initiated, Walker was put forward by
Joseph Fox and other Friends as inoculator-in-chief, and Walker
made application in the following terms--

    TO THE JENNERIAN SOCIETY.

  Friends,--Perhaps there is not any individual who has greater
  reason to be gratified with the interest ye are taking in the
  Vacciole Inoculation than myself.

  Of late years, the practice of it has been the chief business
  of my life, and I am partly indebted, during some of the last
  months, to the zeal of individual members of your Society for
  being enabled to continue it. They have sent patients to me from
  remote and distant parts of this extensive City, when, for want
  of notoriety, I might otherwise have been unemployed.

  May I offer to you my services in this way: during the infancy
  of your Institution, you cannot do me a greater pleasure than to
  increase my number of patients; for where I now vacciolate tens,
  I could easily do the same for hundreds.

  After this declaration, I hope you will consider the present
  address as neither unseasonable nor intrusive, but rather as a
  mark of unwavering zeal in the happy cause in which ye are now
  embarking.

    Respectfully,
    JOHN WALKER.

  _54 Lombard Street_, 29. xii., 1802.

When the day of election arrived, four, out of many, were selected
as candidates, one of them being Dr. Domeier, a German, strongly
recommended by the Queen and Prince of Wales; but the Friends stood
by their man, and Dr. Walker was appointed Resident Inoculator at
the Central House of the Society in Salisbury Square with a salary
of £200 a year, coal and candles, and liberty to take fees for
private “vacciolation.”

The promoters of the Society, operating under the prestige of
Jenner’s name, resolved to hold their annual festival on his
birthday, the 17th of May; and at the first dinner in 1803 he was
subjected to flatteries enough to turn any man’s head who does not
know the reckless insincerity that prevails on such occasions. It
was the adulation connected with the formation of this Society that
as much as anything induced Jenner to set up as west-end physician.
The attempt of the middle-aged country doctor was the occasion
of much grim humour, and his consequent embarrassments were the
concern of his friends for many a day. Apart from the inherent
difficulties of the enterprise (social rather than medical) Jenner
was constitutionally deficient in method and assiduity. Wrapped
up in his wife and family, business was always set aside when
they claimed his affectionate regard; and to leave London for
Gloucestershire for some domestic cause was in his eyes procedure
that required no defence--all which might be amiable, but it
constantly annoyed and frustrated his associates; and it is not
thus encumbered that any man can expect to make way in the world.
When the anniversary in 1804 came round, Jenner was at Berkeley,
and when pressed to attend he wrote--

  Though a post-chaise might bring up my body, my mind would be
  left behind. One cause of my absence, among many others, is the
  sad state of Mrs. Jenner’s health. I cannot leave her even for a
  day with any comfort to my feelings. My friends, who honour the
  glorious cause of Vaccination by assembling on the 17th, will,
  I trust, admit my apology. It is my intention to collect a few
  staunch Vaccinists on that day at my cottage. I shall give them
  some roast beef, not forgetting a horn or two of good October. We
  shall close the day with bumpers of milk-punch to the health of
  the Friends of Humanity at the Crown and Anchor; and if it were
  not for the indisposition of my poor wife, we should roar like
  bulls.

If Jenner was idle and self-indulgent, Walker was the reverse. He
was a fine specimen of the GENUS, _Fanatic_. Possessed with a lust
for what he called Vacciolation, he had a brow of brass, nerves of
steel, and habits like clockwork. Thirteen stations were opened in
London where cowpox was inoculated gratis, and in eighteen months
Walker was able to announce that 12,288 patients had been operated
on, and that 19,352 charges of virus had been dispatched to the
country and foreign parts; whereon Baron observes--

  The effect of these exertions was immediately perceived by a
  striking diminution of the number of deaths from smallpox within
  the Bills of Mortality. In 1803 they amounted to 1173; in 1804
  they were only 622. The contrast will appear still greater when
  it is considered that the deaths amounted to 2409 in the year
  1800; and that the annual average of deaths for fifty years
  previously was 2018.[131]

The passage is noteworthy as representative of many similar
passages in the literature of Vaccination. It might be described as
dishonest, but the craft is so transparent that the epithet would
be extravagant. The probable explanation is, that Vaccination had
come to be regarded as so unquestionably beneficial that _anything_
might be asserted in its favour, and that _anything_ was true.
Else a child might have asked how 12,000 or 24,000 vaccinations
could by any possibility affect an immediate diminution in the
deaths from smallpox in a population of eight or nine hundred
thousand. Baron would also lead his readers to suppose that the
low mortality of 1804, namely 622, was unexampled, though with the
Bills of Mortality before him, he might have seen that the deaths
in 1797 fell to 522; and he knew that the low figure of 1804 was
not maintained, but rose to 1685 in 1805. But as remarked, _any
statement_, if only it be favourable to Vaccination, is expected to
pass muster as veracious, and the public credulity justifies the
expectation.

Let us look at the London Bills for ourselves, taking the last ten
years of the 18th and the first ten years of the 19th Centuries,
and try to discover what they teach.

            Burials from     From        From      From
    Years.  all Diseases.  Smallpox.    Fevers.   Measles.
    1791       18,760        1747        2013       156
    1792       20,213        1568        2236       450
    1793       21,749        2382        2426       248
    1794       19,241        1913        1935       172
    1795       21,179        1040        1947       328
    1796       19,288        3548        1547       307
    1797       17,014         522        1526       222
    1798       18,155        2237        1754       196
    1799       18,134        1111        1784       233
    1800       23,068        2409        2712       395
              -------      ------      ------      ----
              196,801      18,477      19,880      2707

It is to be observed, that we have not here the record of the
deaths in the whole of London, but merely the number of intramural
interments, which diminished as a number of graveyards became
gorged beyond capacity of decomposition and assimilation, and
relief was sought in the cemeteries of extra-mural parishes, such
as St. Pancras and Marylebone. It is only thus that the diminishing
number of burials (which ranged from 25,000 to 30,000 during many
years of the 18th Century) is to be accounted for. In this light we
have to consider the following table, where we note fewer burials,
less smallpox, less fevers, but more measles.

            Burials from     From        From      From
    Years.  all Diseases.  Smallpox.    Fevers.   Measles.
    1801       19,374        1461        2908        36
    1802       19,379        1579        2201       559
    1803       19,582        1202        2326       438
    1804       17,038         622        1702       619
    1805       17,565        1685        1307       523
    1806       17,938        1158        1354       530
    1807       18,334        1297        1033       452
    1808       19,954        1169        1168      1386
    1809       16,680        1163        1066       106
    1810       19,893        1198        1139      1031
              -------      ------      ------      ----
              185,737      12,534      16,204      5680

From whatever cause there was an abatement of smallpox, but it was
a continuous abatement which had set in before Jenner was heard
of; and at the same time we must repeat that at this day (when all
swear by the unity of Nature and the correlation and convertibility
of her forces) it is grossly unscientific to pick out smallpox
from the zymotic diseases and deal with it as an independent
entity. It is a fever among fevers, bred and propagated in the same
conditions, and can never be studied apart from its associates
without serious misunderstanding.

These Bills of Mortality, as compared with the more accurate
statistics of our own time, are of little value; but, such as
they are, they are constantly referred to, and their items used,
as by Baron, as pretexts for most unwarrantable assertions. Any
influence of Vaccination on the smallpox mortality of 1801-10 was
practically nothing. Vaccination was limited to a few thousands,
and those chiefly of the classes least subject to the disease. The
great seething mass of metropolitan squalor, in which smallpox and
typhus were endemic, was untouched by the vaccine lancet. If the
new practice did good, it was in discrediting and discouraging the
culture of smallpox in variolous inoculation.

To return to the ROYAL JENNERIAN SOCIETY. Its halcyon-days were
of brief duration. Enthusiasm abated, subscriptions fell off,
cases of smallpox after vaccination came to be heard of, and
serious illness and death consequent upon “the benign and harmless
operation.” Opponents waxed bold and could not be silenced. Then
jealousies and dissensions began to operate within the Society.
The financial secretary strove with the medical secretary. Dr.
Walker’s habits and eccentricities, viewed at first with amusement,
excited irritation and disgust, whilst Jenner’s easy-going mode of
life and impecuniosity were a source of scandal and distrust. The
climax was reached in 1806 when Jenner and Walker were set openly
at loggerheads, and a fight to the death ensued.

Walker, it is to be said, never treated Jenner with respect. Like
Pearson he took stock of his merits, and did not rate them highly,
and would not listen to his dictation. “Vaccination,” he used to
observe, “is extremely simple as to facts, while, as to causes,
it is entirely out of the reach of medical men with all their
theories.” Jenner, as president of the Medical Council, thought he
had a right to be obeyed, but Walker was the last man in the world
to yield obedience when he had formed an opposite conviction--

  Jenner [writes Baron] considered it his duty to admonish him,
  and repeatedly represented to him, in the most friendly manner,
  the mischievous tendency of his innovations. These remonstrances
  were unavailing, and he ceased to have any communication with Dr.
  Walker after the summer of 1805; submitting rather to lament in
  silence the fate of the Society than come before it as a public
  accuser.

Of course such forbearance could not last long, and instructions
issued by Walker to the Nottingham Vaccine Institution in March,
1806, were made the occasion of an open rupture. Jenner brought
Walker’s conduct under the consideration of the Medical Council,
and secured his condemnation. The question was then referred
to the General Court of the Society on the 25th of July, when a
motion that Walker he dismissed from his office was negatived by a
majority of three, Walker being supported by Sir Joseph Banks and
Jenner by Dr. Sims. But the victory was not satisfactory to Walker,
and on the 8th of August he put an end to the strife by sending in
his resignation.

Baron’s solemn account of the contest must appal every ingenuous
reader. Jenner, it is written, regarded Walker’s proceedings as of
“the most dangerous character,” as “placing in peril the safety of
the practice,” and “as likely to wreck the Society”; so that had
he not retired Jenner would have been compelled to withdraw his
countenance from Salisbury Square. As we read we exclaim, Whatever
did the dreadful Doctor do? Here is Baron’s answer--

  It is unnecessary to mention the specific instances of misconduct
  which were established. They regarded even the very name of the
  affection; the method of managing the pustules; the characters of
  correct vaccination; the precautions to be observed in conducting
  the practice, etc., etc.

Moore states the offence plainly--

  Walker’s method of taking lymph was to cut open the vesicles, and
  to wipe out the contents with lint, in order to procure the fresh
  secretion. This harsh treatment of infants was the reverse of
  that which he was directed to employ; and as he was unalterable
  in his resolution, it was at length deemed necessary to remove
  him.[132]

Turning to the _Life of Walker_, by Dr. Epps, we have the
difference ’twixt Tweedledum and Tweedledee still further
illustrated--

  Two different modes have been adopted in taking the matter of
  inoculation from the vaccinated subject: one, by making punctures
  round the outer part of the pock, Dr. Jenner’s mode; the other,
  by removing the crust or scab from the centre of the pock,
  wiping out the fluid beneath it, and then taking the matter,
  indiscriminately, from any part of the whole substance of the
  pock, Dr. Walker’s mode.[133]

As in brawls and wars generally, the ostensible offence is rarely
the true or entire offence, so when we revert to the events of
1805-6 we discover that Vaccination was being found out, and that
Walker served Jenner’s purpose opportunely as scape-goat. Walker’s
behaviour, too, constituted him a convenient victim. Many who
cared nothing for his mode of “taking lymph” had been hurt by his
scorn of their self-importance, and were ready to assist Jenner in
effecting his humiliation. Mr. Cline, the surgeon, after listening
to many speeches against Walker, summed up the indictment, “All
they complain of are his _dress_ and _address_.” A naval officer,
meeting Walker on 25th July, said, “I came to town to-day to hold
up my hand in your support. You and Jenner do not agree over some
trifles, and your enemies wish to turn the fact to your hurt, but
they have been beaten. Is the man who launches a vessel the only
one who can navigate her? If Jenner were to live for fifty years to
come, he could never have the authority of your experience.”

Jenner’s victory over Walker was utterly disastrous: it destroyed
the Royal Jennerian Society. The substantial supporters of the
Society were the adherents of Walker, and with him they seceded,
secured another house in Salisbury Square, and established THE
LONDON VACCINE INSTITUTION with Walker for manager. The remnant of
the Jennerian Society appointed James Sheridan Knowles, a young
Irish surgeon, as Walker’s successor, and for distinction purchased
him the degree of M.D. from St. Andrews. He had the suavity that
Walker disdained, and little else beside. He neglected his duties,
and soon the traffic in the “benign fluid” was transferred to the
new establishment. Ultimately the lease, fixtures, and furniture
of the Jennerian house were disposed of, and a retreat effected to
humbler offices, until in 1813 what remained of the Society was
incorporated in Walker’s concern.

Walker obtained much assistance from members of the Society of
Friends, and the fact affords Moore (Jenner’s apologist) occasion
for certain sneers. He describes the meetings in Salisbury Square
as--

  Shaded with the Quakers’ broad-brimmed hats; for their schismatic
  assiduity was most conspicuous, though their primitive meekness
  was indiscernible. In support of their friend, they argued slyly,
  wrangled tumultuously, and voted almost unanimously. Yet, in
  spite of this contentious pertinacity, the turbulent Quaker, on
  the motion of Dr. Jenner, was dismissed from his office, and
  peace was restored.

Dismissed he was not, and the peace that ensued on his resignation
was destruction. The success of Walker’s Institution (necessarily
dependent on subscriptions) he accounts for by an anecdote like
this--

  A noble Duke informed me that on a sultry day a steaming, squab,
  broad-faced man, in a Quaker’s garb, with his hat on his head,
  entered his room, saying, “Friend, I am come on a charitable
  mission to request thy mite.” The Duke, amused with the oddness
  of the salutation, desired him to be seated, and to explain his
  business. The Quaker wilily suppressed all mention of disputes
  in the Jennerian Society, and of the dismissal of Dr. Walker,
  which were the real causes for soliciting this subscription;
  and enlarged tediously on the utility of vaccination, and by
  awkward encomiums on Dr. Jenner, led the Duke to believe that the
  subscription was solicited for a Society approved by him. This
  cunning harangue drew forth the Duke’s purse, which the Quaker
  spying, unrolled his list, and added his Grace’s name as a decoy
  for others; and saying, “Friend, fare thee well,” strutted out
  with an uncouth gait and an air of uprightness. By such artifices
  a large subscription was raised from those who prefer paying to
  inquiry; and in the meantime the Jennerian Society diminished
  in numbers, and, undermined by calumnies, declined to its
  downfall.[134]

It is not to be imagined, however, that the collapse of the Royal
Jennerian Society disposed of Jenner and his party. There was
Jenner to provide for: he could not with decency be forsaken: and
there was a stock of vaccine virus to be kept up, for which pride
forbade dependence on Walker’s dispensary. It was in vain to appeal
afresh to a benevolent public, whose confidence had gone elsewhere,
and whose suspicions were excited. It was therefore determined to
resort to Government for help. The political influence of the
Jennerian party was considerable, and we shall see to what purpose
it was exerted.

       *       *       *       *       *


ORIGIN OF THE TERM VACCINATION.

A new practice wants a new name, and it was some time before one
was found for Inoculation with Cowpox. Dr. Walker made use of
Vacciolation and to Vacciolate in 1802; but it was Richard Dunning,
surgeon, of Plymouth, who introduced Vaccination and to Vaccinate.
Jenner writing to Dunning, 2nd April, 1804, observed--

  The useful terms Vaccination and to Vaccinate, are undoubtedly
  yours, and as such I pronounced them at a meeting of the Royal
  Jennerian Society, when an M.D. present mentioned them as
  imported from the Continent.[135]

Vaccination is not as yet a term accepted everywhere. Among the
uneducated we hear of being “cut for the cowpock,” or simply of
being “cut.”

Whilst Vaccination was a useful word, it was, and is, often
misapplied. Jenner’s prescription of Horsegrease Cowpox was
Equination rather than Vaccination; and when virus from the
horse was employed neat, Equination was the accurate designation
without question. Again, when virus was generated from Smallpox on
heifers, the subsequent inoculation of the human subject was not
Vaccination but Variolation, or at least Variolous Vaccination. The
virus in public use at this day derived from Horsegrease Cowpox,
Cowpox, Horsepox, Smallpox, Smallpox Cowpox, etc., etc., inoculated
from arm-to-arm, in series prolonged and unsearchable, is called
Vaccination; but it is Vaccination in faith or fancy, evidence to
anything but uncertainty being unattainable.


FOOTNOTES:

[131] Baron’s _Life of Jenner_, Vol. i. p. 577.

[132] _History and Practice of Vaccination_, p. 212. By James
Moore. London, 1817.

[133] _Life of John Walker, M.D._, p. 88. By John Epps, M.D. Lond.,
1831.

[134] _History and Practice of Vaccination_, pp. 213-215.

[135] Baron’s _Life of Jenner_, vol. ii., p. 336.




CHAPTER XIV.

APPLICATION TO PARLIAMENT FOR JENNER’S RELIEF, 1806.


Baron relates an instance of Jenner’s personal shyness and the
mental torture he endured in prospect of a festival of the Royal
Jennerian Society in which he was expected to take part. Speaking
to Baron he said--

  I can compare my feelings to those of no one but Cowper, the
  poet, when his intellect at last gave way to his fears about the
  execution of his office in the House of Lords. It was reading
  Cowper’s Life, I believe, that saved my own senses by putting me
  fully in view of my danger. For many weeks before the meeting
  I began to be agitated, and, as it approached, I was actually
  deprived both of appetite and sleep; and when the day came, I was
  obliged to deaden my sensibility and gain courage by brandy and
  opium. The meeting was at length interrupted by a dissolution of
  Parliament, which sent the leading people to the country; and
  what was at first merely postponed was ultimately abandoned to my
  no small delight and satisfaction.[136]

Something of this timidity was no doubt due to his consciousness of
playing a deceitful part, and to the appropriation of honour and
reward to which he had no just claim. Like many shy men, Jenner
could be insolent with pen and ink--it was face to face courage
to which he was unequal; and this timidity, with other reasons,
accounted for his failure as a London physician--as “the Cowpox
Doctor,” as he was commonly described. Those whose encouragement
had helped to lead him to disaster, those who were pleased to
believe that he had taught mankind how to escape from smallpox,
and several of his professional brethren, were all concerned to
help him out of his difficulties, and, if possible, at the public
expense. The Duchess of Devonshire wrote to Mr. Angerstein--

  I had not forgot your kind interest about Jenner. I spoke to the
  Duke, the Prince, and Morpeth, and they will all do what you
  think best; but Morpeth has undertaken to make inquiries whether
  it is not possible to bring his case again before Parliament. He
  thinks if that could be done, it would be more satisfactory than
  any subscription. I desired him to find out how Pitt was _really_
  inclined in the matter, and I only waited the result of these
  inquiries to write to you.

At the same time Jenner himself was not inactive, and managed to
advance his own interest effectually. He came to London, 10th
May, 1805, and at once saw Lord Egremont, and enlarged upon the
losses he had incurred in the public service; the result being a
determination to appeal afresh to the liberality of the House of
Commons. Moreover he succeeded in winning over the Chancellor of
the Exchequer in the manner he thus describes--

  During my residence in town in the summer of 1805, Lady Crewe
  happened in conversation to tell me how much Lord Henry Petty
  wished for a conference with me on the vaccine subject; and
  that she would like to bring us together. We met at her villa
  at Hampstead, and went so fully into the matter that his
  Lordship, convinced of the injury I had sustained, expressed his
  determination to bring something forward in the ensuing session.
  Before the session arrived Mr. Pitt died, and Lord Henry Petty
  became Chancellor of the Exchequer. In the early part of 1806,
  I again saw his Lordship, and found that his ardour in my cause
  had suffered no abatement. This was soon after proved by his
  Lordship’s motion in the House.[137]

Lord Henry brought Jenner’s case before the Commons on the 2nd of
July, and recited the fabulous matter communicated to him with
the force of personal conviction. Vaccination was a preventive of
smallpox, that loathsome disease which spreads death throughout
the world. It was in 1777 that Jenner obtained some obscure
knowledge of the peculiar virtue of Vaccine; and from that period
he meditated profoundly on the subject, accumulated information,
and instituted cautious and decisive experiments. At length he
perfected his discovery, and published it for the benefit of
mankind. Lord Henry then proceeded to relate the triumphs of
Vaccination, not only throughout Europe, but China and India!
Wherever the practice was introduced, there smallpox diminished
and vanished. There was Vienna, for instance, where the average
mortality from smallpox was 835 annually. Vaccination was commenced
in 1799, and the mortality dropped in 1802 to 61, in 1803 to 27,
and in 1804 to 2. Thus in Vienna there was an annual salvation of
833 human beings. This undoubted fact had made a deep impression on
his mind [as well it might!] But, alas! what was doing so much good
abroad was neglected and distrusted at home. In the City of London
the deaths from smallpox had been on an average 1811 annually, and
this mortality had been gradually reduced by Vaccination to 629.
Through the diffusion of the disease by variolous inoculation, the
deaths last year (1805) had been raised from 629 to 1685. This
dreadful destruction of life, especially shocking when a certain
preventive existed, demanded their most serious attention, and in
the situation he felt bound to propose a plan to bring forward a
mass of evidence, to elicit the truth, and enlighten the public. He
would therefore move--

  That an humble Address be presented to His Majesty, praying
  that he will be graciously pleased to direct His Royal College
  of Physicians to inquire into the state of Vaccine Inoculation
  in the United Kingdom, and to report their opinion as to the
  progress it has made, and the causes which have retarded its
  general adoption.

Should this report from the Physicians corroborate the favourable
opinion of Vaccination entertained by foreign nations, it must
greatly tend to subdue those prejudices against the practice which
have been fomented here. And in that case, the House may consider
whether the ingenious Discoverer has been remunerated conformably
to the liberal spirit and character of this country.

Dr. MATHEWS seconded the motion, and contrasted the safety of the
vaccine with the dangers of variolous inoculation. He had no doubt
the country would hasten to testify still further its gratitude to
the learned physician to whom they owed this inestimable benefit.

Mr. WILBERFORCE did not approve of the reference to the College of
Physicians. He would have preferred an investigation by a committee
of the House, and another committee of the House of Lords. The
opinions of such unbiased persons would be more congenial to
the feelings of the people, and far more satisfactory than any
medical report from the College of Physicians. The latter might be
suspected of being influenced by professional motives, whereas a
report from the Lords and Commons would be universally received as
proceeding from a pure desire to promote the general good. It did
not surprise him that Vaccination had made less progress at home
than abroad. The resistance was due to that curious principle in
the human mind which accepts what comes from afar with admiration
whilst what is familiar is neglected and despised. The remedy would
be found in diffusing information as to the complete success of
Vaccination in foreign countries. They would thus disperse those
absurd prejudices which are engendered and fostered by certain
selfish and interested individuals.

Mr. WINDHAM did not concur in the advice of Mr. Wilberforce to
refer the matter to a parliamentary committee. It was a question
for medical men. To a committee of the House the adage might be
applied, _Ne sutor ultra crepidam_. Let them enforce with their
approval the report of the physicians, and then let them proceed
to remunerate that meritorious individual to whom society owed
the utmost gratitude. He could not help thinking he had not yet
received what was due for the expense and trouble the discovery had
cost him.

Mr. BANKS was of a sceptical turn. He wished the motion had been
made earlier in the session, for then he should have supported
the suggestion of Mr. Wilberforce. They wished to know whether
Vaccination really did afford reasonable security from smallpox.
It was not a question for medical men for which the House was
incompetent. They were as capable of determining the point, and
setting it clearly before the public, as the most learned body that
ever existed. He wished too, since the motion would be carried,
that the Royal College of Surgeons might be united with the
Physicians in the production of the report. As for Dr. Jenner, if
Vaccination were as efficacious as asserted, he might be left to
find his reward in its practice.

Lord HENRY PETTY in summing up the debate expressed his
satisfaction with the general approval extended to his motion.
He did not think the House competent to form a judgment on
Vaccination. They could not decide whether cowpox was genuine or
spurious, or whether the affection resulting from its inoculation
was regular or otherwise; nor could they determine whether
eruptions that might break out after Vaccination were induced by
the operation, or were due to other causes. Such delicate questions
could only be solved by medical men. As for the proposal to annex
the Royal College of Surgeons to that of the Physicians, it was
superfluous. The College of Physicians would not only consult
the Surgeons, but the Medical Colleges of Scotland and Ireland
likewise. If the report should prove favourable, it would then be
his duty to propose that remuneration be awarded to Dr. Jenner for
his inestimable discovery.

The motion was then put from the Chair and agreed to unanimously.

It is needless to remark that the report of the College of
Physicians was a mere formality toward a vote of credit for
Jenner’s relief. He lay heavy on many hands, and none were more
anxious to be relieved from the pressure than certain influential
members of the College whose report was solicited. The operation
was skilfully planned for the end designed, and Lord Henry Petty
allowed himself to be primed and applied with singular facility:
but public men have often to deliver as of themselves what is
communicated by others, and to stand responsible for absurdities of
which they are unconscious.


FOOTNOTES:

[136] Baron’s _Life of Jenner_, vol. ii. p. 162.

[137] Baron’s _Life of Jenner_, vol. ii. p. 55.




CHAPTER XV.

REPORT OF THE ROYAL COLLEGE OF PHYSICIANS.


The Report of the Physicians appeared on the 10th April, 1807, a
verbose document, wherein assertion and conjecture were awkwardly
intermingled. As to the extension of the practice, it was said--

  During eight years which have elapsed since Dr. Jenner made his
  discovery public, the progress of Vaccination has been rapid, not
  only in all parts of the United Kingdom, but in every quarter
  of the civilised world. In the British Islands some hundred
  thousands have been vaccinated; in our possessions in the East
  Indies upwards of 800,000, and among the nations of Europe the
  practice has become general.

  Professional men have submitted it to the fairest trials, and the
  public for the most part have received it without prejudice. The
  testimony in its favour has been most strong and satisfactory,
  and the practice of it, though it has received a check in some
  quarters, appears to be upon the increase in most parts of the
  United Kingdom.

From the Report it appeared that the opposition to Vaccination
proceeded from the Inoculators; and the document may be described
as a charge against the old practice as much as a positive defence
of the new--

  However beneficial the inoculation of the Smallpox may have been
  to individuals, it appears to have kept up a constant source of
  contagion, which has been the means of increasing the number
  of deaths by what is called the natural disease. It cannot be
  doubted that this mischief has been extended by the inconsiderate
  manner in which great numbers of persons, even since the
  introduction of Vaccination, are every year inoculated with
  Smallpox, and afterwards required to attend two or three times
  a-week at the place of inoculation, through every stage of their
  illness.

Some Inoculators asserted that Vaccination produced “new,
unheard-of, and monstrous diseases,” and made use of pictures to
excite terror and disgust--

  Publications with such representations have been widely
  circulated, and though they originated either in gross
  ignorance, or wilful misrepresentation, yet have they lessened
  the confidence of many, particularly of the lower classes, in
  Vaccination.

Whatever the character of Vaccination--had the claim made in
its favour been a true claim, still the chief resistance to its
practice would have consisted in the common apathy--

  The lower orders of society can hardly be induced to adopt
  precautions against evils which may be at a distance; nor can
  it be expected from them, if these precautions be attended with
  expense. Unless, therefore, from the immediate dread of epidemic
  Smallpox, neither Vaccination or Inoculation appears at any time
  to have been general, and when the cause of terror has passed by
  the public have relapsed into indifference. It is not easy to
  suggest a remedy for an evil so deeply implanted in human nature.

The suggestion was, however, made that Vaccination should be
offered gratis, but at the same time it was the opinion of the
College that until Variolous Inoculation was superseded or
prohibited, “it would be impossible to prevent the constant
recurrence of Natural Smallpox.”

The recommendation of Vaccination gratis provoked the wrath of Dr.
Moseley--

  Gratis! [he exclaimed]: Why, every person knows that for years
  past in almost every street of London, signs or boards on the
  sides of houses, or on Methodists’ shops, or in apothecaries’
  windows, have invited the ignorant multitude to gratuitous
  Vaccination. I have seen as many gratis Cowpox hand-bills, gratis
  puffs, gratis pathetic sermons and addresses, and gratis station
  advertisements as would load an ox. What does the College think
  of the mountebank Jennerian placard, dispersed on walls and
  alleys, and among all the blackguard public houses in town and
  country, and hung up in the shop or parlour of every Cowpoxer in
  England with Their Majesties’ Names and those of Their August
  Family audaciously emblazoned upon it?[138]

The Report of the College is interesting as a historic confession
and a mark of progress. The physicians who drew it up were the
same men who in 1800 professed their unlimited confidence in
Vaccination, whilst as yet they knew little about it, proclaiming
in the newspapers that they considered it their duty to declare--

  _That those persons who have had the Cowpox are perfectly secure
  from the future infection of the Smallpox._

From a profession so unqualified an absolute retractation was not
to be expected; but experience had begotten caution, and it is
instructive to remark with what qualifications the retreat from the
original position was attempted. Thus--

  The security derived from Vaccination _if not absolutely
  perfect_ is as nearly so as can perhaps be expected from any
  human discovery; for among several hundred thousand cases, with
  the results of which the College has been made acquainted, _the
  number of alleged failures has been surprisingly small_, so much
  so as to form no reasonable objection to the general adoption of
  Vaccination.

The Report was not the deliverance of men possessed with the
confidence of 1800: throughout there was manifest the failing
conviction which evades responsibility and seeks for confirmation
from sources external to itself. After a reference to the Variolous
Test, the Report ran on--

  It appears from numerous observations communicated to the
  College, that those who have been vaccinated are secure from the
  contagion of epidemic Smallpox. Towns and districts of country
  in which Vaccination had been general, have afterwards had
  Smallpox prevalent on all sides of them without suffering from
  the contagion. There are also in the evidence a few examples of
  epidemic Smallpox having been subdued by a general Vaccination.

The liability to confound coincidence with cause was not unknown
in 1807, and might have been suggested as a possible explanation
of the cessation of a variolous epidemic contemporaneously with
Vaccination; although at the present day Vaccination, when Smallpox
is epidemic, is known to do little else than invite and extend the
malady.

How the general (that was to say partial) Vaccination of certain
towns and country districts secured universal exemption from
Smallpox, the Physicians failed to explain. Extraordinary tales
of Vicarious Vaccination were current and piously received. If a
fraction of an urban or rural community happened to be vaccinated
(usually a fraction least likely to be troubled with Smallpox
in any event) and Smallpox did not break out, or did not widely
prevail, the salvation of the community was ascribed to the
Vicarious Vaccination. The phenomenon has, strange to say, escaped
the attention of theologians, although medical men constantly
attest its occurrence.

Ruefully was it conceded that Vaccination was not an absolute
preservative from Smallpox, but the pain of concession was softened
with the plea of mitigation--

  In _almost_ every case where Smallpox has succeeded Vaccination,
  the disease has varied much from its ordinary course; it has
  neither been the same in violence, nor in the duration of its
  symptoms, but has, _with very few exceptions_, been remarkably
  mild, as if the Smallpox had been deprived, by the previous
  vaccine disease, of all its usual malignity.

It goes without saying, that such a statement was quackish romance.
How could a physician know that any case of Smallpox had been made
milder by Vaccination? for how could he know how severe the disease
would have been without Vaccination? Any ground of comparison
was wanting. Smallpox is an eruptive fever of wide degrees of
intensity--slight as to be a trivial ailment, severe as to be
inevitably fatal. “So true,” wrote Dr. Wagstaffe in 1722, “is that
common observation, that there is one sort in which a nurse cannot
kill, and another which even a physician cannot cure.” Yet every
case of mild Smallpox after Cowpox came into fashion was placed to
the credit of Vaccination!

  Some writers [the Report continues] have greatly undervalued
  the security Vaccination affords, while others have considered
  it to be of a temporary nature only; but if any reliance is to
  be placed on the statements laid before the College, its power
  of protecting the human body from Smallpox, _though not perfect
  indeed_, is abundantly sufficient to recommend it to the prudent
  and dispassionate. The opinion that Vaccination affords but a
  temporary security is supported by no analogy in Nature, nor by
  the facts which have hitherto occurred.

The analogy of Nature was a treacherous support, whilst the
Physicians did not foresee the time when their successors would
plead the fact of the temporary security of Vaccination as a reason
for systematic Re-Vaccination.

It is not difficult to discern between the lines of the Report a
spirit of doubt and hesitation. Those who framed it had gone too
far to turn back; there was Jenner on their hands; and a public
ready to hoot if there was any open apostasy. The outlook at home
was not encouraging, but there was the Continent, yea more, the
wide world itself wherein to cover the reproach of failure--

  They could not be insensible [said the Physicians] to the
  confirmation they receive not only from the introduction of
  Vaccination into every part of Europe, _but throughout the vast
  Continents of Asia and America_.

The vast Continents of Asia and America! A fine phrase--a very fine
phrase, with more comfort in it than scoffers might imagine.

In the Report we detect one good service, namely, the explosion
of Jenner’s fiction about Spurious Cowpox. When Vaccination was
first brought forward, cases were adduced of Smallpox after
Cowpox. Jenner at once asserted that the Cowpox in such instances
must have been spurious, for Smallpox after genuine Cowpox was
impossible; and Spurious Cowpox was thenceforward freely used to
baffle inquirers and to account for failures. Spurious Cowpox
served the ends of the Vaccinators magnificently, but by and by
it began to have awkward consequences. Genuine Cowpox was said to
be harmless--it was the Spurious that was ineffective or worked
mischief; and the Inoculators plied the terror of Spurious Pox
against Vaccination. It therefore became necessary to clear
Spurious Cowpox out of the way, and Jenner, before the College of
Physicians, pressed upon the point, “owned up,” as Americans say,
and authorised the following explanation--

  Some deviations from the usual course have occasionally occurred
  in Vaccination, which the Author of the practice has called
  Spurious Cowpox, _by which the public have been misled, as if
  there were a true and a false Cowpox_; but it appears that
  nothing more was meant than to express irregularity or difference
  from that common form and progress of the vaccine pustule from
  which its efficacy is inferred.

Mark! Here was a third definition of Spurious Cowpox by Jenner.

_First_, in the _Inquiry_ of 1798, he described Spurious Cowpox
as eruptions on the cow underived from horsegrease, producing no
erysipelas when inoculated on the human subject, and without effect
against Smallpox. True Cowpox was generated from horsegrease, and
from horsegrease only.

_Second_, in the _Origin of the Vaccine Inoculation_ of 1801 all
reference to horsegrease was dropped for commercial reasons, whilst
the existence of Spurious Cowpox was reasserted “as some varieties
of spontaneous eruptions upon the cow.”

_Third_, before the Physicians in 1807, he removed the spurious
disease from the cow altogether, saying, nothing more was meant by
Spurious Cowpox than variations in the form and progress of vaccine
pustules on the arms of the vaccinated!

In short, to vary the phrase of Betsy Prig, “There never was no
Spurious Cowpox.” Slippery, very slippery, was the immortal Jenner.

With the report of the Royal College of Physicians were delivered
reports from the London College of Surgeons, and from the Edinburgh
and Dublin Colleges of Physicians and of Surgeons.

The report from the London College of Surgeons was considered
most unsatisfactory, and could its tenor have been foreseen,
the Jennerians might never have asked for it. 1100 circulars
were dispatched on 15th December, 1806, to all the members of
the College whose addresses were known in the United Kingdom,
submitting the following questions--

  1st. How many persons have you vaccinated?

  2nd. Have any of your patients had Smallpox after Vaccination?

  3rd. Have any bad effects occurred in your experience in
  consequence of Vaccination? and if so, what are they?

  4th. Is the practice of Vaccination increasing or decreasing in
  your neighbourhood? if decreasing, to what cause do you impute it?

To the 1100 circulars only 426 replies were received. Why nearly
two-thirds of the members kept silent when at the outset they were
converted in multitude to Vaccination, was left unexplained. The
replies were thus summarised by the Board on 17th March, 1807--

  The number of persons stated in such letters to have been
  vaccinated, is 164,381.

  The number of cases in which Smallpox had followed Vaccination is
  56.

  The Board think it proper to remark under this head, that, in the
  enumeration of cases in which Smallpox has succeeded Vaccination,
  they have included none but those in which the subject was
  vaccinated by the surgeon reporting the facts.

  The bad consequences which have arisen from Vaccination are--

    66 cases of eruption of the skin, and
    24 of inflammation of the arm, whereof
     3 proved fatal.

Vaccination, in the greater number of Counties from which reports
have been received, appears to be increasing: in the Metropolis it
is on the decrease.

The principal reasons assigned for the decrease are--

    Imperfect Vaccination,
    Instances of Smallpox after Vaccination,
    Supposed bad consequences,
    Publications against the practice,
    Popular prejudices.

The report of the Edinburgh College of Physicians disowned
acquaintance with Vaccination, the practice being entirely in the
hands of surgeons and other practitioners--

  With a view, however, to publish their conviction of the
  immense benefits which have been, and which will in future be
  derived to the world, from Inoculation for the Cowpox, they had
  spontaneously and unanimously elected Dr. Jenner an honorary
  Fellow of their College, a mark of distinction which they very
  rarely confer, and which they confine almost exclusively to
  Foreign Physicians of the first eminence.

The report of the College of Surgeons, dated 3rd March, 1807, left
nothing for the Jennerians to desire. The Edinburgh surgeons were
satisfied from their own experience that Vaccination constituted
a permanent security from Smallpox, and they had observed no ill
consequences from the practice. Vaccination commenced in Edinburgh
in 1801, and was now so general in the city--

  That for two or three years past, Smallpox has been reckoned
  rather a rare occurrence, even among the lower order of the
  inhabitants, _unless in some particular quarters about twelve
  months ago_. Among the higher ranks of the inhabitants the
  disease is unknown.

Rare, unless in some quarters about a year ago! We turn to the
report of the Edinburgh Dispensary for 1805, and there we read--

  The loathsome disease has unfortunately been very prevalent in
  several quarters of the city.

And this coincidently with extensive Vaccination to which
apparently there was no active opposition! We have also to remember
in this connection the statement of Professor Alexander Monro in
1765, that “the inhabitants of Scotland generally have Smallpox
in their infancy or childhood; very few adults being seen in
this disease”; and that in Edinburgh, with conditions strongly
favourable to Smallpox, the mortality from the disease was on an
average little more than a hundred a year. The Edinburgh physicians
knew nothing practically of Vaccination, and we see how the
Surgeons, who did know, shaped their evidence.

The Dublin College of Physicians echoed the fashionable opinion
“that Cowpox Inoculation was safe, and fully answered its purpose.”
They were “willing to allow that doubtful cases had occurred of
Smallpox after Vaccination, but on minute investigation, these
supposed instances originated generally in misrepresentation,
or the difficulty of discriminating between Smallpox and other
eruptions.” Rather awkwardly, seeing how the opposite opinion was
in vogue, they professed their faith in Variolous Inoculation--

  The Smallpox is rendered a much less formidable disease in
  Ireland by the frequency of Inoculation for it, than in other
  parts of His Majesty’s dominions, where prejudices against
  Inoculation have prevailed. Hence parents, not unnaturally,
  object to the introduction of a new disease, in the shape
  of Vaccination, preferring to trust to the practice with the
  mildness and safety of which they are well acquainted.

The Dublin College of Surgeons showed themselves more fully
abreast of the time. They had nothing to say for Inoculation, but
testified their confidence in Vaccination, and how its practice was
increasing in Ireland. From 1800 to 1806 a total of 14,335 had been
“inoculated with vaccine infection” at the Dublin institutions, and
many elsewhere--

  Cowpox has been found to be a mild disease, and rarely attended
  with danger, or any alarming symptom, and _the few cases
  of Smallpox which have occurred in Ireland after supposed
  Vaccination_, have been satisfactorily proved _to have arisen
  from accidental circumstances_.

Arisen from accidental circumstances! Thus was the divine
illumination of experience veiled and denied!

Fortified with this budget of questionable evidence, the Government
proceeded to claim from the House of Commons a second endowment for
Jenner.


FOOTNOTE:

[138] _Review of Report on Vaccination._ By Benjamin Moseley.
London, 1808.




CHAPTER XVI.

JENNER RELIEVED--1807.


Whilst the Royal College of Physicians were preparing their
report, there was perturbation in the political world. Dull
and bigoted George III. refusing on the pretext of his oath to
concede to Roman Catholics the rights of citizens, a change of
administration ensued, and Mr. Perceval, a man after the King’s own
heart, replaced Lord Henry Petty as Chancellor of the Exchequer,
and proceeded to give effect to the plan for relieving Jenner; a
purpose for which the report “On the State of Vaccine Inoculation
in the United Kingdom” was merely a blind.

On the 29th July, 1807, the House of Commons being in Committee
of Supply, Mr. PERCEVAL moved that Dr. Jenner be awarded a second
sum of £10,000 for his matchless discovery. Smallpox was one
of the greatest afflictions of mankind, from which hardly any
one escaped. For this dreadful malady, Jenner had invented a
preventive, unknown before, or if known, which had never been
published. He did not therefore think the Committee would consider
his proposal extravagant; indeed it was rather an act of justice
than of liberality. Those who had read the Report of the Physicians
would recognise the immense advantages of the new practice. As for
its inconveniences, they were as nothing to those which attended
Variolous Inoculation, and the few mistakes recorded were due
to ignorance and carelessness. It might be objected by those
who adhered to Mr. Malthus, that nothing was gained by saving
lives from pestilence; for deaths were not losses where means of
subsistence were inadequate; but for his part he would disregard
the argument even if it were true. It was much better to follow the
dictates of their hearts, and preserve life whenever it was within
their power. He had often heard that the true riches of a state
were its inhabitants. But he would not attempt to measure Jenner’s
award by the number of lives that his invention would preserve to
the world. If he did so, what sum would they have to offer! All he
need say was, that the £10,000 proposed represented no more than a
moderate acknowledgment of labour and genius devoted to the service
of humanity.

Mr. SHAW LEFEVRE opposed the motion. He had thought the former
application for £20,000 excessive, and had concurred with those
who reduced it to £10,000. He had moreover acquiesced in the
smaller sum by reason of his faith in the report of the Committee
of the House on the New Inoculation, but he now discovered that
many of the statements in that report were erroneous. It attested
that Vaccination was an infallible preventive of smallpox, whilst
the report of the Surgeons now admits 56 failures! The first
report stated that no disease followed Vaccination, whilst now
it is confessed that scrofula and other alarming symptoms are its
occasional sequences! The report thus prejudicial to Vaccination
nevertheless argues in its favour, and he would like to call
witnesses to the bar of the House who would make manifest still
further its inconsistencies and inaccuracies. At this late period
of the session, it was not right to vote away such an amount of
public money. [Such “late periods” are, however, always selected
for jobs.] Besides, it was generally known that Benjamin Jesty
of Worth in Dorsetshire discovered the use of cowpox long before
Jenner, and if the House was resolved to be liberal, the reward
should be shared with Jesty, or with Jesty’s family. He should
oppose the vote, but he did not say that he would always do so. His
purpose was to gain time for more careful inquiry.

Lord HENRY PETTY, who had first moved in the matter, came to
his successor’s support. He had no doubt as to the efficacy of
Vaccination, nor as to Jenner being its discoverer. His difficulty
was to find a rule for the justice of the case; for whoever
considered the value of the discovery must perceive that it would
be impossible for them to deal generously with the discoverer. His
service to mankind was entirely beyond any financial estimate.
It was objected that Vaccination was not infallible. He replied
that absolute, never-failing perfection ought not to be expected
from any human device: they should rest well satisfied in the
approximation to infallibility that belonged to Vaccination. Its
daily benefits were numberless. Multitudes of seamen, soldiers,
and citizens of every description had been saved by it, and in
contemplating its future effects on the human race, the mind was
lost in amazement and gratitude. How then should they presume to
talk of liberality towards Jenner, the benefactor! They should
recollect how he stands in the estimation of the world, how they
were acting in view of all nations, and how their own characters
were at stake in their demeanour towards him. As to Malthus there
was a misapprehension. He had taught nothing that forbade the
extinction of an infectious disease which so greatly reduced human
happiness. In their concern for Vaccination, the House should not
forget the mischief that was still wrought by inoculation with
smallpox. Zealous as he was for the new practice, he had no wish to
meddle with what others might imagine (however absurdly) tended to
their own preservation and that of their families, but no one had a
right to endanger the lives of others. It was proved beyond dispute
that those who were inoculated with smallpox diffused the fatal
contagion by going abroad, or being carried abroad. He thought,
therefore, it was not only the right, but the duty of the State to
oblige those who were infected with smallpox to keep within doors
until complete recovery. He would not move an amendment to the
resolution, but would have no hesitation in acceding to a larger
sum.

General TARLETON could not withhold his tribute of praise from
the author of this blessing to mankind. To his knowledge, it had
saved the lives of many in his Majesty’s service. Soldiers could
march and perform every military duty when under the process of
vaccination. It had been said that gentlemen in the army had no
respect for anything save success in war, but he thought that many
officers knew how to admire Jenner, the preserver of millions, and
to allow that in future ages his glory would exceed the renown of
the greatest warriors.

Mr. STURGES BOURNE denounced the practice of inoculating
out-patients at the Smallpox Hospital whereby the disease was
systematically perpetuated and diffused throughout the community.
He thought the legislature would be as much justified in taking
measures to prevent this evil by restraint, as a man would be in
snatching a firebrand out of the hands of a maniac just as he was
going to set fire to a city.

Mr. HAWKINS BROWNE confessed with shame that he had voted for
£10,000 instead of £20,000 in 1802; but at that time he little
knew the extent of Jenner’s service to the human race.

Mr. EDWARD MORRIS did not think that even what had been said
sufficiently set forth their debt of gratitude to Jenner. His
discovery afforded a reasonable expectation of the extermination
of smallpox, and the merit of the transcendent discovery was all
his own. Inoculation in the old mode mitigated the disease in a
few, and spread it in full fury over many. It was therefore a
curse to mankind instead of a blessing. The Smallpox Hospital in
its practice of inoculation, was a source of pestilence and a
multiplier of victims to this deplorable distemper. The pre-eminent
distinction of Vaccination was that it preserved its subject and
injured no one. This unspeakable blessing they owed to Jenner,
nor had the least improvement been effected upon his original and
carefully matured prescription. They were bound to consider how
he had abandoned the lucrative pursuit of his profession, and
surrendered many years of his life for the good of his country and
mankind. He would therefore submit an amendment to the resolution
before the Committee, that the grant be £20,000 instead of £10,000,
to mark their sense of Jenner’s merits and to place him in a state
of independence.

The amendment was warmly supported by Mr. Wilberforce, Mr. Windham,
Sir John Sebright, and Mr. Herbert.

Mr. PERCEVAL, as Chancellor of the Exchequer, stood to his
resolution, but with indifferent arguments. It was without
precedent that a vote recommended by Government should be thus
increased. He admitted that Jenner was entitled to much more than
they could afford, but it was also without precedent that so great
a sum as £30,000 (inclusive of the former vote) should be bestowed
on any discoverer.

Mr. WILLIAM SMITH would not submit to these objections. He recited
the triumphs of Vaccination in Asia and America, and said it was
true as of old that a prophet had no honour in his own country.
[An observation singularly inapplicable to Jenner.] He urged the
Committee to vote for the larger sum, and said that whilst the
Chancellor of the Exchequer might in his public capacity protest,
yet in his secret heart he would not be displeased if overborne by
the sentiment of the House, of the country, and of the world.

Mr. WHITBREAD begged the Committee to bear in mind that Jenner
had scorned to monopolise Vaccination, and had thereby sacrificed
a great fortune. He called on the House to vote for the larger
sum. Vaccination furnished the means for lessening the poor rate.
Reduced smallpox signified fewer deaths, fewer orphans, fewer
widows. Vaccination meant better health for the poor and more money
in the pockets of the rich. They would excuse this appeal of his
to the cupidity of the landed interest inasmuch as he had been
anticipated in the exhibition of loftier considerations. He also
wished to relieve the House from a renewal of this question. Let
them reward Jenner once for all, and liberally: and remember that
what was called economy in this connection, if practised by the
House, would be, in the eye of the world, their disgrace.

Others spoke in a similar strain, and when the House divided, 60
voted for Mr. Morris’s amendment, and 47 against it, £20,000 being
carried by a majority of 13. Including the £10,000 voted in 1802,
Jenner was thus awarded £30,000 of public money, in times, too, of
war and scarcity.

The debate, it will be observed, was conducted in a House of
107 members at a late period of the session, and the variations
among the speakers consisted in degrees of extravagance and
credulity. The fabulous matter as to Jenner personally affords
curious evidence of the manner in which legends originate in the
presence of contemporaries, and how they come to be repeated with
the fervour of good faith by men whose competence and honesty
might be taken for unimpeachable. Jenner’s party had whipped
up their adherents, and the issue was sedulously arranged for;
but because they had their way it need not be assumed that it
was necessary to circumvent any active adversaries. Apathy was
their chief difficulty. There was little to be got out of cowpox
by the ordinary politician; and then, as now, the average M.P.
rarely committed himself to any project that did not obviously
make for his popularity. As for the enthusiasm for Vaccination
displayed by the speakers in the House, we have to recollect
that they were not converts to the practice _per se_. No really
new discovery was ever received with such an instant chorus of
approbation by the mob, educated or uneducated. They were one and
all bred under the severe and dangerous practice of Variolous
Inoculation, whereof Vaccination was no more than a modification
with a seductive promise of equal or greater security from
smallpox, and exemption from its perils and annoyances. Unless this
prepossession be allowed for, the conduct of Parliament toward
Jenner cannot be rightly understood. There was not a word uttered
against Vaccination from the ground which physiologists at this
day occupy, for that ground, in a scientific sense, was as yet
unknown. Smallpox was a mysterious visitation to be mysteriously
dealt with--dodged, if possible, by medical artifice; and not, as
we are persuaded, a crisis of impurity in the blood induced by foul
conditions of life, which cannot be better disposed of than in the
course of nature by eruptive fever. If we could suppress smallpox
(in any other way than by the removal of its causes) we should
merely alter its manifestation and have to accept it in some other
and aggravated form of disease.




CHAPTER XVII.

VACCINATION ESTABLISHED AND ENDOWED.


Jenner provided for, his adherents had yet another end to achieve,
namely, their own release from the burden of the Royal Jennerian
Society, paralysed by the secession of Dr. Walker and the Friends
and the establishment of the London Vaccine Institution. At first
they had endeavoured to discredit the new Institution, even to
the extent of distributing hand-bills like the following in the
streets--


  A CAUTION.

  To persons desirous of obtaining INOCULATION for the Cowpox
  Gratis under the sanction of

    THE ROYAL JENNERIAN SOCIETY.

  Whereas, Doctor JOHN WALKER has, under various pretences,
  obstructed persons going to the Central House of this Society,
  the Public are hereby warned to be upon their guard against any
  insidious representations, the connection between Dr. WALKER and
  the Society having ceased, and Dr. KNOWLES having been appointed
  the Resident Inoculator at the Society’s House, No. 14 Salisbury
  Square.

  _By Order of the Directors and Medical Council, 9th October,
  1806._

It was all in vain. Walker was preferred to Sheridan Knowles
backed by Jenner, whose friends had no liking for the support of
the Society out of their own pockets. It was therefore planned
to resort to Parliament for an annual subsidy so as dispense
with the necessity of subscriptions. The managers of the London
Vaccine Institution, learning what was on foot, naturally argued
that if Government was to be thus propitious, it was they who had
the better claim to assistance, and therefore prepared a petition
setting forth their exertions in spreading Vaccine Inoculation.
This interference with their scheme filled the Jennerians with
fury, and Mr. JOHN FULLER undertook to speak their mind in the
House of Commons. When, therefore, on 2nd June, 1808, Sir THOMAS
TURTON presented the petition, FULLER sprang to his feet and
denounced it, saying a grosser forgery had never been submitted to
the House.

The SPEAKER interposed. The petition had not been read. When it
was, the House would be enabled to judge of its contents. Mr.
FULLER resumed his seat amid general laughter. The petition having
been read--

Mr. FULLER apologised for his abruptness. The petition was a
gross cheat, a wicked trick to swindle the public; or, if it was
not absolute swindling, it went very near the wind. When they
came to solicit his subscription, he thought they represented
some respectable corporation, but what did they turn out to be?
A parcel of Quakers, or Presbyterians, or whatever else they
were called. They had got five guineas from him, but the moment
he detected them, he threatened them with a Bow Street officer
and a charge of swindling, which soon frightened them into a
re-delivery of his money. What a shame it was to see the cause
of such fellows espoused by any man in that House! He did not
suppose the Honourable Baronet shared in their gains, and he might
laugh as he pleased, and spout like a lawyer, but it was a poor
way to show himself off for the sake of a little notoriety among
such despicable sectaries. He hoped the House would not lend any
countenance to the imposture.

Sir THOMAS TURTON good humouredly replied, that the Jennerian
Society, in whose interest the preceding speaker exhibited so
much untempered zeal, was not instituted till 1803. The original
Vaccine Pock Institution was established by Dr. Pearson in 1799.
The Institution to which the petition referred was established
in 1806, chiefly by members of the Society of Friends, a sect to
whose virtuous principles and behaviour it was his privilege to
bear testimony. Since 1806 the Institution had communicated the
vaccine matter to 81,000 persons in every situation of life. The
petitioners only desired to have the facts they adduced inquired
into, and hoped for public aid only in the event of being entitled
to it on public grounds.

This application for assistance by Walker’s Institution rendered
its concession to the Jennerian Society impossible: it was not for
the Government to get into hot water by showing favour to either;
and as both could not be subsidised, it was determined to vary the
application, and to ask the House of Commons to provide means for
the maintenance of a new and independent institution from which
“the Genuine Vaccine Virus could be distributed without expense
throughout the British dominions.” Mr. GEORGE ROSE, Treasurer to
the Navy, took charge of the measure, which he introduced to the
House on 9th June, 1808. After dealing with a notorious failure of
Vaccination at Ringwood, he proceeded to observe, that whilst it
could no longer be said that Vaccination was a certain security
against Smallpox in all cases, yet the evidence showed that the
failures were not one in 300. He would therefore move that the
House having the testimony of the Colleges of Physicians and
Surgeons of London, Edinburgh, and Dublin, that Vaccination was
salutary and generally effective, it is desirable that a Central
Institution be formed for the provision and distribution of Real
Vaccine Matter, and that its administration be committed to the
Royal Colleges of Physicians and Surgeons in London. The expense
would not be more than £2500 or £3000 per annum.

Mr. DAVIES GIDDY said he should not oppose the resolution, but it
would have been much better to have refrained from interference.
The people would neglect inoculation, and then smallpox would break
out with tenfold severity.

Mr. FULLER observed that Smallpox had been annihilated in Calcutta
by systematic and enforced Vaccination, and he believed the same
result was attainable in this country. He thought that even those
who hesitated to resort to general compulsion, would not object to
the Vaccination of all children in workhouses.

Sir T. TURTON would have preferred a committee of investigation.
There were already three Institutions in London for the express
purpose of propagating cowpox, and the object Mr. Rose had in view
was more likely to be attained by private subscriptions and by
assistance from Government than by a special Institution formed and
endowed by the State.

Lord HENRY PETTY contended that as the evidence was now confessedly
incomplete as to the infallible efficacy of Vaccination, it was
highly proper that investigation should be persevered in under the
eye of the public instead of by a number of small institutions
which were not perhaps altogether exempt from the imputation of
being guided by mercenary motives.

Sir FRANCIS BURDETT said Vaccination appeared before them with
a complexion widely differing from that originally assumed. A
short time ago they were assured it was an infallible preventive
of Smallpox, and that its practice was so simple that any old
woman was equal to it. Now they were told that it was a very nice
operation requiring great judgment and skill, the want of which
was held to account for the many failures which had occurred.
Thus there was neither that simplicity nor security which was
originally asserted. Considering these manifest discrepancies
between promise and practice, it was, he thought, most unwise for
the House to intervene in order to help what appeared to be a
failing experiment. They ought to be cautious--they ought not to
prop up what might prove to be pernicious error. Government in this
free country cannot compel people to submit to the prescriptions
of physicians, or the operations of surgeons, or anything except
the laws; and it was doubtful whether science itself would be
benefitted if placed under Government direction. They were referred
to the reports of the Medical Colleges, but as he read these
reports he detected much hesitation and evasion, and anything but
the assurance displayed on behalf of Vaccination by several members
of the House. Many instances of failure were admitted, and such
instances might safely be doubled. As for Spurious Cowpox he wished
to know what it was. It was used to account for all mishaps, and
it was, he suspected, a mere shift, shuffle, and get-off. [Sir
Francis need not have spoken thus dubiously, for the Report of the
Physicians admitted what he suspected.] He would much prefer a
committee of investigation, and hoped the resolution would not be
pressed.

Mr. WILBERFORCE brought up the foreign argument. There might be
failures at home, but these could be satisfactorily accounted
for. It was for them to consider the magnificent successes of
Vaccination in other lands [_Omne ignotum pro magnifico est_],
concerning which there was no room for doubt. He saw no surer
method of inspiring the public with confidence in Vaccination than
by the establishment of the proposed Institution.

Mr. ROSE explained that he merely wished to bring the House to a
resolution, leaving it to his Majesty [that was to say, himself for
the Government] to give it effect.

Mr. GEORGE CANNING, Secretary of State for Foreign Affairs,
declared that though he considered the discovery of Vaccination
to be of the greatest importance, yet he could not imagine any
circumstances whatever that would induce him to follow up the most
favourable report of its infallibility with any measure for its
compulsory infliction.

This declaration of Canning is well worth attention and
commemoration. It serves to mark the reverence for personal
liberty, which was the fine distinction of the former order of
English statesmen, and separated, when little else did, the English
from the Continental Tory. The noble tradition of this liberty
meets with scant favour in these times, and Canning’s avowal in
the new House of Commons would be heard as an anachronism. Nearly
every adventurer who has a prescription for the moral and physical
welfare of his fellow creatures hopes to have it enforced by
legislation; and since, under penalty of fine and imprisonment, our
babes are cut and poisoned to save them from smallpox, there is no
infraction of personal liberty, however outrageous, that can now be
pronounced impossible.

When the House divided there were 60 for the motion and 5 against
it--again a small House for so critical a matter.

With the permission to spend £3000 a year, the National Vaccine
Establishment was constituted, Jenner being consulted in its
organisation. A Board was formed, consisting of the President and
four Censors of the Royal College of Physicians, and the Master
and two senior Wardens of the College of Surgeons. The Board met
on 8th December, 1808, and proceeded to business. Jenner, as was
his fatality on important occasions, was absent, being detained at
Berkeley by family affliction. He wrote to Moore--

  I should be unworthy of the name of father were I to stir from
  my children. Indeed, nothing would make me, not even a royal
  mandate, unless accompanied by a troop of horse.

Jenner was elected Director, but not a member of the Board, and
immediately began to protest that he was disregarded and subjected
to indignity. “The Board,” he said, “appointed me Director, but
they soon contrived to let me feel that I was to be a Director
_directed_.” The arrangement he had made with Mr. Rose and Sir
Lucas Pepys, the President of the College of Physicians, was, he
held, altogether different--

  It was stipulated between Mr. Rose, Sir Lucas, and myself, that
  no person should take any part in the Vaccinating Department who
  was not either nominated by me or submitted to my approbation.
  On my reminding Sir Lucas of this, he replied, “You, Sir, are
  to be whole and sole Director. We [meaning the Board] are to be
  considered as nothing. What do _we_ know of Vaccination.”[139]

Sir Lucas of course was jeering, but Jenner’s head was so turned
with vanity and flattery that he could not distinguish mockery from
sincerity. He had constructed for himself a fool’s paradise, out
of which the Board pitched him unceremoniously. He recommended his
bludgeon bearer, John Ring, for Chief Vaccinator and Inspector of
Stations, but the Board declined to have anything to do with him,
and added insult to contempt; for in Jenner’s words, written in the
third person--

  They appointed a gentleman in his place who was taken from an
  Institution which had been personally hostile to Dr. Jenner on
  all occasions.

Subsequently he sent in a list of seven names for Sub-Vaccinators,
of which the Board rejected five, which brought matters to a
crisis, and he resigned. In the memorandum, from which I have
quoted, he wrote--

  By the whole of these circumstances, Dr. Jenner felt himself
  under the necessity of withdrawing from the establishment.
  He could take upon himself no responsibility where he had
  no power, not even a vote. He did not wish to control the
  establishment; nothing was further from his thoughts. But he
  expected that the practical part of its concerns would have been
  under his direction, as the title of his office implied; and
  he expected that those gentlemen whom, from a consciousness of
  their pre-eminent ability, he had so strongly recommended to
  conduct this practical part, would have been appointed. But as
  his recommendations have been disregarded--as arrangements and
  appointments have been made which are contrary to his judgment,
  and as he is informed by the Board that it was intended for them
  to use their own discretion, and that they alone are responsible
  for the conduct of the establishment, Dr. Jenner declined
  accepting the station of Director, to which they had nominated
  him, since he found that he was to have nothing to do in the
  establishment, and that his office was only a name.[140]

To those who did not know Jenner, or who accepted him at his own
estimate, the treatment to which he was subjected might appear
reprehensible; but the Board understood their man, and only cared
to have the benefit of his name, for little else was worth having.
What could be made of a character indolent and untrustworthy; who
disliked London and was off to Gloucestershire on any pretext;
whose sickly family had from him the supreme consideration of an
affectionate mother! He wrote to Moore--

  I agree with you that my not being a member of the British
  Vaccine Establishment will astonish the world; and no one in it
  can be more astonished than myself.

He was mistaken. The world, so far as it thought at all, considered
he was handsomely rewarded with his £30,000, and with so much
public money in his pocket might have looked for a better
disposition on his part. When his nominations were disregarded, he
declined even to come to London, and thus excused his sulking at
Berkeley--

  I was quite in earnest at the time I informed you of my intention
  to come to town, but while I was getting things in order there
  came a piece of information from a Right Hon. Gentleman which
  determined me to remain in my retirement. It was as follows--

  _That the Institution was formed for the purpose of a full and
  satisfactory investigation of the benefits or dangers of the
  Vaccine Practice, and that this was the reason why Dr. Jenner
  could not be admitted as one of the conductors of it, as the
  public would not have the same confidence in their proceedings as
  if the Board were left to their own judgment in doubtful cases._

  This is the sum and substance of the communication--

  What do we know of Vaccination?

  We know nothing of Vaccination!

  Alas! poor Vaccinia, how art thou degraded!

  You intimated something of this sort to me some time since, and
  now I get it from the fountain head. An institution founded on
  the principle of inquiry seven or eight years ago, would have
  been worthy of the British nation; but now, after the whole
  world bears testimony to the safety and efficacy of the Vaccine
  Practice, I do think it a most extraordinary proceeding. It
  is one that must necessarily degrade me, and cannot exalt the
  framers of it in the eyes of common-sense. I shall now stick
  closely to _my own Institution_, which I have the pride and
  vanity to think is paramount to all others, as its extent and
  benefits are boundless. Of this I am the real and not the
  nominal Director. I have conducted the whole concern for no
  inconsiderable number of years, single-handed, and have spread
  Vaccination round the globe. This convinces me that simplicity in
  this, as in all effective machinery, is best.[141]

In the discussion in the House of Commons it was stated by
his friend, Lord Henry Petty, that one of the objects of the
Establishment would be investigation, and it was absurd for Jenner
to pretend that the fact came upon him as a revelation; and,
unless completely blinded by conceit, he must have recognised
that the general faith in Vaccination exhibited in 1801 had been
much shaken by the experience of the succeeding seven years. But
it is idle to argue the matter. When Jenner could say that he
single-handed had conducted the whole concern for years and spread
Vaccination round the globe, he could assert anything. The letter
is interesting chiefly as an exhibition of character.

We shall return to the National Vaccine Establishment and its
management--a curious story. Suffice it for the present to observe,
that its immediate effects were adverse to Vaccination. The annual
endowment was consumed in salaries, and many ceased to subscribe
to the Cowpox Societies since Vaccination was so well provided
for. The essential mischief consisted in the recognition of the
evil practice by the State, whereby it has been perpetuated to the
common injury to our own day.


THE ORIGINAL VACCINE POCK INSTITUTION.

The national endowment of Vaccination afforded a convenient pretext
for closing this Institution, founded by Dr. Pearson and his
friends in 1799; but some said the true reason was involved in the
following resolutions--

    VACCINE POCK INSTITUTION,
    Broad Street, Golden Square.

  GENERAL QUARTERLY COURT, Nov. 5, 1805.

  _Resolved_--That according to the experience of the medical
  establishment of this Institution, it appears that the
  Inoculation for the Cowpock affords security against the Smallpox
  equally with Variolous Inoculation, and that the new practice
  possesses all the advantages already stated to the public.

  _Resolved_--That, in order to give a further proof to the public,
  and to afford an inducement for information adverse to the new
  practice, the following proposal be made public, viz.:--That,
  in future, every patient who shall be vaccinated at this
  Institution, on discharge, shall receive a Certificate, stating
  that such patient has gone through the Cowpock, and engaging that
  if hereafter the said patient shall take the Smallpox, he or she
  shall be entitled to the sum of Five Guineas, to be paid from the
  funds of this Institution at the first General Court, after the
  proofs have been given, according to the rules of the medical
  establishment.

    WILLIAM SANCHO, _Secretary_.

The offer attested the sincerity of the conductors of the
Institution, but so many patients, it is said, laid claim to Five
Guineas that it was not without satisfaction that a reasonable
cause was afforded for shutting up.

Dr. Pearson held that it was impossible to be re-vaccinated. He
argued that since no one could have Smallpox twice, no one could
have the equivalent of Smallpox, namely Cowpox, twice. It was a
logical contention; but facts did not correspond to the logic.
Pearson also objected to the Variolous Test, or inoculation
with Smallpox after inoculation with Cowpox to prove that the
constitution was fortified against attack. He preferred Cowpox to
Smallpox for the purpose, as milder and less liable to dangerous
results. He found that after Cowpox it was impossible to have
Cowpox--at least immediately. Hence he was confirmed in his opinion
that Cowpox after Cowpox was impossible; just as others argued on
the same grounds that Smallpox after Cowpox was impossible. Yet at
this day none doubt that Pearson was in error; for all believe in
the possibility of re-Vaccination, or Cowpox after Cowpox; likewise
of Smallpox after Cowpox.


FOOTNOTES:

[139] Letter to JAMES MOORE, _16th January, 1809_.

[140] Baron’s _Life of Jenner_, vol. ii. p. 124.

[141] Letter to JAMES MOORE, _4th April, 1809_. Baron’s _Life of
Jenner_, vol. ii. p. 126.




CHAPTER XVIII.

HORSEGREASE AS A SOURCE OF VACCINE.


In order to complete the account of Jenner’s awards and the
adoption of Vaccination by Parliament, I have passed over several
matters of interest and significance, which I shall now proceed to
deal with, commencing with the tactics of our hero in relation to
Horsegrease.

In his _Inquiry_, published in 1798, Jenner set forth Horsegrease
as the origin of that form of Cowpox, which, when inoculated on
the human subject, ensured life-long security from Smallpox.
Many attempts were consequently made to produce pox on the teats
of cows by inoculating them with Horsegrease, but in vain; and
the possibility became discredited. Moreover, the notion of
inoculation with Horsegrease, either immediately or through the
cow, was disliked intensely. It was pronounced repulsive. Why virus
from horses’ heels should be more repulsive than virus from cows’
teats was not explained; but, as we know, there is no accounting
for tastes. Many who eat beef with relish would start with disgust
from horse-flesh. A story is told of a Wesleyan who rebuked a
sister for wearing feathers in her hat, and was sharply referred
to the existence of flowers in her own. “Yes, sister dear,” was
the cogent reply, “but we must draw the line somewhere, and it is
drawn at feathers.” The line was drawn at Horsegrease, and the
origin of Cowpox as asserted by Jenner and his country acquaintance
was conveniently denied. Jenner was not slow to perceive how the
wind of opinion was blowing, and let Horsegrease drop. He said not
a word about it in his petition to Parliament in 1802, nor did he
again advance it as a reason for consideration.

Now, why was this? Was it because he had ceased to believe that
Cowpox originated in Horsegrease? Not at all! Why, then, did he not
vindicate his opinion and confront vulgar prejudice? Simply because
he had the wit to discern, that whilst he might get something out
of the national purse for the Cowpox recipe, he could get nothing
for the Horsegrease one. As Dr. Pearson observed, “The very name
of Horsegrease was like to have wrecked the whole concern”--an
observation that Dr. Mason Good confirms in saying, “The mere idea
of using the matter of grease from the horse’s heel excited from
the first so deep and extensive a disgust that Cowpox Inoculation
had nearly fallen a sacrifice from the supposed union of the two
diseases.”

It is not to be supposed that I am censuring Jenner as a
tradesman.[142] If any of us had two patents for sale, we should
be great fools if we declined to take £30,000 for one without the
other, or suffered one to prejudice the other, or tried to inflict
any doctrine about them upon the purchaser. It is for those who
go to market to adapt themselves to the market, and remember that
sellers were made for buyers, and not buyers for sellers. Since
then the public were ready to pay for Cowpox, whilst they shuddered
at Horsegrease, it was not for Jenner to force Horsegrease upon
them.

Such is mercantile logic; and on its own conditions it is
irrefragable; but it is not the custom to deal with Jenner as a
tradesman, but as a man of science, and to range him with great
discoverers, inventors, and benefactors of mankind; and here it is
that I decidedly demur. What, I ask, did he discover? He did not
discover that Cowpox prevented Smallpox: that was the dairy-maids’
faith. He did not discover that Horsegrease prevented Smallpox:
that was the farriers’ faith. He did not discover that Horsegrease
on milkers’ hands begot pox on cows’ teats: that was the farmers’
belief. He did not discover that inoculated virus could be conveyed
from arm to arm: that was an existing practice. What then did he
discover? He discovered nothing. He did no more than take the
vulgar opinion of his neighbourhood to the London market. He made
a few perfunctory experiments by way of confirmation, advertised
them in a book, and by good or ill luck the notion was caught up,
and worked to practical issues, chiefly by Pearson, who thereby
incurred the full malignity of Jenner’s jealousy.

The distinction between a man of science and a tradesman is this,
that the mind of the one is set on the extraction of truth and
the other on the extraction of profit. The man of science does
not inquire what the public may be pleased to know and pay for,
but he ascertains and defines what is fact, and leaves the public
to adjust themselves thereto as they may find convenient. If they
recognise the truth communicated, it is well for them; if they
dislike or deny the truth, it is ill for them; but well or ill,
the man of science is the disinterested expositor of what he
knows to be true; not unfrequently, when his revelation vitally
affronts popular prejudice, realising the blessing of those who are
persecuted for righteousness’ sake.

What therefore I maintain concerning Jenner is, that the truth (as
we may presume he regarded it) he did not fully reveal; that what
he did reveal, he suffered to be derided and denied; that he was
content to take credit for so much of it as was marketable; whilst
his private conviction about Horsegrease remained unaffected, not
only in theory, but in deliberate practice.

It is for me to establish these assertions.

First, I say, he did not fully reveal what he knew. In 1789 Jenner
inoculated his son, Edward, an infant of 18 months, not with
Cowpox, or with Horsegrease, but with Swinepox; and, according
to the evidence of his own papers, the result was perfectly
satisfactory. The child was subsequently inoculated with Smallpox
on five or six different occasions, and always without effect.
According to the well-known variolous test, he was proof against
Smallpox. In short, there was nothing that Jenner ever adduced
in favour of Cowpox that was not equally valid of Swinepox. And
this Swinepox experiment was made nearly ten years prior to his
advertisement of Cowpox and Horsegrease. Why, I ask, did he keep
back the truth about Swinepox? When Cowpox was scarce, and every
cow-house was explored for virus, why did he not recommend Swinepox
as an alternative? Why, too, did he refrain from the obvious
generalisation, that Cowpox, Horsegrease, Swinepox, and probably
other sorts of pox, generated fevers, during the prevalence of
which inoculation with Smallpox was not apt to take? The answer is
plain, Because he had something to sell rather than something to
teach.

In conformity with this conduct he suffered the origin of Cowpox
in Horsegrease, and the specific virtue of grease to be derided
and denied. “It was fortunate for Dr. Jenner, and the triumph of
his discovery,” wrote Dr. Mason Good, “that a minuter attention
to the subject gave sufficient proof that there was no foundation
for his opinion that Cowpox originated in Horsegrease, nor that
any connection existed between the diseases.”[143] Such was
the convenient medical verdict, which Jenner did not venture
to disturb, though all the while persuaded of its error. There
were failures to inoculate cows with Horsegrease, but Thomas
Tanner, veterinary surgeon, of Rockhampton, Gloucestershire, “had
the merit,” says Dr. Baron, “of proving the truth of Jenner’s
statement.”[144] He succeeded in communicating the disease to
the cow from the heel of the horse, producing on the cow’s teat
a complete vaccine pustule. “From handling the cow’s teats,”
said Tanner, “I became myself infected and had two pustules on
my hand, which brought on inflammation, and made me unwell for
several days. The matter from the cow, and from my own hand, proved
efficacious in infecting both human subjects and cattle.”[145]
Jenner distributed the virus from Tanner, and it operated precisely
like Cowpox. But the proof did not rest with Tanner: others
repeated his experiment with similar issues. Dr. Loy of Whitby
published in 1801 _Some Observations on the Origin of the Cowpox_,
in which he confirmed Jenner’s country tales, and described how
(dispensing with the cow) he managed to inoculate patients with
Horsegrease, producing pustules identical with those from Cowpox,
and subjecting the persons thus equinated to the variolous test
with complete impunity. Yet, with so much to fortify him, Jenner
kept silent. He preferred to be adjudged mistaken rather than risk
the forfeit of public favour and pay. Nor might I blame him, had he
frankly reasserted the integrity of the Gloucestershire faith, and
allowed that since the public were ready to accept Cowpox without
Horsegrease, it was not for him to stand in the way of their
preference by an obstinate defence of what was non-essential in
practice.

But the case for Horsegrease was yet stronger than I have stated.
Dr. Sacco of Milan was sometimes described as “the prince of
vaccinators” by reason of his enthusiasm, his professional
attainments, and the facilities that were accorded to him in
the Cisalpine Republic of those days for universal vaccination.
He tried to generate pox on the cow with grease from the horse,
but failed, and in 1801 reported to Jenner his failure. In 1803,
however, he cried, Eureka! A coachman presented himself at the
Milan Hospital suffering from an eruption contracted in grooming
a horse with greasy heels. He was at once led off by Sacco to the
Foundling Asylum, where nine children were inoculated from the
vesicles on his hands. On three of the children the inoculation
took, producing vesicles which were pronounced to be the same as
those resulting from Cowpox. The virus was propagated from arm to
arm, and distributed in all directions. Dr. Sacco from thenceforth
avowed himself a Horsegreaser. “It is now admitted and settled,” he
wrote to Jenner from Milan, 25th March, 1803, “that grease is the
cause of vaccine, and we cannot too soon alter the designation to
equine.”

Was the designation changed to equine? It was not, nor was the
attempt made. Those chiefly concerned in promoting vaccination in
England would not hear of Horsegrease, and many were ready to swear
that in the matter of pox, the horse and the cow had no connection
whatever, and that Jenner had too hastily assumed the truth of a
vulgar west country opinion.

Dr. De Carro of Vienna, who described himself as Jenner’s friend
and first apostle, having effected the first vaccination on the
Continent and transmitted the first charge of vaccine to India,
was also a Horsegreaser. Whilst Jenner was judiciously holding
his tongue about Horsegrease in England, he wrote to De Carro
congratulating him on his success in conveying Cowpox to the
East, and ascribing the failure of the English attempts to the
absurd prejudice against Horsegrease, which Dr. Loy had, however,
completely annihilated. Here are his words under date, 28th March,
1803--

  I am confident that had not the opponents of my ideas of the
  origin of the disease been so absurdly clamorous, particularly
  the _par nobile fratrum_ [Pearson and Woodville], the Asiatics
  would long since have enjoyed the blessings of Vaccination, and
  many a victim been rescued from an untimely grave. The decisive
  experiments of Dr. Loy have silenced the tongues of these
  gentlemen for ever.[146]

How the clamorous opposition to Horsegrease had deprived Hindoos
of the earlier blessing of vaccination, we are left to conjecture.
Perhaps he meant that Horsegrease would have borne transit to India
better than Cowpox, or that the Hindoos themselves might have
resorted to horses with greasy heels.

In reply, 22nd April, 1803, De Carro wrote to Jenner commending his
moderation in maintaining silence toward his antagonists--little
apprehending the motives of that silence. Pearson’s conduct, he
thought, bordered on insanity. “I am extremely glad,” he continued,
“that you have treated it with the contempt it deserves, though I
am happy to see that your friends have exposed his ridiculous and
malevolent designs.”

De Carro was intimate with Sacco of Milan, and from him received
virus derived from Horsegrease, which he used indiscriminately with
Cowpox, until in Vienna it was unknown who were vaccinated and who
equinated.[147]

De Carro was also in correspondence with Dr. La Font, a
French physician, established at Salonica, who was likewise a
Horsegreaser. He discovered that the Macedonian farriers recognised
three sorts of grease in horses, called in general _javart_,
and discriminated as _l’écrouelleux, le phlegmoneux, et la
variolique_.[148] With the variolous grease, La Font inoculated
two boys, and from them other children, reproducing the experience
of Loy of Whitby and Sacco of Milan. De Carro in communicating
La Font’s success to Jenner, 21st June, 1803, observed, “These
particulars, I hope, will silence all those who still doubt the
truth of your doctrine as to the connection of Grease, Cowpox, and
Smallpox”--Jenner holding that Smallpox was a malignant variety of
Cowpox, whilst Cowpox came out of Horsegrease.

Notwithstanding these confirmations and his boast that the
opposition of Pearson and Woodville was silenced for ever, Jenner
suffered judgment to go against him. 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 public, and
it was not for him to make difficulties. A curious evidence of
how thoroughly the unpopular truth was suppressed is furnished
by Dr. Willan’s treatise _On Vaccine Inoculation_, published in
1806. There is not a word or hint in it concerning Horsegrease.
The treatise was the work of a competent physician, who set forth
what was known of vaccination (from the standpoint of belief) with
fulness and clearness, accompanied with an appendix of letters and
reports from Jenner himself, from Pearson and other experts in the
new practice--but as to Horsegrease, the silence was absolute. How
the disagreeable truth was so effectually covered up is more than I
can account for. It was not mentioned in the debates in Parliament,
nor was it referred to in the reports of the Colleges of Physicians
and Surgeons, nor did the opponents of vaccination use it with
the force that might have been expected. One explanation is,
that Jenner’s _Inquiry_ never entered into general circulation,
that no popular edition ever appeared, and that it was chiefly
known at second hand. The leading representatives of vaccination,
moreover, so boldly disowned Horsegrease and Jenner’s authority
in ascribing Cowpox to its parentage, that there was little use
in charging them with it; whilst all the while Jenner offered no
open resistance to those who contemned him for one mistake, but
exhausted the language of adulation on his imputed merit. Thus we
suppose it came to pass that at the end of twenty years Dr. Mason
Good, as the exponent of orthodox medical faith, felt justified in
asserting that there was no foundation for the opinion that Cowpox
originated in Horsegrease, nor that any connection existed between
the diseases, and that it was fortunate for Jenner and the triumph
of his discovery that the fact was so.

Jenner was silenced, but was he convinced? How could he be
convinced? Horsegrease as the origin of Cowpox might be voted
detestable and impossible, but there was the evidence of the
country folk, confirmed by Tanner, Loy, Sacco, De Carro, and La
Font; and though a weak man may be put down, or think it worth
while to be accounted mistaken, yet, in the stillness of his mind,
he knows that facts are facts whatever may be said to the contrary.
When, therefore, Jenner had filled his purse, obtaining all he
could expect from public favour, and was clear of London, and
the oppression of its savants, he reverted to his first opinion
as true--true and untrue, true with a distinction, which I shall
presently define. Writing to James Moore, Director of the National
Vaccine Establishment, from Berkeley, on 23rd July, 1813, he
observed--

  You seem not perfectly satisfied that the origin of vaccine
  is clearly made out. For my part, I should think that Loy’s
  experiments were sufficient to establish it, to say nothing of
  Sacco’s and others on the Continent. However, I have now fresh
  evidence, partly foreign and partly domestic. The latter comes
  from Mr. Melon, a surgeon of repute at Lichfield. He has sent me
  some of his equine virus, which I have been using from arm-to-arm
  for two months past, without observing the smallest deviation in
  the progress and appearance of the pustules from those produced
  by the vaccine.[149]

And in a subsequent note of 1st August, he repeated--

  DEAR MOORE,--I have been constantly equinating for some months,
  and perceive not the smallest difference between the pustules
  thus produced and the vaccine. Both are alike, because they come
  from the same source.[150]

To Moore again he wrote from Cheltenham, 27th October, 1813--

  I am sorry you have not succeeded in infecting a cow. I have told
  you before _that the matter which flows from the fissures in the
  horse’s heels will do nothing_. [Note the observation placed in
  italics.] The virus is contained in vesicles on the edges and the
  surrounding skin.

  Did I ever inform you of the curious result of vaccinating
  carters? From their youth these men have the care of horses
  used for ploughing our corn lands; and great numbers have come
  to me from the hills to be vaccinated, but the half have proved
  insusceptible. On inquiry, many of them have recollected having
  sores on their hands and fingers from dressing horses affected
  with sore heels, and being so ill as to be disabled from work;
  and on several of their hands, I have found the cicatrix as
  perfect and characteristically marked as if it had arisen from my
  own vaccination.[151]

Then we have a memorandum of Jenner’s, dated 1st April, 1817,
wherein he thus traces the course of the virus--

  Rise and progress of the equine matter from the farm of Allen at
  Wansell. From a horse to Allen; from Allen to two or three of his
  milch cows; from the cows to James Cole, a young man who milked
  at the farm; from James Cole to John Powell by inoculation from
  a vesicle on the hand of Cole; and to Anne Powell, an infant;
  from Powell to Samuel Rudder; from Rudder to Sophia Orpin, and
  to Henry Martin; from H. Martin to Elizabeth Martin. All this
  went on with perfect regularity for eight months, when the virus
  became intermixed with other matter, so that no journal was
  kept afterwards. Proof was obtained of the patients being duly
  protected[152]--

Which was to say, that they were subsequently inoculated with
Smallpox without effect. Among Jenner’s papers, there were other
entries to the same purpose, thus--

  _17th May, 1817._--Took matter from Jane King (equine direct)
  for the National Vaccine Establishment. The pustules beautifully
  correct.[153]

This equine virus from Jane King was extensively diffused. It was,
we see, sent to London; it was also sent to Edinburgh;[154] and
Dr. Baron says he had supplies of it for use in the Gloucester
Infirmary. Baron relates that in the following year he was able
to return the gift, having obtained virus from the hands of a boy
infected directly from the horse. Here is Jenner’s acknowledgment
of the present, dated 25th April, 1818--

  My Dear Baron,--Yesterday H. Shrapnell brought me the equine
  virus and your drawing, which conveys so good an idea of the
  disease, that no one who has seen it can doubt that the vesicles
  contain the true and genuine life-preserving fluid. I have
  inserted some of it into a child’s arm; but I shall be vexed if
  some of your young men at the Infirmary have not done the same
  with the fluid fresh from the boy’s hand.[155]

It is surely unnecessary to adduce further evidence of what was
Jenner’s mature faith and deliberate practice. Further, it is
manifest that to the end of his career he held that pox in the
cow was not only derived from grease in the horse, but that it
was exclusively derived from the horse, and, that apart from the
horse, Cowpox would cease to exist. Owing to the multiplication of
vaccination failures, it began to be conjectured that vaccine might
be worn out by transmission from arm-to-arm, and that a reversion
to the cow might be expedient; and discussing the question in
a letter to Moore, dated 5th March, 1816, Jenner advanced the
objection--

  If there were a real necessity for a renovation, I know not what
  we should do; for the precautions of the farmers with respect to
  their horses have driven the Cowpox from their herds.[156]

Why did not Moore rejoin, Where is the difficulty? Suppose pox
driven from the herds, what conceivable reason was there for
anxiety when the cow had become a demonstrated superfluity?--when,
in Jenner’s own words, “the true and genuine life-preserving
fluid” might be drawn direct from horses’ heels? Except for the
perpetuation of imposture, the cow in the case had ceased to have
any value whatever. But, as so often happens with quacks, their
minds become so saturated with their own humbug that there is
nothing left of common-sense.

Having thus proved my assertions concerning Jenner, it may be
reasonably asked, How was it that some got Cowpox by means of
Horsegrease when others could not? for, it may be argued, that if
Cowpox issued straight and invariably from inoculated Horsegrease,
not even the most resolute prejudice against Horsegrease could have
permanently kept back the truth.

The answer is, that Cowpox never came out of what is commonly known
as Horsegrease. The statement made by Jenner in his _Inquiry_ of
1798 that--

  The limpid fluid which issues from the small cracks or fissures
  in the inflamed and swollen horse’s heel--

infected cows and begot pox was a blunder, which he explicitly
reversed fifteen years afterwards in his letter to Moore of 27th
October, 1813, already cited--

  I am sorry [he wrote] you have not succeeded in infecting a cow.
  I have told you before that the matter which flows from the
  fissures in the horse’s heel will do nothing. It is contained in
  vesicles and the surrounding skin.[157]

Jenner, we have always to remember, was a slovenly investigator,
not apt to take pains, but apt to eke out observation with
invention. His friend, “honest Jack Baron of Gloucester,” who
himself inoculated with horse virus unmodified by the cow, actually
wrote Jenner’s life in two volumes, and not until the work was
ready for the binder did he discover that he was in error in
common with his master in ascribing Cowpox to Horsegrease! Such
was the intellectual muddle in which these prophets of vaccination
operated! In a note stuck at the end of the second volume, we have
the following amazing confession, made, remember, in 1838, fifteen
years after the chief conjurer’s death--

  I take this opportunity of expressing my regret that I have
  employed the word _Grease_ in alluding to the disease in the
  horse. _Variolæ Equinæ_ is the proper designation. It has no
  necessary connection with the _Grease_, though the disorders
  frequently co-exist. This circumstance at first misled Dr.
  Jenner, and it has caused much misapprehension and confusion.[158]

Here we have the secret and desired explanation. It was out of
Horsepox, and not out of Horsegrease, that Cowpox was derived,
and in confounding grease with pox, Jenner mystified himself
and others, and obscured the whole doctrine of vaccination.
The Macedonian farriers who in 1803 informed La Font that they
recognised three sorts of grease, and one of them variolous, were
more accurate observers than the Gloucestershire farriers and
farmers whose opinion Jenner lazily retailed. Whether he had any
clear apprehension of his own blunder is not apparent. We have
seen how long it took his biographer, Baron, to find it out. This
is certain, that he made no public attempt to set right what he
had so egregiously set wrong, nor to withdraw the statement in
his _Inquiry_ that Horsegrease only acquired its efficacy against
Smallpox after inoculation on the cow.

Lastly, we may inquire what is the present state of opinion as to
Horsegrease and Cowpox? When difficult questions are asked, we
usually turn to our cyclopædias, and taking down Hooper’s _Lexicon
Medicum_, 8th ed. 1848, Art. Cowpox, we read--

  It is now ascertained that the horse and the cow each furnish,
  independently of the other, a virus capable of communicating
  genuine Cowpox to the human subject.

Genuine Cowpox communicated by a horse is surely a bull of the
first magnitude! The _Encyclopædia Britannica_, 8th ed. 1860, Art.
Vaccination, illuminates us thus--

  It is now to be regarded as an established fact, that Horsegrease
  and Cowpox are the same complaint, modified by the constitution
  of the animals in which they occur.

An established fact, indeed!--established in quicksand!

Some say the Gloucestershire farmers and Jenner were correct in
attributing Cowpox to Horsegrease, and that they can only he
charged with mistake in nomenclature. When they said Horsegrease,
they meant Horsepox, not discriminating between maladies that
sometimes occurred together. No one now believes that the affection
recognised by veterinarians as “grease” ever originated Cowpox. The
same rural authorities, including Jenner, held that where there was
no Horsepox, there could be no Cowpox; but, so far as I can make
out, that conclusion is surrendered. Pox on the horse may generate
pox on the cow, but the cow may have pox without the horse.

  In this respect only was Jenner in error [says Mr. George
  Fleming, Army Veterinary Inspector]. The two diseases are
  perfectly independent of each other. Cowpox appears where there
  are no horses, or possible contact with horses; and may affect a
  number of cows in a dairy while the horses are entirely free from
  Horsepox.[159]

At this point comes the tug of war. If cows have pox, how do they
contract the malady? Speaking at the London Conference on Animal
Vaccination in December, 1879, Professor J. B. Simonds, Principal
of the Royal Veterinary College, said--

  My contention is, that the existence of Cowpox has to be proved.
  Jenner’s account of the disease was an illusion. In my experience
  among animals for forty years, I have never seen a case of
  Cowpox, and I do not believe that any form of variola belongs to
  the bovine race. Sheep are afflicted with pox, but not cattle. We
  hear of Cowpox, but who ever heard of Bullpox? And is it credible
  that a disease should be confined to cows and never attack bulls
  and steers? Let any one point out an affection of females that
  does not extend to the males of the same species.

Professor Simonds and others believe that Cowpox as described by
Jenner was a parasitic affection of Smallpox, probably communicated
by milkers; and that Ceely, Badcock, and others did intentionally,
what milkers had done inadvertently, when they inoculated cattle
with Smallpox in order to create virus for vaccination. On the
other hand, those who assert the independent existence of Cowpox,
hold no terms with this heresy. As Dr. Cameron says, “We can no
more make Smallpox into Cowpox than by stunting an oak-tree we can
make it a gooseberry bush.” Fortunately I have no call to pronounce
judgment on the controversy. The more it rages, the better I
like it, and if the combatants disposed of each other as did the
Kilkenny cats, I might not be very sorry.

A last word as to Horsepox. There seems to be little doubt that
when inoculated on man it gives rise to vesicles indistinguishable
from those raised by Cowpox. In 1863 Professor Bouley of Alfort
produced pox on a cow by inoculating it with pox from a horse,
and children were successfully vaccinated with the virus. In the
Transactions of the Clinical Society, Vol. X., Mr. John Langton,
describes the case of a groom who came to St. Bartholomew’s
Hospital, 20th March, 1877, with an eruption caught from a horse
exactly like that induced by vaccination; and there could be no
question, says Mr. Langton, that the disease was the same as that
described by Jenner as grease.

There is much virus in currency as vaccine that is equine, and many
of us are equinated who suppose ourselves vaccinated; and it might
be argued that we have been saved from Smallpox by reason of our
equination. Why with all the notorious failures of vaccination, and
of re-vaccination, some of the more audacious medical quacks do not
recommend Horsepox as an infallible alternative, is not easy to
understand. It would be a Napoleonic stroke; nor is it improbable
that before vaccination is surrendered the attempt will be made.
How easily it might be asserted that vaccination is a failure in
so far as it has lost the original virtue of equination, that the
remedy is to dismiss the cow and revert to the horse, from whose
poxy heels, as the immortal Jenner observed, there issues “the true
and genuine life-preserving fluid.” The oracle might be worked
thus--

“Let us hear no more of pure lymph from the calf, too often, alas!
an illusion. Sure and certain salvation from Smallpox can only
be guaranteed to those inoculated with pure pox from the horse.
Come then to the horse, the horse with pox! Come quickly! Come
yourselves! Come with your wives! Come with your children! Come and
be saved by Horsepox from the loathsome pestilence that decimates
the human race and brings myriads to untimely graves!”


FOOTNOTES:

[142] As tradesman, however, Jenner was not honest. He took to
market what was not his to sell. The introduction of Cowpox for
inoculation (stigmatised in _The Inquiry_ as spurious, not being
derived from Horsegrease) was effected by Pearson, and Jenner’s
claim to it was an act of piracy.

[143] _Study of Medicine_, vol. iii. p. 59.

[144] _Life of Jenner_, vol. i. p. 248.

[145] _Treatise on the Cowpox._ By John Ring. P. 336.

[146] Baron’s _Life of Jenner_, vol. i. p. 428.

[147] Copeland’s _Medical Dictionary_.--Art. Vaccination.

[148] _Histoire de la Vaccination._ Par Jean de Carro. Vienne, 1804.

[149] Baron’s _Life of Jenner_, vol. ii. p. 388.

[150] _Ib._ p. 388.

[151] Baron’s _Life of Jenner_, vol. ii. p. 390.

[152] _Ib._ p. 226.

[153] _Ib._ p. 226.

[154] _Account of Varioloid Epidemic in Edinburgh._ By John
Thomson. London, 1830.

[155] Baron’s _Life of Jenner_, vol. ii. p. 227.

[156] _Ib._, p. 399.

[157] Baron’s _Life of Jenner_, vol. ii. p. 390.

[158] Baron’s _Life of Jenner_, vol. ii. p. 456.

[159] _Lancet_, 29th May, 1880, p. 834.




CHAPTER XIX.

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.




CHAPTER XX.

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.




CHAPTER XXI.

MOSELEY, ROWLEY AND SQUIRREL.


It may be well to devote a chapter to those antagonists of
Vaccination who, though right in their contention against cowpox,
did more or less to discredit their cause by scurrility and
extravagance. The faults of these men are frequently adduced
as evidence of the absurd and brutal resistance with which
Vaccination was encountered, but it is forgotten how intense was
their provocation, and how the bad on one side was matched by
the bad on the other. It was a contest between Smallpoxers and
Cowpoxers, alike ignorant of the conditions of physical well-being.
It is plain, however, in the light of our later experience, that
much that was asserted by the Smallpoxers of the uselessness and
harmfulness of cowpox must have been exactly and painfully true,
though persistently and ferociously denied.

In the _Edinburgh Review_ for October, 1806, appeared an article
entitled “Pamphlets on Vaccine Inoculation,” which may be taken
as a reflection of the state of the controversy at that date, and
as an index to the chief offenders against propriety. The article
was written by the editor, Francis Jeffrey, and was a product of
that perspicuous intelligence, which reduced to order whatever was
subjected to its action, in much the same way that a housemaid
“sets to rights” a library by ranging the books according to
their sizes and bindings, and assorting the papers so that they
lie neatly disposed. As is the habit of able editors, a view of
the variolous controversy was evolved that might be comfortably
accepted and confidently repeated by his readers--the evolution
of such rational mirage being regarded for the time as veracious
matter-of-fact.

First we may take the reviewer’s evidence as to the extent and fury
of the controversy--

  The ample and public testimony offered in favour of Vaccination
  seemed for a while to set the question at rest; and, except in a
  few obscure pamphlets and communications to the medical journals,
  little was heard in opposition to it, till 1804, when Mr.
  Goldson of Portsmouth published six cases of Smallpox occurring
  after Vaccination, accompanied with observations, calculated to
  shake the confidence which was now very generally placed in the
  security of the Jennerian inoculation. These were answered by
  Mr. Ring and others, who endeavoured to show that, in some of
  his cases, Mr. Goldson’s patients had not had the genuine Cowpox
  in the first instance, and that in others, they had not had the
  genuine Smallpox thereafter. This part of the controversy was
  conducted with temper, and with a reasonable degree of candour.
  In the end of the same year however, Dr. Moseley published his
  treatise on the Cowpox, in which the ravings of Bedlam seemed to
  be blended with the tropes of Billingsgate. Dr. Rowley followed
  on the same side, and in the same temper, with 500 cases of
  “the beastly new diseases produced from Cowpox,” and attracted
  customers by two coloured engravings at the head of his work
  of “the Cowpoxed, ox-faced boy,” and the “Cowpoxed, mangey
  girl.” The battle now became general. The Reverend Rowland Hill
  thundered in defence of vaccination--Dr. Squirrel leaped from
  his cage upon the whole herd of vaccinators--Mr. Birch insisted
  upon stating his serious reasons for objecting to Cowpox--Drs.
  Thornton and Lettsom chanted pæans in its praise--Mr. Lipscomb
  strutted forward with a ponderous, wordy dissertation on its
  failures and mischiefs; and Messrs. Ring, Merriman, and Blair
  answered everybody; and exasperated all their opponents by their
  intemperance and personality. Charges of murder and falsehood
  were interchanged among the disputants without the smallest
  ceremony; the medical journals foamed with the violence of their
  contention; it raged in hospitals and sick-chambers; and polluted
  with its malignity the sanctity of the pulpit and the harmony of
  convivial philanthropy.

  In the whole course of our censorial labours, we have never had
  occasion to contemplate a scene so disgusting and humiliating as
  is presented by the greater part of this controversy; nor do we
  believe that the virulence of political animosity or personal
  rivalry or revenge ever gave rise, among the lowest and most
  prostituted scribblers, to so much coarseness, illiberality,
  violence and absurdity as is here exhibited by gentlemen of
  sense and education discussing a point of professional science
  with a view to the good of mankind. At one time, indeed, we
  were so overpowered and confounded by the clamour and vehement
  contradictions of the combatants, that we were tempted to abandon
  the task we had undertaken, and leave it to some more athletic
  critic to collect the few facts and the little reasoning which
  could be discerned in this tempest of the medical world.

Furious was the controversy, but why was it furious? There are
often great fights over little matters, but the reason is that
the little matters are vitally related to the self-love of the
combatants; and thus it was with the Cowpoxers and the Smallpoxers.
The Cowpoxers set out with the absolute assertion that whoever
submitted to their prescription would be secure from smallpox for
life. Without proof, or with powerful sham proof, the assertion was
endorsed by the mass of the medical profession, and there followed
the conversion of the community in that sort of faith-panic which
is described by Carlyle as Swarmery--

  All the world assenting, and continually repeating and
  reverberating, there soon comes that singular phenomenon called
  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.[169]

People thus enchanted do not like to be brought to their senses;
and medical men, who in 1800 attested the perpetual prophylaxy
of cowpox, were naturally very unwilling to be proved deceivers
and deceived. When cases of smallpox were reported as following
vaccination, they at first denied the possibility, saying that
either there had been no vaccination, or that the smallpox was
not smallpox. On the other hand, the Smallpoxers who had been
snuffed out by the Cowpoxers, revived in presence of the discovered
impotence of the new practice, and stoutly maintained, and cruelly
demonstrated that unquestionable vaccinations were followed by
unquestionable smallpox. It needs little acquaintance with human
nature to see unlimited elements of bitterness in these conditions.
To be convicted of imposture does not beget equanimity, nor
contradiction as to plain matter-of-fact; and thus convicted were
the Cowpoxers and thus contradicted were the Smallpoxers.

The Edinburgh reviewer described Dr. Moseley’s treatise on
cowpox as blending “the ravings of Bedlam with the tropes of
Billingsgate.” Some Billingsgate I concede, but not Bedlam at all.
Much however depends on the point of view. Vaccination if regarded
as a blessing in which the inspiration of heaven was consummated
in the salvation of the human race from smallpox,[170] resistance
thereto might appear, as Carlyle observes of creatures under
enchantment, as “malignantly insane.”

Dr. Moseley’s book,[171] it is to be allowed, was singularly
exasperating. He had spoken against cowpox from the outset, and was
charged with condemning that of which he knew nothing; to which he
cogently replied that he could scarcely know less than the gang of
medical men who attested its perpetual efficacy in the newspapers
in 1800 before they had any proper experience of it whatever. If
his scepticism was premature, what was their credulity? Moseley
had patience: no argument could be heard in the rage that set in
for the new salvation. “Cowpox, I admit, is not contagious,” he
said, “but cow-mania is.” When, however, in process of time it was
seen in hundreds of cases that cowpox conferred no immunity from
smallpox, he published in 1804 _Lues Bovilla_--a somewhat pompous
treatise, with frequent touches of superfluous learning, and
permeated with the irritating superiority of the true prophet--“You
see it has turned out just as I predicted.” Nor was he content to
make general assertions: he specified the names and addresses of
those who had been correctly vaccinated, or had taken cowpox from
the cow, and had subsequently suffered from smallpox with their
neighbours; also of cases of severe illness, injury, and death
resulting from vaccination. Bluster was idle in presence of such
facts. Even the Royal Jennerians had to eat humble pie, for in
their Report, dated 2nd January, 1806, we read--

  It is admitted by the Committee that a few cases have been
  brought before them of persons having the Smallpox who had
  apparently passed through the Cowpox in a regular way.

With so much admitted by such furious fanatics, what might not be
inferred!

Moseley was held in high esteem alike by the profession and the
public, and his judgment enforced by so much serious evidence
contributed heavily to the discredit of vaccination, and
unfortunately to the resumption of variolous inoculation. That the
reaction was extensive, especially in London, appears from numerous
contemporary testimonies, which Moseley confirms in saying--

  The people at large are not to be reproached for putting their
  faith in this splendid imposition on humanity; and to the
  credit of their discernment and parental feelings, the middle
  and inferior classes have taken precedence in renouncing the
  delusion. At this moment, unless attacked by surprise, or with
  threats, or cajoled by artifice (all of which have been practised
  on them) there are now none among them in London and the adjacent
  villages who will expose their children to Cowpox Inoculation.

Rowland Hill was a religious and philanthropic notable in those
days, and in common with many of his kind, was an enthusiastic
vaccinator. A leading spirit in the Royal Jennerian Society, he had
the school-room of Surrey Chapel constituted a vaccination station
whereat Dr. Walker officiated. Nor was he content to patronise the
practice, but was himself an energetic operator. Speaking at the
annual meeting of the Jennerian Society, 17th May, 1806, he said--

  “With my own hands I have vaccinated upwards of 5000 persons,”
  and, lifting up his eyes to heaven, exclaimed, “I solemnly
  declare before God, I have not had a failure in a single
  instance. What then shall we say of the false and daring
  publications of those who denounce the benign practice, and how
  shall they answer for their conduct to their King, their Country,
  and their God!”

Hill and Jenner were great friends. Hill visited Jenner at
Berkeley, and Jenner heard Hill when he preached at Cheltenham.
Introducing Jenner to a nobleman, Hill remarked--

“Allow me to present to your Lordship my friend Dr. Jenner, who has
been the means of saving more lives than any other man.”

To which Jenner, being of a pious turn, sighed with meek effusion--

“Ah! would I, like you, could say _souls_.”[172]

So committed and so possessed, Hill naturally resented the growing
distrust of vaccination. It cut him deeply to be supposed a quack;
and in 1806 he issued a pamphlet[173] relating his experiences as a
Jennerite, defending his practice, and denouncing those who treated
it despitefully. Moseley especially was subjected to severe and
contemptuous condemnation. Hill’s sanctimony and virulence, his
vigour and venom compose a piquant mixture, and if we could tarry
for amusement we might produce it abundantly from a variety of
elegant extracts. Consider, for instance, this his adjuration, and
its pitiful object--

  Oh, the blessing of the Jennerian inoculation! Did ever man stand
  as Jenner so much like an Angel of God, an instrument in the
  hands of Divine Providence between the living and the dead till
  the plague was stayed!

Hill’s latent assumption throughout his discourse was--

First, that all must have smallpox; and

Second, that all the vaccinated who escaped smallpox, owed their
salvation to their Jennerisation.

It never apparently occurred to him that before Jenner was
heard of, many passed through life exempt from smallpox; nor,
consequently, did he inquire _how_ they escaped; nor _why_, when
vaccination was introduced, escape should be placed to its credit.

The belief in the vicarious influence of vaccination comes out
strongly, too, in Hill’s pamphlet. Of Londoners there were then
over 1,000,000, and of these, he says, at least, 100,000 had been
vaccinated, and with this effect--

  Vaccination reduced the deaths from Smallpox in London to 10 per
  week; but after the Inoculators had been making their clamours,
  the applicants for Vaccination diminished, and the deaths soon
  rose to 100 per week.

  Now can effrontery itself deny that the introduction of
  Vaccination was the sole cause of reducing the fatality on the
  Smallpox list?

Thus one in ten being vaccinated, smallpox was reduced throughout
the unvaccinated 9-10ths; and as soon as the vicarious operations
dropped, up went the rate of mortality! Nor was Hill singular in
this persuasion. He cited his friend Dr. Lettsom as writing to him,
25th March, 1806--

  Vaccination was gradually lessening the mortality in 1804, when
  about the middle of 1805 false reports against Vaccination gained
  very general credit, and Vaccination was nearly suspended;
  the consequence was the death of 1286 children in four months
  (September to December) or ten every day, each of whom might now
  have been alive had the blessing of Vaccination been accepted.

And again I find Lettsom wrote to Moseley, November, 1808--

  The increase of births and decrease of deaths has added 3000
  lives annually to the population of London during the period that
  Vaccination has been practised.

Talk evidently sincere, and widely repeated, but with how little
consideration for truth!

To return to Moseley. He was not the man to endure Hill’s
aggression submissively, and in a pamphlet entitled _An Oliver
for a Rowland_,[174] he made a terrific reprisal. The public
were delighted with it, and in the course of a few months it ran
through ten editions. Hill was generally regarded as a clerical
mountebank, with more impudence than piety, and to see him knocked
over, kicked, and rolled in the mire, was sport that carried many
sympathisers. Moseley’s opening address gives the key to the whole
performance--

  ROWLAND,--I bought your pamphlet, entitled _Cowpox Inoculation
  Vindicated_, dated the 25th of March, 1806.

  I paid a shilling for it. Rowland,--it is not dear. The same
  quantity of folly, falsehood, and impudence, could not have been
  bought for twice the money of any other Cowpoxer from the Ganges
  to the Mississippi.

  But let me ask you, Rowland, what could induce you to take
  up your pen to attack me on the subject of Physic, who never
  attacked you on the subject of Religion? Would it not have been
  more prudent in you to have continued to expose yourself in your
  own trade in your own shop?

  As to my learned friend Dr. Lettsom (who is never out of the way
  when there is good to be done) being moved to instigate you, a
  Methodist parson, to enter into a medical controversy--that can
  only be accounted for by supposing he owes you a grudge, and put
  you into my hands for payment.

Paid he was with interest--gross and Rabelaisian; and Hill, when he
had picked himself up and recovered his senses, discreetly retired
from the combat.

Spite of his pomposity and buffoonery, there was good sense and
humour in Moseley, and his resistance to the Jennerian mania was
not ineffective. As he wrote in 1808--

  It is ten years since I began this Trojan war against Vaccinia;
  and if it be not yet ended, I have at least the satisfaction
  to see that her original troops are no longer able to defend
  her throne; and that the mobled Queen with “a clout upon her
  head where late diadem stood,” has fallen to a new dynasty of
  mercenaries.[175]

In Dr. Munk’s _Roll of the Royal College of Physicians_ we read,
that Dr. Moseley was appointed physician to Chelsea Hospital in
1788, “an office which he filled with the highest _éclat_ for more
than thirty years”--until his death in 1819--

  Though a shrewd practitioner, and undeniably a man of extensive
  mental capacity and very considerable attainments, Dr.
  Moseley was a violent opponent of Vaccination, on which his
  communications to the press were incessant. They did little
  credit to his medical penetration, or his qualifications as
  a dispassionate searcher after truth, and, happily for his
  reputation, are now well nigh forgotten.[176]

Are they? For what else is Dr. Moseley remembered? So that a man
does his duty in the world, whether he be forgotten or remembered
is not worth a thought; but Moseley’s early and steadfast
resistance to the Cowpox Imposture will long constitute his title
to grateful recollection.

Dr. William Rowley, Physician to the Marylebone Infirmary, also
left his mark in medical history as a determined opponent of
vaccination. He had seen the profession and the public go mad
about so many absurd novelties, that it did not surprise him
that they should go mad about cowpox: and after due experience
and investigation he delivered judgment on the craze and its
pernicious effects in a pamphlet entitled _Cowpox Inoculation no
Security against Smallpox_,[177] containing two coloured engravings
representing the Cowpoxed Ox-Faced Boy, and the Cowpoxed Mangey
Girl. Much ridicule was expended on these pictures, and to this
day whoever wishes to be funny and create giggle over the early
resistance to vaccination tells how one Dr. Rowley maintained
that Jenner’s benign virus induced the face of an ox on a boy;
but like the majority of comic anecdotes, it is untrue. The
engraving represents a comely lad with a swelling on the upper
part of his left cheek, which was thought to give that side of
his face an ox-like expression. Many a medical practitioner among
the poor would at this day have little difficulty in presenting
living examples of affliction answering to Rowley’s pictures--and
worse. It was, moreover, the fear or fancy of many at the time
that inoculation with cowpox might beget bovine characteristics
in the human species, and the fear or fancy was turned to
inevitable account in jest and earnest. The jest is visible in
some of Rowlandson’s caricatures, and stories like this got into
circulation--

  A child at Peckham, after being inoculated with Cowpox, had its
  former natural disposition absolutely changed to the brutal,
  so that it ran upon all fours like a _beast_, bellowing like a
  _cow_, and butting like a _bull_.

In order to discredit Rowley, it is thought fair policy to connect
him with such nonsense, and to have it supposed that he rested
his case upon “the cowpoxed ox-faced boy:” it was far otherwise.
He diligently tracked the vaccinators, and accumulated 504
cases of smallpox and injury after vaccination with 75 deaths,
particulars being accurately specified. Nor was he content merely
to report what he had ascertained. “Come and see,” was his forcible
argument. “I have lately had under my care,” he wrote, “some
of the worst species of malignant smallpox in the Marylebone
Infirmary, which many of the faculty have examined and know to
have been vaccinated.” His trust in “Come and see,” he still more
powerfully exemplified in an exhibition of the injuries inflicted
by vaccination in his Lecture Room in Savile Row in October, 1805.
“Knowing,” he said, “the caviling character of the Cowpoxers,
I determined to leave them no hole for retreat”; and therefore
he brought together Joules, “the ox-faced boy, who also had a
terribly diseased elbow-joint”; Marianne Lewis, the mangey girl,
“who was covered with blotches like a leopard”; “a load of children
in a cart from the south of London,” and others accompanied by
their parents, and displaying their various maladies, said, “Behold
the effects of the new disease that has been taken from the cow and
implanted in humanity!” This painful exposition was continued over
two days, and as he records, “the scene was truly affecting and
distressing to all who witnessed it.” An antagonist like Rowley is
a serious factor in any controversy, and we may estimate the havoc
he wrought by the extreme anxiety of the Jennerites to have him
estimated by the supposed absurdity of the ox-faced boy.

To a man of practical temper like Rowley, the enthusiasm with which
vaccination was at first advocated appeared akin to delirium--

  I have been in some vaccination storms, and have had the buttons
  torn off my coat, cloth and all, to convince me of the great and
  infallible excellence of Cowpox. I have seen some of the vehement
  vaccinators redden like a flame with fury, their lips quivering,
  their eyes starting out of their heads, their mouths foaming,
  their tongues dropping hard words, and their fists clenched like
  pugilists, ready to accompany their violent wrath with other
  knock-down arguments. In such circumstances, mild, investigating
  Philosophy quits the scene and leaves the field of battle to the
  Bedlamites.

The fury had subsided in 1805, and Rowley held that many medical
men were deeply ashamed of the extravagance into which they had
been committed, but lacked courage to make frank confession.

Rowley died in 1806, and the regard in which he was held was
manifest in the crowds who flocked to his funeral. In the _Roll of
Physicians_, Dr. Munk observes--

  Dr. Rowley was a determined opponent of Vaccination, and obtained
  an unenviable notoriety by his association with Dr. Moseley in
  opposing every conceivable obstacle to the reception and progress
  of that invaluable discovery.

The obstacles interposed were matters-of-fact, and as
matters-of-fact were recognised and prevailed.

The controversy that followed the introduction of Vaccination
“gave birth,” says the Edinburgh reviewer, “to an infinite number
of publications of all descriptions” from which he could only
select the most characteristic. Among these we find Dr. Squirrel,
whose book is described “as the most entertaining of the whole”--

  We will venture to say, though we know it to be a bold assertion,
  that there never was anything so ill-written, or so vulgar and
  absurd, produced before by a person entitling himself a Doctor of
  Medicine. There is a certain nimbleness and agility about him,
  however, which keeps us in good humour, and he whisks about with
  such a self-satisfied springiness and activity, that it is really
  enlivening to look on him.

Turning up Squirrel’s pamphlet[178] I find little or nothing to
warrant this description. It is not ill-written, if judged by
the standard of medical literature, and the “springiness” is a
conceit of the reviewer’s to sport with the Doctor’s name. My own
impression is that Squirrel was a dull fellow, jealous of cowpox
as injurious to the trade in smallpox inoculation, and that he
availed himself of the depression in the vaccination business to
assert its superiority. He admits, indeed, that he kept silent
during the Jennerian furore, “but the overwhelming torrent being
gradually reduced to a feeble current,” he reckoned that he “might
now promulgate his opinion with a reasonable hope of success.” He
cites Jenner’s account of the origin of cowpox in the greasy heels
of horses, and proceeds to argue that the disease is scrofula,
which its inoculation is certain to diffuse, whilst affording no
protection from smallpox. He then adduces a number of cases in
proof that inoculated cowpox had not averted smallpox, and had in
several instances brought on serious and fatal ailments.

Jenner in a letter to Moore from Berkeley, 28th February, 1810,
thus refers to Squirrel--

  John Gale Jones, I see, has at length succeeded in obtaining the
  situation for which he has long been a candidate. This fellow
  had once the impudence to desire a man to call on me in Bedford
  Place to say, that he, Jones, would advise me immediately to quit
  London, for there was no knowing what an enraged populace might
  do. He was the writer of Squirrel’s book, the long anti-vaccine
  columns in the _Independent Whig_, and many of the most violent
  papers in the _Medical Observer_. I was held up in his Forum for
  several nights as an object of derision; but I silenced him by
  the same weapon as I have others--contempt.[179]

Jenner’s contempt was of a miraculous quality, operating insensibly
upon those to whom it was applied. Some might fancy it was his
idleness and others his cowardice; but he knew that it was _his
contempt_, and that it blasted his adversaries in much the same way
that vaccination blasted smallpox.

There is the woeful monotony of truth in these old pamphlets,
not merely in the occurrence of smallpox after vaccination, but
in the sadder stories of acute and chronic blood-poisoning. We
recognise the narratives as true, for they are reproduced among us
continuously by the same means, with the same miseries and agonies,
and with the same death for grateful release.

It is clear from the testimony of Moseley, Rowley and Squirrel,
confirmed too by others and by the Jennerites themselves, that
the extension of vaccination met with a decided check in London.
It was proved to many in a fashion that did not admit of dispute,
that vaccination conferred no security from smallpox, whilst it was
attended with dangers to health, certain if as yet undefinable.
Variolous inoculation was again reverted to, but by diminished
numbers; for that practice never had prevailed with popular
good-will, but through sedulous medical persuasion as duty of
dire necessity. Vaccination afforded excuse for hesitation, and,
between rival claims, many contrived to elude either form of
pollution. Thus indirectly as it were, vaccine inoculation set
aside variolous, and when in 1840 the latter was forbidden by law,
there was little of the practice left, whilst at the same time the
majority of the population existed without Jennerian protection.

It is not to be forgotten that the early resistance to vaccination
proceeded entirely from inoculators with smallpox. It was as yet
unimagined that smallpox and other fevers were preventible, that
their causes lay within control, and that health was the best
defence of health. The world as yet lay in darkness as to those
truths which we now recognise as laws of health, hygiene, and
sanitary science; nor has the darkness rolled away, but is rolling
away, and the time is not distant when to be vaccinated in order to
be safe from smallpox will be accounted the drollest of absurdities.

Going back to the _Edinburgh Review_, we remark with curious
interest how the chief position then asserted was the abiding
efficacy of vaccination. Inoculators were ready to concede that it
might possess a temporary prophylaxy, inasmuch as until one blood
fever had subsided another was unlikely to supervene; but this view
Jeffrey declined to entertain--

  It seems contrary to all analogy, and all rules of reasoning
  to suppose, _a priori_, that an immunity which is found to
  subsist for a certain time in the usual and healthful state of
  the system, will gradually and insensibly wear away without
  any apparent cause, or any sensible change to indicate its
  extinction; and the facts which bear at all upon the question, so
  far from suggesting or supporting such a supposition, seem, in
  our apprehension, completely to refute and discredit it.

Yet what in 1806 was accounted “contrary to all analogy,”
and “completely refuted and discredited by facts,” is
precisely what vaccinators now admit. Hence their cry for
re-vaccination--septennially, triennially, annually. Dr. Lionel
Beale, a great authority in the matter, recently owned to having
been vaccinated ten times, and in terror of an epidemic was
about to be vaccinated once more--a striking exemplification of
contemporary theory and practice. To have foreseen such an issue
would have confounded the early vaccinators. When re-vaccination
was mentioned to Dr. Pearson, he denied its possibility; “for,”
said he, “Vaccination is equivalent to smallpox, which cannot
recur. If a child can be re-vaccinated, then it can take smallpox;
_ergo_ vaccination is not an equivalent for smallpox; and where
then is the good of it?” Where indeed!

The Edinburgh reviewer was sufficiently impartial to recognise
violence alike among Cowpoxers and Smallpoxers, and specified John
Ping, Jenner’s bully, as an offender, describing his _Treatise on
Cowpox_ as “one thousand and forty chaotic pages in defence of the
new practice.” Ring verified the criticism by issuing a pamphlet,
_The Beauties of the Edinburgh Review_ alias _the Stink-Pot of
Literature_; reminding us of the man who writing to his wife from
an inn-parlour remarked, “I must conclude, for an unmannerly
Irishman is looking over my shoulder and reading every word I
write;” an observation that was immediately clenched with, “You are
a liar, sir; a liar!”


FOOTNOTES:

[169] _Shooting Niagara._

[170] “Neglect not, I exhort you, such proffered blessing. Secure
yourselves from danger; preserve your children; and render
most grateful thanks to Almighty God who has so providentially
permitted to man this means of defence against the pestilence
that walked in darkness, and the sickness that destroyed in the
noon-day.”--_Address of the Rev. T. A. Warren to his Parishioners_,
reprinted by the Royal Jennerian Society, 1803.

[171] _A Treatise on the Lues Bovilla or Cowpox._ By Benjamin
Moseley, M.D. Second Edition. London, 1805. Pp. 142.

[172] Sidney’s _Life of Hill_, p. 225.

[173] _Cowpox Inoculation Vindicated and Recommended from Matters
of Fact._ By Rowland Hill, A.M. London, 1806. Pp. 72.

[174] _An Oliver for a Rowland; or, a Cowpox Epistle to the Rev.
Rowland Hill under the wing of Surrey Chapel._ By Benjamin Moseley,
M.D. Tenth Edition. London, 1807. Pp. 102.

[175] _A Review of the Report of the Royal College of Physicians of
London on Vaccination._ By Benjamin Moseley, M.D. London, 1808. Pp.
86.

[176] _The Roll of the Royal College of Physicians comprising
Biographical Sketches._ By William Munk, M.D. London, 1878.

[177] _Cowpox Inoculation no Security against Smallpox Infection.
To which are added the Modes of treating the Beastly New Diseases
produced from Cowpox, explained by two coloured copper-plate
engravings, as_--

    _Cowpox Mange_       _Cowpox Evil or Abscess_
    _Cowpox Ulcers_      _Cowpox Mortification_.

_With the Author’s certain, experienced and successful mode of
Inoculating for the Smallpox which now becomes necessary from
Cowpox Failure, etc._ By William Rowley, M.D., Member of the
University of Oxford, the Royal College of Physicians, London, and
Physician to the St. Marylebone Infirmary. London, 1805. Pp. 82.
The first edition appeared 4th October, 1805, and a third 27th
January, 1806.

[178] _Observations on the Cowpox showing that it originates in
Scrophula, commonly called the Evil; illustrated with Cases to
prove that it is no Security against the Smallpox. Also pointing
out the dreadful Consequences of this new Disease, so recently and
rashly introduced into the Human Constitution._ By R. Squirrel,
M.D., formerly Resident Apothecary to the Smallpox and Inoculation
Hospital. London, 1805. Pp. 76. A Second edition appeared in 1806.

[179] Baron’s _Life of Jenner_, vol. ii., p. 367.




CHAPTER XXII.

WILLIAM COBBETT.


Everybody appeals to common-sense, but what is common-sense? It is
a question difficult to answer; and yet, as I propose to show that
Cobbett’s opposition to vaccination was justified by common-sense,
I am bound to give some definition of the term.

Common-sense is reason as evolved from common experience. What
the multitude of men have found to be true in the course of
life, that is common-sense, which to question or resist is folly
or fanaticism. This vulgar and vigorous rationality is often
summoned to service where it has no vocation. For example, when
it was first taught that the earth was a sphere and that its
inhabitants had antipodes, the revelation was denounced as contrary
to common-sense; but it is obvious that in such a case (which
represents myriads) it was wrongly invoked; the form of the earth
being at the time outside common cognisance. As soon, however,
as it was realised by experience that the earth was spherical
and inhabited in all its quarters, then its rotundity became
incorporated in the constitution of common-sense.

The realm of common-sense I therefore hold to be limited by its
origin in common experience, and in matters above or beyond
that experience, its dicta are illegitimate, and synonyms for
presumption and prejudice.

William Cobbett was essentially a man of common-sense. His power
lay in his community with the experience and reason of his
countrymen; and, like all of us, he had the defects of his virtue.
He continually applied his vulgar judgment to the criticism of men
and matters beyond the range of his competence, and the result was
a luxuriance of arrogance and contempt for which at this day we
must resort to Mr. Ruskin for a parallel.

Such being the case, we have to inquire, What was the worth of
Cobbett’s opinion in the matter of vaccination? The attempt
is sometimes made by vaccinators to withdraw their practice
from popular discussion. They say it is a medical question for
medical men; but the assertion provokes suspicion rather than
confidence, for mystery is an invariable note of imposture. It
is fair, I allow, to say of any abstruse knowledge that it can
only be apprehended by those whose faculties are trained for its
apprehension; but what is there abstruse about vaccination? With
little trouble, everybody may know as much about it as anybody.
It is the simplest of surgical operations. It is almost as easy
as taking pills--instead of putting poison down the throat it is
inserted into the skin. The operation may result in any number of
pathological complications, but whether such complications be
admitted or denied, what vaccination is prescribed for, namely,
the prevention of smallpox, comes within the range of common
observation. What, therefore, I have to answer is, that Cobbett’s
common-sense was competent to deliver judgment upon vaccination.

Moreover, the circumstances of the time compelled an opinion:
silence or neutrality was impossible. England was swarming with
vaccinators. All the fussy folk who had a taste for doing much good
at little cost were plying the cowpox lancet. Encouraged by Jenner,
they got vaccine, inoculated a victim, and propagated the virus
from arm to arm. Here I may let Cobbett speak for himself--

  This nation is fond of quackery of all sorts; and this particular
  quackery having been sanctioned by King, Lords, and Commons, it
  spread over the country like a pestilence borne by the winds.
  Speedily sprang up the Royal Jennerian Institution, and branch
  institutions issuing from the parent trunk, set instantly to
  work, impregnating the veins of the rising generation with the
  beastly matter. Gentlemen and ladies made the commodity a pocket
  companion; and if a cottager’s child was 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.
  One would have thought that half the cows in the country had been
  tapped to get such a quantity of stuff.[180]

Nor was vaccination merely forced on Cobbett’s attention as a
popular craze. He had to deal with it as a possible compulsory
infliction. At a public meeting in 1803, Wilberforce and Dr.
Clarke advocated the prohibition of smallpox inoculation and the
enforcement of vaccination; and Cobbett, in a letter addressed to
Wilberforce, rebuked the arbitrary project in a strain impressive
and dignified as that of Burke himself. He wrote--

  It seems there are prejudices against cowpox which it is
  necessary to destroy by force. That there are prejudices, and
  very strong ones too, I am ready to allow, but I cannot agree
  that these prejudices should be eradicated by force; nor is it
  perhaps fair to use the degrading term as expressive of the
  dislike which so large a portion of the community entertain to
  the practice you are so anxious to compel them to adopt. The
  charge of prejudice has been preferred but too often, and with
  but too fatal success against every one opposed to change. The
  truth is that whoever has been found to object to innovation,
  however wild in itself, however destructive in its consequences,
  has constantly been accused of prejudice; and as prejudice thus
  used implies a mixture of _ignorance_ and _perverseness_, and as
  few persons are willing to be thought ignorant and perverse, the
  imputation is employed to coerce assent where reason hesitates.

He then aptly applied the repudiated recommendation of inoculation
with smallpox as cause for hesitation in assenting to inoculation
with cowpox--

  There was, you must well remember, a strong and general
  objection, which for a long time prevailed, against Inoculation
  with Smallpox; and you cannot have forgotten that this objection
  was termed _prejudice_, and the persons entertaining it were
  regarded as _illiterate_, _ignorant_, or _perverse_; yet it now
  appears from the Address of your Royal Jennerian Society that
  it would have been well for the human race if the prejudices of
  those illiterate, ignorant, or perverse persons had universally
  obtained; for you now tell us that “Inoculation by spreading the
  contagion has considerably increased the mortality of Smallpox.”
  With an example like this before our eyes, Ought we not to be
  very cautious how we adopt your new system of Inoculation with
  Cowpox?

Then turning upon Wilberforce in his favourite character of
constitutional Englishman, he proceeded--

  Give me leave to ask you, Sir, how you reconcile a proposition to
  enforce this novel practice with the spirit of that Constitution
  of which you profess to be so great an admirer, and with that
  freedom of which you wish to be regarded as one of the principal
  supporters? What I am opposed to, and what I am alarmed at, is
  the proposition to obtain an Act of Parliament which would in its
  operation be nothing short of compulsion on every man to suffer
  the veins of his child to be impregnated with the disease of a
  beast--a measure to be adopted in no country where the people are
  not vassals or slaves.

Lastly came these remarks which at this day have force and
application greater even than when written--

  I like not this never-ending recurrence to Acts of Parliament.
  Something must be left, and something _ought_ to be left, to the
  sense and reason and morality and religion of the people. There
  are a set of _well-meaning men_ in this country, who would pass
  laws for the regulating and restraining of every feeling of the
  human breast, and every motion of the human frame: they would
  bind us down, hair by hair, as the Liliputians did Gulliver, till
  anon, when we awoke from our sleep, we should wonder by whom we
  had been enslaved. But I trust, Sir, that Parliament is not, and
  never will be, so far under the influence of these minute and
  meddling politicians as to be induced to pass laws for taking out
  of a man’s hands the management of his household, the choice of
  his physician, and the care of the health of his children; for,
  under this sort of domiciliary thraldom, to talk of the liberty
  of the country would be the most cruel mockery wherewith an
  humble and subjected people were ever insulted.[181]

Cobbett, be it observed, thus addressed Wilberforce in 1803, when
vaccination was as yet imperfectly tested, and its advocates
were in the full blast of enthusiastic persuasion that to be
Jennerised was to be made proof against smallpox for ever. When
Cobbett had again occasion to write about cowpox, six years had
passed away, bearing with them the phantastic certainty with which
vaccination had been imposed upon public credulity. Nevertheless
the practice was not abandoned: quackery once alive and lucrative,
dies hard: but it was discredited, and its apologists exercised
their ingenuity in devising explanations and excuses for its
manifest failures. The Royal Jennerian Society had split between
Jenner and Walker, and application to Parliament was resolved
upon for two purposes--first, to save Jenner from poverty; and
second, to provide funds for the maintenance of vaccination,
voluntary subscriptions having fallen off irretrievably. In short,
vaccination had broken down, and the House of Commons was called
upon to save it from extinction. There were wire-pullers in the
House and out of the House who were compromised by their patronage
of Jenner and his imposture, and they had the craft and the power
to transfer the responsibility of which they were sick to the
national exchequer. With this explanation, we shall understand the
following article from the _Register_ of 18th June, 1808. Cobbett
wrote--

  This experiment with Cowpox, which has cost the nation £30,000
  to Dr. Jenner, is now, it seems, to have an Act of Parliament
  to give it currency. Mr. Rose has brought in a bill for the
  purpose of establishing a central institution in London for the
  distribution of Cowpox matter, which bill in all appearance will
  pass; and this disgusting and degrading remedy will cost the
  nation another £4,000 or £5,000 annually, though it has been
  clearly proved not to have answered the purpose intended. This,
  however, I regard as cheap when compared with the menace of Mr.
  Fuller, who, in the debate, proposed a compulsory law on the
  subject. He took up the old idea of Mr. Wilberforce, who was for
  a law to prevent parents from having their children inoculated
  with Smallpox unless they chose to send them to pest-houses,
  or to some place at a considerable distance from any other
  habitations. This cruel and tyrannical proposition I opposed
  at the time; and I am happy to perceive that it is now almost
  universally exploded.

Whilst Cobbett could not arrest the action of Parliament, he
was short-sighted in considering that the proposed endowment of
vaccination was merely a question of the loss of a few thousands
a year. We are saddled with vaccination at this day, its costs
and mischiefs, by reason of the vote for the National Vaccine
Establishment in 1808. As soon as an annual subsidy is placed on
the estimates, interests are created, which not only perpetuate
themselves, but constantly tend to enlargement; and such interests,
once created, can only be got rid of when proved useless by
agitation out of doors and persistent pressure on the House of
Commons.

Referring to a notorious outbreak of smallpox among a vaccinated
population at Ringwood in Hampshire, Cobbett continued--

  I should like to have heard Mr. Rose’s statement of the
  circumstances at Ringwood, whence, he says, it is evident that
  the failure arose “from the use of _improper matter_.” That many
  persons, who had been inoculated with Cowpox, caught Smallpox and
  died at Ringwood, is a fact that even the Royal Jennerian Society
  cannot deny; and this being the case, what man in his senses
  will put any faith in the efficacy of Cowpox as a preventive of
  Smallpox? _The thing is done._ It _has failed_, and it is vain to
  endeavour to prop up its reputation; for, in a few years, it will
  become proverbial as humbug.

A prophecy, it will be said, that has not been fulfilled. True:
but in Cobbett’s time it advanced far to fulfilment. All the
unqualified promises under which vaccination was brought into
practice, were one by one surrendered under the compulsion of
experience. The mass of the people remained unvaccinated; the zeal
for vaccinating the poor abated; and the practice continued among
the middle and upper classes on the humblest pretexts--as something
that might hinder or mitigate smallpox, and in any case do little
harm. We have to recollect that the mania for vaccination which
now prevails is a revival of a prescription which our forefathers
had tested and found wanting. Vaccination fell into neglect, not
because there was indifference to smallpox, but because it did not
prevent that disease.

The excuse for the first failures of vaccination was, that spurious
cowpox must have been employed--spurious cowpox being the artful
invention of Jenner to cover disasters; artful, and yet absurd,
for how could cowpox exist spuriously any more than smallpox? The
precise fact, that spurious cowpox was the dodge of an unscrupulous
quack was unknown to Cobbett, but he was sharp enough to recognise
imposture, and thus wrote--

  The pretext of _spurious matter_ is the weakest defence that ever
  was set up, because it is evident that such will always be an
  excuse. The Methodist pike who told his shoal of gudgeons that
  _if they had faith_, they might jump into a chalk pit without so
  much as spraining their ankles, answered all their reproaches
  with saying, that their broken bones were owing to their own sin
  in not having faith, and referred, for proof, to one among them
  who had accidentally escaped unhurt. All who catch Smallpox and
  die have been Cowpoxed with spurious matter, and all who have not
  yet caught Smallpox, after the Cowpox operation, have had the
  pure matter; and so it will be, to be sure, to the end of the
  chapter.

  _Who_ is to collect this genuine matter, and _whence_ is it to
  come? Who shall tell whether he inoculate with Cowpox or King’s
  Evil? Or with many other disorders, one of which I will not name,
  but which I do hope, that fathers and mothers who have given
  their children that greatest of blessing, a pure stream of blood,
  will not forget when they are about to cause that blood to be
  impregnated with matter taken from the ulcerous bodies of others.

In this latter warning, we have to remark Cobbett’s prescience.
He knew that it was impossible to transfer organic virus from
arm-to-arm without transferring more than was intended, inclusive
of the dreadful disease he indicated. Vaccinators naturally
denied the possibility of such extra transmission; for if they had
admitted the possibility, they must have ceased to vaccinate. M.
Ricord has put the alternative plainly--

  The obvious fact is, that if ever the transmission of this
  disease with vaccine lymph is clearly demonstrated, _Vaccination
  must be altogether discontinued_.

The clear demonstration demanded by M. Ricord has been abundantly
supplied; and what at one time was conveniently considered
questionable, is now openly confessed. Mr. Brudenell Carter,
writing in the _Medical Examiner_, 24th May, 1877, testifies--

  I think that syphilitic contamination by vaccine lymph is by
  no means an unusual occurrence, and that it is very generally
  overlooked because people do not know either when or where to
  look for it. I think that a large proportion of the cases of
  apparently inherited syphilis are in reality vaccinal; and that
  the syphilis in these cases does not show itself until the age of
  from eight to ten years, by which time the relation between cause
  and effect is apt to be lost sight of.

And we have Sir Thomas Watson’s memorable declaration in the
_Nineteenth Century_, June, 1878--

  I can readily sympathise with, and even applaud, a father who,
  with the presumed dread or misgiving in his mind, is willing to
  submit to multiplied judicial penalties rather than expose his
  child to the risk of an infection so ghastly.

Thus belated, thus after infinite mischief to the public health,
the Nestor of Medicine appears and solemnly allows that the warning
of William Cobbett, given seventy years before, was a true warning,
and that worthy of praise are the wise parents who give it heed.

Cobbett, grateful for escape from compulsory vaccination,
overlooked, I said, the danger perpetuated through the endowment of
the practice. He was overjoyed at Canning’s emphatic declaration,
that “he could not imagine any circumstances whatever that
would induce him to follow up the most favourable report of the
infallibility of vaccination with any measure for its compulsory
infliction.” Hence he continued--

  I am glad to perceive that the Ministry took care to intimate
  their decided hostility to any law for propagating Cowpox by
  _force_, by the aid of _pains_ and _penalties_. This being the
  case, I care little about Mr. Rose and his Cowpox Institution.
  Those who choose to have their children impregnated from that
  shop, will be at liberty to do so; and those who wish to avoid
  it, may. This is all right; though it may be very foolish for
  Government to interfere in such a matter. I think we may thank
  the events at Ringwood for the ministerial protest against
  compulsory measures. It would have been curious enough to see
  people paying penalties for being so obstinate as not to consult
  their own health, or that of their children.

What Cobbett thought would be “curious enough” we witness daily.
English liberty, if it has advanced in some directions, has
gone back in others since Cobbett wrote. Parents are now haled
before magistrates, fined and imprisoned, because (knowing that
vaccination cannot avert smallpox, whilst it may seriously injure
the health of their children, and even cost them their lives) they
refuse to submit to the infliction. Never, perhaps, was there a
more impious invasion of liberty than compulsory vaccination, and
yet we have free and enlightened Englishmen who excuse and defend
it! These are the Pharisees of Liberalism, blatant over tyranny,
extinct or foreign, but dull to similar tyranny within their own
domain. They garnish the sepulchres of the prophets of freedom, but
(in their petty measure) repeat the deeds of those who persecuted
and slew them.

Lastly, in the article from which I have been quoting, Cobbett
assumed that the resort to the House of Commons for money was
evidence that the enthusiasm for vaccination was abating. He wrote--

  The present application to Parliament is a pretty good proof that
  Cowpox is beginning to be _blowed upon_. The Royal Jennerian
  Society _wants funds_. The subscribers have fallen off; and so
  application to the public purse has become necessary. _Why_
  have the subscribers fallen off? Their _humanity_ has not waxed
  cold. It were slander, indeed, to suppose that. But I suspect
  that their _faith_ has waxed cold; and when that is the case,
  zeal soon slackens its operations, more especially when these
  operations consist chiefly in the expenditure of money.

The fact was, that as vaccination failures multiplied, Jenner
tried, _more suo_, to make a scape-goat of Walker, the Resident
Inoculator of the Royal Jennerian Society. There was a dreadful
row, and a secession of the better part of the members with Walker,
who set up the London Vaccine Institution. Those who adhered to
Jenner were not of the philanthropic and subscribing order, but
they had political influence, and used it to get rid of their
liabilities, first in obtaining a vote of £20,000 for Jenner, and
second in the establishment of a National Vaccine Establishment
with a subsidy of £3,000 a year.

So far Cobbett in his _Register_, where he had no occasion to
discuss vaccination again; but toward the end of his life, 1829-30,
he produced a series of papers entitled _Advice to Young Men_, in
which he reiterated and enforced his protest against the Jennerian
imposture--

  I contend [he wrote] that the beastly application could not,
  in nature, be efficacious in preventing Smallpox, the truth of
  which assertion has now been proved in thousands upon thousands
  of instances. For a long time, for ten years, the contrary was
  boldly and brazenly asserted.... But Smallpox, in its worst form,
  broke out at Ringwood, and carried off, I believe (I have not the
  account at hand), more than a hundred persons, young and old,
  _every one of whom had had the Cowpox “so nicely.”_ And what was
  then said? Was the quackery exploded? Not at all: the failure
  was imputed to _unskilful operators_: to the _staleness of the
  matter_: to its not being of the _genuine quality_. Admitting all
  this, the scheme stood condemned; for the great advantages held
  forth were, that _anybody_ might perform the operation, and that
  the matter was everywhere abundant and cost free.

  But these were paltry excuses: the mere shuffles of quackery;
  for what do we know now? Why, that in _hundreds_ of instances,
  persons Cowpoxed by JENNER HIMSELF, have taken the real Smallpox
  afterwards, and have either died from the disorder or narrowly
  escaped with their lives! I will mention two instances. The first
  is Sir Richard Phillips, whose son, several years after Jenner
  had given him the insuring matter, had a very hard struggle
  for life, under the hands of the old-fashioned, seam-giving,
  and dimple-dipping Smallpox. The second is Philip Codd, Esq.,
  of Rumstead Court, near Maidstone, whose son had a very narrow
  escape under the real Smallpox, and who also had been Cowpoxed
  _by Jenner himself_. Mr. Codd I have known, and have most
  sincerely respected, from the time of our both being eighteen
  years of age. When the young gentleman, his son, was very young,
  I, having him on my knee one day, asked his kind and excellent
  mother whether he had been _inoculated_. “Oh, no!” said she, “we
  are going to have him _vaccinated_.” Whereupon I, going into the
  garden to the father, said, “I do hope, Codd, that you are not
  going to have that beastly cow-stuff put into that fine boy.”
  “Why,” said he, “you see, Cobbett, it is to be done by _Jenner
  himself_.” What answer I gave, what names and epithets I bestowed
  upon Jenner and his quackery, I will leave the reader to imagine.

  Now, here are instances enough; but every reader has heard of,
  if not seen, scores of others. Young Mr. Codd caught Smallpox at
  a school; and if I recollect rightly, there were several other
  vaccinated youths who did the same at the same time. Quackery,
  however, has always a shuffle left. Now that Cowpox has been
  proved to be no guarantee against Smallpox, it makes it _milder_
  when it comes! A pretty shuffle, indeed, this! You are to be all
  your life in fear of it, having as your sole consolation, that
  when it comes (and it may overtake you in a camp or on the seas)
  it will be milder! It was not too mild to kill at Ringwood, and
  its mildness, in the case of young Mr. Codd, did not restrain it
  from blinding him for a suitable number of days.

  I shall not easily forget the alarm and anxiety of Mr. and Mrs.
  Codd on this occasion--both of them the best of parents, and both
  of them punished for having yielded to fashionable quackery. I
  will not say _justly_ punished; for affection for their children,
  in which respect they were never surpassed by any parents on
  earth, was the cause of their listening to the danger-obviating
  quackery. This, too, is the case with other parents; but parents
  should be under the influence of _reason_ and _experience_, as
  well as under that of affection; and _now_, at any rate, they
  ought to set this really dangerous quackery at naught.

Such was Cobbett’s case against vaccination, and I ask, Was he not
justified in his opposition? He saw vaccination introduced to the
world as an infallible preventive of smallpox, and he lived to
see the claim gradually minimised until reduced to that of making
smallpox milder! Even thus abated, he had to stigmatise the claim
as a last shuffle of quackery. It is asserted to this day, that
vaccination makes smallpox milder, but the pretence is exploded
whenever we demand, How do you know? In any case, or in any number
of cases of smallpox, Who can define the severity that has been
reduced by vaccination? any more than if I were to assert that
vaccination intensifies smallpox, it would be impossible to confute
me. We can only meet unverifiable assertion with indifference or
contempt. If it pleases people to believe in metempsychosis or the
constitution of the moon in green cheese, the wise leave them to
the enjoyment of their humour. On the other hand, I have to remark,
that smallpox is a disease of wide range of intensity, from an
ailment almost trivial to one invariably fatal; and this wide range
of intensity was as characteristic of the disease before as since
the introduction of vaccination. On what pretext then are mild
cases of smallpox attributed to the influence of vaccination? There
are mild and malignant cases of smallpox alike among the vaccinated
and unvaccinated, and not unfrequently when the vaccinated and
unvaccinated are found in approximate conditions, as in the same
household, it is the unvaccinated who are most lightly afflicted,
or who make the better recovery.

It often helps to a clearer apprehension of a position if we
endeavour to conceive its opposite. We have seen Cobbett as
an opponent of vaccination: let us try to think of him as its
advocate. Suppose he had joined with the polite and educated mob in
hailing Jenner as the saviour of mankind from smallpox, and assured
the readers of the _Register_ that they would be secure from the
disease for ever if inoculated with cowpox--an easy and harmless
operation. Then after a while imagine him reporting that he had
been misled--that the operation was not so easy as represented,
nor always so harmless. By and bye he would be the bearer of a
more serious revelation. Some of the vaccinated, warranted secure,
had taken smallpox, but such misadventures, he would explain, were
due to the use of a wrong sort of cowpox, of which there was a
spurious variety. But the suggestion of spurious cowpox creating
alarm and discouragement of vaccination, it would be necessary for
him to counteract the declaration with the avowal that by spurious
cowpox was not meant spurious cowpox, but simply irregularities
in the action of the genuine virus on the arms of the vaccinated.
But even these excuses would be insufficient. It was not difficult
to ascribe smallpox after vaccination to careless practice, or
to virus that was not the right sort of cowpox; but when smallpox
was found to occur in numerous instances after Jenner’s own
vaccinations and those of the most accomplished practitioners, What
was to be said? Why, what was said, that when vaccination did not
prevent smallpox, it made it milder!

Imagine, if we can, Cobbett’s honest and vigorous intelligence
retreating through this slush of apology and prevarication! Yet
through such slush every follower of Jenner had to trudge.

I am not intent on setting Cobbett forth as a model of wisdom.
I simply maintain that his common-sense was adequate to the
judgment of vaccination, and that it was correctly exercised. Of
physiology and hygiene he was as ignorant as his contemporaries;
but if a lotion were sold to prevent toothache, and it did not
prevent toothache, it would be safe to denounce its vendors as
quacks, even though the vendors happened to be the Royal College
of Physicians and the Royal College of Surgeons. The causes of
disease were unconsidered in Cobbett’s days. It was not asked why
people suffered from smallpox and other fevers, nor whether fevers
were avoidable. Such maladies were accepted like bad weather, and
encountered by medical dodges, or by charms like vaccination, the
more irrational and nasty being taken for the more effective.
Cobbett himself, if he did not believe in vaccination, believed in
inoculation with smallpox. He had his children poxed in infancy,
and when he argued against vaccination, it was in the confident
possession of a surer prophylactic. Taking smallpox for a probable
calamity that could only occur once in a lifetime, it seemed to him
expedient to incur the disease when convenient, and to have done
with the dread of it. How far he was mistaken in this course I need
not stay to debate. Suffice it to say, that he thought he could
make sure that smallpox was smallpox, whilst what cowpox might be
none could tell, especially after transmission through arms and
constitution unnumbered and unknown.

The causes of smallpox, I said, were unconsidered in Cobbett’s
days. It never even entered into Jenner’s head that the disease
might be a consequence of bad conditions of life; nor did he try
to explain why the malady was on the decrease ere he appeared
with his magical prescription. The decrease was claimed for
vaccination, but it had set in before vaccination was heard of,
and was continued among those who never received it. No sanitary
improvements had been effected to account for the abatement of
the disease. To what, then, was it due? I answer, in part at
least, to a progressive change in the diet of the people--to the
substitution of tea for malt liquors, and to the displacement of
arid fare by potatoes. The food of city folk up to the close of
last century was closely akin to that of men at sea, and their
scorbutic habit of body was notorious--a habit that rendered acute
or chronic whatever disorders they were subject to. The remedy came
of inclination and necessity rather than of intention. Tea was
instinctively preferred by women, and the dearness of provisions
compelled resort to the potato, easily grown and grateful to the
palate as a mitigant of the saltness of beef, bacon, and fish. If
any are disposed to dispute the fact of this revolution in the
popular dietary, they may be referred to Cobbett. He witnessed the
change, and persistently denounced it. Tea-drinking was to him an
abomination. It was a slatternly indulgence, costly to the poor,
and innutritious. Potatoes were as detestable. They were trash
as compared with bread; wasteful, dirty, and unfit to satisfy a
man’s appetite. It is true that tea and potatoes are poor forms of
food, but the one as a substitute for beer, and the other as an
antiscorbutic, were eminently useful. It is not said that smallpox
is caused or prevented by food, proper or improper, but that the
character of food may predispose to disease, and intensify it; as
is manifest on ship-board. Hence it is (in the absence of other
adequate influences) that I am disposed to ascribe the abatement
of smallpox which set in toward the close of last century to
the better blood of the people ameliorated by that increased
consumption of tea and potatoes, against which Cobbett so blindly
and vainly testified.

A last word about Cobbett. His prejudices had nearly always a
creditable root. He hated potatoes because they were strenuously
recommended by Wilberforce and other good and goody people as cheap
food for the poor. Cobbett’s contention was, that not cheap food,
but political justice was the true remedy for popular misery. It
was very nice of Wilberforce and his friends to be kind to the
poor, but, said Cobbett, if they were first just, the poor might
dispense with their kindness. If the poor had their own, they might
have beer instead of tea, and bread and beef and bacon instead
of potatoes, with much else besides. Cobbett was often enough in
error, but behind all his perversities lay ardent good-will for
the welfare of the greatest number of his countrymen; and the
consideration now enjoyed by the working classes is largely due to
his dauntless spirit and unwearied exertions in presence of what
appeared at the time to be omnipotent opposition.


FOOTNOTES:

[180] _Advice to Young Men._ London, 1837. Sec. 262.

[181] _Political Register_, 22nd January, 1803.




CHAPTER XXIII.

THE GROSVENOR CASE.


It may be asked, Why, if Vaccination was proved useless and
injurious, was it not entirely discontinued? but the question
implies a logical consistency which is rarely exemplified in
human experience. Vaccination was discontinued, but it was not
entirely discontinued: it was chiefly continued among the upper
and middle classes where fees were to be had for its performance.
It was admitted that the rite might not prevent smallpox, but it
would make it milder. The last thing a medicine man admits is,
that he is helpless and can do nothing. Even in presence of that
for which there is no remedy, it tends to his importance, and the
satisfaction of the patient, and those around the patient, to make
believe to do something. Now for smallpox, there was no preventive.
Its causes were unknown. It broke out, and it disappeared, none
knew how. Jenner’s household was devastated with fever, but he
never asked, why? As observed disease was accepted like so much
bad weather. Whether fevers were avoidable, or whether they
were consequences of ill living, were questions as yet outside
cognizance. The predominant thought about smallpox was, that it
might be dodged, be it from God or devil. Inoculation with smallpox
was a dodge with disagreeable accompaniments: inoculation with
cowpox was a dodge on easier terms: by a trick, that left every
evil circumstance unaffected, smallpox was to be got rid of.
In the nature of things, the dodge was ineffective--mercifully
ineffective; for who that is wise would care to have the
consequences of evil abated save by the putting away of evil? The
dodge proved illusory in the presence of those who recommended it,
but whilst a manifest failure as to the main intention, they had
the craft to shift its efficacy to rendering the disease milder--a
claim as to which no test was immediately available. Moreover,
vaccination had the merit of action, which the quack, whether lay
or professional, insists on at all hazards. To confess ignorance
and inability is self-denial for which the quack’s mind is unequal,
as whoever is ailing and has friends may perceive. All come bearing
advice and prescriptions for the control of nature, when, with
simple quiescence and a right disposition of circumstances, nature
is instant to effect recovery.

The failures of vaccination to prevent smallpox were chiefly
visible among the poor, smallpox being predominantly an affliction
of poverty; but in 1811 a case occurred in aristocratic life which
produced more talk and dismay than scores of similar cases among
trades-folk and artizans. Robert Grosvenor, son of Earl Grosvenor,
vaccinated by Jenner in 1801 when a puny babe of a month old, fell
ill on 26th May, 1811; in a few days smallpox developed, became
confluent, and the lad narrowly escaped with life. There was no
mistake about the vaccination; the mark on the boy’s arm indicated
“the perfect disease”; he was attended by Sir Henry Halford and Sir
Walter Farquhar, and was visited by Jenner, who happened to be in
town; and, in short, the evidence of the impotence of vaccination
to avert smallpox was complete and indisputable. The commotion
was intense, and in a letter from Jenner to Baron we see how it
affected his mind. He wrote--

    COCKSPUR STREET, CHARING CROSS,
    _11th June, 1811_.

  MY DEAR FRIEND,--It will probably be my lot to be detained in
  this horrible place some days longer. It has unfortunately
  happened, that a failure in vaccination has appeared in the
  family of a nobleman here; and, more unfortunately still, in a
  child vaccinated by me. The noise and confusion this case has
  created are not to be described. The vaccine lancet is sheathed;
  and the long concealed variolous blade ordered to come forth.
  Charming! This will soon cure the mania. The Town is a fool--an
  idiot; and will continue in this red-hot--hissing-hot state
  about this affair, till something else starts up to draw aside
  its attention. I am determined to lock up my brains, and think
  no more _pro bono publico_; and I advise you, my friend, to do
  the same; for we are sure to get nothing but abuse for it. It is
  my intention to collect all the cases I can of Smallpox after
  supposed security from that disease. In this undertaking I hope
  to derive much assistance from you. The best plan will be to
  push out some of them as soon as possible. This would not be
  necessary on account of the present case, but it will prove the
  best shield to protect us from the past, and from those which are
  to come.--Ever yours, EDWARD JENNER.[182]

The defence, therefore, was, that as an attack of smallpox did
not always avert a second attack, it was not reasonable to expect
that vaccination should be more effective; and to make good this
position, a diligent search was instituted for cases of repeated
smallpox. Many were found, though they were generally regarded
as rarities, whilst their reality was frequently disputed; but
whatever their number or genuineness, they were insignificant
in comparison with the instances of smallpox subsequent to
vaccination. Moreover, the Jennerites were taunted with their
late discovery of smallpox after smallpox. Why had they not
stated from the outset that smallpox might follow vaccination as
smallpox followed smallpox? Why, on the contrary, had they asserted
vaccination to be an absolute and life-long defence against
smallpox? Why had they abused as fools or denounced as liars all
the early reporters of smallpox after vaccination? And why did it
require evidence, that could not possibly be wriggled out of, to
bring them to an acknowledgment of the truth?

But even in presence of such evidence, Jenner persisted in his
asseverations as if he had lost the very sense of truth. Writing
to Miss Calcraft on 19th June, 1811, he actually claimed that he
had foreseen and predicted such disasters as had occurred in the
Grosvenor family! Here are his words--

  Take a comprehensive view of Vaccination, and then ask yourself
  what is this case? You will find it a speck, a mere microscopic
  speck on the page which contains the history of the vaccine
  discovery. In the very first thing I wrote upon the subject,
  and many times since, I have said the occurrence of such an
  event should excite no surprise; because the Cowpox must possess
  preternatural powers if it would give uniform security to the
  constitution, when it is well known that Smallpox cannot; for
  we have more than one thousand cases to prove the contrary, and
  fortunately seventeen of them in the families of the nobility.

Obviously had such been his uniform testimony, the Grosvenor
incident would have excited neither surprise nor alarm; and mark
this additional hardihood--

  Indeed, I have often said it was wonderful that I should
  have gone on for such a series of years vaccinating so many
  thousands, many under very unfavourable circumstances, without
  meeting with any interruption to my success before. And now this
  single solitary instance has occurred, all my past labours are
  forgotten, and I am held up by many, perhaps the majority of the
  higher classes, as an object of derision and contempt.... What if
  ten, fifty, or a hundred such events should occur? they will be
  balanced a hundred times over by those of a similar kind after
  Smallpox.

Whilst thus he maintained that it was far more extraordinary that
young Grosvenor had smallpox after vaccination than that others
should have smallpox after smallpox, he went on to assert that
vaccination had saved the lad’s life!

  The child would have died (that is universally allowed) but for
  the previous Vaccination. There was but little secondary fever;
  the pustules were sooner in going off than in ordinary cases;
  and, indeed, the whole progress of the disease was different. It
  was modified and mitigated, and the boy was saved.[183]

Such was the _mot d’ ordre_. If Grosvenor had not been vaccinated,
he would have perished! The National Vaccine Board reported on the
case to the same effect, and the faithful suffered themselves to be
re-assured.

In connection with 1811 and London smallpox, there is a letter to
Dr. Lettsom which throws still farther light on Jenner’s temper and
philosophy. He wrote--

    CHELTENHAM, _22nd November, 1811_.

  I have considered London as the centre of opposition to the
  vaccine practice; but even there, in spite of the base and
  murderous designs of a few bad minded individuals, the Smallpox
  has wonderfully decreased; and in the provinces its mortality
  has lessened in a still greater proportion. For the great and
  grand effects of Vaccination the eye must quit this little
  spot, and survey it among other European countries, and still
  more particularly among the vast empires of Asia and America.
  In Mexico and Peru the disease is nearly extinct. The documents
  which pour in upon me from these distant regions fill me with
  inexpressible delight. You shall have copies when I can get them
  transcribed.

  The chief impediments to the general adoption of Vaccination
  in England are, I am confident, our newspapers and some of our
  magazines. Whenever a case of what is called failure starts up,
  in it goes to a newspaper, with all the exaggeration with which
  envy and malice can garnish it.[184]

Was there ever a more delicious bit of self-revelation! The
wicked newspapers! The base, murderous and bad minded enemies
of vaccination! The smallpox of London reduced by vicarious
vaccination in spite of its ingratitude! The consolation derived
from the survey of the countries of Europe and the vast empires of
Asia and America with inexpressible delight from Mexico and Peru!
Not Mrs. Jellyby herself lost in an atmosphere of Borrioboola-Gah
is more piquant.


FOOTNOTES:

[182] Baron’s _Life of Jenner_, vol. ii. p. 161.

[183] Baron’s _Life of Jenner_, vol. ii. p. 158.

[184] Pettigrew’s _Memoirs of J. C. Lettsom, M.D._ London, 1817.
Vol. iii. p. 405.




CHAPTER XXIV.

DR. JOHN WALKER.


Jenner’s references to the good effects of vaccination in London
were curiously inconsistent. That vaccination in which he professed
to rejoice was chiefly the work of Dr. John Walker, whose practice
he had denounced as so widely at variance with what he considered
correct, that even the wreck of the Royal Jennerian Society was not
thought too heavy a price to pay for deliverance from complicity
with him. The London Vaccine Institution, established in 1806 by
Walker and his friends, was responsible for the large majority
of vaccinations effected in the metropolis. Walker was a pure
enthusiast, of boundless energy, with a craze for vaccinating.
Adverse results had no effect upon him: he did not deny, but simply
did not recognise them, and held on prophesying and practising with
mechanical persistency. Nevertheless, he ran aground. The income of
the Institution had dwindled to less than £100 a year when Andrew
Johnstone, a Cumberland man, a school-fellow of Walker, came to
his assistance. With a commercial eye he surveyed the situation.
He perceived that though vaccination had fallen into disrepute,
there remained many believers who only required stirring up and
solicitation to provide funds to keep Walker going and to yield
the collector a satisfactory commission. As the Royal Jennerian
Society had ceased to exist for any active purpose in 1810, nothing
remaining “but a Patronage, a Presidency, and an unorganised body
of Subscribers and Governors,” it occurred to him that it would be
good policy to annex these to the revived enterprise, and in due
course a union was effected, and the LONDON VACCINE INSTITUTION
AND ROYAL JENNERIAN SOCIETY became the title to conjure with. An
attempt was made to secure Jenner for President, but that was too
bold a stroke. He thus answered the application--

    CHELTENHAM, _3rd September, 1813_.

  Although it must be evident that every institution which has for
  its object the extension of Vaccine Inoculation, must have my
  best wishes for its success, yet, for reasons which on reflection
  must be obvious, you must see the impossibility of my accepting
  the offered appointment.

Highly impressive were the Reports of the reconstituted Institution
under the patronage of the Corporation of the City of London with
the City Arms on the covers. Subsequently the King, George IV.,
appeared as patron, and the City Arms gave place to the Royal Arms.
Among the presidents were the Archbishop of Canterbury, four or
five Dukes (one of them Wellington), half a dozen Marquises and as
many Bishops, about a score of Earls, with M.P.’s and pious and
philanthropic notables many. So much was due to the tact of Andrew
Johnstone, who understood the use of names, who never dropped one
of the least influence, and, spite of Jenner’s ill-will, dealt
with his honours and countenance as though they belonged to the
Institution. Business is business, he would have said, and holds
no reckoning with pique and dislike. Nevertheless the financial
results did not correspond with the overpowering patronage. The
income of the Institution never attained £1000 a year, whilst the
bills for advertising and printing sometimes approached £500. In
the Report for 1827 we find the operations thus summarised--

    Vaccinated during 1826 by Dr. Walker,                4,217
    From the beginning, 1803,                           65,750
    By appointed Inoculators in London and environs
      in 1826,                                          16,999
    From the beginning,                                237,119
    By appointed Inoculators in the country in 1826,    21,261
    From the beginning,                                548,430

The income of the Institution in 1826 was £620 15s., and the
expenditure £715 12s., leaving a deficit of £94 17s.

The figures are interesting, for they afford some idea of the
extent of London vaccination during a quarter of a century. The
operations of the Vaccine Institution lay chiefly among the
poor--the vast majority in London as in every city; and if we
allow that in the course of five-and-twenty years, 350,000, in
a population of upwards of 1,000,000 in the flux of life and
death, were operated on, we give a liberal estimate in favour
of vaccination. That even so many could have much effect on the
prevalence of smallpox (except for aggravation) is incredible,
unless the vicarious action of vaccination be seriously asserted.
Turning over Walker’s report it is amusing to observe how any
abatement in London smallpox was attributed to vaccination, and any
increase to its neglect--an ingenuous exemplification of the fable
of the Fly and the Wheel.

The appointed inoculators of the Institution were a numerous
body--250 names and addresses are given in one of the Reports. They
were chiefly London tradesmen with a taste for doing what they
thought “good.” As vaccination came to be regarded as professional
work, these “unqualified practitioners” gave cause for offence,
but Walker held stoutly to his opinion, which he shared with
Jenner, that vaccination might be performed by any man or woman.
In Walker’s words, “It is easier to perform the whole business of
vaccination than it is to thread a needle--yea, it is easier.”

The annexation of the remains of the Royal Jennerian Society by
Walker was much disliked by Jenner and his associates; and when
the revived enterprise showed signs of prosperity, their dislike
developed to open enmity, and John Ring’s services as bravo and
satirist were called into requisition. He first tried his hand,
anonymously, in a volume of doggerel, published in 1815, entitled
_The Vaccine Scourge_,[185] in which Walker is represented as
singing--

      I am a jolly beggar,
        From Cockermouth I came;
      I do pretend to be a Friend,
        John Walker is my name;
      And a-begging we will go, will go, will go,
      And a-begging we will go.

The verses, extending over a hundred pages, are wretched stuff,
vulgar and malevolent, and a few extracts from the Preface will
indicate the animus of the entire performance. Ring’s assumption
was, first, that Walker was a rogue from whom the public required
to be protected; second, that his Institution was superfluous; and
third, that if greater facilities for vaccination were wanted in
London, it should be left to the Government to provide them--

  These hints may serve to warn the public. Dr. Walker is an
  artful, avaricious, and ambitious man; but let him be cautious
  how he acts when he tries to exercise his art, to glut his
  avarice, and to gratify his ambition. Let him recollect what was
  inscribed on the tombstone of an infamous scoundrel--

      “Lie still if you’re wise;
      You’ll be damned if you rise.”

  We recommend him and his accomplices not to try to obtain
  money by false pretences. A Vaccine Institution has long been
  established by the Legislature, where, as well as at other
  Institutions, matter may be procured free of expense; and no one
  who has much zeal in the cause of Vaccination will find much
  difficulty in procuring it. If farther aid is necessary, let it
  be granted by Parliament, and not to a set of swindlers. It is
  not meet to take the children’s bread and throw it to the dogs.

Many of the agents of the London Vaccine Institution were chemists
and apothecaries, and these, according to Ring, had an interest in
the propagation of smallpox--

  To exterminate Smallpox by means of chemists and apothecaries,
  the greatest friends of Smallpox, is to cast out devils by
  Beelzebub, the prince of the devils. You might as well expect
  a foxhunter to destroy the breed of foxes, or a ratcatcher to
  exterminate the race of rats.

The _Vaccine Scourge_ producing little effect, Ring returned to
the charge in the following year, 1816, with _A Caution against
Vaccine Swindlers and Imposters_.[186] The _Caution_ is a series
of libels, the puerility and extravagance of which were their own
nullification. A motto was taken from the _New Monthly Magazine_
for the title-page, as follows--

  The Jennerian discovery has shed a brilliant lustre on our era;
  but unfortunately, the discovery has been in a great degree
  rendered abortive by _bastard institutions_, created for the
  purpose of filling the pockets of _a set of adventurers, without
  education_, and _destitute of principle_. We could name several
  wretches who have fattened, and are still fattening, on such jobs.

Ring delivered his mind unequivocally. Walker was an imposter, and
the London Vaccine Institution prospered by his frauds--

  There is a Society in this Metropolis [he wrote], falsely calling
  itself the Royal Jennerian Society, which has been collecting
  subscriptions to a considerable amount under that assumed name;
  and thus collecting money under false pretences.

  An eminent physician speaking of this Society and its successful
  state, called it a successful villany; and villany is not the
  less villany because it is successful.

  It has also been organising a complete system of quackery, by
  granting diplomas to persons totally ignorant of the first
  principles of the medical profession, which will add to the
  present host of empirics.

  No one can now pass along the streets without being annoyed with
  the inscription, VACCINATION GRATIS UNDER THE SANCTION OF THE
  LONDON VACCINE INSTITUTION in one pane of glass, MACASSAR OIL in
  a second, and PATENT BLACKING in a third. In short Vaccination is
  now _quite a drug_.

These were words of envy and malice, and came with odious
inconsistency from the spokesman of Jenner, who had instructed
and encouraged his acquaintances, male and female, to practise
vaccination. We may, however, take Ring’s evidence as to Walker’s
activity in London--

  Dr. Walker glories in his chemical, galenical, pharmaceutical,
  and dentrifical inoculators; and boasts that they exceed in
  number those of any other vaccine institution; but he glories in
  his shame. _Non numerentur, sed ponderentur._ They are springing
  up under every pestle and mortar, and barber’s pole, like
  mushrooms in a hot-bed, from Hyde-Park Corner to Whitechapel, and
  from Whitechapel to Blackwall. It is the duty of every regular
  practitioner to expose such imposters, and to encourage such
  exposure. It is, in fact, the rescuing of life from fraudulent
  and rapacious hands.

  One of his inoculators is Mr. Campbell, who cures all sorts of
  incurable diseases with _Elephants’ Milk_. He says he recently
  sent 20,000 bottles to Russia at 11s. each. He also sells the
  Milk in pills at 2s. 9d. a box. The poor have the Milk at
  half-price; and strict secresy is preserved.

  In Walker’s Plan for 1814, it appears that he grants his diplomas
  to those who _are not_, as well as to those who _are_, of the
  medical profession, and that Inoculators in the country are
  requested and _authorised_ to put up a board with the following
  inscription, PROTECTION FROM SMALLPOX UNDER THE SANCTION OF
  THE LONDON VACCINE INSTITUTION. Then is to follow the name
  of the farrier, cobbler, barber, barber-surgeon, apothecary,
  man-midwife, tooth-drawer, druggist, chemist, oil-man,
  cheesemonger, drysalter, or grocer, who dispenses the blessing of
  Vaccination gratuitously.

  The motley crew thus appointed are directed to make an Annual
  Return of the numbers inoculated by them in order to swell Dr.
  Walker’s list; and such inoculators are not in general very nice
  in their calculations. Many of them will, in all probability,
  like other quacks, pretend to a hundred times more than they
  really perform.

Those who continued to believe that Vaccination was an easy and
harmless operation, could see nothing but good management in the
multiplication of Walker’s agencies, nor anything but meanness
in Ring’s sneers at tradesmen. His assertion that the use of
the title of the Royal Jennerian Society was fraudulent, had no
justification, yet it was his persistent reproach--

  Honesty is the best policy. I therefore sincerely advise Dr.
  Walker and his Board, to assume no more the title of the Royal
  Jennerian Society, to which they must know they have not the
  least claim, lest they should be brought before the Lord Mayor
  as swindlers, and be prosecuted for obtaining money under false
  pretences. I am informed that they have already been compelled
  to refund a legacy of £100; and it is to be hoped they will be
  compelled to refund the rest of their ill-gotten store.

Lastly, he appealed to the members of the Jennerian Society,
demanding--

  How long will they suffer their names to be prostituted, and the
  public to be deluded by a set of swindlers and imposters; by
  men who are neither dignified by their rank, nor distinguished
  by their talents; by a set of daring adventurers and despicable
  upstarts! It is a gross insult and indignity, to which no man of
  the least sense of honour, or of shame, would submit.

But they did submit, and why not? Enthusiasm for Vaccination had
passed away. It had been found out; it was everywhere distrusted;
and those who held by it had to see it pushed on the same terms as
any other quack prescription. What then was there to object to in
Walker s procedure? The reason for Ring’s libels lay in Jenner’s
jealousy. Walker was Jenner’s abhorrence. He had joined in the
conspiracy to oust Walker from the Jennerian Society in 1806, but
the operation proved fatal to the Society, whilst Walker conveyed
the confidence and subscriptions of the faithful to his new
Institution. What wonder, then, that Jenner disliked the eccentric
Quaker! Even worse; Walker accurately appraised Jenner’s share in
“the vaccine discovery,” which came, he said, from Jenner as a
hint, and was developed by Pearson and Woodville in practice--a
fact that was as gall and wormwood to Jenner. Moreover, Walker
had written a Jenneric Opera in which Jenner was represented as a
country apothecary riding up to London on a cow, and going round
a-begging among the nobility and gentry. Wherefore says Ring--

  As to the calumny and detraction which Dr. Jenner and his friends
  have received at the hands of that desperate adventurer in his
  Jenneric Opera and elsewhere, they are content to bear it,
  provided he will not again use the language of flattery toward
  them; nor lavish his encomiums on them in that polluted channel,
  the Medical Journal. His resentment can do very little harm,
  which is more than can be said of his adulation.

      “It is the slaver kills, and not the bite!”

Ring was an awkward champion. He sneered at Walker’s diplomas
certifying fitness to act as vaccinator--

  They will have the same authority [he said] and the same virtue
  as a diploma from the University of St. Andrews; and in all
  probability will in a short time be sold at the same price--

Forgetful that it was from St. Andrews that Jenner purchased his
M.D.!

With equal recklessness, he denounced Walker as a vaccinator,
saying--

  He tells the public in his Address that “Vaccination will shed
  consolation into the bosom of every family;” but alas! I have
  known many a family that has had reason to rue the day in which
  they believed him, when he told them this flattering tale....
  It is very necessary that his followers pray that the Lord have
  mercy on them, if they have no other director than Dr. Walker.

Concerning the consequences of Walker’s operations, Ring, no
doubt, testified truly. Many continue to rue the day when they
listen to the flattering tale of the vaccinator. But the testimony
came strangely from a Jennerite, who was ready to swear that
any abatement of smallpox in London was due to the vaccinations
effected in great part by “that desperate adventurer,” Walker!

Ring was implacable, the more so, perhaps, as Walker and his
friends were apparently indifferent to his abuse. He burst forth
afresh in the _London Medical Repository_ for 1821, where among
much else we find the following--

    HANOVER STREET, _11th October, 1821_.

  The mock Royal Jennerian Society is extending its impositions and
  depredations. The emissaries of this bastard institution, as well
  as the principals, should suffer transportation if there be any
  public spirit among us.

  I beg leave to add that the present Society is disclaimed by Dr.
  Jenner, who cautioned the Emperor of Russia against it when his
  Majesty was in London in 1814.

  In my _Caution against Vaccine Swindlers and Imposters_,
  published in 1816, I related several instances of the ill effects
  of Dr. Walker’s practice, and some in which it had proved
  fatal. It was partly for his mal-practice, and partly for his
  mis-conduct, that he was about to be expelled from the Royal
  Jennerian Society; and, after his artful and wicked stratagems,
  was permitted to resign; yet now he has the arrogance to call
  himself Director of that Society, and to issue his venal diplomas
  in its name. If Dr. Walker must imitate the universities of St.
  Andrews and Aberdeen, let him at least have like them _some_
  certificate of qualification. If he is determined _to grow rich
  by degrees_, let him also endeavour to grow wise and honest.

The diplomas which thus moved Ring’s wrath were imposing documents,
certifying that the holder was authorised to vaccinate, intended to
be framed and exhibited in the shop or parlour. There was a picture
of something like an arch of Waterloo Bridge with London in the
background and the Royal Arms overhead; Jenner standing on a pier
with a dead serpent hanging in limp folds over his arm, with the
inscription, _Per omnia littora vincitur variola_; a woman milking
a cow with a group of children around her, drinking milk out of
porringers, as if milk were cowpox; whilst the bed of the Thames
was blocked with the names of the great and good who had testified
in favour of vaccination--an allegorical style of representation
then much in vogue and considered impressive.

In order to create prejudice, Ring had much to say of Walker’s
religious and political principles. He was a Quaker of the Thomas
Paine pattern, and like Paine had associated with the French
revolutionists; but whilst dressing as a Friend, and associating
with Friends, he was too unconformable a personality for their
Society, and was never received into membership. Ring’s imputations
of rapacity and avarice were grossly absurd as applied to Walker.
He cared for nothing beyond support in his work as vaccinator. It
was said he would take a £5 note, fold it, stick a pin through
it, write an address on the back, and post it. He would rarely
vaccinate the well-to-do. If they came to his office, he would
ask, “Who is thy medical attendant?” and wrapping up some fresh
matter on glasses would say, “Take this with my compliments to
thy medical attendant, and he will do what is requisite quite as
well as myself.” When he did call at a house to vaccinate, he
never asked for a fee, and his biographer, Dr. Epps,[187] observes
that he was only known on one occasion to express a wish for
remuneration. Meeting a merchant in St. Paul’s Churchyard, whose
household he had vaccinated at some inconvenience, he observed,
“Friend, if thou has sent by thy servant a draft for my services to
thy family, he has either robbed me or deceived thee.” When money
was brought to him, he usually called his wife to receive it, she
having the undivided care of all that pertained to him apart from
vaccination. Of this good woman, Annie, he was in the habit of
speaking with an admiration and unreserve that constituted one of
his numerous oddities. For example, when Dr. Moore in his _History
of Vaccination_ observed somewhat maliciously--

  John Walker, it is said, procured a medical diploma from the
  indulgent University of Leyden; and more excellent work than
  Walker’s has rarely been performed by a humbler instrument--

Walker good-humouredly replied, that Moore as a Glasgow man
naturally preferred his own University to that of Leyden, but he
too had cause to love Glasgow--

      “Glasgow is a bonnie town, and there are bonnie lasses in it.”

  There is not any other spot on the surface of the globe where
  I have experienced a happiness so complete as I obtained in it
  in 1799. Let any bachelor who cannot divine what this assertion
  may mean, be informed, that it was then and there I entered into
  marriage; and the covenant was ratified in the office of the
  Clerk of the Peace for the county of Lanarkshire.[188]

Walker was obstinate, but not vindictive. Dr. James Sims offered
him £1000 in 1806 to prosecute his adversaries for conspiracy,
but he left them to their devices, and proved his quality by
outworking and superseding them. He replied to Moore’s flippant
version of the causes that led to the division and destruction of
the Royal Jennerian Society with perfect self-control and manifest
truthfulness, but at the same time with a simplicity not of this
world.[189] Jenner’s spite, Ring’s abuse, and the sneers of the
superfine did him little harm; and, if vaccination were beneficial,
I should have nothing but praise for the good people, who,
recognising the sincerity of his work, disregarded trivialities of
manner, and supported him loyally as a faithful servant.

Walker was nothing but a vaccinator. Day after day, in rain or
sunshine, his lank figure, and self-complacent visage under a
white broad-brimmed hat were to be seen making the round of the
vaccine stations. When he entered a room, he first glanced at the
table on which he expected to find his books. If any mothers had
placed their children’s bonnets or garments thereon, they were at
once swept off. He then ranged the company in order against the
wall like a schoolmaster, and delivered a short address on the
protection he was about to confer. The children’s names were taken
down with a preliminary caution to speak distinctly. When women
muttered or gabbled, the Doctor grew irritable, and would sometimes
make a troublesome woman spell her infant’s name half-a-dozen
times, adding, “Now thou wilt know how to speak plainly.” Having
got the names, he had next to look out for virus. The few mothers
who had ventured to return with their vaccinated babes for
examination, would perhaps lose courage and attempt to escape, when
Walker would dart to the door and arrest the fugitive, saying,
“Thou foolish woman! If thou wilt not do good to others, I will
bless thy little one,” and would proceed to gather what he called
his “Vaccine Roses.” He pursued his operations calmly indifferent
to the screams of the children and the complaints of the
mothers, and as he disposed of each case pronounced the illusory
benediction, “Thy child is safe: fear not: fare thee well.”

Walker died in 1830, aged seventy-one, after a short illness, in
which “he refused to take any medicine though himself a physician.”
In the Report of the London Vaccine Institution for 1831 we read--

  He was a man who day after day, month after month, and year after
  year, watched with the care of a parent the cause of which he
  was so experienced an advocate; who was willing to know nothing
  but the object of his early love, Vaccination; who for upwards
  of a quarter of a century never omitted one lawful day going his
  rounds to the numerous stations of the Institution; and who, it
  may be almost said, ended his life with the lancet in his hand,
  for he went round to the stations two days before he died.

Toward the end of his life, he used to boast that he had performed
upwards of one hundred thousand vaccinations. So far as vaccination
prevailed in London, it was chiefly through Walker’s exertions; and
he was just the character, being set going, to keep going whatever
the adverse evidence or obloquy. He had his plans and his methods,
and those who tried to modify them took nothing by their pains.
He was a man to have his own way, and those who did not like him
might leave him. Whether from incapacity or affectation, he made no
attempt at politeness, and said precisely what he thought without
accommodation. He was a piece of mechanism rather than of genial
humanity.


FOOTNOTES:

[185] _The Vaccine Scourge containing the New Beggar’s Opera_ alias
_the Walkerian Farce_, alias _the London Vaccine Hoax; in answer to
Dr. Walker’s Jenneric Opera. A Rod for the Fool’s Back._ London,
1815. Pp. 122. Price 3s.

[186] _A Caution against Vaccine Swindlers and Imposters._ By John
Ring. London, 1816. Pp. 140.

[187] _The Life of John Walker, M.D., Graduate of the University of
Leyden; Licentiate of the Royal College of Physicians of London;
and late Director of the Royal Jennerian and London Vaccine
Institutions._ By John Epps, M.D., London, 1831. Pp. 342.

[188] _John Walker’s Reply to James Moore._ London, 1818. Pp. 16.

[189] _John Walker’s Reply to James Moore on his Mis-Statements
respecting the Vaccine Establishments in the Metropolis and their
Officers and Servants both Living and Dead._ London, 1818. Pp. 114.




CHAPTER XXV.

JENNER’S LATER WRITINGS.


Jenner’s later writings were chiefly apologies for the failures
of vaccination. His position was one of much difficulty, and its
peculiarity is rarely, if ever, recognised. For example, how few
know that his _Inquiry_ published in 1798, “that master-piece of
medical induction,” according to Mr. John Simon, was kept out of
print and referred to as rarely as possible after 1801-2.

“Why?”

The answer to the question is so important that at the risk of
repetition I give it explicitly.

The _Inquiry_ was suppressed because of its ascription of cowpox to
horsegrease.

It was the belief of dairy-maids in Gloucestershire that to
have had cowpox was to be secure from smallpox. Jenner was
much impressed by the rustic superstition, and brought it so
persistently before his medical brethren at their convivial
assemblies, that they threatened to expel him if he bored them any
longer with the subject. “It is true,” they said, “that the maids
believe an attack of cowpox keeps off smallpox, but we know they
are wrong; for we are all familiar with cases of smallpox after
cowpox.”

Thus frustrated, Jenner’s ingenuity took another turn. It was the
belief of farriers that if infected in dressing horses’ greasy
heels, they too were secure from smallpox. The area of this
conviction was narrower than that of the dairy-maids, farriers
being neither so numerous, nor so observant of their beauty: but
Jenner entertained their faith and converted it to his purpose.

Horsegrease protected from smallpox, if cowpox did not. But might
there not be one sort of cowpox that answered to the dairy-maids’
faith, if another sort did not? Happy thought! The defensive sort
was derived from the horsegrease which protected the farriers: the
non-defensive originated spontaneously on the cows. Men, fresh from
handling horses’ greasy heels, milked cows and communicated to them
the horses’ disease. Milkmaids, who in turn contracted from the
cows that sort of pox, were like the farriers secure from smallpox,
yea securer; whilst milkmaids who contracted pox spontaneously
developed on cows were not secure. The milkmaids’ superstition was
therefore justifiable: they were right and they were wrong--right
when they got pox through the cow from the horse; wrong when they
got pox from the cow simply.

Why then, it may be asked, did not Jenner dismiss the cow from
consideration? Why did he not base his prescription on the
farriers’ experience, and use and recommend horsegrease exclusively
for inoculation? The question is an obvious one, but it is not easy
to make out Jenner’s answer with precision. His assertion was,
that--

  The virus from the horse is not to be relied upon as rendering
  the system secure from variolous infection, but the matter
  produced by it on the nipple of the cow is perfectly so--

which was to say that horsegrease attained its highest prophylaxy
after transmission through the cow.

Such was the doctrine of the _Inquiry_, “that master-piece of
medical induction.”

When the doctrine came to be reduced to practice, difficulties
arose. Cowpox was considered wholesome and credible, whilst
horsegrease was repulsive and incredible. Still fact was fact; and
many were ready to accept horsegrease through the cow, or without
the cow, if such indeed were the source of the new salvation.
Cowpox proved to be a rare commodity, whilst horsegrease was
common, and numerous attempts were made to produce cowpox by means
of grease, but ineffectually. At some attempts, Jenner officiated.
Marshall records that--

  Mr. Sewell, Assistant Professor at the Royal Veterinary College,
  informs me that he was a witness to a series of experiments,
  twice repeated, at the College in the presence of Dr. Jenner,
  Dr. Woodville, Mr. Wachsel, and Mr. Turner, with a view to
  produce the vaccine disease on the teats of a cow. The matter of
  grease had been immediately taken from the horse, and variously
  applied by long continued friction, punctures, scarifications,
  and by scratching the surface with a needle; but from these
  trials neither inflammation, nor any affection resembling a pock
  resulted.[190]

To this discomfiture Jenner had to submit. His ascription of
cowpox to horsegrease was stigmatised as an error of which the
less that was said the better. It is true that other experimenters
were more successful, and that Loy of Whitby and Sacco of Milan
dispensed with the cow as a superfluity and used matter direct
from the horse for inoculation, passing the virus from arm to
arm into general circulation until what was equine was lost
sight of and indistinguishable from what was vaccine; but Jenner
did not care to be justified at the risk of his popularity and
the money on which he had set his heart. He saw how the wind of
public favour was blowing, and went with it. Since horsegrease
was disliked, he consented to its oblivion. Pearson, the chief
promoter and organiser of vaccination, scoffed at horsegrease,
and used spontaneous cowpox, which Jenner knew was of no avail
against smallpox; but he entered no protest upon that score. On the
contrary, he let the futile practice go on; he claimed it as his
own; and he set about manufacturing excuses for the failures which
were imminent.

Spurious cowpox was one of the most dexterous of these excuses.
If injury or smallpox followed vaccination, the disaster was
ascribed to spurious cowpox. Jenner’s _Further Observations_,
published in 1799, was designed to teach “how to distinguish with
accuracy between that peculiar pustule which is the _true_ Cow
Pock and that which is _spurious_;” and in his _Origin of the
Vaccine Inoculation_ in 1801 even greater stress was laid on the
distinction. By and bye, however, the excuse worked more harm than
advantage. People got terrified with the mischiefs ascribed to
spurious cowpox, and as which was genuine and which spurious was
only discoverable in their consequences, they began to decline to
have either. It then became expedient to deny spurious cowpox,
which Jenner did. He confessed to the Royal College of Physicians
that there was not a true and a false cowpox; and that by spurious
cowpox he “meant nothing more than to express irregularity in the
form and progress of the vaccine pustule from which its efficacy is
inferred.”

In view of facts like these, there is little cause for surprise
that the publication of Jenner’s _Inquiry_ with its two supplements
was not continued. What he set forth as essential was treated
as illusory, whilst the cowpox in which he had taught there was
no security had been brought into use everywhere. Why therefore
embarrass himself with proclamations of his own blunders? The
believers in vaccination were good-natured and incurious, and he
had their homage, which was agreeable and profitable, and why
should he dissipate it? The _Inquiry_ was printed for the third
time in 1801, but “this master-piece of medical induction” has
never been republished; and the probability is, that if ever
reproduced, it will be to prove to the world the emptiness of its
author’s pretensions.

Jenner’s original promises of immunity from smallpox by inoculation
with horsegrease cowpox were absolute. Thus he wrote--

  The person who has been affected with Cowpox Virus is for ever
  after secure from the infection of the Smallpox.[191]

  It clearly appears that this disease, Cowpox, leaves the
  constitution in a state of perfect security from the infection of
  the Smallpox.[192]

  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 the
  Smallpox.[193]

Experience was not slow to demonstrate the futility of these
assurances. At first the facts were flatly denied: it was
impossible for smallpox to succeed cowpox. The evidence, however,
grew too strong to be outsworn, and then it was said the cowpox
must have been spurious. As failures accumulated over the
operations of Jenner himself and his choice disciples (who were
naturally presumed to know and avoid spurious cowpox) they began
to lay great stress on the fact that smallpox itself did not
always avert a subsequent attack; and if smallpox did not save
from smallpox, why, they demanded, should cowpox be expected to do
more?[194] Why, indeed! Still the cases of smallpox after cowpox
were as scores to those of smallpox after smallpox, and then the
argument was reduced to a competition between variolation and
vaccination. “You inoculators with smallpox,” said the vaccinators,
“are continually having smallpox after variolation, and why should
we be expected to be more successful?” Why, indeed! The inoculators
with smallpox in turn denied that after efficient variolation
smallpox ever occurred, or could possibly occur; and thus the
wrangle went on. One thing was plain and certain--the original
claim of Jenner for the absolute infallibility of Horsegrease
Cowpox as a preventive of Smallpox was reduced and surrendered bit
by bit until it came to this at last--it made Smallpox milder!

These repeated surrenders were, however, never ingenuous. Mistakes
are inevitable, and they are forgiven when frankly confessed; but
frank confession was not Jenner’s habit. When vaccination failures
had become notorious in 1808, he had the hardihood to assert, that
from the outset he had recognised that as smallpox did not always
avert smallpox, neither did he expect cowpox to do so; and cited as
proof of his prescience this passage from _Further Observations_ in
1799--

  It should be remembered that the constitution cannot, by previous
  infection, be rendered _totally_ insusceptible of the variolous
  poison; neither the casual, nor the inoculated Smallpox, whether
  it produce the disease in a mild or violent way, can _perfectly_
  extinguish the susceptibility.[195]

Here Jenner made a bold draft on his reader’s ignorance. It was
his claim for horsegrease cowpox that it conferred an absolute
security from smallpox without any qualification whatever. The
assumed prescience in 1799 is completely belied when we refer to
his arrogant manifesto of 1801. These are his words--

  The scepticism that appeared amongst the most enlightened of
  medical men, when my sentiments on Cowpox were first promulgated,
  was highly laudable. To have admitted the truth of a doctrine,
  at once so novel _and so unlike anything that ever appeared in
  the Annals of Medicine_, without the test of the most rigid
  scrutiny, would have bordered upon temerity; but now, when the
  scrutiny has taken place, not only among ourselves, but in the
  first professional circles in Europe, and when it has been
  uniformly found in such abundant instances, that _the human
  frame, when once it has felt the influence of the genuine Cowpox_
  in the way that has been described, _is never afterwards_, at any
  period of its existence, _assailable by the Smallpox_, may I not
  with perfect confidence congratulate my country and society at
  large on their beholding, in the mild form of Cowpox, an antidote
  that is capable of extirpating from the earth a disease that is
  every hour devouring its victims; a disease that has ever been
  considered as the severest scourge of the human race![196]

Cowpox was thus set forth as a prophylactic with powers hitherto
unknown and unique; so that Jenner was cut off from the claim of
its equivalence with smallpox in character and consequences. He
knew in 1799, as we have seen, that infection with smallpox did not
render the constitution proof against the subsequent influence of
the disease; but in 1801, as we see, it was his express contention
that what smallpox failed to do _that_ cowpox did--it protected
the constitution perfectly and for ever from smallpox, and nothing
to compare with it had ever appeared in the Annals of Medicine. It
was only under the pressure of exposure and defeat that he humbled
himself to write to Dunning, 1st March, 1806--

  The security given to the constitution by Vaccine Inoculation is
  _exactly equal_ to that given by the Variolous. To expect more
  from it would be wrong. As failures in the latter are constantly
  presenting themselves, we must expect to find them in the former
  also.[197]

To this pass was the infallible preservative from smallpox, with
nothing to match it in the Annals of Medicine, reduced within the
experience of seven years!

The most thorough-going and far-reaching of Jenner’s excuses for
vaccination failures were herpetic affections of the skin. In his
journal we read--

  Inoculated C. F. a second time. It is very evident that the
  affection of the skin called red gum deadens the effect of the
  Vaccine Virus. This infant was covered with it when inoculated
  four days ago. The same happened with Mrs. D.’s infant.[198]

To Mr. Dunning he wrote from Cheltenham, October 25th, 1804--

  How frequently does the Vaccine Disease become entangled with
  herpes! I see that the herpetic fluid is one of those morbid
  poisons which the human body generates, and when generated, that
  it may be perpetuated by contact. Children who feed on trash at
  this season of the year are apt to get distended bellies, and on
  them it often appears about the lips. This is the most familiar
  example that I know. _A single vesicle is capable of deranging
  the action of the vaccine pustule._ Subdue it, and all goes on
  correctly.[199]

And again to the same correspondent, 23rd December, 1804--

  My opinion is that the chief interference with the success of
  Vaccination is herpes in some form or another. I have discovered
  that it is a very Proteus, assuming as it thinks fit the
  character of the greater part of the irritative eruptions that
  assail us.[200]

Having thus detected an all-sufficient explanation of the failure
of vaccination to prevent smallpox, he communicated his discovery
to the _Medical and Physical Journal_, August, 1804, in a paper
entitled, “On the Varieties and Modifications of the Vaccine
Pustule occasioned by an Herpetic State of the Skin,” but he
complained to Dunning “that it seemed not to have excited the
slightest interest.” In order to call attention afresh to the
subject, he had the article reprinted as a pamphlet at Cheltenham
in 1806 and at Gloucester in 1819, but in vain. He complained to
Baron in 1817 that he could not get the Board of the National
Vaccine Establishment to attend to his cautions touching the
interference of cutaneous diseases with the progress of the vaccine
vesicle. “I am afraid,” he observed, “that the extreme ignorance
of medical men on this subject will destroy the advantages which
the world ought to derive from the practice.”[201]

What of course medical men with the least common sense perceived
was, that the excuse provided for vaccination failures was too
liberal to be worth anything. If the least cutaneous eruption
was sufficient to frustrate vaccination, what operation could be
pronounced efficient? for it could scarcely be intended that every
patient should be stripped to the skin and minutely examined for
herpetic vesicles. There was nothing transitory in Jenner’s opinion
about herpes: he harped upon its mischiefs and omnipresence to the
close of his life. William Dillwyn of Walthamstow having asked
him for any observations that occurred to him on the practice of
vaccination for the benefit of Friends in Philadelphia, Jenner
replied in a letter dated Berkeley, 19th August, 1818, in which we
find these remarks--

  I must candidly acknowledge that I am not at all surprised that
  a partial prejudice should now and then lift up its head against
  Vaccination. It is called into existence, not from anything
  faulty in the principle, but from its wrong and injudicious
  application. For example, a child, or family of children,
  may be in such a state, that the action of the vaccine fluid
  when applied to the skin shall be either wholly or partially
  resisted. It may either produce no effect at all, or it may
  produce pustules varying considerably in their rise, progress
  and general appearance from those which have been designated
  _correct_. It was about the year 1804 that I was fortunate enough
  to discover the general cause of these deviations, and no sooner
  was it fully impressed on my mind, than I published it to the
  world. Yet few, very few indeed, among those who vaccinate,
  have paid any attention to it; yet I am confident, from the
  review of the practice on an immense scale, that it is a matter
  which has a greater claim on our attention than any one thing
  besides connected with Vaccination--indeed I may say than any
  other thing. What I allude to is a coincident eruptive state
  of the skin, principally bearing what we call the herpetic or
  eruptive character. If we vaccinate a child under its influence,
  we are apt to create confusion. The pustule will participate in
  the character of the herpetic blotch, and the two thus become
  blended, forming an appearance that is neither vaccine nor
  herpetic; but the worst of it is that the patient does not
  receive that _perfect_ security from Smallpox infection which is
  given by the perfect pustule.[202]

These complaints of the indifference of the medical world to his
prophesying, show how completely the business of vaccination
had passed out of Jenner’s hands. The influence of herpes on
vaccination, although declared by him to be of the utmost
importance, even to the extent of imperilling the advantages of the
practice, was disregarded as unworthy of serious attention.

Another of Jenner’s apologetics was a pamphlet in 1808[203]
designed to explain away the failure of the variolous test--the
test that deceived so many in the early days of vaccination. The
inoculated with cowpox were inoculated with smallpox, and when
the smallpox did not “take,” it was said, “Behold the perfect
protection!” The smallpox inoculators complained bitterly of the
hocus-pocus. “No wonder,” they said, “that when the system is in
a fever with bestial corruption, that human pox will not ‘take,’
but try after awhile.” And they did try after awhile, and it was
found that the vaccinated could be inoculated with smallpox like
the unvaccinated. Indeed, when it was seen that the vaccinated
fell victims to smallpox, many who had been vaccinated resorted to
the smallpox inoculators for their supposed superior protection,
and received it without hindrance from their previous vaccination.
It therefore became judicious to disown the variolous test; but
neither in this case was the surrender frankly made, but with
prevarication that deprived it of all grace. What the smallpox
inoculators maintained, Jenner had to allow, but after this
fashion--

  My principal object is to guard those who may think fit
  to inoculate with variolous matter after Vaccination from
  unnecessary alarms; a pustule may sometimes be thus excited,
  as on those who have previously gone through Smallpox; febrile
  action in the constitution may follow; and, as has been
  exemplified, a slight eruption.

For the variolous he recommended the substitution of the vaccine
test; saying--

  At the commencement of Vaccination, I deemed the Variolous Test
  necessary; but I now feel confident that we have one of equal
  efficacy, and infinitely less hazardous in the re-insertion of
  the vaccine lymph--

Which was to say that vaccination immediately after vaccination
would be found impossible--the later practice of periodical
re-vaccination being unforeseen.

Jenner might have perceived that after his proclamation of the
influence of herpes on vaccination, there was nothing to be said
for the variolous test. When he consented to run vaccination on
the same terms as variolation, and admitted that it would be wrong
to expect more from the one practice than from the other, he was
bound in consistency to allow that if vaccination was frustrated
by eruptions of the skin, it was matter of consequence that
variolation should be frustrated by the fever of vaccination. He
informed Dillwyn that he destroyed cutaneous eruptions by the
application of _unguentum hydrargyri nitrati_, and then vaccinated
with success. The smallpox inoculators did so likewise. When the
irritation induced by vaccination had had time to subside, they too
variolated with success.

The letter to Dillwyn, 1818, contains some other points which it
is instructive to note. For example, the following passage proves
two things, first, how notorious had become vaccination failures;
and, second, how vaccination, from an easy art that any one might
practise, had been converted into a mystery to which even “an
eminent surgeon” might be unequal. Jenner says--

  One word more with respect to prejudice. How frequently have we
  seen in the public prints paragraphs of this description--“A
  gentleman’s family, consisting of three or four or half-a-dozen
  children, were vaccinated by an eminent surgeon, and all went
  through the disease in the most satisfactory manner, and were
  pronounced safe; yet, on being exposed to the infection of
  the Smallpox, they all had the disease, but happily they all
  recovered.” Here, Sir, the mind becomes entangled with a false
  association. The public conceive that _an eminent surgeon_ must
  be a perfect master of this little branch of our art; but it
  often happens that he has not stooped to look at anything beyond
  its outline; and when deviations arise in the progress of the
  pustules [as from herpes] to that extent which I have pointed
  out as momentous, they are passed by without attracting any
  particular attention.

A report having got abroad that Jenner had renounced his faith in
vaccination, he replied to Dillwyn--

  My confidence in the efficacy of Vaccination to guard the
  constitution from Smallpox is not in the least diminished.
  That exceptions to the rule have appeared, and that they will
  appear, I am ready to admit. They have happened after Smallpox
  Inoculation; and by the same rule, as the two diseases are so
  similar, they will also happen after Vaccine Inoculation.

In presence of such a declaration, it is easy to understand why
the _Inquiry_ with its supplements was kept out of print, and
never referred to. His confidence in vaccination not in the least
diminished! In the words cited, he surrendered afresh the claim
with which he started, and for which he was paid, namely, that
inoculation with cowpox rendered the constitution proof against
smallpox for life, and that the protection thus afforded was
without precedent in medical experience.

Having thus, under stress of necessity, reduced vaccination to the
level of variolation, and tried to shelter the failures of the one
practice under those of the other, the spirit of the old quack
surviving, he went on to prophesy in the familiar strain--

  It is a curious and most delightful fact that Smallpox is flying
  before Vaccination in all directions. In a wide district around
  me, embracing the most populous part of the county of Gloucester,
  the Smallpox is scarcely heard of; and if it does happen to
  appear from infection brought by the wandering pauper, it either
  finds itself insulated, or is rendered incapable of spreading
  by giving immediately the vaccine security to those within its
  atmosphere who may happen to remain unprotected.

With Jenner’s turn for romance, there is no need for dealing with a
statement like the foregoing seriously, else we might ask what was
the prevalence of smallpox in Gloucestershire before vaccination?
and to what extent had it been cultivated by inoculators?
Throughout England there was a remarkable subsidence of smallpox
precedent to the introduction of vaccination (for which vaccination
obtained the credit), which subsidence was no doubt accelerated by
the cessation of variolation. Jenner resumes--

  Wherever Vaccination has been _universally_ practised, there the
  Smallpox ceases to exist. It matters not how wide the district,
  or how populous the city, the result is, and, from the nature
  of things, must be the same. There is scarcely a part of the
  civilised world that cannot bear testimony to the truth of this
  position. For extent of territory, we may turn our eyes to our
  possessions in the East, and to various parts of South America;
  and to towns and cities, many of the most conspicuous in Europe.

  In the island of Ceylon, the ravages of Smallpox were dreadful,
  although many efforts had been made to lessen its fatality by
  Variolous Inoculation. This, wherever it was practised, produced
  a spreading of the disease, and made a bad matter worse; so that
  the people would have nothing to do with it. But after a little
  time they took to Vaccine Inoculation very readily, and Smallpox
  became totally extinct.

  From Sweden, too, we have a report that proves the extinction of
  Smallpox throughout the kingdom. Now as the good sense of the
  Swedes brought about this happy event, why should not Britain
  avail herself of the great gift, and employ it to the same
  effect? Here the Boon is distributed with a partial and a sparing
  hand, and consequently Smallpox still exists in several parts of
  our island.

There was no checking Jenner when he rose into rhodomontade about
the myriads of Asia and the vastness of America, but descending to
the definite in Ceylon and Sweden we can test him with precision,
and as to both we shall find his statements at wide variance with
facts. For the present, however, let us keep to our own country,
and note especially what he had to assert of London in 1818--

  Nevertheless I have the happiness to say, that since the first
  promulgation of my discovery in 1798, the deaths of Smallpox in
  the British Realms, according to the best estimates I can form,
  are reduced from more than 40,000 to less than 6,000 annually.
  The metropolis for the last ten or twelve years exhibited a
  reduction of about one half only; but during the last two years,
  Vaccination has been more extensively practised than ever, both
  from the benevolence of private individuals and the faculty,
  and by public institutions; and this year, 1818, promises a far
  greater reduction in the number of deaths than any that has
  preceded it.

In London in 1818 the deaths from smallpox were low (421); but a
single year is of little account, and must be viewed in relation to
preceding years. Here we have a statement for the decade, 1811-20,
taken from the metropolitan Bills of Mortality.

               Burials from     From      From     From
       YEARS.  all diseases.  Smallpox.  Fevers.  Measles.
         1811     17,043         751        906      235
         1812     18,295        1287        783      427
         1813     17,322         898        714      550
         1814     19,783         638        908      817
         1815     19,560         725       1309      711
         1816     20,316         653       1299     1106
         1817     19,968        1051       1299      725
         1818     19,705         421       1170      728
         1819     19,228         712       1150      695
         1820     19,348         792       1156      720
                 -------        ----     ------     ----
                 190,568        7928     10,694     6714
    1801-1810    185,737      12,534     16,204     5680
    1791-1800    196,801      18,477     19,880     2707

From this statement we see that the decrease in London smallpox
that set in toward the close of the 18th Century was maintained;
but that vaccination had aught to do with the decrease there is no
reason to believe--unless in so far as the new practice discouraged
variolation. How, we ask, could the vaccination of one-tenth of the
Londoners (if so many) reduce the smallpox among nine-tenths? We
have also to observe that mortality from fevers abated in common
with smallpox; and it cannot be pretended that that abatement was
also due to vaccination! The rational assumption is, that what
diminished fevers in London, likewise diminished smallpox. Nor
should we overlook the fact, that as the deaths from smallpox
declined, those from measles increased; nor the probability that
many deaths formerly ascribed to smallpox were derived from
measles, and that part of the decline in one column is accounted
for by the increase in the other.

Jenner’s assertion, that the national mortality from smallpox had
been reduced from more than 40,000 to less than 6000 annually,
had no basis whatever in reality. As we know, the 40,000 deaths
were got by multiplying the deaths of a bad year of London smallpox
by the population of the United Kingdom--as if London were the
standard of England, Ireland, and Scotland! How he obtained the
reduced number of 6000 we are left to conjecture. In reviewing
Jenner’s writings we are startled with his inconsistencies,
and scarcely less with the carelessness and credulity of his
adherents. He set out with the common knowledge that cowpox did
_not_ prevent smallpox, and for that reason he substituted pox
generated by horsegrease on the cow. Horsegrease cowpox could
not, however, be procured on demand; and was, moreover, disliked
on the score of its origin; and cowpox was resorted to by Pearson
and Woodville, and diffused everywhere with acclamation; and
Jenner did not only not object, but took credit, and actually was
allowed to take credit for the pox he had described as ineffective
for the purpose designed! By and bye cowpox from horsegrease,
or horsepox, according to the original recipe, was obtained and
brought into circulation with Jenner’s sympathy, if without his
open approval--he discerning that praise and pay were not to be
had from that notion. After a while, horsegrease, or horsepox, was
used for inoculation without the intervention of the cow; and that
too entered into currency as vaccine, Jenner himself employing and
distributing it, although according to his _Inquiry_ it was not to
be trusted to prevent smallpox.

I repeat these facts, even at the risk of tedium, because it is
essential to have them clearly apprehended. For at least three
descriptions of virus Jenner stood responsible, namely--

I.--Horsegrease Cowpox--the virus warranted in his _Inquiry_.

II.--Cowpox, known by Jenner to be ineffective in preventing
smallpox, but favoured by the medical profession and the public.

III.--Horsegrease (said to have been horsepox), also described by
Jenner as ineffective, but latterly used and diffused by him.

To which of these did he attribute the success claimed for
vaccination? Apparently to all indifferently; but if one were as
good as the others, why did he not say so, and proceed to explain
how it was that cowpox did not save the Gloucestershire milk-maids,
nor horsegrease the farriers from smallpox? Was it that the power
to put such questions, and to answer them, does not consist with
the quack’s intelligence; and that in his lucre he rests content?
Observe, too, how when credit was to be had for London vaccination,
Jenner took it, though at mortal enmity with the chief agent in the
work, repudiating Walker’s practice as subversive of principles he
considered essential to success.

Jenner’s final publication in 1822 had nothing to do with
vaccination, but was a bid for fame in a new direction.[204] It was
an attempt to originate a new method of cure by irritating the skin
with tartarated antimony. He had dabbled with the chemical when
a young man, and John Hunter had suggested that his preparation
should be sold and puffed as Jenner’s Tartar Emetic. In his last
years he returned to it, and produced a series of cases to prove
how many diseases might be alleviated and removed by using it as a
counter-irritant--just as in the _Inquiry_ he recommended cowpox
inoculation with the same intention. The matter does not concern
us further than to observe that the vesicles and scars produced
by tartarated antimony are almost indistinguishable from those of
vaccination; and that Hufeland, the German Nestor of Medicine,
taught and proved that tartar emetic was every whit as effective
against smallpox as cowpox--an opinion from which I see no reason
to dissent.


FOOTNOTES:

[190] _A Popular Summary of Vaccination with reference to its
Efficacy and Probable Cause of Failure._ By John Marshall, M.R.C.S.
and District Vaccinator of the National Vaccine Establishment.
London, 1830. Pp. 96.

[191] _Inquiry_, 1798, p. 7.

[192] _Ibid._, p. 58.

[193] _Petition to the House of Commons_, 1802.

[194] Jenner to Dunning, 23rd Dec., 1804. Baron’s _Life of Jenner_,
vol. ii. p. 26.

[195] _Facts for the most part unobserved, or not duly noticed
respecting Variolous Contagion._ London, 1808, 4to, pp. 17.

[196] _A Continuation of Facts and Observations relative to
Cowpox._ By Edward Jenner, M.D. London, 1801.

[197] Baron’s _Life of Jenner_, vol. ii. p. 28.

[198] Baron’s _Life of Jenner_, vol. i. p. 449.

[199] _Ibid._, vol. ii. p. 344.

[200] _Ibid._, vol. ii. p. 26.

[201] _Life of Jenner_, vol. ii. p. 223.

[202] _Letter from Dr. Edward Jenner to William Dillwyn, Esq.,
on the Effects of Vaccination in Preserving from the Smallpox._
Philadelphia Vaccine Society. Philadelphia, 1818. Pp. 20.

[203] _Facts for the most part unobserved, or not duly noticed,
respecting Variolous Contagion._ London, 1808. 4to, pp. 17.

[204] _A Letter to Charles Henry Parry, M.D., on the Influence of
Artificial Eruptions in certain diseases incidental to the Human
Body; with an Inquiry respecting the probable advantages to be
derived from further experiments._ By Edward Jenner, M.D., LL.D.,
F.R.S., M.N.I.F., etc., and Physician to the King. London, 1822.
4to, pp. 68.




CHAPTER XXVI.

BARON’S LIFE OF JENNER.


We owe much to Baron’s Life of Jenner, but as a collection of
evidence rather than as an organic biography. It is verbose and
loosely put together, and would never be read unless by some one
in quest of information, or with nothing better to do. Fortunately
Baron was reverent and not critical. Jenner was to him a sacred
being, admirable in all relations, whose only contention was with
“the blindness and wickedness of his traducers.” Lives written in
this temper are often most instructive. Tales are told and letters
produced in pious simplicity that biographers of the judicious
order discreetly suppress.

Baron made Jenner’s acquaintance in the summer of 1808 when he was
living at Fladong’s Hotel, Oxford Street, revelling in a fool’s
paradise as to his importance in the formation of the National
Vaccine Establishment. Baron had recently come from Edinburgh, and
says,--

  I was about to commence practice: all the world was before me.
  In seeking the acquaintance of Jenner I was impelled mainly by a
  desire to do homage to a man whose public and private character
  had already secured my warmest admiration. I little thought that
  it would so speedily lead to an intimacy, and ultimately to a
  friendship, which terminated only at his death, and placed me in
  a relationship to his memory that no one could have anticipated.
  The greatness of his fame, his exalted talents, and the honours
  heaped upon him by all the most distinguished public bodies of
  the civilised world, while they made me desirous of offering
  my tribute of respect to him, forbade the expectation of more
  than such an acknowledgment as a youth, circumstanced as I was,
  might have expected. I soon, however, perceived that I had to do
  with an individual who did not square his manners by the cold
  formality of the world. He condescended as to an equal; the
  restraint and embarrassment that might naturally have been felt
  in the presence of one so eminent vanished in an instant. The
  simple dignity of his aspect, the kind and familiar tone of his
  language, and the perfect sincerity and good faith manifested in
  all he said and did, could not fail to win the heart of anyone
  not insensible to such qualities. Though more than twenty years
  have elapsed since this interview took place, I remember it, and
  all its accompaniments, with the most perfect accuracy. He was
  dressed in a blue coat, white waistcoat, nankeen breeches, and
  white stockings. All the tables in his apartment were covered
  with letters and papers on the subject of vaccination, and the
  establishment of the National Vaccine Institution. He talked
  to me of the excellent article which had lately appeared in
  the _Edinburgh Review_, relative to the vaccine controversy.
  He spoke with great good humour also of the conduct of the
  anti-vaccinists, and gave me some pamphlets illustrative of the
  controversy then going on. The day before he had had an interview
  with the Princess of Wales, and he showed me a watch which her
  Royal Highness had presented to him on that occasion.[205]

The passage is a long one, but it has some value in itself, and
exhibits Baron’s habitual attitude toward his hero. In his private
relations, Jenner was amiable, but it is with his public life
that we are concerned, and find so reprehensible. Mischievous
leaders and teachers are frequently distinguished by private
graces; and austere personal virtue is frequently associated with
bland indifference to conventional immoralities; and we need
not go far to discover counterparts of Jenner in ordinary life.
Nothing is commoner than suavity combined with self-love that is
malignant and mendacious when thwarted. All is pleasant as long
as admiration prevails, but with dissent or resistance the sunny
temper vanishes, and clouds of contempt and fury overspread the
spiritual sky. A sharp test of character is a man’s disposition to
his adversaries; and Jenner was never magnanimous. His conduct to
Pearson, Woodville, and Walker has been sufficiently described; and
similar jealousy and spitefulness were displayed to whoever dared
to impugn his infallibility in the prevention of smallpox. No one,
for instance, could have brought forward the fact that smallpox
occasionally succeeded vaccination with more simple good faith than
Goldson; yet Jenner wrote of him with insufferable insolence--an
insolence that is thrown into stronger relief by the knowledge
that what Goldson testified is accepted at this day, even by
vaccinators, as indisputable matter-of-course. His bully, too, John
Ring, attacked Goldson, and Jenner, in writing to Dunning, 23rd
December, 1804, thus excused his brutality--

  You speak of Ring and Goldson. Recollect there was not time to
  be cool. What lover of Vaccination--what man, well acquainted
  with its nature, and that of Smallpox, could read Goldson’s book,
  and lay it down coolly? Ring, the moment he read it, and what
  indeed was infinitely worse than the book itself, its murderous
  harbinger--the advertisement, instantly charged his blunderbuss,
  and fired it in the face of the author. I must freely confess, I
  do not feel so cool about this Mr. Goldson as you do. His book
  has sent many a victim to a premature grave; and would have sent
  many more, but for the humanity and zeal of yourself and others
  who stepped forward to counteract its dreadful tendency.[206]

In the same spirit he wrote to Baron, 6th November, 1810, of Brown
of Musselburgh, who had reported certain cases of smallpox after
vaccination in a London newspaper--

  Some notice must be taken of Mr. Brown’s communication; but
  if he thinks he shall be able to draw me into controversy, he
  will be mistaken. His letter, under the veil of candour and
  liberality, is full of fraud and artifice; for he knows that
  every insinuation and argument he has advanced, have been
  refuted by the first medical characters in Edinburgh and Dublin.
  But the mild, gentle, complaisant antagonist, is a character
  more difficult to deal with than one who boldly shows his
  ferocity.[207]

As applied to Brown, sagacious and sincere, this was the very
ecstasy of abuse. Even Brown’s adversaries within his own
neighbourhood, ultimately yielded to his contention. In the
_Edinburgh Medical and Surgical Journal_ of July, 1818, we read--

  Before we conclude, we must in justice to ourselves pay the
  _amende honorable_ to Mr. Brown of Musselburgh, whose opinions we
  strenuously controverted in 1809; and to which we now, in 1818,
  confess ourselves partly converts in consequence of increased
  experience and observation.

In short, calm discussion of vaccination with Jenner was never
possible. Inquiry was borne down with clamour, and scepticism
denounced as malevolence. “He could not altogether escape,” says
Baron, “from the annoyance occasioned by _the blindness and
wickedness_ of his traducers”[208]--and all were traducers who were
not believers. Indeed, Baron could only account for the perversity
of those who did not recognise Jenner as the saviour of mankind
from smallpox by a resort to the doctrine of inbred depravity,
saying--

  We are compelled to believe that there is a principle in our
  nature which has too strong an affinity for what is untrue to
  permit the understanding to discern or acknowledge an opposite
  principle till both the moral and intellectual vision has been
  purified and strengthened.[209]

Purified and strengthened, and the affinity with falsehood
dissolved, it became possible for the understanding to appreciate
the virtue of cowpox and the veracity of its advertiser!

Jenner, it may be said, instinctively resented investigation. He
was uneasy in conscious duplicity. He knew there was no safety
in vaccination as practised; for the cowpox employed was not the
horsegrease cowpox he had commended as efficacious. What he had
prescribed was disregarded; what he had condemned was approved;
but, strange to say, he was praised and rewarded by the world as
if cowpox had been his specific! Jenner accepted the situation,
and possibly came to believe (after a fashion) that he was
enjoying no more than his own; but under the circumstances it
was not surprising that he shrank from criticism, kept his early
publications out of the way, and resorted to scolding and shrieking
whenever scrutiny appeared imminent.

Worse even than his behaviour to investigators and opponents was
his treatment of those who converted vaccination to practice.
The _Inquiry_ was no handbook, and Pearson, Woodville, and other
early vaccinators, had to make their own way, not only unassisted,
but with Jenner ready to appropriate their successes and to
reproach them with their failures. Baron avers that nothing in
the art of vaccination was due to any one but Jenner himself,
qualifying this praise with a slight exception in favour of Dr.
Bryce of Edinburgh, who made the discovery that if a subject under
vaccination is re-vaccinated, the subsequent inoculation is caught
up and brought to maturity with the precedent--a phenomenon that
as Bryce’s Test was used to ascertain whether true vaccine fever
was operative. But even Bryce received scant acknowledgment, and
Baron tries to make out that Jenner was possessed of the fact ere
it was announced.[210] Jenner’s meanness toward those who displayed
any intelligent independence in co-operation with him is written
at large in Baron’s biography, but with such innocence that it
would be absurd to describe it as indecent. His good faith is
perfect, and it is only a critical reader that finds out how he is
identified with Jenner, seeing merit nowhere save in his abject
servitors and feminine _claque_.

Vaccinators at this day allow that the influence of vaccination
wears out and ought to be renewed; yet Jenner would not listen for
a moment to such a modification of its perpetual prophylaxy. Baron
writes--

  The year 1804, in Jenner’s estimation, formed an era in the
  history of the Variolæ Vaccinæ. The assertion, that the Cowpox
  afforded only a temporary security was then insisted on. Had it
  been correct, it would have deprived the discovery of nearly
  all its value. This assertion was very easily made; and in the
  infancy of the practice could not be well disproved. To these
  circumstances it was owing, that the crude and unsupported
  statements of Mr. Goldson acquired any influence. Dr. Jenner
  himself, from the commencement, perceived that in his cases of
  failure, Cowpox had never been properly taken.[211]

When in 1813 Lord Boringdon introduced his bill to Parliament for
the restriction of variolation, Lord Ellenborough observed--

  No doubt Vaccination is of some use, but if the noble lord
  considers it a complete preventive of Smallpox, I differ from
  him in opinion. At the same time, I have proved my respect for
  the discovery by having my eight children vaccinated. I believe
  in the efficacy of Vaccination to a certain extent. It may
  prevent the disorder for eight or nine years; and in a large city
  like this with a large family of children, even this limited
  protection is desirable.

In this declaration the Chief Justice was not singular, but
expressed the general conviction of the public who held by
vaccination in spite of the manifest failure of the early promises
made for it. Nevertheless Jenner was extremely annoyed: it was to
him as the formal deliverance of judgment. Baron says--

  I have seldom seen Jenner more disturbed than he was by this
  occurrence; not certainly because he had any fears that the
  unsupported assertion of his lordship would prove correct, but
  because it unhappily accorded with popular prejudices, and when
  uttered by such a person, in such an assembly, was calculated
  to do unspeakable mischief by unsettling the confidence of
  numberless anxious parents, and by attempting to deprive
  Vaccination of more than half its virtue.[212]

Thorough was Baron in his defence of Jenner: no inconsistency
appalled him. He records in capitals (as produced) the following
as Jenner’s solemn and final testimony, written, a few days before
he expired, on the back of a letter, bearing the post-mark, 14th
January, 1823--

  MY OPINION OF VACCINATION IS PRECISELY AS IT WAS WHEN I FIRST
  PROMULGATED THE DISCOVERY. IT IS NOT IN THE LEAST STRENGTHENED
  BY ANY EVENT THAT HAS HAPPENED, FOR IT COULD GAIN NO STRENGTH;
  IT IS NOT IN THE LEAST WEAKENED, FOR IF THE FAILURES YOU SPEAK
  OF HAD NOT HAPPENED, THE TRUTH OF MY ASSERTIONS RESPECTING THOSE
  COINCIDENCES WHICH OCCASIONED THEM WOULD NOT HAVE BEEN MADE
  OUT.[213]

Self-deception after this pattern is far from uncommon, and is
proof against evidence and death itself; but Jenner was not
quite so crazy as his words imply. From his first opinion about
vaccination, and its absolute efficacy against smallpox (unlike
anything hitherto known in medical experience) he had retreated
considerably. Even so early as 1804 he had reduced his claim for
vaccination to equality with variolation. In that year he observed--

  What I have said on Vaccination is true. If properly conducted,
  it secures the constitution as much as Variolous Inoculation
  possibly can. It is the Smallpox in a purer form than that which
  has been current among us for twelve centuries past.[214]

And again Baron cites him as saying--

  Duly and efficiently performed, Vaccination will protect the
  constitution from subsequent attacks of Smallpox, as much as that
  disease itself will. _I never expected that it would do more_,
  and it will not, I believe, do less.[215]

Jenner presumed freely on the forgetfulness of those he addressed.
In a document so well known as his petition to the House of Commons
in 1802, he expressly claimed that a person inoculated with cowpox
was thereby “rendered perfectly secure from the infection of
smallpox through life”; nor would the furore which attended the
introduction of the practice have been possible had it been set
forth as no more than a milder form of variolation. That cowpox
was equivalent to smallpox for inoculation was laughed at by
the variolators; but that a vaccinated person was as safe from
smallpox as one who had passed through the disease, was true in no
other sense than that Jenner wished it to be true, and prophesied
accordingly. It was by such contrivances that he broke his own
fall, and alleviated the disenchantment of the credulous.

Oddly enough Jenner’s fiction, that vaccination was as good against
smallpox as smallpox itself, was revived in the innocence of
ignorance by Sir William Gull before a committee of the House of
Commons in 1871. “Vaccination is as protective against smallpox
as smallpox itself,” said the fashionable physician. Confutation
was, however, at hand. Mr. Marson (for thirty-five years resident
surgeon of the Highgate Smallpox Hospital) attested that cases of
smallpox after smallpox were comparatively rare--not 1 per cent.;
whilst 84 per cent. of those admitted to the Hospital in 1864 were
vaccinated. An instructive contrast between the logic of fancy and
matter of fact!

Baron, with unscrupulous disregard of evidence, complains that
vaccination should ever have been represented as an infallible
preventive of smallpox; so that as pointed out in the Report of the
Royal College of Physicians in 1807, “the fate of the new practice
was made to hang on the occurrence of a single case of smallpox”;
and goes on to observe--

  This, I am sorry to say, was a great misapprehension; the
  opposers of Vaccination endeavoured to place the fate of
  Vaccination on such an issue; but if Jenner’s principles be
  duly considered, he never at any time sanctioned such an idea;
  and long before the practice of Vaccination became general, he
  anticipated failures, and explained the circumstances under which
  they were most likely to occur.[216]

The summary answer to this statement is, that it is untrue. Jenner
anticipated no failures. On the contrary, he vehemently denied
them; and when denial could no longer avail, he invented a variety
of excuses, such as spurious cowpox and omnipresent herpes, to
account for their occurrence; though always ready (as we have seen)
to hark back to his original assertion that vaccination was “an
infallible preventive of smallpox.” Baron did not like the word
“infallibility.” He writes--

  I am not sure that the expression was ever used by Dr. Jenner
  himself. If he did use it, he certainly very soon accompanied
  it with the necessary qualification. He may perhaps at the
  outset have stated his opinion somewhat too decidedly; but no
  one qualified to judge can doubt that from the very beginning he
  was possessed of the gauge by which to measure the virtues of
  Vaccination.[217]

Whether he did make use of the word “infallible” is of slight
importance. There are various modes in which the same meaning may
be conveyed, and Jenner’s was unequivocal. It was in 1801 that
appealing to the rigid scrutiny that had taken place in the first
professional circles of Europe, he deliberately proclaimed it as
certain--

  That the human frame, when once it has felt the influence of
  the genuine Cowpox in the way that has been described, is never
  afterwards, at any period of its existence, assailable by the
  Smallpox.[218]

When Lord Ellenborough in 1813 described vaccination as affording
no more than a temporary security from smallpox, he merely
expressed the diminished confidence of the community in the
practice; but it is the habit of adventurers to ascribe adverse
manifestations of public feeling to petty causes; and thus Jenner
held that the Chief Justice was indulging a personal grudge when he
threw doubt on the perpetual efficacy of his prescription. On one
occasion, so ran the story, Ellenborough was relating in a company
at St. James’s how Jenner had so little faith in cowpox that he
had used smallpox to inoculate his own child, when he was suddenly
confronted by an irate personage, who exclaimed, “I am Dr. Jenner,
and what you have stated is not true!” whereupon Ellenborough slunk
aside in confusion. The fact of the rencontre in the sensational
form, we may credit as we please; but about the variolation of
Jenner’s child there is no doubt whatever. We have the circumstance
recorded by himself with such explanation as he considered adequate.

Turning to the _Inquiry_, we find under Case XXII. that Robert F.
Jenner, aged eleven months, was vaccinated on 12th April, 1798,
and that he did not receive the infection. The operation was not
repeated, and he remained unvaccinated. Some time afterwards,
whilst Jenner was residing at Cheltenham, Mr. Cother, a surgeon,
happened to drop in, and having taken the child in his arms,
mentioned in the course of conversation, that he had just left a
family suffering from smallpox. “Sir,” cried Jenner, “you know not
what you are doing! That child is not protected.” What was to be
done? “There was no doubt on my mind,” says Jenner, “that the boy
was infected;” and having none of the precious horsegrease cowpox
in his possession, he held that he was without alternative, and by
Mr. Cother the lad was immediately inoculated with smallpox.

The fact in due course got abroad, and, as Baron relates, was made
the most of by the opponents of vaccination--

  One observed, “Dr. Jenner may say what he likes about
  Vaccination, but we know for certain that he has inoculated his
  own son with Smallpox.” Another repeated this statement with the
  addition, that he had done so because he mistrusted Vaccination.
  A third added another tint to deepen the colouring, affirming
  that he knew that Dr. Jenner had abandoned his confidence in
  Vaccination, and the proof is incontestable, as he has inoculated
  his own child with Smallpox. These stories passed from mouth to
  mouth, and afterwards appeared in print with every malignant
  interpretation.[219]

Such talk was very natural, nor was it without justification.
Jenner ought to have proved his sincerity by the vaccination of
his son; and he who denounced variolation and variolators with
such bitterness might have accepted the risk of infection from
Mr. Cother rather than have compromised himself so injuriously.
Moreover (as was asked at the time) if the child was infected, what
was the use of inoculation? Variolation and vaccination (it was
argued) may be serviceable in keeping off smallpox, but are of no
avail after infection.

Vaccination has been described as a remarkable survival of
superstition in hygiene--many, who disowning all other dodges for
the maintenance of health, holding by it. Of course Jenner knew
nothing of hygiene in the scientific sense--it was revealed after
his time; but it is noteworthy that in none of his publications
or letters is there any anticipation of the truth that has proved
so fruitful in our experience, namely, that ill-health indicates
ill-living, and that the misery of disease is only remediable in
so far as we come out of the conditions of disease. Whilst of
such truth he knew nothing, he might have known something. It lay
plainly before him that smallpox was an affliction of the poor,
and of the prosperous in so far as they shared the conditions of
the poor, but he never recognised the fact. On the contrary, he
cherished the fantasy that various diseases were derived from
association with animals; and that thus smallpox originated in
cowpox, which in turn came from horsegrease. “There,” said he
to his nephew, pointing to a horse with greasy heels, “there is
the source of smallpox.”[220] To entertain such an opinion was
to be stone-blind to the true causes of disease, and therefore
we have no reason for surprise that the Jenner household lived
in chronic ill-health, piously submissive to what they supposed
the divine will. Typhus fever was recurrent in the household
without a suspicion that anything was amiss on the human side.
There was a genius named Dawes Worgan, whom Jenner received into
his family as tutor to his son, but ere a year had elapsed the
poor fellow had two attacks of typhus, and finally succumbed to
pulmonary consumption in 1809, in his nineteenth year. Chantry
Cottage, Jenner’s residence at Berkeley, was no temple of Hygeia:
on the contrary, such a place at this day would be a terror to a
respectable neighbourhood, and subject to the attention of the
sanitary inspector.

The principle of vaccination conceded--that health may be purchased
by disease, it was not surprising that it was thought that measles
and scarlet fever could be extirpated by similar treatment. Sir
Humphry Davy suggested that hydrophobia might be anticipated by the
inoculation of another animal virus, but Jenner held that cowpox
should be tried--“nothing like leather.” It was reported from
Constantinople that the plague itself was stayed by vaccination,
and that experiments, exactly like those used to demonstrate its
power against smallpox, had been repeated with complete success.
There was not, however, enterprise in the East for the development
of the quackery.

Jenner taught that distemper in dogs was preventible by
vaccination, and accumulated a variety of “first-rate evidence”
in proof. It was no transitory whim. He vaccinated twenty of the
King’s staghounds in 1801, and in 1809 contributed a paper to the
Medico-Chirurgical Society on the subject, wherein he expressed
the opinion that the disease had only existed in England for the
past half century. Several great fox hunters had their hounds
vaccinated, and the results were pronounced satisfactory.[221]
Why, then, was the practice not continued? Why is not distemper
exterminated? May we not say the reason is plain? The first-rate
evidence was illusory. Men are apt to create the facts they wish
for, but as desire subsides, they recover their normal eyesight.
Cowpox, we are persuaded, was as good against distemper in dogs as
against smallpox in human beings, and but for extraneous causes, it
would have been abandoned for the one as for the other.

For Jenner it has to be said, that if deceived, he had much to
excuse his self-deception. There are men possessed of convictions
which they maintain in the face of an indifferent or antagonistic
world, but Jenner was not such a man. If his _Inquiry_ had gone
the way of waste-paper, he would have offered no resistance; but
instead, it was proclaimed by Pearson as worthy of universal
attention, and the hour being propitious, the middle-aged country
doctor suddenly found himself treated as the deliverer of mankind
from smallpox, whilst Pearson, his promoter, was swept aside as
a half-hearted worshipper of the new divinity. Adulation was
administered without measure, and if Jenner took it for true, and
was led to imagine that he had more in him than he ever imagined,
what marvel! He became the centre of a European craze of a
character and intensity that is perhaps without parallel. Emperors
and kings, statesmen and philanthropists, men of science, and
in short the whole educated world conspired to do him reverence.
The craze gradually abated, and the abatement was most decided
in the country of its origin, and chiefly in London where cowpox
and its advertiser were most closely scrutinised. Jenner abhorred
London. There he had proposed to flourish as a West-End physician,
and there he had encountered a dismal failure. There, too, his
antagonists were active, and their demonstration of the futility
of his assertions most conclusive. We see his temper toward London
in such a passage as the following from a letter to Dunning, dated
Cheltenham, 21st February, 1806--

  What havoc the Anti-Vaccinists have made in town by the
  re-introduction of Variolous Inoculation! It is computed that
  not less than 6000 persons in the metropolis, and the adjacent
  villages, have fallen victims to the Smallpox since April last.
  One would scarcely conceive it possible, but these murders are,
  for the most part, to be attributed to the absurd productions of
  Moseley, Rowley, and that pert little Squirrel, to say nothing
  of Goldson. It is about London that the venom of these deadly
  serpents chiefly flows.[222]

Whilst the doors of almost every scientific corporation in the
world were thrown open to receive him, the Royal College of
Physicians of London maintained an honourable reserve; and when
in 1814 his claim to admission was strongly urged, the majority
insisted that, if received, he should submit to the usual
examination--a sufficient check in Jenner’s case.[223] The College
has been reproached for its treatment of “the immortal benefactor
of the human race,” but it is forgotten how intimately the leading
members were acquainted with his immortality, and with what
disgust they must have received his confession in 1807 as to the
non-existence of spurious cowpox.

Toward the close of his life, Jenner rarely appeared in London.
His last visit took place in 1814, when he was presented to the
Emperor of Russia. “I am happy to think,” said Alexander, “that
you have received the thanks, the applause, and the gratitude of
the world;” to which Jenner made answer, “I have received the
thanks and the applause, but _not_ the gratitude of the world”--the
absent gratitude being a periphrase for absent cash, and a hint
to the Czar that he might repeat the superb munificence of his
grandmother, Catharine, to her inoculator Dimsdale. The Emperor,
however, gave nothing, and Jenner retired keenly disappointed.
Whatever the imperial disposition, Jenner did little to render it
more propitious by using his audience to denounce Walker and the
Friends by whom vaccination was at that time chiefly promoted; for
as Alexander said, “I love the good Quakers: they are my friends,
indeed;” and whoever slandered them was not likely to advance in
his favour.

With all he got Jenner reckoned himself ill-paid; and taking
the words of his admirers for sincere, he was ill-paid. Many a
successful slayer of his kind had much more from the House of
Commons with less fuss than their ideal preserver; but there is
often a measure of sincerity within insincerity, and many of those
who praised Jenner most rapturously felt that he had not been dealt
with illiberally as the advertiser of cowpox.

Jenner’s wife died in 1815, an ailing, pious, affectionate woman,
and thenceforth he dwelt in retirement until his death on the
26th of January, 1823, at the age of seventy-four. “Never,” he
wrote to his friend Gardner on 13th January, a week before his
demise, “Never was I involved in so many perplexities.” Hailed with
acclamation in 1800-2 as the saviour of mankind from smallpox,
during the remaining twenty years of his life he underwent a
steady course of discredit as failure after failure was recorded
and attested against vaccination. Appropriate therefore was
his farewell to the world in 1823, “Never was I involved in so
many perplexities.” There was not enthusiasm left to effect the
interment of his remains in Westminster Abbey, and the funeral
took place at Berkeley. An attempt was made to obtain a grant from
Parliament for a monument, but the proposal fell flat. Baron then
set on foot a subscription for the purpose, but it met with little
encouragement. The only public bodies which contributed anything
were the Edinburgh Colleges of Physicians and Surgeons, the first
sending £50 and the second £10. With much difficulty sufficient
was scraped together to order a statue from Sievier, which was
set up at the west end of the nave of Gloucester Cathedral. The
front panel of the pedestal originally bore the dates of birth and
death, but Baron had them removed, considering the word JENNER all
significant.

In latter times, in 1859, a statue was erected to his memory in
Trafalgar Square, London, close by the College of Physicians, but
it was felt to have an air of possible quackery about it, and by
and bye was quietly removed to a corner in Kensington Gardens.
There is, as I have remarked, a measure of sincerity even in
insincerity; and it is impossible for any one with a lively sense
of veracity to _know_ Edward Jenner and entertain for him any
respect.


FOOTNOTES:

[205] Vol. ii. p. 136.

[206] Vol. ii. p. 24.

[207] _Ibid._ p. 47.

[208] Vol. ii. p. 148.

[209] Vol. ii. p. 110.

[210] Vol. i. p. 450.

[211] Vol. ii. p. 18.

[212] Vol. ii. p. 197.

[213] Vol. ii. p. 311

[214] Vol. ii. p. 15.

[215] Vol. ii. p. 135.

[216] Vol. ii. p. 135.

[217] Vol. ii. p. 134

[218] _Continuation of Facts and Observations_, p. 181.

[219] Vol. ii. pp. 43-49 and 198.

[220] Vol. i. p. 135.

[221] Vol. i. pp. 444, 450; Vol. ii. p. 148.

[222] Vol. ii. p. 352. The London Bills of Mortality record 1685
deaths in 1805 and 1158 in 1806 from Smallpox--numbers in no
respect extraordinary.

[223] Vol. ii. p. 191.




CHAPTER XXVII.

THE MEDICAL POSITION IN 1823.


When Jenner died in 1823, the judgment of the majority of the
people was pronounced against cowpox inoculation; but medical men,
who are expected to _know_ something, and _do_ something, against
every ailment, rarely surrender a prescription until it can be
replaced by another. The doctors therefore held by vaccination, but
on modified terms; and the position to which they had been reduced
is set forth in an article in the _Edinburgh Review_, for November,
1822, concerning which Jenner wrote to Gardner, 13th January, 1823,
a week before his death--

  I have an attack from a quarter I did not expect, the _Edinburgh
  Review_. These people understand literature better than physic.
  It will do incalculable mischief. I put it down at 100,000 deaths
  at least. Never was I involved in so many perplexities.

What an extraordinary article! working mischief incalculable,
and bad for at least one hundred thousand deaths! A criticism in
the _Quarterly_ is said to have killed Keats, upon which Byron
remarked--

      ’Twas strange the mind, that very fiery particle,
      Should let itself be snuffed out by an article.

If, however, Jenner was right, it will be allowed, I think, that
the murder of a poet was exceeded in atrocity by the slaughter
of at least one hundred thousand ordinary mortals. Wherefore,
to discover the manner of the great iniquity, I looked up the
_Edinburgh Review_ and discovered the diabolical article. It is
entitled “Vaccination and Smallpox”; is obviously written by the
editor, Jeffrey; and the rock of offence was at once apparent.
Doubt is thrown on the efficacy of vaccination to prevent smallpox;
_ergo_, vaccination thus discredited will be neglected; _ergo_,
vaccination thus neglected will enlarge the domain of smallpox;
_ergo_, at least one hundred thousand persons will perish. Q.E.D.
But it will be asked, “What did Jeffrey say?” The article thus
opens--

  Vaccination, we are perfectly persuaded, is a very great blessing
  to mankind; but not quite so great a blessing, nor so complete
  a protection, as its early defenders conceived it to be. The
  proof of this has been admitted with great reluctance; but it
  has unfortunately become too strong for denial or resistance.
  The first answers given to the instances of failure, with which
  the friends of Vaccination were pressed, were, either that the
  disease which had occurred after Vaccination was Chickenpox,
  and not Smallpox; or that the process of Vaccination had been
  unskilfully or imperfectly conducted; or that it was one of those
  very rare cases which occurred in the times of Inoculation, and
  from which Vaccination itself did not pretend to be wholly exempt.

The Report of the Vaccine Pock Institution for 1803 is cited, as
follows, to show how absolute was the confidence in vaccination in
the days of inexperience--

  We have been alarmed two or three times with intelligence of
  Smallpox occurring several weeks or months after our patients
  had undergone the Cowpox. We thought it our duty to visit and
  examine these patients, and also to inquire into their history
  among their attendants, and by these means we obtained the
  completest satisfaction that the pretended Smallpox was generally
  the Chickenpox.

As time went on, cases of smallpox after vaccination kept
multiplying, and the various excuses to account for their
occurrence, though obstinately asserted, utterly broke down. There
remained no doubt whatever that to be vaccinated in the most
approved fashion afforded no guarantee against smallpox. In 1820,
said Jeffrey, the Board of the National Vaccine Establishment was
compelled to make the following melancholy admission--

  It is true that we have received accounts from different parts
  of the country of numerous cases of Smallpox having occurred
  after Vaccination; and we cannot doubt that the prejudices of
  the people against this preventive expedient are assignable (and
  not altogether unreasonably perhaps) to this cause. These cases
  the Board has been industriously employed in investigating;
  and though it appears that many of them rest only on hearsay
  evidence, and that others seem to have undergone the Vaccine
  Process imperfectly some years since when it was less well
  understood, and practised less skilfully than it ought to be;
  yet, after every reasonable deduction, we are compelled to allow
  that too many still remain on undeniable proof, to leave any
  doubt that the pretensions of Vaccination to the merit of a
  perfect and exclusive security in all cases against Smallpox,
  were admitted at first too unreservedly.

The significance of a confession like the foregoing is not to be
estimated literally. It was exacted under irresistible pressure of
facts, numerous, definite and undeniable, after every method of
excuse and prevarication had been exhausted. In short, it was an
authoritative retractation of the flaming medical testimony with
which vaccination had been commended to the public in 1800, when
the heads of the profession thought it their duty to declare in the
newspapers--

  That those persons who have had the Cowpox are perfectly secure
  from the future infection of the Smallpox.

And of Jenner’s emphatic assurance--

  That the human frame, when once it has felt the influence of
  the genuine Cowpox is never afterwards, at any period of its
  existence, assailable by the Smallpox.

The occasion of Jeffrey’s article was the publication by Dr. John
Thomson of a treatise on a violent epidemic in Edinburgh, and other
parts of Scotland, in 1818-19.[224] The disease differed from
ordinary smallpox in respect of the smallness of the pustules,
which contained a milky fluid, and began to dry up on the fourth or
fifth day. In Thomson’s words--

  The epidemic appeared to exhibit all the varieties of Smallpox
  from the mildest to the most malignant; and it was curious to
  observe that the mildest forms, as well as the most malignant,
  were strictly vesicular eruptions, in which scarcely a trace of
  purulent matter was to be seen from their commencement to their
  termination.

Whether this epidemic was smallpox or chickenpox, was the question.
It was chickenpox said some. It was modified smallpox said others.
It probably was chickenpox said Thomson; and if so, he argued,
chickenpox should be accounted a variety of smallpox. The chief
cause of uncertainty was, that the vaccinated constituted the
majority of sufferers--

  Had the unvaccinated alone been attacked [wrote Thomson],
  nothing, it appears to me, but the most unreasonable scepticism
  could ever have suggested a doubt of the disease being genuine
  Smallpox.

Thomson reported 556 cases in Edinburgh of which--

    310 had been Vaccinated;
     41 had had Smallpox; and
    205 had neither been Vaccinated nor had Smallpox.

And William Gibson, surgeon at Robert Owen’s mills, New Lanark, had
322 cases, of which--

    251 had been Vaccinated.
     11 had had Smallpox, spontaneous or inoculated.
     57 had neither been Vaccinated nor had Smallpox.
      3 had had Smallpox and Cowpox simultaneously.

As is usual in epidemics of smallpox, it was the young who were the
majority of sufferers; Thomson saying--

  The epidemic has been observed to attack those chiefly who were
  under ten years of age; _increasing years appearing in general to
  lessen the susceptibility to Smallpox contagion_.

Thomson supported his opinion that chickenpox and smallpox were
interchangeable varieties of variola with much cogent evidence
and argument. He cited instances in which they occurred together,
one constitution bringing forth chickenpox where another brought
forth smallpox, whilst the infection of one appeared at times in
the manifestation of the other. The controversy is not one on
which it is necessary to pronounce judgment beyond saying that the
whole drift of philosophic pathology is now in Thomson’s favour;
and indeed at the time he wrote, his position would not have been
seriously contested, save for the discredit it accumulated upon
vaccination. One of Thomson’s correspondents, P. Mudie, M.D., of
St. Andrews, stated the difficulty with artless force. He wrote,
18th October, 1818--

  Of late years I have remarked, that the disease called Chickenpox
  has been much more severe than formerly; and many of the cases
  occurring after Vaccination, so much resembled Smallpox, that _if
  my mind had not been prejudiced against the possibility of such
  an occurrence_, I should have pronounced the eruption to have
  been of a variolous nature.

Notwithstanding his experience, Thomson held firmly by vaccination.
Whilst compelled to admit that it did not avert either form of
variola, he maintained with curious fervour that it made the
disease milder, as if to excuse his partial surrender of faith. We
all see more or less according to our prepossessions, and we need
not blame Thomson if with his perspicacity he was unequal to the
entire truth. The vaccinated belonged to classes who were better
housed, better fed, and better cared for than the unvaccinated;
and if their ailment had been measles or pneumonia in place of
chickenpox, they would have all the same made better recoveries.
Precisely the same error is made at this day: what is due to
kindlier conditions of life is ascribed to vaccination.

Some tried to account for the manifest failure of vaccination on
the supposition that the original virus had lost its force in
transmission from arm to arm, but Thomson would not allow that it
had deteriorated. He said--

  The Vaccine Virus used in Edinburgh for a series of eighteen
  years produces exactly the same appearances as are delineated
  by Dr. Jenner as characteristic of Cowpox. I know, also, that
  the appearances of the vaccine vesicle produced by this matter,
  which must have passed through a succession of at least 900
  individuals, agree exactly with those exhibited by vesicles
  produced by inoculation, _with the more recent equine matter with
  which I have been, lately favoured by Dr. Jenner_.

The latter words are noteworthy. When Jenner’s ascription of
the origin of Cowpox in Horsegrease is referred to, the answer
frequently is, that Jenner was mistaken, and that he did not
persist in his opinion. It is true that he did preserve a judicious
silence about horsegrease when he saw that it would mar rather than
make his fortune. But when he obtained all he was likely to get,
he resumed the expression of his original opinion, and used and
diffused what he described as horsegrease; and the vesicles raised
by the virus, and the cicatrices which remained were identical with
those induced by so-called Cowpox.

Another point developed in Thomson’s evidence was the mistake made
crediting vaccination with the prevention of smallpox where there
was no smallpox to prevent. The victories ascribed to vaccination
were victories either over an imaginary or a retreating enemy.
We cannot too firmly insist upon this point in presence of the
claim continually advanced for the subjugation of smallpox by
vaccination. For some cause undefined, and, probably in its full
extent, undiscoverable, a subsidence of smallpox over the whole
of Europe set in toward the close of last century, and continued
during the early years of the present; and to this subsidence the
favour that vaccination met with was largely due. The decline in
the disease concurrently with the introduction of vaccination,
was ascribed to vaccination, although the decline prevailed among
an overwhelming majority who had never received vaccination. To
make good the claim for vaccination it would have been necessary
to maintain that the vaccine rite, as applied to 2 or 3 per cent.
of Europeans, effected the salvation of 98 or 97 per cent. For
example, a great point was made by Jenner and his friends of the
extinction of smallpox in Vienna, according to the following table--

                          TOTAL     FROM
        YEARS.           DEATHS.  SMALLPOX.
    1791-1800   average  14,600     835      or one in     17½
         1801            15,181     164                    93
         1802            14,522      61                   238
         1803            14,383      27                   582
         1804            14,035       2                 7,017

Yet it was never pretended that in these years more than a fraction
of the Viennese were vaccinated, or that the death-rate of the city
was reduced by the disappearance of smallpox. The like fatuity
characterised the whole of the vaccinators’ statistics. Smallpox
had declined, _therefore_, they argued, vaccination is the cause of
the decline, and multitudes were convinced by the illicit logic.
When vaccination was, however, brought to the test of epidemic
smallpox, its inefficacy became manifest, and thus Thomson had to
avow, as the result of his experience in the Edinburgh epidemic of
1818-19--

  It is to the severity of this epidemic, I am convinced, that we
  ought to attribute the greatness of the number of the vaccinated
  who have been attacked by it, and not to any deterioration in the
  qualities of the Cowpox Virus, or to any defects in the manner in
  which it has been employed. _Had a variolous constitution of the
  atmosphere_, similar to that which we have lately experienced,
  _existed at the time Dr. Jenner brought forward his discovery, it
  may be doubted whether it ever could have obtained the confidence
  of the public_.

Such was the article which Jenner “put down for 100,000 deaths at
least.” Yet neither Jeffrey nor Thomson renounced vaccination.
They agreed that whilst it could no longer be trusted to prevent
smallpox, it made the disease milder in those it attacked. When a
cherished belief is surrendered, it is rarely unconditionally: it
is only by degrees that full concession is made unto truth.


FOOTNOTE:

[224] _An Account of the Varioloid Epidemic which has lately
prevailed in Edinburgh and other Parts of Scotland; with
Observations on the Identity of Chickenpox with Modified Smallpox._
By John Thomson, M.D. London, 1820. Pp. 400.




CHAPTER XXVIII.

INTRODUCTION OF VACCINATION TO THE UNITED STATES.


Leaving England for awhile, let us see how it fared with
vaccination in some other countries.

As before observed, the introduction of vaccination to practice
is sometimes described, as having been a labour of difficulty, a
strife with prejudice, a victory of light over darkness; but there
was nothing in reality answering to such magniloquence. The battle
was won for vaccination by variolation, for which it was exhibited
as a harmless and more efficient substitute. Unless the entrance
of vaccination into the place of variolation be recognised, its
quick and easy triumph is inexplicable. A novelty that King George
and Queen Charlotte, the Prince of Wales, and the Royal Dukes
accepted without hesitation or reserve, could not in the nature of
things have required the exercise of much intelligence. Any serious
resistance proceeded from the variolators, who considered their
craft in danger when parsons, women, and tradesmen were approved of
as vaccinators by Jenner himself. Such opposition to vaccination as
is common at this day was not possible in the early years of the
present century. We know that health is the best defence of health,
and that illness is proof of ill-living; but, to our forefathers,
illness was a mysterious dispensation to be encountered with
submission, relieved by prescriptions, magical and natural. Hence
not only dull Royalty was involved in the cowpox craze, but men
of science like Davy, Wollaston, and Darwin, with the whole troop
of men of letters, of whom Sir Walter Scott may be taken for
spokesman. Describing Queen Caroline in “The Heart of Midlothian,”
he says--

  The lady had remarkably good features, though somewhat injured by
  Smallpox, that venomous scourge, which each village Æsculapius
  (thanks to Jenner) can now tame as easily as his tutelary deity
  tamed the Python.

For credulity thus expressed there was large excuse. What else,
indeed, could one in Scott’s position have been expected to
believe? It was only through the hard disenchantment of experience
that vaccination did not prevent smallpox, nor mitigate its
severity, nor was in itself harmless, that the early delirium
abated, and a less rabid persuasion supervened.

The wave of conviction spread from England over the world, and
nowhere was the substitution of vaccination for variolation
welcomed more enthusiastically than in New England. As Boston led
the way in 1721 in the practice of smallpox inoculation, so from
Boston in 1800 was announced the project for the extermination of
smallpox by cowpox. But ere advancing farther, it may be well to
say a word about Boston smallpox.

Boston was an extremely unhealthy town. For fifty years, from 1701
to 1750, the births were exceeded by the deaths. In a population
of about 15,000, the annual death rate ranged from 30 to 70 per
thousand. There were epidemics of fever and of smallpox; the latter
occurring in general at intervals of ten years, when large numbers
died, the smallpox as usual displacing other forms of fever, but
nevertheless raising the mortality of the year. The most deadly
outbreak of smallpox was that of 1721, the year in which Cotton
Mather and Zabdiel Boylston introduced variolation. The mortality
of that year was 1102, of which 884 were ascribed to smallpox.
In 1752 there was an extraordinary epidemic, but how much of its
prevalence was due to circumstance and how much to contrivance,
it is impossible to divine. Here are the figures, which are of
singular interest--

    BOSTON in 1752. Population 15,684.

                                               Died in
                Had     Died.     Were      consequence of
             Smallpox.         Variolated.   Variolation.
    Whites,    5060      470      1985            24
    Blacks,     485       69       139             6
               ----      ---      ----            --
    Total,     5545      539      2124            30

    Fled from    Had neither      Had Smallpox
    Boston for   Smallpox by       either by
      safety.   nature or art.   nature or art.
       1843          174              5998

Under these heads the entire population of 15,684 was accounted
for, with the important exception of the discrimination of the
5998, whose immunity was presupposed, into subjects of induced and
spontaneous smallpox. The deaths, 569, were less numerous than in
1721, when 884 died, but the disease was more widely diffused,
upwards of one-third of the inhabitants, 5545, being attacked. The
epidemic exhausted itself within four months, the record standing
thus--

    January,  died,    1
    February,  ”       2
    March,     ”       2
    April,     ”     119
    May,       ”     205
    June,     died,  203
    July,      ”      31
    August,    ”       5
    September, ”       1
                     ---
                     569

The diffusion of the epidemic was largely due to the extensive
variolation that went on, no fewer than 2124 having been inoculated
in the panic, and they moving freely about in the assurance of
safety, spread the distemper on every side. For every five who
had the smallpox, so to say, naturally, two had it artificially,
and the one sort was almost as “catching” as the other. It was
an instance of a community (excepting the 1843 who fled) rushing
into smallpox to escape from smallpox. The deaths of 24 Whites and
6 Blacks from variolation gave rise to much concern, and by some
they were spoken of as so many murders. Against this fatality was,
however, set the low death rate of the regular sufferers, 539 out
of 5545, or less than 1 in 10. The Rev. T. Prince, who communicated
an account of the epidemic to the _Gentleman’s Magazine_ for 1753,
p. 413, was puzzled to account for the variation from the London
standard--

  Dr. Jurin computes that there generally die in London in the
  natural way 2 in 11 or 18 in the 100; but in Boston we see that
  not more than 1 in 10 died; whilst in the inoculated way the
  deaths were more numerous than is commonly allowed. What were the
  natural causes, under their Divine Director, of Smallpox in the
  natural way being less mortal in Boston than in London, and more
  mortal in Boston than in London in the inoculated way, may be
  worthy of our humble inquiries.

The difference was broader than Prince perceived. An outbreak of
smallpox in which a third of the population was affected never
occurred in London, and a mortality proportionate with that of
Boston among a third of the Londoners would have appeared like a
recurrence of the Plague. I am in nowise concerned to minimise the
ravages of smallpox when conditions are prepared, as of design,
for its development; but I do insist on their accurate definition.
Boston suffered severely, but was by no means “decimated”--the
invariable rhetorical phrase. The deaths were at the rate of 1
in 27, and, as observed, smallpox replaced other forms of fever.
The 539 deaths from smallpox were not extra deaths; the excess
was less than half that number, and might fairly be attributed to
the extraordinary energy displayed in propagating the disease by
inoculation.

Spite of such adverse experience, variolation continued to be a
common, though intermittent, practice in America, and especially in
New England, where the habit of doctoring for the cure of present
ailments, and the prevention of anticipated ones, was established
and inveterate. In Boston the practice became systematised, and the
inoculated were confined for three weeks to an hospital situated
on a promontory in the Charles River, where they were treated as
veritable centres of infection--a course widely different from that
pursued in the epidemic of 1752. Nevertheless, it is not to be
supposed that smallpox was ever endemic in New England as it was
in London. Dr. Waterhouse writing in 1787 observed--

  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.

The disease broke out now and then, and was always traced to some
wayfarer, or ship, or parcel of goods--never to bad drainage, or
no drainage, or the stenches that pervaded the domestic interiors
of last century, whether in America or Europe. In this matter,
the exercise of a little imagination is requisite to realise the
historic facts: they are disagreeable; but if people will insist
on comparing the smallpox of the 18th century with that of the
19th, it may become necessary to be explicit as to certain domestic
details concerning which there is a conventional reserve.

It was by Dr. Benjamin Waterhouse, Professor of the Theory and
Practice of Physic in the University of Cambridge, Massachusetts,
that vaccination was introduced to America. He described the new
rite in the _Columbian Centinel_ of 12th March, 1799, as “Something
Curious in the Medical Line”; and formally promulgated the novelty
a year afterwards in a pamphlet thus entitled--

  _A Prospect of Exterminating the Smallpox; being the History of
  the Variolæ Vaccinæ, or Kine-Pox, commonly called the Cowpox,
  as it has appeared in England: with an Account of a Series of
  Inoculations performed for the Kine-Pox in Massachusetts._
  Printed for the Author at the Cambridge Press by William Hilliard
  and sold by him and other Booksellers in Boston. 1800.

Kine-Pox! Why Kine-Pox? The reason is stated by the Doctor--

  From kine the plural of cow; thus in the Scriptures, “And they
  took two milch-kine, and shut up their calves at home”; a word
  equally expressive, and, in the opinion of some, more delicate.

There we have it: _More delicate_! If it had been bull-pox the
objection might have been insuperable. Writing to Jenner, 24th
April, 1801, Waterhouse says--

  _Could you believe that not a single inoculation with Cowpox has
  yet been effected in Philadelphia? It seems that the leading_
  physician there pronounces it too beastly and indelicate for
  polished society.[225]

The pamphlet on Kine-Pox set forth the mystery of the new
inoculation as received from England with a significant
omission--there was not a word in it about Horsegrease! Waterhouse
was in correspondence with Pearson, and Pearson may have told him
how not only the asserted generation of Cowpox in Horsegrease
was discredited, but “how it was like to damn the whole thing”;
which might have been true enough, but if true, Where then stood
Jenner? He knew that cowpox did not prevent smallpox: the fact was
notorious among the medical men in cowpox districts: and he had
expressly pledged his faith in the _Inquiry_ to Cowpox begotten
from Horsegrease and to nothing else. But Horsegrease Cowpox did
not suit the market, and it was withdrawn with Jenner’s tacit
assent, and spontaneous Cowpox advanced in its stead, and accepted
as Jenner’s veritable discovery. It might be good business to drop
the horse out of the case, but what was it else?

Cowpox, testified Waterhouse, was unknown in New England, but he
received the revelation concerning it at once--but _not_, be it
repeated, Jenner’s revelation: _that_ he suppressed. He had long
suspected that smallpox was communicated from brutes to the human
race; and now his suspicion was confirmed. And, such being the
origin of variola, it seemed to him not unreasonable that the
disease as it existed in a mild form in kine might be used for
inoculation with all the advantages pertaining to smallpox, whilst
attended with neither injury to the inoculated, nor with risk of
infection to those about them--

  What makes this newly discovered disease so very curious, and so
  extremely important is, that every person thus affected, is ever
  after secured from the ordinary Smallpox, let him be ever so much
  exposed to the effect of it, or let ever so much ripe Smallpox
  matter be inserted into the skin by inoculation. In other words,
  a person who has undergone the local disease and specific fever
  occasioned by the Cowpox Infection is thereby rendered ever after
  insusceptible of the Smallpox.

How incautious, to say the least, was the acceptance of this
prophecy of perpetual security! With less than three years’
experience an absolute prediction was delivered, received, and
repeated over the whole earth as if by parrots. Such, however, is
the habit of mankind when possessed by a strong delusion.

In justice to Waterhouse it has to be said that he did not commit
himself openly until he had gone through the illusory experiments
that were then fashionable in England. He had much difficulty in
obtaining a supply of active virus. Several remittances failed, but
at last he had one, an inch and a-half of infected thread, from
Dr. Haygarth which proved, it was thought, effective.[226] His
first patient was his son, Daniel Oliver, aged five; then another
child aged three; then a servant lad aged twelve; then a weaned
infant of one year--all five successful, whilst two domestics
failed “to take”--seven experiments in his own household. Then he
had the children taken to the Smallpox Hospital, where they were
inoculated by Dr. Aspinwall, and issuing scatheless from the test,
the truth was taken as demonstrated, and there was no need for
further hesitation. Four gentlemen, including a physician, offered
themselves for public encouragement--

  One of them [says Waterhouse] chose to live pretty freely by way
  of experiment, and the febrile symptoms, especially headache,
  were full as much as he could bear and walk about with. This
  convinced me that the Kine-Pox was a disease not to be trifled
  with.

Waterhouse then appealed to the pride of his countrymen--

  The people of New England, particularly of Boston, set a noble
  example to their elder brethren of Old England, in adopting the
  Turkish practice of Inoculation for the Smallpox in 1721. Now
  the English in their turn, lead the way in a practice still more
  salutiferous. For though the Inoculation which commenced here in
  1721, stripped that horrid disease, the Smallpox, of more than
  half its terrors, yet it is the Kine-Pox that will effect its
  extermination.

Following this prophecy came a frank request for business--

  Dr. Waterhouse informs those who have applied to him out of
  Cambridge to inoculate their families that he declined it only
  until the disorder had gone fairly through his own family, and
  until some of them had been inoculated by Dr. Aspinwall, and
  otherwise exposed to Smallpox. But having now confirmed his
  assertion, that the Kine-Pox protects the constitution from the
  infection of Smallpox by a fair experiment, he is ready to attend
  them whenever they choose. Those who live in Boston may rest
  assured that from the proximity of his residence to the capital,
  he shall make such arrangements as to be able to attend them as
  punctually as if he resided there.--CAMBRIDGE, 18th _August_,
  1800.

After an English pattern he published the following table--

    NATURAL SMALLPOX.   | INOCULATED SMALLPOX.  |     KINE-POCK.
  A Contagious Disease. |    Contagious.        |  Non-Contagious.
                        |                       |    Never fatal.
  One in 6 who take     | One in 300 dies.      | It is like crossing
  it dies. It is like   | It is like crossing   | the stream on a new
  an attempt to cross   | the stream in an old, | and safe bridge.
  a dangerous stream    | leaky boat, where     |
  by swimming, where    | one in 300 perishes.  |
  one in six perishes.  |                       |

The operations, so hopefully begun, came speedily to grief. In a
letter addressed by Waterhouse to Jenner, 24th April, 1801, we
read--

  One inch and a-half of infected thread from Dr. Haygarth was
  the whole stock from whence perhaps 3000 persons have been
  inoculated, _but I fear the greatest part of them have been
  spurious_. I gave out that the winter was an unfavourable season
  for this new inoculation, and by that means I suspended the
  practice throughout the country until the arrival of fresh matter
  and your letter. Now we are going on again, but not with the
  faith and spirit of the last season. Some unlucky cases have
  damped the ardour of a people who received this new inoculation
  with a candour, liberality, and even generosity, much to their
  credit. The first political and literary characters in our nation
  are still warm advocates for the practice.[227]

Waterhouse continued to correspond with Jenner, and was regarded
as his accredited representative in New England. Writing to Dr.
Lettsom, 16th November, 1802, he says--

  Dr. Jenner has just sent me a present I highly prize--a silver
  box inlaid with gold of exquisite taste and workmanship, bearing
  this inscription--

      EDWARD JENNER to BENJAMIN WATERHOUSE.

  But Mr. Ring annexed the superscription in rather an hyperbolical
  style--

      From THE JENNER of THE OLD WORLD
      To THE JENNER of THE NEW WORLD.

  Long will it remain among the sacræ relictæ of my family.[228]

Waterhouse was a man of an ingenious turn of mind. When troubled
with ill-results from his operations at the end of 1800, he tried
what has since been called retro-vaccination, probably for the
first time. Here are his words from his letter to Jenner, 24th
April, 1801--

  I inoculated one of my cows with the Vaccine Virus, and obtained
  from her a crop of matter on the ninth day, which produced the
  disease in the human subject to perfection. Is this experiment
  known among you? As I operated myself there was no avenue opened
  for deception in the whole experiment.

A sentence which follows is too characteristic to be passed over.
Says Waterhouse--

  I have invariably found that weakly children have been benefited
  by the Vaccine Inoculation, and some it has cured of the Hooping
  Cough.

And this after less than twelve months’ experience!

Waterhouse had also to relate a case of cows having smallpox--

  At one of our periodical inoculations, which occur in New
  England once in eight or nine years,[229] several farmers drove
  their cows to an hospital near a populous village, that the
  patients might have the benefit of their milk. The cows were
  milked by persons in all stages of Smallpox; and in consequence
  they had an eruptive disorder on their teats and udders that
  every one in the hospital, as well as the physician who told me,
  declared was Smallpox. Since Cowpox has been talked of, this
  account has been revived and credited. Have you found anything
  like it in England?

Waterhouse had inquiries from Virginia, and wished Jenner to let
him have, if possible, a picture of the vaccine vesicle on the
negro--

  Could I procure two or three coloured plates, delineating the
  appearances on the skin of the negro, I would send them into such
  of our Southern States as are blackened by these degraded beings.

“Some in this country, as well as in England,” observed Waterhouse,
“having had all their objections to Kine-Pox obviated, persist in
asking, ‘Who can tell what may be the consequences in the lapse
of years of introducing a bestial humour into the human frame?’
I answer them as does Mr. Ring with a spirit and wit worthy of
Franklin, ‘Who can tell what may be the consequences in the lapse
of years of introducing milk, beef steaks, or mutton chops, into
the human frame?’”

The pertinacity with which this “wit” was employed by the early
vaccinators leads us to suppose that they found it effective; but
was ever argument by analogy more absurdly misapplied? Milk or
steaks from a cow, or chops from a sheep known to be suffering
from pox would be rejected with loathing; nor was it ever proposed
to cook and eat cowpox; and yet corruption, mere association with
which, would render milk, or steaks, or chops loathsome, it was not
thought abominable to infuse into the blood!

“The first political and literary characters in our nation are
warm advocates of the practice,” said Waterhouse; and it was so.
President Adams was quite of a mind with King George in that
respect; and Jefferson not only approved of the practice in common
with Queen Charlotte, but, as soon as he could obtain virus, set
to work with his sons-in-law, and vaccinated their families and
neighbours to the number of two hundred. There is a letter from
Jefferson to Jenner in 1806, which is remarkable as an absolute
confession of faith at a date when much had occurred to shake
faith. The President wrote--

    MONTICELLO, VIRGINIA, _14th May, 1806_.

  SIR,--I have received the copy of the evidence at large
  respecting the discovery of the Vaccine Inoculation, which you
  have been pleased to send me, and for which I return you my
  thanks. Having been among the early converts in this part of
  the globe to its efficacy, I took an early part in recommending
  it to my countrymen. I avail myself of this occasion to render
  to you my portion of the tribute of gratitude due to you from
  the whole human family. Medicine has never before produced
  any single improvement of such utility. Harvey’s discovery of
  the circulation of the blood was a beautiful addition to our
  knowledge of the animal economy; but on a review of the practice
  of medicine before and since that epoch, I do not see any great
  amelioration which has been derived from that discovery. You
  have erased from the calendar of human afflictions one of its
  greatest. Yours is the comfortable reflection that mankind can
  never forget that you have lived. Future nations will know by
  history only that the loathsome Smallpox has existed, and by you
  has been extirpated. Accept the most fervent wishes for your
  health and happiness, and assurances of the greatest respect and
  consideration.

    TH. JEFFERSON.

That smallpox should be erased from the calendar of human
afflictions, and be known only in history as extirpated by Jenner,
were vain expectations; but to recognise their vanity did not
lie within Jefferson’s possibilities. He had been bred in the
belief that inoculation with smallpox prevented smallpox, and it
came forth as a corollary, that as cowpox was an equivalent for
smallpox, if all were cowpoxed, the disease must be extirpated.
His expectations, therefore, were not without plausibility. Nor
was it possible for Jefferson in the light of his time to see that
smallpox was no specific entity that could be got rid of _per
se_ whilst all else remained unaffected. We know that if even
vaccination made an end of smallpox, and did no harm of itself,
we should reduce neither illness nor mortality (supposing no
other change in the conditions of existence were effected), but
should have our due allotment of disease in other forms. To attack
smallpox as smallpox, and suppose that if suppressed we should be
in anywise advantaged, is mere illusion. Zymotic diseases, to be
dealt with effectually, must be dealt with as forms of a common
malady; to get rid of one, we must get rid of all; and with a
graver sense of the difficulties to be encountered we, too, believe
with Jefferson, that smallpox may be extirpated, but in company
with much else, and by practice that has no affinity with the
creation of disease implied in vaccination.

Of all people the English are most abandoned to medical quackery,
said Lady Mary Wortley Montagu; and the English characteristic was
reproduced and exaggerated in New England. The first resistance to
vaccination being overcome, there was a run upon the practice--

  The zeal of American medical men [says Baron] was excited to
  an unparalleled degree; but, unfortunately, their discretion
  did not keep pace with it. They disregarded the cautions of Dr.
  Waterhouse, and paid no attention either to the state of the
  matter with which they inoculated, or to the progress of the
  pustule. It appears, likewise, that the cupidity of persons not
  of the medical profession was stimulated, and the manner in which
  they carried on their traffic was alike indicative of their
  avarice and their ignorance. The followers of this trade obtained
  the shirt-sleeves of patients which had been stiffened by the
  purulent discharge from an ulcer consequent on Vaccination.
  These they cut into strips, and sold about the country as
  impregnated with the true Vaccine Virus. Several hundred persons
  were actually inoculated with the poison, which, in several
  cases, produced great disturbance in the constitution. A vessel
  arrived from London at Marblehead with a sailor on board, who
  was supposed to have Cowpox: matter was taken from him, and was
  used extensively. It was soon discovered that Smallpox matter
  had been employed, and _that_ disease spread rapidly through
  the neighbourhood. These blunders, it is to be feared, were not
  confined to vagrant quacks, inasmuch as medical men were not
  quite blameless.[230]

Whilst such doings discredited vaccination in one way, they served
it in another: they made it easy to conceal its failures and
injuries by ascribing them to the use of spurious virus. Everything
is to be gained for truth in the question of vaccination by taking
it in what its believers allow to be its unexceptionable form, so
as to leave no room for evasion. Smallpox in America as in England
soon showed itself indifferent to the art of the vaccinator, and
then it was settled that at least it made the disease milder; and
under cover of the convenient fiction, it continued to be practised
where fees were to be had for the performance.

The attitude of the medical mind to epidemics, and the ignorance
of what we now regard as the first elements of sanitary science,
are illustrated with touching sincerity in a letter addressed by
Dr. Waterhouse, in 1817, to the surgeons of the United States army.
Said the Jenner of the New World--

  You need not waste your time, or distract your attention by
  guessing at the remote causes of dysenteries or epidemic fevers.
  We learn from the highest authority, that the pestilence “walketh
  in darkness.” The enemy approaches unseen. We are pretty well
  convinced that epidemic fevers depend not on any of those changes
  in the air that are pointed out by the thermometer, barometer, or
  hygrometer. These wide-spreading maladies, as well as endemics,
  or local disorders, seem as if they arose from some secret
  movements, or alterations in the earth, or on its surface--that
  is, on some new combinations in the soil, or some effluvium
  from a deeper situation, affecting not only the air we breathe,
  but the water which we use for everything. Epidemics seem to
  accompany or follow a blighted state of vegetation. They seem
  also to accompany an abundant harvest; but whether in the series
  of cause and effect is not fully known. As to myself, I’m weary
  of conjecture.

Well might he be weary! He does not say so, but neither does he
make any reserve in favour of vaccination; and, after seventeen
years’ trial of it, the old physician must have included it in his
cry of _Vanitas Vanitatum!_


FOOTNOTES:

[225] Baron’s _Life of Jenner_, vol. i. p. 442.

[226] “It was Dr. Lettsom who first sent the Vaccine Lymph across
the Atlantic, and consigned it to the fostering care of his friend
Dr. Waterhouse.”--Pettigrew’s _Life of Lettsom_, vol. i. p. 121.
“Dr. Waterhouse at length succeeded in getting some Cowpox matter
from Dr. Haygarth of Bath, who forwarded it from Bristol.”--Baron’s
_Life of Jenner_, vol. i. p. 386.

[227] Baron’s _Life of Jenner_, vol. i. p. 440.

[228] Pettigrew’s _Life of Lettsom_, vol. iii. p. 405.

[229] As Dimsdale advised, the inhabitants of a village or district
were inoculated with Smallpox simultaneously, so that all being
infected none should be unwillingly infected!

[230] Baron’s _Life of Jenner_, vol. i. p. 387.




CHAPTER XXIX.

INTRODUCTION OF VACCINATION TO INDIA AND THE EAST.


The enthusiasm for cowpox in England was reproduced with fury among
the English in India. It is always so. What is the fashion at home
is an intenser fashion abroad.

When we say India, we speak as of a country when we are dealing
with a continent--of not one but many peoples, of races numerous
and tongues various: wherefore, in naming India, I would be
understood as limiting my remarks to the portion designated, and
to the population affected by English influence. In several parts
of India smallpox is endemic--begotten in permanently unwholesome
conditions of life, and cultivated and propagated by inoculation.
When, therefore, it was heard that cowpox might be substituted for
smallpox, and that the mild served every purpose of the severe
disease, there arose a demand among the English for the virus,
alike for their own and for native use. Dr. Underwood, writing to
Jenner from Madras, 28th Feb., 1801, observed--

  I have read with very great pleasure your publications on Cowpox,
  and feel particularly anxious to introduce and extend it in this
  country, under the greatest confidence that it would save many
  lives. I have hitherto embraced every opportunity of inoculating
  with variolous matter, but the loss of a beautiful little patient
  has humbled me, and I confess I never now take up a lancet but
  with fear and trembling.[231]

It was easier to ask than to obtain. There was no cowpox to be
heard of in India, and the long voyage round the Cape, and the
tropical heat were fatal to its transmission. Repeated attempts
were made, but all ended in failure. Jenner proposed to place a
number of picked men on board an East Indiaman, and to have them
successively vaccinated in the course of the voyage, so as to
land with fresh virus in Bombay or Calcutta; but the East India
Company declined the proposal. An attempt was then made to raise
a subscription for the purpose, Jenner putting his name down for
1,000 guineas; though it was difficult to imagine where the 1,000
guineas were to come from, unless out of the pockets of some of his
admirers.[232]

These efforts were, however, superseded by the energy and ingenuity
of Dr. De Carro, of Vienna. Lord Elgin, British ambassador to the
Porte, had made acquaintance with De Carro, and had received virus
from him with which his infant son and others were vaccinated at
Constantinople. The news spreading abroad, Lord Elgin was entreated
to meet the Indian demand, sending the vaccine overland to Bombay
by way of Bagdad and Bussora. He made several futile attempts, and
thereon determined to place the matter in the hands of De Carro;
and for that purpose addressed himself to the Hon. Arthur Paget,
British ambassador at Vienna, saying--

  I have so many applications for Vaccine Virus from Bussora, the
  East Indies, and Ceylon, that I beg you will immediately apply to
  Dr. De Carro, and request him to send some by every courier.[233]

De Carro accepted the commission with alacrity. He had already had
an application from Bagdad, and, dismissing the vehicles which
had been tried and failed, such as lancets of steel, silver,
gold, and ivory, and threads enclosed in quills, he saturated
lint with virus, and, placing it between glasses, in one of which
was a cavity for its reception, tied them together, sealed the
edges, and, taking them to a wax chandler, had them dipped until
enclosed in a ball of wax, which was packed in a box stuffed
with shreds of paper. In this manner virus was conveyed through
Constantinople, across the deserts to Bagdad, where it was received
on 31st March, 1802, still liquid, and was used “with complete
success.” The like success was reported from Bussora, Muscat, and
Bushire. From Bussora virus was conveyed to Bombay, arriving,
after a three weeks’ voyage, early in June. Twenty or thirty were
inoculated with the Vienna virus, but only one “took,” namely, Anna
Dusthall, a child about three years of age, who was operated upon
by Dr. Helenus Scott. The progress of the case was watched with
intense anxiety, and correspondent satisfaction when the symptoms
developed according to the recognised description. On the eighth
day five children were vaccinated from Dusthall’s arm, and loud
was the rejoicing when it was known that for India was secured
the genuine Variolæ Vaccinæ. From Bombay “the precious fluid” was
in due course conveyed to Ceylon, Madras, Calcutta, and wherever
English influence prevailed. De Carro was naturally elated with his
success. The virus he transmitted was originally obtained from the
stock of Dr. Sacco, of Milan, who had it off some Lombard cows.[234]

Jenner wrote to De Carro to congratulate him, 28th March, 1803--

  Since the commencement of our correspondence, great as my
  satisfaction has been in the perusal of your letters, I do not
  recollect when you have favoured me with one that has afforded
  me pleasure equal to the last. The regret I have experienced at
  finding that every endeavour to send the Vaccine Virus to India
  in perfection has again failed, is scarcely to be described to
  you; judge, then, what pleasure you convey in assuring me that my
  wishes are accomplished.[235]

The imported cowpox was diffused and recommended with energy
and with fraud. Jenner, writing to Dunning, 2nd November, 1804,
observed--

  Conceiving it might be a gratification to you to see how
  systematically they manage vaccine affairs in India, I have sent
  you a copy of a paper just transmitted to me from the India
  House. Would to Heaven we could boast of such arrangements here!

Here is the paper which sets forth the energetic policy pursued--

    FORT-WILLIAM, _15th January, 1804_.

  With a view of extending the practice of Vaccine Inoculation
  throughout the East India Company’s territories in India,
  the Governor-General in Council of Bengal has appointed a
  Superintendent-General of Vaccine Inoculation at the Presidency,
  and established subordinate superintendents at several of the
  interior stations of the country; namely, at Decca, Moorshedabad,
  Patna, Benares, Allahabad, Cawnpore, and Farruckabad. These
  superintendents are the surgeons of the stations, and are to
  act under the orders of the Superintendent-General in whatever
  regards Vaccine Inoculation. The civil surgeons also at the
  several judicial and revenue stations are to co-operate with
  these superintendents for the purpose of forwarding the general
  object.

  Vaccine Inoculation has also been introduced with success
  into Prince of Wales Island, and it is intended to extend the
  practice to Malacca and other places to the eastward; and a
  confident expectation is entertained that the benefits of this
  valuable discovery will be diffused throughout Asia. It is even
  in contemplation to extend it to China; but as the suspicious
  disposition of the Chinese might possibly ascribe any attempt to
  introduce this novel practice to sinister motives, it has been
  postponed until the opinion of the Company’s servants there can
  be obtained.

Much of this policy was due to the Marquis Wellesley, the
Governor-General, whose habit it was to convert conviction without
delay into performance. To what extent it was found practicable to
substitute vaccination for variolation among the natives does not
clearly appear. It was comparatively easy to operate upon those
immediately dependent upon their conquerors; but it was a different
matter to disarm the aversion of the external myriads. Supposing
the variolators preferred their ancient practice because it was
more lucrative, a number of them were brought to Calcutta, and
inquiry made as to the amount of their gains, which ascertained,
they were offered double pay if they would adopt vaccination.
The offer was readily accepted, and other variolators, hearing
of it, volunteered their services on similar terms, and were
instructed and enrolled as official vaccinators. A declaration was
drawn up and signed by twenty-six of these converted variolators,
recommending vaccination to the Eastern world. The declaration was
published in the _Calcutta Gazette_, printed in four languages, and
widely circulated throughout India.[236]

So much was possible to Government; but other means of persuasion
were not neglected. It was at first imagined that pox from the
cow would exactly suit people who held that animal in reverence;
but, on the contrary, the fact was converted by the Brahmins into
an argument against its use, they contending, and justly, that
cowpox was impure. To meet this difficulty, various pious frauds
were attempted. It was pretended that vaccination was no novelty
in India, and that it was known, sanctioned, and practised from
time immemorial. Baron, Jenner’s biographer, relates these details
without animadversion--

  A native physician of Bareilly put into the hands of Mr. Gillman,
  who was surgeon at that station, some leaves purporting to be
  an extract from a Sanscrit work on medicine, entitled “Sud’ha
  Sangreha,” by a physician named Mahadeva, to this effect--

  “Take the matter of pustules, which are naturally produced on the
  teats of Cows, carefully preserve it, and before the breaking out
  of Smallpox make with a fine instrument a small puncture (like
  that made by a gnat) in a child’s limb, and introduce into the
  blood as much of that matter as is measured by a quarter of a
  ratti. Thus the wise physician renders the child secure from the
  eruption of the Smallpox.”

The Sanscrit work from which this passage was asserted to be
taken was never forthcoming, and by competent authorities was
pronounced “nothing more than a well-meant device for the reduction
of ignorant prejudices,” the native physician who put the leaves
into the hands of Mr. Gillman being included in the fiction. Baron
continues--

  In order to overcome these native prejudices the late Mr. Ellis,
  of Madras, who was well versed in Sanscrit literature, actually
  composed a short poem in that language on Vaccination. The poem
  was written on old paper, and was said to have been _found_, that
  the impression of its antiquity might assist the effect intended
  to be produced on the minds of the Brahmins while tracing the
  prevention to their sacred cow.

  The late Mr. Anderson, of Madras, adopted the very same
  expedient, in order to deceive the Hindoos into a belief that
  Vaccination was an ancient practice of their own. It is scarcely
  necessary to observe that had any authentic record of such a
  practice existed these gentlemen would never have resorted to
  such contrivances to gain their object.[237]

These impostors were not priests, but medical men; not Jesuits, but
Protestants; not Levantines, but Englishmen in the service of the
Honourable East India Company. To what extent their frauds were
operative is not related. They were probably too contemptuous of
native acumen. For good and for evil the Hindoo listens to English
advice courteously and without contradiction, but persists in his
accustomed way of life with the equanimity of indifference. That
vaccination was an ancient practice in India came to be repeated
in Europe and seriously believed, when, Jenner’s originality being
impugned, the truth came out, that old Indian vaccination was a
device limited to Indian circumstances, and never designed for
Western acceptance.

In Madras vaccination was practised with much energy. Jenner,
writing on 7th May, 1808, said, “Wonderful to relate, the numbers
vaccinated in that Presidency in the course of last year amount
to 243,175.”[238] In Bombay it was claimed that smallpox was
extirpated; Dr. Helenus Scott reporting, 5th December, 1806, that
“in this island, swarming with mankind, no loss from smallpox has
been suffered for several years since the introduction of vaccine
inoculation.”[239] It was not pretended that all the inhabitants
of Bombay had been vaccinated, or even a considerable portion of
them; but the early vaccinators appear to have regarded vaccination
as a sort of charm, the possession of which kept off smallpox;
that by the vaccination, say, of one-tenth of any population,
the unvaccinated nine-tenths were protected. This faith in the
vicarious efficacy of vaccination was not expressly avowed, but
was implied in the numerous reports of extirpated smallpox in
circumstances where no attempt was made, or was indeed possible, to
effect universal vaccination.

Confuted and frustrated in England, it was Jenner’s habit to sigh,
and turn from his ungrateful country to the vast realms of Europe
and Asia and America. Writing to Dunning, on 23rd December, 1804,
he observed--

  Foreigners hear, with the utmost astonishment, that in some parts
  of England there are persons who still inoculate for Smallpox.
  It must, indeed, excite their wonder when they see that disease
  totally exterminated in some of their largest cities and in
  wide-extended districts around them.

Mark the words--Smallpox totally exterminated in some of the
largest cities in 1804; that was to say, after, _at the utmost_,
five years’ acquaintance with vaccination! A miraculous time--was
it not? Jenner went on--

  Let us not, my friends, vex ourselves too much at what we see
  here. Let us consider this country as but a speck when compared
  with the wide surface of our planet, over which, thank God!
  Vaccinia has everywhere shed her influence. From the potentate
  to the peasant, in every country but this, she is received
  with grateful and open arms. What an admirable arrangement is
  that made by the Marquis of Wellesley, the Governor-General of
  India, for the extermination of the Smallpox in that quarter of
  the globe! Contrasted with our efforts here, what pigmies we
  appear.[240]

_Omne ignotum pro magnifico est._ What inference worth a straw
could Jenner or anyone else draw from the introduction of
vaccination to India? The number of the various Indian peoples
was unknown; and the periods and prevalence of smallpox among
them; also the extent to which they practised variolation. In the
absence of such elementary information, tales of the triumphs of
vaccination in India were so much romance.

So far as vaccination displaced variolation, it might be taken
as the substitution of a less evil for a greater; and much is
accounted for in some of the early records of vaccination when it
is remembered that the new practice was welcomed as a deliverance
from the inconveniences and horrors of the old; and that the
discredited practice was frequently abandoned without resort to
its successor. A cessation of variolation was a cessation of the
culture and diffusion of smallpox; and vaccination had often the
credit of the reduction of smallpox when the credit was due to
the abatement of variolation. As to the propagation of smallpox by
variolation, no one was more emphatic than Jenner, as for example--

  Where Variolous Inoculation is put in practice, Smallpox must
  necessarily spread.[241]

  Smallpox will never be subdued so long as men can be hired to
  spread the contagion by Inoculation.[242]

If then it be taken as conceded that variolation spread smallpox
wherever practised, can it be fair to omit the consideration of
the consequences of its abatement when estimating the results
of the introduction of vaccination? Yet scarcely an advocate of
vaccination permits the fact to enter into his reckoning!

The gratitude of the English in India to Jenner did not evaporate
without substantial expression. A subscription was started, and
between 1806 and 1812 he received remittances to the amount of
£7,383, the contributors being--

    Bengal,    £4,000
    Bombay,     2,000
    Madras,     1,383

An amusing instance of Jenner’s ignorance of India is found in
a letter to Dunning, 14th March, 1807, wherein he ascribes his
English money from India to the gratitude of Hindoo women--

  You will be pleased to hear that the _dingy_ Hindoo ladies are
  convincing me of their grateful remembrance, not merely in
  words, but by a _tangible_ offering, while my _fair_ Christian
  countrywomen pass me unheeded by.[243]

Jenner, in returning thanks to Dr. Fleming, of Calcutta, for the
first remittance of cash in 1806, took occasion to communicate some
English news, which is not without interest at this day. He wrote--

  To say the truth, this country has been dreadfully supine in
  the matter of Vaccination hitherto. Some pamphlets, full of the
  grossest misrepresentations and forgeries, have been spread; and
  the common people became so terrified, particularly when told
  that their children, if vaccinated, would take the similitudes of
  bulls and cows, that a great dislike to the practice has arisen
  among them; and these accounts have been circulated through the
  country with peculiar industry. The consequence has been the
  re-introduction of Variolous Inoculation, which has produced an
  epidemic Smallpox through the metropolis and the whole island,
  except in those parts where Vaccination had previously been so
  generally adopted as to forbid its approach. This, now too late,
  has opened their eyes, and they see the powers of the Cowpox. The
  folly of the oppositionists has gone so far as to exhibit prints
  of children undergoing transformation from the human being into
  that of the brute.[244]

These prints were, many of them, intended for fun, and could have
no serious influence. The decline of faith in vaccination was due
to the general discovery that it did _not_ prevent smallpox, and
that it _did_ excite other ailments. “It made smallpox milder”
was the apology even then coming into vogue. As for the epidemic
of smallpox raised in London and the whole island by the neglect
of vaccination and a return to variolation, it was a creation of
Jenner’s fancy. There was less smallpox in London in 1806 than in
1805; but if there was not more, the bold Jennerian would answer,
there _ought_ to have been, and it could only be through the mercy
of Providence that there was not.

Throughout the century, the English in India have spared no pains
to diffuse and enforce vaccination among the inhabitants, numerous
medical men finding place and pay in the futile occupation.
Smallpox can only be overcome by systematic sanitation, which is
laborious and difficult; and among peoples whose conditions and
habits of life freely generate zymotic disease, vaccination is
as likely to be effective as any other sort of incantation. Sir
Richard Temple states the position at this day in these words--

  Smallpox is universally prevalent in India, carrying off tens
  of thousands of victims, children especially, in almost every
  province year by year, and impairing or disfiguring others for
  life. The Government has for many years made persistent efforts
  to arrest the disease by means of Vaccination, with remarkable
  success in some districts, like that of Kumaon in the Himalayas,
  but generally with indifferent success, and often without any
  perceptible result. The practice of Vaccination not being in
  vogue, Inoculation used to be largely adopted by the natives in
  many districts, but has now been prohibited, though not always
  prevented actually. The State everywhere undertakes or encourages
  Vaccination. Hundreds of native vaccinators are employed, and
  returns are rendered of large numbers of persons said to be
  successfully vaccinated. Nevertheless Smallpox appears again and
  again with terrible manifestations before the people, and causes
  them to disbelieve the efficacy of Vaccination.[245]

We now come to Ceylon, in which vaccination was held to have had
a perfect triumph. “To Sweden and to Ceylon,” says Baron, “Dr.
Jenner was in the habit of pointing when he wished to prove what
his discovery might accomplish; or when he lamented that fatal
obstinacy of his fellow-creatures which, with such examples
before them, could induce them to reject blessings within their
reach.”[246] Sweden we shall discuss in another chapter, and of
Ceylon I may observe that a portion of the island was taken by the
British from the Dutch in 1795, and that in several parts it was
extremely unhealthy. Smallpox was a frequent and deadly epidemic,
but to what extent there is no evidence save hearsay and estimates
from hearsay. The Dutch did not concern themselves with the health
of the natives, but when the English took over their settlements in
1800 in the midst of a severe epidemic, they opened hospitals for
smallpox and for inoculation with smallpox under the supervision
of Dr. Christie.[247] He, hearing the glad tidings of vaccination,
resolved to introduce the practice, and having in 1802 received
virus from Dr. Scott, of Bombay, he set to work with systematic
energy and perseverance. Supported by the authority of successive
Governors, he closed the hospitals, forbade variolation, organised
a staff of vaccinators, and kept them employed, until the greater
part of the population under English influence was vaccinated. In
the words of Moore, writing in 1816--

  At length the priesthood submitted to Vaccination, the last to
  adopt this innovation upon their ancient customs; and the remains
  of the Smallpox were happily extinguished in all that part of the
  island which belonged to Great Britain.[248]

That smallpox had been exterminated by vaccination in Ceylon was
set forth by vaccinators as something indisputable; but there were
two observations to make--first, that smallpox was often suppressed
in the sense that for a time there was no smallpox in a certain
population, and especially subsequent to a severe epidemic; and
second, that variolation was suppressed. Granted that smallpox
ceased in Ceylon coincidently with the introduction of vaccination,
it may be fairly held that the exhaustion induced by the preceding
epidemic, and the cessation of variolation, were sufficient to
account for the phenomenon. What remains to be said of Ceylon, I
shall leave Dr. George Gregory, physician of the London Smallpox
and Vaccination Hospital, to say for me. He wrote--

  Ceylon was the British colony where the Government earliest
  interfered and most vigorously encouraged the practice of
  Vaccination. Salaried vaccinators were scattered over the
  whole island. So successful were their labours, that up to the
  beginning of 1819, it had often been said that the experiment of
  exterminating Smallpox had been made and successfully carried out
  in Ceylon. In July, 1819, however, a severe epidemic Smallpox
  broke out there. In 1830 a second epidemic overspread the
  island--in 1833 a third, and in 1836 a fourth. In these four
  epidemics, 12,557 persons were attacked, of whom 4,090 died,
  being at the rate of 33 per cent., or one out of every three.

  In each of these epidemics a certain number of vaccinated
  persons took Smallpox. The proportion of the vaccinated to the
  unprotected varied. In the third epidemic, out of a total of 460
  attacked, 341 represented themselves as vaccinated.[249]

Vaccination was introduced to China from the English factory at
Canton, and Sir George Staunton translated into Chinese a tract on
Cowpox, and had it printed at Canton in 1805, the translator’s name
and the foreign origin of the practice being suppressed. Jenner,
writing to Dunning, 10th December, 1806, said--

  From Canton I have a most curious production--a pamphlet on
  Vaccination in the Chinese language. Little did I think, my
  friend, when our correspondence first began, that Heaven had in
  store for me such abundant happiness. May I be grateful!

The Chinese had their own system of variolation, namely, the use
of pulverised smallpox scabs as snuff; but some of them accepted
vaccination, tried it, and dropped it when they found it did not
keep off the disease as warranted. Smallpox in China is almost
exclusively a disease of childhood, and is little dreaded. Dr. D.
F. Rennie, medical officer to the British Embassy at Peking in
1861-62, says of that city--

  Since 1820 vaccination (introduced from Canton) has been
  practised to a limited extent among the population--probably
  one-fifth may be vaccinated. At one time it was believed to
  afford protection, Smallpox not having been so common immediately
  after its introduction. Of recent years, however, confidence in
  it has considerably diminished, owing to the frequency with which
  those are attacked who have been vaccinated.[250]

Persia was sometimes referred to in the ravings that went on as
to the triumphs of vaccination in the East; but what was known
of Persia? The practice was introduced where Europeans were
resident, but it never became general. Dr. C. J. Willis has
recently described surgery and medicine in Persia as extremely
rude and superstitious, and that “vaccination is not in favour,
whilst inoculation, or the direct communication of the disorder,
by placing the patient in the same bed with one suffering from
smallpox of the most virulent type, is the method pursued.”[251]

It was natural enough for Jenner, in presence of failure and
contempt in England, to appeal to success in the East, and to try
to overwhelm his adversaries with evidence which they could not
overtake; but any one of judicial temper must have perceived that
if vaccination was to be vindicated, data of a very different order
would have to be forthcoming. Where the number of the population
in a distant region was unknown, where the ordinary prevalence
of smallpox among the people was undefined, where the extent of
artificial variolation was unspecified, and the existence and
intensity of related forms of zymotic disease were undescribed,
what conclusion could be drawn as to the efficacy of vaccination
that a man of science was bound to respect? Why should certain
knowledge in England be surrendered for assertion from abroad.


FOOTNOTES:

[231] Baron’s _Life of Jenner_, vol. 1. p. 410.

[232] Baron’s _Life of Jenner_, vol. i. p. 409.

[233] _Ibid._ vol. i. p. 419.

[234] _Histoire de la Vaccination en Turquie et l’Orient._ Par Jean
de Carro. Vienne, 1804.

[235] Baron’s _Life of Jenner_, vol. i. p. 428.

[236] _The History and Practice of Vaccination._ By James Moore.
London, 1817. P. 236.

[237] Baron’s _Life of Jenner_, vol. i. pp. 556-559.

[238] Baron’s _Life of Jenner_, vol. ii. p. 359.

[239] _Ib._, vol. ii. p. 92.

[240] Baron’s _Life of Jenner_, vol. ii. p. 24.

[241] Letter to Dunning, 23d December, 1804.

[242] Letter to Worthington, 4th May, 1810.

[243] Baron’s _Life of Jenner_, vol. ii. p. 356.

[244] Baron’s _Life of Jenner_, vol. ii. p. 89.

[245] _India in 1880._

[246] _Life of Jenner_, vol. i. p. 426.

[247] _An Account of the Introduction, Progress, and Success of
Vaccination in Ceylon._ By Thomas Christie, M.D. London, 1811.

[248] _The History and Practice of Vaccination._ By James Moore.
London, 1817. P. 242.

[249] _Lectures on the Eruptive Fevers._ London, 1843. P. 210.

[250] _Peking and the Pekingese._ London: 1865.

[251] _British Medical Journal_, 26th April, 1879.




CHAPTER XXX.

DIFFUSION OF VACCINATION THROUGHOUT EUROPE.


Vaccination was accepted as a revelation, and diffused as a
religion, and was almost everywhere received gladly. We have to
bear in mind, however, that the way had been made straight for it
by the practice of inoculation with smallpox; which practice, after
a struggle prolonged over many years, had become an established
part of medical art, and was only limited in its application by
the inconvenience and risks that attended it. The promise of the
primitive vaccinators was, that the security which resulted from
inoculation with smallpox was to be had from inoculation with
cowpox, with absolute certainty, absolute safety, and absolute
permanence. The argument was, that since no one could have smallpox
twice (however slight the attack), and as cowpox was a mild form
of smallpox, it sufficed to be inoculated with cowpox to be safe
from smallpox through life; and if only the infliction of cowpox
were made universal, smallpox would be extirpated. Such was the
plausible doctrine; so plausible that it had only to be stated to
command assent; whilst so great was the elation over the discovery
(as much, perhaps, for deliverance from inoculation with smallpox
as from smallpox itself) that it was accounted a sacred duty to
diffuse its benefits over the whole earth. Greater good on easier
terms it was difficult to imagine. With a scratch of a needle one
of the worst penalties attached to over-crowding, to filth, and to
ill-living, might be avoided and done away with for ever.

      How pleasant are such sugared lies,
      Deceiving by their sweetness!

The first cowpox missionaries were Dr. Marshall and Dr. Walker.
£100 was teased out of the Admiralty, and £100 out of the War
Office toward their expenses, and placed on board the _Endymion_,
they proceeded, on 1st July, 1800, to the Mediterranean. At
Gibraltar, Minorca, and Malta, they vaccinated soldiers and
sailors, first operating on orphans and foundlings to give the
gallant fellows courage. Then Walker accompanied Sir Ralph
Abercrombie to Egypt, from whence, after a variety of adventures,
he returned to London to serve as domestic apostle, and vex Jenner
for the remainder of his life. Marshall proceeded to Sicily and
Naples. In Palermo, in the preceding year, 1799, there had been an
epidemic, in which, it was said, 8,000 had perished, and Marshall
appeared on the scene as a belated messenger of salvation. At
Naples he had a cordial reception from the wretched Ferdinand IV.
and his wretched court, who, with general indifference or enmity
to what was good, were ready to show themselves gracious toward
cowpox. Marshall went through the customary performances of the
variolous test and the exposure of the vaccinated to infection; and
without further ado an hospital was opened, and all who would be
saved from smallpox were entreated to hasten and receive the new
inoculation.

  It was not unusual [wrote Marshall to Jenner] to see in the
  morning a procession of men, women, and children, conducted
  through the streets by a priest carrying a cross, coming to
  the hospital to be inoculated. By such popular means, the
  practice met with no opposition; and the common people expressed
  themselves as certain that it was a blessing sent from Heaven,
  though discovered by one heretic and practised by another.

When Marshall was at Gibraltar, Lord Keith issued the following
memorandum to the fleet--

    H.M. Ship _Foudroyant_,
    GIBRALTAR BAY, _19th October, 1800_.

  Any soldiers, seamen, or marines in the Fleet who may not have
  had the Smallpox, and wish to avoid that dreadful malady, may,
  by application to Dr. Marshall, on board the flag-ship, be
  inoculated with the Cowpox, which, without pain or illness, or
  requiring particular diet or state of body, or leaving any marks,
  effectually excludes all possibility of the patient ever being
  affected with the Smallpox.

    By command of the Vice-Admiral,      PHILIP BEAVER.
        To the respective Captains of the Fleet.

I may observe, in passing, that there was little delay in
introducing vaccination to the British navy. Sir Gilbert Blane was
urgent, Earl Spencer, first Lord of the Admiralty, acquiescent, and
Dr. Trotter, physician to the fleet, enthusiastic. So early as 9th
December, 1800, Trotter was prophesying--

  The Jennerian Inoculation will be deservedly recorded as one of
  the greatest blessings to the navy of Great Britain that ever was
  extended to it.

Smallpox was one of the pests of the service. Trotter, writing 20th
February, 1801, said--

  Within the past seven years there have been more than a hundred
  instances in which the seamen have been infected; twenty having
  occurred in the last six months in the Channel fleet alone.

These outbreaks were invariably referred to an origin external to
the ship; as if anywhere smallpox could have had a more congenial
breeding-place than the crew of a man-of-war! As Dr. Johnson
observed, “When you look down from the quarter-deck to the space
below, you see the utmost extremity of human misery; such crowding,
such filth, such stench!”[252] Incited by the enthusiastic
Trotter, the medical officers of the Fleet subscribed for a gold
medal, and presented it to Jenner. On the obverse, Apollo was
represented introducing a young seaman recovered from cowpox
to Britannia, who, in return, extended a civic crown, on which
was inscribed JENNER; above were the words, _Alba nautis stella
refulsit_, and below the date, 1801. On the reverse was an anchor
and over it _Georgio Tertio Rege_, and under it _Spencer Duces_.
The medal was presented to Jenner in February, 1801.

The dates are worth noting afresh. Jenner’s _Inquiry_ was published
in the summer of 1798; and thus we see that within three years
his prescription for the prevention and extermination of smallpox
was adopted in a branch of the public service where obstinate
conservatism was the ruling temper; and an assertion that only time
could test was accepted without hesitation as verified and certain.
If vaccination had answered to the claim made for it, the haste
wherewith it was acknowledged would have been unjustifiable, and
wholly unlike the struggle that truth has commonly to pass through
in order to obtain supremacy in the intellect and practice of
mankind.

The first attempts to inoculate with cowpox in France proving
futile, Dr. Woodville went over to Paris in 1800 to show in
practice the method of operation. He had a warm reception, and the
Quaker was overwhelmed with the exuberant attentions to which he
was subjected. In the _Moniteur_ he was described as “a learned
man, animated with generous zeal, and worthy of gratitude and
praise;” who had inoculated six thousand children with invariable
success; and that cowpox as a preventive of smallpox could only be
spoken of as something miraculous. A house was opened as a vaccine
station, and men, women, and children, flocked thither to receive
the benign fluid and life-long protection from a dreadful malady.

When the negotiations for the peace of Amiens were in progress,
1802, an address was presented with much pomp to the Marquis
Cornwallis by the Medical Committee of the Somme, claiming
brotherhood with the physicians of England, eulogising Jenner,
denouncing his detractors, stigmatising variolators as acting
neither from the love of truth nor for the glory of their
profession, but, from avarice and hatred of improvement; whilst, as
the result of numerous experiments, “the discovery made in England
had been stamped with the seal of infallibility in France.”

At first, vaccination in France was left to voluntary effort, and
made little progress in face of a strenuous resistance developed by
alarmed variolators; but a severe smallpox epidemic in 1802 incited
the Government to action. A medical commission was appointed to
investigate and report, and in 1804 it was determined to spare no
effort to extend vaccination over the whole of France. A Central
Committee for Vaccination was constituted, and appeals and commands
were addressed to the clergy and officials of all orders to have
those under their authority and influence inoculated with cowpox.
Some préfects were content to recommend and warn, but others
adopted more vigorous measures, such as the exclusion of the
unvaccinated from schools, from employment, from charities--in
short, anticipating much legislation that has come into force, or
that fanatics wish to bring into force. Nevertheless, the progress
made did not satisfy Napoleon, and seeing that until vaccination
was everywhere paid for by the State, its performance must remain
irregular and perfunctory, a manifesto was issued to the effect
that his Majesty the Emperor and King had learned from the reports
of the Central Committee that the preservation and increase of his
vast dominions were immediately related to systematic and universal
vaccination; wherefore, his Majesty, wishing to give a signal mark
of his paternal solicitude for his subjects, had granted to his
Excellency the Minister of the Interior, an annual special credit,
destined to provide for the expenses necessary for extending the
new practice, and for forming centres of issue of vaccine virus
in twenty-four of the chief cities of the Empire--these, then,
including Brussels, Florence, Parma and Turin. And his Majesty
had also, out of his paternal benevolence, provided annual prizes
as incentives to emulation in propagating vaccination, so that
the scourge of smallpox might be completely banished from his
territories.

It would be idle to speculate as to how much serious faith lay
within this apparent zeal for vaccination; for, as Professor
Seeley observes, “Napoleon seemed to care for no opinion, though
he adopted, with studied artificial vehemence, every fashionable
opinion in turn.” There might be, I dare say, something piquant to
his theatrical genius in opposing his odious contempt for human
life to the rigorous enforcement of what was considered a supreme
prescription for its preservation. Jenner availed himself of the
Emperor’s histrionic instinct in soliciting the release of English
travellers detained in France. To one of these occasions we owe
the artless anecdote of the arrest of Napoleon’s refusal by the
interposition of Josephine, who exclaimed, “Jenner!” The Emperor
paused and said, “Jenner! ah, we can deny nothing to that man!” It
is sad to relate, the favour was not reciprocated. When Jenner,
at the suggestion of Baron Corvisart, appealed to the British
Government for similar indulgence to a Frenchman, he had to report
that there was no charm in his intervention among his countrymen.

That vaccination should have a welcome in Spain was not surprising,
after its reception in Naples. The craze was universal, and
diffused through the lowest intelligences. Cowpox was introduced to
Madrid with the certificate of France under that of England; and,
spite of the distractions of the time, excited much attention. Mr.
Allen, secretary to Lord Holland, writing to Jenner from Madrid in
1803, observed--

  There is no country likely to receive more benefit from your
  labours than Spain; for, on the one hand, the mortality among
  children from the Smallpox has always been very great; and, on
  the other hand, the inoculation for the Cowpox has been received
  with the same enthusiasm here as in the rest of Europe; though
  I am sorry to add that the inoculation of the spurious sort has
  proved fatal to many children at Seville, who have fallen victims
  to the Smallpox after they had been pronounced secure from that
  disease.[253]

There were philosophising doctors in Madrid who did not see why
cowpox should possess a singular efficacy, and induced the King,
in 1804, to order that all the children in the foundling hospital
should be inoculated with goatpox. They did not, perhaps, know that
Jenner had inoculated his son with swinepox, and that the child
underwent the variolous test on several occasions with impunity.

The great event in connection with Spain was the expedition of
Dr. Francis Xavier Balmis, physician to his Catholic Majesty. He
obtained a concession to introduce vaccination to the colonies
in America and Asia, and to defray expenses by freely trading in
merchandise. He sailed from Corunna, 30th November, 1803, with
twenty-two children for the propagation of virus. The Canary
Islands were first visited, then Porto Rico, and at Caracas the
party divided, Don Francis Salvani proceeding to Peru and Chili,
whilst Balmis attended to Cuba and Mexico, crossing the Pacific
to the Philippines with twenty-six children to maintain the
succession of the virus, and proceeding from thence to Macao and
Canton. Having circumnavigated the globe as vaccinator and trader,
Balmis re-appeared in Madrid with great _éclat_, and kissed the
King’s hand on 7th September, 1806. Philanthropy and business were
successfully combined, for as Moore, writing in 1817, observes--

  Nearly three years were nobly spent by this excellent man in
  putting a Vaccine Girdle round the globe; and it is an additional
  pleasure to learn that by trading during his circumnavigation, he
  acquired an easy fortune. He now enjoys at Madrid the distinction
  he has merited, and patronises the diffusion of Vaccination
  through the Peninsula.[254]

The expedition of Balmis naturally excited much attention, and its
progress and results were described in terms of inflated rhetoric.
Thus, we read in Baron’s _Life of Jenner_--

  The conductors of the expedition were _everywhere_ welcomed
  with the _utmost enthusiasm_. It was to be expected that the
  representatives of the Spanish Monarch, and all the constituted
  authorities, would gladly co-operate; but it was scarcely to be
  anticipated that the unenlightened minds of the Indians would so
  soon appreciate the value of the mission. It is, nevertheless,
  most gratifying to know that the numerous hordes which occupy
  the immense tract of country between the United States and the
  Spanish colonies _all_ received the precious fluid with _the
  utmost readiness_. They acquired the art of vaccinating, and soon
  performed the operation with great dexterity.

Thus not only the Spanish Americans were brought under the dominion
of cowpox, but the Indians, yea, _all_ the Indians; and not
reluctantly, but joyfully, and became experts in the practice of
the rite! Baron continues--

  Fame had preceded the arrival of Salvani at Santa Fé. On
  approaching the capital, he was met by the Viceroy, the
  Archbishop, and all the civil and ecclesiastical authorities.
  The event was celebrated with religious pomp and ceremonies;
  and in a short time more than fifty thousand persons were
  vaccinated. Similar honours awaited the expedition _throughout
  its whole course_. At Quito they were greeted with boundless joy
  and festivity. Such expressions well became them. The people of
  Colombia, the Indians more especially, having been often scourged
  by the horrid ravages of Smallpox, regarded it as the most
  terrible affliction which Heaven could send them. On its first
  appearance in a village, a panic seized every heart; each family
  prepared an isolated hovel, to which those who were supposed to
  be infected were banished. _There_, without succour, without
  remedy, and with a very insufficient supply of food, they were
  exposed to the alternations of a very variable climate, and
  left to their fate. _In this way whole generations perished._
  Under Viceroy Toledo the population of the native Indians had
  amounted to 7,500,000; but at the time of the Balmis expedition,
  the number was supposed to be reduced to one-fifth--that is
  1,500,000.[255]

Indian and savage statistics in connection with smallpox and
vaccination are usually little else than exercises in imaginative
desire--less what is true than what is wished to be true, or
to be taken for true. We know the difficulty of vaccinating
populations dwelling within defined limits and under highly
organised governments, and we can therefore estimate the claims
made for Balmis and his partners as roving traders and quacks in
the territories occupied by Spaniards and Indians. Yet it was with
yards of mythical rubbish of this sort that English vaccinators
tried to divert the attention of their countrymen from the failures
of vaccination within their own experience; and when worried with
ever-recurring disasters at home, it was in turning to Mexico and
Peru that Jenner professed to find consolation.

Dr. Sacco, of Milan, was described as “the apostle of vaccination
in Northern Italy,” and “unquestionably the greatest vaccinator
in the world.”[256] His operations received the sanction of the
Napoleonic administration, and as early as 1801 he was appointed
Director of Vaccination to the Cisalpine Republic. “Strong
measures,” writes Moore, “were adopted; proclamations were read
from every pulpit; vaccination was practised in every church;
and the clergy gave such effectual aid, that the Professor and
his associates in three years vaccinated 70,000 persons, and
extinguished smallpox in Lombardy.”[257] In other words, the
vaccination of 70,000 persons extinguished smallpox in a population
of several millions! Baron enlarges the numbers, saying that Dr.
Sacco and his assistants in the course of eight years vaccinated
1,300,000 persons; and cites a letter from Sacco, dated from
Trieste, 5th January, 1808, with the following extraordinary
statement--

  During eight years I reckon more than 600,000 vaccinated by my
  own hand, and more than 700,000 by my deputies in the different
  departments of the kingdom. I assure you, out of a population
  of 6,000,000 to have vaccinated 1,300,000 is something to boast
  of; and I flatter myself that in Italy I have been the means of
  promoting Vaccination in a degree which no other kingdom of the
  same population has equalled.[258]

Moore’s 70,000 is a credible number, whatever may be thought of
its vicarious operation; but Sacco’s 600,000 by his own hand
in eight years! Ah, well! when we are lost in the fabulous, it
is unnecessary to waste our strength in the discrimination of
the greater from the less in falsehood. Nevertheless, taking
Sacco’s figures, we have to observe that the vaccination of
1,300,000 saved 6,000,000 from smallpox. That Italy was freed from
smallpox is true, and the exemption of the population, whether
vaccinated or unvaccinated, was prolonged over nearly thirty
years. The disappearance of the disease had, however, set in
before vaccination was heard of, but the subsidence was claimed
for Sacco, although it extended to millions of Italians who owed
nothing to the new prophylactic. As already observed, from some
cause undefined, the area and intensity of smallpox was signally
diminishing toward the close of last century, and this in spite of
the stimulus applied to the disease by variolous inoculation. It
may have been so stimulated as to have been worked out--forced, as
it were, to exhaustion, after the habit of much else, good and bad,
when developed to the extremity of existence.

As a grand vaccinator Dr. De Carro, of Vienna, was scarcely less
distinguished than Sacco. He was a Swiss from Geneva, who had
studied and graduated at Edinburgh, and settled in Vienna. He
performed the first vaccination on the Continent, in 1799, with
virus conveyed on a couple of threads from Dr. Pearson; and in 1802
he succeeded in transmitting the first effective virus to India.
De Carro conducted his operations with great energy and tact, and
in 1802 he induced the Austrian Government to issue an ordinance
conferring on vaccination Imperial sanction and recommendation.
Concurrently with this activity, smallpox was abating, and _post
hoc_ was converted into _propter hoc_. De Carro was credited with
the extinction of smallpox in Vienna; but as no more than a portion
of the citizens had been vaccinated, Vienna thus supplied another
instance of the vicarious influence of the Jennerian rite.

Sacco and De Carro corresponded with Jenner, and it is worth noting
that both concurred with him in the opinion that cowpox originated
in horsegrease; and, further, that horsegrease was as good against
smallpox as horsegrease cowpox itself. Indeed, Sacco set up a stock
of virus derived from horsegrease, operated with it, and supplied
De Carro, who used it so freely in Vienna that, as he said, he
could not tell the vaccinated from the equinated. Writing to
Jenner, on 21st June, 1803, De Carro observed--

  The means of making your discovery were everywhere; yet nobody
  before you had the least idea of the singular connection between
  the Horsegrease, the Cowpox, and the Smallpox.[259]

The favour shown for vaccination by the English Court facilitated
its adoption throughout Germany; and yet it might be said the craze
went of itself, compelling patronage and exacting advocacy. The
King of Prussia opened a Royal Inoculation Institute in Berlin,
and tracts and medals, speeches and sermons, were brought into
requisition to recommend the new rite. From the furore created,
many were led to believe that all Prussia was vaccinated, and as
smallpox ceased to prevail, cowpox had the credit. To vaccinate a
nation, however, is far from easily accomplished, and when we refer
to the official accounts, we discover that, notwithstanding great
ado, the numbers operated upon constituted less than a tithe of
the people. Jenner cites a report of Professor Avelin, of Berlin,
in a letter to Moore, 15th February, 1812, as authority for these
statistics--

  The anniversary of the invention of the Cowpox Inoculation, or
  the Jennerian Feast, was celebrated very solemnly at Berlin
  on 14th May. By public accounts, it appears that there were
  inoculated in all the Prussian States--

    In 1801         9,772
       1802        17,052
       1803        50,054
       1804       102,350
       1805        43,585

  At these times the population was about 9,743,000. From 1806 to
  1810 (since the horrible war and the diminution of the population
  to 4,338,000) the inoculated were 160,329. Dr. Bremer alone at
  the Royal Institute in Berlin inoculated 14,605. The total, as
  officially and voluntarily sent to the Government, amounted to
  402,720 vaccinated, but certainly one-half was not officially
  mentioned. It may certainly be at least 600,000, or even
  800,000.[260]

Supposing a million had been vaccinated in Prussia in the course
of ten years, let me ask once more, how could they have saved the
remaining millions from smallpox? Yet, with knowledge of these
figures, Moore, the Director of the National Vaccine Establishment
in London, did not hesitate to write--

  The King of Prussia directed his children to be vaccinated,
  and also issued orders that Vaccination should be immediately
  employed in the Army; and the new practice encountered no
  further difficulties. By which, and by the total abandonment of
  Variolous Inoculation throughout Germany, the Smallpox rapidly
  declined; and in a few years was extinguished in some of the
  largest cities, from whose purlieus infectious diseases are
  expelled with great difficulty. Thus even in Vienna, where full
  four hundred persons had annually been destroyed by the Smallpox,
  this mortality diminished rapidly after the introduction of the
  Vaccine, and in five years absolutely ceased.[261]

Russia, of course, followed suit in cowpox inoculation. At the
coronation of Alexander in Moscow in 1801 a foundling was operated
on, christened Vaccinoff, pensioned for life, and dispatched to St.
Petersburg to serve as a source of virus for other foundlings. Then
followed imperial decrees prescribing vaccination, and Dr. Crichton
was directed to organise a medical staff for the performance of the
rite in each province of the Empire. In 1811 a ukase was issued
commanding all Russians to be vaccinated within three years. As
measuring the possibilities of despotism in such a matter, we learn
from Dr. Crichton that between 1804 and 1812 there were 1,235,597
vaccinations performed in Russia--a similar number to that which
Sacco professed to have accomplished in Northern Italy in the same
time. It was estimated in Russia that of every seven children
born, one perished of smallpox, and therefore Crichton argued
the lives of 176,514 had (up to 1812) been saved by vaccination.
The calculation illustrates the facility with which the early
vaccinators deceived themselves--first, as to the certainty of
their prophylactic; second, as to its vicarious efficacy; and,
third, in assuming that a reduction in smallpox represented a
reduction in mortality.

From Crichton, too, we learn that there were anti-vaccinists in
Russia in those days--

  Notwithstanding the supreme order of His Imperial Majesty, that
  all his subjects he vaccinated within three years, we find that,
  powerful as his Majesty is, this cannot be executed. There is
  a power greater than sovereignty, namely, the conscience of
  religious opinions of men, and in one or two of the distant
  governments there exists a peculiar religious sect belonging to
  the Greek Church, who esteem it a damnable crime to encourage
  the propagation of any disease, or to employ any doctors, or
  to swallow any medicines under the visitations of God. Reason
  has been employed in vain with these poor people; they have
  been threatened with severe punishments in case they remain
  refractory, but all to no purpose. You may well imagine that
  no punishment has been resorted to, though threatened, and the
  Government has come to the wise conclusion of leaving the dispute
  to time.[262]

To complete this rapid survey of the diffusion of vaccination
throughout Europe, there remain Sweden with Finland, and Denmark
with Iceland; but as the case of Sweden is specially interesting
and instructive from the fulness and precision of its vital
statistics, coupled with the claim made by vaccinators that Sweden
affords irrefutable evidence of the efficacy of their prescription,
I reserve it for a special chapter. There is nothing pleasanter
than finding the strongholds of one’s antagonists, capturing, and
occupying them.


FOOTNOTES:

[252] Boswell (Croker’s Ed.) vol. vii. p. 102.

[253] Baron’s _Life of Jenner_, vol. i. p. 604. Allen little
suspected that there never was any spurious Cowpox; that it was
only “spurious” when it did not prevent Smallpox.

[254] _The History of Vaccination._ By James Moore. London, 1818.
P. 279.

[255] Baron’s _Life of Jenner_, vol. ii. pp. 80-2.

[256] Baron’s _Life of Jenner_, vol. ii. p. 234.

[257] _Ib._ vol. ii. p. 112.

[258] _History of Vaccination_, London, 1817. P. 263.

[259] Baron’s _Life of Jenner_, vol. ii. p. 432.

[260] Baron’s _Life of Jenner_, vol. ii. p. 378.

[261] _History of Vaccination_, p. 245.

[262] Baron’s _Life of Jenner_, vol. ii. p. 186.




CHAPTER XXXI.

SWEDEN, DENMARK AND ICELAND.


Jenner was in the habit of pointing to Sweden and Ceylon as proofs
of what vaccination might accomplish. We have seen how badly Ceylon
answered to his reference; and I now proceed to inquire whether
Sweden served his purpose any better.

The decline of smallpox in some communities, contemporaneously
with the introduction of vaccination, might be ascribed to the
cessation of inoculation with smallpox--virtually the culture of
that disease; but in Sweden little had to be accounted for in
that way. Spite of strong recommendations, variolation was rarely
practised, and never became popular. The very year that vaccination
was introduced, Dr. Acksell, of Kalmer, stated in an official
report, dated 30th March, 1801, “that it is impossible to convince
the lower classes of the advantages of inoculation. Dr. Colliander
and I have had it announced to the people from the pulpit, that,
we were ready to give our services, gratis, in inoculating their
children, but not a single person applied.” And such undoubtedly
was the state of things throughout the kingdom.

Sweden last century was sorely afflicted with smallpox, and,
considering the repute of variolation in other lands, it is
surprising how the people refrained from its vaunted protection.
It is thought dreadful that in London one death in ten should have
been due to this disease, but in Sweden the ratio stood as high as
one in seven. To give some idea of the extent of the mischief at
its highest and its lowest, let us look at eighteen years in the
latter half of the century--

    Year.   Population.   Total Deaths.   From Smallpox.

    1752     1,799,188       49,467          10,302
    1757     1,870,372       55,829          10,241
    1763     1,940,011       64,180          11,662
    1768     2,006,790       54,751          10,650
    1769     2,015,127       54,991          10,215
    1773     1,972,407      105,139          12,130
    1775     2,020,847       49,949           1,275
    1776     2,041,289       45,692           1,503
    1777     2,057,147       51,096           2,943
    1778     2,073,396       55,028          16,607
    1781     2,132,912       54,313           1,485
    1784     2,145,213       63,792          12,453
    1786     2,156,109       55,951             671
    1787     2,163,862       51,998           1,771
    1792     2,211,643       52,958           1,939
    1797     2,322,814       55,036           1,733
    1798     2,344,228       53,862           1,357
    1800     2,347,303       73,928          12,032

In these figures we see how wide were the variations in smallpox
mortality prior to the introduction of vaccination; and also how
indifferent was its influence on the general mortality, much
smallpox not raising the death-rate, nor little smallpox lowering
it.

Among the factors of mortality in Sweden were scarcity and famine.
At this day, when the ends of the earth are drawn together, we
are apt to forget the struggle, the misery, and the sickness that
prevailed when a deficient harvest in one country, or parts of
the same country, could not be made good from the sufficiency of
others. Population in Northern Europe did little more than maintain
existence through several centuries against the severity of Nature,
with food scant and bad, and raiment and shelter inadequate. Of the
latter fifty years of last century, at least fifteen were years of
dearth in Sweden, and consequently of increased mortality.

The chief sufferers from deficient and unsuitable food are the
young, their suffering having form in various ailments, and among
them smallpox. I have repeatedly had to point out how smallpox is
especially an affection of childhood, and how in Scotland, for
instance, it used to be almost exclusively confined to the young,
like measles and whooping-cough. The like was true of Sweden; for
of the deaths from smallpox from 1774 to 1798--

     8·19 per cent. were under one year of age;
    21·90  ”             between one and three;
    31·77  ”               ”     three and five;
    23·74  ”               ”     five and ten;

a total of 85·60 per cent, being mere children. Or, to put it
otherwise--

    In 1778, when 16,607 perished, 13,096 were under ten.
       1784   ”   12,453    ”      11,789       ”
       1786   ”      671    ”         625       ”
       1798   ”    1,357    ”       1,207       ”

and so on.

Now, whilst I have no wish to minimise the sadness and culpability
of the mortality of the young, I have yet to maintain that its
consequences are by no means so serious to the State as when the
heads of families and bread-winners are stricken down; and that
it is a gross exaggeration to compare the fatality of smallpox
with that of men slain in battle. Again, we have to recollect how
many of the young die from smallpox, so to say, needlessly, from
inattention and malpractice. This was clearly recognised in a Royal
Letter issued from Stockholm in 1763, recommending variolation,
in which the Medical Board was directed “to instruct the common
people how children should be treated when suffering from natural
smallpox,” assigning the cogent reason, “because many more children
die from want of care than from the disease.” The assertion may
be taken as indisputable; and, being true, it stands for the fact
that the mortality from smallpox might have been largely reduced
if parents had had the knowledge and the means to nurse their
offspring through their illness. They died less of smallpox than of
ignorant and defective treatment whilst under smallpox.

I have also to observe that smallpox in Sweden was steadily
declining toward the close of the century, and that the decline
continued into the present century. Taking the years in decades
from 1749 to 1868, and casting the average, we have these results--

                                        Annual      Annual
                            Deaths    Death-rate  Deaths from
     Decade.  Population.  Annually.  per 1,000.   Smallpox.

    1749-58    1,821,009    50,556      27·76       6,056
    1759-68    1,946,258    53,288      27·38       5,309
    1769-78    2,028,141    59,262      29·22       4,535
    1779-88    2,140,315    56,766      26·52       5,179
    1789-98    2,246,744    57,883      25·76       3,810
    1799-08    2,394,432    63,365      26·46       3,282
    1809-18    2,444,568    67,537      27·63         690
    1819-28    2,787,025    63,121      22·60         373
    1829-38    2,976,829    70,168      23·57         633
    1839-48    3,255,604    68,080      20·91         299
    1849-58    3,588,571    78,218      21·80         816
    1859-68    4,016,690    79,033      19·68         861

With these details before us, we are in a position to appreciate
the claim made for vaccination, that it exterminated Smallpox in
Sweden.

Vaccination began to be practised in Sweden in the year 1801. It
was at first viewed with distrust by some of the leading medical
authorities, but grew so rapidly in favour, that the medical board
in 1803 ventured to make proposals for its general introduction.
By Royal Letters in 1804 and 1805 measures were decreed for the
encouragement of Vaccination; and in the almanacs for 1806,
information and advice were inserted concerning “the new and
certain means for the prevention and extirpation of Smallpox.”
Nevertheless, the practice made way but slowly into the confidence
of the common people, and not until 1812 did a committee of the
Diet go so far as to recommend its compulsory adoption. The
principle of compulsion was affirmed by the Diet in 1815, leading
to a Royal Decree of 6th March, 1816, whereby Vaccination was made
obligatory under penalty of fine and imprisonment.

Subsequently, the law was modified, but never relaxed. Whilst
the rite was obligatory, it was offered gratuitously, and public
vaccinators, usually parish clerks and midwives, were appointed
throughout the land, and stimulated to exertion by special rewards.
Vaccination was made a condition of admission to school, and was
placed by the clergy on a level with baptism and confirmation.
Wherefore, in course of time, it has come to pass that Sweden is
described as “the best vaccinated country in the world.”

To this result the recognised interest of the Swedish clergy
in medical practice largely contributed. They were not slow to
perceive a fresh line of business in vaccination. Archbishop
Lindblom, among others, was extremely zealous in promoting the
practice in his diocese, and from a correspondence between the
Consistory of Upsala and the Medical Board, it appears that the
competition between the physicians and the parsons was severe.
The Consistory complained that the rewards for vaccination energy
were more liberally bestowed on medical men than on the deserving
clergy, and that it was unfair to insist on the clergy taking out
a license to vaccinate, ending with the reproach that the mishaps
of some medical men had so alarmed the people in certain districts,
that very few were willing to avail themselves of the wonderful
prophylactic. The Board replied, that they were aware that mistakes
had occurred through the use of spurious cowpox, as proved by the
outbreak of smallpox afterwards; but, at the same time, what better
check could be devised on incompetent practitioners than a medical
license? The right of the clergy to vaccinate was not contested,
but only that they should possess some recognised qualification.
The extent of the ecclesiastical operations in cowpox appears from
the return of the Archbishopric of Upsala, which showed that from
1804 to the end of 1810 there were 33,298 persons vaccinated, of
whom 7,025 were inoculated by clergy, 20,000 by church officers,
and 6,273 by medical men and others. It was by the clergy and the
doctors that the project of compulsion was initiated. In a letter
from the Medical Board to the King in 1810, complaint was made
that “the public in Sweden do not in all places manifest the care
and zeal which might be expected from sensible and tender parents
in applying for, or allowing to be applied, the precious means
of salvation provided for their children’s good looks and future
health.” In 1814, the same Board wrote that “several of the Bishops
who take the deepest interest in the spread of vaccination, have
expressed their conviction that certain well-devised penalties
have become as necessary as regards the ignorant masses as
encouragements are useful”; and as late as 1815, the Board had to
testify against the “sluggishness and indifference prevalent among
the less enlightened classes.”

Compulsion was, therefore, enacted in 1816 to overcome the inertia
of the lower orders, the mass of the people who at all times yield
the largest crop of smallpox.

“Smallpox was exterminated in Sweden by vaccination,” is a common
saying. Moore, in his _History of Vaccination_, published in 1817,
after describing the various measures taken, observed--

  It is superfluous to add, that by such a concurrence of virtuous
  exertions, Smallpox was quickly suppressed in Sweden.

Ere proceeding to inquire whether smallpox was thus suppressed,
I would call attention to the hands by which vaccination was
administered in Sweden. It is the custom at this day to describe
vaccination as a delicate operation, and to attribute subsequent
smallpox to some irregularity or defect in its performance; and
yet here we are asked to contemplate a whole nation delivered
from smallpox, the vaccinators being chiefly priests, clerks, and
midwives. What does it mean? Is it that any sort of vaccination
is good when smallpox does not follow, and that any sort is bad
when smallpox does follow? If smallpox had not ceased out of the
land, would it then have been said, “What wonder, considering the
character of the vaccinators”?

To the assertion that smallpox in Sweden was exterminated by
vaccination, the answer is an unqualified contradiction. It is
not true; it is demonstrably untrue. Smallpox was declining in
Sweden before vaccination was heard of, and the fall continued
irrespective of its influence. Look at the figures. Here we have
the returns of smallpox mortality in Sweden during the last sixteen
years of the past, and the first sixteen years of the current
century, up to the time when vaccination was made compulsory--

             Deaths                     Deaths
    Year.     from             Year.     from
            Smallpox.                  Smallpox.

    1785      5,077            1801      6,057
    1786        671            1802      1,533
    1787      1,771            1803      1,464
    1788      5,462            1804      1,460
    1789      6,764            1805      1,090
    1790      5,893            1806      1,482
    1791      3,101            1807      2,119
    1792      1,939            1808      1,814
    1793      2,103            1809      2,404
    1794      3,964            1810        824
    1795      6,740            1811        698
    1796      4,503            1812        404
    1797      1,733            1813        547
    1798      1,357            1814        308
    1799      3,756            1815        472
    1800     12,032            1816        690
             ------                     ------
    Total,   66,866            Total    23,376
             ======                     ======

Thus we see the process of subsidence, with alternations from year
to year, with the reduction of two-thirds, from 66,866 in the
former to 23,376 in the latter series of years.

It will be said, of course, that vaccination was introduced into
Sweden in 1801. True, but the introduction of vaccination was
one thing, and its diffusion over the nation another. It was a
section of the people least likely to be affected with smallpox
who welcomed and practised vaccination; and however energetic
and successful they might be in their promotion of the new rite,
their efforts were limited to thousands among millions. All the
while smallpox was declining, and they took the decline for
encouragement, and began to cry out, “See! see what we are doing!”
The enactment of compulsory and gratuitous vaccination in 1816 was
an open confession that the lower classes remained to be dealt
with, that is to say, the very people among whom smallpox had its
stronghold. There are tribes whose priests profess to bring rain,
and drive away sickness with their enchantments; but if showers had
begun to descend, and the sick to recover, ere their assistance
was invoked, it would be hard to convince even the credulous
that the desired relief was due to their subsequent magic. But it
is precisely in the subsequent magic of the vaccinators that we
are asked to believe when told that vaccination drove smallpox
out of Sweden. It was going out before vaccination was called in,
and kept going out all the same when the vaccinators plied their
enchantments. Happily, patient Nature holds her way unprovoked by
human quackeries. Not even to confute impostors does she reverse
for an instant her impartial operations.

But, although deaths from smallpox fell off so rapidly, there was
no correspondent improvement in the public health. Smallpox was
merely replaced by other forms of disease. Thus, the death-rate of
Sweden per 1,000 for seventy years, stands as follows--

    Decade.        Deaths.  |  Decade.        Deaths.
                            |
    1749-1758       27·76   |  1789-1798       25·56
    1759-1768       27·38   |  1799-1808       26·46
    1769-1778       29·22   |  1809-1818       27·63
    1779-1788       26·52   |

Moreover, smallpox mortality, whilst rapidly decreasing before
the enactment of compulsory vaccination, has since been slowly
increasing. Thus--

    Years before   Average annual  |  Years after  Average annual
    Compulsion.       smallpox     |  Compulsion.     smallpox
                     mortality.    |                 mortality.
    1756-1775           5,480      |  1816-1835           450
    1776-1795           4,617      |  1836-1855           577
    1796-1815           2,303      |  1856-1875         1,031

We therefore see that while Jenner and his friends were boasting
of their achievements in Sweden, they had to account for the fall
in smallpox before their intervention, and for its continued
decline ere their intervention was operative; and, moreover, to
answer the question, What is the profit of salvation from smallpox
if death ensue from other causes? It is, however, to be observed
that such large considerations were outside the scope of Jenner’s
intelligence. _There was_ smallpox, and _there was_ vaccination,
_his_ invention, the infallible preventive of smallpox, and he saw
nothing beyond. His self-love was implicated in the defence of
vaccination, and any story in its favour was accepted as true, and
proclaimed abroad, whilst anything to its discredit was resented as
a personal affront, or denounced as wilful and diabolic falsehood.
As for statistics, he had no capacity. Baron says, “Neither Dr.
Jenner’s previous education nor his habits gave him a relish for
any of the branches of pure science; and he seemed to have a
peculiar horror of arithmetical questions, and was often jocular
on this defect in his nature.”[263] This inability to calculate
goes far to account for the absurdity of many of his statements
concerning the miraculous effects of vaccination among populations
where only two or three per cent. had been operated upon; and
who, therefore, must have vicariously delivered the remainder
from smallpox. To an intellect thus defective, the introduction
of vaccination to Sweden was the vaccination of the Swedes; the
decline of smallpox was its suppression; and its suppression was
the consequence of vaccination. But the excuse that is available
for Jenner does not serve those who cannot plead his congenital
defect, and are satisfied to repeat his preposterous assertions.

Smallpox kept declining in Sweden until the decade (1841-50)
when the annual average of deaths per million fell to 212. The
variations in the mortality in single years are remarkable. Here
are thirteen years when the deaths were under a hundred--

    1821   37
    1822   11
    1823   39
    1829   53
    1842   58
    1843    9
    1844    6
    1845    6
    1846    2
    1847   13
    1848   71
    1855   41
    1856   52

On the other hand, here are eighteen years when the deaths were
over a thousand--

    1825   1,243
    1833   1,145
    1834   1,049
    1838   1,805
    1839   1,934
    1850   1,376
    1851   2,488
    1852   1,534
    1858   1,289
    1859   1,470
    1865   1,336
    1866   1,217
    1867   1,061
    1868   1,429
    1869   1,474
    1873   1,122
    1874   4,063
    1875   2,019

The death-rate from smallpox, which fell to 212 per million in
1841-50, rose to 862 per million in 1851-60, to 867 per million in
1861-70, and, owing to the epidemic of 1873-74, the worst in Sweden
since 1801, the last decade, 1871-80, will exhibit a higher average.

In presence of these statistics, it is fair to repeat the inquiry,
“Why was smallpox declining before vaccination was introduced; and
why has smallpox revived and increased in ‘the best vaccinated
country in Europe’?”

Again, too, I must call attention afresh to the fact of the
irrelevant influence of smallpox upon the national mortality. Mr.
P. A. Siljeström has published a diagram of the course of mortality
in Sweden from 1774 to 1878, with the part smallpox has played in
that mortality, from which it is manifest (to all who choose to
use their own eyes) that the action of smallpox as a destroyer of
life has been wildly exaggerated.[264] Bad years of smallpox are
not years of a high death-rate, nor are years with little smallpox
years of a low death-rate. When smallpox is prevalent it appears
to replace other forms of disease, and when not prevalent, to be
replaced by diseases of greater fatality. Wherefore, argues Mr.
Siljeström--

  Of what use is it to the public that a smaller number of citizens
  die annually from Smallpox (supposing that this result is brought
  about by Vaccination), if an equally large number, nevertheless,
  die from other diseases? We can see no farther advantage in it
  than there would be in a battle, if none of the men fell before
  the fire of the artillery, but all the more died from the fire of
  the line. To the individual it may possibly be more agreeable to
  die of any other disease than Smallpox, and it ought, therefore,
  to be allowed to everyone to save himself, through Vaccination,
  or any other lawful means, from an eventuality which he fears;
  but this cannot possibly, in itself, be regarded as the business
  of the State.

Sweden is a large country, and its diseases must be subject to many
local variations; but Stockholm, representing a compact population,
exhibits much the same phenomena. In some years of last century the
city was severely afflicted with smallpox, as the deaths in these
years show--

    1778    639
    1783    714
    1784    411
    1787    414
    1795    447
    1800    703

These years were the worst; there were variations such as these--

    1780    14
    1782    12
    1785    20
    1793    22
    1797    13
    1798    12

As in Sweden at large, so in Stockholm, a fall in smallpox had set
in, and was continued into the new century, until years appeared
without a single death; for which vaccination had the credit,
and the disease was proclaimed “stamped out,” none dreaming of
reverse ahead. By and by it began to revive, and deaths were thus
registered--

    1857    319
    1865    273
    1866    157
    1870     96
    1871    113
    1873    191

And then came the dreadful epidemic of 1874, when 1,191 perished,
and 317 in 1875.

Thus, in two years, 1,382 perished in a population of 150,000--a
death-rate of 7,916 per million--against 2,430 per million in
London during the memorable epidemic of 1871; the severest outbreak
of smallpox in the century in “the best and most vaccinated
population in Europe!”

Under examination, the case for vaccination in Sweden altogether
disappears. By Mr. P. A. Siljeström the examination has been
conducted with a precision, a thoroughness, and a judicial
temper that leave nothing to desire. His treatise was translated
into English by Miss Frederica Rowan, and published in 1875,
under the title of “The Vaccination Question: an Essay towards
determining the Boundaries within which a Scientific Theory may
rightfully claim to have effect given it by Legislation;” and a
skilful abridgment was produced by Prof. F. W. Newman; but the
original, which extends to no more than 104 pages, should be
studied by whoever is seriously interested in the vaccination
question. Sweden, through the possession of a long series of vital
statistics, offers special facilities for a comprehensive study of
the phenomena of smallpox; and in Mr. Siljeström’s treatise, we
have veracity with good sense, and science with philosophy, instead
of the inadequate and catchpenny stuff current in this country as
“truth about vaccination.”

In Finland, the story of vaccination is much the same as in
Sweden, with the difference that there was no natural subsidence
of smallpox to be placed to its credit. Wherefore, as concerns
Finland, it is the habit of vaccinators to preserve a discreet
silence, the facts not tending to edification in the Jennerian
faith.

A curious evidence of the simple trust with which the cowpox
revelation was received in certain countries, is found in an
ordinance issued in Finland constituting smallpox after vaccination
a proof of imposture on the part of the vaccinator. The ordinance
ran thus--

  That the Inoculator or Vaccinator whose patients, within a
  shorter or longer time after having by him been inoculated
  or vaccinated, shall prove to have been attacked by natural
  Smallpox, with deadly result or other serious consequence,
  shall without pardon be declared unworthy of all further right
  to reward or confidence, and moreover, be impeached for due
  punishment on account of dishonest and unprofessional behaviour.

Under such a law (no severer than many which enact punishment
where the buyer does not obtain from the seller what he gives his
money for) how would it fare with the legion who now practise
vaccination? But I am reminded that vaccinators no longer undertake
to preserve their patients from smallpox, but only to keep it off
until it comes, and then to make it milder.

Vaccination was introduced to Denmark at the same time as Sweden,
and was made compulsory in 1810. As in Sweden, smallpox was
falling off, and, as in Sweden, the vaccinators were loud in
their outcry over their success; but their claim was absurd. The
population of Denmark in 1801 was 925,680, and up to 1810 no more
than 118,782 persons had been vaccinated, whilst the births during
the same period were 283,905. It was, therefore, assumed that the
vaccination of less than a tenth of the population in eight years
had reduced and extinguished smallpox among the unvaccinated
nine-tenths! Where there is a disposition to believe, anything may
pass for credible.

Subsequently to 1801 there was little smallpox in Copenhagen, and
from 1811 to 1823 not a death from the disease was recorded; but
in 1824 smallpox reappeared; and in 1835 there were 434 deaths in
the city; when it began to be admitted that vaccination did not
prevent smallpox, and that revaccination was necessary for complete
protection; but, if requisite, how was the miraculous extinction of
the disease by the primary vaccination of less than a tenth of the
population in the early years of the century to be accounted for?

Here we have the record of Copenhagen smallpox for seventy-five
years, 1801-75--

     Years.   Deaths.   Annual
                       Average.
    1801-10     639       64
    1811-20      --       --
    1821-30     119       12
    1831-40     568       56
    1841-50     245       24
    1851-60     160       16
    1861-70     168       16
    1871-75     518      103

Thus the number of deaths in the five years, 1871-75, was nearly
equal to the deaths in the preceding thirty years, 1841-70;
whilst at the same time the more or less smallpox had no apparent
influence in raising or lowering the general mortality.

Iceland, as a dependency of Denmark, is often cited as evidence
for the virtue of vaccination. Speaking in the House of Commons
recently, Mr. T. W. Evans proclaimed, “Vaccination has extinguished
smallpox in Iceland! There has not been a case in the island for
thirty years.” Could aught be more conclusive? and the assertion is
re-asserted with triumph: yet, under examination, we shall see the
statement and the inference vanish like smoke.

First, the absence of smallpox from Iceland for series of years
was nothing uncommon. Iceland’s history is singularly copious and
accurate; and from Schleisner’s _Iceland from the point of view of
Medical Science_, Copenhagen, 1849, we have the following list of
smallpox epidemics during five hundred years--

    1347--A great epidemic.
    1380--Ditto.
    1430--Terrible epidemic--8000 deaths.
    1511--A great epidemic.
    1555--Ditto.
    1574--Ditto.
    1580--A kind of variolous disease.
    1590--Smallpox epidemic.
    1616-17--Ditto by importation.
    1632--Smallpox epidemic.
    1636--Ditto.
    1655--Ditto.
    1658--Ditto.
    1670-1--Varioloid and Smallpox.
    1707-9--A dreadful epidemic by importation--18,000 died.
    1742--A small epidemic from case brought in Dutch vessel.
    1762-3--A mild epidemic.
    1785--A small epidemic--73 deaths.
    1786--Epidemic--1237 deaths.
    1787--Epidemic--113 deaths.
    1839-40--Smallpox again brought to Iceland, but prevented from
             spreading by strict quarantine.

From this list it will be seen that for centuries Iceland has had
long terms of immunity from smallpox. Thus--

      Dates.        Immunity.
    1347 to 1380    33 years.
    1380 ”  1430    50  ”
    1430 ”  1511    81  ”
    1511 ”  1555    44  ”
    1671 to 1707    36 years.
    1709 ”  1742    33  ”
    1787 ”  1839    52  ”

Inasmuch then as vaccination could have nothing to do with the
years of immunity in former times, on what ground of reason can
vaccination be set forth as the cause of immunity at this day?
Schleisner observes--

  Since 1306 Smallpox has been epidemic in Iceland nineteen times,
  and has always been brought in either by French, English, Dutch,
  or Danish ships. In early times it frequently caused a terrible
  mortality, as in 1707, when 18,000 out of a population of 50,000
  perished; and in 1430, when 8000 are said to have died. In
  later years its violence has diminished _in consequence of the
  introduction of Vaccination_. In 1785-6-7, its last attack in the
  eighteenth century, only 1425 persons died.

Very good; but in 1785-87, vaccination was unknown; and as the
epidemics of 1742 and 1762 are recorded by Schleisner as “small”
and “mild” respectively, while so early as 1580 one is described
as “a kind of variolous disease,” it is evident that vaccination
could have as little to do with making “smallpox milder” as with
the long terms of immunity which Iceland has enjoyed.

In an appeal by Mr. William Morris on behalf of the Icelanders,
threatened with famine in 1882 he observed--

  Lastly, the Measles, which has not been in Iceland for thirty-six
  years, and which falling on a people not used to it, is a deadly
  and not a trivial disease, has attacked Reykjavik, where half
  the people are down with it, and many have died, and it is now
  spreading over the island.

Measles absent from Iceland for thirty-six years! Supposing there
were some dodge against measles corresponding to vaccination
against smallpox, would not the exemption in every year up to the
thirty-sixth have been ascribed to its efficacy?

Dr. Garth Wilkinson relates that in 1866 when standing on the
Lawrock, where the Althing was held, Dr. Hjaltalin, Medical
Inspector of Iceland, told him--

  When, in 1000 A.D., Christianity was first introduced into
  Iceland, the heathen party in the Althing credited the wrath
  of their gods with a volcanic eruption which broke out on a
  neighbouring farm. Snorri, the great Icelandic historian, being
  present, asked, “What then was it that made the gods angry when
  the older lava was on fire?” It clearly was not Christianity
  then. He carried the day against the gods by this common-sense
  question, and Christianity became the law of the land.

  Somewhat parallel with this history is the claim made for the
  extirpation of Smallpox by Vaccination in Iceland. It is a
  case of _ante hoc_ pricking the windbag of _post hoc_, and, _a
  fortiori_, of _propter hoc_.[265]

Whilst thus the Icelandic Vaccination Bubble is burst, it remains
to be observed that if vaccination had saved the Icelanders from
smallpox it could only have been vicariously--as in so many
instances of similar salvation; for during the first half of the
present century no more than 17,072 vaccinations were effected in a
population of between fifty and sixty thousand in the flux of birth
and death. The vaccinations are thus recorded--

    YEARS--1804-15   VACCINATIONS--  1345
      ”    1816-30        ”        10,386
      ”    1831-37        ”         None.
      ”    1838-50        ”          5341
                                   ------
                          Total,   17,072[266]

There is much of the like order of “facts in favour of vaccination”
current concerning other European populations, which only pass
muster because they are rarely subjected to criticism; because
vaccination is considered such a benign invention that to question
its credentials is wicked; and because it is held that if even some
of the claims made for it are touched with fable, yet their effect
on the popular mind is so clearly for good in inspiring confidence
and overwhelming occasional mishaps, that it is inexpedient to be
over-scrupulous. But, however instructive and wholesome may be
the exposure of such sophistications, it is necessary to restrain
ourselves, and for the remainder of my Story we shall keep to
English ground.

From the preceding details we see how far vaccination in Sweden,
Denmark and Iceland fell short of the claims made for it by Jenner
and his successors. Jenner, it is true, died in 1823, before the
more pronounced refutations of his assertions had been evolved,
but, as said, it is questionable whether he ever realised that the
names of countries stood for millions of men, women and children
whose vaccination could only be overtaken by organised exertion in
the process of years. His various boasts, therefore, of vaccinated
nations and exterminated smallpox are to be taken as proofs of
defective arithmetical capacity and of that scientific imagination
which runs with possibility and matter-of-fact.


FOOTNOTES:

[263] Baron’s _Life of Jenner_, vol. ii. p. 293.

[264] _Tables relative to Vaccination in Sweden, 1774-1778._ London
Society for the Abolition of Compulsory Vaccination.

[265] _Vaccination Tracts_, Part III. No. 14. London, 1878.

[266] _Report on the Vaccination Act (1867) from the Select
Committee of the House of Commons_, 1871. P. 414.




CHAPTER XXXII.

NEWCASTLE SMALLPOX: A COMMON STORY.


To examine the statistics of the larger English towns in order
to determine whether vaccination has had any influence on the
abatement of smallpox, would involve us in discussion interminable.
For our immediate purpose it may suffice to select three examples;
1st, NEWCASTLE-ON-TYNE, as an instance of a common story; 2nd,
NORWICH, as an instance of a smallpox epidemic; and 3rd, GLASGOW,
as an instance of smallpox displaced and replaced as a factor of
mortality.


THE NEWCASTLE DISPENSARY.

We often hear of “the statistics of the Anti-Vaccinators;”
to which the summary answer is that Anti-Vaccinators have no
statistics. Their statistics are the statistics of the Vaccinators,
in which they provide the material for their own condemnation;
which is probably the reason why the so-called statistics of the
Anti-Vaccinators are so intensely disliked, avoided, and unanswered.

The Newcastle Dispensary in 1877 completed its hundredth year,
having been founded in 1777, and Dr. Monteith prepared a concise
history of the institution, which was published in 1878 by order of
the Committee.[267] The report is especially valuable as a record
of the comparative incidence of disease in a large industrial
population, where, if anywhere, smallpox might be expected to
show itself in severe form. In 1781 the population of Newcastle
was estimated at 23,000; in 1821 it had risen to 41,794; in 1851
to 87,784; and in 1871 to 128,443; and through all these years
and changes, the Dispensary continued in active operation, the
percentage of the patients to the population being maintained with
remarkable uniformity. It is needless to add that the majority
of the patients have been from the ranks of the poor, among whom
smallpox has always its chief seat. As Dr. Monteith observes--

  They are the class intermediate between the well-to-do
  working-man and the pauper. The state of distress in which
  these people continually live is known to few. The patient,
  when visited by the doctor, is usually found lying in “poverty,
  hunger, and dirt,” and the treatment of the cases is undertaken
  in circumstances very unpropitious to success. Medical advice and
  medicine are not the only things needed. Good food, warmth, and
  judicious nursing are imperatively required, and are seldom if
  ever attainable.

Before turning to the Dispensary’s record of a century of smallpox,
it may be well to observe that Variolation was practised in
Newcastle with great assiduity, and that the Dispensary took a lead
in the business, the surgeons inoculating any one who applied. Dr.
Monteith relates--

  By the year 1777 the arguments in favour of Variolation had so
  far triumphed over the habits and prejudices of the profession
  that there is no instance mentioned in our reports of any
  medical man in Newcastle opposing it. It is always spoken of as
  one of the best established facts of medical science. With the
  general public the case was different. Their prejudices were as
  strong as ever, and they exhibited a horror of Variolation which
  would satisfy the most ardent Anti-Vaccinator. To combat these
  prejudices various means were tried--sermons from the pulpit,
  pathetic exhortations in the newspapers, etc. The last and most
  convincing argument consisted of a pecuniary reward to parents
  who should allow their children to undergo the operation. The
  sum offered was 5s. for one child, 7s. for two, 9s. for three,
  and 10s. for four, and upwards. The success of this expedient
  was remarkable. Parents came flocking in with their children
  in great numbers. Tempted by the rewards, they subjected their
  little ones to an operation which, unless their sentiments had
  greatly altered, they believed to be barbarous and hurtful in
  the extreme, and a clear temptation of Providence. Variolation
  on these terms commenced in the spring of 1786; and every
  year thereafter, until 1801, children were operated on at the
  Dispensary at the rate of over 200 per annum. In 1801 there had
  been in all 3,268 operated upon.

As soon as Vaccination came into vogue, Variolation was denounced
as the chief cause of the existence of smallpox. It was said that
what was done to avert the disease from the individual diffused it
among the multitude. Vaccinators long maintained that they could
easily exterminate smallpox, if only Variolators would refrain from
keeping it alive. Variolation gradually ceased, and was formally
prohibited in 1840, and by and by Vaccination was made compulsory.
Nevertheless, the confident prophecy of the Vaccinators remains
unfulfilled, for smallpox is not exterminated.

The change from Variolation to Vaccination at the Newcastle
Dispensary was immediate. Dr. Monteith says--

  It is creditable to the good sense and enlightenment of the
  Dispensary authorities that they _at once_ abolished Inoculation
  of Smallpox, and substituted Vaccination in its stead. In 1801,
  the first year, 215 children were vaccinated. The annual number
  rapidly rose until it reached its maximum in 1813, when 1,874
  were vaccinated, after which the numbers as rapidly declined.

For this decline various reasons were assigned, such as the
increase of the private practice of vaccination, and the
disposition to undervalue every benefit, however great, that is
purely eleemosynary. It is forgotten that Vaccination fell off
as its illusory character became more and more manifest, and as
the promises made on its behalf were, one and all, indisputably
belied. When Jenner died in 1823, he passed away amid indifference,
if not contempt. His bubble had burst. The furore for vaccination
witnessed in the present generation is by no means a continuation
of the original furore. That passed away. Our furore is a revival,
dating from the popularity of sanitary reform, to the back of which
a new generation of medical men contrived to attach vaccination!

In the hundred years, 1777 to 1877, the Dispensary had to deal with
2,616 cases of smallpox, of which 428 terminated fatally, which as
to years and mortality may be thus classified--

    Years.           Cases.   Deaths.   Mortality
                                         per 100.
    1777 to 1802       365      90        24·6
    1808 ”  1827       273      57        20·8
    1828 ”  1852       925     152        16·4
    1853 ”  1877     1,053     129        12·25
                     -----     ---        ----
                     2,616     428        16·3

The progressive reduction in mortality is, of course, ascribed
to vaccination having made the disease milder; though the report
informs us that “the mortality from smallpox reached its highest
point--33·3 per cent. in the five years from 1802 to 1807,” the
very time when enthusiasm in favour of the Jennerian rite was
at its acme. We, on the other hand, would attribute the lower
mortality, as did Dr. Andrew Combe, to better modes of treatment,
even neglect being preferable to much of the old-fashioned regimen
for smallpox. Considering the figures, Dr. Monteith observes--

  Of Smallpox I desire to speak with circumspection, for in
  Newcastle Anti-Vaccinators are somewhat rampant. Figures,
  however, are stubborn things, and their import is not easily
  explained away. Like the vast majority of medical men, I have
  always firmly believed in the good results of Vaccination.
  Without admitting that my faith has been shaken by considering
  these statistics, I must confess that I have been a good deal
  disappointed with them. I had expected to find this terrible
  disease regularly decimating the population every year until the
  epoch of Jenner’s discovery, and afterwards diminishing, rapidly
  and steadily, almost to nothing. These figures do not warrant us
  in taking so sanguine a view of the matter.

  Whilst, therefore, we observe considerable improvement in
  the figures, I am of opinion that they leave us in this
  dilemma--either that there now exists a grossly exaggerated
  impression of the prevalence and fatality of Smallpox in former
  times, or else that they had begun to decrease long before the
  discovery of Vaccination, the beneficial effects of which must,
  therefore, have been at least assisted by other causes.

Here we have an honourable confession from out the bonds of
professional prejudice, and a reluctant exposure of the legend of
a world decimated by smallpox, and ceasing to be decimated after
the advent of Jenner. There is nothing singular in the Newcastle
evidence that has awakened distrust in the mind of Dr. Monteith.
Similar evidence is found wherever facts are available. The legend
to the contrary has become established, like many other legends,
by dint of repetition, until those who venture to question it are
regarded with suspicion and dislike.

The Report of the Newcastle Dispensary illustrates another truth,
namely, that the abatement or cessation of smallpox is by no means
equivalent to a reduction of death; that evil conditions of life
remaining unchanged, a fall in smallpox is compensated for by a
rise in some cognate form of zymotic disease. Thus Dr. Monteith
remarks:

  It is generally said by the opponents of Vaccination that the
  other exanthemata have increased since its introduction. It must
  be allowed that our figures (probably unreliable as general
  data), give some support to this supposition. The proportion of
  cases of Scarlatina in the five years, 1827-32 was 4·3 per cent.
  It has never reached that high limit since; but the percentage
  has never fallen below 2 in the last thirty-five years. Mortality
  has also increased to an alarming extent. At one time so low as
  2·5 per cent., it has amounted to 17 per cent. in the last five
  years. Scarlatina is now by far the most fatal disease on the
  list, with the exception of Consumption.

Of Scarlatina, the Dispensary record stands thus--

      Years.       Cases.  Deaths.  Mortality
                                     per 100.
    1777 to 1802     355     33       9·3
    1803 ”  1827     795     30       3·7
    1828 ”  1852   1,856    155       8·3
    1853 ”  1877   3,659    567      15·5
                   -----    ---      ----
                   6,665    785      11·7

Of Measles it is said, “the disease has somewhat increased in
numbers, whilst the proportion of deaths to cases has not varied
much.” Thus the record stands--

      Years.       Cases.  Deaths.  Mortality
                                     per 100.
    1777 to 1802     186     16       8·6
    1803 ”  1827     435     22       5·0
    1828 ”  1852   1,572     83       5·2
    1853 ”  1877   2,537    123       4·8
                   -----    ---       ---
                   4,730    244       5·1

Of Whooping Cough it is observed--

  The death-rate in former years fluctuated widely. At present
  it appears to remain stationary at a figure somewhat above
  the average of the century. There is a common impression that
  Whooping Cough is a disease of little danger and no importance,
  but the following table shows that of late years it has been more
  fatal than Smallpox or Measles.

      Years.        Cases.  Deaths.   Mortality
                                       per 100.
    1777 to 1802      245       22       9·0
    1803 ”  1827      220       23      10·4
    1828 ”  1852      743      112      15·0
    1853 ”  1877    1,716      241      14·0
                    -----      ---      ----
                    2,924      398      13·6

Smallpox, Scarlatina, Measles, and Whooping Cough may be regarded
as convertible forms of infantile zymotic disease. Conditions of
existence remaining equal, one may be the substitute of the other,
maintaining thereby a common death-rate. Diarrhœa is sometimes
placed in the same category; and, like erysipelas, it is to a
large extent a consequence of vaccination. It should never be
forgotten that vaccination induces a constitutional disturbance or
fever, which illness is offered to Nature as a propitiation for
smallpox; with which propitiation, say the vaccinators, Nature is
satisfied, and withholds the infliction of smallpox. Vaccination,
as an illness, however, is frequently attended with diarrhœa, and
the increase of that affection, _pari passu_, with the increase of
infant vaccination, is marked. Thus stands the record of Diarrhœa--

      Years.        Cases.  Deaths.   Mortality
                                       per 100.
    1777 to 1802    1,390      67       4·8
    1803 ”  1827    1,529       7        ·4
    1828 ”  1852    3,995      43       1·0
    1853 ”  1877    6,117     362       5·9
                    -----     ---       ---
                   13,031     479       3·6

Dr. Monteith observes--

  The mortality from Diarrhœa is unfortunately steadily increasing,
  the percentage for the last five years, 1872-77, being the
  highest on record--viz., 14·4. The majority of the deaths takes
  place among infants; and the disease is produced in most cases
  by the ignorance or carelessness of mothers in giving them
  food which is not fit for them. But why this should be the case
  now any more than it was twenty or fifty years ago, I cannot
  understand. An increased consumption of alcoholic stimulants in
  later times has been suggested to me as an explanation.

Any explanation is welcome that will preserve vaccination from
reproach, yet what medical man is ignorant of the fact that
diarrhœa is one of the commonest sequences of vaccination? Nature
thus endeavouring to throw off the effects of the virus infused
into the blood.

Taking, then, these five diseases in the order of their mortality,
they range thus--

                           1777-   1803-   1828-   1853-
                             1802    1827    1852    1877   Total.

    Scarlatina,  { Cases,    355     795   1,856   3,659    6,665
                 { Deaths,    33      30     155     567      785
    Diarrhœa,    { Cases,  1,390   1,529   3,995   6,117   13,031
                 { Deaths,    67       7      43     362      497
    Smallpox,    { Cases,    365     273     925   1,053    2,616
                 { Deaths,    90      57     152     129      428
    Whooping-    { Cases,    245     220     743   1,716    2,924
      Cough,     { Deaths,    22      23     112     241      398
    Measles,     { Cases,    186     435   1,572   2,537    4,730
                 { Deaths,    16      22      83     123      244

In the course of a century the Newcastle Dispensary had dealt with
a total of 250,637 cases, of which no more than 2,616 were of
smallpox, or about 1 in 96. The total deaths during the century
were 14,088, of which no more than 428 were due to smallpox,
or about 1 in 33; whilst from scarlatina they were 1 in 18,
from diarrhœa 1 in 30, and from whooping-cough 1 in 35. It may
be said, the record of the Dispensary does not account for the
population of Newcastle. True; but it accounts for the lower strata
of the population, and, therefore, for an excessive proportion
of smallpox. The complete statistics of the city would exhibit
smallpox as a still lighter affliction. And, we repeat, there is
nothing singular about the record of the Newcastle Dispensary. It
is a common story. Whenever we get out of the region of romance,
and tread the ground of matter-of-fact, it is to discover that the
wilder horrors and ravages of smallpox have been originally evolved
from imagination, and are perpetuated in ignorance from hearsay.


FOOTNOTE:

[267] _Report of the Newcastle Dispensary, from its Foundation
in 1777._ Printed by order of the Committee. Newcastle-upon-Tyne,
1878.




CHAPTER XXXIII.

THE NORWICH EPIDEMIC--1819.


I have repeatedly cautioned my readers against the common
assumption that the London smallpox of last century was the
measure of English smallpox. It was not so. Smallpox was endemic
in London, whereas it occurred as an occasional epidemic in other
English towns, and was almost unknown in many rural districts.
Moreover, the disease was not allowed to die out, but was
diligently cultivated and diffused by variolation. As vaccination
was introduced, the practice of variolation correspondently
ceased, and with its cessation there was an abatement of smallpox,
which abatement was unwarrantably ascribed to vaccination. How
much of the smallpox of last century was due to variolation it
is impossible to determine; nor would it be safe to accept the
assertions of the early advocates of vaccination on the point. I
apprehend that if smallpox were something desirable which everyone
was intent on catching, it would be discovered that it could not
be universally caught, and that its propagation had definite
limits; and it is not improbable that among Londoners the limit
of propagation was closely approached, so that nearly all who
were susceptible contracted the disease. What, however, I wish
to enforce is, that the decline in the prevalence of smallpox in
some places coincidently with the introduction of vaccination was
largely due to the discontinuance of smallpox culture, and that
the suppression of that culture would have given the same result.
Nor let it be forgotten that an almost world-wide fall in smallpox
had set in toward the close of last century, which the vaccinators
attributed to their prophylaxy in the nineteenth. Miraculous
effects are frequently asserted where miraculous causes would be
disowned.

The vital statistics of last century are, to a great extent, the
products of inference and conjecture, and more or less affected
by the purpose and bias of their collectors; but if even we had
the correct mortalities of smallpox in the chief centres of
population,--such as York, Hull, Norwich, Chester, Coventry, Bath,
Bristol, Exeter, and Plymouth--we should still be puzzled to
separate what was due to insanitary conditions of life from what
was due to the artificial induction of the disease by variolation.
It has been said that the 18th Century did not terminate in England
until 1830; and accepting that liberal allowance, we may resort to
an interesting record of a virulent epidemic in Norwich in 1819 for
some light on the character and incidence of urban smallpox prior
to the rise of such great communities as Liverpool, Manchester,
Leeds, Sheffield, and Birmingham. The account of the epidemic was
written by John Cross, a surgeon practising in Norwich.[268]

In those days Norwich contained a population of about 40,000. The
city was accounted salubrious, and smallpox was little known. Cross
writes that “in 1805, _after being for a time almost extinct_,
smallpox prevailed so much in Norwich as to excite some attention.”
The attention excited led to an attempt to introduce vaccination.
A meeting was held in the Guildhall, 16th July, 1805, “to concert
measures for the extermination of the disease,” and resolutions
were passed to discourage inoculation with smallpox, and “to
substitute immediate and universal vaccination of the inhabitants
of the city and its hamlets.” This outbreak of smallpox and
vaccination appears to have subsided together, for Cross continues--

  After being absent for a year or two, Smallpox was again
  introduced to Norwich by an individual from London, and spread
  so extensively among those whose obstinacy or whose prejudices
  made them resist Vaccination, that 203 deaths from Smallpox were
  recorded in the Bills of Mortality between 1807 and the end of
  1809. Smallpox again appeared in 1813, in which year 65 deaths
  took place; the mortality being confined to so small a number by
  the early and extensive adoption of Vaccination before the danger
  was actually at hand. From the year of 1813, it may be said,
  there was no Smallpox in Norwich until the rise of the epidemic
  which I propose to describe. Not a death from the disease was
  noticed for four years. Indeed, the only case that came to my
  knowledge, during the time specified, was the servant of a
  celebrated public character, who, being seized with Smallpox, was
  detained in Norwich, but from whom, so far as I could learn, the
  contagion did not extend.

I shall presently refer to the number of vaccinations effected in
Norwich, and to their influence in arresting smallpox. What I would
now draw attention to is, the comparative rarity of smallpox in
Norwich in those times. Years two, three, and four elapsed without
a single death from the disease! How does such a fact accord with
the common-place of vaccinators, that before the advent of Jenner
the people of England were decimated with smallpox, and that
40,000 perished annually? When we press for evidence for these
extraordinary statements, we either get no answer, or we discover
that the mortality of a bad year of London smallpox has been
multiplied by the population of the United Kingdom, thus yielding
the astounding total of 40,000 victims. Our reply is, that there is
no warrant whatever for this conversion of London mortality into
national mortality; that London was unique in its circumstances;
and that, setting the immense rural majority aside, even in the
largest cities, such as Norwich, years passed without any deaths
from smallpox.

Vaccination had the prestige of fashion, and the leading citizens
of Norwich were philanthropic and scientific after the newest
lights, and whatever was accounted “proper,” they were intent to
effect. To have the vulgar vaccinated was, however, no easy matter.
Many declined because they had no fear of smallpox. What, indeed,
had they to be alarmed about? Moreover, as experience advanced,
the futility and danger of the new inoculation became more and more
apparent. It began to be known that it not only failed to avert
smallpox, but it frequently induced serious illness, permanent
injury, and sometimes death. It is to be remembered that the
symptoms of vaccination were watched at the outset of the practice
with keen attention, and that the general verdict, especially of
mothers, was distinctly adverse to its harmlessness. That such was
the common judgment was manifest from the rapid decline of the
early furore in its favour, and its contemptuous neglect by the
mass of the people until revived and enforced by legislation. As
the citizens of Norwich would not be vaccinated, it was determined
to try the effect of bribery, and surgeon Rigby in 1812 induced the
court of guardians to offer a reward of 2s. 6d. to every person
“who should bring a certificate from a surgeon of having gone
satisfactorily through the cowpox.” The results of this bribery are
set forth as follows by Cross--

     511 received the award in 1813
      47    ”          ”       1814
      11    ”          ”       1815
     348    ”          ”       1816
      49    ”          ”       1817
      64    ”          ”       1818
    1402    ”          ”       1819

The larger numbers in 1813, ’16, and ’19 were due to panic and
pressure; but the figures maybe taken for a graphic representation
of the distrust with which vaccination was regarded after ample
experience. Of course many were vaccinated who did not claim the
parish half-crown; and at the end of 1819 it was calculated that
10,000 in Norwich had submitted to the Jennerian rite from the
date of its introduction at the beginning of the century. Thus
considerably less than a fourth of the inhabitants were what is
called “protected.”

We now come to the narrative of that great outbreak of smallpox,
which, says Cross, destroyed more lives in less time in Norwich
than any epidemic since the Plague. It is almost superfluous to
state that the disease did not originate in Norwich: it never
appears to originate anywhere: it was imported. A girl travelling
with her parents from York caught the infection in transit at a
market-town, and as soon as she arrived in Norwich was laid up with
the disease.

  This happened [says Cross] in the latter end of June, 1818; and
  the earliest cases of Smallpox that were seen by any medical
  man were traced to this origin. I have been able to ascertain
  the different families by which the disease was kept up during
  the remainder of that year, but it extended to very few, and
  proved fatal in only two instances. A druggist inoculated three
  children in January, 1819, thus helping in a small degree to
  spread the contagion, which the season of the year was calculated
  to keep within narrow bounds. Still no alarm was excited; a
  single medical man only was acquainted with the disease; and the
  cases of Smallpox were so few until the latter end of February
  as to be scarcely noticed. At this time, however, the disease
  extended from one of our greatest charity schools to all quarters
  of the city.... Comparatively dormant during the winter, as the
  season became milder it burst upon us suddenly and unexpectedly,
  continuing its work of devastation for three or four months with
  undiminishing fury. The following list of burials taken from the
  Bills of Mortality will give a sufficiently accurate idea of the
  advance and decline of the disease--

    1819.    Deaths from   Deaths from     Total of
             Smallpox.   other diseases.    deaths.
    January,     3             61              64
    February,    0             71              71
    March,       2             68              70
    April,      15             61              76
    May,        73             63             136
    June,      156             70             226
    July,      142             61             203
    August,     84             63             147
    September,  42             96             138
    October,    10             63              73
    November,    2             62              64
    December,    1             83              84
               ---            ---            ----
               530            822            1352

  The greatest mortality occurred in June when 43 were buried from
  Smallpox in one week. The rapid declension of the disease from
  that period is obvious from the above table; and it was so nearly
  extinct at the end of the year, that I could not find a variolous
  patient from whom ichor could be procured for an important
  experiment. As probably one in six of all who were affected by
  the epidemic died of it, I am convinced it is not far from the
  truth to assert that considerably over 3000 individuals, or a
  thirteenth part of the whole population of Norwich, had Smallpox
  in the year 1819.

It is always sound policy to take what is considered the case
against us at its worst; and as this dreadful Norwich epidemic
is cited as evidence of what is possible in the absence of
vaccination, and as something that opponents of vaccination
should regard as conclusive against them, there is cause to give
it special attention; and the more so as the leading facts are
well ascertained. First, however, I would remark that I have no
desire to minimise the horrors of smallpox: it is a loathsome,
and, because preventible, a discreditable disease: but neither let
us maximise its horrors, but try, at least, to recognise facts in
their true dimensions.

Five hundred and thirty died in Norwich of smallpox in 1819 of 3000
supposed to have had the disease, the deaths being, as commonly
estimated, one in five or one in six of those affected. The deaths
from all diseases in Norwich in 1819 were 1352--a mortality of
30 per 1000; a high rate, but by no means uncommon in urban
populations free from smallpox. I have next to observe that if 3000
had smallpox, there were 37,000 who escaped, and to ask, How did
they escape? By what means were they protected? It may be replied
that a fourth of them were vaccinated; but how does that account
for the immunity of 30,000 unvaccinated? The 10,000 vaccinations
reputed to have been effected in Norwich from the beginning of the
century were the work of nearly twenty years, and the major part
of them in 1819 must have been represented by adults practically
out of the range of infection, protected not by vaccination, but by
their years.

“Protected by their years! What do you mean?” exclaims a reader.

Precisely what I say--that in the Norwich epidemic, as in variolous
epidemics generally, adults are comparatively secure, and the
young, and especially infants, are the victims. In Norwich, in
1819, scarcely a bread-winner, or a father or mother was laid in
the grave slain by smallpox.

“It is incredible!”

It is incredible simply because the facts of smallpox are
persistently overlooked. Here is proof of the incredible in a
statement carefully prepared by Cross of the ages of the 530 who
died in the Norwich epidemic--

    Under two years of age,           260
    Aged from two to four years,      132
       ”      four to six years,       85
       ”      six to eight years,      26
       ”      eight to ten years,      17
       ”      ten to fifteen years,     5
       ”      fifteen to twenty years,  2
       ”      twenty to thirty years,   2
       ”      thirty to forty years,    1
                                      ---
                                      530

It will be said, as a matter of course, that if these children
had been vaccinated they would not have perished; but the answer
is that at this day the chief mortality of smallpox is among the
vaccinated young, in whom the whole virtue of the rite may be
supposed to abide fresh and efficient. Cross was an enthusiastic
vaccinator, but he allows, with due excuses, that the vaccinated
minority contributed a certain quota to the sick and the dead, and
that the ill repute of vaccination caused many in their terror to
resort to variolation, and thus to incur and diffuse the mischief
of which they stood in dread. Some old women and a druggist were,
he says, responsible for four or five hundred of these creations
of smallpox during the epidemic, “each of which became a centre of
contagion.”

Age, I said, constituted the chief protection from smallpox,
but good houses and good fare formed another line of defence.
“The effects of the Norwich epidemic were confined _almost
exclusively_,” says Cross, “_to the very lowest orders of the
people_.” Moreover, he observes--

  The disease was often aggravated, and made to assume its worst
  characters, by the most injudicious treatment. The prejudiced and
  most ignorant being the principal sufferers, the prescriptions of
  old women were more listened to than the advice of medical men.
  A practice kept up by tradition among the poor of the city for
  above a century was revived, in spite of all remonstrance, as
  follows--

  “At the commencement, to set the object before a large fire and
  supply it plentifully with saffron and brandy to bring out the
  eruption; during the whole of the next stage to keep it in bed
  covered with flannel, and even the bed-curtains pinned together
  to prevent a breath of air. To allow no change of linen for ten
  or more days, until the eruption had turned; and to regard the
  best symptom to be a costive state of the bowels during the whole
  course of the disease.”

  Such were the means by which the horrors of the epidemic were
  aggravated. The old nurses triumphed not a little in having an
  opportunity of showing their skill after it had been so long
  unexercised; nor was it often easy, among the deluded persons in
  whose families this affliction occurred, to persuade or compel
  them to adopt a different plan of treatment.

Cross described several cases in which unquestionable vaccination
had been followed by unquestionable smallpox. In one instance, a
girl of eleven years of age, correctly vaccinated in both arms,
perished of malignant smallpox, whilst her unvaccinated brother,
six years of age, recovered from a severe attack. Such cases in
1819 were treated as exceptional, but they have long passed into
the category of matter-of-course, and ceased to excite observation
or surprise.

Such was the memorable Norwich epidemic. However dreadful, it was
in no wise extraordinarily dreadful. If the death-rate was raised
for a single year, it would be reduced in subsequent years, and
the average rate recovered that accorded with the common obedience
of the community to the laws of health. In Nature consequences are
equal, and any temporary aberration is in the long run compensated
for. If vaccination could have kept smallpox from Norwich, the
citizens would have had in some other form the measure of disease
that pertained to their way of life.

We might, moreover, inquire, whether to escape an epidemic, severe
as that of 1819, it would have been economical to put 40,000
people through the pains and perils of vaccine fever. Why should
a universal affliction be incurred to avert a partial one?--an
affliction confined to the young of the lower orders. The
vaccination of Norwich from 1801 to 1819 would have cost far more
sickness and death than did the smallpox of the same years. In
short, if vaccination had conferred the immunity claimed for it,
the price of the salvation would have been in prodigious excess of
its value.


FOOTNOTE:

[268] _A History of the Variolous Epidemic which occurred in
Norwich in the year 1819, and destroyed 530 Individuals; and an
Estimate of the Protection afforded by Vaccination, and a Review of
Past and Present Opinions upon Chickenpox and Modified Smallpox._
By John Cross, Member of the Royal College of Surgeons in London.
London, 1820. Pp. 296




CHAPTER XXXIV.

SMALLPOX DISPLACED AND REPLACED.

DR. WATT’S DISCOVERY--GLASGOW, 1813.


Addressing the House of Commons in 1878, Sir Thomas Chambers said,
“You cannot show that Vaccination has reduced deaths, or saved a
single life. There may be no Smallpox, but the disappearance of
Smallpox is by no means equivalent to a reduction of mortality.”
M.P.’s were astonished and incredulous; but ignorantly. The fact
is incontestable; and Dr. Robert Watt of Glasgow had the signal
distinction of detecting and setting it forth in the year 1813.[269]

Watt was writing a treatise on Chincough, otherwise Whooping Cough,
and in the course of his work made a careful examination of the
registers of death in Glasgow to ascertain how far it was true
“that the disease was more fatal some years than others; that it
was more dangerous at a particular age; and that the female sex
suffered more from it than the male;” and, from the outset of his
investigation, “was struck with the immense numbers carried off
yearly by the Smallpox.” He might well be struck; for Glasgow was a
rare place for Smallpox, as appears from the following statement
compiled from Watt’s Tables--

    DEATHS IN GLASGOW FOR TEN YEARS, 1783-1792.

    Year.   From    Measles. Whooping | Children  Children  Total,
          Smallpox.           Cough.  |  under     under      all
                                      |   Two.      Ten.     Ages.
    1783     155      66       153    |   479       719      1413
    1784     425       1        13    |   671       877      1623
    1785     218      --        34    |   576       744      1552
    1786     348       2       173    |   706       941      1622
    1787     410      23        57    |   746      1016      1802
    1788     399       1        17    |   770      1059      1982
    1789     366      23        45    |   794      1058      1753
    1790     336      33       177    |   903      1236      1866
    1791     607       4       117    |   984      1367      2146
    1792     202      58        68    |   664       902      1848
            ----     ---       ---    |  ----      ----    ------
    Total,  3466     211       854    |  7293      9919    17,607

The succeeding ten years, 1793-1802, repeat much the same tale,
with, however, a diminution of mortality in an increasing
population, and a decrease in smallpox with an increase in measles
and whooping-cough: thus--

    DEATHS IN GLASGOW FOR TEN YEARS, 1793-1802.

    Year.   From    Measles. Whooping | Children  Children  Total,
          Smallpox.           Cough.  |  under     under      all
                                      |   Two.      Ten.     Ages.
    1793     389       5       112    |   807      1126      2045
    1794     235       7        51    |   553       759      1445
    1795     402      46       180    |   761      1048      1901
    1796     177      92        60    |   562       797      1369
    1797     354       5        76    |   586       884      1662
    1798     309       3        98    |   642       864      1603
    1799     370      43        95    |   783      1105      1906
    1800     257      21        27    |   545       716      1550
    1801     245       8       125    |   494       766      1434
    1802     156     168        90    |   544       985      1770
            ----     ---       ---    |  ----      ----      ----
    Total,  2894     398       914    |  6277      9050    16,685

Considering these figures said Watt--

  I remarked that the deaths by Smallpox were chiefly in infancy;
  hence the deaths under two or three years of age bore a very
  great proportion to the whole deaths in the city. Taking an
  average of several years, I found that more than half the human
  species died before they were ten years of age, and that of this
  half more than a third died of the Smallpox; so that nearly a
  fifth part of all that were born alive perished by this dreadful
  malady.

Watt meant of course the human species as exhibited in Glasgow,
of whom more than half died before the age of ten, and a fifth of
smallpox. What was true for a time of Glasgow smallpox was not even
true of Edinburgh, much less of the whole earth.

Variolation was practised in Glasgow, but to what extent appears
to be unknown. Certain, however, it is that smallpox was as little
dreaded as are other calamities accounted common and unavoidable.
Indeed many were not unwilling to subject their offspring to the
disease at seasons supposed to be favourable on the principle of
“getting a bad job over.” Then, too, the mass of the population was
disposed as if by design for the generation of febrile ailments.
Tall buildings forming narrow lanes, wynds, or closes issued
like so many rents or fissures from the leading thoroughfares.
These buildings were divided into flats packed with humanity from
basement to attic. Air and light were treated as superfluities.
Water there was none, save what was brought from wells; and middens
received the slops and refuse often shot from the windows. Life
in a Glasgow wynd in former days is indescribable, yea almost
inconceivable; yet in such wynds multitudes passed their existence,
conscious of no hardship, recognising nothing better, and withal
characterised by many virtues. Bearing such conditions in mind,
the vital statistics of Glasgow excite no surprise: the wonder
is that the death-rate did not draw nearer to extermination. As
for smallpox, how could a family resident in a flat in a noisome
Glasgow close at the end of last century escape smallpox, if
smallpox were prevalent? To them smallpox lay in fate, and was
accepted on the same terms as wind and weather, summer and winter.

Novelties have always had a ready welcome in Glasgow, and when
cheap and easy salvation from smallpox was proclaimed, there was a
rush for it. Smallpox abated: vaccination had the credit: and faith
was justified. Considering the devastation smallpox had wrought
among the young, Watt says--

  I began to reflect how different the case must be now; and to
  calculate the great saving of human life that must have arisen
  from the Vaccine Inoculation. At this time [1813] above 15,000
  had been inoculated publicly at the Faculty Hall, and perhaps
  twice or thrice that number in private practice. In eight years
  [1805-12] little more than 600 had died in Glasgow of Smallpox;
  whereas in 1784 the deaths by that disease alone amounted to 425,
  and in 1791 to 607; which, on both occasions, exceeded the fourth
  of the whole deaths in the city for the year.

It seemed reasonable to infer that since the mortality from
smallpox had so largely declined, fewer children must have died;
but to Watt’s astonishment the facts did not answer to the logic.
He writes--

  To ascertain the real amount of this saving of infantile life, I
  turned up one of the later years, and by accident that of 1808,
  when to my utter astonishment, I found that still a half, or
  more than a half, perished before the tenth year of their age! I
  could hardly believe the testimony of my senses, and therefore
  began to turn up other years, when I found that in all of them
  the proportion was less than in 1808; but still on taking an
  average of several years, it amounted to nearly the same thing
  as at any former period during the last thirty years. This was a
  discovery I by no means expected, and how it could have come to
  pass appeared to me inexplicable.

We shall better understand Watt’s perplexity over smallpox reduced
and death unaffected, if we set before us the table of mortality
for the decade during which vaccination was brought into practice
in Glasgow.

    DEATHS IN GLASGOW FOR TEN YEARS, 1803-1812.

    Year.   From    Measles. Whooping | Children  Children  Total,
          Smallpox.           Cough.  |  under     under      all
                                      |   Two.      Ten.     Ages.
    1803     194      45        60    |   610       940      1860
    1804     213      27        52    |   583       863      1670
    1805      56      90       129    |   616       884      1671
    1806      28      56       162    |   517       786      1620
    1807      97      16        85    |   595       899      1806
    1808      51     787        92    |  1079      1775      2623
    1809     159      44       259    |   782      1187      2124
    1810      28      19       147    |   765      1027      2111
    1811     109     267        62    |   769      1274      2342
    1812      78     304       103    |   804      1278      2348
            ----    ----      ----    |  ----    ------    ------
    Total,  1013    1655      1151    |  7120    10,913    20,175

To make the facts clear let us bring the results of the three
decades together--

  Decade.   From   Measles. Whooping | Children  Children    Total
          Smallpox.           Cough. |  under     under     Deaths,
                                     |   Two.      Ten.    All Ages.
  1783-1792   3466    211      854   |  7293      9,919     17,607
  1793-1802   2894    398      914   |  6277      9,050     16,685
  1803-1812   1013   1655     1151   |  7120     10,913     20,175

Before making any commentary on these remarkable figures, it may
be well to attend to what Watt had to say concerning them. He was
satisfied that vaccination arrested smallpox, but it was plain
that it did not arrest death, and he felt bound to find some
explanation--

  From every circumstance that has come under my observation, the
  efficacy of Vaccine Inoculation appeared certain. The experience
  of pretty extensive practice had confirmed me fully in this
  opinion. But still the question recurred, how are we to account
  for the same, or nearly the same, number of deaths under ten
  years of age? As no new disease has appeared, the deficiency
  occasioned by the want of Smallpox must have been made up by a
  greater mortality among the other diseases of children. Has it
  been equally divided among them, or has a greater share fallen to
  some than to others? To solve this question is the chief object
  of my inquiry.

To ascertain the fact, he divided the thirty years, 1783-1812, into
five periods of six years each, and thus set forth the average
proportionate mortalities--

   Years.    From   Measles. Whooping | Children  Children    Total
           Smallpox.           Cough. |  under     under     Deaths,
                                      |   Two.      Ten.    All Ages.
  1783-1788  19·55     ·93      4·51  |  39·40     53·48      9,994
  1789-1794  18·22    1·17      5·13  |  42·38     58·07     11,103
  1795-1800  18·70    2·10      5·36  |  38·82     54·48      9,991
  1801-1806   8·90    3·92      6·12  |  33·50     52·03     10,034
  1807-1812   3·90   10·76      5·57  |  35·89     55·69     13,354

  The first three of these periods, 1783-1800, had passed before
  the Vaccine Inoculation could have had any influence [observes
  Watt]; in the fourth, 1801-1806, it had nearly reached its
  maximum; and in the last, 1807-1812, it may be said to have been
  pretty fully established, perhaps as much so as in any other city
  in the empire.

Vaccination having been introduced to Glasgow to save life, Where
was the salvation? Smallpox had fallen off, but if its victims
were merely assigned to other modes of death, where was the
advantage? Watt continues--

  The first thing which strikes the mind on surveying the preceding
  Table, is the vast diminution in the proportion of deaths by
  the Smallpox--a reduction from 19·55 to 3·90 per cent.; but the
  increase in the Measles column is still more remarkable--an
  increase from ·93 to 10·76 per cent. In Smallpox we have the
  deaths reduced to nearly a fifth of what they were twenty-five
  years ago, whilst in the same period, the deaths by Measles have
  increased more than eleven times. This is a fact so striking,
  that I am astonished it has not attracted the notice of older
  practitioners.

  The greatest number of deaths from Smallpox in any one month
  during the last thirty years was 114 in October, 1791. In
  the following December they were 113. These are the only two
  instances in thirty years when the deaths by Smallpox amounted to
  100 in a month. But these were slight visitations when compared
  with the ravages which have been committed in an equally short
  time by Measles. In May, 1803, the deaths by Measles alone
  amounted to 259, in June to 260, and in July to 118. In December,
  1811, they amounted to 161, and in the January following to 130.
  What an amazing difference when we compare these numbers with
  433, the sum of all the deaths by Measles in eighteen years
  preceding 1801! In the last five years 1430 have died of Measles
  in Glasgow.

This prodigious increase in the mortality from Measles was
naturally referred by some observers to the practice of
Vaccination, and Watt held there was ground for the assumption
inasmuch as when Smallpox preceded Measles it made Measles milder--

  When Measles was so prevalent and fatal in 1808, I was often
  told that it was owing to the Vaccine Inoculation; but this I
  considered an idle tale, the invention of those who were hostile
  to Cowpox. I could readily admit that more must die of Measles
  than formerly; for some of the weak and unhealthy, who would have
  died of Smallpox (saved from Smallpox) would fall a sacrifice to
  Measles; but I could not then go farther.

  But however novel and strange the opinion may appear, it must be
  admitted that while Smallpox was in full force, it had the power
  of modifying and rendering Measles mild; and now that Smallpox is
  in great measure expelled, Measles is gradually coming to occupy
  the same ground. I am sorry to make this statement, but the
  facts, at least with regard to Glasgow, are too strong to admit
  of doubt....

  That Measles should have been modified by Smallpox is rendered
  highly probable by the manner in which the Vaccine Disease
  prevents Smallpox or renders it so mild as to be without the
  smallest danger. May not Smallpox have a similar effect in
  relation to Measles?

  When Smallpox was in full force, few children escaped, and most
  of those who had Smallpox and Measles had Smallpox first. This,
  I believe, will have been the case with more than nine-tenths
  of the community. Still, however, as Measles came round, it
  occasionally had precedence of Smallpox, and it was perhaps
  chiefly among such patients that it proved fatal. In looking over
  the registers of former years, I find the deaths by Measles were
  generally among very young children.

He was even disposed to believe that Smallpox, on the whole,
exercised a beneficial influence in the eradication of latent
disease--

  An opinion has prevailed with some, that Vaccination does
  positive harm by infusing peccant or vicious humour into
  the constitution. I do not see the smallest ground for this
  hypothesis; but that Smallpox does good to those who survive
  the disease by rendering the system insusceptible of other
  infections, or by rendering them milder when incurred, must, I
  think, be admitted.... I do not presume that the constitution
  is improved by Smallpox, but perhaps by eradicating certain
  unobserved deviations from health, which, if not early removed by
  the accession of some acute disease, would have proved the seeds
  of early mortality by gaining a deeper hold of the constitution
  before Measles and other epidemics of later appearance came round.

  In this point of view, we are not to consider Smallpox as
  peculiarly fatal, but fatal merely as having the start of
  some other diseases. Measles, Chincough, Croup, and Scarlet
  Fever would have proved equally fatal had any of them occurred
  first.... It is only on this principle that we can explain how
  it happened that thirty years ago not one in a hundred died of
  Measles, whereas now one in ten dies. Thirty years ago as few
  escaped Measles as now, but before they were affected they had
  generally passed through Smallpox, by which the secondary disease
  was so modified as to be almost completely divested of danger.

Watt, it will be observed, treats smallpox throughout as a malady
of childhood; thus confirming Monro’s observation in 1765, that
“the inhabitants of Scotland generally have smallpox in their
infancy or childhood, very few adults being seen in the disease.”

From the preceding excerpts, it is not difficult to comprehend
Watt’s position. He was persuaded of the prophylaxy of
vaccination; he was satisfied that it had reduced smallpox in
Glasgow; but, to his astonishment, he discovered that it had not
reduced the general death-rate; and that in so far as smallpox
had been displaced, other ailments, and specially measles, had
maintained the tale of fatality.

The discovery that the fall in smallpox was compensated for by a
rise in deaths from other diseases was a remarkable discovery,
the importance of which is as yet far from appreciated. Watt was
however at fault in attributing the decline of smallpox in Glasgow
to vaccination; and in failing to inquire whether the phenomenon
had any relation to vaccination whatever. He is the best scientific
demonstrater who most completely exhausts the possibilities to
the contrary of what he seeks to establish. Supposing vaccination
to be as powerful against smallpox as its promoters averred, the
causes in Glasgow was not commensurate with the effect. Nowhere was
vaccination more practised. 15,000 were vaccinated at the Faculty
Hall, says Watt, “_and perhaps twice or thrice that number in
private practice_”--a loose and questionable statement. The 15,000
operated on at the Faculty Hall in the course of ten years were the
poor, the vast majority in Glasgow and elsewhere, and the chief
sufferers from smallpox. The assumed “twice or thrice that number”
were those who employed their own medical men--a luxury less common
then than now. The population of Glasgow approached 100,000, and
it is obvious that the larger part must have lived outside the
fortification of the Jennerian rite.

But admitting that all, or nearly all, in Glasgow were vaccinated
who had not had smallpox, still that would afford no proof for what
was claimed. Watt was cautious, and held closely by his Glasgow
evidence, content to have it taken for what it was worth; but
had he ranged wider, he would have discovered that the fall in
smallpox extended over Europe, and was as well marked in Vienna as
in Glasgow, in Stockholm as in London, in Italy as in Denmark. As
in Glasgow the credit for the fall was claimed for vaccination,
but the fall had set in before vaccination was heard of, and
extended over populations to which vaccination had no application.
Indeed Watt allows that the fatality of smallpox had begun to
decline and that of measles to increase prior to the conveyance of
the Jennerian salvation to Glasgow; but he failed to discern the
significance of the fact. So too in other cities where smallpox
fell off: the death-rate did not fall off; but, as in Glasgow, was
kept up by cognate varieties of fever.

As concerns Watt, we have the advantage of some notes upon his
“remarkable treatise” by Dr. William Farr in the _Thirtieth Annual
Report of the Registrar-General_, 1869. Having given an abstract of
Watt’s results, Dr. Farr observes of his discovery of displaced and
replaced mortality--

  This is an important point in pathology; and it must be admitted
  that although there were defects in his data, Dr. Watt succeeds
  in showing (1) that Smallpox was one of the greatest causes of
  death in Glasgow down to the year 1800, (2) that the deaths by
  Smallpox were reduced to a fifth of their original number by
  Vaccination,[270] and (3) that the children died in nearly the
  same numbers as before, but of other forms of disease.

  Glasgow has always been famous for statistics, and these
  unfortunately show an increase of the mortality of children. Thus
  in the five years 1821-25 the mortality of boys under five years
  of age was 8·08; in 1831-35 it was 9·78. In the year 1865 the
  mortality of boys in Glasgow was 11·48, of girls, 10·36. These
  recent returns confirm the principle. Smallpox is no longer so
  fatal as it was before Vaccination was introduced; in Glasgow it
  caused in the year 1864 no longer 20 but 2 in 100 deaths--only
  180 in 6054 deaths, that is 3 per cent. of the deaths under five
  years of age; yet the mortality of children is certainly as high,
  probably higher, than it was in the last 10 years of the last
  century.

  Compulsory Vaccination in England has reduced further the
  fatality of Smallpox, but since 1853 other diseases have so
  prevailed as to counter-balance the gain under this head. The
  mortality of children has not declined in a corresponding degree.

With confirmation under such authority, it is needless to enforce
the validity and importance of Watt’s discovery. Dr. Farr is
pleased to ascribe the subsidence of smallpox alike in England and
Glasgow to vaccination, but he makes no effort to prove his case:
indeed the effort might have led him to recognise his mistake.
Referring to scarlet-fever, he shows how from a mild it has become
a severe affliction--

  Sydenham (d. 1689) describes simple Scarlatina distinctly: he
  does not refer to the throat affections, and says the patient
  can only die by the doctor’s default. Joseph Frank describes the
  disease as _now_ the most dreadful scourge in Europe.

If then scarlet fever has of itself acquired this terrible
intensity and predominance, why should it be thought incredible
that smallpox of itself should undergo correspondent mitigation
and diminution? Or, is it to be argued that vaccination has
extinguished smallpox to revive as scarlet fever?

Dr. Farr proceeds to observe--

  It is singular that Dr. Watt, evidently a practitioner of great
  sagacity, does not at all advert to the wretched sanitary
  condition in which the increasing population of Glasgow lived at
  the time he was writing.

It is the observation of Dr. Farr that is singular. At the time
when Watt wrote there was no clear conception of the relation of
condition to disease. Jenner was always writing about smallpox, yet
there is not a hint in any of his papers as to its development in
filth and stench. His own residence was a pesthouse, but it never
entered into his head to ask, Why? Let us avoid anachronism. Those
whose memory or reading extends to the cholera epidemic of 1831-32
will know, that it was regarded as an inscrutable visitation toward
which humble submission was the proper attitude. A letter of
Collins, the artist, to the Rev. R. A. Thorpe, 26th November, 1831,
correctly expresses the common feeling. Referring to the Cholera
and the Reform Bill, he says--

  Of the two scourges now afflicting us, I know not which is the
  worse, but I _do_ know that we have fallen into the hands of God
  in both cases, and not before we deserved it.[271]

I myself recollect the dismay the Combes excited in Scotland
when they began to teach that we were largely responsible for
our ailments, and that sickness and sanctity were an unwholesome
alliance; and how a pious physician remarked, when the prevalence
of typhus in Glasgow had been denounced as disgraceful to the
authorities, “We have learnt the truth in another school, and would
shudder to impeach the Divine prerogative in life or in death.”
What Watt really thought of smallpox is to be found in a passage of
his treatise which Dr. Farr must have overlooked. He says--

  We may it seems, by the permission of Divine Providence, deprive
  death of some of its apparently most efficient means, but
  deprived of these, new means are discovered, or the old improved.

  I cannot help quoting the following passage from Dr. Woolcombe as
  somewhat prophetic of this general result. Says he--

  “May not the discovery of the Cowpox, if it should ultimately
  effect the extermination of the Smallpox, which it may do when
  the prejudices of mankind shall permit, be welcomed rather on
  account of its influence in diminishing human suffering, than
  on account of its effect in diminishing human mortality? Since
  disease is one of the appointed checks to excessive population,
  and the plan of Providence in the creation of human life requires
  the termination of the existence of one-third of its creatures
  before they have attained the age of two years, it may be doubted
  whether the annihilation of so efficient an instrument as
  Smallpox can be admitted without the substitution of some other
  equally destructive malady. The substituted malady may indeed
  be productive of less collateral affliction than the loathsome
  distemper whose place it supplies. But granting that no direct
  substitute should arise, it will not follow that disease in
  general will be deprived of its accustomed share in checking
  population; and if it be not, the only difference will be in the
  proportion of victims submitted to other disorders. The infant
  rescued from Smallpox, may be rescued only to perish in childhood
  by Measles or Scarlatina, or be preserved to swell the list of
  youthful victims to the insatiate maw of Consumption.”[272]

Such was the manner in which Watt dealt with the problem of
mortality. Sanitation had no place in his consideration. It was,
he thought, the design of Providence to limit population, and if
children were saved from smallpox, they would be cut off otherwise;
and the statistics of Glasgow confirmed the opinion. Smallpox had
abated, but funerals were numerous as ever. The uniformity of the
mortality we admit, but no longer ascribe it to Providence intent
on the limitation of population. If children die, it is not of
fate, but from the ignorance, or indifference, or wickedness of
those who are responsible for them.

Still some may object, “If by vaccination or any other means
smallpox is got rid of, Should we not to that extent save life?”
The answer is, No. Life is only extensible in so far as improvement
is effected in the conditions of life. Forms of disease are subject
to modification; they are probably convertible and interchangeable;
one form comes as another goes; but conditions remaining the same,
the crop of death is equal. Hence Mr. Edwin Chadwick’s advice--

  Keep your eye on the death-rate. Let nothing short of its
  reduction satisfy you. There may be no startling outbreak of this
  fever or of that fever; but if the death-rate is unabated, there
  can be no improvement that ought to satisfy you. The death-rate
  is the test of sanitary progress. Keep therefore your eye on the
  death-rate.

Thus it was that though smallpox subsided in Glasgow no lives
were saved; for no change for the better having taken place in
the condition of the inhabitants, the means of death were merely
transferred to other agencies. As Dr. Farr observes--

  The Glasgow victims were gathered together from all quarters,
  from the Highlands, from Ireland, and from elsewhere; they were
  lodged in conditions unsuitable to human life.... To render them
  unassailable by the matter of Smallpox was not enough, for it
  left them exposed to the 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 operate on mortality, protection against every one of the
  fatal zymotic diseases is required; otherwise the suppression of
  one disease-element opens the way to another.

Dr. Farr thus exactly expresses what I wish to enforce. Whether
smallpox prevail or disappear is of little importance. What is of
importance is the prevalence of disease and death, and not the
presence or absence of any of their special factors when the total
result is constant and the measure of violated physiological laws.
It is true that Dr. Farr recognises a virtue in vaccination, but
on much the same terms that obeisance is rendered to a fetish.
Vaccination might be struck out of his arguments without affecting
his conclusions. How, for example, could the facts with their
rationale be better stated than in these his words?--

  Out of 1000 born in Liverpool, 518 children were destroyed in the
  first ten years of their life; some by Smallpox, many by Measles,
  Scarlatina, Whooping Cough, many by Typhus and Enteric Fever;
  one disease prevailing in one year, another disease prevailing
  in another; _but still yielding the like fatal results_. This
  represents what Dr. Watt found in Glasgow long ago. Out of 1000
  children born in London, 351 died under ten years of age by
  zymotic diseases and other causes; the deaths are less by 167
  than the deaths in Liverpool. How much less is the loss of life
  by these diseases in the healthy districts of England! There,
  out of 1000, only 205 children die in the first ten years of
  life. The enormous difference cannot be ascribed to Vaccination,
  as common in town as in country; the protection of life against
  Smallpox alone leaves it still at the mercy of the dangerous
  diseases of the insalubrious city.

Death from disease in insalubrious circumstances is but part of
the mischief. Those who survive find their energies enfeebled and
depressed in the struggle for survival. The time must surely come
when smallpox and all allied forms of disease will be accounted
discreditable and intolerable, and when their occurrence will be
taken for notes of warning and command to search for and root out
their causes. Then, too, magical preventives and palliatives and
medical cures will have a very different place in the popular
imagination.

       *       *       *       *       *

Jenner read Watt’s pamphlet, and, _more suo_, the wretched creature
failed to discern its scope and significance, seeing in it a
malevolent aggression upon his interest in vaccination. He wrote to
Moore from Cheltenham, 6th December, 1813--

  You probably may not have seen a pamphlet lately published
  by Dr. Watt, as there is nothing in its title that develops
  its purport or _evil tendency_. Measles, it seems, has been
  extremely fatal in Glasgow for the last four or five years among
  children, and during this period Vaccination has been practised
  almost universally. Previously to this, Measles was considered a
  mild disease. Hence Dr. Watt infers that Smallpox is a kind of
  _preparative_ for Measles, rendering the disease more mild. In
  short, he says, or seems to say, that we have gained nothing by
  the introduction of Cowpox; for that Measles and Smallpox have
  now changed places with regard to their fatal tendency. Is not
  this very shocking? Here is a new and unexpected twig shot forth
  for the sinking Anti-Vaccinist to cling to.[273]

Observe, the truth of Dr. Watt’s evidence was passed over! Inasmuch
as it did not tend to the glory of vaccination, it was “evil,” and
it was “shocking.” At a later date Baron assumed the same line,
saying--

  Notwithstanding the proofs of the power of Vaccination in
  diminishing the mortality from Smallpox, it has been a question
  whether _infantile_ mortality has been diminished; it having
  been supposed that the beneficial effects of Vaccination were
  countervailed by a greater mortality in the other diseases of
  children. This very discouraging statement was published by Dr.
  Watt, of Glasgow; and the opinion, which was hastily adopted and
  unwisely promulgated, has unquestionably had a great effect in
  retarding the progress of Vaccination. It, unfortunately, gave
  countenance to some of the worst prejudices of those who were
  opposed to the practice.[274]

Here again we see no attempt made to disprove Watt’s statement,
whilst its mischievousness was assumed because it was
“discouraging,” and lent “countenance to some of the worst
prejudices of those who were opposed to vaccination!” Truth is
the best of all things--except when it spoils business. Then it
becomes “evil,” and “shocking,” and “gives countenance to the worst
prejudices.”


FOOTNOTES:

[269] _An Inquiry into the Relative Mortality of the Principal
Diseases of Children, and the numbers who have died under Ten Years
of Age in Glasgow during the last Thirty Years._ By Robert Watt,
M.D., Lecturer on the Theory and on the Practice of Medicine in
Glasgow. Glasgow, 1813. Pp. 64.

[270] An inference disputed for reasons given.

[271] _Memoirs of William Collins, R.A._ By his Son. Vol. ii. p. 3.

[272] _Remarks on the Frequency and Fatality of Different
Diseases._ 1808.

[273] Baron’s _Life of Jenner_, vol. ii. p. 392.

[274] _Ibid._, vol. ii. p. 248.




CHAPTER XXXV.

THE NATIONAL VACCINE ESTABLISHMENT--1808-40.


We shall now return to the current of our Story, nor turn aside
until it is brought to a conclusion in the enactment of Compulsory
Vaccination.

With £3000 a-year the National Vaccine Establishment was
constituted by the House of Commons, on 9th June, 1808; sixty
members voting for the project, and five against.

The reasons for the institution were somewhat complicated. The
Royal Jennerian Society had been wrecked by Jenner’s jealousy and
intrigue. The working and subscribing members seceded with Dr.
Walker, and set up the London Vaccine Institution; and a variety
of ornamental and influential folk, who paid little and did less,
found themselves with Jenner on their hands, exigent, impecunious,
and helpless, and they publicly committed to the patronage and
diffusion of vaccination.

It was an awkward situation, and two operations for relief became
necessary: first, to dispose of Jenner; and second, to escape from
the maintenance of vaccination.

The first was effected by inducing the House of Commons to vote
Jenner £20,000, and the second by the institution of the National
Vaccine Establishment. Thus dexterously, fashionable and medical
London contrived to get rid of Jenner and vaccination on terms
satisfactory to all concerned.

The early furore for vaccination had spent itself. Scepticism had
thriven by experience. Many of the vaccinated had taken smallpox,
and explanations and excuses were becoming exhausted. It was easy
to claim the benefit of mistakes when the operators were amateurs;
but when the failures were the work of Jenner and his certified
associates, it was hard for faith to hold out. Spurious cowpox
served to account for many disasters; but when Jenner, pressed to
define spurious cowpox, was driven to confess its non-existence,
and that, when he had spoken of it, he had only meant any irregular
action of cowpox on the persons of the vaccinated, it is easy to
imagine how people who had respect for themselves were pleased to
drop out of the connection. They might not care to express all they
suspected, nor to proclaim their credulity, but it was a welcome
deliverance to be no longer responsible for a practice and a
character grown so questionable. On John Bull’s broad back was laid
the burden.

In the project of the National Vaccine Establishment there was
an explicit concession to the scepticism of the time. One of its
purposes was alleged to be _Investigation_. Lord Henry Petty, in
recommending the measure in the House of Commons, observed--“The
evidence as to the infallible efficacy of vaccination is
confessedly incomplete; and it is highly desirable that the truth
should be ascertained by public inquiry, rather than by societies
whose conductors are liable to the imputation of mercenary
motives.” Jenner bitterly resented the indignity implied in placing
vaccination under investigation. He held, and in a sense justly,
that it was too late to speak of investigation when the reality of
his discovery had been attested in the public honours and rewards
conferred upon him. “Alas!” he exclaimed, “poor Vaccinia, how art
thou degraded!” He was still further outraged by his exclusion
from the Board of the Establishment, on the ground that the public
might have assurance of impartiality. How much sincerity there was
in the profession, I do not pretend to divine; it is sufficient to
point out that matters had come to such a pass with vaccination
that it was considered expedient to conciliate the taxpayers with
the promise of inquiry for their money. Plainly the enthusiastic
certainty of 1802 had given place to a widely different sentiment
in 1808.

There were, however, wheels within wheels. “You may take it for
granted,” said a Radical of those days, “that every vote of public
money has an object in excess of the ostensible one, and covers
jobs big or jobs little.” And so it was in the case before us. The
discomfited residue of the Royal Jennerian Society had influence
with the Government to take over their smashed-up enterprise;
but their solicitation might have been ineffectual, had not the
Government seen a way of providing for a certain claimant in the
course of the operation. Sir John Moore was serving his country
in the Peninsula; he had friends at the sources of power; and he
had a brother named James, surgeon to the Life Guards, for whom
a comfortable berth was wanted. Let us make Moore, they said,
Director of this new Establishment, with a salary of £200 a-year;
and the thing was done. Investigation was promised, Cowpox was
endowed, and Moore was provided for.

Jenner had actively promoted the formation of the Establishment,
under the conviction that he should be its governor; but when
the organisation was revealed, he was profoundly disgusted. The
management was assigned to a Board of eight members, consisting
of the president and four censors of the College of Physicians,
and the master and two governors of the College of Surgeons,
with salaries of £100 a-year apiece. From this Board, as stated,
Jenner was deliberately excluded, “so as to ensure impartial
investigation.” It was at first proposed to hold Jenner subordinate
to the Board, giving him the title of Director, with Moore as his
working deputy; for it was clearly recognised by those who had
had experience of him during his London career, that for regular
duty he was good for nothing; and that with his sickly family
resident in Gloucestershire, he was never to be reckoned upon
for a day. When, however, the Board disregarded his nominations,
especially that of his bully, John Ring, as “Principal Vaccinator
and Inspector of Stations,” he at once severed his connection with
the Establishment; “since,” in his own words, “he found that he was
to have nothing to do, and that his office was only a name.” “My
not being a member of the British Vaccine Establishment will,” he
wrote, “astonish the world; and no one in it can be more astonished
than myself”; but so far as can be discerned, the astonishment
was chiefly limited to himself. Evanescent and futile is the
astonishment of the world under most circumstances, and had the
public opinion of the time been consulted, there is little doubt
that it would have gone with the Board against Jenner.

Moore was, therefore, promoted to Jenner’s place as Director of the
National Vaccine Establishment, in subordination to the Board of
Physicians and Surgeons. Seven stations, with seven superintendent
surgeons, were opened in London for vaccinating all who should
apply, and for collecting and distributing virus.

  At first [writes Moore] the applicants for Vaccination at the
  various stations were not numerous, not amounting to 3,000
  a year; but, by continued exertions, and the declension of
  prejudice, the numbers regularly increased, and 7,771 persons
  were vaccinated in London in the year 1816.[275]

These numbers are significant, as indicating the extent of the
collapse of vaccination, and how little the continuous decline of
smallpox in London was due to its extension.

Moore was a shrewd tactician. He had the sense to recognise that
if there was anything in vaccination, it was folly to stand at
variance with Jenner; and by persuading him that he exaggerated
the offence implied in the policy of the Board, he gradually
soothed his feelings and led him into a long and confidential
correspondence. Jenner, on his side, finding that nothing resulted
from his sulks, relaxed, and from time to time favoured the Board
with the light of his countenance and counsels.

The national endowment of vaccination affected prejudicially all
other enterprises in the same line. What remained of the Royal
Jennerian Society withered up, and the conductors of the London
Vaccine Institution found the collection of subscriptions almost
impossible. It was naturally objected by those solicited, “Why
should we be asked to subscribe for what Government has already
provided?” But with Dr. John Walker, the director of the London
Institution, vaccination was a fanaticism, and he was ready to
live on bread and water rather than withdraw from the promotion
of what he was persuaded was a work of salvation. He therefore
struggled on, in spite of discouragement and petty means, and as
the inability of the Government Establishment to meet demands
became manifest, whether from excess of dignity or apathy, the
Quaker Institution, as it was called, began to thrive, to acquire
the confidence alike of the medical profession and the public, and
to rival in business the Establishment itself.

As for the investigation promised in the House of Commons, it was
never even attempted. Jenner’s anxiety was superfluous. When a case
of smallpox, or injury, or death after vaccination was reported,
it was the recognised formula to assert either some defect in
the operation, or the virus, or some cause, or any cause _ab
extra_ rather than allow the Jennerian principle to suffer. As an
illustration of the procedure of the Board in this respect, we have
the instance of Mr. Thomas Brown, surgeon, Musselburgh, as served
up in Moore’s insolence--

  The Vaccine was in two years spread over Scotland. After a time,
  however, one croaking voice was raised to disturb the general
  concord. Mr. Brown, who was fretting in obscurity at Musselburgh,
  published a book in 1809 to maintain that the Vaccine only
  possessed the property of preventing Smallpox temporarily; that
  in three years its influence declined; and in five or six, hardly
  any security against Smallpox remained.

Brown submitted his cases to the Board, but they met with no
attention.

  In this extremity [continues Moore] he wrote a scurrilous
  accusation of the National Vaccine Establishment to the Secretary
  of State, which was referred to the Board. When they met, the
  Registrar read it, and then tied it up with red tape among that
  mass of papers which are consigned to rest.[276]

Could more be expressed in less? Thus was Brown, the representative
of true science and enlightened and honest inquiry, set at naught
and traduced by a Board endowed for investigation! Nor, in saying
so, do I speak simply as an antagonist of vaccination. Brown was no
anti-vaccinist. What he contended for is now everywhere admitted by
vaccinists. They allow that the protection afforded by vaccination
is temporary, and that it is necessary to renew its prophylaxy
from time to time. The practice of revaccination is based on the
verity of Brown’s contention, and yet, according to Moore, he was a
vain-glorious and scurrilous fellow, and by Jenner was pronounced
“an object of commiseration rather than resentment.”

As purveyors of virus, too, the Establishment fell behind Walker’s
Institution, and the Quakers’ pox had the preference among
connoisseurs in the article. Jenner wrote to Moore, 5th March,
1816--

  The Matter sent out by the National Vaccine Establishment is much
  complained of. I was applied to a few weeks since by the surgeons
  of the hospital at Gloucester for some Vaccine Matter, and their
  request was accompanied by the observation, “That after using
  thirty points sent from town, not a single pustule was produced.”

To account for such failures, it began to be reported that the
virus was gradually losing its virtue in transit through many arms;
but, continued Jenner--

  Medical men are more expert than others in discovering causes
  without the fatigue of much thinking, and in the present
  instance they have all hit upon the wrong one--no great wonder.
  They attribute the lessened activity of the Matter, and its
  disposition to produce imperfect vesicles, to the great length
  of time which has elapsed since it was taken from the cow, and
  to the immense number of human subjects through whom it has
  passed. This is a conjecture, and I can destroy it by facts. The
  Matter may undergo a change that may render it unfit for further
  use by passing even from one individual to another; and this
  was as likely to happen in the first year of Vaccination as the
  twentieth. There are medical men who will take anything they can
  catch under the mere name of Vaccine Matter, or from pustules
  incorrect in character. It is from the spread of such Matter that
  the dissatisfaction of which I speak has arisen.[277]

When we refer to the record of the National Vaccine Establishment,
there is little reason for surprise over its inefficiency. The
House of Commons, having voted the endowment of £3,000 a-year, the
Government committed the organisation of the Establishment and the
administration of its funds to the heads of the Royal College of
Physicians. How the £3,000 a-year was disposed of, came to light in
1822, when the accounts were published. The statement stood thus
for 1821, representing what had gone on during the past twelve
years--

                                                 £     £

    PHYSICIANS.--Sir Henry Halford, Bart.       100
                 Dr. Frampton                   100
                 Dr. Thomas Hume                100
                 Dr. Charles Badham             100
                 Dr. R. Lloyd                   100
                                               ----   500

    SURGEONS.--Sir Everard Home                 100
               Sir W. Blizard                   100
               Henry Cline                      100
                                               ----   300

    REGISTRAR.--James Hervey, M.D.              300
    DIRECTOR.-- James Moore                     200
    SECRETARY.--C. Murray                        50
                                               ----   550

    VACCINATORS.--One at £150                   150
                  Five ”  100                   500
                  One  ”   75                    75
                  Six  ”   50                   300
                                               ---- 1,025

    HOUSEKEEPER                                  40
    MESSENGER                                    52
    Rent of furnished House, 18 Percy Street    260
                                               ----   352

    Printing, stationery, coal, candle, &c.           183
                                                   ------
                   Total                           £2,910
                                                   ------

The accounts, though they revealed what was suspected, were widely
denounced as scandalous. Parliament voted £3,000 a-year to extend
vaccination among the poor, and here were a set of physicians
and surgeons pocketing £800 of it, and muddling away the greater
part of the remainder. They affected to regard vaccination as
the deliverance of mankind from the scourge of smallpox, and yet
they had not hesitated to appropriate the means provided for its
diffusion! There was scarcely the pretence of work for wages.
The Board met once a week, but the attendance was irregular, and
at each member’s discretion. The eight hundred-a-yearers dropped
in when convenient for gossip, and to ask what was doing. When
set upon their defence, the argument was that the public were
distrustful of vaccination, and that to inspire confidence it was
necessary that the Establishment should have the benefit of the
ostensible support of the College of Physicians and the College
of Surgeons, for which the honorarium of £100 annually to each of
their representatives was by no means excessive. In reply, it was
pointed out that Dr. Walker, supported by voluntary contributions,
collected with difficulty, and with less than the pay of many an
artizan, had done more for vaccination in London and the country,
and was more respected and trusted, than the Establishment with all
the prestige of corporate authority.

As the result of many protests, the waste of public money was
brought before the House of Commons by Joseph Hume. It was Mr.
Hume’s distinction that, with strong good sense and invincible
patience, he upheld the standard of honesty in public finance,
holding that it was as wrong to defraud the nation as to defraud
an individual; and that it was as foolish (not to say more wicked)
to pay away the people’s money for nothing, as to throw away
one’s own. The principle, so obviously indisputable, and yet
so shamelessly violated in every department of the State, was
enforced in detail by Mr. Hume with a persistency and success
that has never been surpassed, and, I fear, never appreciated as
deserved. He showed that patriotism is a practical virtue, instead
of a sentimental pretext for public plunder, and taught honour to
placemen to whom honour was unknown. Appropriately, therefore, Mr.
Hume led the charge against the National Vaccine Establishment, and
in 1827 the annual vote was reduced from £3,000 to £2,500, £300
of the £500 being saved by knocking off two useless physicians
and one useless surgeon. Even then the extravagance that remained
continued to excite indignation, the consequences of which are
recorded in a “Report from the Select Committee on the Vaccine
Board, with the Minutes of Evidence, ordered by the House of
Commons to be printed, 28th August, 1833.” If space allowed, it
would be easy to linger over the disclosures of this Committee.
Suffice it to say, that Dr. George Gregory, of the Smallpox
Hospital, held that the whole work of the Board might be done
handsomely on £1,200 a-year. The Committee, however, shrank from
such a severe exercise of economy, and recommended the provision of
the following staff and expenses--

    Vaccinators at Stations in London (a sum which will
         probably admit of reduction)                      £900
    Inspector }                                           { 200
    Registrar } Qualified on occasion to exchange duties  { 200
    Messenger                                                55
    Offices, rent of                                        100
    Incidental expenses                                     150
                                                         ------
                          Total                          £1,605

The Committee observed that the Board might consist of two
physicians and one surgeon, whose duties, not being onerous,
might be discharged gratuitously. As the Committee was more
loose-handed than Dr. Gregory, so the Commons were laxer than the
Committee. The President and a Censor of the College of Physicians,
and the President of the College of Surgeons, were suffered to
continue their £100 a-year each, and the annual subsidy for the
Establishment stood fixed at £2,200, until vaccination, under the
disguise of sanitation, developed into the monstrous proportions
with which we are at this day afflicted.

There is much talk prevalent in favour of “the endowment of
research;” but what may come of such endowment, when not sharply
looked after, is manifest in the example of the National Vaccine
Establishment. The investigation, assumed to start with, was never
pursued; and the guardianship of the public interest undertaken
by the Colleges of Physicians and Surgeons was never anything but
make-believe. Annual Reports were presented to Parliament, signed
by the heads of the Establishment, but of research they bore no
trace, and many of them might have been dashed off by the Registrar
in the course of an hour. Destitute of any scientific merit, these
reports yet afford some curious glimpses of what was going on from
year to year, with indications of the chief points of resistance
encountered by the practice of vaccination; and, in turning over
the series from 1810 to 1840, I have made the following notes,
which may be read, perhaps, with interest.


VARIOLATION.

The chief resistance proceeded from the inoculators with smallpox;
indeed, with the exception of apathy, there might be said to be no
other resistance. Hence we read under the several dates--

  1810.--During 1809, the surgeons vaccinated 1,493 persons. We
  are sorry to have to relate a decline of Vaccination in the
  Metropolis, and an apparent indisposition to the practice of it;
  and to express regret that there should be evil-disposed persons,
  who are endeavouring to frustrate His Majesty’s intentions by
  alarming the misinformed with stories which they know to be false.

  1812.--We have reason to ascribe the increase of Smallpox in
  London during last year to the rash and inconsiderate manner
  in which great numbers are still inoculated for the Smallpox,
  and afterwards required to attend two or three times a week at
  the place of inoculation in every stage of their illness. The
  practice of Inoculation is the great means whereby Smallpox is
  kept in existence, and its infection propagated to persons and
  places where it would not otherwise be seen.

  1814.--The Board has with great regret to observe that, although
  the punishment of three months’ imprisonment was awarded against
  Sophia Vantandillo, for carrying her child, whilst under the
  influence of Smallpox, through the streets, (which infected many
  others, eight of whom died) the unwary are still enticed by the
  hand-bills of shameless empirics to submit their children to
  Variolous Inoculation. It is, however, to be hoped that the above
  sentence passed by the Court of King’s Bench, which the Board
  has taken every method of promulgating, may produce considerable
  benefit. The Board selected Sophia Vantandillo as a proper
  example on account of the extent of the mischief occasioned by
  her misconduct; and that this prosecution, followed by a lenient
  punishment, may prevent any further wilful exposure of inoculated
  persons, is its fervent wish. The Board at the same time
  prosecuted Mr. Burnet, who inoculated the child, and who has long
  circulated most mischievous and offensive hand-bills, offering
  to inoculate persons with Smallpox gratis, and stigmatising
  Vaccination as productive of the most loathsome disease. This
  practitioner having suffered judgment to go by default, has
  been sentenced by the Court of King’s Bench to six months’
  imprisonment.

  The whole of the expenses incident to this Establishment for
  1814 have been defrayed by the vote of last year, but the Board
  regrets that in consequence of the recent prosecutions and
  convictions, and the measures adopted for the more effectual
  extension of the practice of vaccination throughout the Empire,
  an addition of £500 to the annual grant will be necessary.

  1815.--In Edinburgh, Glasgow, and Norwich, Inoculation is
  disused, and, in consequence, the Smallpox is scarcely known. In
  the country about Aberystwith in Wales, and Bawtry in Yorkshire,
  it has entirely disappeared. The reverse is, unhappily, the case
  in Portsmouth, Bristol, and London. In the Metropolis alone the
  mortality may be estimated at 1,000 annually; perhaps throughout
  the United Kingdom it is not less than ten times that number. It
  appears to us that this waste of human life can be prevented only
  by such legislative enactments as will entirely put a stop to
  Inoculation with Smallpox.

That smallpox was increased by variolation we have no reason to
doubt, notwithstanding the fact that toward the close of the last
century, when variolation was most practised, smallpox was steadily
falling-off; but to ascribe the existence and persistence of
smallpox to variolation was absurd. Smallpox was a widely-diffused
disease before variolation was introduced to anticipate and
minimise it.

  1817.--The pernicious practice of Smallpox Inoculation, now
  very generally relinquished by the medical profession, is only
  persisted in by a very few of the least creditable class of
  practitioners, and is usually carried on clandestinely; yet the
  Board are concerned to state that this destructive operation
  is now performed for gain by itinerant Empirics, Farriers,
  Publicans, Nurses, low, cunning people of both sexes, and of
  various descriptions. And such is the infatuation of the poor
  and ignorant, that many of them carry their infants to be
  inoculated by those who only know how to inflict, but not how
  to assuage, the violence of Smallpox. The consequence has been
  that many have perished under their management; and the disease
  in particular districts has been widely disseminated. As this
  iniquitous conduct has prevailed much in London, an epidemic of
  Smallpox was last year excited among those who were not secured
  by Vaccination, and 1,051 persons died of the disease.

  1836.--Only 300 died of Smallpox in London in the course of
  last year; and it is probable that this mortality, however
  comparatively small, is owing to the continued partial practice
  of Inoculation, which is liable to disseminate far and wide its
  contagious influence, to the imminent danger of all who have not
  been protected by previous Vaccination, or by having had Smallpox
  already.

Variolation was made a penal offence in 1840, and became less
available as an excuse for the persistence of smallpox in defiance
of vaccination.


FAILURE OF VACCINATION.

Accepting Jenner’s revelation, the heads of the medical profession
in London assured the public, in a manifesto in 1800, that “those
persons who have had Cowpox are perfectly secure from the future
infection of Smallpox.” It was a rash assertion. Proofs of its
untruth were not slow to appear. At first they were denied, then
explained away, and then admitted under qualifications more or
less adroit. When, in 1808, the National Vaccine Establishment was
constituted, the fact of the failure of Vaccination to answer to
its original promise was generally recognised. Nevertheless, the
reports of the Establishment exhibit much ingenious wriggling and
attempts to out-lie Nature. For example--

  1811.--That in some instances Smallpox has affected persons who
  have been most carefully vaccinated, is sufficiently established;
  nor ought we to be surprised at this, when we consider that
  Inoculation for Smallpox sometimes fails, and that several
  cases may be produced in which persons have been affected with
  the natural disease more than once in the course of life. The
  Board have infinite satisfaction in stating the two following
  important and decisive facts in proof of the efficacy and safety
  of Vaccination, namely, that in the cases which have come to
  their knowledge, Smallpox after Vaccination, with a very few
  exceptions, has been a mild disease, and that out of the many
  hundred thousand persons Vaccinated, not a single authenticated
  instance has been communicated to them of the occurrence of fatal
  Smallpox after Vaccination.

  The Board have great pleasure in stating that the money granted
  by Parliament during the last session has been sufficient to
  defray the expenses of the year 1811, and they are of opinion
  that the same sum will be adequate to the expenditure of the
  current year.

There were 3,148 vaccinations effected under the Board in 1811,
which was at the rate of about £1 a-head.

Moore, after reporting some cases of smallpox after vaccination, at
St. Osyth, in Essex, went on to say--

  1816.--Some very rare instances of failures in Vaccination, as
  exceptions to a general law, may be expected as long as Smallpox
  is prevalent; since it has been fully ascertained that when
  the air is strongly impregnated with the infectious vapour of
  Smallpox, some of those who have had the disease are attacked a
  second time.

  1818.--From the foundation of this Establishment in 1808 to the
  present year there have been vaccinated 52,253 persons at the
  stations in London. Only four of these are yet known to have had
  Smallpox afterwards, and these were never very seriously ill.

  1819.--The testimonies of some of our correspondents concur in
  showing that great numbers of persons who had been vaccinated
  have been subsequently seized with a disease presenting all the
  essential characters of Smallpox; but that in the great majority
  of such cases, the disease has been of comparatively short
  duration, unattended by symptoms of danger. In several of these
  cases, however, the malady has been prolonged to its ordinary
  period, and in eight reported cases it has proved fatal. It
  appears to us to be fairly established that the disposition in
  the vaccinated to be thus affected by the contagion of Smallpox
  does not depend upon the time that has elapsed after Vaccination,
  since some persons have been so affected who had recently been
  vaccinated, whilst others who had been vaccinated eighteen and
  twenty years have been variolated, and exposed to contagion with
  impunity.

  1820.--It is true that we have received accounts from different
  parts of the country of numerous cases of Smallpox having
  occurred after Vaccination, and we cannot doubt that the
  prejudices of the people against this preventive are assignable
  (and not altogether unreasonably, perhaps) to this cause. These
  cases the Board have industriously investigated, and though it
  appears that many of them rest only on hearsay evidence, and that
  others seem to have undergone the Vaccine Process imperfectly,
  yet after every reasonable deduction, we are compelled to allow
  that too many still remain on undeniable proof to leave any doubt
  that the pretensions of Vaccination, to the merit of a perfect
  and exclusive security in all cases against Smallpox, were at
  first admitted too unreservedly.

  1825.--That a considerable number of persons have had Smallpox
  after having been vaccinated, we are ready to admit; although of
  cases of this kind, a large majority are found on examination
  to be without that test of the operation being performed
  successfully and effectually, which all agree to be necessary to
  perfect security. Vaccination, therefore, it will be said, does
  not afford an absolute and perfect security. We do not present it
  to the world with that pretension, but we declare it to be the
  least imperfect of the resources we possess for encountering the
  disease.

  1827.--It is true, cases are reported to us very often of the
  occurrence of Smallpox after Vaccination; but we have reason to
  believe that the number of those who fall into this safe, though
  sometimes severe disease, after Vaccination, is not greater than
  that of those who formerly _died_ by Inoculation whilst that
  practice prevailed.

  1833.--Of an equal number of persons vaccinated and variolated,
  only so many of the former will be capable of taking the Smallpox
  afterwards, and that in a safe degree of the disease, as are
  found to die by the latter.

  1836.--If 300 children be vaccinated, one will be susceptible of
  Smallpox afterwards, but only in a mild and perfectly safe form,
  whereas if 300 be variolated, one will surely die.

As evolutions from inner consciousness, the statistics of
Variolation and Vaccination under 1827, 1833, and 1836 are
noteworthy. They illustrate the facility of the Board at the
discovery of what was thought _ought to be true_.


DEVELOPMENT OF A FABULOUS SALVATION.

  1811.--Previous to the discovery of Vaccination, the average
  number of deaths by Smallpox within the London bills of mortality
  was 2,000 annually; whereas during 1811, only 751 died of the
  disease, notwithstanding the increase of population.

  1818.--During the year, 6,289 have been vaccinated in London
  and the vicinity; and the Board have much satisfaction in
  adducing unequivocal evidence of the increasing advantages of the
  Jennerian discovery; for it appears from the bills of mortality
  of London that, instead of 2,000 deaths by Smallpox, which was
  the annual average previous to the practice of Vaccination, there
  died in 1818 only 421.

That, previous to the introduction of vaccination, 2,000 was the
average annual death-rate from smallpox in London is a statement
that requires definition. At an early date the number is under the
mark, and at a later it is over the mark. Dr. Farr delivers the
truth in these words--

  Smallpox attained its maximum mortality after Inoculation was
  introduced. The annual deaths from Smallpox in London, from 1760
  to 1779, were on an average 2,323. In the next twenty years, 1780
  to 1799, they declined to 1,740. 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.

Bearing Dr. Farr’s figures in mind (and not forgetting the 2,000
adduced by the Board in the reports for 1811 and 1818), what does
the reader think of the following audacious attempts on public
credulity?--

  1826.--From the quantity of vaccine lymph distributed, we are led
  to presume the practice of Vaccination is becoming daily more
  general; and the inference is still further confirmed by the fact
  that in 1826, only 503 deaths have occurred from Smallpox within
  the bills of mortality; whereas in the preceding year, 1,299
  persons are recorded as having fallen victims to the loathsome
  disease. The whole of this difference ought not, perhaps, in
  candour to be attributed to the influence of Vaccination; for
  Smallpox during 1825 assumed a peculiarly malignant character;
  and there were more instances of the distemper occurring twice
  in the same individual than had ever been reported to us before.
  But when we reflect that before the introduction of Vaccination
  the average number of deaths from Smallpox in London was annually
  about 4,000, no stronger argument can reasonably be demanded in
  favour of the value of this important discovery. Nor can any more
  striking proof be given of the paternal care of the Government
  to protect the people at home and abroad from this destructive
  disease than the establishment and maintenance of this Board.

The bouncing falsehood, having passed muster, was repeated with
enlargement at a suitable interval--

  1834.--Only 334 deaths by Smallpox have been reported, a
  number considerably less than have died in any year since the
  introduction of Vaccination, and falling short by at least 4,000
  of the average of deaths annually by Smallpox in London before
  the protecting influence of Cowpox was discovered and promulgated.

And again it appeared with a fresh touch of exaggeration--

  1836.--The annual loss of life by Smallpox in the Metropolis
  before Vaccination was established exceeded 5,000, whereas, in
  the course of last year, only 300 died of the distemper.

Impunity being apparently assured, the fable came to be delivered
as matter-of-course, thus--

  1839.--Formerly 5,000 died annually of Smallpox within the
  London bills of mortality; but since Vaccination superseded
  Variolation, the number has gradually decreased, until it
  amounted to only 200 in the year 1837. In the course of the
  year that has terminated (during which Smallpox prevailed
  epidemically), there died 800; not one more, after all, than
  one-sixth of the number who died annually [that is to say,
  4,800] during the prevalence of Variolation, notwithstanding the
  increased population of London and its environs. By a careful
  retrospect, we are, therefore, justified in stating that 4,000
  lives are saved every year in London, since Vaccination so
  largely superseded Variolation.

The fall in smallpox that set in toward the close of last century
was not confined to London, but extended to many European
populations. It began before vaccination was heard of, and
continued independently of it, though the vaccinators eagerly
claimed the phenomenon as the result of their superfluous efforts.
The claim was absurd as concerned London, for it plainly appears
that vaccination during the years in question never overtook, or
even approached, the metropolitan birth-rate. Here is the record of
the vaccinations effected by the Establishment in five years--

     1818    1819    1820    1821    1822    Total.
    -----   -----   -----   -----   -----   ------
    5,490   7,874   6,054   6,627   8,230 = 34,275

The entire vaccinations in five years not equalling the London
births in any one year! There were, we dare say, as many more
vaccinated by voluntary effort; but the figures, however extended,
cannot be got to cover the immense mass of lower-class Londoners,
who then, as now, were the chief factors of smallpox. What I say
emphatically is, the National Vaccine Establishment had as much
influence on London smallpox as the Holy Alliance.


POCK-MARKED FACES.

One of the arguments for vaccination at this day runs thus--“How do
you account for the absence of pock-marked faces? When I was young,
forty years ago, nothing was commoner than countenances disfigured
by smallpox.” Occasionally the reminiscence is transferred to a
mother or grandmother, who is reported to have said that she
remembered when every third or fourth person was pitted.

We need not take seriously the motherly or grand-motherly
reminiscences, so apt to be touched with the glamour of years.
Confining ourselves to living memories, the owners thereof may,
perhaps, be surprised to learn that the transformation for which
they personally avouch was effected before they were born, or
were qualified observers; and before vaccination was sufficiently
practised to have wrought the change; and here is the evidence, as
set forth in the reports of the National Vaccine Establishment, and
printed by order of the House of Commons. Under the following dates
we read--

  1822.--As a proof of the protecting influence of Vaccination,
  we appeal confidently to all who frequent theatres and crowded
  assemblies to admit that they do not discover in the rising
  generation any longer that disfigurement of the human face which
  was obvious everywhere some years since.

  1825.--The deaths by Smallpox amounted to 1,299 in 1825, a much
  greater number than has been reported for some years past.
  From this melancholy statement it is impossible to avoid the
  conclusion that the lower orders of society continue to be
  prejudiced against Vaccination, and allow Smallpox to take its
  course.

  And yet what argument more powerful can be urged in favour of
  Vaccination than the daily remark which the least observant must
  make, that in our churches, our theatres, and in every large
  assemblage of the people, to see a young person bearing the marks
  of Smallpox is now of extremely rare occurrence.

  To what can the freedom from the vestiges of so loathsome a
  disease be attributed, but to the protecting influence of
  Vaccination? for Variolation has now been disused by all
  respectable practitioners for some time past.

  1837.--The rarity of an example of disfigurement by Smallpox
  now to be found in the theatres, in churches, or in any large
  assemblage of the people, affords proof that Vaccination has lost
  none of its efficacy.

Pock-marked faces are by no means uncommon at this day in London,
though their number has diminished through more careful nursing
and the use of well-known means for preventing disfigurement; and
whoever cares to pursue the inquiry will discover that the majority
of the marked have been vaccinated and many re-vaccinated--a proof
that it is not the rite which prevents the scars.

The general impression we derive from the reports of the
Establishment, 1808-40, is that they proceeded from men who
were committed to vaccination, but had no profound faith in its
efficacy; who were averse from the admission of its impotence,
and ultimately held by it as possibly the best available defence
against smallpox. With ample means and opportunities for
investigation, they made no discovery, nor achieved any advance in
practice, nor apparently conceived that there was either discovery
or advance to be made. They accepted smallpox as a mysterious
ordinance of Nature, with cowpox for a probable antidote, and there
stuck fast, thoughtless and helpless. They did not even observe
that smallpox was specially a disease of the young and the poor,
nor deduce conclusions therefrom. They had their money, and went
through an appropriate routine, and there their action ended.


FOOTNOTES:

[275] _History and Practice of Vaccination_, p. 223.

[276] _History and Practice of Vaccination_, p. 226.

[277] Baron’s _Life of Jenner_, vol. ii., p. 398.




CHAPTER XXXVI.

THE NATIONAL VACCINE ESTABLISHMENT--1841-50.


Along with the prohibition of Variolous Inoculation in 1840,
Parliament passed an Act for the provision of Vaccination out of
the poor-rate. A scheme had been formulated and petitioned for
by the Provincial Medical and Surgical Association in 1838, with
the expectation that the Government might be induced to create
a multitude of places for “regularly educated vaccinators, with
suitable salaries, in districts sufficiently numerous to embrace
the whole of the poor population of the country.” The House of
Commons being of a thrifty turn in those days, did not however
favour such a magnificent development of place and pay under
the National Vaccine Establishment, and disposed of the project
by referring the provision of vaccination to the parochial
authorities, who might be trusted to do what was needful with due
regard to economy. In every union, and in every parish that was
not in union, it was provided that there should be one or more
medical practitioners appointed by the Guardians for the gratuitous
vaccination of the inhabitants, with remuneration from the rates
according to the number operated upon.[278] This accession to
their burdens met with anything but welcome from the ratepayers
in general. Contracts for vaccination at so much per head were
submitted for competition, and those who accepted the rite at the
public expense were spoken of as paupers, and in some places had
their names published to “shame them.” To remove the stigma of
pauperism from the parish prophylaxy, an Act was passed in 1841 in
which it was declared that public vaccination was not of the nature
of “parochial relief, alms, or charitable allowance,” and did not
therefore deprive the recipient of any “right or privilege,” or
subject him “to any disability or disqualification whatsoever.”[279]

The reports of the National Vaccine Establishment from 1841 to 1850
continued to be of the same perfunctory character. They usually
started with a profession of confidence in vaccination, after the
fashion of Mrs. Micawber’s resolution never to desert Micawber; the
signature to which declaration by the President and Senior Censor
of the Royal College of Physicians, and the President of the Royal
College of Surgeons being accompanied with a douceur of £100 to
each. For example, we read--

  1841.--Smallpox has prevailed epidemically with considerable
  severity since our last Report; but we do not abate an iota of
  our confidence in Vaccination as the best protective against its
  malignant influence.

  1845.--The unabated confidence with which we continue to regard
  Vaccination, etc., etc.

  1847.--Nothing has occurred to diminish our confidence in the
  protective influence of Vaccination. It is true that Smallpox
  has now and then reappeared; and lately to an extent which has
  called for additional efforts on the part of all the officers of
  the Establishment; but we regard such recurrence as due to the
  ordinary operations of those periodical influences which give to
  the disease its epidemic character; and in some localities, as in
  Ireland, to that distress with which contagious diseases are so
  invariably associated.

The reporters apparently forgot that according to the doctrine
of which they were the representatives, vaccination excluded the
possibility of smallpox under whatever circumstances of atmosphere,
filth, or privation. If only effective in the absence of the
ordinary conditions of smallpox, wherein consisted the benefit of
the rite?

Ceely of Aylesbury in 1839, and Badcock of Brighton in 1840,
succeeded in inoculating cows with smallpox, and the resulting
virus was described as cowpox, and used for vaccination far and
wide. Apparently the procedure was not approved by the Vaccine
Establishment, for we read in the report--

  1841.--The matter we employ is obtained by succession from the
  original virus communicated by Dr. Jenner himself, and that we
  find is as effectual as ever. We may be excused therefore, we
  hope, if we discourage an incautious dissemination of matter
  obtained from new sources, which has not stood the test of ample
  experience.

The original virus communicated by Jenner himself! What was it?
When the National Vaccine Establishment was instituted in 1808,
the virus in circulation in London was accepted as stock, and
it certainly had several origins. It was cowpox as discovered
by Pearson; it was horsegrease cowpox and horsepox as derived
from Jenner; and there is reason to believe it was smallpox from
Woodville and others. The claim, therefore, to the possession of a
specific variety of matter communicated by Jenner was fictitious.

Again, through the recurrent failure of vaccination to avert
smallpox, the Board had to discountenance the assertion that their
virus had lost its virtue through prolonged transmission--a reason
which led some to prefer the fresh variolous stocks of Ceely and
Badcock--

  1840.--The experience of another year has afforded proofs of the
  propriety, in the present state of our knowledge, of preferring
  Vaccine Matter, the produce of the original virus furnished by
  Dr. Jenner, which has now passed happily through successive
  generations of subjects in the course of 43 years, and which
  forms the principal source of our supply, to any which may have
  been recently taken from the cow.

Here we have “the original virus furnished by Dr. Jenner” set forth
as no more than “the _principal_ source of supply.” The reports are
characterised by many similar inconsistencies--

  1845.--We regard as erroneous the belief that Vaccine Virus
  undergoes deterioration by being kept; in proof of which we are
  prepared to establish, by unquestionable documents, the striking
  fact, that Lymph which had been conveyed to and from India has
  retained its protective properties wholly unimpaired after a
  lapse of 20 years.

Another vexation of the Board was due to the assertion that the
protective virtues of vaccination gradually wore out, and that
the repetition of the rite was necessary for the maintenance of
salvation. In the _London Medical Gazette_, 2nd August, 1844, it
was proclaimed--

  We are sorry to announce the extensive prevalence of Smallpox at
  this time among us. REVACCINATE, REVACCINATE, say we.

Such advice was essentially heretical and damnable; for Jenner
affirmed and maintained--

  That the human frame, when once it has felt the influence of
  the genuine Cowpox, is never afterwards, at any period of its
  existence, assailable by Smallpox.

If revaccination were possible, smallpox after vaccination was
possible; and if so much were conceded, on what ground was
vaccination to be defended? Whatever the facts, the members of
the Board resolved to stand loyally by the primitive Jennerian
doctrine, and in their Report for 1851 thus testified--

  It may be expedient to remind the public of the established fact
  which the Board upon former occasions anxiously insisted upon,
  that 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.

Notwithstanding the prohibition of Variolous Inoculation, the
Board had repeatedly to deplore its continuance especially in
Ireland. Thus we read--

  1850.--The Board again entreat the attention of the Government to
  the fact that Inoculation for the Smallpox still continues; and
  that the disease is communicated by vagrants to those unprotected
  by Vaccination in town and country. The contagion is carried
  throughout the land by wandering Irish, and no care, however
  great, can be successful in eradicating Smallpox, whilst the
  neglect of Vaccination and the practice of Variolous Inoculation
  are permitted in Ireland.

It was Jenner’s practice to attribute to wilful blindness and
innate depravity any scepticism as to the efficacy of vaccination;
and throughout the Reports of the Establishment this habit of
imputation was maintained. Vaccination was treated as a sort
of divine revelation, plenary and manifest, which could only
be disputed or resisted from deliberate perversity, or, more
charitably, from abject dulness or ignorance; and it would be
easy to construct a catena of piquant deliverances under this
semi-theological persuasion. Such observations as the following
were of the order of matter-of-course--

  1850.--We regret to learn that in our own country the spread of
  Vaccination is still materially impeded by influences emanating
  from ignorance and prejudice in the lower orders, and from
  prejudices in many who cannot plead the excuse of ignorance.

  1851.--It is lamentable to observe not only the indifference, but
  the active hostility displayed by the community to Vaccination.
  Deeply-rooted prejudices and absurd superstitions are ever
  opposing its adoption.

The Reports of the Establishment year after year displayed in
full measure the familiar complacency of official routine--where
pay is constant and wheels propelled from office desks revolve
smoothly in space--so many Londoners vaccinated, so many charges
of virus distributed, and confidence in the sacred prophylactic
unabated. A revolution was, however, impending. The attitude of
the public mind toward disease had become transformed. Faith in
sanitation as a preventive of fevers had been created, and a
popular demand for sanitary improvement had set in. Under cover of
this new enthusiasm some of the shrewder advocates of vaccination
conjectured that it would be possible to effect its endowment
and establishment on a scale hitherto unattempted in England. It
was true that vaccination had no relation to sanitation; but the
reforming and philanthropic mob were madly in favour of whatever
bore the promise of health, and were not likely to show themselves
hypercritical or obstructive.

The first movement toward a new advance is discernible in the
Report of the Establishment for 1850 wherein we read--

  The Board have had to solicit the attention of Her Majesty’s
  Government on several occasions to the deplorable fact that a
  very large proportion of the children of the poorer classes
  in the Metropolis, and in England and Wales generally, but
  above all in Ireland, remain year by year without the benefit
  of Vaccination. Their testimony on this important part of the
  sanitary condition of the population has been derived from the
  reports of numerous competent medical witnesses in all parts of
  the United Kingdom, and from the frequent recurrence of rapid
  and fatal invasions of Smallpox, to which their attention has
  been repeatedly called by urgent applications for Vaccine Lymph.
  It is satisfactory to find that the representations which the
  Board have made are most unequivocally confirmed by the report of
  Mr. Grainger, from which it appears that the number of persons
  under one year who were vaccinated during the year ended 29th
  September, 1848, in 627 Unions of parishes in England and Wales
  (exclusive of those vaccinated at the cost of their parents)
  amounted to no more than 33 per cent., compared with the total
  number of births registered in the same period.

These figures are worth noting. Dating from 1840, an effort was
made to overtake the vaccination of the people by the agency of
the poor law; and yet so late as 1848, not more than one-third
of the children born were accounted for as Jennerised. Adding to
this third the offspring of the upper and middle classes, we may
safely conclude that up to 1850 not half the inhabitants of England
and Wales were vaccinated; and the unvaccinated half included the
lower classes most subject to smallpox--victims of that “distress
with which contagious diseases are so invariably associated,” to
cite the words of the Report for 1847. The point is especially
worth noting because the decline of smallpox, which set in last
century, is continually ascribed to vaccination. A true cause
however must be commensurate with the effect; and yet here we see
the asserted cause of the fall in smallpox did not apply in 1848 to
half the English people; in which half, moreover, lay nine-tenths
of the field in which smallpox was possible. The Report for 1850
continues--

  The Board lament that they have no means of adopting or enforcing
  such measures as are obviously necessary for the prevention of
  Smallpox. They have no power of instituting domiciliary visits,
  or house to house visitation; and indeed hitherto such have been
  deemed too much of an encroachment on the liberty of the subject.
  They have no power to punish officially the practice of illegal
  Inoculation, or the exposure of infected persons; and they have
  only had the means granted to them of prosecuting such offenders
  in two cases, in order to establish the fact of the illegality of
  Variolous Inoculation. They can only recommend and aid, but they
  cannot enforce Vaccination.

  The progress of Vaccination is more rapid in Foreign Countries
  where municipal measures or legislative enactments are adopted
  to promote its dissemination; and they beg to express their
  conviction that if England is to be free from Smallpox, the
  interposition of the Legislature alone, by wise and comprehensive
  measures, can disarm the Pestilence of its terrors, and realise
  the fond hopes and prayers of the Friends of Humanity for its
  extinction.

In these observations is revealed the movement of a new spirit--of
a revived resolution to obtain for vaccination the force of
law. Similar projects had from time to time been advanced by
enthusiasts, and swept aside by statesmen. Canning, for instance,
had declared that he could not imagine any circumstances
whatever that would induce him to consent to the compulsory
infliction of vaccination; and, at a later date, Sir Robert Peel
expressed himself to like effect, saying, “To make vaccination
compulsory, as in some despotic countries, would be so opposite
to the mental habits of the British people, and the freedom of
opinion wherein they rightly glory, that I never could be a
party to such compulsion.”[280] But Peel died in 1850, and a
strong public opinion in favour of sanitary reform had come into
existence without much scruple as to methods. Diseases, hitherto
regarded as supernatural inflictions, were traced to conditions
of life, remediable or avertible; so that the submission and
terror which sickness formerly inspired gave place to widely
different sentiments--a temper of intolerance with illness, and
a determination to extirpate its infectious forms with those who
in ignorance or wilfulness should persist in their generation and
diffusion.


FOOTNOTES:

[278] 3 & 4 Vict., cap. 59.

[279] 4 & 5 Vict., cap. 32.

[280] _Report of Royal Jennerian and London Vaccine Institution_,
1853.




CHAPTER XXXVII.

VACCINATION ENFORCED--1853.


Vaccination, it will be objected, had no connection with sanitary
reform. True: it had none; but the dull public when possessed with
a new enthusiasm is not apt to discriminate; and those who had an
interest in pushing vaccination found their operations facilitated
by the rising faith in the preventibility of disease; their promise
of saving the country from smallpox seeming of a piece with much
else that had become credible.

Yet, strange to say, the credit of vaccination had never fallen
lower than prior to its enforcement. The proof is written at large
in the reports of the National Vaccine Establishment from 1831 to
1850, which it is difficult to peruse without perceiving them to
be the testimonies of half-hearted officials to a generation grown
sceptical and indifferent. The medical literature of the time
reflects the same uncertainty and doubt. Vaccination was admitted
to be no sure defence against smallpox: it might, it probably did,
mitigate the disease when it occurred; and, in the absence of
anything better, its practice was advisable; but on such terms,
what scope was there for its advocacy! In the writings of Dr.
George Gregory, this scepticism is so pronounced, that he scarcely
hesitates to recommend a reversion to inoculation with smallpox.
A like scepticism as to the virtue of vaccination with a like
disposition to return to variolous inoculation, is exhibited by Dr.
Copland in his _Dictionary of Practical Medicine_, 1844-58--a work
of high repute, and the standard of medical opinion for the time.
In short, vaccination was subject to general distrust; every claim
made for it had been belied; and except for its endowment by the
State, and the determination of sundry adventurers to have that
endowment enlarged, the practice would gradually have fallen into
disuse.

The same absence of confidence in vaccination was conspicuous in
the school of sanitary reformers. It was of the essence of their
revelation that smallpox was as preventible as other fevers, and
by the same methods. I might, indeed, challenge any one to produce
aught from the utterances of the early apostles of sanitation in
deliberate or explicit praise of vaccination. The prescription
might not be formally condemned; it might even be cursorily
approved; but it was foreign to the tenor of their doctrine, and
its recommendation must have died in their throats. Dr. Southwood
Smith delivered two lectures in Edinburgh in 1855 on the Prevention
of Epidemics, but of smallpox as preventible by vaccination he
said not a word. On the contrary, this was his testimony, his all
inclusive testimony--

  Overcrowding we can prevent; the accumulation of filth in towns
  and houses we can prevent; the supply of light, air, and water,
  together with the several other appliances included in the
  all-comprehensive word CLEANLINESS, we can secure. To the extent
  to which it is in our power to do this, it is in our power to
  prevent epidemics.

  The human family have now lived in communities more than
  six thousand years, yet they have not learnt to make their
  habitations clean. At last we are beginning to learn the lesson.
  When we shall have mastered it, we shall have conquered epidemics.

Among the upper and middle classes distrust in vaccination was
general. How, indeed, could it be otherwise? All were vaccinated,
yet whenever smallpox was epidemic, recipients of the rite
enjoyed no immunity. In one of Miss Mitford’s letters we find an
experience and a judgment which were far from uncommon. Writing,
1st February, 1850, she observed--

  About two months ago, my man, a very steady and respectable
  servant, was seized with Smallpox after Vaccination. He was very,
  very ill, delirious nearly a fortnight, and not a nurse could
  be had for love or money. I have lost all faith in Vaccination,
  either as preventing or mitigating Smallpox. I know of thirty
  severe cases this winter, five of them fatal, in my own immediate
  neighbourhood, and in Reading it has been a pestilence.[281]

Vaccination among the poor was (as it is) detested. Coaxed or
forced into its reception without consideration or preparation,
like sheep or cattle, they realised its mischiefs and misery in
full measure; and naturally, whenever pressure was relaxed, avoided
its acquaintance.

How then did vaccination come to be imposed upon a community thus
affected? The answer is the usual one, illustrated continually
in English politics: an organised interest, possessed with a
definite intention, can always prevail over the public--careless,
uninstructed, and without positive conviction. Under such
circumstances, it is a mere question of management what may be
achieved in Parliament at variance with the common welfare. Those
there get, who know how to take.

All trades and professions fulfil the law of their being in
striving after advantage and extension. The clergy and the
clerically-minded laity are persuaded that to multiply churches and
provide stipends, is to prepare for the millennium, and nothing
save hopelessness prevents demands upon the national exchequer for
the purpose. The sacrifices the army and navy would exact on their
own behalf for security from foreign aggression are only limited
by the public incredulity. The commercial classes are free-traders
in principle; but if a protective bounty could be had for any
manufacture, it would be instantly grasped at by those concerned,
and most ingenious reasons invented to justify that particular
departure from the rule of justice. This tendency of interests to
aggrandise themselves, _per fas et nefas_, at the public expense,
is recognised by all statesmen, and is only kept in check by
perpetual vigilance.

What is true of all, is true of the medical profession, crowded
with competitors eager for employment. Vaccination as a branch
of business, capable of development and endowment at the public
cost, was certain of vigorous promotion whenever there was
opportunity; but not until 1853 did the way open for the compulsory
infliction of the Jennerian rite. The undertaking was hazardous.
The opposition to which Canning and Peel had given expression, had
to be circumspectly encountered. It was a job that might easily
be wrecked; and therefore it was considered inexpedient that the
medical corporations should appear too openly in the transaction.
Instead, a committee was formed in 1850 under the title of
“The Epidemiological Society for the Investigation of Epidemic
Diseases,” with a number of suitable decoys, and ostensible
occupation; but chiefly designed as an instrument wherewith to
operate on Parliament for the better establishment and more liberal
endowment of vaccination.

It was resolved to proceed tentatively--to secure if possible the
affirmation of compulsion, allowing the shock of innovation to
subside before going on to provide the effective means of espionage
and persecution. As it turned out, the caution exercised was
superfluous. Much more might have been demanded and conceded of the
ignorance and indifference of the legislature. Lord Lyttelton was
selected to introduce what was called the Vaccination Extension
Bill, and in moving the second reading in the House of Lords on
12th April, he ingenuously disowned any qualification for the task,
saying--

  I have no scientific knowledge of the subject myself, and for
  my information I am indebted to some able and learned persons
  belonging to the Epidemiological Society--

Adding in proof of the manner in which he had been crammed by the
said “able and learned persons”--

  It is unnecessary for me to speak of the certainty of Vaccination
  as a preventive of Smallpox, that being a point on which _the
  whole medical profession have arrived at complete unanimity_!

The statistics with which Lord Lyttelton supported the necessity
for compulsion are interesting as indicating the extent and
irregularity of vaccination among the English people. He said--

  We are told that the number of births registered in England and
  Wales in the year ending 29th September, 1852, was 601,839, and
  the number vaccinated under the Act of 1840 was 397,128; so that,
  in round numbers, 400,000 were vaccinated by the machinery in
  force, leaving only 200,000, or one-third of the whole number, to
  be treated by private vaccination. There are several fallacies in
  that statement. The general result is by no means the consequence
  of anything like a uniform system throughout the country. I have
  before me a detailed statement of the extent of Vaccination in
  various parts of England in 1851, which shows there is great
  want of uniformity in certain districts. In towns where people
  have a shorter distance to go to get their children vaccinated,
  the result is more favourable than in the rural districts. For
  example, in Birmingham, on the total number of births in 1851,
  the vaccinations were 91 per cent.; in Leicester they were only
  41 per cent.; and in Loughborough only 18 per cent. The contrast
  between the manufacturing and the rural districts is favourable
  on the side of the former. In Bideford, the vaccinations were
  only 11 per cent. upon the births; in West Ashford in Kent,
  they were only 22 per cent.; and in Winchcomb only 6 per cent.
  While the general average is lower in the agricultural than in
  the manufacturing districts, some contrary instances are found.
  Thus in Derby the vaccinations are only 42 per cent.; while at
  Watford, which is a rural district, the vaccinations were 126 per
  cent. upon the births in 1851--which included, of course, the
  vaccination of children born in previous years. But in London,
  and in no less a parish than that of St. James, Westminster, it
  is reported that in 1851 on 973 births only 44 vaccinations took
  place; while in Wellingborough Union, where there were 800 births
  in 1851, no vaccination at all is reported!

Strange to say, Lord Lyttelton made no attempt to complete
his argument. He ought to have shown that in the places where
vaccination was least practised there was most smallpox, and where
most practised there was least smallpox. Had he made the attempt,
his eyes might have been opened to the untrustworthy character of
“the able and learned person” by whom he had been mendaciously
primed.

Lord Shaftesbury, in supporting the measure, adduced similar
instances of neglected vaccination as follows--

                    Births 1851.   Vaccinations.
    Paddington            1458          386
    Hampstead              286           93
    Huntingdon             805           68
    St. Neots              671           17
    Carnarvon              929          125
    Bangor and Beaumaris  1025          420
    Newton Abbott         1563          150

He, too, forgot to show that these places were “decimated” (that’s
the word) with smallpox, whilst other places where vaccination
was generally practised enjoyed exemption. On the contrary, with
curious inconsequence, he went on to recommend a sure prescription
of his own, namely, improved dwellings for the poor. These were his
words--

  It is perfectly true that Smallpox is chiefly confined to
  the lowest classes of the population; and I believe that
  _with improved lodging-houses, the disease might be all but
  exterminated_.

Not a doubt of it; but if improved lodging-houses would “all
but exterminate smallpox,” why resort to such a superfluity as
vaccination?

There was no adverse discussion--indeed, no discussion whatever.
Lord Ellenborough observed of the Epidemiological Society, under
whose direction they were legislating, that he “would not adventure
upon the extraordinary name by which the members are designated.”
The bill was read for the third time, _nem. diss._, on 18th April,
and was introduced to the House of Commons on 5th May, where its
course was as uninterrupted as in the Lords. Sir John Pakington, in
moving the second reading on 20th July, pleaded like Lord Lyttelton
his own ignorance, and the evidence and authority of the Society
with “the extraordinary name,” thus stating the case--

  An Act was passed in 1840, by which Boards of Guardians were
  authorised to defray the expenses of Vaccination in their
  respective unions. The Poor Law Board have done all in their
  power to carry out the provisions of the Act; but still the
  grave fact remains, that the system is voluntary: that in many
  places the people are prejudiced; that a large proportion of the
  population is not vaccinated; and that mortality from Smallpox
  exists to a very great extent. In the year ending March, 1843
  out of 527,325 born in England and Wales, only 183,000 or 34 per
  cent. were vaccinated. In the succeeding years the vaccinated
  stood to the unvaccinated in the following ratio:--

    1844-45,   100 to 156
    1845-46,   100 to 134

  In 1846-47 the births were 552,000 of which only 267,000 were
  vaccinated, or about 50 per cent. of the whole. In consequence,
  however, of stimulus applied by the Poor Law Board, two-thirds of
  the births in 1847-48 were accounted for as vaccinated; but still
  in many parts there prevails excessive neglect. For example, so
  late as 1851 in 32 unions in and around Birmingham, the births
  were 17,700 while the vaccinations were only 6,174--two-thirds
  being unvaccinated.

Here, too, we note the omission of proof, that where vaccination
was neglected smallpox was prevalent, and where practised smallpox
was absent. Lord Palmerston supported the second reading without
hesitation. Sir George Strickland was the only dissentient, saying--

  Sir John Pakington has himself supplied the strongest reason
  why the bill should not pass. He has shown that Vaccination as
  at present conducted is working well; but because some mothers
  object to the practice, we are to be saddled with a compulsory
  law. We are too prone to resort to force to overcome resistance,
  which would yield to reason with the exercise of patience. What
  need is there that we should imitate the legislation of Saxony,
  or Austria, or Prussia in such a matter? In this country we
  cannot have one law for the poor and another for the rich, and
  yet here we are asked to apply a measure to the former which we
  could not think of for the latter. How can we expect to abate
  prejudice against Vaccination by compulsion? If we acted more
  on the old English principle of leaving people to secure their
  welfare by their own good sense, we should in the end achieve our
  purpose much more successfully.

The bill was read, for the third time in the House of Commons
without debate on the 13th, and received the royal assent on 20th
August, 1853. In short, it passed through Parliament without
opposition. What, it will be asked, were its provisions?

By the Act (16 and 17 Vict. cap. 100) it was required--

  1. That every child, whose health permits, shall be vaccinated
  within three, or in case of orphanage within four months of
  birth, by the public vaccinator of the district, or by some other
  medical practitioner.

  2. That notice of this requirement, and information as to the
  local arrangements for public vaccination, shall, whenever a
  birth is registered, be given by the registrar of births to the
  parents or guardians of the child.

  3. That every medical practitioner who, whether in public or
  private practice, successfully vaccinates a child shall send to
  the local registrar of births a certificate that he has done so;
  and the registrar shall keep a minute of all the notices given,
  and an account of all the certificates thus received.

  4. That parents or guardians who, without sufficient reason,
  after having duly received the registrar’s notice of the
  requirement of Vaccination, either omit to have a child duly
  vaccinated, or, this being done, omit to have it inspected as to
  the results of Vaccination, shall be liable to a penalty of £1;
  and all penalties shall be recoverable under Jervis’s Act, and
  shall be paid toward the local poor-rate.

Thus from 1853 every English parent became liable to a fine of
twenty shillings and costs who refused or neglected to have
his child vaccinated within three months of birth. It may seem
surprising that an Act so arbitrary, enforcing an indefinite
medical prescription (for Vaccination was _not_ defined, and
Vaccination _is_ a rite of several varieties) should have been
passed so lightly; but we have to recollect the circumstances.
The House of Commons in those days was the house of the upper and
middle classes, and was as little affected as the House of Lords
itself by the proposed legislation. It was an Act for application
to the vulgar--to the prejudiced, whose prejudices were to be
encountered, not with arguments, but with fines; an illustration of
the levity with which the unconcerned can dispose of the opinions
and feelings of those to whom they owe no allegiance. Since that
time the working-classes have plainly discovered that they only
obtain consideration in Parliament in so far as they can make
their power felt in the constitution of Parliament. No rights are
secure that cannot be enforced, nor any justice certain that cannot
be vindicated. Those who hold their ground by any other tenure
than their own intelligence and vigour are liable to continual
imposition and depredation.

      The good old rule, the simple plan,
        That they should take who have the power,
      And they should keep who can--

is the abiding social law, however veiled or elevated in
application.

Again we have to recollect, that in 1853 there was no developed or
scientific resistance to vaccination. As to the nature and value of
the practice there was wide diversity of opinion, notwithstanding
Lord Lyttelton’s affirmation of the complete unanimity of the
medical profession; but although such scepticism was general, the
rite constituted an established poll-tax among the respectable
classes, which sort of thing is never readily surrendered. Hence
it seemed less unreasonable to enforce the like observance on “the
ignorant and prejudiced” at the cost of the poor-rate. When Canning
refused to consent to compulsion in 1808, cowpox had a competitor
in smallpox inoculation; and Peel in his later protest expressed
the preference of an expiring generation for living English
liberty over cut-and-dry subservience. Despotic philanthropy was
coming into vogue, and it was no longer thought impracticable or
inexpedient to do good to people in spite of themselves. There was
therefore little to be said against the Act of 1853 beyond what
Sir George Strickland expressed. The right of the prejudiced and
ignorant to the enjoyment of their prejudice and ignorance had
become obsolete and indefensible.

The report of the Epidemiological Society was taken as the warrant
for the Act of 1853 alike by the Lords and Commons. Turning to
that report,[282] it is difficult in a few words to convey an
adequate idea of its untruthful character. Whoever, it is said,
wills the end wills the means; and certain medical men having
resolved to make vaccination compulsory whatever was requisite had
to be accomplished; and Dr. Seaton undertook the operation, the
Epidemiological Society, of which he was “the ruling spirit”,[283]
playing the part of guarantee. For the persuasion of the Lords
and Commons, an advocacy of vaccination without hesitation or
qualification was deemed advisable, and the line was thus followed
up--

  Smallpox is a disease to which every person is liable who is
  not protected by a previous attack or by Vaccination. In its
  unmodified form it is fatal to about one in four or one in five
  of all whom it invades; and, when it does not destroy life, it
  in many cases disfigures and deteriorates the general health.
  Every case of it is a centre of contagion, and every unvaccinated
  or imperfectly vaccinated population is a nidus for the disease
  to settle in and propagate itself. It is on the two latter
  propositions, which do not admit of being controverted, that we
  conceive any enactment for rendering Vaccination compulsory must
  be based. If it admit of doubt how far it is justifiable in this
  free country to compel a person to take care of his own life and
  that of his offspring, it can scarcely be disputed that no one
  has a right to put in jeopardy the lives of his fellow-subjects.

All will recognise the authoritative air of the foregoing, so
impressive where nothing better is known; but the indisputable
proposition, “that no one has a right to put in jeopardy the lives
of his fellow-subjects,” was curiously inconsistent with faith in
the asserted prophylactic; for if the vaccinated were secure from
smallpox, how could the unvaccinated place their lives in jeopardy?
The style assumed was thus maintained--

  We are ourselves satisfied, and it is the concurrent and
  unanimous testimony of nearly 2,000 medical men with whom we have
  been in correspondence, that Vaccination is a perfectly safe and
  efficient prophylactic against this disease.

  This proposition we hold to be proved--

  1. By the general immunity with which it is found that those who
  have been vaccinated can mingle with Smallpox patients, a fact so
  familiar that we do not feel that we need adduce any illustration
  of it.

  2. By the gradual decrease which has taken place in the mortality
  from Smallpox, as compared with the mortality from all causes,
  since Vaccination has been introduced and been generally received.

As to the immunity of the vaccinated, it was disproved in every
smallpox epidemic, and in every smallpox hospital, and by the
precautions and terrors of those accounted secure. To sustain the
proposition that smallpox had decreased in consequence of the
introduction of vaccination, a variety of statistical tables were
adduced, English and Continental; but had the Lords or Commons
subjected them to scrutiny they would have discovered that the
details were either irrelevant or adverse to the conclusion
asserted. Many of the statistics, especially of last century, were
not certainties, but conjectures and estimates, vitiated, too,
with the bias of their compilers. When it is said that smallpox
decreased in consequence of the introduction of vaccination, the
answer is that smallpox was decreasing prior to its introduction
in almost every country of Europe; and that the decrease continued
irrespective of its influence, save in so far as it might have
discouraged the culture of smallpox by inoculation. To illustrate
this contention it may suffice to take the table of London Smallpox
set forth by Dr. Seaton, in which the average of deaths from
Smallpox in every 1000 deaths from all causes was contrasted in
decennial periods for fifty years, prior and subsequent to the
introduction of vaccination.

    PRIOR TO VACCINATION.

                         Deaths from
    Ten Years ending--    Smallpox.
        1760                100
        1770                108
        1780                 98
        1790                 87
        1800                 88

    SUBSEQUENT TO VACCINATION.

                         Deaths from
    Ten Years ending--    Smallpox
        1810                 64
        1820                 42
        1830                 32
        1840                 23
        1850                 16

The figures are far from trustworthy, but taking them as they
stand, and admitting the decline, where was the proof that it
was due to vaccination? The introduction of that practice was
one thing: its application quite another. There was no reason to
believe that more Londoners were vaccinated in 1820 than in 1810,
or in 1840 than in 1830; indeed, the available evidence went to
the contrary, vaccination having fallen in repute after the
furore of 1801-5, and the demonstration of its impotence and its
injuriousness. Probably not ten per cent. of the births in London
up to 1840 were accounted for as vaccinated; and notwithstanding
the provision of vaccination at the cost of the poor-rate by the
Act of 1840, not fifty per cent. in 1850. Yet to a cause so utterly
inadequate, the steady decline in London Smallpox was ascribed! The
same fallacy pervaded the statistics of other countries and cities,
yet so strong was the prepossession in favour of the conclusion
determined upon, that it was apparently neither seen nor suspected,
obvious though it was.

Nor was it surprising that with a disposition so fixed and obtuse,
no enlarged or philosophic views should have been entertained.
“Smallpox,” said Dr. Seaton, “had decreased compared with
mortality from other causes.” True; but what if mortality from
other causes had compensated for the decrease of smallpox? and if
such compensation had taken place, as, for example, in Glasgow,
in what consisted the advantage? Again, no reference was made to
illness and death resulting from vaccination, as if the rite were
harmless as baptism. Allowing that the practice did in some occult
fashion tend to the abatement of smallpox, it was still open to
question whether the infliction of an acute specific disease on
all sorts and conditions of infancy was not likely to be far more
injurious to life than the smallpox it was supposed to avert.
Such considerations, however, were foreign to Dr. Seaton and his
Epidemiological Society with whom vaccination stood for little else
than an extension of medical business at the public cost.

It is not to be forgotten that the Act of 1853 brought to fruition
what was long hankered after by the trade spirit of the medical
profession. The Act of 1840 endowed vaccination out of the
poor-rate; but to make the rite compulsory and to ensure good pay
for its performance was the consummation desired. The terms and
conditions that ensued on the Act of 1840 are thus described by Dr.
Seaton--

  The fee paid in England and Wales varies from 1s. to 2s. 6d.,
  never falling below or rising above those sums. In 1842 and 1843,
  the Commissioners estimated the average fee at 1s. 9d. From our
  inquiries, it appears that in the large manufacturing towns the
  fee varies from 1s. to 1s. 6d.; the larger sums of 2s. and 2s.
  6d. being paid for the most part in country towns. In London,
  the more ordinary fee is 1s. 6d.; in several parishes 2s. 6d. is
  paid; and in one, 1s. In some few unions a bad principle obtains
  of paying a larger sum for a certain number of cases, as 50, and
  a smaller sum for all above. The average payment per case for the
  whole of England and Wales from 1841 to 1851 inclusive, was 1s.
  5½d.

  In Ireland, the payment appears to be very low. The more general
  sum is 1s., often 6d.; in three or four instances, 3d. and 4d.
  The vicious principle just noticed, of paying a higher fee for
  a limited number of cases, seems to be almost universal. Thus,
  where 1s. is the fee, this is paid for the first 200 cases, and
  6d. for all above. In one case, Nenagh, 1s. is paid up to 200,
  and 1d. for all above. In other cases, 3d. and 4d. are paid for
  all above a certain number. Whilst this pitiful remuneration
  exists, it is not surprising to find that in many districts the
  medical practitioners decline the appointment, leaving the people
  unvaccinated.

  According to the information we have received, it is found, as
  might be anticipated, that on the whole Vaccination is more
  efficiently carried out in the districts where the higher fee
  of 2s. 6d. is paid; or where, as in large towns, the number and
  proximity of children compensate the vaccinator in some degree
  for lower payment.

The better pay, the better vaccination! The object of the
Epidemiological Society, as the stalking-horse of the medical
trades-unions, lay in those fees. Vaccination was a pretext for
a universal poll-tax, set at as high a figure as practicable,
to be succeeded when possible by compulsory revaccination, with
a correspondent tariff annexed. Recalling the early days of
vaccination when the operation was described as simplicity itself,
and when women, parsons, and busybodies inoculated and propagated
“the benign fluid” under Jenner’s authority, it was remarkable to
have the rite thus formalised and converted into the peculium of a
priesthood. Nor can it be objected that when vaccination was thus
practised, it was ineffective against smallpox; for whenever its
virtue is brought into dispute, we are referred to those primitive
times and that primitive practice for the most successful and
unquestionable exhibitions of its power.

_Caveat emptor_ is a well-recognised caution, which to avoid
was the purpose of the Epidemiological Society. A mercantile
transaction was carried out under the cloak of impartial science.
No reader of Seaton’s report could suppose otherwise than that
vaccination was universally regarded as an infallible preventive
of smallpox, and that if by any means the English people could be
subjected to its observance, they would obtain immunity from the
disease. Evidence to the contrary was kept out of sight; and yet
evidence to the contrary lay within the knowledge of every medical
man; and proof might be adduced to weariness from contemporary
medical literature to show that in this respect the Epidemiological
report was contrived to blind and mislead Parliament. As a witness,
none will impugn Sir Henry Holland, and writing in 1839 he
observed--

  Not only in Great Britain, but throughout every part of the
  globe, we find that Smallpox has been gradually increasing in
  frequency as an epidemic; affecting a larger proportion of the
  vaccinated; and inflicting greater mortality in its results.

  The early enthusiasm for the great discovery of Jenner swept
  doubts away; and they returned only tardily, and under the
  compulsion of facts.... Any explanation from the ignorant or
  imperfect performance of Vaccination was found insufficient to
  meet the number and variety of the proofs. And, though more
  palpable at one time than another, according to the greater or
  less prevalence of epidemic causes, yet every succeeding year
  has multiplied them, and every statement from other countries
  attested their truth.

  It is no longer expedient, in any sense, to argue for the present
  practice of Vaccination as a certain or permanent preventive of
  Smallpox. The truth must be told, as it is, that the earlier
  anticipations on this point have not been realised.... Whether
  Smallpox may ever be wholly eradicated is a very doubtful
  question, and the probability is on the negative side.[284]

In statements like these, Dr. Holland did no more than express the
contemporary conviction of the medical profession. Vaccination
was not surrendered: whilst it was allowed that it could not be
trusted to prevent smallpox, it was held that it made the disease
milder, and that whilst its prophylaxy wore out, it was renewable
by revaccination. Obvious it was that vaccination thus qualified
could never obtain legislative sanction; but such sanction being
imperatively demanded, the Epidemiological Society provided what
was thought requisite for Parliamentary conviction.

It is said that Vaccination was a medical question; but all
questions are transformed when they ascend to politics. The origin,
character, and action of varieties of animal virus are mysteries,
and may remain mysteries with general indifference; but when it is
claimed that the inoculation of such virus prevents smallpox, and
that whoever refuses to submit his child to the said inoculation
shall be fined 20s., then the matter is brought within the
personal jurisdiction of every citizen, and he becomes entitled to
information, to the exercise of his judgment, and the expression
of his opinion. As a mystery, vaccination belongs to experts;
but as a Parliamentary preventive of smallpox it is within the
discrimination of all who can observe and appreciate the evidence
of numbers. For a legislator like Lord Lyttelton to confess his
ignorance, and that he moved under the dictation of certain “able
and learned persons,” was to abandon his proper function, and
surrender himself to imposture.


FOOTNOTES:

[281] _Memoirs._ By C. Boner. Vol. i. p. 176.

[282] _Letter from Dr. Edward Seaton to Viscount Palmerston with
Report on Smallpox and Vaccination in England and Wales and
other Countries, and on Compulsory Vaccination, with Tables and
Appendixes presented to the Epidemiological Society._ Ordered by
the House of Commons to be printed, 3rd May, 1853.

[283] _British Medical Journal_, 3rd July, 1880.

[284] _Medical Notes and Reflections._ By Henry Holland, M.D.,
F.R.S. London: 1839. Pp. 401, 415, 416.




CHAPTER XXXVIII.

UNIVERSAL COMPULSION DEMANDED--1855.


Under the terror of the 20s. fine, proclaimed everywhere by
vaccinators voracious for fees, a prodigious extension of practice
was effected in 1854. The vaccinations under one year of age were
more than doubled; and nearly 300,000 children above one year old,
to whom the law did not apply, were driven into the net, and “cut
for the pox” at the public expense. Thus the public vaccinations
of 1854 exceeded the births of that year by 75,000. Subsequently
the rate fell off and fluctuated as appears from the following
table for England and Wales--

                       Public
    Years.  Births.  Vaccinations.
    1853    601,223    376,218
    1854    623,699    698,935
    1855    623,181    464,099
    1856    640,840    435,012
    1857    649,963    423,421
    1858    654,914    468,008
    1859    669,834    455,349
    1860    689,060    494,942

Yet this extension of practice did not satisfy the medical
adventurers of the Epidemiological Society. They pointed out that
universal vaccination was the desideratum, and these results fell
short of universality--

  The Act of 1853 was intended to apply not to 65 per cent. of the
  births, but to every child born. A certain deduction, it is true,
  must be made for those privately vaccinated; and whilst there are
  no data for exactly estimating the proportion of these (which
  probably varies considerably in different parts of the Kingdom);
  yet taking the country throughout, there is reason to believe
  that not more than from 10 to 15 per cent. of the children
  born are so vaccinated; for it is found that in unions where
  particular care is bestowed upon public vaccination, the number
  publicly operated on is from 85 to 90 per cent. of the births.
  If we estimate 80 per cent. only, as the number requiring to be
  provided for by public vaccination, the results of last year
  [1854] fall short of those which should be attained by nearly
  100,000.

This estimate is worth attention as sustaining a conclusion I
have repeatedly tried to enforce. Prior to 1840, vaccination was
a matter almost exclusively of private concern, extending to no
more than 10 or 15 per cent. of the population--or, let us allow,
20 per cent.--and those chiefly the well fed, well clad, and well
housed. Yet the diminution of smallpox, dating from a period in
last century when variolous inoculation was in full practice and
cowpox was unknown, is persistently ascribed to the introduction of
vaccination which up to 1840 did not apply to more than one-fifth
of the people; the four-fifths exempt from the prophylaxy being
notoriously the chief factors of the disease!

Parliament having so readily consented to the Compulsory Act of
1853, it gave cause for acute chagrin that more had not been asked,
when more might so easily have been had; and the operators behind
the Epidemiological Society set to work to try whether the lost
opportunity might not be retrieved. In a Memorial addressed to
the President of the Board of Health in the name of the Society,
in 1855,[285] we find a project developed which lacked nothing of
audacity and comprehensiveness. First, the virtue of vaccination
was asserted in unqualified terms--

  Smallpox is the most preventive of diseases, differing from all
  other epidemic diseases in this remarkable respect, that while
  these latter can only be prevented by discovering and remedying
  the various conditions (as of crowding, want of drainage, filth,
  and the like) which give rise to or assist in the dissemination
  of the specific poison of each disease, the former may be
  guarded against and prevented by a direct prophylactic measure.
  To Smallpox, in short, there is an antidote. The same cannot
  be affirmed, in the present state of knowledge, of any other
  epidemic disease.

  That antidote is Vaccination. In exact proportion as this has
  been efficiently practised, have the extent and severity of
  Smallpox been diminished over the surface of the world. To the
  neglect of it, or to its inefficient performance, is due the
  large existing mortality from the disease in this country.

Evidently the advice, _Pecca fortiter_, had been laid to heart
by the framer of the preceding declaration. Certainly the scheme
for which it stood as preamble required violent justification.
It was no less than the institution of a Vaccination Office with
despotic powers as a department of State. The appointment of public
vaccinators subordinate to the Board of Guardians, subject to
contract, and paid out of the poor-rate, was held to be a degrading
form of service: it prejudiced vaccination as a form of alms, and
reduced medical men to the rank of parochial officers. Worst of
all, the pay was bad--

  The provisions for the remuneration of public vaccinators
  have not been such as to secure their hearty and zealous
  co-operation. The most injurious consequences have undoubtedly
  resulted from this, both in limiting the numbers vaccinated,
  and in discouraging the vaccinators from giving that pains and
  attention to watch the progress of the Vaccine Disease which are
  imperatively necessary.

They must, therefore, be emancipated. An independent organisation,
with a medical chief, was essential alike to the mystery and
dignity of the craft, and the universal and efficient exercise of
its functions. To save the country from smallpox, two conditions
were requisite--

  First, that it be made a matter of legal obligation on all
  persons resident within England and Wales, whether born within
  that portion of the Kingdom or not, to give evidence of being
  vaccinated.

  Second, that to achieve this end, there be provided
  administrative science, zeal, and activity.

  The union of these conditions is indispensable; either without
  the other will fail.

It was pointed out that the Act of 1853 only applied to children
born in England and Wales after a certain date--

  It does not extend to the whole existing population, nor to
  immigrants. It is well known that Smallpox is largely imported
  into this country, and kept up from Ireland. These Irish not
  only form a nidus for the disease in towns where they collect in
  large numbers, but they disseminate it throughout the country at
  harvest time, and in the season of hopping.

To fight and overcome smallpox, to meet and arrest epidemics, the
law must be administered by qualified, zealous, and “adequately
remunerated” officers; but “the keystone to any effective system”
must be a commander-in-chief--

  No compulsory enactment, however comprehensive and stringent; no
  alteration in the mode of appointing public vaccinators, however
  desirable; no additional remuneration and encouragement to them,
  however necessary, will be sufficient to secure the grand object
  to be had in view, the Universal diffusion of Vaccination and
  the Extinction of Smallpox, unless there be some competent and
  energetic Medical Officer to harmonise the whole system and keep
  it in constant activity; to examine continually its working, that
  what is defective may be immediately supplied; and, in cases in
  which it is required, to enforce the law, whether against those
  who refuse to submit themselves to Vaccination, or against those
  who, by travelling about, diffuse Smallpox throughout the Kingdom.

It was further said, “The changes thus proposed _have long
been looked forward to_ by the president and council of the
Epidemiological Society as essential to a proper system of public
vaccination”--of which, indeed, there was no doubt; for to effect
the said changes was the chief end of the Society and of its ruling
spirit, Dr. Edward C. Seaton. Though it may seem incredible,
it will not surprise any who have studied the habit of the
thorough-bred quack, that the designated commander-in-chief, “the
keystone of the system,” the miraculous combination of scientific
and administrative ability, was none other than the projector, Dr.
Seaton himself! He it was who in fancy saw himself the elected head
of the New Vaccination Office, with place and pay at his disposal,
and power to examine and vaccinate every resident upon English soil.

The Memorial concluded with the opinion that in view of “the
continued high rate of mortality from smallpox,” some measure
should be concerted “for carrying out the alterations suggested
during the present (1855) session of Parliament.”

It goes without saying that the project developed in the Memorial
was an impracticability; and that it should have been “long looked
forward to by the president and council of the Epidemiological
Society” proves what manner of dreamers they were. The mortality
from smallpox in England and Wales constituted, they said, 2
per cent. of the national mortality; but not even the reduction
of the 2 per cent. could have reconciled the people to the New
Vaccination Office with its ruling spirit, its expenditure, and its
inquisitors. Bad as smallpox may be, there is worse than smallpox;
and much worse would have been Dr. Seaton with his pernicious
quackery and his intrusive myrmidons. The recrudescence of similar
projects from time to time attests the existence of visionaries
who not only misunderstand the temper and traditions of their
countrymen, but the constitution of human nature itself.

The year 1855 was one of war and excitement, but a bill drawn on
the lines of the Memorial was introduced to the House of Commons
providing that from the 1st of January, 1856, the vaccination of
the people should be committed to a medical superintendent with a
medical staff, drawing their salaries from the Treasury, who would
take over the existing local administration from the Poor Law
authorities, and organise and develop it afresh. Further, it was
provided--

  That every adult person resident in England and Wales on 1st
  January, 1856, who had not already been successfully vaccinated,
  nor had Smallpox, be vaccinated by a duly qualified practitioner,
  or by a public vaccinator, within three months of that date, and
  submit to an inspection by the medical man, or public vaccinator,
  eight days after vaccination, under a penalty of £1.

  That adults not born in England and Wales, and coming to reside
  therein, be vaccinated (if not already vaccinated) within three
  months of their arrival, under a penalty of £1.

  That children be taken by their parents to be vaccinated within
  three months after 1st January, 1856, and be inspected eight days
  after vaccination, under a penalty of £1.

  That children brought to England and Wales from other parts be
  vaccinated in like manner within three months of their arrival.

  That children and adults be revaccinated until the operation is
  declared successful. If after repeated vaccinations, a patient
  prove insusceptible, a certificate to that effect shall protect
  him from the penalty otherwise rigidly inflicted.

  That Public Vaccinators be entitled to a fee of 2s. 6d. for every
  child or adult successfully vaccinated within two miles of the
  Vaccinator’s residence, and 3s. 6d. if beyond that limit. That
  Medical Practitioners, not public vaccinators, be entitled to 1s.
  for every person entered by them on the register as vaccinated.

  That a certificate of successful vaccination be granted for the
  trifling fee of 6d.

  That the Superintendent be empowered to institute rigid inquiry
  and to prosecute for penalties wherever he suspects the
  regulations of the Act have been neglected or violated.

Here, indeed, was a dose of despotism for Englishmen! Nothing being
done in 1855, there was time for reconsideration. It was felt that
the withdrawal of vaccination from local administration was too
revolutionary; and another bill was introduced in 1856, under the
direction of Mr. W. F. Cowper, President of the Board of Health
(dropping the New Vaccination Office), with provisions for the
inspection and vaccination of children in public schools, and of
emigrants; for revaccination in the event of epidemics; and for
coroners’ inquests on unvaccinated children dying of smallpox.
There was no popular demand for such legislation. It was promoted
by a group of medical place-hunters operating under the mask of the
Epidemiological Society. The solitary petition in its favour was
presented, 26th May, 1856, by Mr. James Furness Marson, a comrade
of Dr. Seaton in the direction of the Society. Marson was resident
surgeon of the Smallpox Hospital at Highgate, and as evidence of
his unscrupulous advocacy, we may take the following assertions--

  Your Petitioner has, in the course of twenty years, vaccinated
  upwards of 40,000 persons, and has never seen any evil results
  traceable to Vaccination, with the exception of a single instance
  in which measles occurred at the same time, and four or five
  examples of rather severely sore arms arising from lymph recently
  taken from the cow. He has never seen other diseases communicated
  from the Vaccine Disease, nor does he believe in the popular
  reports that they are ever so communicated.

  The mortality from Smallpox in the Unvaccinated, of cases taken
  generally, is 35 per cent.; and among the Vaccinated attacked by
  Smallpox it is 7 per cent.

  Among children under fourteen years of age who have been
  vaccinated, Smallpox hardly ever proves fatal.

  As an example of what can be done by efficient Vaccination, your
  Petitioner begs to state that not one of the servants or nurses
  of the Smallpox Hospital has had Smallpox for the last twenty
  years. They have all been either vaccinated or revaccinated on
  coming to live at the Hospital.

The Petitioner omitted to mention how many of the said servants
and nurses had entered the Hospital as patients, and were pleased
to remain as officials. Prevarication throughout was the note
of Marson’s petition: he might argue that what he stated was
true--true under conditions and reserves unstated.

It is often observed that the crafty never operate so successfully
as when they have the earnest and ingenuous for instruments; and in
Mr. Cowper, President of the Board of Health, the wire-pullers of
the Epidemiological Society had just such a tool. He believed what
he was told, and delivered it with his own sincerity. In moving the
second reading of the Bill on 31st March, he represented its object
as “nothing more than the consolidation and amendment of preceding
Acts;” and went on to say--

  It is admitted by every medical man whose opinion is worth a
  moment’s consideration, that Vaccination is a specific against
  Smallpox; of course I mean where the operation is properly
  performed. In fact, it is a point decided in the medical world
  that Vaccination, when properly performed, is a guarantee against
  Smallpox, except in extremely rare cases; and no evidence has
  been produced to justify the idea that it is attended with
  injurious consequences. Statistics show that in proportion
  as Vaccination is extended, the mortality from Smallpox is
  diminished.

And so on; the lesson being recited with all the docility of a good
child. Mr. Henley struck a different note--

  There is considerable dissatisfaction throughout the country
  with the mode in which Vaccination is performed. In my own
  neighbourhood, for example, the poor people complain that all
  sorts of eruptions appear on their children after the Vaccination
  they are compelled to undergo; and though they may be quite
  wrong, you cannot persuade them to the contrary. Then, too, I
  cannot approve of the transfer of Vaccination from the Guardians
  to a Central Medical Board. That change must be removed from the
  bill.

The second reading having passed unopposed on 31st March, and
nothing more being heard of the bill, Mr. T. Duncombe, who knew
the ropes of the parliamentary ship, grew suspicious, and on 7th
July asked Mr. Cowper if he could fix a time when the bill would be
brought on. Suspicion was amply justified by Mr. Cowper’s answer.
He said--

  The bill is not one in which Members take any great interest. It
  is one of that class of bills which are usually taken at a late
  period of the evening; and I hope the Hon. Member will not object
  to its being taken at the same time as other bills of similar
  character.

To which Mr. Duncombe replied--

  If Hon. Members do not care for the bill, they do great
  injustice to the people, because it is a compulsory bill. Two
  hundred petitions have been presented against it, and only one in
  its favour. A more arrant job than this bill I never knew, and I
  hope an opportunity may be given me to oppose it.

Mr. Cowper’s simplicity was apparent in his answer. He said--

  I do not mean that the bill is of no importance, for it is
  intended to check the ravages of a disease which kills thousands
  every year. What I intended was, that the opposition which my
  Hon. Friend offers is not shared by other Members. My Hon. Friend
  says the bill will make Vaccination compulsory; but Vaccination
  is compulsory already. The purpose of the bill is to consolidate
  and improve existing legislation. It would be much fairer if my
  Hon. Friend brought in a bill to repeal compulsion. I will not
  bring in the bill after 12 o’clock at night.

The pledge not to bring on the bill after midnight settled its
fate. Its promoters, aware that its provisions would not hear
discussion, had reckoned on its unopposed passage at an hour when
members were few, weary, and indifferent. Mr. Duncombe’s vigilance
defeated the scheme, which Mr. Cowper incontinently revealed. The
bill was brought into Committee on 10th July, and the order for its
reading discharged amid general satisfaction. Mr. Henley observed--

  I am very glad this bill is withdrawn. The endeavour to make
  Vaccination compulsory has been most mischievous. Vaccination was
  quietly making its way. People were adopting it more and more;
  but from the moment it was made compulsory, they began to think
  every evil which happened to their children afterwards ensued
  from it. I have no objection to refer the question to a Select
  Committee as suggested, but whatever their report, nothing will
  satisfy me that it is advisable to make Vaccination compulsory.

Mr. Duncombe agreed that the course proposed was judicious--

  The question is delicate and difficult, and investigation should
  precede legislation. In 1853, at a later period of the session
  than that at which we have arrived, the Compulsory Vaccination
  Act was smuggled through the House. Fortunately it became
  inoperative through its own defects, which it is now proposed to
  remove, and to make the law more stringent; but while I believe
  that great good has resulted from Vaccination, I do not think we
  should try to encourage it by penal enactment.

Mr. Cowper, in protesting against surrender, observed--

  Some argue as if people should never be forced to do what they
  do not like; but the force of this objection is greatly weakened
  when we recollect that in compelling Vaccination we are not
  obliging parents to do anything disadvantageous to themselves,
  but merely to take precautions against a loathsome and terrible
  disease.

The most intolerable tyrannies vindicate themselves by the
advantages they enforce on their perverse subjects. The claim made
for vaccination, that it protects the vaccinated from smallpox,
deprived the vaccinated of any right to complain of risk of injury
from the unvaccinated. Moreover, that those who were persuaded
that vaccination neither prevented nor mitigated smallpox should
be required to undergo an operation, that was to them a cruel and
dangerous imposture, was surely a wrong of the most excruciating
character. It was well that neither the bill of 1855 or 1856 was
allowed to pass; but if either had passed, it might have brought
the question of compulsion to an earlier issue.


FOOTNOTE:

[285] _Memorial presented to the President of the Board of Health,
by the President and Council of the Epidemiological Society, on
a proper State Provision for the Prevention of Smallpox and the
Extension of Vaccination._ Ordered to be printed by the House of
Commons, 1st March, 1855.




CHAPTER XXXIX.

JOHN GIBBS’S LETTER--1855.


As we have said, there was little living confidence in vaccination.
Jenner’s undertaking, “that the person inoculated with cowpox is
rendered perfectly secure from the infection of smallpox,” had
been everywhere conspicuously belied. But latterly a new faith
had come into existence as to the preventibility of disease and
the possibility of its suppression; and, thus persuaded, the
public were less disposed to be sceptical toward new or revived
prophylactic impostures. Favoured by this disposition of the
public mind, a clique of vaccinators, operating under cover of the
Epidemiological Society, were able to obtain concessions from
Parliament which, prior to the sanitary evangel, were unattainable.
It was only when too audacious, they proposed to set up a
Vaccination Office, endowed from the Exchequer, with inquisitorial
and punitive functions, that they suffered check.

To resist doctrine it is necessary to possess doctrine. People
might distrust or dislike vaccination, but they were at a great
disadvantage against aggressors until prepared to justify their
distrust and dislike in definite and scientific form, setting
evidence against assertion, and veracious against factitious
statistics. Unfortunately the mischief of coercive legislation
was consummated ere opposition was organised. The first to frame
a comprehensive indictment against vaccination was John Gibbs, an
Irish gentleman. It took the form of a letter addressed to Sir
Benjamin Hall, dated from Maze Hill Cottage, St. Leonards-on-Sea,
30th June, 1855. On the motion of Joseph Brotherton, M.P. for
Salford, the letter was ordered to be printed by the House of
Commons, 31st March, 1856.[286]

Mr. Gibbs opened his letter with drawing attention to the fact
that whilst the Compulsory Act of 1853 was the first direct attack
upon personal liberty in medical matters, there was “no subject
upon which so many otherwise well-informed persons betrayed such
ignorance and credulity as upon vaccination.” Indeed, upon nothing
were the legislators who enacted compulsion so frank as in their
confession of ignorance and submission to medical instruction. What
was there to justify legislation on terms thus abject against their
fellow-countrymen?--

  Why is Vaccination held in abhorrence by so many? Have those who
  reject it no weighty reasons to justify their rejection? They do
  not believe that it affords an efficient and assured protection
  against the invasion of Smallpox; they have a natural disgust
  to the transfer of a loathsome virus from a diseased brute,
  through they know not how many unhealthy human mediums, to the
  veins of their children; they have a dread, a conviction, that
  other filthy diseases, tending to embitter and shorten life, are
  frequently transmitted through the vaccine virus; they cannot
  bring themselves to believe that the true way to health can be to
  corrupt the blood and lower the vital energies by the infusion
  of a poison and its consequent train of morbid influences; and
  further, they have a conscientious conviction that voluntarily to
  propagate disease is to set at naught the Divine Providence and
  violate the Divine Will.

  Are such scruples and objections entitled to no respect? Should
  they be permitted to have no force? Are they capable of no
  justification? Should the sole answer to them be a Coercion
  Act? Such is not the best way to disarm hostility, and to
  ensure conviction. Who would put faith in the professions of a
  philanthropist who should threaten the objects of his beneficence
  with fine or imprisonment if they did not accept his proffered
  boon? Or who could receive with cordiality and respect the doctor
  of physic who should thunder at the door, armed with scab and
  lancet, threatening to assault the inmates if they did not accept
  his services? If Vaccination be indeed a blessing which must
  needs be showered upon the land, would it not be more becoming in
  a wise Government and a free people to trust to the dissemination
  of information rather than attempt to make unconverted converts
  by force?

Had smallpox been preventible by vaccination, such contention
would have been useless. The virtue of the rite, manifest in
its efficacy, would have secured its observance. The bitterness
of compulsion lay in the attempt to enforce imposture, and to
suppress the convictions of those whose perceptions were sharper,
and whose loyalty to right was more determined than in the mass of
the nation. Mr. Gibbs had no difficulty in adducing evidence in
proof that vaccination did not prevent smallpox. The reports of the
Registrar-General and the hospitals furnished testimony in such
profusion, that his difficulty lay in the selection of examples
likely to be most convincing. From the _Lancet_, of 21st May, 1853,
he took the following confession--

  In the public mind extensively, and to a more limited extent in
  the medical profession itself, doubts are known to exist as to
  the efficacy and eligibility of Vaccination. The failures of the
  operation have been numerous and discouraging.

Nor did the failure to prevent smallpox exhaust the condemnation
of vaccination. Ineffective, it was far from harmless. Itself a
disease, it was a conductor and excitant of other diseases, and,
inoculated, occasionally bore with it other company. Erysipelas,
as Jenner taught, was the note of successful vaccination; but
erysipelas, not being a limitable affection, was frequently a
mortal one; and deaths from erysipelas as a sequence of vaccination
were of constant occurrence. Then there were skin eruptions,
carbuncular and glandular swellings, tuberculosis, scrofula,
syphilis, etc., either provoked or inseminated with the vaccine
disease. Such results were so distinctly recognised that, in the
_Lancet_, of the 11th November, 1854, it was stated--

  So widely extended is the dread that along with the prophylaxy
  something else may be inoculated, that few medical practitioners
  would care to vaccinate their own children from a source of the
  purity of which they are not well assured.

But the care vaccinators exercised over their own offspring was
impracticable for the multitude. Again, citing the _Lancet_, 23rd
October, 1854, it was said--

  The poor are told that they must carry their children to be
  vaccinated by medical men who may be strangers to them. They
  apprehend--and the apprehension is not altogether unfounded,
  or unshared by the educated classes, that the vaccine matter
  employed may carry with it the seeds of other diseases not less
  loathsome than the one it is intended to prevent.

Useless against smallpox, and injurious in itself, it remained to
test the influence of vaccination on the health of the community--

  What is the per centage of deaths from all epidemics among the
  Vaccinated as compared with the Unvaccinated? What is the per
  centage respectively of cases of disease of the respiratory
  organs, of skin diseases, of scrofula, and of convulsions? What
  is the average duration of life among the Vaccinated and among
  the Unvaccinated? Of a thousand children vaccinated within a
  given time after birth, and of a thousand unvaccinated, the
  whole two thousand being placed as nearly as possible in like
  circumstances, what per centage in each thousand attain the age
  of puberty?

  These are statistics with which the advocates of Vaccination have
  never grappled. Is it not, then, rather premature to decide that
  Vaccination is an unmixed good, a boon which we ought not only
  gratefully to accept, but which we should even combine to force
  upon the acceptance of others?

  If it should appear that before a given age the rate of mortality
  from all causes be the same among a thousand vaccinated and a
  thousand unvaccinated children, of what avail is Vaccination?
  Of what import is it, as a public question, in what shape death
  claims his allotted number of victims, whether by Smallpox,
  Scarlet Fever, or Hooping Cough? If, however, the rate of
  mortality should prove to be greater among the Vaccinated than
  among the Unvaccinated, how shall we avoid the conclusion that
  Vaccination is a curse and not a blessing?

The interdependence of the forms of zymotic disease, so luminously
displayed by Dr. Watt in the statistics of Glasgow, was apparently
a conception in excess of the capacity of the average medical mind.
It was the custom of vaccinators to treat smallpox as a solitary
existence, any diminution of which was ascribed to the observance
of their rite, and any increase to its neglect, although the
observance of the rite was neither less in the waxing, nor more in
the waning of the disease. With many illustrations from medical
literature, Mr. Gibbs enforced the lesson that diseases were
not irregular and detached disasters, but varied manifestations
of a common disorder: that when one form prevailed, other forms
abated or disappeared; that health, and the defect of health, were
referable to habits and conditions of life; and that the consequent
rate of mortality was unaffected whether smallpox happened to be
one of its factors--indeed, in numerous instances, a reduced rate
of mortality signalised the prevalence of smallpox. In short,
to suppose that the creation and culture of an ailment like
vaccination could by any means tend to the invigoration of life was
to reverse the canon--that health always and everywhere was the
best defence of health.

Among the supporters of his thesis, none had greater weight than
Dr. George Gregory. Adducing “the experience which twenty years of
official connection with the Smallpox and Vaccination Hospital had
given him,” he asserted--

  The great principle that there are no diseases strictly isolated
  from others. They are links in a chain--

      “All are but parts of one stupendous whole.”

  They must be viewed in conjunction, if we would hope to form
  just, enlarged, and legitimate views of the character and
  pathological affinities of each.

Long surmised, but never proved, until the statistical inquiries of
recent times showed its correctness, Dr. Gregory continues--

  We may, for want of a better name, call this curious doctrine the
  Law of Vicarious Mortality; by which is understood that whenever
  one epidemic diminishes, another increases, so that the sum total
  of epidemic mortality remains, on an average of years, nearly the
  same.

  EPIDEMIC MORTALITY IN ENGLAND AND WALES DURING 1838, 1839, AND
  1840.

    +------------------------------+----------+----------+----------+
    |                              |Year 1838.|Year 1839.|Year 1840.|
    +------------------------------+----------+----------+----------+
    |Smallpox                      |   16,268 |    9,131 |   10,434 |
    |Measles                       |    6,514 |   10,937 |    9,326 |
    |Scarlet Fever                 |    5,802 |   10,325 |   19,816 |
    |                              +----------+----------+----------|
    |  Total Mortality by the      |   28,584 |   30,393 |   39,576 |
    |      Exanthemata,            |          |          |          |
    |Hooping Cough                 |    9,107 |    8,165 |    6,132 |
    |                              +----------+----------+----------+
    |  Total Epidemic Mortality    |   37,691 |   38,558 |   45,708 |
    |                              +----------+----------+----------+
    |  Total Mortality throughout  |          |          |          |
    |    Englandand Wales          |  342,529 |  338,979 |  359,561 |
    +------------------------------+----------+----------+----------+

  We learn from this table, that every year is distinguished by
  some master epidemic. In 1838, Smallpox was the ruling epidemic
  throughout England. In 1839, Measles and Scarlet Fever struggled
  for the mastery. In 1840, Scarlet Fever was so general and so
  fatal, that the mortality by it exceeded by one-fifth the ravages
  of Smallpox during the epidemic season of 1838, and more than
  doubled the mortality by that disease in 1839....

  Everything teaches us that when one avenue to death is closed
  another opens--

      “Noctes atque dies patet atri janua Ditis.”

  Vaccination, great as its merits are [What are they?--J. G.],
  and no one more fully appreciates them than I do, does not, and
  cannot do, all that its too sanguine admirers promised. The
  blessings of Vaccination are met and balanced by the Law of
  Vicarious Mortality. How and why is this? The explanation is
  easy. The weak plants of a nursery must be weeded out. If weakly
  children do not fall victims to Smallpox, they live to fall into
  the jaws of tyrants scarcely less inexorable. Scarlet Fever and
  Measles are both advancing in respect of mortality; and the
  increase of deaths by Hooping Cough since this century set in
  [that is, since the introduction of Vaccination.--J. G.] is quite
  extraordinary.[287]

The concession of so much was the concession of all. If smallpox
was merely displaced to be replaced, and the tale of death
maintained by cognate diseases, what was there to claim for
vaccination, even if it were allowed to have an influence adverse
to smallpox? Where were the lives saved? and where the glory of the
immortal Jenner?

The advocates of compulsory vaccination were accustomed to cite
countries like Austria, where the practice was enforced, for
English imitation. Let us then compare, said Mr. Gibbs, the
death-rate of the chief centres of English population with the
death-rate of the chief divisions of Austria, and note which had
the advantage in the years 1850-51--

                        Death-rate
                         per 1000.

    England and Wales      22·0
    London                 23·3
    Liverpool              29·0
    Manchester             29·0
    Birmingham             23·3
    Leeds                  24·6
    Dublin                 26·8
    Cork                   23·3
    Lower Austria          35·7
    Upper Austria          27·7
    Styria                 30·3
    Bohemia                38·6
    Moravia                30·9
    Galicia                30·8
    Lombardy               33·9
    Venetia                33·3

These figures required no commentary. If vaccination had stopped
smallpox in Austria, it evidently had not reduced mortality even
to the level of the most insanitary English towns.

Assuming, said Mr. Gibbs, that vaccination is entitled to all the
credit claimed for it, let us endeavour to estimate the gain, if it
should be enforced. The yearly average of deaths from all causes,
in England and Wales, is 370,000, of which about 7,000 are from
smallpox--

  This 7,000, then, is the limit of gain which enforced Vaccination
  could confer; but from the 7,000 should be deducted about
  one-third for deaths from Smallpox among the Vaccinated; and from
  the remainder should be deducted an equivalent for the deaths
  caused immediately and remotely by Vaccination; and another
  equivalent for the deaths resulting from the Law of Vicarious
  Mortality. This done, it would require no little ingenuity to
  discover a balance in favour of Vaccination.

Having thus argued the matter out, was not Mr. Gibbs justified in
asking--

  What would be thought of the tinker who would knock a hole in the
  bottom of his saucepan lest one should be burned there in the
  ordinary way?

  Yet it is just what the vaccinator does; and when he finds--as he
  might have foreseen, had he been governed by common sense--that
  his saucepan does not wear a bit the better, but rather the
  worse, he gravely endeavours to excuse the failure, by asserting
  that unfortunately he made the hole too big, or too little, too
  much on this side, or too much on that, or by offering some other
  equally wise excuse.

Lastly, there were the political and moral considerations involved
in compulsory vaccination--the first attempt in England to confer
on a medical prescription the force of law--

  Surely, a wise Government may perceive that there are greater
  evils than the occasional outbreak of an epidemic. The systematic
  violation of human rights and natural affections, the uprooting
  from the human breast of feelings of self-reliance, a state
  religion in physic, coercion which may well be regarded as odious
  persecution, the belief of the poor that what they hold dearest
  is sacrificed to the selfish prejudices of the rich--any one of
  these is far worse than a pestilence.

  Cannot they who believe in Vaccination protect themselves? Nobody
  seeks to hinder them; nobody presumes to dispute their right to
  adopt any medical practice, however questionable it may be.
  Why cannot they act with like forbearance to others? Surely, if
  freedom be more than a name, it implies the right of the freeman
  to reject not only that which other men may choose to regard as
  evil, but even that which they may combine to urge upon him as
  good....

  How absurd that an attempt should be made to visit with
  punishment the want of belief in a scientific, or rather
  unscientific, dogma! How absurd to pretend to the possession of a
  prophylactic of such unquestionable potency that its acceptance
  requires the threat of force! In their anxiety to coerce others,
  compulsory vaccinators demonstrate their own defect of faith in
  the prescription which they assert affords complete security from
  Smallpox.

As observed, the service of Mr. Gibbs is entitled to special
commemoration, because it was the first attempt to put the
arguments against vaccination into systematic shape. He
demonstrated the quackery of the practice, and the fallacies
wherewith it was defended; and denounced the tyranny of the
legislation that would compel those who recognised the imposture to
submit to it. The service thus rendered by Mr. Gibbs constituted a
ground of vantage for further operations: those who had to contend
against the delusion had their hands strengthened, and their power
of assault magnified, by what he was favoured to accomplish.

       *       *       *       *       *

JOHN GIBBS was born at Enniscorthy, County Wexford, on 25th May,
1811. Owing to the unsettled life of his father as Captain of the
Royal Cork Volunteers, his education was desultory--at various
schools, and under various masters. Sagacious, bright, earnest, and
independent, he early manifested a passion for such things as made
for human welfare, and improvement. Abstinence from alcohol, in
connection with Father Mathew’s mission, had in him an enthusiastic
advocate. A book by Captain Claridge on the water cure excited his
interest, and led to the formation of the Enniscorthy Hydropathic
Society. Anxious to master the mysteries of this new treatment of
disease, he set out for Silesia in 1843, and placed himself under
the instruction of Priessnitz, remaining with him as a chosen
disciple until 1847, when he left with a certificate of competency.

[Illustration: (John Gibbs, with his signature)]

Whilst acquiring his art with Priessnitz, he communicated his
experiences to his Enniscorthy friends, who published them in
the Wexford newspapers, a selection from which was reproduced as
_Letters from Grœfenberg_, in 1847. A passage in one of these
letters, dated 27th November, 1844, indicates the manner in which
his attention was drawn to smallpox--

  Another case of Smallpox has just been treated by Priessnitz. The
  patient is the daughter of a peasant in the neighbourhood, and is
  about twenty years old. She was confined for eight days, and was
  most profusely covered with the eruption. An Italian physician
  said that he never saw the symptoms come out better. She had at
  first the usual treatment--wet sheets, wet rubbings, and tepid
  baths; and, after the eruption appeared, three wet sheets and
  three tepid baths daily. She will not have the slightest mark.
  Under the water cure Smallpox appears to be deprived of half its
  terrors; as far as my observation extends, it neither robs man of
  life, nor women of beauty.

On his return, he assisted Dr. Lovell in opening a hydropathic
establishment at Barking, Essex; and, in 1848, he undertook the
medical superintendence of the Grande Chartreuse in Piedmont.
There he met Miss Anna Skelton, to whom he was married, at Nice,
in 1849. Ultimately he made his home at St. Leonards, Sussex. The
passage of the Compulsory Vaccination Act, in 1853, led him to
publish a pamphlet, _Our Medical Liberties_, 1854, which excited
the attention and won the approval of many thoughtful people. At
the suggestion of Mr. Thomas Baker, he constructed a letter from
the substance of the pamphlet, and addressed it to the President
of the Board of Health, which, as we have seen, was issued as a
parliamentary paper. The more vehement controversy which sprang up
in recent years when the Vaccination Act was tightened, found Mr.
Gibbs in health too feeble for active exertion. After his wife’s
death, he retired to Jersey to be near his sister, Mrs. General
Lane, in whose house he died in the winter of 1875.


FOOTNOTES:

[286] COMPULSORY VACCINATION.--Copy of a Letter, dated 30th
June, 1855, addressed to the President of the Board of Health by
JOHN GIBBS, Esquire, entitled, _Compulsory Vaccination briefly
considered in its Scientific, Religious, and Political Aspects._
Ordered by the House of Commons to be printed, 31st March,
1856.--Folio, pp. 31.

[287] _Eruptive Fevers_, pp. 5-8. London, 1843.




CHAPTER XL.

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.




CHAPTER XLI.

COMPULSION INTENSIFIED--1861 AND 1867.


The Vaccination Act of 1853 imposed a forfeit not exceeding 20s. on
any parent or guardian who failed to have a child vaccinated within
three months of birth; but experience revealed a grave defect in
the law. There was no provision for the prosecution of defaulters;
and those who had no faith in vaccination, or accounted it a
nuisance, enjoyed immunity without serious annoyance. To meet this
defect a bill was introduced to Parliament in 1861, providing that
“the guardians or overseers of any parish may appoint some person
to institute and conduct proceedings for enforcing obedience.” The
bill was passed through the House of Commons under the care of
Mr. Robert Lowe, meeting with little resistance, and with less in
the Lords. In vindicating the measure, 10th July, 1861, Mr. Lowe
observed--

  Parliament in 1853 passed an Act for Compulsory Vaccination, but
  owing to a defect in the provision of expenses for prosecution,
  it has fallen into desuetude. When the present Government was
  formed in 1859, a clause was introduced to the Public Health
  Act correcting the defect; but under pressure of the Member for
  Finsbury [Mr. Thomas Duncombe] I surrendered it. It has been to
  me a bitter reflection that I did so; for I am convinced that the
  sacrifice of that clause has occasioned the loss of thousands of
  lives in this country.

The question is sometimes asked, Why is it that association with
horses is so prejudicial to morality? This interrogation might be
accompanied with another, namely, Why is it that the advocacy of
vaccination is so frequently associated with romance and rant? That
public vaccination had fallen into desuetude was untrue. There
were fluctuations from year to year, but the rate was maintained
without practical abatement. That in 1861 it could be said that
thousands of lives had been lost because prosecuting officers were
not provided in 1859, was romance and rant without mitigation. In
England and Wales there died of smallpox--

    In 1858     6460
       1859     3848
       1860     2749
       1861     1320
       1862     1628
       1863     5964
       1864     7684
       1865     6411

Where then were the thousands of lives lost from the formation of
the Government in 1859 to 1861? and where were the lives saved
after the enactment of the vital clause? But who that knew Mr.
Robert Lowe could believe that he was convinced that the surrender
of the clause occasioned the loss of thousands of lives, and that
the loss was to him a bitter reflection? Would not the vulgar
version of the invocation, _O mihi beate Martine!_ have been
appropriate to the situation?

Further, continued Mr. Lowe--

  From 1837 to 1840 the deaths from Smallpox amounted to 12,000
  a-year. From 1840 to 1863, during which period Vaccination was
  provided by the Poor Law Boards, the annual average of deaths was
  only 5,200. Thus by the diffusion of Vaccination, the mortality
  of Smallpox was reduced by more than one-half. Then in 1853 the
  Compulsory Law came into operation, and its first effect was
  remarkable. The number of vaccinations enormously increased and
  the deaths diminished. In 1854 they sank to 2,808, and in 1855
  to 2,525. Afterwards they gradually increased up to the present
  time [When in fact they never were lower!], the Act having, as I
  already explained, fallen into desuetude. Thus is the efficiency
  of Vaccination established!

Into such stuff may a clever man descend! The statement was rotten
with untruth. It was gross misrepresentation to set forth the
average mortality of 12,000 for the years 1837-40 as permanent
mortality which the Act of 1840 reduced to 5,200. The years
1837-40 embraced a severe epidemic, following years of quiescence
during which vaccinators had been singing pæans over their
imaginary victory. Holding as we do that smallpox comes and goes
with indifference to vaccination (unless in so far as it keeps
the disease alive) the figures cited by Mr. Lowe as completely
illustrate our contention as they nullified his. By no contrivance
can the fluctuations of smallpox be associated with more or less
vaccination.

Probably Mr. Lowe was inspired by his medical staff, but, if so, he
made the inspiration his own, evolving as from personal certainty,
such fancy-work as this--

  Out of 1000 who take Smallpox without being vaccinated 350 die;
  while out of 1000 badly vaccinated only 150 die; but out of 1000
  well vaccinated only 5 die.

To which the conclusive answer would have been, that a mortality
of 7 in 20 of the unvaccinated was about double that of smallpox
in the time when all were unvaccinated; and that disregarding the
factitious classification, the mortality over all cases continued
as it was in the pre-vaccination era. What smallpox was, smallpox
has remained--discrete, confluent, malignant; each type being
qualified as slight, dangerous, and deadly; the relation of
vaccination to the type being wholly irrelevant.

Further, he proclaimed without reserve, that smallpox was
transmuted to cowpox in the cow--

  There was a theory started that the efficacy of Vaccination was
  wearing out; but the valuable discovery of Mr. Ceely has set any
  apprehension on that score at rest for ever. Mr. Ceely has proved
  that Smallpox, when taken from the human body and introduced to
  that of the cow, produces Cowpox. It is thus evident that we
  have the means of obtaining Cowpox of the requisite strength to
  any extent. The beautiful discovery has also been made that the
  security of Vaccination may be almost indefinitely increased by
  multiplying the number of punctures.

Thus was mystery dispelled! Cowpox was smallpox diversified in
the cow, and the lost security of Jenner’s single puncture was
recovered in tattoo!

Appealing to the sentiment of medical men in favour of vaccination
as exhibited in the replies to Simon’s queries in 1857--a fallacy
for conviction which Mr. Lowe would have been quick to detect if
advanced for any clerical, scholastic, or other trading interest,
he observed--

  The terrible malady falls heavily upon young children: in
  Vaccination is their defence. Consider, then, what a painful
  responsibility will rest upon us, if, in the face of almost
  unanimous medical testimony, we leave them to perish, and
  communicate a dreadful contagion throughout the country. These
  children have no discretion of their own; and it is a profanation
  of liberty and self-government to say that any man has a right to
  set up his own sordid and brutal prejudices against such medical
  opinion, and expose his child to disease and death.

Words, ferocious words; but how do they bear examination? Why
should disbelief in vaccination be stigmatised as sordid and brutal
prejudice? Why should parliamentary affection for children surpass
parental affection? The argument, if valid, would equally apply to
any matter in which the conviction of a minority was at variance
with that of a majority; and if in such circumstances the minority
is bound to submission, where is the substance answering to civil
and religious liberty? If the clear scientific persuasion of the
smallest minority concerning such a matter as vaccination is to be
subjected to vulgar medical dictation by the brute force of the
majority, what form of tyranny may not be justified?

  The Bill [continued Mr. Lowe] which I wish to pass into law is
  very simple. All that it enacts is that Poor Law Boards may
  appoint persons to prosecute those whom the medical officers
  report ought to be prosecuted.

And the bill was passed without division. Mr. Duncombe and Mr.
Coningham protested, but neither had mastered the question so as
to offer effective opposition. Mr. Coningham observed that figures
might be made to prove anything; and as concerned the unanimous
opinion of medical men, they had to bear in mind the saying, “There
is nothing like leather.” If smallpox had fallen off, there were
extensive sanitary improvements to account for the fall; and, for
his part, he placed his trust much more in better conditions of
life for the people than in a prescription like vaccination.

The Act obtained did not fulfil the expectations of its promoters.
Mr. Lowe’s bitter regret for thousands of lives lost in consequence
of his concession to Mr. Duncombe proved to be wasted emotion.
Guardians did not exercise their powers as inquisitors and
persecutors with adequate energy. Sir Morton Peto, in the House of
Commons, on 14th March, 1864, asked--

  Whether the registration of Vaccination is not a total failure,
  alike for statistical purposes and for the prosecution of
  offenders under the Compulsory Act; and whether it is the
  intention of the Government to amend the law this session.

To which Mr. Lowe made answer--

  It is quite true that the system of registration under the Act
  is very bad, but it would cost a great deal of money to improve
  it. Moreover, even when improved, it would not make the measures
  for compulsion effectual to any extent. The great difficulty of
  working compulsion is not so much due to defective legislation
  as to the reluctance to prosecute poor people for disobedience
  to the law, the neglect of which is countenanced by too many who
  ought to know better. I am sorry, therefore, I cannot hold out
  any hope of improving the system.

The medical officers of the Poor Law Board were, however, intent
upon coercive legislation; and Mr. H. A. Bruce, more pliant than
Mr. Lowe, introduced a bill of their contriving in 1866, which he
assured the House of Commons “involved no new principle, and merely
consolidated provisions dispersed over six Acts of Parliament,
_with a few amendments_.” On going into committee on the bill, 11th
April, 1866, he delivered an elaborate defence of vaccination,
prepared for him by the astute promoters of the measure, starting
in this fashion--

  At the close of last century Dr. Jenner achieved his immortal
  discovery by which, perhaps, more misery has been prevented
  through the alleviation of pain and the preservation of life than
  by any other discovery that has ever been made.

Spoken from whatever elevation, nothing divides talk like this from
that of a quack at a country fair. Having struck the note, Mr.
Bruce ran through the familiar gamut of assertion wherewith the
rite of vaccination is supposed to be justified. The following is
a sample of the advocacy imposed upon him--

  A statement has been widely circulated that Syphilis has been
  communicated by Vaccination. Millions of children have been
  vaccinated in the last sixty years, but not a single case has
  occurred in which it has been proved that Syphilis has been
  communicated. A case is alleged to have occurred in France in
  which a child had been vaccinated from another which inherited
  Syphilis, but the surgeon in that case, in taking lymph from
  a child covered with syphilitic blotches, acted in monstrous
  disregard of common prudence and medical knowledge. No such
  case, so far as the most careful medical research can discover,
  has happened in this country.

Whilst this statement would now incur general discredit, yet even
in 1866 the official prompters of Mr. Bruce presumed over much
on public credulity. It was not probable that what vaccinators
did not wish they would discover; or, if discovered, proclaim.
Nevertheless, the denunciation of the “alleged” French instance
was entirely inconsistent with the contention that syphilis could
not be communicated from a syphilitic vaccinifer, blotched or
unblotched. So much it was imperative to maintain, for it was
obvious that the complete vaccination of any population must
involve infants with latent syphilis whose virus might transfer the
disease to the untainted. This peril, opponents of vaccination,
from Cobbett onwards, had recognised; and as its recognition was
prejudicial to vaccination, its possibility was stoutly outsworn
until manifold and indisputable evidence compelled its admission,
and shifted the question to the extent of its frequency.

Mr. Henley, following Mr. Bruce, spoke some homely sense--

  We all know that when we want anything of the kind done, the
  medical man entertains us with a fine cock-and-bull story about
  waiting until he can get lymph from a healthy child. This caution
  implies risk; and though it is said that not a single case of
  injury has occurred in sixty years, yet nobody will persuade me
  that medical men take all these pains (where they are well paid
  and watched) if there are not grounds for the exercise of care.
  Undoubtedly it was an abomination to take vaccine from a diseased
  child, but how is a public vaccinator to know that any child is
  diseased? If he inquires too particularly, he will run the risk
  of a slapped face from the mother for his trouble.

Mr. Henley also drew attention to the claims made for vaccination,
coupled with the admission that the greater part of it was good for
little--

  One remarkable statement has been made--that there has been an
  examination of 500,000 children belonging to the humbler classes
  chiefly affected by Compulsory Vaccination. Of the number so
  examined only one in eight was found to have been perfectly
  vaccinated, which fact involves the further fact that seven out
  of the eight were imperfectly vaccinated, or not vaccinated at
  all. If only one in eight has been perfectly vaccinated, great
  doubt will come upon many people’s minds as to the matter with
  which the others have been inoculated.

Much in the bill was crude and impracticable, and Mr. Ayrton
expressed the sense of many in the House when he observed--

  The bill before us is badly drawn, and bears too much the
  marks of its official origin. Great powers have been taken for
  the vaccinating department, but nothing is provided for the
  protection of the public. It seems to me that if Vaccination is
  to be enforced by penalties, public vaccinators should be subject
  to penalties for inefficient and injudicious work. I have been
  entrusted with a great many petitions against the bill, and I
  have been much impressed with the admission that the existing
  system of Vaccination has entirely failed in effecting its
  object. The bill will have to be referred to a Committee, and as
  many believe that Vaccination does as much harm as good, I trust
  the members will not be fettered in their inquiries.

It is needless to say the asserted failure of vaccination was
an artifice to induce Parliament to pass the bill. The public
vaccinations for 1863, 1864, and 1865, were as numerous as ever,
and accompanied with a marked increase of smallpox. No doubt
vaccination was a failure, but in a different sense from that in
which the word was used to acquire increase of power and pay for
the application of the rite. The bill was referred to a select
committee, who reported; but the Conservatives having displaced the
Liberals, it was withdrawn. Mr. Corry, in announcing the fact to
the House of Commons, 23rd July, 1866, said--

  I have ascertained that the measure is likely to meet with great
  opposition on both sides of the House; and it is, therefore, very
  doubtful whether it could be carried at this late period of the
  session. Moreover, some of its provisions require further and
  careful consideration.

The bill was framed and promoted by the Poor Law Board,
independently of Liberals and Conservatives, the problem of the
medical officials being, “How far is it possible to obtain the
assent of Parliament to what we consider desirable.” There were
limits to parliamentary complaisance, however wide, and, informed
by the experience of 1866, a revised bill was introduced to the
House of Commons by Lord Robert Montagu in 1867, who, like his
predecessors, reproduced the instructions of his advisers with
sufficient flavour to pass them off as his own. A portion of his
business was to obtain recognition for the payment of extra fees
for successful vaccination--

  When an Inspector reports that certain Vaccinations are of the
  1st class, the Public Vaccinator will receive 1s. over and
  above the sum paid by the Guardians for each Vaccination he has
  performed. If the Vaccinations are reported of the 2nd class, he
  will receive 8d. For 3rd class Vaccinations nothing in excess of
  the Guardians’ contract fee will be paid.

This graduation of vaccination excited no comment though why aught
save first-class should have been accounted tolerable, or paid for,
was far from obvious. The possible amount chargeable for these
awards was thus estimated--

  The ratio of children born to the population is about 3½ per
  cent., which gives 700,000 a year for the population of 20
  millions. Reckoning that four-fifths of these children, or
  560,000, are vaccinated gratuitously during the year, the
  expenditure will be £28,000 if all the Vaccinations are 1st
  class, and £18,500 if 2nd class. Shall we, then, think it too
  much if, for a sum between £18,500 and £28,000 we ensure that
  there shall never occur a case of smallpox, and that we save
  7,000 lives a year?

Such was the argument put into the mouth of Lord Robert Montagu for
the persuasion of Parliament! Only pay an extra price for first and
second class vaccination, and not a case of smallpox shall occur
in England, and 7,000 lives a year shall be saved! When we inquire
where the 7,000 lives a year were lost, we discover how boldly the
credulity of Parliament was imposed upon. There died of smallpox in
England and Wales--

    In 1861    1,320
       1862    1,628
       1863    5,964
       1864    7,684
       1865    6,411
       1866    2,977

Where, then, were the 7,000 lives to save? In 1864 the mortality
exceeded 7,000; but to select an extreme year and represent it
as ordinary would have incurred a sharp epithet if practised in
finance instead of smallpox.

A similar fable of salvation from smallpox was related by Lord
Robert Montagu concerning Scotland. He said--

  It is wiser to save people’s lives than to consult their
  prejudices. The example of Scotland shows the value of a
  thorough-going Vaccination Act. The measure for that country has
  reduced the smallpox death-rate from 2,000 to 120 per annum.

The Act to extend and make Vaccination compulsory in Scotland was
passed in 1863--an Act little else than superfluous, for the people
were vaccinated without it. There died of smallpox in Scotland--

    In 1859     682
       1860   1,495
       1861     766
       1862     426
              -----
              3,369

    In 1863   1,648
       1864   1,741
       1865     383
       1866     200
              -----
              3,972

The average of these eight years was 907 deaths annually; and one
inquires with some amaze, Where were the 2,000 which compulsory
vaccination reduced to 120? It is difficult to repress some
indignation over such measureless misrepresentation; nor to point
out that we are not dealing with theologians, who are often assumed
to hold a license for prevarication, but with medical officials
with M.P.’s for spokesmen. The following years, of which Lord
Robert Montagu, speaking in 1867, was necessarily ignorant, gave
these deaths from smallpox in Scotland--

    In 1867     100
       1868      15
       1869      64
       1870     114
       1871   1,442
       1872   2,488

Smallpox was proclaimed “stamped-out” of Scotland in 1870, but the
epidemic of 1871-72 proved how vain was the boast. Smallpox, in
common with typhus, may be exterminated, but by no such irrelevance
as vaccination.

One object of the bill was the reconstruction of vaccination
districts, so as to secure sufficient numbers for arm-to-arm
practice.

  It is necessary [said Lord R. Montagu] to successful Vaccination
  that the two classes of patients, those who have been vaccinated
  eight days before should meet those who are to be vaccinated, so
  that the doctor may take vaccine from the arms of one set and
  transfer it to those of the other.

Mr. Henley, in opposition, maintained that careful vaccination on
such terms was impracticable, saying--

  It seems a large proportion of the Vaccination provided by the
  public is imperfect; but the bill before us is wholly inadequate
  to secure Vaccination that is trustworthy. If a vaccinator never
  sees a child until it is brought to him, and knows nothing of its
  parentage, how can he judge whether it is fit to be vaccinated,
  or fit to serve for the vaccination of others? No torture will
  induce a mother to confess before company that anything ails her
  baby. Every one who knows anything of women is aware that they
  will conceal in public what they may reveal in the privacy of
  home. The shame of making known her own infirmities, or those of
  her family, will keep a woman silent in a crowd, and if she does
  reply to awkward questions, it will be to mislead. Medical men
  will consequently be perplexed and outwitted; and, therefore, on
  the terms prescribed a safe and efficient system of Vaccination
  cannot be secured.

Further, said Mr. Henley, the bill was defective because no attempt
was made to conciliate the prejudices or consult the convenience of
the people who were compelled to have their children vaccinated.

  The bill is one of pure coercion, making no allowance for those
  who are brought under its scope. It must not be forgotten that
  the poor mother is not able to do much within the month after
  her confinement. The period of three months specified within
  which Vaccination must be effected will press very severely upon
  the lower orders. We are told that no district of less than
  5,000 inhabitants will work successfully, and that 10,000 is a
  better number. If country districts are to comprise 5,000, how
  many miles will poor folk have to travel to reach a vaccination
  station? Consider the inconvenience it will be to a woman to drag
  her child two or three miles for vaccination, and be obliged to
  go a second time for inspection! The medical authorities insist
  that four punctures at least ought to be made on the unfortunate
  children. Not only are those four wounds to be inflicted, but the
  children are to be brought in all weathers to have their wounds
  opened and matter extracted for the benefit of others, thus
  prolonging their sufferings and the cares of their mothers. If
  we are to act upon the principle of doing as we should be done
  by, I would ask how you would like to be compelled to carry your
  children to a vaccination station and have them mixed up with all
  and sundry, and inoculated at a hazard with you know not what?
  For myself I see no difficulty in having the children of the poor
  vaccinated at their own homes. It would be far better to pay more
  and work discriminately than let the people think there is one
  law for the rich and another for the poor. If you simply try to
  drive you will find the people apt to kick, and still more ready
  to evade the restrictions you put upon them.

Mr. Kendall confirmed Mr. Henley, saying--

  As Chairman of a large Union, I have seen great inconvenience
  from the crowding of children at vaccination stations. They
  are taken to those stations whether wet or dry, and cold and
  shivering are kept huddled together in a manner most likely to
  breed illness and diffuse infection.

Mr. Lowe sneered at Mr. Henley’s concern for the poor, reminding
him that the wounds he deplored would save them from a loathsome
disease. Mr. Henley did not dispute the salvation, as he might have
done, but pleaded for its more considerate performance. Spite, too,
of his assumption, there _is_ one law for the rich and another
for the poor. Compulsory vaccination as applied to the majority
would never be tolerated by the upper and middle class minority;
nor would a plutocratic Parliament have entertained so profane a
project. Nor (it must be said) would working men show themselves
much more enduring in their own persons. The victims of the law are
their wives and children; and it is surprising how much indignity
and cruelty they will endure in these helpless dependents. Mr.
Henley was more chivalrous for them than they are for themselves.

An argument for fresh legislation was the failure of the Act of
1853. Mr. Brady said--

  As a medical man I can testify that medical men are almost
  unanimous in favour of Compulsory Vaccination; but in order
  to give the public the full benefit of the system it must be
  fairly paid for. We shall be penny wise and pound foolish unless
  the persons employed to carry out this measure are liberally
  remunerated. When the bill of 1853 was before the House, I said
  the remuneration was inadequate, and that the Act would be a
  failure, and that prediction has proved true.

That the Act of 1853 was a failure, in the sense of not securing
the vaccination of the people, was untrue--though necessarily true
as concerned the prevention of smallpox. The assertion of failure
in 1867 was an artifice to overcome the apathy of Parliament. It
was assumed that there was a population to be vaccinated, and
vaccinated in a new and superior fashion, if only better pay were
provided. More money was wanted to work the Vaccination Mill. In
the words of Lord Robert Montagu--

  On the birth of a child being registered, the Registrar is
  bound to give notice to the parent, and to supply him with
  proper forms, whether for public or private Vaccination. He
  will enter in a book the name of the child, with the means of
  identification. After Vaccination, the Public Vaccinator will
  send the certificate of successful Vaccination to the Registrar,
  who will enter it in his book. Thus the Registrar will know which
  children have been registered in his district and which have not;
  which children are liable to Smallpox and which are not liable.
  [_O Credulitas!_] Then it is made the interest of all concerned
  to work the system and enforce its checks. It is the interest of
  every Local Registrar to hunt up every birth, because for every
  entry he has 1s. It is his interest to obtain the certificate of
  successful Vaccination, for entering which he has 3d. It is the
  interest of the Public Vaccinator to operate on as many children
  as possible, because for each successful operation he has at
  least 1s. 6d., and for first class work an extra 1s. It is the
  interest of the parent to have his child vaccinated, for he is
  otherwise subject to legal proceedings and a penalty of 20s.

Colonel Barttelot objected, saying--

  There are about 750,000 births annually in this country, and
  the parents of the majority surely deserve some consideration.
  250,000 of them can neither read or write, yet they are liable to
  a fine of 20s. if they do not comply with the printed forms of
  this Act. It would be much better to send doctors to the homes
  of the children than collect mothers and infants in crowds at
  vaccination stations.

Mr. Bruce replied that it was proposed to do nothing new--

  Compulsory Vaccination on the same terms has been the law of the
  land since 1853. The present bill lays down no new principle. It
  merely collects the scattered provisions of the law, and supplies
  machinery found necessary after much experience.

The observation was, no doubt, ingenuous on the part of the
speaker; but, misled himself, he assisted to mislead the House. The
bill, Section 31, ran as follows--

  _If any Registrar, or any Officer appointed by the Guardians to
  enforce the provisions of this Act, shall give information in
  writing to a Justice of the Peace, that he has reason to believe
  that any child under the age of 14 years, being within the Union
  or Parish for which the informant acts, has not been successfully
  vaccinated, and that he has given notice to the parent or person
  having the custody of such child to procure its being vaccinated,
  and that this notice has been disregarded, the Justice may summon
  such parent or person to appear with the child before him at a
  certain time and place, and upon the appearance, if the Justice
  shall find, after such examination as he shall deem necessary,
  that the child has not been vaccinated, nor has already had the
  Smallpox, he may, if he see fit, make an order under his hand and
  seal directing such child to be vaccinated within a certain time;
  and if, at the expiration of such time, the child shall not have
  been so vaccinated, or shall not be shown to be then unfit to be
  vaccinated, or to be insusceptible of Vaccination, the person
  upon whom such an order shall have been made shall be proceeded
  against summarily, and, unless he can show some reasonable ground
  for his omission to carry the order into effect, shall be liable
  to a penalty not exceeding 20s._

Yet, said Mr. Bruce, it was proposed to do nothing new! Here was a
development of compulsion subjecting a parent to prosecution during
fourteen years of the life of his child, and it was nothing new!
What resulted from this aggravation of the law, devised with craft
and enacted with indifference, remains to be seen.

The bill was opposed by Sir J. Clarke Jervoise, Mr. Thomas
Chambers, and Mr. Barrow. Mr. Chambers prophesied--

  I am persuaded that when the bill is passed an agitation will
  commence which will never cease until the Act is repealed.

The carelessness and indifference of the House were, however,
insuperable. It was legislation for “the lower orders,” and
concerned “respectable folk” not at all. The bill was read a third
time without opposition, slipped through the Lords unopposed,
and received the Royal assent, 12th August, 1867, as 30 and 31
VICTORIÆ, Cap. 84--_An Act to consolidate and amend the Laws
relating to Vaccination_.

As another example of the advocacy with which this bill was
commended to the House of Commons, I take the following from the
close of the speech of Lord Robert Montagu, when introducing it to
committee, 14th June, 1867. He said--

  Smallpox differs from other epidemics in this, that it is one
  of the worst, but is absolutely preventible. In other diseases
  all that can be done by the removal of predisposing conditions
  is to mitigate their virulence; but Smallpox may be altogether
  prevented. If, then, one who raises his hand against another and
  kills him is guilty of murder, of what shall he be guilty who, by
  voice or vote in this House, endeavours to prevent the passing
  of a measure which will make it absolutely certain that Smallpox
  shall no longer kill 7,000 a-year in this country!

This absurd adjuration was too much for Mr. Henley, who observed--

  The somewhat formidable close of the noble Lord’s speech made it
  difficult to know whether I ought not to walk out of the House
  and leave the responsibility of the measure to others. He said
  those who objected to the bill would be guilty of the deaths of
  those who died of Smallpox.

  Lord ROBERT MONTAGU--I said that Smallpox was so far preventible
  that those who stopped the adoption of Vaccination would be
  guilty of the deaths of 7,000 children a-year.

  Mr. HENLEY--I understood the noble Lord to say that they would
  incur that guilt if they objected to the machinery of the bill.

  Lord ROBERT MONTAGU--No; not to its machinery.

  Mr. HENLEY--Then I do not know precisely what the noble Lord does
  mean.

In short, the bill was neither honestly advocated or seriously
considered. On the one hand, members of Parliament were prejudiced,
ignorant and credulous, and careless as to legislation that did not
affect their families or those of their influential constituents.
On the other hand there was a knot of medical officials eager
for power and the aggrandisement of their profession, who did
not disdain to practise upon the prejudice, the ignorance, and
the credulity of Parliament. The result was an insufferable
outrage upon the rights of every nonconformist--an outrage which,
if perpetrated on the theological instead of the scientific
conscience, would have roused Englishmen to fever heat.




CHAPTER XLII.

THE GATHERING MOVEMENT--1867-70.


Section 31 of the Act of 1867 implied the doom of Vaccination.
It was bad enough to fine a parent for refusing to vaccinate his
child; it was, however, a circumscribed annoyance; but to make of
refusal a continuous offence until a child attained the age of
fourteen was to set up a cause of quarrel that had to be fought
out. Slavery in the United States is abolished, but slavery might
have endured to this day had the Southerners been more forbearing;
but, in the arrogance of their power, they imposed on the Union the
Fugitive Slave Law, compelling the people of the North to surrender
runaway negroes. This triumph of the slaveholders determined the
fate of slavery. In like manner the arrogance of the vaccinators
overcame their prudence. Resolved to subdue resistance to their
rite, they drove resistance to extremity, and set up an irreducible
insurrection. As a medical prescription accepted at discretion,
vaccination might have survived unquestioned and paid for; but its
transition into an aggressive statute removed it from the safe
realm of professional mystery into the jurisdiction of common
sense, common observation, and every man’s business.

Sec. 31, Act ’67, was quickly turned to account by the medical
officials who had devised and imposed it upon the indifference of
Parliament. They had, of course, to operate through local poor-law
authorities--a painful necessity; but guardians were occasionally
as fanatical as themselves, and exasperated, too, that their petty
authority should be set at naught, and especially by parents
in humble life. Consequently, here and there over the country
continued prosecutions for refusing to vaccinate were initiated,
stirring up strife, begetting sympathy with the prosecuted, and
gradually converting vaccination into a living political question.
Whatever may be thought of Sec. 31, Act ’67, all will allow that
it drew a line and established irritation and conflict. Opposition
to vaccination had hitherto to contend with nothing so deadly
as apathy, but from that drawback it was now delivered. On the
other hand, in many parishes, Sec. 31, Act ’67 was allowed to
make no difference. Those who disliked vaccination were warned,
or prosecuted once, and then let alone; but this leniency served
to accentuate the severity practised elsewhere, and to render the
law still more odious by reason of the flagrant inequality of its
administration.

The scientific opposition to vaccination, initiated by Mr. John
Gibbs in 1855, had for some years few accessions, and it required
faith in truth in full measure to persist in its advocacy. The
Jennerian tradition was so rooted in the public mind that to
question it savoured of paradox or profanity. There were occasional
manifestations of scepticism when smallpox attacked the vaccinated,
but doubt was crushed down as impious and dangerous to established
confidence. Mr. Herbert Spencer, for example, in _Social Statics,_
published in 1851, observed--

  The measures enjoined by the Vaccination Act of 1840 were to have
  exterminated Smallpox; yet the reports of the Registrar-General
  show that deaths from Smallpox have been increasing.

To such matter-of-fact criticism, any answer must have taken
form in the style of the bewildered divine, who exclaimed, “Dear
brethren, what theology can we enjoy if such objections be
entertained!”

Dr. Charles T. Pearce was one of the first to unite with Mr.
Gibbs in his labours. As editor of a medical journal, he happened
to receive an article from Mr. Gibbs which set him thinking,
and as the result of his inquiries, he came out an enthusiastic
anti-vaccinator. He made the question of vaccination completely
his own, and lectured on the subject throughout the country, eager
and ready for combat. In Northampton, in 1860, he held his first
public debate, and under his influence the town became a centre
of resistance to the compulsory law, so that Mr. Charles Gilpin,
M.P. for the borough, addressing his constituents in 1870, thus
expressed himself--

  I have always thought that when we try to enforce one of the
  ever-changing opinions of medical men, we touch upon the
  liberty of the subject and the rights of human nature. I find
  that a number of parents are fined because they are convinced
  that Vaccination is useless and injurious. I ask, What is the
  character of those parents? Are they idle? Are they dissolute?
  Are they drunken? Are they careless of the welfare of their
  children? The answer is emphatically, No! They are thoughtful,
  they are industrious, they are sober. They are men who look into
  the reasons of things, and who decline to be driven into any
  course of conduct which they do not rationally approve. When
  I was in business in the City of London I had my goods seized
  almost every year for Church rates. I objected to the law,
  and with a free heart and a firm voice, I said I will endure
  the penalty. I would not obey a law which I knew to be wrong.
  Therefore it is that I sympathise with those who are persuaded
  that Vaccination is wrong; and for their encouragement and
  consolation let me say, that as compulsory Church rates were
  abolished because of the stedfast testimony borne against them
  by Nonconformists, so will compulsion as applied to Vaccination,
  if resistance is consistently and seriously maintained. As the
  Society of Friends has demonstrated, no law can survive under the
  persistent protest of conscience.

Tenacity was the distinction of Dr. Pearce. Undismayed by whatever
odds, he maintained his position with deliberation and patience,
and by neither historical, statistical, or physiological data was
it possible to circumvent him. When he entered into the controversy
in 1856, fool and fanatic was the summary designation of whoever
ventured to dispute the salvation wrought by vaccination; but,
living until 1883, he witnessed such epithets received with
amusement as denoting the ill-humour and impotence of those who
employed them.

An energetic advocate of the good cause appeared in Dr. W. J.
Collins, who, after twenty years of service in London as public
vaccinator, felt compelled to renounce the practice as useless and
injurious. He stated his conviction frankly and forcibly before
the St. Pancras Sanitary Committee in 1863,[290] and in an essay,
vigorous with mother-wit, published in 1867,[291] he communicated
much useful and unpleasant information to the credulous and
deceived public. To contend with a judgment thus instructed and
qualified was useless; and those who were affected by the exposure
took care to avoid it. Nor considering the danger to the craft from
discussion, was the policy injudicious. Truth has many adversaries,
but none so hard to overcome as the non-resistant silence of
timorous self-interest.

A leader and organiser of the opposition was wanted, and he
appeared in Richard Butler Gibbs, cousin of John Gibbs, who, as we
have seen, framed the first systematic indictment of vaccination in
1855. Mr. Gibbs, of Irish parentage, was born in London in 1822,
and in the course of a commercial career became agent at Pease’s
West Collieries for Joseph Pease of Darlington, the first Quaker
M.P. It was in 1863, when a member of the Bishop Auckland board of
guardians, that he first moved publicly against vaccination, and
then less against the practice itself than against its prescription
by the authority at that time vested in the Privy Council. He
cautioned his colleagues that they were likely to become (as they
since have) the tools of a central medical clique. Subsequently
finding himself comparatively free from business, he devoted
himself to the cause with which his name has been identified.
Gathering together the scattered elements of resistance, he formed
in 1866 the Anti-Compulsory Vaccination League, and travelled over
the country, lecturing and holding public meetings. The enactment
of repeated penalties for non-vaccination, strenuously resisted
by Mr. Gibbs, established “a raw,” and conferred on the League a
grievance and purpose everywhere recognised as indisputable by
the people. Sec. 31, Act ’67 was in a popular sense the making of
the agitation against vaccination; and it has been maintained (in
a sense fortunately) until even the withdrawal of the aggravation
cannot save vaccination itself from ultimate rejection. What at the
moment we like least, often in the end serves us best.

Mr. Henry Pitman of Manchester entered actively into the movement.
He had observed the ill effects of vaccination upon one of his own
children, and in connection with Mr. R. B. Gibbs organised public
meetings in Manchester and other places. In 1869 he tried how far
a penny journal would succeed, and started _The Anti-Vaccinator_
which ran for eighteen weeks. As editor of _The Co-operator_, which
he conducted for ten years, he gave prominence to vaccination news,
and in 1870 adjoined _Anti-Vaccinator_ to the title, which was
continued until _The Co-operative News_ was established in 1871,
when he maintained the publication as _The Anti-Vaccinator_ until
the close of the year. In 1876 Mr. Pitman bore testimony to his
convictions by going to the Knutsford House of Correction rather
than pay the fine and costs imposed upon him for refusing to have
his daughter, Violet, vaccinated, and in _Prison Thoughts_ conveyed
to others the lesson of his experience. Mr. Pitman has been
remarkably successful in impressing public men with his opinions.
Courteous and persistent, he has won consideration where rougher
speech might not have prevailed.

Professor F. W. Newman was led to a knowledge of the dangers of
vaccination by Mr. Henry Pitman; and those who have been observant
of his career in later years know with what courage and consistency
he has asserted his convictions. Having asked the Professor how he
became concerned in the opposition to vaccination, he favoured me
thus--

“The outline of my mental history in this direction is as follows.
Circumstances had led me to respect Mr. Henry Pitman as a competent
and truthful witness of fact. On a certain occasion he spoke
publicly on the miserable state to which he had seen a poor lad,
Ira Connell of Southport, reduced by vaccination. Ira’s parents,
and his brothers and sisters, were all hale: his mother attested
that previous to vaccination so was Ira. But _after_ vaccination,
Ira had never recovered its dreadful effects, three of his four
limbs being crippled.

“Some years later, I myself saw Ira Connell at Southport. I think
his age was then 25, but am not sure. He had only one leg sound,
and hardly one arm. I will not undertake to describe his state
exactly, but it was _very pitiable_. I am happy to add that in nine
or ten years more he has gradually recovered, so as at least not to
be visibly crippled.

“Previously I had _refused to read_ anti-vaccination tracts,
_having too much already to read_. I had never _known_ or _heard_
in my own circles of mischief from vaccination, and when some
German ladies spoke of its ‘_horrors_’ I thought them absurd and
fanatical; but now that Henry Pitman publicly attested _a fact_,
this woke me up to the duty of further inquiry.

“I at once remembered that in my early youth or boyhood I had
been staggered by reading in a medical journal that experience
made it impossible to sustain Jenner’s doctrine that vaccination
was a certain preventive of smallpox; but the writer nevertheless
urged that it was valuable for making smallpox _milder_ if it did
follow. This struck me as an ugly shifting of the basis, and far
from plausible. One school-and-college fellow of mine, _after
vaccination_, had smallpox that marked him; but nothing further led
me to pursue the argument.

“I now at once saw that _compulsory_ vaccination was an infamy,
since Parliament could not secure any one from Ira Connell’s
fate: and I was indignant on learning that doctors pooh-poohed
such miseries, as endured ‘_for the general good_,’ a theory
which justifies any amount of tyranny under the influence of
superstition; and I presently remembered that in Roman pestilences
_sacrifices_ were believed efficacious, and the arguments of the
priests and senators were quite as good as those of our physicians.

“I find that in 1869 I had a sharp debate with a clever young
student of Medicine, who poured out the doctrines of the Faculty,
which he had been getting up. My respect for the whole Faculty has
rapidly got less and less; it had long been declining. I need not
obtrude on you the depth to which it has now sunk, excepting always
a noble few, who are what Heretics were to the Mediæval Church.

“Next I saw that no Parliament or King has, or can have, any right
(_on medical theory_) to stick a poisoned lancet into a _healthy_
person; and that to fancy that Human Health can be improved by
altering the natural blood of Health is _an imbecile contemptible
fancy_. Moreover, that unless Vaccination is believed to _remove
the causes_ of smallpox, those causes would entail disease in other
ways, and perhaps worse, by suppressing _the natural eruption_,
which eruption alone is called ‘Smallpox.’ My mind was thus decided.

“I did not learn till some years later (_what alone concerns
Parliament_) that the more active is smallpox, the less is the
Total Mortality of any year; and conversely, the less active the
smallpox, the greater is the Total Mortality. This is the only form
of statistics worth attending to. All the rest is dust thrown in
our eyes.

“Statistics not founded on a scientific principle are the commonest
_nidus_ of fallacy; but if _any_ statistics are to be listened
to, those of Total Mortality are the least open to suspicion. The
_primâ facie_ evidence is, that instead of Vaccination saving
yearly 80,000 lives (Sir Lyon Playfair’s monstrous assertion)
Vaccination does only harm; but that Smallpox _saves_ every year
many lives (some hundreds or thousands) by a natural eruption,
under the morbid circumstances _desirable_.”

The Countess de Noailles contributed most efficient assistance
toward opening the public mind and letting in light. In a
communication her ladyship says--

“You ask me how it was that my name came to be connected with the
present anti-vaccination movement.

“It was in this way. On my return to England in 1865, Mrs.
Cowper-Temple, now Lady Mount Temple, asked me to visit the office
of the Ladies’ Sanitary Association, which I had joined her in
starting four years before. I had wished the Association to be
called the Ladies’ Association for the Protection of the Health of
the Children of the Poor; but that was thought too long a name,
and was changed; and I mention it only to explain what my idea
was in helping to form the Society. Well, on visiting the office
of the Association, I saw among the sanitary tracts one with the
title, _When were you vaccinated?_ On reading the words, it struck
me suddenly that vaccination was all wrong, but as I knew nothing
whatever about it, and had heard naught but praise of the practice,
I told the excellent secretary of the Association my misgivings
on the subject, and she set to work to find out all that was
known or thought on the question. Miss Griffiths soon learnt that
three relatives--John, Richard, and George Gibbs--had for twenty
years been writing and working against vaccination, besides Dr.
Collins and others. Seeing that I was not alone in my conviction,
I resolved to elicit more opinion on the subject by giving a
prize for the best essay on the same, setting forth the supposed
benefits, dangers, etc. Miss Griffiths went heart and soul into the
question, and with the help of Dr. Druitt, I think, she had judges
named and the prize of £100 offered. The judges were Mr. Marson,
Dr. Richardson, and Dr. Francis Webb--all in favour of vaccination.
The great length of the essay by Dr. Ballard gave it a claim for
the prize, and the tremendous because _unavoidable_ admissions as
to the dreadful dangers of vaccination contained in this Prize
Essay, have caused the doctors to try to suppress it--so at least
I have heard.

“Miss Griffiths sent me in November, 1866, the _Lancet_, containing
a horrible account of the poisoning of thirty-six children in
Morbihan, Brittany, by public vaccination.

“My forebodings being thus so terribly confirmed, I tried to
interest all the doctors who advised the Ladies’ Sanitary
Association in the new difficulties in the way of this dreadful
practice; but the only one who lent an ear to the sad tale was Dr.
Garth Wilkinson, who began mildly, but afterwards waxed valiant in
fight. May he and the little band which his genius has helped to
bring into the field ‘soon put to flight the armies of the aliens.’

“In 1867 a letter from the Rev. W. Hume-Rothery against compulsory
vaccination struck me, and he set to work at the question in the
co-operative newspapers; and latterly in the _Reporter_, in which
he has been ably helped by Mrs. Hume-Rothery, the daughter of the
late Mr. Joseph Hume, M.P. The strength given to the bad law by
Lord Robert Montagu’s Act in 1867 roused its enemies at the same
time; and, feeling that my task was done, I left the contest to
abler hands.

“I thus found that the Association I had inaugurated in order ‘_to
protect the health of poor children_,’ was being made into an
instrument to bind them through their mothers’ ignorance to the
most wholesale plan for their degeneration, if not destruction,
ever invented by the mind of man. It was in vain that I tried
to get the ladies of the Sanitary Association to think over the
matter. I was always met by the remark that it was _a medical
question_ and one which _doctors alone could decide_; and all I
could obtain of them was to allow me to buy up the offending tract
and to remain neutral in the question. When I left the Association
a few years after, the tract was circulated again.

“The compulsory law seems to me well described in these words of
Carlyle:--‘To decree _injustice_ by a _law_--inspired prophets have
long since seen, what every clear soul may still see, that of all
Anarchies and Devil-worships there is none like this; that this is
the “throne of iniquity” set up in the name of the Highest, the
human apotheosis of Anarchy itself.’”

Dr. Ballard’s essay was of itself a notable achievement. Written in
defence of vaccination, the difficulties, dangers and futility of
the practice were so largely revealed, that any thoughtful reader
was compelled to inquire, Where shall we find compensation for all
this trouble, these risks, these sufferings? Dr. Ballard’s essay
soon ran out of print, and the author was judiciously enlisted in
the medical service of the Local Government Board.

In Dr. Garth Wilkinson the movement obtained the assistance not
only of an able physician, but of one whom Emerson has described as
“a philosophic critic, with a coequal vigour of understanding and
imagination comparable only to Lord Bacon’s;” and “with a rhetoric
like the armoury of the invincible knights of old.” Having asked
Dr. Wilkinson how he came over to the side we identify with sound
science and sound sense, he answered--

“The early History of my Opposition to Vaccination is, briefly,
this--I had not considered Vaccination a question; but practised
it when required. About 1865 the Countess de Noailles assailed my
conscience on the subject, and her earnestness forced me to study
it. She was backed by the late Mrs. Gibbs, then Miss Griffiths.
Through Miss Griffiths I sent the following message to Madame de
Noailles--‘Tell her Ladyship that the question is comparatively
unimportant. Vaccination is an infinitesimal affair; its reform
will come in with greater reforms.’ I also wrote to Madame that the
only short way of getting rid of the Medical vested interest was by
paying half a million or a million of money down to the Profession,
and buying the slaves, the people, out, as the West Indian Blacks
were bought out.

“After-studies extending over eighteen years have convinced me that
I was wrong in my estimate of the smallness of the Vaccination
question compared with other Evils. As forced upon every British
Cradle, I see it as a Monster instead of a Poisonous Midge; a
Devourer of Nations. As a Destroyer of the Honesty and Humanity
of Medicine, which is through it a deeply-degraded Profession. As
a Tyrant which is the Parent of a brood of Tyrants, and through
Pasteur and his like a Universal Pollution Master. As a Ghoul
which sits upon Parliament, and enforces Contamination by Law,
and prepares the way for endless violations of personal liberty
and sound sense at the bidding of cruel experts. Not denying other
forms of Social Wickedness, I now, after careful study, regard
Vaccination as one of the greatest and deepest forms, abolishing
the last hope and resort of races, the new-born soundness of the
Human Body.”

The agitation against compulsory vaccination prospered under
the leadership of Mr. Gibbs. He sought help on all sides, and
harmonised its various elements to the common purpose of the
League. In his various labours he derived efficient assistance
from his brother, Mr. G. S. Gibbs of Darlington, who displayed
remarkable ability in the interpretation of vital statistics and
in the exposure of their misapplications. Mr. Gibbs established
branches of the League wherever there were adversaries of the
practice, and was especially successful in the north of England.
The relentless application of Sec. 31, Act ’67, in certain parts
of the country did much to rouse public attention and sympathy.
Parents were repeatedly fined for persistent refusal to have
children vaccinated, and in default of payment had their property
seized, or were committed to prison, sometimes with hard labour.
Occasionally sentences were accompanied with gross insolence from
the bench. For example, Mr. Bowman having pleaded at Newcastle his
conscientious conviction that vaccination might prove injurious
to his child, whilst it could never save him from smallpox, was
compared to a thief by the magistrate, who said, “I once knew a
man who had conscientious scruples against working so long as he
could live by stealing; and I do not think conscience of that
sort is entitled to respect.” Law on such terms naturally invites
execration, and many who might hold by vaccination are thereby
turned against it.

By some it was thought questionable whether Sec. 31, Act ’67, did
afford warrant for repeated prosecutions. Mr. John Candlish, M.P.
for Sunderland, who sat on the Committee of 1866 which dealt with
the Bill which became law in 1867, maintained “that it was not
intended that penalties should be repeated, but that one penalty
should be a discharge from any obligation to submit a child to
vaccination.” It is needless to say, an Act of Parliament is not to
be interpreted by the intentions of its framers, but by its words.
Moreover, if intentions are brought into question, it would be fair
to set intentions against intentions. Several who were concerned in
promoting the Act of ’67 had intentions more arbitrary than were
conveyed in Sec. 31.

The question, was raised by the Rev. H. J. Allen, Primitive
Methodist. He had been repeatedly before the bench at St. Neots,
and was committed to prison for fourteen days, but, having paid
the fine, £5, was liberated. In less than a month, he was summoned
again, and fined £1 for each of his children, including costs. An
appeal was made to the Court of Queen’s Bench in 1870, and judgment
confirmed the severer interpretation of Sec. 31, Act ’67. Lord
Chief Justice Cockburn held that a parent having been fined under
the Act for disobeying an order to have his child vaccinated, may
be proceeded against from time to time as long as the child remains
unvaccinated. He declined to discuss whether vaccination was
good or bad; the Legislature had treated it as a matter of great
importance, and had passed Acts to ensure attention to it; that
being so, he could not doubt that the intention of the Legislature
was not merely to impose a penalty upon a person, once and for all,
for having omitted to do that which the public health and safety
required; but to enforce obedience to the requisitions of the law.
He thought, therefore, the order to vaccinate might be renewed,
and the penalties might be repeated until the order was obeyed.
Mr. Justice Mellor and Mr. Justice Hannen concurred. The judgment
in this case, known as Allen _v._ Worthy, has been repeatedly
questioned and always reaffirmed.

Immediately after Mr. Candlish introduced a Bill to the House
of Commons to amend the law, repeating his conviction that the
construction put upon the Act of ’67 was never intended by
Parliament, and that it was by mere verbal accident that penalties
were made continuous. The Bill was introduced too late in the
session (6th July, 1870) to be carried, but it led to discussion
and a promise from Government that the question would be remitted
to a Committee next year, 1871.


FOOTNOTES:

[290] _Twenty Years’ Experience of a Public Vaccinator._ Read
before the Sanitary Committee of St. Pancras, 9th June, 1863. Third
edition. London, 1866.

[291] _Have you been Vaccinated? and What Protection is Vaccination
against Smallpox?_ By William J. Collins, M.D. Fourth edition.
London, 1868.




CHAPTER XLIII.

HOUSE OF COMMONS COMMITTEE, 1871.


On 13th February, 1871, Mr. W. E. Forster moved that a Select
Committee be appointed to inquire into the operation of the
Vaccination Act of 1867, and to report whether such Act should be
amended. Mr. Forster’s remarks on the occasion are noteworthy, as
manifesting the prevalent prejudice. He said--

  I make the motion in compliance with a promise made to the
  Member for Sunderland last session, who had brought in a Bill
  to relax the punishment for refusal to permit Vaccination. I do
  not imagine that Mr. Candlish, more than any other member of the
  House, has the slightest doubt of the utility and necessity of
  Vaccination, and that it is necessary not only to encourage the
  practice, but to make it compulsory. Opposition to Vaccination is
  not heard in the House of Commons; but it is found, I am sorry
  to say, among certain persons in the country, who have carried
  their resistance to an extent that has been injurious to health
  and destructive to life. [Evolution this from Forster’s fancy.]
  These people must have forgotten the state of the country before
  Vaccination was introduced.

Then followed the usual fabulous matter of rote--the awful
mortality prior to vaccination, the reduction of that mortality
by vaccination, the extraordinary immunity enjoyed by the
vaccinated and revaccinated, and so forth--uttered and accepted as
indisputable.

  The Government do not entertain any doubt of the efficacy and
  advantages of Vaccination, nor of the necessity of enforcing
  it. They have to contend with opposition--the opposition of
  ignorance, and also, I am sorry to say, with the opposition
  arising from interested motives [What possibly could they be?]
  preying upon that ignorance; and lastly, with the great neglect
  arising from apathy.

Sir Charles Adderley opposed the appointment of the Committee.
Accepting Mr. Forster’s statement as valid, he demanded--

  What is there to inquire about? Inquiry that is superfluous may
  be mischievous. Nothing can be more dangerous than to affect
  doubtfulness concerning legislation as to which there is not only
  no doubt, but a call for more rigorous administration.

Apparently the Government were of the same mind as Sir Charles, and
the Committee was conceded in fulfilment of an inadvertent pledge.
Mr. Forster assured the House--

  The Government do not propose this Committee with the slightest
  doubt about the principle of Vaccination, or the necessity of
  Compulsory Vaccination; and I need not say we have no intention
  of relaxing the operation of the law during the deliberations of
  the Committee.

The Committee was nominated as follows on 16th February--

    Dr. BREWER, Colchester.
    Mr. JACOB BRIGHT, Manchester.
    Mr. JOHN CANDLISH, Sunderland.
    Mr. R. M. CARTER, Leeds.
    Mr. STEPHEN CAVE, Shoreham.
    Sir SMITH CHILD, West Staffordshire.
    Sir DOMINIC CORRIGAN, Dublin.
    Mr. W. E. FORSTER, Bradford.
    Mr. J. T. HIBBERT, Oldham.
    Mr. J. M. HOLT, North-East Lancashire.
    Lord ROBERT MONTAGU, Huntingdonshire.
    Mr. P. H. MUNTZ, Birmingham.
    Dr. LYON PLAYFAIR, Edinburgh University.
    Mr. W. H. SMITH, Westminster.
    Mr. P. A. TAYLOR, Leicester.

The first witness examined was Mr. Candlish, himself a member of
the Committee and promoter of the inquiry. Whilst professing a
limited faith in vaccination, and willing to exercise a degree
of pressure sufficient to overcome mere apathy, Mr. Candlish
was strongly opposed to the compulsion of parents who seriously
objected to vaccination, and especially to their persecution by
repeated penalties and imprisonment.

Dr. W. J. Collins, the next witness, opened the entire question of
vaccination, and by a variety of experience showed that the vaccine
disease neither superseded nor mitigated smallpox, whilst it was
frequently a severe ailment and the means of exciting and conveying
other diseases.

Dr. C. T. Pearce followed suit. The purpose of the Committee
(limited to the consideration of the compulsory law) was apparently
forgotten, and Dr. Pearce delivered a comprehensive discourse, in
which the history, claims, failure, fallacies, and disasters of
vaccination were freely displayed; and in the cross-examination
which followed made good the positions he had assumed.

Sir Jervoise Clarke Jervoise, Bart., formerly M.P. for South
Hants, disputed the common notions of infection as confused with
contagion, and pointed out that it was absurd to draw comparisons
between the vaccinated and unvaccinated unless their pecuniary
status were at the same time defined: cases of smallpox in
Belgravia were not to be likened to cases in Clerkenwell. Smallpox
was not mitigated by vaccination: he had two relatives vaccinated
by Jenner himself who subsequently had confluent smallpox so
severely that “their own father did not know them.” Nor if smallpox
had diminished was there any reason to ascribe it to vaccination:
Jenner’s cowpox had ceased out of the land, and the cause of its
cessation might equally apply to smallpox.

Dr. Garth Wilkinson gave evidence with the characteristic wisdom of
the physician of genius who sees with his own eyes. He showed how,
endowed and lucrative, the futility and mischief of vaccination
were concealed or denied, and how, considered all sufficient
against smallpox, the causes of the disease were overlooked, and
the introduction of improved methods of treatment were unattempted
or discouraged.

Mr. George S. Gibbs contested the right of the State to inflict
vaccination, or to interfere between parent and child. Having a
faculty for statistics, he had applied himself to the records of
smallpox before and since the practice of vaccination, at home and
abroad, and showed that smallpox was the same at present as in the
past, neither more mortal nor less mortal, while there was reason
to believe that vaccination was a breeder of smallpox as well as a
source and excitant of other maladies.

Mr. Aaron Emery related in vigorous English how an infant of his
had been vaccinated from a healthy-looking child on 31st May,
1869; how erysipelas followed; how it gradually got worse; how
“the little fellow had no rest night nor day from 9th June to 4th
July, when death put an end to his sufferings.” Then he told the
difficulty he had to obtain a true certificate of death from the
vaccinator; how he forced an inquest; how a verdict was returned,
“Died from erysipelas caused by vaccination”; and how its terms
were subsequently altered by Coroner Lankester and registered as
altered at Somerset House. Up to the time of this fatality, Mr.
Emery had been an unsuspicious believer in vaccination; but his
sorrow led him to acquaintance with numerous cases like his own,
screened from public recognition, any artifice being accounted
laudable which seemed necessary to preserve vaccination from
reproach.

Mr. F. Covington, secretary of the Northampton Anti-Vaccination
League, described injuries from vaccination in his family and among
his acquaintance; the distrust and dislike of the practice in
Northampton with widespread resistance to the compulsory law.

Mrs. E. Kemp brought her baby, and told how it had been vaccinated
without examination, although there was a sore on the side of its
head. As the vaccination began to take, the child’s face and ears
broke out, until through the mass of eruption “you could only see
its little eyes.”

Mr. Thomas Baker, barrister, had been engaged in the Board of
Health from 1849 to 1854, and officially connected with several
sanitary inquiries. In his opinion what were called epidemics
were fevers with a common origin, against which cleanliness was
the efficient prophylactic, and to which his friend, Dr. Southwood
Smith, held smallpox was equally amenable. As a shareholder in the
Metropolitan Association for the Improvement of the Dwellings of
the Industrial Classes, he knew that residents in wholesome houses,
even in insanitary neighbourhoods, enjoyed remarkable exemption
from epidemic maladies.

Mr. W. J. Addison testified that his perfectly healthy child had
had syphilis invaccinated, and had died in consequence after
horrible suffering. The facts of the case were beyond question.
One hospital doctor had the temerity to ask the mother, “Whether
is it not better for one in a thousand to die like this than have
smallpox raging about our towns.” “Possibly,” replied the poor
woman, “but it is strange that my child should be the thousandth.”

The Rev. Wm. Hume-Rothery said his attention was first drawn
to vaccination by the operation on his own child, his wife
observing instinctively, “This is an unnatural and wrong thing.”
Investigation confirmed his wife’s judgment, and he became an
open opponent of the practice, writing and lecturing against it.
His acquaintance with the people in Lancashire had led him to the
conviction that the majority disliked and distrusted vaccination:
they were coerced to its observance, and evaded it when possible.
He himself was opposed to vaccination because there was nothing in
nature, human nature, or revelation to justify it. This assertion
of principle over and above practice led to considerable discussion
as to divine law, providence, and the nature of things, and the
right of conscience to withstand corporate dictation.

Mr. R. B. Gibbs, secretary of the Anti-Compulsory Vaccination
League, referred to the origin of vaccination, as attested
by Jenner, in the production of cowpox from the contagion of
horsegrease, and subsequently to the use of horsepox, by which
equination was substituted for vaccination; the diverse virus thus
derived from Jenner continuing in official arm-to-arm currency to
the present day. What vaccination was had never been determined;
and consequently there had been no proper basis for legislation.
Nor had legislation been preceded by impartial and adequate
inquiry: it had been promoted by certain medical men, supported
by the press, and especially by _The Times_, the editors of which
jealously suppressed all communications which impugned the efficacy
of the rite. Interrogated as to the amendment of the law, Mr. Gibbs
said he had no amendment to propose: the State should withdraw
all assistance from the practice, and leave its use or disuse to
individual discretion.

At this point the evidence of the anti-vaccinists was cut short.
They had much more to produce, but enough had been heard. The
Committee had forgotten its purpose, which was not to discuss
vaccination, but, accepting the rite as unquestionable, to consider
whether the law which enforced it was capable of amendment. Still,
the mischief being done, it was thought advisable to counteract it;
and forthwith contrary testimony was laid on. Various officials who
for years had made the promotion of vaccination their business were
summoned to the rescue, along with certain fashionable physicians,
whose assurance, it was calculated, would overcome any distrust
that might be excited in the public mind.

The first of the officials was Mr. John Simon, a review of whose
_Papers on Vaccination_ forms Chapter XL. of the present volume.
Evidence from Mr. Simon relative to vaccination was of much the
same order as that of a Virginian of former days on slavery, or a
thriving London publican on the liquor traffic. Mr. Simon answered
to the demand upon him: he was thorough: there was nothing like
leather--nothing! Smallpox was among the most contagious and most
fatal of pestilences, and “for an overwhelming majority of persons,
well vaccinated in infancy, vaccination was a security for life
against even an attack of smallpox.” The unvaccinated died at
the rate of 35½ per cent.; the vaccinated in general at 7 per
cent.; and “the properly vaccinated” at from 1 to ½ per cent.--the
fact being concealed that in times when all were unvaccinated,
the smallpox death-rate ranged from 10 to 18 per cent., the same
overhead death-rate of vaccinated and unvaccinated at this day.
There had never been, he believed, a case of death from the direct
effect of “properly performed vaccination”--the qualification,
it will be observed, referring all cases of death to something
other than the correct rite. He admitted there was not the least
doubt that syphilis had been invaccinated on the Continent, but
either from carelessness or culpable intention. Sanitation, he
said, had little or no influence on smallpox: vaccination was the
only protective--which variety of vaccination being judiciously
left undefined. Smallpox did not displace other fevers during its
prevalence, as alleged by Dr. Pearce. Holding that 97 per cent.
of Londoners were vaccinated, he did not see that the epidemic
then raging, the severest of the century, disproved the security
asserted for vaccination.

As we read Simon’s evidence, we realise afresh the possibilities
of audacity operating on credulity: there is nothing that men,
otherwise sane, may not believe when their disposition is set
toward belief. This Committee sat in London amid a population,
almost universally vaccinated, suffering from smallpox as they
never had suffered within living memory; and yet in presence of
such a demonstration of the impotence of the vaccine ordinance,
they listened to the soothsayer with abject acquiescence! Strange
as are the records of witchcraft, there is nothing in them more
marvellous than this 1871 Committee of select men from the House of
Commons taking for true what under their own eyes was visible as
untrue--deceived and consenting to be deceived.

As for those who disputed the efficacy of vaccination, and
justified their disbelief by smallpox among the vaccinated, Simon’s
contempt was unqualified--contempt being essential to the success
of the part enacted. “Some of them were ignorant,” he said, “and
others dishonest.” They were a “league of persons interested in
interrupting the fulfilment of the law, and very actively engaged
in disseminating falsehoods against vaccination”--falsehoods in its
favour actively disseminated by Simon and his trade-union being
disinterested and praiseworthy.

Dr. R. Hall Bakewell, vaccinator-general for Trinidad, was somehow
produced by mistake, his evidence being in several respects the
reverse of what was wanted. He thought vaccination good, but that
“it should be done in a more careful manner.” It ought not to be
compulsory, but left to the good sense of the people. Having been
proved to cause death, “it was unjust to oblige a parent to submit
his child to an operation attended with such risk, however rare.”
Referring to his experience in Trinidad, he said--

  3557.--I have seen Vaccination produce inflammation of the arm
  and general fever lasting for several days. Such illness was
  often alleged as an excuse by mothers for not bringing their
  children for inspection on the 8th day. At first I was inclined
  to regard the assertion as a mere excuse, but on visiting the
  homes I found the children were really ill, and that it was not
  safe to bring them for inspection.

  3563.--There is a strong opinion prevalent in Trinidad, and in
  the West Indies generally, that Leprosy has been introduced
  to the system by Vaccination. I found that medical men when
  they had occasion to vaccinate their own children, or those of
  patients in whom they were specially interested, applied to me
  for English lymph in order to avoid the invaccination of Leprosy,
  notwithstanding there was an equal, and probably a greater,
  chance of the English lymph being contaminated with Syphilis. I
  had several cases of Leprosy in which Vaccination seemed the only
  means of accounting for the disease.

As a consequence of this prevalent opinion, vaccination was
much disliked in Trinidad, and, although by law compulsory, was
indifferently enforced, so that at least half the population
escaped unvaccinated.

Interrogated concerning smallpox in Trinidad, Dr. Bakewell said
there had been no epidemic for fourteen or fifteen years when one
occurred “frightfully severe, as are all epidemics in Trinidad,
owing to the entire neglect of sanitary precautions”; adding that
“the mortality from smallpox may be greatly diminished by sanitary
measures independently of vaccination.” The Doctor still further
ruffled the prejudices of the Committee in asserting--

  3783.--I do not believe that the general mortality of the country
  is at all diminished by the absence of Smallpox. In Trinidad, for
  instance, our mortality is none the less because we have neither
  Smallpox, nor Whooping Cough, nor Scarlet Fever, nor Measles--the
  four most prolific causes of death among young children.
  Nevertheless infant mortality in Port of Spain is double that of
  London. By merely cutting off one disease from the category of
  diseases, you do not lessen the mortality of a country--

Precisely what Dr. Watt proved of Glasgow in 1813, and Dr. Farr at
a later date confirmed; and what the comparison of the statistics
of mortality in epidemic and non-epidemic years everywhere
illustrates.

With the examination of Mr. Danby Palmer Fry, head of the legal
department of the Poor Law Board, the Committee reverted to its
proper function. Questioned as to the state of the law and the
difficulties connected with its administration, Mr. Fry showed
that whilst vaccination was nominally compulsory, any resolute
parent might disregard it. To make vaccination really compulsory,
it would be necessary to legislate for its application by force,
which legislation public opinion would not tolerate. For himself,
he thought that parental conviction adverse to vaccination was
entitled to respect, and he therefore suggested--

  3845.--That it might, perhaps, be worthy of consideration whether
  a man might not be exempted from the penalty who takes an oath
  or makes an affirmation that he has a conscientious objection
  to the vaccination of his child. It seems to me that this would
  be similar in principle to the statutes which prohibited the
  Ecclesiastical Courts from issuing execution against the person
  of a Quaker, though they might do so against his goods, on the
  express ground that the people called Quakers were known to
  entertain conscientious objections to the payment of tithes and
  church rates.

Sir Dominic Corrigan, M.D., a member of the Committee, next gave
evidence, and the defence of vaccination was resumed. So little
did Sir Dominic apprehend the purpose of the Committee that he
observed--

  3992.--I think the great question before us is whether vaccine
  poison can contain within itself syphilitic poison or any other
  poison.

As to the invaccination of syphilis, he was clear: it was
impossible. Vaccination induced no disease. Virus was nothing but
pure lymph, even when taken from an impure subject. Vaccination
was regarded with favour throughout Ireland. It was enforced, but
it required no enforcement: there was no disposition to resist the
law. He disliked penalties, and would rather operate by excluding
the unvaccinated from schools, factories, and public employments,
on the ground that “they might become a mine of disease and injure
others,” namely, to the vaccinated fortified against smallpox!

Smallpox had been gradually declining in Ireland under the
influence of vaccination, and the disease was then, 28th April,
1871, practically extinct. Foolhardy was the assertion. Even while
Sir Dominic was testifying, smallpox had reappeared: 665 died of it
in 1871 and 3,248 in 1872. From 1871 to 1875 there perished 5,521
of smallpox in a land from which it was claimed vaccination had
banished the disease!

Mr. James Furness Marson followed Sir Dominic--a fanatical
vaccinator and promoter of compulsion. For thirty-five years
surgeon of the Highgate Smallpox Hospital, he had there elaborated
the whimsical notion that the efficacy of vaccination was measured
by the number and character of the cicatrices; holding that--

  4149.--A large number of the people in this country are very
  badly vaccinated, having but one cicatrix hardly perceptible, and
  have Smallpox as bad as if they had never been vaccinated at all.

Confronted by Mr. Jacob Bright with the fact that Dr. Gregory, of
wide experience and admitted authority, had expressed the contrary
opinion in his work on _Eruptive Fevers_, saying--

  4670.--Hence we may learn how small importance is to be attached
  to the cicatrix as an evidence of the perfection or imperfection
  of the vaccine process. Perfect security is compatible with a
  small and scarcely distinguishable cicatrix or without a large
  wafery cicatrix at all; at least none perceptible five years
  after the operation--

Marson made answer--

  Dr. Gregory was an authority; but he was a very singular man
  indeed, and had never investigated the subject in the extensive
  way I have.

Marson was the victim of a notion, and that a poor one, to which
whatever stood in opposition was sacrificed. Among his assertions
and admissions, the following are characteristic and illustrative--

  4151.--If all children were properly vaccinated, the mortality
  from Smallpox would be less than 1 per cent. There are
  difficulties: there is the opposition of mothers to having their
  children well vaccinated.

  4125.--Persons who catch Smallpox after being vaccinated do not
  generally have it until 18 to 25 years afterwards.

  4220.--Smallpox itself is a much greater protection from Smallpox
  than Vaccination.

  4136.--Certainly Smallpox has no tendency to die out: it is
  precisely the same disease it was a thousand years ago, and will
  be a thousand years hence.

  4148.--We have no control over Smallpox: there is no specific.
  We have no power whatever of controlling Smallpox, Scarlatina,
  Measles, and other febrile eruptive affections.

  4694.--I look upon hospitals as necessary evils. They are not
  places I would recommend the sick to go to. Anybody who can
  afford to keep in his house should not go to an hospital.

  4327-28.--Dr. Jenner was wrong when he said Cowpox was derived
  from Horsegrease: it was supposed so at one time, but that is set
  aside now.

  4325 and 4697.--I have two sources of vaccine lymph; one from the
  inoculation of a cow with Smallpox, and the other from a cow in
  the neighbourhood of Brussels which had Cowpox in the natural way.

  4646.--There was no epidemic of Smallpox in London from 1796 to
  1825; and as the absence of Smallpox was contemporaneous with the
  introduction of Vaccination, it was imagined that Vaccination had
  a great deal to do with it; and it was a fair conclusion.

  4705.--Smallpox was raging to a great extent in the east of
  London before the French war broke out--

Yet it is customary to ascribe the Smallpox epidemic of 1870-71 to
the Franco-German war.

The unscrupulous ferocity which animated Marson and his associates
toward those who impugned their practice is forcibly displayed in
the following questions and answers; premising that Simon attested
of Marson that “he was a singularly careful observer”--

  4174.--I suppose you are aware there is a strong feeling and
  a great objection on the part of a number of people against
  Vaccination?

  Yes, I know there is; but I nearly always find that it is the
  father who objects and not the mother; and it makes it very
  suspicious.

  4175.--What do you mean?

  The father would like the family as small as possible that he has
  to work for. I am afraid that is at the bottom of it.

  4176.--Do you not think that is giving credit to the father for
  looking much further ahead than people in that class of life
  generally do?

  I do not think they have very far to look when they have their
  daily bread to earn. When the wages come in on Saturday night, it
  pretty often comes to their mind how the money is disposed of--

A libel as atrocious as absurd, and significant.

Dr. Alexander Wood was brought from Edinburgh to give evidence as
to Scotland of much the same tenor as that of Sir Dominic Corrigan
concerning Ireland. Dr. Wood’s note was clear--“I do not think,”
he said, “that a person has a right to keep an unvaccinated child
any more than to keep a mad dog.” Smallpox had been prevalent
in Scotland for some years, and had been made use of to pass a
Compulsory Vaccination Act in 1863; but it was neither shown that
prior to that Act the Scots were unvaccinated, nor that it was
the unvaccinated who suffered from smallpox--apart from those
conditions of life which make for smallpox. In the course of
nature, smallpox abated in Scotland, and the Act had the credit of
the abatement: the vaccination of the people being so complete that
Dr. Wood testified--

  4399.--There would not be an unvaccinated child in Scotland if
  we had some means of overtaking the migratory population--the
  railway navvies and tramps, the children born by the roadside and
  under hedges.

As in Ireland, there was little or no resistance to the law; and
as in Ireland, it was asserted that smallpox had been stamped out;
but as in Ireland, the assumption was nullified by experience. In
the epidemic of 1871-73, there died of smallpox no fewer than 5034
in Vaccinated Scotland--a contradiction unforeseen by Dr. Wood and
the Committee before whom he prophesied.

Sir William Jenner appeared as court physician. He had advised Her
Majesty the Queen to encourage vaccination in the case of all the
members of the Royal Family, and Her Majesty had complied with his
advice, and the Prince of Wales too. He had had great experience as
physician to the Children’s Hospital and elsewhere, and had never
seen any serious illness or death result from vaccination. His
testimony as to the harmlessness of the practice was unqualified,
and he was “unable to conceive of any medical practitioner of
standing disbelieving in it, or thinking it mischievous”; adding--

  4521.--I should consider I was very much wanting in my duty, and,
  in fact, deserving of punishment, if I neglected to have my six
  children vaccinated.

He approved of the compulsory law, and wished that revaccination
was likewise compulsory. As to the statistics of smallpox and
vaccination, he disowned sufficient acquaintance; nevertheless he
did not hesitate to assert that smallpox, as a form of zymotic
disease displacing other forms, or replaced by others, was “a
theory utterly without foundation.” Of course testimony of this
order was produced for social rather than scientific ends.

The like was true of Dr. Gull, now Sir William. He also professed
to have never seen any serious illness caused by vaccination;
nor did he believe that vaccination from a diseased child would
communicate disease. As a defence against smallpox, he held that
vaccination was as protective as smallpox itself. It was the duty
of the Legislature to enforce vaccination; adding--

  4830.--That with our present knowledge, I should think it the
  most insane thing that any human creature could think of to give
  up Vaccination.

He had advised the Government to accept no one for service in India
without revaccination. Asked by Mr. Candlish whether he would take
a child by force from its parents and vaccinate it, he replied--

  4854.--I certainly would; just as I would take an ignorant child
  and have it educated.

Less judicious than Sir William Jenner, Dr. Gull adventured on
statistics. It having been pointed out that though smallpox was
then epidemic in London, the death-rate was not raised thereby, he
attributed the result to vaccination. “In former times smallpox
produced an enormous increase in mortality”--

  4780.--I think we read of 100,000 people dying of the disease in
  epidemics, and I am not sure that it was not double the number.
  I hardly like to trust myself as to numbers, but when I was a
  professor of medicine at Guy’s Hospital, I brought those numbers
  before my class, and I was astonished at the enormous number of
  deaths in a Smallpox epidemic. I remember that taking all the
  deaths which had occurred in the wars of Napoleon, they were not
  so many by any means as the number of lives which had been saved
  by Vaccination at that time. I do not remember, at the moment,
  the authority for that statement, but I remember that that was
  the kind of evidence that I had to bring before the class.

Verily the class at Guy’s had romance for science, and the
Committee had similar entertainment. They were told that except
for vaccination the epidemic then prevalent in London would result
“in a perfect pestilence”; for mortality among unvaccinated
populations “had been something terrific.” They had “the history
of smallpox in China and India, where its effects had been
perfectly depopulating.” “To neglect or discourage vaccination in
their crowded English towns would be much the same as thrusting
a fire-brand into a powder magazine.” Before the introduction of
vaccination, “France lost year after year a quarter of a million
of inhabitants (250,000) by smallpox”; and so forth and so forth;
assertions without warrant outside the intention to excite fear in
order to obtain confidence.

The next witness was Dr. Charles West, for twenty years physician
to the Hospital for Children, London, where children under two
years old were not received--at ages when the immediate effects
of vaccination are obliterated or forgotten. Vaccination, in his
opinion, prevented or mitigated smallpox. “It had, no doubt, the
effect in many cases of developing a disposition to some forms
of skin disease, especially eczema;” but on the whole it was not
injurious. In the course of his immense experience he had only
known of one child whose death was due to erysipelas caused by
vaccination. He had no proof of the invaccination of syphilis.

There was nothing peculiar about Dr. West’s evidence. It was
according to professional orthodoxy, from which it would have
required more than ordinary courage to depart. Medical men by the
gross could have been put up to deliver similar evidence; but what
was it worth? The medical mind is fixed in two directions; first,
that vaccination prevents smallpox, or mitigates it; and second,
that it induces a harmless disease; a couple of conclusions that it
seems possible to maintain in presence of a vast array of evidence
to the contrary.

If any one chooses to assert that vaccination prevents smallpox or
mitigates it, How can he be confuted? The prevented smallpox is
hid in the unknown, likewise the severity that has been mitigated.
Again, if vaccination be held harmless, any instance of its ill
effects can be resolved into coincidence with a sneer at the vulgar
fallacy of converting _post hoc_ into _propter hoc_. Possessed with
these notions, nothing is easier than to assert with Dr. Stevens,
for example, “No man has seen more of vaccination than I have, but
I have yet to see any bad effect from the practice.” None are so
blind as those whose business it is not to see; or as Mr. Aubrey
De Vere has it, “Prejudice, which sees what it pleases, cannot see
what is plain.” It is, I contend, plainly impossible to inflict a
disease like _Vaccinia_, in any of its varieties, without injury to
the extent of the disease; without intensifying active or exciting
latent disease; or without the risk of conveying other inoculable
disease from the vaccinifer.

“The great question before the Committee,” said Sir Dominic
Corrigan, “is whether vaccine poison can contain within itself
syphilitic or any other poison”--the great terror being syphilitic
poison. That question the next witness, Mr. Jonathan Hutchinson,
an expert in syphilis, determined. He had been called to examine
thirteen persons, mostly young adults, engaged in a London shop,
who had been revaccinated by order of their employer during the
prevalent smallpox panic. The vaccinifer was “a fine, full-grown,
healthy child,” yet it conveyed syphilis, beyond mistake, to 11 of
the 13 vaccinated. Mr. Hutchinson allowed that the vaccinator was
not to be blamed for the disaster, saying--

  5032.--I very much doubt whether it could have been avoided by
  inspection. The child looked healthy, and it had passed at the
  Vaccine Station as healthy.

Having similar cases within his experience, and convinced “that
syphilis _can_ be communicated in the act of vaccination,” Mr.
Hutchinson was asked by Mr. Candlish whether he was aware that the
medical profession in general denied the possibility, he replied--

  5060.--I am not aware that the authorities on the subject deny
  it; I believe that several of them hold it very clearly; I am
  aware that the general opinion of the profession is perhaps
  opposed to it, but not the opinion of those who have carefully
  investigated the question.

To reduce the effect of testimony so injurious to vaccination, it
was attempted to make out that the danger was limited to virus
tainted with blood; and although Mr. Hutchinson conceded that blood
_might_ be the medium of transmission, it was undecided.

  5073.--It is not a subject on which I should like to infer
  anything; I should like to have experiments and facts.

Subsequent experience has shown that with blood or without blood,
syphilis may be invaccinated. Still, Mr. Hutchinson, as an advocate
of vaccination, and of its compulsory infliction, “considering it
of the utmost necessity and importance,” conceded that the risk
was infinitesimal; but (as was remarked at the time) unless the
diffusion of syphilis were infinitesimal, there was no ground
for the assumption of an infinitesimal risk. As Mr. Hutchinson
admitted--

  5089.--I believe there are cases of latent Syphilis which cannot
  be detected by any medical man, unless he examines into the
  history of the child as well as its appearance.

Mr. James Neighbour, vaccination officer of St. Luke’s, Middlesex,
a district of 60,000 inhabitants, chiefly poor, described the
operation of the Vaccination Acts. He met with little resistance
to the law; the births were vaccinated up to the registration
point, but he had no check on those who might neglect or evade
registration, or leave or settle in St. Luke’s.

Dr. E. C. Seaton, as select representative of the official vaccine
ring, was reserved for the consummation of the inquiry. To review
his evidence, delivered with much elaboration, would be to repeat
much of our story. Vaccination was afresh set forth as “a perfectly
safe and efficient prophylactic against smallpox, which might be as
reasonably disputed as the demonstrations of Euclid.” Nevertheless,
the perfectly safe and efficient variety of vaccination was neither
defined by the witness, nor demanded by the Committee--whether
with horsegrease cowpox, cowpox, horsepox, or smallpox cowpox;
an omission that illustrates the slovenly and credulous habit of
those concerned--a 19th century miracle and mystery, being under
discussion, and matter and mode being taken for granted under cover
of a word!

Throughout Seaton’s evidence, smallpox was treated as an isolated
disease, which might be dealt with specifically and exterminated
without reference to other fevers, the common mortality being
reduced to the extent of its reduction: no relation being
recognised between fever and fever, epidemic and epidemic--

  5344.--Epidemics of Smallpox, like epidemics of other diseases,
  come and go according to laws which we have not made out. They
  vary in their intensity, and vary in their power of diffusion.
  I have no explanation to offer why the present epidemic (1871)
  should be so much more intense than the epidemic of 1863, any
  more than I can tell why the epidemic of 1863 should have been
  more severe than the subsequent epidemic of 1866-67; or why one
  Cholera or Scarlet Fever epidemic should be so much more fatal
  than another Cholera or Scarlet Fever epidemic--

Yet when explanation was offered, namely, that the febrile disease
of a community is a measure of its sanitary aberrations; that
whilst the forms of fevers may vary, the activity of one form is
balanced by the quiescence of others, the tale of death being
equal--the explanation was waved aside; and why? Because it did not
make for the glory of vaccination!

Curiously, and for a different reason, Malthus argued, as we now
argue, that if vaccination could exterminate smallpox, not a life
would be saved--supposing, let us add, no change effected in the
conditions out of which smallpox and cognate maladies arise. Thus
Malthus wrote--

  I am far from doubting that millions of human beings have been
  destroyed by Smallpox; but were its devastations, as Dr. Haygarth
  supposes, many times greater than the Plague, I should still
  doubt whether the average population of the earth had been
  diminished by them by a single unit. Smallpox is certainly one
  of the channels, and a very broad one, which Nature has opened
  for the last thousand years to keep down population; but had this
  been closed others would have become wider, or new ones would
  have been formed. For my own part I feel not the slightest doubt,
  that, if the introduction of Cowpox should extirpate Smallpox,
  we shall find a very perceptible difference in the increased
  mortality of some other diseases.[292]

Like Simon and Marson, Seaton had his insult for the opponents
of Smallpox. Simon charged them with ignorance and dishonesty;
and Marson, with the desire to have their families reduced by
smallpox. Seaton held that they enjoyed martyrdom and courted
imprisonment, in order to get silver watches from their admirers on
their release! Here imputation was self-revelation. Seaton had won
place and pay by his promotion of State vaccination; and absurdly
ascribed to his antagonists his own venality. Indeed, his evidence
throughout was pervaded by the temper and tactics of the quack,
with an end to promote _per fas et nefas_. Asked what would happen
if compulsion were withdrawn from vaccination, he answered--

  5510.--Simply an awful increase in the mortality from Smallpox,
  and a considerable increase therefore in the amount of mortality
  in the kingdom.

The typical answer of the quack when his dupe hesitates over
his prescription is, “You’ll see then what will happen!” When
vaccination was not compulsory prior to 1853, nothing “awful”
happened; it had been compulsory for fourteen years in 1871, and
yet in 1871 the kingdom was under experience of the severest
smallpox epidemic of the century! Nevertheless, the anticipation
of Malthus was fulfilled: there was no proof that the average
mortality was increased by a single unit.

The evidence concluded, a draft report was drawn up by the medical
officials, submitted to the Committee, and, after some trivial
alterations, agreed to. The character of the report may be
estimated from this its second article--

  That Cowpox affords, if not an absolute, yet a very great
  protection against an attack of Smallpox; and _an almost absolute
  protection against death from that disease_--

And this in face of the fact that deaths from smallpox among the
vaccinated and revaccinated were recorded by thousands!

Against the evidence in favour of vaccination, the prevalence of
the present (1871) smallpox epidemic, especially in London, was
alleged, and the awkward circumstance was thus tried to be evaded--

  Your Committee, however, believe that, on the one hand, if
  Vaccination had not been general, this epidemic might have become
  a pestilence as destructive as Smallpox has often been where the
  population has been unprotected; and that, on the other hand, if
  this preventive had been universal, the epidemic could not have
  approached its present extent.

There is no arguing against what might have been. When Sangrado’s
patients died, he averred that if only they had been bled more
and taken more water, they would indisputably have recovered; and
Sangrado had believers. So when vaccination does not save from
smallpox, we are assured, “Ah, but it would, if only there had
been more of it.” Descending from fancy to experience,--from what
_might have been_ to what _has been_, there is no record of a worse
epidemic in England than that of 1871-72. The only one to compare
with it was the epidemic of 1838-40, which occurred when not 50 per
cent. of the English were vaccinated; but they fared no worse than
in 1871-72, when the number of vaccinated was doubled.

The proper business of the Committee lay in legislation, and their
report thereon took this form--

  There appear to have been several cases of infliction of more
  than one fine or imprisonment in regard to the same child; and
  your Committee, though by no means admitting the right of the
  parent to expose his child or his neighbour’s to the risk of
  Smallpox, must express great doubt whether the object of the law
  is gained by thus continuing a long contest with the convictions
  of the parent.

  The public opinion of the neighbourhood may sympathise with a
  parent thus prosecuted, and may in consequence be excited against
  the law; and after all, though the parent be fined or imprisoned,
  the child may remain unvaccinated. In such a case the law can
  only triumph by the forcible Vaccination of the child.

  In enactments of this nature, when the State, in attempting to
  fulfil the duty, finds it necessary to disregard the wish of the
  parent, it is most important to secure the support of public
  opinion; and, as your Committee cannot recommend that a policeman
  should be empowered to take a baby from its mother to the Vaccine
  Station--a measure which could only be justified by an extreme
  necessity, they would recommend that, whenever in any case two
  penalties, or one full penalty (20s.), have been imposed upon a
  parent, the magistrate should not impose any further penalty in
  respect of the same child.

  It has been suggested that the parent’s declaration of belief
  that Vaccination is injurious might be pleaded against any
  penalty, but your Committee believe that if the law were thus
  changed it would become a dead letter, prosecutions would soon
  cease, and the children of the many apathetic and neglectful
  parents would be left unvaccinated, as well as the children of
  the few opponents of Vaccination.

The recommendations of the Committee, chiefly administrative,
were embodied in a Bill, passed by the House of Commons on 15th
August. The tenth clause, limiting penalties, was the subject of a
short debate, and was carried on a division by 57 to 12. When the
Bill was brought before the House of Lords on 18th August, Lord
Redesdale moved to omit clause 10, saying--

  The clause exempts persons who have been fined the full penalty,
  or two penalties of any amount, from any further proceedings.
  The clause has been hailed with triumph by the opponents of
  Vaccination, who justly think it destroys the whole effect of the
  compulsory law. The poor will naturally argue that, if the rich
  are let off with a fine of 20s., the penalty ought in their case
  to be reduced; and such a resistance to the measure will spring
  up, that the whole purpose of the former Acts will be done away.

Viscount Halifax replied--

  I hope the House will not strike out the clause, as it might
  entail the loss of the Bill. I admit there are objections to its
  principle; but it has been unanimously recommended by a Committee
  of the House of Commons. Determined opposition has been offered
  to Vaccination by a limited number of persons on grounds which I
  deem unreasonable; but, nevertheless, whilst this feeling exists,
  it is the opinion of Mr. Simon, the medical officer to the Privy
  Council, that it is unwise to insist upon anything which is not
  indispensable; and, further, that the penalty now proposed will
  answer all the practical purposes of the Act. It is desirable
  that public feeling should go with the Act, which will be the
  case, since the exceptions will be very few; whereas an adverse
  feeling may be excited to the prejudice of the Act, if even a
  few prosecutions are persisted in. The strongest advocates of
  Vaccination deprecate repeated fines and imprisonments, which
  leave the defendants’ children unvaccinated.

Lord Redesdale rejoined--

  I presume the noble Viscount thinks it useless to fine a man
  more than once for drunkenness? The clause surrenders the whole
  principle of Compulsory Vaccination.

On the question whether the clause should stand part of the Bill,
their Lordships divided:--Contents 7; Non-contents, 8; Majority, 1.
Resolved in the negative.

On the 19th August the House of Commons considered the Lords’
amendment, when Mr. W. E. Forster observed--

  The House of Lords has struck out of the Bill the 10th Clause,
  the important clause which mitigates penalties. That clause was
  passed in this House by a majority of 57 to 12, and expunged in
  the other House by a majority of 8 to 7, the total number of
  peers voting being just equal to the number of members of the
  Select Committee which, after long and careful consideration,
  came to a unanimous conclusion in favour of the clause. I
  should have no hesitation in asking the House to disagree to
  the amendment, if the period of the session would allow of such
  disagreement being made without loss of the Bill; but as that
  is not the case, and as such a course may involve the loss of
  the Bill, which effects several great improvements, I fear the
  House has no choice, and must accept the amendment. Although the
  clause is doubtless an important one, I may remark it is not
  necessary to other parts of the Bill, and, with Smallpox raging
  in the country as it is, I think it will not be safe to postpone
  the measure. I regret the omission of the clause, because in my
  opinion it strikes a heavy blow at the principle of Compulsory
  Vaccination, which their Lordships, as well as I, think necessary
  for the health of the country. I move that the House agree to the
  Lords’ amendment.

Mr. M‘Laren said--

  Whilst I concur in the course proposed, I hope the Government may
  lose no time in bringing in a Bill to enact the clause that is
  dropped.

The motion was agreed to, and repeated penalties continue to this
day.


FOOTNOTE:

[292] _Essay on the Principle of Population._ 2nd Ed. London, 1803.




CHAPTER XLIV.

THE STRUGGLE FOR FREEDOM.


The temper and conduct of Parliament satisfied Mr. Gibbs and his
associates that they must turn again to the people and achieve
success through their instruction, enlightenment and fears. At this
juncture, however, the labours of Mr. Gibbs terminated. He had
married Miss Griffiths (for many years secretary of the Ladies’
Sanitary Association), and had gone with her on a tour through
the United Kingdom, holding meetings and discussing the evidence
and report of the House of Commons Committee. His last public
appearance was at Cork; proceeding thence to Dublin, he died there
after a short illness on 1st December, 1871.

The removal of Mr. Gibbs was a severe discouragement; but a good
cause may always be trusted to evolve its own prophets. Mrs. Gibbs,
as became a wise woman, felt that she could not better honour her
husband than by consecrating herself to his work. She formed the
Mother’s Anti-Compulsory Vaccination League; and until her own
death, 10th November, 1878, devoted her training, experience and
intelligence to awakening an interest in those divine laws of life
of which a practice like vaccination is a deliberate negation.

In 1872 Mr. John Pickering, of Leeds, in conjunction with Mr.
Henry Pitman, started the _The Anti-Vaccinator_ fortnightly, and
continued it for a year. To maintain such a journal is far from
easy. As Napoleon III. observed to Cobden, “There are a good many
free-traders in France, but you must remember that the people
are not organised, whilst the trades which prey upon the people
are organised and are always alert.” To overthrow the trade in
vaccination, established, endowed and enforced, is to encounter
the enmity and opposition of the organised profession at whose
instigation and for whose advantage vaccination was established,
endowed and enforced; and to effect the overthrow, it is necessary
to raise up a countervailing force among a public apathetic,
ignorant, and credulous as to medical mysteries. The overthrow
might be thought hopeless were it not for the leverage afforded by
the compulsory law. Every parent who has wisdom and love enough
to refuse to have his child vaccinated, is enabled to bear his
testimony in court, to have it certified by fine or imprisonment,
and to have his triumph published for encouragement and repetition.
There is no preaching like such practice, for which the evil law
itself provides opportunity.

Mr. Pickering was fined over and over again, and in his
_Anti-Vaccinator_ he proved abundantly that he had reason and
science without end for his steadfast resistance to the legalised
superstition. In 1876 he was enabled to strike a blow for the
truth not likely to be forgotten, especially in Yorkshire. The
statistics of the Leeds Smallpox Hospital had been published after
the fashion of similar concoctions--an insignificant mortality
among the vaccinated being set against a prodigious mortality among
the unvaccinated. The statistics were denounced as fictitious, and
proof of the accusation being demanded, Mr. Pickering produced the
proof.[293] The requisite inquiry was tedious and difficult; and
because tedious and difficult it was presumed it would never be
attempted, and that impunity was assured. The exposure demonstrated
afresh how little dependence is to be placed on the collocation
of figures by those whose pride and interest are committed to a
foregone conclusion.

The severity of the compulsory law is subject to frequent abatement
in its administration by poor law guardians. They appoint and
pay vaccination officers, and it is for them to consider and, to
sanction repeated prosecutions. Hence a majority, or an energetic
minority of guardians adverse to vaccination may do much to
frustrate its public administration. What is practicable in this
way was shown by the Keighley guardians in 1876. They declined to
prosecute; they disregarded the admonitions of the Local Government
Board; and they refused to obey a mandamus issued from the Queen’s
Bench. They were thereon arrested for contempt of court, and
committed to York Castle, from which they were released after
nominal submission. They were re-elected by the ratepayers, and did
as before, but more discreetly.

There is a proverb about taking a horse to the water and trying to
make him drink, which applies to legislation when equally disliked
by those expected to enforce it and by those on whom it is to be
enforced. Under such conditions the compulsory act is of no effect
in Keighley: those who like may be vaccinated, and those who do
not, need not. The majority are unvaccinated and nowhere is
smallpox less feared. In several towns where public sentiment is
similarly enlightened, something of the same freedom is enjoyed. In
many parishes it is the rule to disallow repeated prosecutions: the
vaccination officer fulfils his commission in prosecuting once, and
then his hand is stayed. In some parishes those who are known to be
opposed to vaccination are passed over on the tacit understanding
that they keep quiet as to their indulgence; a course of procedure
extremely injurious to the good cause, damping enthusiasm and
suppressing that conflict and agitation by which it prospers.
In other parishes no quarter is allowed: the law is worked with
rigour. Prosecution follows prosecution until either fury exhausts
itself, or the nonconformist is driven elsewhere.

Such persistent prosecution often becomes a public scandal. To a
parent with adequate means, the fines and costs are trivial, and
are amply repaid by the satisfaction of setting guardians and
justices at defiance, and publishing far and wide his contempt for
the vaccine superstition. On the other hand, a parent in humble
circumstances is often put to cruel straits between his love and
duty to his child and the comfort of conformity.

In the difficulty thus created by the law, the Local Government
Board is frequently appealed to for advice; and in 1876 the Board,
at that time under the presidency of Mr. Sclater-Booth, addressed
a letter of counsel to the Evesham guardians, which, translated
from official circumlocution, came to this--Prosecute until you
are satisfied your antagonist cannot be overcome: then consider
whether you had not better desist; for he may obtain sympathy, and
the law and the rite alike suffer discredit in public estimation.
In Cowper’s words, “Safe policy, but hateful.” This Evesham letter
has become a standard document, and is regularly posted by the
Board to guardians in perplexity as to the extent of vengeance
they should execute. Such is the variety of valour taught from
Whitehall--“Fight until you discover you are not likely to prevail;
and take care to leave off before you make yourselves hateful or
ridiculous.” Law was never, perhaps, reduced to baser terms.

Several attempts have been made to modify the law as recommended
by the Vaccination Committee of 1871 and approved by the House of
Commons. Mr. Pease (now Sir Joseph) introduced a bill with that
purpose in 1872 and 1878, limiting the penalty in any case to 20s.,
but without success. In 1880 the Gladstone administration, fresh
from the country, and flushed with good intentions, brought forward
a similar bill, but dropped it in abject fright in consequence of
the clamour of the medical trade unions, who fancied their vested
interest in vaccination endangered. Nevertheless, those responsible
for the law at the Local Government Board avow their disapprobation
of repeated prosecutions, and regret that Parliament does not
appear to be of a like mind, reckless of the fact that Parliament
is rarely unwilling to consent to an administrative change when
those in authority state the reasons for it, and insist on the
necessity of giving them effect.

Mr. Forster, when moving for the Committee of 1871 in the House of
Commons, spoke as if no member was prepared to dispute the efficacy
of vaccination against smallpox; and, though the assumption was
excessive, it was not far from correct. Even Mr. Candlish only
objected to the injustice of compulsion. Since then considerable
progress has been made. Mr. P. A. Taylor, who shared the position
of Mr. Candlish, subsequently examined the history and evidences of
vaccination for himself, with the inevitable result: he discovered
that he had been imposed upon, and having made sure, straightway
began to make known his discovery to others. Mr. C. H. Hopwood,
equally enlightened, moved Parliament for various statistical
returns which exhibited the influence of enforced vaccination, in
authentic form and on a national scale, as a factor of death and a
communicator and aggravator of other maladies. In conjunction, Mr.
Taylor and Mr. Hopwood have raised the standard of resistance to
vaccination in the House of Commons; and what Mr. Forster in 1871
set forth as indisputable, is now openly and unanswerably disputed;
for those who have come to the defence, like Sir Lyon Playfair
and Sir Charles Dilke, have been convicted of unquestionable
mis-statements which could only pass muster as addressed to
uncritical credulity.

Parliament is the creature of public opinion, and to arouse and
inform that opinion and to bring it to fruit in legislation, it
is necessary to agitate and to organise. Consequent on the death
of Mr. R. B. Gibbs in 1871, the League, of which he was leader,
underwent a course of vicissitude until, in 1876, it was revived
under the presidency of Mr. William Hume-Rothery, with the
_National Anti-Compulsory Vaccination Reporter_ for its organ,
edited by Mrs. Hume-Rothery. The energy and ability which Mr.
and Mrs. Hume-Rothery have brought to their arduous enterprise
have been unwearied and conspicuous--their self-consecration has
been unreserved. Sometimes they have been charged with vehemence
and intolerance, but when we consider the craft with which they
are confronted on one side, and the credulity on the other, the
misery and mortality resulting from the cruel practice, and the
monstrous oppression exercised on those who resist the despicable
superstition, it is not easy to be calm, or to adjust invective
to a scruple. “Thou shouldst not speak so strongly, John,” said a
Friend to her husband, when denouncing some iniquity. “Ah! Jane,”
he replied, “thou knowest not what I keep back.”

It is frequently said that anti-vaccinators are fanatical, which
may be more or less true; but if in quest of fanaticism, where
shall we find it so ruthless, so untruthful, or so mercenary as
among vaccinators? Take for example, Jenner, or Ring, or Seaton, or
Marson, or Simon. The fury of anti-vaccinators stands excused by
the strongest reason that can justify or ennoble fury. If a father
has a child injured or killed by vaccination, and is threatened (as
is often the case) with a second attack on his family life, with
what temper may he be expected to regard the law? When Macduff’s
children were slaughtered, it was only in Macbeth’s blood that he
could ease his soul, and with Macduff goes the sympathy of every
human heart. So it is with those bereaved by vaccination; only for
them there is no personal Macbeth to receive his deserts, but a
bodiless law.

It is not difficult to philosophise over other people’s wrongs,
or advise forbearance where there is no sense of hurt; but fury
and indignation constitute the natural reaction against outrage
and injustice, and where feeble or absent denote defective moral
sensibility. Nevertheless, fury and indignation are poorly spent
if allowed to exhaust themselves in vituperation. Their proper use
is to give vigour to action, and, invested in prudence, to achieve
swift and sure redemption. Wise is the advice--

      “Prune thou thy words, the thoughts control
        That o’er thee swell and throng:
      They will condense within thy soul,
        And change to purpose strong.”

The National League holds an annual conference in some convenient
centre, to which representatives from affiliated societies are
appointed. Many of these societies co-operate for the defence of
their members under prosecution; they organise public meetings and
discussions; provide lectures; distribute tracts; bring to light
vaccination disasters; frustrate the attempts of medical men to
get up smallpox panics; and, in short, to do all in their power to
turn confidence aside from a magical, misleading and mischievous
prescription to trust in the common conditions of health, as
verified by science and continual experience.

It is needless to say that these societies excite much annoyance
and evoke much bad language from the practitioners whose craft
they discredit and despoil. Thus, for example, the British Medical
Association, in a petition addressed to Government in 1879,
protesting against any relaxation of the compulsory law, and signed
by several thousand members of the profession, gave voice to the
trade grievance--

  The outcry against Compulsory Vaccination is mainly due to
  certain interested persons [_interested in what?_] who, by
  the dissemination of inflammatory literature and distorted
  statements, stir up opposition to Vaccination on the part of
  ignorant and thoughtless people.

Here what is wished to be taken for true is set forth as fact.
Whatever the opponents of vaccination may be, they are neither
ignorant or thoughtless, nor do they influence the ignorant and
thoughtless. On the contrary, it is their exact acquaintance
with the history and theories, the inutility and dangers of the
multiform rite, designated vaccination, which renders them such
dangerous and disagreeable antagonists. Further be it said,
compulsory acquaintance with vaccination has been for thousands an
introduction to vigorous intellectual life. It has demonstrated
the fallibility of authority, and how it is possible for what is
accounted established beyond dispute to be false to the core.
Certain it is that ere long vaccination will be ranked among the
crassest of human follies, and what force that exposure will lend
to scepticism in conflict with other forms of conventional opinion,
may be left to the consideration of the judicious reader.

The London Society for the Abolition of Compulsory Vaccination was
formed in 1880 with objects thus defined--

  1.--The Abolition of Compulsory Vaccination.

  2.--The Diffusion of Knowledge concerning Vaccination.

  3.--The Maintenance of an Office in London for the Publication of
  Literature relating to Vaccination, and as a Centre of Action and
  Information.

An office was opened in Victoria Street, Westminster, with Mr.
William Young, as secretary, and _The Vaccination Inquirer_,
established by Mr. William Tebb in 1879, was adopted as the organ
of the Society. The executive committee, liberally assisted by the
Countess de Noailles, Mr. P. A. Taylor, Mr. Tebb, and others, have
been enabled to make many and visible marks on public opinion,
which by all means possible they are ever intent to repeat. Mr.
J. G. Talbot, M.P. for Oxford University, took early opportunity
to stigmatise the London Society as a Murder League, and Dr.
Barrow, president of the British Medical Association in 1881, as “a
Disgrace to Humanity”--these and similar amenities being taken as
badges of honour and tokens of success. The London Society has also
actively co-operated in successive International Anti-Vaccination
Congresses--at Paris in 1880, at Cologne in 1881, and at Berne in
1883.

Of late years the literature of anti-vaccination has been steadily
increasing in volume, variety and power. A notable effort to
bring the question within range of common apprehension was the
publication in 1876 of _Our Medicine Men_, by Mr. H. Strickland
Constable. Apart from vaccination, _Our Medicine Men_ is a pleasant
book, full of anecdote, good humour, shrewdness and excellent
philosophy, not likely to be forgotten by those who make its
acquaintance.[294]

A series of _Vaccination Tracts_,[295] fourteen in number, was
commenced by Mr. Wm. Young in 1877 and completed by Dr. Garth
Wilkinson in 1879. Fuseli, reproaching his contemporaries for
their indifference to Flaxman, said, “You English, you see
with your ears”; and Fuseli’s observation recurs as we think
of the limited repute of Dr. Wilkinson; not that any more than
Flaxman he is unknown, but because he is so _inadequately_
known, probably because he is so frequently at variance with
the fashionable science of the day, nor has paid court to its
fashionable professors. Nevertheless, those who have sense and
courage to recognise what is admirable without direction find in
these _Tracts_ not only vaccination made an end of, but thoughts
new and deep, with felicities of diction and cadence that every
connoisseur in words must appreciate and revert to with delight.
However wide our acquaintance with English literature, a variety
of singular affluence and originality remains until Dr. Garth
Wilkinson has been discovered.

It is a mistake to suppose that all medical men believe in
vaccination in one or any of its varieties. Those who use their
eyes and are not bewitched by prescription or self-interest,
recognise the failure and disasters of the practice, but may not
care to set themselves at open variance with their profession. Many
privately confess their vanishing or vanished faith in the rite,
adding, perhaps, that its dangers are exaggerated, and that it does
little harm with due precaution, whilst affording a comfortable
sense of security to its recipients. Others go further, and wish
the discredit of compulsion were removed from the practice, when
they would leave it to their patients to decide for themselves
to vaccinate or not to vaccinate, they disowning responsibility.
A nobler few decline to hold any terms of compromise with the
imposture, and among these Mr. Enoch Robinson is conspicuous. He
has lectured and debated against vaccination, and by his temperate
and competent advocacy has made converts of the most unwilling
and prejudiced. Moved by a popular compilation in defence of
vaccination, he published a reply to it in 1880, entitled, _Can
Disease protect Health?_[296]--a polemic cogent and perspicuous,
and ingenuous as its opposite was the reverse. As illustrative
of the character of the medical press, it may be mentioned that
advertisements of Mr. Robinson’s pamphlet were declined by _The
Lancet_ and _The British Medical Journal_, it being their rule
to exclude announcements injurious to the interests involved in
vaccination--surely in such quarters a superfluous precaution.
Some people appear to fancy that intolerance is a peculium of
theologians; but they would find abundant cause for a different
opinion if familiar with the medical world.

It is said that inasmuch as the rising generation of medical men
are more roundly educated than their predecessors, they are likely
to deal with vaccination in a more scientific and independent
spirit. The experience of Dr. W. J. Collins at St. Bartholomew’s
Hospital lends reason to the anticipation. Study and observation
confirmed Dr. Collins in his father’s practical judgment, which
he has re-stated firmly and temperately on proper occasions;
supporting it with the wide and open evidence at his command. He
has been heard with patience and favour, nor has he encountered any
but honourable opposition; proving how much depends on the manner
in which a man fights his battle, and how much is conceded to
courage with courtesy. Dr. Collins has argued, “Ought Vaccination
to be enforced?” before the Abernethian Society; he has met Dr. W.
B. Carpenter in public debate; he has discussed the Vaccination
Disaster at Norwich in 1882; he has answered Sir Lyon Playfair; and
he has brought the doctrine of evolution to bear on the generation
of disease.[297] If sometimes we refer to the medical profession
with severity, the recollection of members like Dr. Collins
operates as a check. Still we must be just. Professions, like
kindred trade unions, are controlled by their interests, and there
never was church, or community, or corporation which surrendered
any source of gain, save by external compulsion. Public vaccination
in England represents a medical endowment of £100,000 annually,
which the profession, true to the law of its being, cannot renounce
voluntarily; and there is no sense in shutting our eyes to that
certainty. Of course, it would be absurd to charge medical men
individually with defending vaccination because of the gain
attached thereto: nothing of the kind is intended: but as Hobbes
observed of mankind in the gross, “Even the axioms of geometry
would be disputed if their interests were peculiarly affected by
them.”

When, therefore, it is said that vaccination is a medical question
which may be left to medical men to settle, the answer is--“Nay:
vaccination is paid for out of the public pocket, and whatever the
evidence adverse to its usefulness, it will be upheld as beneficial
by those who profit by it. If those who pay do not object, those
who are paid never will. In face of common experience, we hold it
cannot be otherwise.”

There are fashions in medicine as in millinery: they are started;
they flourish; they pass away; but the permanence of any medical
fashion might be secured if fortified by endowment. Venesection
was once in vogue; now it is scarcely known; but if in its heyday
a law had been passed for its performance at the public expense,
a ring of official venesectors would have been created to justify
the practice against all gainsayers; to deny or explain away every
disaster and fatality; and at all hazards preserve its credit from
reproach; whilst it would cost something like a constitutional
struggle for the nation to escape from the imposition. It is thus
with vaccination. Left to itself, it would, like venesection, have
dropped into disuse; but it acquired permanence from the initial
error--the endowment of the National Vaccine Establishment in 1808.

The enforcement of vaccination supplies a yet stronger reason
for public interference. A church endowed by the State might be
endured by Dissenters, but if submission to any of its offices were
made compulsory, endurance would give place to active resistance.
Such is the case with vaccination. As it is endowed and enforced,
it is hopeless to try to reserve it from general discussion and
denunciation. Since citizens are liable to fine and imprisonment
who withhold their children from the lancet, it becomes their duty
to satisfy themselves as to the character of the operation for
which they are taxed, and with which their families are menaced;
and should their convictions be adverse to its utility and safety,
they cannot do their fellow-citizens better service than by bearing
the testimony of open resistance.

Thus vaccination is translated to politics and made every man’s
business; whilst the interest created by its endowment and
enforcement deprives its medical advocates of judicial authority in
the controversy. It would be as reasonable to expect slaveholders
to denounce slavery, or protected manufacturers to advocate free
trade as for those whose professional prestige and advantage are
involved in the practice to speak the truth about vaccination.
Let us be reasonable. Do men gather grapes of thorns, or figs of
thistles? We should not require of average human nature the virtue
of its rarer forms. Like all monopolies, vaccination endowed and
enforced, is defended with unanimity from within, and must be
attacked and overthrown from without--nevertheless be it said with
_some_ assistance from within, and that assistance most efficient.

It is therefore no cause for surprise that a large share in the
agitation against compulsory vaccination has fallen to laymen. Mr.
George S. Gibbs (cousin of John Gibbs and brother of R. B. Gibbs)
has for thirty years maintained a criticism, chiefly statistical,
of the official defences of vaccination, characterised throughout
by an accuracy which has never been impugned.[298]

Mr. H. D. Dudgeon has been described as “a veritable and venerable
apostle of health.” With a consummate knowledge of hygiene, and a
profound faith in its power to overcome zymotic disease, he has
set forth its principles with such lucidity and persistency that
he has gone far to educate Leicester in setting at naught the
vaccine superstition. To the standard assertion of the vaccinators,
that sanitation is good against all febrile affections, except
smallpox, for which there is no preventive save vaccination (the
sovereign variety being conveniently undefined) he has been an
opponent merciless as truth. Regret is frequently expressed that
the abundant information and admirable sense which pervade Mr.
Dudgeon’s writing have been confined to newspapers and occasional
pamphlets, but it is probable his teaching has been all the more
fruitful because adapted to immediate circumstances.[299] The word
spoken in due season how good it is!

The name of Mr. Alexander Wheeler of Darlington is familiar
wherever vaccination is brought under discussion. Mr. Wheeler’s
interest in the subject was first excited, he writes, by Mr. G. S.
Gibbs, “whose scepticism as to its virtue seemed to me absurd”--

  Mr. Gibbs inquired whether I had examined the question, and when
  I confessed that I had not, he asked if I would read Baron’s
  _Life of Dr. Jenner_. Nothing loath, I accepted the loan of the
  volumes. Doubts began to trouble me with the first volume, and
  the second quite upset my confidence in Vaccination as a positive
  preventive of Smallpox. I then set to work to ascertain with
  what care I could, whether there was any truth in the assertion
  that Vaccination diminished Smallpox or modified its virulence.
  The process of determination was not rapid, but long before I
  had formed a definite opinion, I was satisfied that _Compulsory_
  Vaccination was indefensible; and my first efforts were directed
  to the protection of my own children from the infliction.
  Unsatisfied as to what Vaccination was, or what the Vaccinator
  effected, I clearly saw that the State had no right to enforce a
  practice by no means harmless, nor preventive of Smallpox, nor
  easy to explain the use of.

As lecturer, debater and newspaper controversialist, Mr. Wheeler
has acquired well-earned distinction. Knowing far more of
vaccination, its history, varieties, consequences, and statistics
than his adversaries, they are usually overthrown with a dexterity
realised as horrible and astonishing. Like savages with bows and
arrows, they come forth in the innocence of faith to encounter arms
of precision. In 1878 Mr. Wheeler held a debate with Dr. George
Wyld, an enthusiastic advocate of the cowpox discarded by Jenner
as impotent against smallpox. Sir Thomas Chambers presided, and
the question discussed being, “Is Vaccination worthy of National
Support?” How rash and how futile was Dr. Wyld’s championship is
recorded in the report of the debate.[300]

Mr. William Tebb is another well-known name in connection with the
movement against vaccination. For a time dubious, his attention was
quickened and his course decided by the summons of the St. Pancras
guardians to have his daughter, Beatrice, vaccinated. His refusal
was followed by prosecution after prosecution in the Marylebone
police-court, until at last the guardians gave up the contest as
hopeless.[301] It was a bad day for vaccination when the compulsory
law was applied to Mr. Tebb. As with many others, persecution
made of him an inflexible and active antagonist. His tongue, his
pen, and his purse, coupled with untiring industry and eminent
executive ability, have been devoted to the exposure and overthrow
of the conjoint superstition and tyranny. Mr. Tebb is a fine
exemplification of Sir T. Fowell Buxton’s opinion, “Vigour, energy,
resolution, firmness of purpose--these carry the day. Is there
one whom difficulties dishearten, who bends to the storm? He will
do little. Is there one who will conquer? That kind of man never
fails:” adding, “The longer I live, the more I am certain that the
great difference between men, between the feeble and the powerful,
is energy--invincible determination, a purpose once fixed, and then
death or victory. That quality will do anything that can he done
in this world.”[302]

Mr. P. A. Taylor’s speeches in the House of Commons have been
widely read, but his Letter to Dr. W. B. Carpenter has been,
perhaps, the most effective contribution to the good cause.[303]
Dr. Carpenter had volunteered for the defence of vaccination, and
had challenged Mr. Taylor; and being of a credulous and uncritical
habit of mind, he collected and recited the various legends and
factitious statistics that form the body of vaccination, with
additions from his private resources; thus constituting himself an
objective of attack, and providing Mr. Taylor with an excellent
opportunity. Mr. Taylor accepted the challenge: he captured and
destroyed Dr. Carpenter’s positions seriatim, leaving him routed
and helpless. The Letter has had an immense circulation, and its
influence on public opinion is manifesting itself in a thousand
ways. Neither Dr. Carpenter nor any vaccinator has ventured to
reply to Mr. Taylor; the fact being that no reply is possible.
Any one who attentively reads Mr. Taylor’s Letter cannot fail to
perceive that the practice represented by Dr. Carpenter is rooted
in illusion and imposture. Silence under the circumstances may
therefore pass for discretion: silence on Dr. Carpenter’s part
possesses a significance it would be difficult to misinterpret.
Indeed, none know better than those responsible for vaccination as
a medical interest, that the less it is brought under discussion
the more likely it is to endure. _Quieta non movere_ is their
motto; and officious champions like Dr. Carpenter have little
thanks for their restlessness.

Correspondence in newspapers is a well-recognised means for the
diffusion of new ideas, and in the use of this means the opponents
of vaccination have acquired no little distinction. There is an
increasing number throughout the country who not only know their
own case, but the case of their adversaries better than do their
adversaries themselves; and if an editor has grace enough to
maintain a fair field and show no favour, the issue is invariably
satisfactory. Two able correspondents, who have gone hence, are
especially worthy of mention--Andrew Leighton and William Gibson
Ward. Mr. Leighton was a Liverpool merchant, who, having become
interested in the vaccination question, made its discussion the
occupation of his leisure. With a clear and logical mind, patient,
sagacious, and tolerant, prejudice itself could scarcely withstand
his sweet reasonableness. Almost to the day of his death, 14th
January, 1877, he was engaged in newspaper controversy, each
letter bearing witness to his admirable temper and persuasive
power.[304] Mr. Ward of Perriston Towers was a man of wide reading
and perfervid character, who wrote and talked after the manner of
Cobbett, whom in many respects he resembled. Having discovered the
truth as concerned vaccination, he applied himself vigorously and
successfully to its diffusion. He sustained his prosecution as a
parent with the joy of one who delights in battle; and, indeed,
as it was said, a periodical prosecution would have suited him
exactly, providing him with occasion for a rousing speech in
court and a discussion with the bench, to be duly reported in
the Herefordshire newspapers. Mr. Ward died 18th October, 1882.
Latterly he had access to _The Times_, and followed up a series
of letters on subjects he had made his own with one on which he
argued, that smallpox was neither an unmixed evil, nor a cause of
extra mortality.[305]

To enter into a closer enumeration of those engaged in the movement
against vaccination would be invidious and bound to imperfection.
Still it would be grateful to refer to the various services of
veterans like Sir Jervoise Clarke Jervoise, Mr. Thomas Baker,
Dr. Edward Haughton, Mr. T. B. Brett of St. Leonards, Mr. Edmund
Proctor of Newcastle, Mr. John Lucas of Gateshead, Mr. R. A.
Milner of Keighley, Mr. W. F. Fox of Dewsbury, Dr. E. J. Crow of
Ripon, Mr. Francis Davis, jun., of Enniscorthy, Mr. Wm. Thurlow
of Sudbury, Mr. Wm. Adair of Maryport, Mr. Charles Gillett of
Banbury, Dr. T. L. Nichols, Mr. James Burns, and Mr. Amos Booth
of Leicester. These and others have borne the odium of despised
truth, and live to see it steadily acquiring favour and force,
whilst the delusion to which it is opposed is entering the region
of scepticism preparatory to dispersion and contempt.

All means are good against evil, but deeds are more than words; and
talk against vaccination counts far less than resistance to its
infliction. The more who are withheld from the rite, the more live
to prove its inutility; and the more the law designed to enforce
is set at defiance, the surer and sooner will be its overthrow.
Nevertheless, let us not forget what this warfare costs, nor how we
are indebted to the men and women, brave, tender, and true, by whom
it is endured. As a rule, the rich are exempt: the contest is with
the poor. As Mrs. Jacob Bright says--

  I object to Compulsory Vaccination because it is an outrageous
  piece of class legislation. No one in easy circumstances, no one
  possessing the luxury of a family doctor, need have his child
  vaccinated. He has only to tell his family doctor that he objects
  to Vaccination, and the matter is at an end. Did ever any one
  hear of a family doctor who threatened to prosecute the head of
  a family for nonconformity in this respect? I think not. But
  the family doctor of the poor is the parish doctor. He is quite
  independent of his patient, and being paid by other people to
  vaccinate them, he not only vaccinates them in many cases against
  their will, but he does it _when_ he likes, and with _what_ virus
  he likes, irrespective of the feelings or opinions they may
  entertain.

  I was riding some time ago in Sherwood Forest, and stopped to
  ask for a glass of water at a cottage, where a poor woman was
  standing with her fat little baby in her arms. I said, “You’ve
  got a pretty boy there. Has he been vaccinated?” The mother’s
  face, which was glowing with pride at praise of her boy, suddenly
  fell, and she said, “No, madam, he hasn’t, but he’ll have to be.
  We’ve lost one through it,” she added, with tears in her eyes.
  She is one of a great number of poor people who, rightly or
  wrongly, believe that Vaccination is dangerous, and yet are not
  able to resist the pressure put upon them to vaccinate; they are
  too poor, and in most cases have not the spirit to resist.

  I say that it is disgraceful to fine and imprison people for
  forming an independent opinion on a medical question; and it is
  particularly disgraceful that my poor neighbour should be thus
  persecuted when I am free, absolutely free, to please myself
  whether my children shall be vaccinated. It is not possible that
  this thing can continue.[306]

The contest, be it repeated, is with the poor. “There is no
getting over the fact,” says Dr. John Scott of Manchester, “that
vaccination is hated among the working class, in Lancashire, at
least.” Vaccination is hated, and rightly hated, and the law is set
to overcome that hatred. Multitudes submit because they either know
not how, or dread to do otherwise; but an honourable and increasing
number prefer the better part--holding by what they recognise for
right, resolved to obey God rather than man. It has been said,
“The days of martyrdom, like those of miracles, have ceased”; but
have they? The record of humble English folk, who, during the
past thirty years, have withstood the infamous Vaccination Acts,
bears witness to the contrary. Martyrdom and heroism are rarely
recognised by those who occasion or dislike their manifestation:
it is sympathy that opens the eyes to their appearance. Unknown
or despised, these medical nonconformists have stood true to
their faith in the order of nature against doctor-craft, and have
counted nothing dear to them if so be they could preserve their
children and conscience from outrage. They have been prosecuted
with all the malice and pertinacity of petty authority--of Justice
Shallow and Bumble; have been insulted from the judgment seat; have
been fined to the uttermost farthing and loaded with uttermost
costs, and this repeatedly; have had their goods and furniture
distrained, and their homes broken up; have been sent to jail
with hard labour, and subjected to every indignity and cruelty of
the prison-house; have been hunted from parish to parish, and in
despair driven to exile. And these have been Englishmen, the law
English, and the time our own! The Master of the Rolls recently
observed, “What is contrary to the feelings of every honest man
cannot be the law of England--or, if it be, the sooner it ceases
to be law the better.” It would be unfair to charge the injustice
of the Vaccination Acts to the English people. To most of them
their character and operation are unknown. The chief sufferers are
hidden under the hatches of poverty, and are unable to make the
land resound with their wrongs. Those, too, who essay to speak
for them are confronted with that obdurate dulness with which the
early Free-Traders had to contend when restriction was thought to
be as good for commerce as cowpox is thought to be good for health
in stopping smallpox. Mr. Bright, in praising the speeches of Mr.
Villiers at Birmingham, 29th January, 1884, remarked--

  I mention their publication to revive the strange and painful
  fact that during the years when those speeches--so convincing,
  so absolutely unanswerable, were spoken in the House of Commons,
  they were addressed, as it were, to men morally stone deaf.
  The arguments were not answered, the facts adduced were not
  disproved, the appalling suffering of the people was not denied.

A similar deafness to the oppression of compulsory vaccination
prevails, though there are signs of awakening. Still it is not for
those who suffer to wait on politicians. The words are trite, but
true as trite--

                                      “Know ye not,
      Who would be free, themselves must strike the blow?”

Many are discovering that in union is strength. Combinations for
mutual protection and insurance against penalties are multiplying.
Resist and Organise is their watchword: organise, study the
law, find out its weak places, make the most of them, harass
its administrators, vote only for guardians who are opposed to
compulsion; and, in short, do whatever is possible to frustrate
the pernicious legislation.

Sometimes it is asked, “Why not obey the law and agitate for
its repeal?” but the suggestion is designed for stultification.
Suppose the Society of Friends had consented to take oaths until
the law was adjusted to their consciences, would they not have
been swearing to this day? Suppose some dissenters had not refused
to pay church rates, when would church rates have been abolished?
Suppose the Irish had submitted to English rule until convinced by
reason of the wickedness and folly of their domination, how long
would they have had to wait for the redress of their wrongs? Such
questions might be run over pages, but to what purpose? All know
(unless submerged in cant) that those who would have must take;
and that no man’s rights can be entrusted to another’s good-will,
be the trustee ever so just. Vaccination is a medical monopoly
established, endowed, and enforced--a tyranny to be overthrown.
Those who profit by it will never consent to its surrender,
whatever the evidence of its inutility and mischief: it would be
against experience to expect otherwise: and they will never be
so valiant in defence of their monopoly, and so profuse in the
assertion of its overwhelming advantages, as when its dissolution
is imminent. The wise understand these things. There is, therefore,
but one way in which to get rid of the incubus, and that way is
outright resistance. Already such resistance has proved successful
in several parts of the country. The law has been reduced to
abeyance, and similar resistance will be rewarded with similar
results. Moreover, further legislation in favour of vaccination has
been checked. Parliament will pass no more Vaccination Acts. The
plague thus far is stayed: the worst possible has been seen: the
business is to clear away what remains.

       *       *       *       *       *

It is sometimes said that vaccination is unnatural, and the saying
is disregarded as unscientific or absurd. But is it unscientific?
and is it absurd? Men deserve an order in Nature, and when they
perceive that any procedure is at variance with that order, they
instinctively condemn it as unnatural, though possibly they may be
unable to give a philosophic account of their aversion.

We unite in the assertion that vaccination is unnatural, and when
we are asked, Why? we answer, Because it is an operation which
violates the order maintained in the formation of the blood. If
we follow food into the stomach and attend to the processes of
digestion, rejection, and assimilation--the infinite care, in
short, with which blood is made, we shall start back with dislike,
and even horror, from a practice which sets at naught all this
care; which attacks the blood directly, and attacks it to poison
it. Hence it is that vaccination is stigmatised as unnatural,
being a process which not only reverses the course of Nature in
blood-making, but doubly unnatural, as violating that course and
poisoning its product.

To re-affirm and illustrate our meaning, we take the following
piece of physiological poetry, poetic yet scientifically accurate,
from Dr. Garth Wilkinson--

  In the human body, whatever enters the blood, be it even the
  most bland food, the juice of the grape or the pomegranate, or
  the fine flour of wheat, be it oil, wine, or fig, is broken up
  first, and then led inwards through long avenues of introduction.
  The most innocent food goes in most easily and first. The police
  and surveillance for the rest are exceeding great and many. The
  senses electively appetise the fine food; it has to pass through
  their peremptory doors of liking and disliking; instructed doors
  of memory, association, imagination, reason, wisdom, religion,
  in adults. It is then attacked by digestive salivas, tests,
  examinations, and severe juices, and questioned to the uttermost
  in that degree, which corresponds to the former. It is strained
  through organ after organ; each a tribunal of more than social
  exactitude. It is absorbed by the finest systems of choice in
  pore and vessel, organic judgment sitting in every corner, and
  presiding over each inner doorway. It is submitted to glandular
  and lung purifications, and their furnaces of trials and
  eliminations. At last it is weighed in the balances, and minted
  by supreme nerve wisdoms; and only after all these processes is
  it admitted into the golden blood. This of the best food, such
  as good and wise men eat. The worst food is made the best of by
  a constant passage through bodily mercies and mitigations--a
  no less sedulous though a penal process. This is physiology,
  and divine-human decency, and like a man’s life. Vaccination
  traverses and tramples upon all these safeguards and wisdoms;
  it goes direct to the blood, or, still worse, to the lymph, and
  not with food; it puts poison, introduced by puncture, and that
  has no test applicable to it, and can have no character given
  to it but that it is fivefold animal and human poison, at a
  blow into the very centre, thus otherwise guarded by nature in
  the providence of God. This is blood assassination, and like a
  murderer’s life.[307]

Finally, vaccination is an attempt to swindle Nature. The
vaccinator says, “Come, my little dear, come and let me give you a
disease wherewith I shall so hoax Nature that henceforth you may
live in what stench you please, and smallpox shall not catch you.”
But can Nature be swindled? can Nature be hoaxed? Mr. Lowell, in
praising the genius of Cervantes, says, “There is a moral in _Don
Quixote_, and a very profound one it is--that whoever quarrels
with Nature, whether wittingly or unwittingly, is certain to get
the worst of it.” There is sometimes an apparent triumph over
Nature. We do wrong, and fancy we may evade the penalty by some
cunning contrivance, but ere long we perceive with dismay that the
consequences were only concealed or staved off, and that we have to
answer to the uttermost farthing. Vaccination is a dodge kindred
with incantations and similar performances whereby it is hoped to
circumvent the order of the Highest, and compel his favour apart
from obedience to his will. By artifice it is attempted to obviate
a consequence of ill-living, whilst persisting in ill-living; but
if it were possible to escape smallpox by such means, we should
have equal punishment in some other mode. No: smallpox with its
alternatives and equivalents can only be avoided through compliance
with the old-fashioned prescription, “Wash you, make you clean;
cease to do evil, learn to do well.” The lesson is hard to learn,
and harder to practise; but there is no evading it if we would be
healthy and happy. Wherefore all tricks like vaccination are bound
to nullity and disaster. As Hosea Biglow says--

      “You hev gut to git up airly
        Ef you want to take in God.”

       *       *       *       *       *

  WILLIAM A. GUY, F.R.C.P., F.R.S.

  Is Vaccination a preventive of Smallpox? To this question there
  is, there can be, no answer except such as is couched in the
  language of figures.--_Journal of the Statistical Society_, 1882,
  vol. xlv. p. 414.

  G. F. KOLB,

  _Member of the Royal Statistical Commission of Bavaria._

  From childhood I had been trained to look upon Cowpox as an
  absolute protective from Smallpox. I believed in Vaccination
  more strongly than in any ecclesiastical dogma. Numerous and
  acknowledged failures did not shake my faith. I attributed them
  either to the carelessness of the operator or the badness of the
  lymph.

  In course of time the question of Compulsory Vaccination came
  before the Reichstag, when a medical friend supplied me with a
  mass of statistics in favour of Vaccination, in his opinion,
  conclusive and unanswerable. This awoke the statistician
  within me. On inspection, I found the figures delusive; and
  closer examination left no shadow of doubt in my mind that the
  statistical array of proof represented a complete failure.

  My investigations were continued, and my judgment was confirmed.
  For instance, Cowpox was introduced to Bavaria in 1807, and for
  a long time none, except the newly-born, escaped Vaccination;
  nevertheless in the epidemic of 1871, of 30,472 cases of
  Smallpox, no less than 29,429 were vaccinated, as is shown in the
  documents of the State.--_From Letter to_ MR. WILLIAM TEBB, _22nd
  January, 1882_.


FOOTNOTES:

[293] _The Statistics of the Medical Officers to the Leeds Smallpox
Hospital Exposed and Refuted in a Letter to the Leeds Board of
Guardians._ By John Pickering. Leeds, 1876.

[294] Mr. Constable’s publications have been as follows--

    _Medical Evidence in the Case of Dale_ v. _Constable_. York, 1872.
        Pp. 30.
    _Doctors, Vaccination, and Utilitarianism._ York, 1873. Pp. 239.
    _Our Medicine Men: a Few Hints._ Hull, 1876. Pp. 689.
    _Fashions of the Day in Medicine and Science._ Hull, 1879. Pp. 300.

[295] _Vaccination Tracts with Preface and Supplement._ London,
1879. Pp. 348.

[296] _Can Disease protect Health? being a Reply to Mr. Ernest
Hart’s pamphlet, entitled The Truth about Vaccination._ By Enoch
Robinson, M.R.C.S. London, 1880. Pp. 38.

[297] _A Review of the Norwich Vaccination Inquiry._ London,
1883. _Sir Lyon Playfair’s Logic._ London, 1883. _Specificity and
Evolution in Disease._ By W. J. Collins, M.D., B.S., B.Sc. (Lond.)
London, 1884.

[298] The first publication of Mr. Gibbs, _The Evils of
Vaccination_, is dated 1856: the latest is a reply to the question,
“Is Vaccination Scientific?” in _The Journal of Science_, March,
1884.

[299] An article, “Compulsory Vaccination,” in evidence of Mr.
Dudgeon’s quality, will be found in _The Westminster Review_, No.
CXXX., April, 1884.

[300] _Vaccination: Is it Worthy of National Support? A Public
Discussion in South Place Chapel, Finsbury, on 28th May, 1878_,
under the Presidency of Sir Thomas Chambers, M.P., Recorder of the
City of London. London, 1878.

Mr. Wheeler has published the following pamphlets--

  _Vaccination in the Light of History._ London, 1878.

  _Vaccination--Opposed to Science and a Disgrace to English Law._
  London, 1879.

  _Vaccination--1883._ London, 1884.

[301] _Government Prosecutions for Medical Heresy; a Verbatim
Report of the case Regina_ v. _Tebb_. _Dedicated to the Board
of St. Pancras Guardians. With an Introduction and Appendix of
Illustrative Matter._ London, 1879.

[302] Mr. Tebb’s publications have been many, and his last is
especially noteworthy--_Compulsory Vaccination in England: with
Incidental References to Foreign States_. London, 1884. Pp. 64.

[303] _Vaccination. A Letter to Dr. W. B. Carpenter, C.B._ By P. A.
Taylor, M.P. London, 1881.

[304] Mr. Leighton published nothing outside the newspapers except
a letter addressed to William Chambers of Edinburgh, entitled, _The
People of Dewsbury and Vaccination_. London, 1876.

[305] “A New View of Smallpox.”--_The Times_, 25th December, 1879.

[306] Letter from Ursula M. Bright to Annual Meeting of the London
Society for the Abolition of Compulsory Vaccination, held in
Shoreditch Town Hall, 13th May, 1884.

[307] _On Human Science, Good and Evil, and its Works; and on
Divine Revelation and its Works and Sciences._ London, 1876.




INDEX.


  Abbott, Mr., speaker, House of Commons, 219.

  Abercrombie, Sir Ralph, 396.

  Aberdeen degrees, 330.

  Aberdeenshire, Maitland at home, 34.

  Acksell, Dr., 408.

  Adair, William, 590.

  Adams, Dr., Waltham, uses smallpox cowpox, 76.

  Adams, Dr., pearly pox for variolation, 120;
    on cowpox before Jenner, 138.

  Adams, American president, 379.

  Adderley, Sir Charles, 553.

  Addington, Mr., 186, 195.

  Addington, John, surgeon, 189, 218.

  Addison, W. J., evidence House of Commons’ committee, 1871, 556.

  Alexander, Emperor of Russia, cautioned by Jenner against Walker, 329;
    disappoints Jenner, 362;
    enforces vaccination, 406.

  Allen _v._ Worthy, 551.

  Alsop, Mr., surgeon, Calne, 130.

  Amelia, Princess, variolated, 18, 22.

  Anderson, Mr., Madras, fraud, 387.

  Anderson, Dr., Leith, 151.

  Angerstein, Mr., 230.

  Antimony, tartarated, substitute for cowpox, 121, 348.

  Anti-Vaccination Congresses--Paris 1880, Cologne 1881, Berne 1883, 581.

  _Anti-Vaccinator_, Henry Pitman’s, 544;
    John Pickering’s, 574.

  Anti-Vaccinators, characterised by Robert Lowe, 528;
    by Simon, 558-59;
    by Marson, 563;
    by Seaton, 569;
    by British Medical Association, 580;
    by J. G. Talbot, M. P., and by Dr. Barrow, 581.

  Aspinwall, Dr., variolator, Boston, 376, 377.

  Atheism imputed to variolators, 42.

  Austria, death-rates compared with those of England, 506.

  Avelin, Professor, vaccination in Prussia, 405.

  Ayrton, A. S., vaccinators should be subject to penalties, 532.


  Badcock, Mr., Brighton, produces and uses smallpox cowpox, 75, 272,
        472, 512, 514.

  Bagehot, Walter, 8.

  Baillie, Dr., witness for Jenner, 190.

  Baker, Sir George, practice of the Suttons, 47.

  Baker, John, one of Jenner’s victims, 117, 154.

  Baker, Thomas, 509, 590;
    evidence House of Commons’ committee 1871, 555.

  Bakewell, Dr. R. H., evidence House of Commons’ committee 1871,
        559-560.

  Ballard, Dr., prize Essay on Vaccination, 547, 548.

  Balmis, Dr. F. X., expedition as trader and vaccinator, 401.

  Banks, Mr., Jenner’s claims, 195, 233.

  Banks, Sir Joseph, 146, 147, 226.

  Baptism conjoined with vaccination, 276.

  Barbados, variolation, 38.

  Barge, Mary and John, 104, 119.

  Baron’s _Life of Jenner_, 349-363, 586.

  Baron, Dr. John, romance as to Jenner’s early years, 94;
      extra-ordinary narrative, 95;
      gush over George IV., 220;
      Jenner _v._ Walker, 226;
      Jenner’s shyness, 230;
      letter from Jenner on Grosvenor case, 319;
      first meeting with Jenner and attitude toward him, 349, 352;
      appalled by no inconsistency, 354;
      nor admitted change of mind in Jenner, 355-356;
      rant over Balmis expedition, 402;
      Jenner’s inability to count, 416;
      Dr. Watt’s mischievousness, 452.
    Uses and sends Jenner equine virus, 269;
      apology for confounding horsegrease with horsepox, 270.

  Barrow, Dr., “a disgrace to humanity,” 581.

  Barrow, Mr., 538.

  Barttelot, Colonel, 537.

  Bath Vaccine Pock Institution, 163.

  Bathurst, Lord, servant variolated and died, 34.

  Batts of Temple variolated, 19.

  Bavaria, results of vaccination, 596.

  Beale, Dr. Lionel, much vaccinated, 302.

  Beaufort, Duke of, 176.

  Beddoes, Dr., cowpox, 138;
    smallpox after cowpox, 165.

  Bedford, Duke of, 219, 220.

  Bengal subscription to Jenner, 390.

  Berkeley, Jenner’s birthplace and home, 92;
    inhabitants variolated, 99.

  Berkeley, Admiral, 186, 194.

  Berkeley, Earl of, 176, 191.

  Berlin Royal Vaccine Institution, and Jennerian feast, 405.

  Berne Anti-Vaccination Congress, 1883, 581.

  Birch, John, variolation harmless, 66;
    treatment of smallpox a chief cause of fatalities, 85;
    summoned on Jenner’s case, 187;
    character of his opposition to vaccination, 274;
    scorn for means used to extend craze, 276;
    nature of evidence submitted to House of Commons, 276;
    desire to know what cowpox was, 277;
    absurdity of spurious cowpox, 277;
    what had Jenner discovered? 278;
    assertion that cowpox was harmless and would never prove fatal, 279;
    futility of variolous test, 279;
    smallpox following vaccination, 280;
    Jenner pestered with failures, 280;
    fine promises belied, 281;
    death and epitaph, 281, 282;
    Jenner’s treatment of Birch, 283;
    mention in _Edinburgh Review_, 290.

  Birch, Penelope, reprints brother’s papers, 281,
      and erects his monument, 282.

  Blandford fire and smallpox, 85.

  Blane, Sir Gilbert, 83, 397;
    witness for Jenner, 187;
    estimate of smallpox for United Kingdom, 208, 209.

  Bleeding, 519, 584.

  Blistering, 519.

  Blood-making, process described, 594-595.

  Bombay, vaccination introduced, 385, 388;
    subscription to Jenner, 390.

  Bompas, flaming fire-brand, 77.

  Booth, Amos, 590.

  Boringdon, Lord, bill to suppress variolation, 73, 353.

  Boston, variolation first practised, 2-4, 7, 377;
    completely variolated, 57;
    method of practice, 58, 373;
    smallpox in 18th century, 371-373.

  Bouley, Prof., experiments with horsepox, 273.

  Bourne, Sturges, denounces variolation, 72, 246.

  Boy, cowpox ox-faced, 297.

  Boylston, Dr. Zabdiel, variolation in New England, 2, 5-7, 56, 371.

  Bowman, Mr., Newcastle, 550.

  Bradley, Dr., Jenner’s conjectural income, 188.

  Brady, Mr., liberal pay for vaccination, 536.

  Bragge, Mr., surgeon, attempts use of cowpox, 138.

  Brahmins hold cowpox impure, 387.

  Bread, Beef and Beer, 88, 316.

  Bremer, Dr., vaccinations in Berlin, 406.

  Brett, T. B., St. Leonards, 590.

  Bridgewater, Duke of, son variolated and killed, 34.

  Bright, Jacob, 553;
    cites Gregory against Marson on marks, 561.

  Bright, John, deafness of House of Commons, 592.

  Bright, Ursula M., forcible vaccination of poor, 590.

  _British Medical Journal_, refusal of advertisements, 582.

  British Medical Association on anti-vaccinators, 579-580.

  Brodie, Sir Benjamin, medical practice, 92.

  Brotherton, Joseph, 501.

  Brown, Thomas, Musselburgh, criticism of vaccination, 285;
    sees vaccinated with smallpox, 286;
    fallacy of variolous test, 287;
    attempted refutation by Edinburgh vaccinators, 287;
    re-affirmed position in 1842, 288;
    Jenner’s malice toward, 351;
    Moore’s insolence, 457;
    confession that Brown was in the right, 458;
    cited by Hamernik against re-vaccination, 520.

  Browne, Hawkins, 246.

  Bruce, H. A., spokesman for vaccination ring, 530-531;
    untruthful statement, 537-538.

  Bryce’s Test, 353.

  Buchan, Dr. William, _Domestic Medicine_, 53;
    recommends variolation, 54;
    appeal to clergy, 54;
    mortality from smallpox and variolation, 66;
    maltreatment of smallpox, 85;
    prevalence and cause of scurvy, 87-88;
    denounces tea, 90.

  Bullpox, 144, 272, 374.

  Burdett, Sir Francis, scepticism as to vaccination, 253.

  Burnet, Mr., prosecuted for variolation, 463.

  Burns, James, 590.

  Burrows, Dr., London bills of mortality, 1818, 77.

  Burrows, Sir J. Cordy, production of smallpox cowpox, 76.

  Butler, Bishop, national insanities, 91.

  Buxton, Sir T. Fowell, 587.

  “Buying the smallpox,” 29.

  Byng, Lady, two children variolated, 21.


  Calcraft, Miss, Jenner on Grosvenor case, 320.

  _Calcutta Gazette_, 1804, 383.

  Cameron, Dr., smallpox cowpox, 273.

  Candlish, John, 565, 567, 577;
    repeated prosecutions, 550-552;
    witness before House of Commons’ committee 1871, 553.

  Canning, George, declaration as to compulsory vaccination, 254, 310,
        476, 480, 485.

  Canterbury, Archbishop of, would not commit Church, 275.

  Carioli, syphilis invaccinated, 523.

  Carlyle, stupidity, 19;
    teeth outwards, 215;
    swarmery, 291, 292;
    injustice by law, 548.

  Caroline, Princess of Wales, has six felons variolated, 14;
      six charity children, 17;
      her own children, 18, 22;
    promoter of Maitland’s experiments, 171.

  Carpenter, Dr. W. B., answered by Dr. Collins, 583,
      and by P. A. Taylor, 588.

  Carter, R. Brudenell, invaccination of syphilis, 310.

  Catharine, Empress of Russia, variolated, 62, 362, 514;
    payment to Dimsdale, 64.

  Catpox, 170.

  _Caution against Vaccine Swindlers_, 326.

  Ceely of Aylesbury generates smallpox cowpox, 75, 272, 472, 514, 528.

  Cervantes, 595.

  Ceylon, variolation and vaccination, 345;
    smallpox, 392-393; 408.

  Chadwick, Edwin, “Keep your eye on the death-rate,” 450.

  Chambers, Sir Thomas, denies that smallpox increases mortality, 439;
    his prophecy, 538;
    Wheeler and Wyld debate, 586.

  Chambers, Wm., Andrew Leighton’s letter to, 589.

  Chapman, Mrs., variolator, 44.

  Charlotte, Queen, 171, 219, 221, 370, 380.

  Chastellux, 59.

  Chavasse, Dr., ravages of smallpox, 77.

  Chemists and apothecaries friends of smallpox, 325.

  Chester smallpox in 18th century, 69.

  Cheyne, Dr. George, prevalence of scurvy, 87-88.

  Chickenpox, _alias_ smallpox, 366-367.

  China, vaccination introduced, 386, 393.

  Chinese method of variolation, 16, 394.

  Chincough, Watt’s treatise, 439.

  Christ’s Hospital, smallpox from, 15;
    mortality of smallpox among inmates, 23, 32, 524.

  Christie, Dr. Thomas, Ceylon, 392.

  Chiswell, Sarah, 8, 10.

  Cholera, 1831-32, 448.

  Church-rates, compulsory, 542, 560, 593.

  Clarence, Duke of, (William IV.) 171, 191, 219.

  Clarke, Dr., advocates compulsory vaccination, 305.

  Cline, Henry, letter describing first vaccination, 128;
    advises Jenner to come to London, 129;
    witness for Jenner, 189;
    apology for Walker, 227;
    National Vaccine Establishment, 459.

  Cobbett, William, shuffles of quackery, 20;
    in Gray’s Inn, 81;
    denounces potatoes and tea, 89-90, 316;
    power in common sense, 304;
    vaccination fury, 305;
    addresses Wilberforce on compulsion, 305;
    endowment of vaccination, 307, 311;
    its proved failure, 308;
    spurious cowpox dodge, 309;
    foresees invaccination of syphilis, 309, 531;
    _Advice to Young Men_, 312;
    smallpox-made-milder dodge, 313;
    had Cobbett followed Jenner, 314;
    children variolated, 315;
    sanitary science undiscovered, 316;
    honourable prejudices, 317.

  Cockburn, Lord Chief Justice, unvaccinated infants, 77;
    repeated prosecutions, 551.

  Cockermouth and Dr. Walker, 220, 325.

  Codd, Philip, son vaccinated by Jenner takes smallpox, 312.

  Cole, James, infected with horsegrease, 115.

  Collins, William, painter, 448.

  Collins, Dr. W. J., opponent of vaccination, 543, 547;
    evidence House of Commons’ committee, 1871, 554.

  Collins, Dr. W. J., 583.

  Colchester, itch and vaccination in 85th Regiment, 126, 277.

  Coldbath Fields Smallpox Hospital, 40.

  Colliander, Dr., Swedes decline variolation, 408.

  Cologne Anti-Vaccination Congress, 1881, 581.

  Combe, Andrew, 427.

  Combes, The, 449.

  Common-sense defined, 303.

  Condamine, La, 59.

  Coningham, William, 529.

  Connah, Mr., Seaford, rarity of smallpox, 83.

  Connell, Ira, 545.

  Constable, H. Strickland, writings, 581.

  Constantinople, practice of variolation, 1, 8, 11, 12, 18.

  Convulsions, enormous death-rate in London, 80.

  Cook, Turkey merchant, 15.

  Cook, Captain, and Jenner, 92.

  Cooke, C., cowpox did not prevent smallpox, 165.

  Copenhagen, smallpox and vaccination, 420.

  Copland, Dr., scepticism as to vaccination, 478.

  Corfield, Dr., “the falsest of falsehoods,” 86.

  Cornwallis, Marquis, 398.

  Corrigan, Sir Dominic, evidence House of Commons’ committee, 1871,
        560-561, 567.

  Corry, Mr., withdraws 1866 vaccination bill, 532.

  Cortez, Mexican smallpox, 511.

  Corvisart and Jenner, 400.

  Cother, Mr., variolates Jenner’s child, 357;
    resulting scandal, 358.

  Cough, Whooping, Newcastle, 429, 430;
    Glasgow, 439-443;
    England and Wales 1838-40, 505.

  Courtney, Mr., amazing estimate, 194.

  Covent Garden grave-yard, 82.

  Covington, F., evidence House of Commons’ committee, 1871, 555.

  Cowper, William, 80, 576.

  Cowper, W. F., 496;
    operates in House of Commons for Epidemiological Society, 497;
    extreme docility, 498;
    answer to Mr. Duncombe, 499;
    simple-minded defence of compulsion, 500.

  Cowpox, Jenner’s cases in _Inquiry_, 104-108;
      assures absolute security from smallpox unaffected by time, 105,
            121, 141;
      incommunicable to those who have had smallpox, 106;
      taken repeatedly, 107, 108, 141;
      action in conjunction with smallpox, 150;
      cowpox and smallpox modifications of same disease, 166;
      description of in cow and man, 109;
      generation in horsegrease beyond possibility of denial, 100, 110,
            112;
      reasons for this belief, 154;
      difficulty of proof, 100;
      indistinguishable in effects from horsegrease, 156, 157;
      an uncommon and erratic disease, 75;
      probable extinction, 111;
      when it ought to be taken, 111;
      its inflammation always erysipelatous, 143;
      sores eat into flesh, and action checked with escharotics, 157;
      recommended as an expulsive irritant, 123.
    Mr. Knight attests common faith, 132;
      notorious belief in its prophylaxy, 94, 136-139, 179;
      Jesty and Nash’s claims, 94-95, 204-206;
      unnoticed in Cheshire, 133;
      well known in south and unknown in north of England, 137;
      known in Gloucestershire _not_ to prevent smallpox, 95, 165;
      inquiry of Ingenhousz in Wilts, 130;
      unknown in New England, 375;
      unknown in bulls, 144, 272.
    Discovered, 1799, in London, 145;
      distributed by Pearson, 146;
      its diverse action, 149;
      Jenner’s views discriminated from Pearson’s, 153, 178, 198, 203,
            347.
    Spurious Cowpox, 99, 113;
      various definitions by Jenner, 240;
      in Spain, 401;
      disowned by Jenner, 239, 336, 454;
      a dodge, 278, 356;
      Birch’s inquiry, 277-278;
      Cobbett, 309;
      Hamernik’s opinion, 519-522.

  Crewe, Lady, and Jenner, 231.

  Crichton, Dr., vaccination and enforcement in Russia, 406-407.

  Croft, Dr., faith in cowpox in Staffordshire, 137.

  Cross, John, the Norwich epidemic, 1819, 432-439.

  Crow, Dr. E. J., 590.

  Cumberland, Duke of, 219.


  Dairymaids’ faith in cowpox, 95, 114, 334.

  Dalkeith, vaccination introduced, 151.

  Darwin, Erasmus, letter to Jenner, 275, 371.

  Davis, Francis, Enniscorthy, 590.

  Davy, Sir Humphry, hydrophobia, 359, 371.

  De Carro, Vienna, writes to Jenner, 264, 266-267, 405;
    uses horsegrease, 265, 404-405, 512;
    conveys virus to India, 384;
    Jenner’s congratulation, 385.

  Decimation by smallpox, 76.

  Delafaye, Dr., preaches and writes against variolation, 42.

  Denmark, variolation, 62;
     vaccination, 419-420.

  Des Gouttes, smallpox and variolation in Geneva, 61.

  Devonshire, Duchess of, works for Jenner, 230.

  Diarrhœa and vaccination, Newcastle, 429-430.

  Diderot, promotes variolation, 59.

  Diet, influence on smallpox, 87.

  Dilke, Sir Charles, 578.

  Dillwyn, William, letter from Jenner, 341-344.

  Dimsdale, Dr. Thomas, variolator, 47-48;
    controversy with Lettsom, 49;
    summoned to Russia to variolate Catharine, 63;
    price paid for job, 64, 362;
    variolation from arm-to-arm, 76;
    parish variolations, 379;
    might have anticipated Jenner, 514.

  Doddridge, Dr., favours variolation, 41.

  Dog distemper, 360;
    Jenner vaccinates King’s staghounds, 360.

  Dolling, Mr., Blandford, vaccination before Jenner, 138.

  Domeier, Dr., 221.

  _Don Quixote_, 595.

  Downe, Mr., Bridport, vaccination before Jenner, 139, 204.

  Drew, Rev. Herman, anticipates vaccination, 138.

  Drysdale, Dr., 84.

  Druitt, Dr., 547.

  Dublin, variolation, 34.

  Dublin Colleges of Physicians and Surgeons report on vaccination,
        242-243.

  Dudgeon, H. D., 585-586.

  Dumfries, variolation introduced, 34.

  Duncan, Dr., introduces vaccination to Edinburgh, 151.

  Duncombe, Thomas, discomfits sharp practice in House of Commons,
          498-499;
    disapproves of compulsion, 499, 529.

  Dundee, vaccination introduced, 151.

  Dunning, Mr., surgeon, 89, 340, 361, 385, 389, 390, 394;
    enthusiasm for Jenner, 196;
    first uses words vaccinate and vaccination, 229.

  Dusthall, Anna, first vaccinated in India, 385.

  Dutch in Ceylon, 392.


  East India Company, 220.

  Edinburgh, smallpox in 18th century, 50;
    triumph of vaccination, 1806, 71;
    vaccination introduced, 1799, 151;
    smallpox epidemic among the vaccinated, 1818-19, 366;
    variolation disused, 1815, and no smallpox, 463.

  Edinburgh Colleges of Physicians and Surgeons report on vaccination,
        241.

  Edinburgh Dispensary and smallpox, 1805, 242;
    official answer to Dr. Brown, 287.

  _Edinburgh Medical Journal_, Brown of Musselburgh, 351.

  _Edinburgh Review_, 300, 302, 303, 350;
    comparative fatality of smallpox and variolation, 66;
    smallpox diffused by variolation, 69;
    rapid acceptance of vaccination, 70;
    attacked by John Ring, 173;
    anti-vaccinators described, 289;
    a homicidal article, 364.

  Edwards, Jonathan, killed by variolation, 56.

  Egremont, Earl of, 167, 168, 220, 231.

  Eldon, Lord, 73.

  Elephants’ milk, 327.

  Elgin, Lord, 384.

  Ellenborough, asserts influence of vaccination to be transient, 353;
    Jenner’s indignation, 354;
    encounter with Jenner, 357;
    Epidemiological Society, 482.

  Ellis, Mr., fraud, 387.

  Emerson, R. W., Dr. Garth Wilkinson, 549.

  Emery, Aaron, evidence House of Commons’ committee, 1871, 555.

  _Encyclopædia Britannica_, horsegrease and cowpox, 271.

  Endowment of research illustrated by National Vaccine Establishment,
        461.

  _English Cyclopædia_, Cotton Mather and Lady M. W. Montagu, 7.

  English death-rates compared with Austrian, 506.

  Engrafting the smallpox, 1.

  Enniscorthy, 508-509, 590.

  Epidemics, Dr. Waterhouse bewildered, 382.

  Epidemics of smallpox, Dr. Seaton on their irregular character, 568.

  Epidemiological Society, organised to promote trade in vaccination,
        480-491;
    primes Lord Lyttelton, 480,
      and W. F. Cowper, 497;
    untruthful report, 485;
    presses for more vaccination, 492;
    bolder demands and more untruthful, 493-495;
    medical place hunters, 497, 500.

  Epps, Dr., variolation, 74;
    Tweedledum and Tweedledee, 226;
    character of Dr. Walker, 331.

  Equination, 229, 264, 265, 368;
    practised by Jenner, 268-269.

  Erskine, Sir J. Sinclair, Jenner’s sacrifices, 194.

  Erysipelas, a note of effective vaccination, 113, 119, 143, 157, 240,
        279, 429, 503, 555.

  Escharotics to allay vaccination, 109, 118, 157, 161, 198.

  Evans, T. W., vaccination in Iceland, 420.

  Evesham Guardians, advice from Local Government Board, 576.

  Excell, Hannah, vaccinated, 118,
      and vaccinifer, 128.


  Faces, pock-marked, 468;
    disappearance avouched by National Vaccine Establishment, 469-470.

  Faith magic, 213.

  Famine and smallpox in northern Europe, 409.

  Farquhar, Sir Walter, 129, 188, 319.

  Farr, Dr. W., decline of smallpox prior to vaccination, 86, 211,
          466-467;
    confirms Watt’s discovery in Glasgow, 447-448, 450-451;
    evidence reinforced from West Indies, 560.

  Farriers’ faith in horsegrease, 100, 114, 179, 334-335.

  Ferdinand IV. and Naples, 396.

  Fewster, Mr., cowpox more severe than smallpox, 139.

  Finland, vaccinators to be punished if smallpox ensue, 419.

  Flaxman, 581.

  Fleuart, Dr., Boston, results of variolation, 5.

  Fleming, Dr., Calcutta, letter from Jenner on variolation and
        vaccination in England, 390.

  Fleming, George, cowpox and horsepox, 272.

  Florence, variolation introduced, 62.

  Forster, W. E., moves for committee on 1867 Vaccination Act, 552, 553;
    surrenders to House of Lords, 572;
    private faith in vaccination, 577, 578.

  Foundling Hospital, 40.

  Fox, Joseph, friend of Dr. Walker, 218, 220.

  Fox, C. J., 215.

  Fox, W. F., Dewsbury, 590.

  France, variolation introduced, 35, 59;
    prohibited, 60;
    application to Cowpock Institution, 168;
    Woodville introduces vaccination, 169, 398;
    Napoleon’s despotism, 399-400.

  Frank, Joseph, scarlet fever, 448.

  Freeman, Mr., variolates after Jenner’s vaccination, 280.

  Freind, Dr., letter from Dr. Wagstaffe, 17.

  Friends, Society of, church-rates, 542, 560;
    oaths, 593.

  Fry, Danby Palmer, evidence House of Commons’ committee, 1871, 560.

  Fugitive Slave Law, 540.

  Fuller, John, denunciation of London Vaccine Institution, 250-252.

  Fuseli, 581.


  Gale, Samuel, a London grave-yard, 82.

  Gardner, Edward, Jenner’s witness, 95-96, 97, 99, 101, 131, 152, 192,
          362, 363;
    Jenner’s prophetic vision, 122;
    a hint for the newspapers, 147.

  Gartshore, Dr., discovery of cowpox in London, 146.

  Gassner in 1801 produces smallpox cowpox, 512.

  Geneva, practice of variolation, 61.

  George I., favours variolation, 5;
    assigns felons for experiment, 15.

  George II., extolled for gracious patronage of practice, 43.

  George III., receives Jenner, 171,
      and promotes vaccination, 219, 243, 370, 380.

  George IV., does as his father, 323, 370.

  Germany, variolation, 62,
      and vaccination introduced. 151.

  Gibbs family, 547.

  Gibbs, George S., 550, 585, 586;
    evidence House of Commons’ committee, 1871, 554.

  Gibbs, John, birth and career, 508-509;
    Letter on Vaccination, 500-509, 541, 585.

  Gibbs, Richard Butler, leader of anti-vaccinators, 543-544, 550, 578,
          585;
    evidence House of Commons’ committee, 1871, 556;
    death, 573-574.

  Gibbs, Mrs. R. B. (Miss Griffiths), 547, 573, 574.

  Gibson, Wm., New Lanark, 366.

  Giddy, Davies, prefers variolation to vaccination, 252.

  Giffard, Mr., cowpox in Dorset, 137.

  Gillett, Charles, Banbury, 590.

  Gillman, Mr., fraud in India, 387.

  Girl, cowpoxed mangey, 297.

  Gilpin, Charles, character of anti-vaccinators, 542.

  Gilpin, John, illustration of London life, 80.

  Gladstone administration, pitiful performance, 577.

  Glasgow, boarding-school girl, 51;
    Dr. Walker, 331;
    rare place for smallpox, 439;
    statistics, 1783-1812, 440, 442-443;
    variolation practised, 441;
    insanitary conditions, 441;
    vaccination introduced, 441;
    extent of practice, 442, 446;
    mortality unaffected, 442;
    other diseases replace smallpox, 442-443, 446-447;
    activity of measles, 444;
    Dr. Farr on the evidence, 447-448;
    character of smallpox victims, 450;
    variolation disused, 1815, and no smallpox, 463.

  Gloucester cathedral, Jenner’s monument, 363.

  Goatpox used in Madrid, 401.

  Goethe, stupidity, 279.

  Goldson, Wm., reports smallpox after vaccination, 283,
      which Jenner would not look at, 284;
    publishes pamphlet, 284;
    suggestions, 285;
    infamous treatment by Jenner and Ring, 285, 350-351, 361;
    _Edinburgh Review_, 290.

  Good, Dr. Mason, horsegrease, 100, 260, 262, 267.

  Goulburn, Mr., prohibition of variolation, 1840, 74.

  Grainger, Mr., extent of vaccination in 1850, 475.

  Granville, Dr., decimation by smallpox, 77.

  Grattan, patriot, 184, 185.

  Graveyards in London, 82.

  Gregory, Dr. George, mortality from variolation, 66;
    regrets prohibition, 74;
    smallpox declining before vaccination, 86;
    letters from Brown of Musselburgh, 288;
    smallpox and vaccination in Ceylon, 393;
    estimate for National Vaccine Establishment, 461;
    scepticism as to vaccination, 477;
    cited by Jacob Bright against Marson on marks, 561.

  Grey, Mr., Jenner’s reward, 195.

  Griffiths, John, 189.

  Grosvenor, Robert, vaccinated by Jenner, 1801, has smallpox, 1811,
          318-321.

  Gull, Dr. Wm., asserts vaccination as protective as smallpox, 355,
          564;
    evidence House of Commons’ committee, 1871, 564-565.

  Guy, Dr. W. A., vaccination a question of figures, 596.

  Guy’s Hospital, 1802, 275.


  Halford, Sir Henry, 319, 459.

  Halifax, smallpox in 18th century, 27, 30.

  Halifax, Viscount, compulsory vaccination, 572.

  Hall, Sir Benjamin, letter from John Gibbs, 501.

  Hamernik, Dr. Joseph, pustules from tartar emetic, 121;
    answer to Simon, 519-523.

  Hannen, Mr. Justice, 551.

  Hanover, variolation, 34.

  Hart, Ernest, 582.

  Haughton, Dr. Edward, 590.

  Hawes, Dr., 218.

  Haygarth, Dr., 57, 83, 569;
    variolation in Geneva, 61;
    Chester smallpox, 69;
    transmits vaccine virus to Boston, 376-377.

  Haynes, William, smallpox and horsegrease, 117.

  Heaths of Hertford variolated by Maitland, 19-20.

  Heberden, Dr. William, successful variolator, 140.

  Hecquet, Dr., 35.

  Henley, J. W., homely sense and sympathy with poor, 498, 499, 531,
          535, 536;
    Lord R. Montagu’s nonsense, 539.

  Herpes, interference with vaccination, 340-343, 356.

  Hertford, 19, 20, 23, 48.

  Hervey, Dr. James, 459.

  Hicks, Henry, 102, 134.

  Hicks, Dr., letter to Jenner on cowpox from horsegrease, 133.

  Highlands of Scotland, variolation practised, 29.

  Highmore, Anthony, tribute to Woodville, 163.

  Hignells vaccinated by Jenner, variolated by Freeman, 280.

  Hill, Rev. Rowland, thundered for vaccination, 290;
    controversy with Moseley, 293-296.

  Hjaltalin, Dr., Iceland, 422.

  Hobbes, 583.

  Holland, variolation in, 62.

  Holland, Lord, letter to Jenner from Madrid, 400.

  Holland, Sir Henry, failure of vaccination, 490.

  Holstein, cowpox believed good against smallpox, 94.

  Home, Sir Everard, 193, 459.

  Hooper’s _Lexicon Medicum_, 271.

  Hopwood, C. H., 577.

  Horsegrease, Jenner shows his nephew a horse with diseased heels,
          saying, “There is the source of smallpox,” 97, 359, 513;
    belief of farriers and farmers that cowpox originated in horsegrease,
          100, 110, 111, 154, 179;
    originates on thigh of colt with erysipelas, 112;
    action indistinguishable from cowpox, 157;
    futile inoculations of cows by Dr. Woodville and others, 145, 259;
    Jenner’s account of his faith, 154;
    Pearson sets aside Jenner’s doctrine, 153, 158, 178, 472, 512;
    considered horsegrease “like to damn the whole thing,” 158, 260,
          336, 375;
    Jenner dropped horsegrease, 180;
      and why, 178, 260, 368, 375;
    dropped and resumed, 512;
    not a word about horsegrease in New England, 375;
    repudiated by Dr. Mason Good, 263;
    used successfully by Thomas Tanner and Loy, 263;
      Sacco, 264, 405;
      and De Carro, 265, 405;
      La Font, 265;
      Melon, 267;
      Baron, 269;
      and by Jenner, 267-268, 271,
        who uses and distributes the equine virus, 268, 347;
    explanation of mystification, 270-272.

  Horsegrease Cowpox, Jenner’s happy thought and original prescription,
          114, 201, 334, 347, 472;
    the note of _Inquiry_, 125, 202;
    Marson’s opinion, 562.

  Horsepox, 472, 568;
    Prof. Bouley’s experiments, 273;
    cases described by Mr. Langton, 273;
    probable resort to, 273.

  Hosty, Dr., report on variolation in London, 59.

  Houlton, Rev. Robert, engaged to puff Suttons, 46.

  House of Commons’ committee on Jenner’s petition, 186-193;
    report, 194;
    vote, £10,000, 1802, 196;
    vote, £20,000, 1807, 243-249;
    committee, 1871, 552-573.

  Howgrave, Francis, opposes variolation, 31.

  Hufeland, tartar emetic for vaccine virus, 121, 348.

  Hume, Joseph, exposure of malversation of public money by National
        Vaccine Establishment, 460.

  Hume-Rothery, Mrs., 548, 578.

  Hume-Rothery, Wm., 548, 578;
    evidence House of Commons’ committee, 1871, 556.

  Hunter, John, “Don’t think, but try,” 98;
    relations with Jenner, 91-93, 348;
    heard of cowpox from Jenner, 136, 193;
    two diseased actions in same part cannot occur simultaneously, 164.

  Hutchins’s _History of Dorset_, 85.

  Hutchinson, Jonathan, evidence House of Commons’ committee, 1871,
        567-568.

  Huxham, John, 521.

  Hydrophobia, inoculation, 359, 371.


  Iceland, smallpox and vaccination, 420-423;
    measles, 422.

  India, vaccination introduced, 383-393;
    variolators bribed, 386;
    frauds practised, 387-388;
    subscriptions for Jenner, 390;
    Sir Richard Temple on vaccination at this day, 391.

  Indians vaccinated by Balmis, 402;
    fabulous stories of smallpox, 402.

  Ingatestone, Suttons’ variolation establishment, 45.

  Ingenhousz, Dr., discovers Jenner’s mis-statements, 130-132, 140.

  Inoculation. See Variolation.

  _Inquiry_, Jenner’s, publication, 102;
    analysis, 103-127;
    pronounced by Simon a masterpiece of medical induction, 103, 333;
    its essential doctrine, 335;
    printed last time in 1801, 337;
    why kept out of print, 344.

  _Inquiry_, Pearson’s, 136.

  Ireland, variolation introduced, 34;
    practised after prohibition, 474;
    distress a cause of smallpox, 472;
    fees for vaccination, 489;
    vaccination said by Sir Dominic Corrigan in 1871 to have practically
          extinguished smallpox, 561.

  Irish oppression, 593.

  Italy, Sacco’s vaccinations, 403-404.

  Itch prevents vaccination, 126, 277.


  Jefferson, Thomas, letter to Jenner, 380.

  Jeffrey, Francis, 289;
    fury of vaccination controversy, 290;
    contrary to all analogy that vaccination wears out, 302;
    homicidal article in _Edinburgh Review_, 364;
    declining faith in vaccination, 365.

  Jellyby, Mrs., 322.

  Jenner, Edward, regimen prior to variolation, 45;
      birth and education, 91;
      relations with John Hunter, 92-93;
      Sodbury legend, 93;
      a bore about cowpox, 95;
      miraculous prevision, 95;
      Gardner’s questionable reminiscences, 97, 122;
      horse with greasy heels the origin of smallpox, 97, 359;
      marriage in 1788, 97;
      a good hand at verses, 97;
      purchase of degree from St. Andrews, 98;
      inoculates son with swinepox, 98;
      experiments with cowpox, 98-99;
      origin of cowpox in horsegrease beyond denial, 100;
      difficulty of proof, 100.
    First vaccination, 1796, 101;
      publishes _Inquiry_, 1798, 102;
      describes cowpox, 109;
      tries in vain to generate it from horsegrease, 110-112;
      invents spurious cowpox, 113;
      denies virtue for cowpox and asserts it for horsegrease cowpox,
            114;
      cases of horsegrease, 115;
      fancy as to origin of smallpox, 120, 359, 513;
      absolute security from smallpox after horsegrease cowpox, 121;
      cowpox as an expulsive irritant, 123;
      single point of originality, 124;
      visit to London, 1798, 127;
      without cowpox, 129;
      advised by Cline to settle in London, 129;
      difference with Ingenhousz, 130-132;
      favourable reception of _Inquiry_, 134;
      Pearson claims association, 134;
      brick-bats flying around, 135;
      cowpox always erysipelatous, 143;
      uses cowpox from London, 147;
      jealousy of Pearson, 147;
      inquiries at a stand, 148;
      visits London to counteract Pearson and Woodville, 148;
      anxious, fretful, helpless, 151;
      _Further Observations_, 1799, 152;
      purpose and poverty of pamphlet, 152;
      differences with Pearson and Woodville, 158;
      slovenly and incomplete knowledge, 158;
      Vaccine Pock Institution, 160-161;
      _Continuation of Facts and Observations_, 1800, 163;
      annexation of Pearson and Woodville’s work, 163-164, 181;
      re-asserts the abiding prophylaxy of cowpox, 166;
      tries to undermine Vaccine Pock Institution, 167;
      reception by King and Queen, 171;
      John Ring’s alliance, 172, 176;
      presented with plate, 1801, 176;
      finds honour windy fare, 177;
      determines to drop horsegrease, 178, 180;
      mode of transformation, 178;
      _Origin of the Vaccine Inoculation_, 1801, 178;
      claims discovery of cowpox, 179,
        and discriminates true from spurious, 180;
      artful explanations, 182-183;
      application to Lord Sherborne, 183;
      prepares petition, 184-185,
        which is referred to committee of House of Commons, 186;
      evidence before committee, 186-194;
      claim limited to conveyance of cowpox from arm to arm, 193;
      voted £10,000 by House of Commons, 196.
    Jenner’s case examined by Pearson, 197-203;
      could he have taken a patent? 207;
      factitious glory, 215;
      delay in payment of £10,000, 216;
      fate as London physician, 216;
      Royal Jennerian Society, 218-219;
      head turned with adulation, 221;
      uxorious habits, 222;
      quarrel with Walker, 225-226;
      wreck of Royal Jennerian Society, 227;
      impecuniosity, 228;
      shyness, 230;
      “the cowpox doctor,” 230;
      plans for pecuniary relief, 231;
      reference of Parliament to Royal College of Physicians, 232-234;
      Jenner’s evidence and disownment of spurious cowpox, 239-240;
      voted £20,000, 243-248;
      director of National Vaccine Establishment, 255;
      withdraws and expects sensation, 256;
      sulking at Berkeley, 257;
      tactics as to horsegrease, 259, 262, 263;
      what did he discover? 261;
      swinepox, 262;
      reverts to original position, 264, 267;
      uses and diffuses horsepox, 268-269;
      a slovenly investigator, 270, 272;
      Birch on spurious cowpox, 277-278;
      pestered with failures, 280-281;
      Birch “a sad wicked fellow,” 283;
      treatment of Goldson, 285;
      claim to absence of failures, 287;
      friendship with Rev. Rowland Hill, 294.
    Miraculous quality of Jenner’s contempt, 301;
      split with Walker, 307;
      vaccinates sons of Sir Richard Phillips and Philip Codd, who
            afterwards had smallpox, 312-313;
        also of Earl Grosvenor, 318-321;
      the slush his followers had to march through, 315;
      dislike of Walker and his Institution, 324;
      Ring as bully and libeller, 324-330;
      Jenner’s later writings, 333-348;
      why _Inquiry_ was suppressed, 333-337;
      mystery of horsegrease, 334-336;
      experiments with horsegrease on cows, 335;
      spurious cowpox dodge, 336;
      herpes and vaccination, 340-342;
      elusion of variolous test, 342;
      smallpox flying in all directions, 344-345;
      comparative London mortalities, 346;
      successive poxes for vaccination, 347-348, 525;
      final publication on Tartar Emetic, 348;
      Baron’s biography, 349-363;
      meeting with Baron, 349-350;
      treatment of adversaries, 350-352, 474;
      investigation resented, 352;
      appropriation of work of others, 352-353;
      denial that influence of vaccination wore out, 353;
      Lord Ellenborough, 353-354, 357;
      dying testimony to vaccination, 354;
      contrivances to break his fall, 355-356;
      variolation of son and scandal, 357-358;
      insanitary house and sickly family, 85, 318, 358-359, 448;
      belief that human diseases originated in animals, 97, 359;
      suggested extension of vaccination, 359-360;
      much adulation excused self-deception, 360;
      abhorrence of London, 361;
      exclusion from Royal College of Physicians, 361;
      presentation to Emperor Alexander, 362;
      death of Mrs. Jenner, 1815, 362;
      perplexities toward close of life, 362;
      death, 1823, 362;
      funeral and memorials, 363;
      statue in London, 363;
      sends equine virus to Edinburgh, 368;
      tactics as concerned horsegrease, 375;
      sends gold box to Dr. Waterhouse, 378;
      project and reward for conveyance of virus to India, 383-384;
      vaccination in Madras and Bombay, 388;
      tribute from India, 390;
      Sweden and Ceylon, 392;
      medal from naval officers, 398;
      anecdote of Napoleon, 400.
    Arithmetical incapacity, 415, 423;
      reason for vote of £20,000, 453;
      denial of spurious cowpox, 454;
      deceived as to National Vaccine Establishment, 454-456;
      insolence toward Brown of Musselburgh, 457-458;
      his virus the stock of National Vaccine Establishment, 472-473;
      treatment of opponents, 474;
      did not introduce cowpox, 512;
      smallpox from horse through cow, 513;
      vaccinates King’s staghounds, 515;
      ruthless, untruthful, mercenary, 578.

       *       *       *       *       *


JENNER’S

PUBLICATIONS ON VACCINATION AND SUCCESSIVE ASSURANCES.


_An Inquiry into the Cause 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._ London: 1798.

  1798.--What renders the Cow Pox Virus so extremely singular is,
  that the person who has been thus affected is for ever after
  secure from the infection of the Small Pox; neither the exposure
  to the variolous effluvia, nor the insertion of the matter into
  the skin, producing this distemper.

  It is curious to observe, that the virus, which with respect
  to its effects is undetermined and uncertain previously to its
  passing from the horse through the medium of the cow, should then
  not only become more active, but should invariably and completely
  possess those specific properties which induce in the human
  constitution symptoms similar to those of the variolous fever,
  and effect in it that peculiar change which for ever renders it
  unsusceptible of the variolous contagion.

  It clearly appears that this disease leaves the constitution
  in a state of perfect security from the infection of the Small
  Pox.--Pp. 121, 337.


_Further Observations on the Variolæ Vaccinæ._ London: 1799.

  1799.--The result of all my trials with the virus on the human
  subject has been uniform. In every instance the patient who has
  felt its influence has completely lost the susceptibility for the
  variolous contagion.--Pp. 152-158, 336.


_A Continuation of Facts and Observations relative to the Variolæ
Vaccinæ, or Cow Pox._ London: 1800.

  1800.--The scepticism that appeared even among the most
  enlightened of medical men, when my sentiments on the important
  subject of the Cow Pox were first promulgated, was highly
  laudable. To have admitted the truth of a doctrine, at once
  so novel and so unlike anything that had ever appeared in the
  Annals of Medicine, without the test of the most rigid scrutiny,
  would have bordered upon temerity; but now, when that scrutiny
  has taken place, not only among ourselves, but in the first
  professional circles in Europe, and when it has been uniformly
  found in such abundant instances, that the human frame, when
  once it has felt the influence of the genuine Cow Pox in the
  way that has been described, is never afterwards, at any period
  of its existence, assailable by the Small Pox, may I not with
  perfect confidence congratulate my country and society at large
  on their beholding in the mild form of the Cow Pox, an antidote
  that is capable of extirpating from the earth a disease which is
  every hour devouring its victims; a disease that has ever been
  considered as the severest scourge of the human race.--Pp. 166,
  338-339, 357, 365, 473.


_The Origin of Vaccine Inoculation._ London: 1801.

  1801.--It now becomes too manifest to admit of controversy, that
  the annihilation of the Small Pox, the most dreadful scourge of
  the human species, must be the final result of this practice.--P.
  183.


_Petition for Remuneration to House of Commons._ 1802.

  1802.--Cow Pox 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
  persons so inoculated perfectly secure from the infection of the
  Small Pox.--Pp. 184, 337, 355.


_On the Varieties and Modifications of the Vaccine Pustule
occasioned by an Herpetic State of the Skin._ Printed in _Medical
and Physical Journal_, August, 1804; and reprinted as a pamphlet,
Cheltenham, 1806, and Gloucester, 1819.--P. 340.


VACCINATION EQUAL TO VARIOLATION.

  1804.--What I have said on Vaccination is true. If properly
  conducted it secures the constitution as much as Variolous
  Inoculation possibly can.--Baron’s _Life of Jenner_, vol. ii. p.
  15.

  Duly and efficiently performed, Vaccination will protect the
  constitution from subsequent attacks of Small Pox as much as that
  disease itself will. I never expected that it would do more, and
  it will not, I believe, do less.--_Ibid._ p. 135.

  1806.--The security given to the constitution by Vaccine
  Inoculation is _exactly equal_ to that given by the Variolous.
  To expect more from it would be wrong. As failures in the latter
  are constantly presenting themselves, we must expect to find
  them in the former also.--_Letter to Richard Dunning, 1st March,
  1806._--Pp. 339, 355.


_Facts for the most part unobserved or not duly noticed respecting
Variolous Contagion._ London: 1808.

  1808.--It should be remembered that the constitution _cannot_,
  by previous infection, _be rendered totally insusceptible of the
  Variolous Poison_. Neither the casual, nor the inoculated Small
  Pox, whether it produce the disease in a mild or violent way, can
  perfectly extinguish the susceptibility.--P. 338.


_Letter to William Dillwyn on the Effects of Vaccination in
Preserving from the Small Pox._ Philadelphia: 1818.

  1818.--My confidence in the efficacy of Vaccination to guard
  the constitution from Small Pox is not in the least diminished.
  That exceptions to the rule have appeared, and that they will
  appear, I am ready to admit. They have happened after Small Pox
  Inoculation; and by the same rule, as the two diseases are so
  similar, they will also happen after Vaccine Inoculation.--P. 344.


LAST TESTIMONY.

  1823.--My opinion of Vaccination is precisely as it was when
  I first promulgated the discovery. It is not in the least
  strengthened by any event that has happened, for it could gain no
  strength; it is not in the least weakened; for if the failures
  you speak of had not happened, the truth of my assertions
  respecting those coincidences which occasioned them would not
  have been made out.--P. 354.

  The whole of Jenner’s claims re-asserted for Smallpox Cowpox by
  Mr. John Simon, after Inoculation with which--

  1857.--“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.”--_Papers relating to the History
  and Practice of Vaccination._ London: 1857.--P. 513.


JENNER’S SUCCESSIVE POXES
  In their order, 124, 185, 207, 240, 334-338, 347-348, 472-473,
        512-513.
  Cowpox, first faith, 93-95, 99, 114, 334.
  Swinepox, 98, 99, 262.
  Cowpox did not prevent smallpox, 99, 113, 143, 179, 201, 347, 512.
  Horsegrease, 97, 99-100, 104, 124, 142, 273, 335.
  Spurious Cowpox defined, 99, 113-114.
  Horsegrease Cowpox, 100, 110-114, 119-121, 124-125, 153-155, 198,
        201, 259-274, 335, 375.
  Horsegrease dropped, 178-180, 201-203, 260, 266, 375.
  Cowpox resumed, 180-183, 202-203, 512.
  Spurious Cowpox dropped, 239-240, 277-278, 314, 336, 356, 454.
  Horsegrease or Horsepox adopted neat, 229, 264-273;
    the true and genuine life-preserving fluid, 269;
    equine virus sent to Edinburgh, 368.
    Sacco’s practice, 264, 267, 336, 512,
      and De Carro’s, 265, 405.


LETTERS FROM JENNER TO--

  John ADDINGTON, Surgeon.
    1802.--Detained at Berkeley by domestic joys, 218
    1804.--Cannot leave his wife, 222

  John BARON, M.D.
    1810.--Denunciation of Brown of Musselburgh, 351
    1811.--London and the Grosvenor disaster, 319
    1818.--The true and genuine life preserving fluid from a horse, 269
      ”  --Vaccination equivalent to smallpox, 355

  Miss CALCRAFT.
    1811.--Apology for Grosvenor disaster, 320

  Dr. DE CARRO, Vienna.
    1803.--Opposition to horsegrease hindered vaccination, 265
      ”  --Transmission of virus to India, 385

  W. DILLWYN, Walthamstow.
    1818.--Difficulties which attend vaccination, 341-345

  Richard DUNNING, Surgeon, Plymouth.
    1804.--Terms Vaccinate and Vaccination, 229
      ”  --Herpes the pest of vaccination, 340
      ”  --John Ring and Goldson, 351
      ”  --Despotism in India, 385
    1804.--England compared with India, 389
    1805.--Potatoes, 89
    1806.--Vaccination equal to variolation, 339
      ”  --Wicked opposition in London, 361
    1807.--Odd notion about Hindoo women, 390
      ”  --Vaccination in Chinese, 394

  Dr. FLEMING, Calcutta.
    1806.--Vaccination and variolation in England, 390

  A FRIEND.
    1794.--Origin of cowpox in horsegrease beyond denial, 100
    1797.--Difficulty of raising cowpox from horsegrease, 100
    1804.--Experience as London physician, 216-217

  Edward GARDNER.
    1796.--First arm to arm vaccination, 101
    1798.--True and false cowpox, 99
      ”  --Perplexity and agitation, 129
      ”  --Conceit and ignorance of Ingenhousz, 131
    1798.--Brickbats flying around, 135
    1799.--Counteract Pearson, 147
      ”  --Extreme pains with _Further Observations_, 152
    1823.--Homicidal _Edinburgh Review_, 364

  Dr. INGENHOUSZ.
    1798.--Prophylaxy of cowpox certain and permanent, 131

  Andrew JOHNSTONE.
    1813.--Declines to preside over United London Vaccine Institution
           and Royal Jennerian Society, 323

  Dr. LETTSOM.
    1811.--Perversity of London: comfort in Asia and America, 321

  James MOORE.
    1808.--Family afflictions, 255
    1809.--Sir Lucas Pepys, 255
      ”  --Expected astonishment, 256
      ”  --Views and wrongs, 257
    1810.--Impudence of John Gale Jones, 301
    1812.--Vaccination in Prussia, 405
    1813.--Fresh evidence of cowpox from horsegrease, 267
      ”  --Has been equinating for months, 267
      ”  --Experience with horsegreased carters, 268
      ”  --Proper variety of equine virus, 270
      ”  --Watt’s mischievous discovery, 451
    1816.--Cowpox likely to cease through disappearance of horsegrease,
           269
      ”  --Bad virus of National Vaccine Establishment, 458

  Dr. George PEARSON.
    1798.--Cowpox follows cowpox, 142
      ”  --Vaccination always erysipelatous, 143
    1799.--Refusal to join Vaccine Pock Institution, 161

  John RING, Surgeon.
    1801.--Ignorance of time for taking virus, 181

  W. F. SHRAPNELL.
    1794.--Typhus at Berkeley, 85
    1800.--Success in London, 171
      ”  --Praise of John Ring, 173

  Dr. William WOODVILLE.
    1799.--Success with Woodville’s London virus, 149

  Rev. Dr. WORTHINGTON.
    1810.--Away with Malthus!, 89
      ”  --While variolation is practised smallpox cannot be subdued,
           72, 390


LETTERS TO JENNER FROM--

  John ADDINGTON, Surgeon.
    1802.--Royal Jennerian Society, 218

  Henry CLINE, Surgeon.
    1798.--Experiments, with cowpox, 128

  Dr. Erasmus DARWIN.
    1802.--Christening and vaccination united, 276

  Dr. DE CARRO, Vienna.
    1803.--Horsegrease Jenner’s distinction, 405

  Joseph FOX.
    1802.--Royal Jennerian Society, 218

  Dr. HICKS, Bristol.
    1798.--Cowpox from horsegrease, 133

  Lord HOLLAND.
    1803.--Vaccination in Spain, 400

  John HUNTER.
      ”  --Puffing Jenner’s tartar emetic, 93

  Dr. INGENHOUSZ.
    1798.--Adverse inquiries as to cowpox, 130

  Thomas JEFFERSON.
    1806.--Glorifies vaccination, 380

  Rev. G. C. JENNER.
    1799.--Excites jealousy of Pearson, 147

  Francis KNIGHT, Surgeon.
    1798.--Attests country faith in cowpox, 132

  Dr. MARSHALL.
    1801.--Vaccination in Naples, 398

  Dr. George PEARSON.
    1798.--Associates himself with Jenner and reports public dislike
           of horsegrease, 134
    1799.--Invitation to join Vaccine Pock Institution, 160

  Dr. PERCIVAL, Manchester.
    1798.--Failure to get cowpox from horsegrease, 133

  Dr. SACCO, Milan.
    1808.--Miraculous exploits as vaccinator, 403

  Lord SHERBORNE.
    1801.--Advice as to petition for reward, 184

  Benjamin TRAVERS.
    1803.--Royal Jennerian Society, 219

  Dr. UNDERWOOD, Madras.
    1801.--Dread of variolation, 383

  Dr. Benjamin WATERHOUSE.
    1801.--Vaccination accounted beastly and indelicate in
           Philadelphia, 374
      ”  --Dexterous management of vaccination, 377
      ”  --Vaccinates cows, 378
      ”  --Cows with smallpox, 379

       *       *       *       *       *


  Jenner, Edward, inoculated with swinepox, 1789, and subjected to
        variolous test, 98, 262.

  Jenner, Rev. George C., sent to Colchester to vaccinate 85th
        Regiment, 126;
    excites Jenner’s jealousy against Pearson, 147;
    bears witness before committee of House of Commons, 1802, 192;
    asserts he had never had one failure with vaccination, 287.

  Jenner, Robert F., vaccinated, 118;
    variolated, 357;
    scandal, 358.

  Jenner, Mrs., marriage, 1788, 97;
    habitual invalidism, 222;
    death, 1815, 362.

  Jenner, Sir William, evidence before committee of House of Commons,
        1871, 564.

  _Jenneric Opera_, Walker’s, 325.

  Jervoise, Sir J. Clarke, 590;
    opposes compulsory vaccination, 1867, 538;
    evidence before committee of House of Commons, 1871, 554.

  Jesty, Benjamin, claim to cowpox inoculation, 94, 204, 245;
    invited to London and portrait painted, 205;
    put to variolous test, 205;
    epitaph at Worth Matravers, 206;
    distinction from Jenner, 206.

  Johnson, Dr., condition of sailors, 397.

  Johnstone, Andrew, 322.

  Jones, John Gale, 301.

  Jordan, Mrs., 171.

  Joules, the ox-faced boy, 298.

  Jurin, Dr., mortality of London smallpox, 25, 373;
    conditions of variolation, 30.

  Justice, Mr., Axminster, inoculates with cowpox, 138.


  Keats, Mr., introduces vaccination to British army, 151.

  Keighley guardians committed to York Castle and released to do as
        before, 575.

  Keith, Dr., 13;
    son variolated, 22.

  Keith, Lord, 397.

  Kemp, Mrs. E., 555.

  Kendall, Mr., vaccination of poor, 536.

  Kennedy, P., 1.

  Kine-pox, 374, 377.

  Kirkpatrick, Dr., denied that smallpox followed variolation, 41;
    etiquette of variolation, 44,
      and success, 45.

  Knight, Francis, attests prevalent faith in cowpox, 132;
    vaccinates Duke of Clarence’s children, 171.

  Knowles, J. Sheridan, 227, 250.

  Kolb, G. F., Bavarian vaccination and smallpox, 596.


  Ladies’ Sanitary Association, 547, 548.

  La Font of Salonica, 265, 267.

  Lanark, New, smallpox among vaccinated, 1818, 366.

  Lancashire, Leigh’s _Natural History of_, 3;
    vaccination hated in, 591.

  _Lancet, The_, vaccination failures and dangers, 502-503;
    refuses advertisements against vaccination, 582.

  Lane, Mrs. General, 509.

  Langrish, Dr., variolator, 40.

  Langton, John, case of horsegrease, 273.

  Lankester, Coroner, falsifies certificate of death, 68, 555.

  Lansdowne, Marquis of, 130.

  Leeds, mortality of smallpox in 18th century, 30;
    Mr. Pickering’s exposure of fraudulent statistics, 575.

  Lefevre, Shaw, opposes grant to Jenner, 244.

  Leicester, 585.

  Leighton, Andrew, 589.

  Leprosy induced by vaccination in West Indies, 559.

  Lettsom, Dr., Society for General Inoculation, 49;
    denounces inoculation, 71;
    bears witness for Jenner, 187;
    ascription of London smallpox to United Kingdom, 187, 208-209, 212,
          215, 295;
    Royal Jennerian Society, 219, 220;
    pœans for Jenner, 290;
    letter from Jenner on perversity of London, 321;
    sends virus to Dr. Waterhouse, Boston, 376;
    letter from Waterhouse, 378.

  Lewis, Marianne, “the mangey girl,” 299.

  Lichfield Cathedral, 52.

  Lindblom, Archbishop, 411.

  Lipscomb, Mr., anti-vaccinator, 290.

  Lister, Dr., Cline’s experiment, 128.

  Liverpool mortality, 451.

  Lyttelton, Lord, instrument of Epidemiological Society, 480-481;
    confession of personal ignorance, 480, 491.

  Local Government Board, repeated penalties, 577.

  London, condition 1701 to 1722, 25;
    population in 18th century unknown with accuracy, 77;
    prodigious infantile mortality, 80;
    manner of life of citizens, 80;
    overcrowding and defective light and water, 81;
    cesspools, and rain the chief scavenger, 82;
    grave-yards, and church-going a cause of illness, 82;
    no standard for England or the world, 83, 347;
    influence of variolation on smallpox, 86;
    diet of inhabitants, 88;
    considered by Jenner the centre of opposition to vaccination, 321;
    variolation revived, 1806, 321.

  London Bills of Mortality, 1701-22, 24;
    fallacy of taking them as standard of other populations, 25;
    untrustworthiness, 26, 77;
    how got up, 26, 78;
    evidence as to disease, 1791-1800 and 1801-1810, 223-224.

  London Corporation, subscription to Royal Jennerian Society, 220.

  _London Medical Gazette_, 1844, “revaccinate, revaccinate,” 473.

  _London Medical Repository_, 1821, Ring’s libels on Walker, 329.

  London Smallpox, 1701 to 1722, 24-25;
    heaviest and lightest years in 18th century, 79;
    no standard for smallpox elsewhere, 25, 208-210, 347, 431, 433;
    did not raise death-rate, 210;
    ever present waxing and waning, 211;
    unchecked and cultivated yet diminishing, 211;
    decline ascribed to vaccination, 222-225;
    statistics, 1791-1800, 223,
      and 1801-1810, 224;
    diminishing in common with fevers before vaccination, 346;
    before and after vaccination, 487;
    a natural phenomenon, 511;
    no epidemic from 1796 to 1825, 562;
    prevalence prior to outbreak of Franco-German war, 1870, 562.

  London and Boston Smallpox, 373;
    Norwich, 433;
    Vienna, 232, 369.

  London Smallpox Hospitals, sermon of Bishop Maddox, 40.

  London Society for Abolition of Compulsory Vaccination instituted,
        1880, 580.

  London Vaccination, decline of smallpox ascribed to, 222-225;
    Lord Henry Petty’s speech, 1806, 232;
    its vicarious operation, 295, 324;
    extension checked, 301;
    statistics from 1791 to 1820, 346,
      in 1816, 456;
    development of a fabulous salvation, 466-468.

  London Vaccine Institution founded 1806, 227;
    petitions Government for assistance, 250;
    annexes Royal Jennerian Society, 322-324, 453, 457;
    number of vaccinations, 1803 to 1826, 323;
    character of agents, 325;
    charged with fraud and imposture, 326-329;
    diplomas, 330;
    tribute to Walker, 333;
    thrives despite National Vaccine Establishment, 457, 458, 460.

  Louisa, Princess, introduces vaccination to Berlin, 151.

  Louis XV., died of second attack of smallpox, 60.

  Lowe, Robert, passes Vaccination Act, 1861, 526;
    romance and rant, 526-527;
    asserts that smallpox is transmuted to smallpox, and that security
          from smallpox is proportioned to vaccination marks, 528;
    denunciation of anti-vaccinators, 528;
    the Act a failure, 530;
    sneers at Mr. Henley, 536.

  Lowell, J. Russell, 595, 596.

  Loy, Dr., horsegrease inoculation, 263, 265, 336.

  Lucas, John, 590.

  Ludlow, Mr., Sodbury and Jenner, 91.

  _Lues Bovilla_, 292.


  MacLaren, Duncan, 573.

  Maddox, Bishop, 40.

  Madras, vaccination introduced, 388;
    subscription to Jenner, 390.

  Madrid, vaccination, 400;
    use of goatpox, 401.

  Maitland, Charles, adviser of Lady M. W. Montagu, 10;
    variolation of her son, 11,
      and her daughter, 12;
    variolates in Newgate, 15-16;
    the Batts and Heaths, 19;
    in Aberdeenshire and Hanover, 34;
    defence of variolation, 18;
    controversy with Massey, 28;
    Prince of Wales promoted his experiments, 171.

  Malthus, 244, 245;
    vicarious mortality, 569-570.

  Manchester, experiments with horsegrease, 133;
    address of Cow Pox Dispensary, 169;
    vaccination widely practised, 175.

  Mar, Countess of, 21.

  Marcolini, 523.

  Maria Teresa variolated by Ingenhousz, 130.

  Marks, Vaccine, protective power of many according to Robert Lowe,
          528;
    Mr. Henley’s observation, 535;
    Marson’s whimsical notion, 561.

  Marlborough, Duke of, 8.

  Marlow, Dr., Oxford, 176.

  Marseilles, vaccination found useless in 1828, 520.

  Marshall, John, experiments with horsegrease, 335.

  Marshall, Dr. Joseph, witness for Jenner, 189;
    first cowpox missionary, 220, 396, 397.

  Marson, J. Furness, smallpox after smallpox, 355;
    petitions Parliament, 1856, for more stringent vaccination laws,
          497;
    judge of prize essays, 547;
    evidence before House of Commons’ committee, 1871, 561-563;
    whimsical notion about marks, 561;
    other assertions and admissions, 562;
    ferocious and foolish calumny, 563;
    ruthless, untruthful, mercenary, 578.

  Massey, Rev. Edmund, variolation and high treason, 23;
    sermon against variolation, 28.

  Massey, Isaac, Maitland’s assurance, 18;
    how variolation was promoted, 22;
    mortality of smallpox, 23;
    challenge to the variolators, 23;
    no comparison between variolation as practised and smallpox, 31;
    concealments of the variolators, 33.

  Master of the Rolls, law and human nature, 592.

  Mather, Cotton, introduces variolation, 2, 3, 7, 29, 56-57, 371;
    fabulous relation to Lady M. W. Montagu, 7, 10.

  Mathews, Dr., denounces variolation, 71, 232.

  May, Henry, preserving vaccination from reproach, 67.

  Mayerne, Sir Theodore, 199.

  Maunsell, Dr., usefulness of the spurious cowpox dodge, 278.

  Mead, Dr., Newgate experiment, 16;
    revived variolation, 36;
    experience of variolation, 39;
    “it is more material into what kind of body smallpox is infused than
          out of what it is taken,” 516;
    slight and severe smallpox, 521.

  Measles, inoculated, 359;
    in Iceland, 422;
    Newcastle, 428-430;
    Glasgow, 444-445;
    England and Wales, 505-506.

  Mellor, Mr. Justice, 551.

  Merret, Joseph, horsegrease cowpoxed, 99, 104.

  Merriman, Mr., 290.

  Mexico, terrible tale, 511.

  Mexico and Peru vaccinated, 321, 322, 401-403.

  Micawber, 471.

  Milan horsegrease, 264.

  Mildmay, Sir Henry, 194.

  Mill, J. Stuart, 510.

  Millet, Mr., erysipelatous colt, 112.

  Milner, R. A., 590.

  Mitford, Miss, lost faith in vaccination, 479.

  Monro, Dr. Alexander, variolation and smallpox in Scotland, 49-50;
    smallpox an infantile malady, 242.

  Montagu, Lady Mary Wortley, fabulous statement as to Cotton Mather, 7;
    visits Turkey, 8;
    description of variolation as practised there, 9, 20;
    has her son “engrafted,” 10;
    and her daughter in London, 12;
    Maitland’s account of transaction, 13-14;
    opinion of English quackery, 21, 381;
    epitaph in Lichfield Cathedral, 51-52;
    “immortality,” 74.

  Montagu, Lord Robert, reckless advocacy of vaccination, 533-535;
    money wanted to work the mill, 537;
    absurd adjuration, 539;
    evil Act of 1867, 548;
    member of House of Commons’ committee, 1871, 553.

  Montagu, Wortley, ambassador to Turkey, 8;
    letters from wife, 10, 21.

  Monteggio, 523.

  Monteith, Dr., Newcastle Dispensary, 424-430.

  Moore, James, Spain preserved from variolation, 62;
    meetings of vaccinists in Salisbury Square, 228;
    Walker and the Duke, 228;
    Walker characterised, 331;
    vaccination in Ceylon, 393;
    Balmis’ vaccine girdle round the world, 401;
    vaccination in Germany, 406;
    smallpox and vaccination in Sweden, 412-413;
    appointed Director of National Vaccine Establishment, 455, 456, 459;
    insolence toward Brown of Musselburgh, 457.

  Moore, Sir John, 455.

  Moore, Parson, derivation of cowpox from horsegrease, 155.

  Morley, John, Catharine’s variolation, 62.

  Morris, Edward, mischiefs of variolation, 246-247;
    moves that Jenner have £20,000, 247-248.

  Morris, William, horsegrease indistinguishable from cowpox, 156.

  Morris, William, measles in Iceland, 422.

  Mortality, Total, unaffected by smallpox, 438, 439, 546, 560.

  Mortality, Vicarious, in Glasgow, 443-446;
    Dr. Farr’s illustration, 447-448, 451;
    Dr. Woolcombe’s, 449;
    Dr. Gregory’s, 505-506;
    Malthus’s, 569, 570.

  Moseley, Dr., 72, 187, 361;
    “vaccination gratis,” 236;
    _Edinburgh Review_, 290;
    exasperating and matter of fact, 292;
    controversy with Rev. Rowland Hill, 295;
    character, 296.

  Mount Temple, Lady, 547.

  Mudie, Dr. P., chickenpox must be smallpox, 367.

  Munk, Dr., character of Moseley, 296-297.


  Naples, vaccination, 396.

  Napoleon enforced vaccination, 399;
    anecdote about Jenner, 400.

  Nash of Shaftesbury inoculates with cowpox, 94, 204.

  National Anti-Compulsory Vaccination League, 543, 550, 578-579;
    _Reporter_, 578.

  National Health Society’s statistical fraud, 209.

  National Vaccine Establishment founded, 1808, 255, 453;
    for investigation, 257-258, 454;
    equine virus received from Jenner, 268;
    Cobbett’s judgment, 307;
    indifference to Jenner’s advice, 340;
    Jenner’s interest, 350;
    reports, 1808-1840, 453-470;
    constitution, 455;
    Moore appointed director, 456;
    investigation unattempted, 457;
    lax management, 458;
    funds looted, 459;
    Board a gossipping place, 460;
    Joseph Hume comes to judgment, 460;
    Parliamentary report on extravagance, 1833, 461;
    reports, 1841-50, 470-477;
    the initial error of State vaccination, 584.

  Nature not to be swindled, 595.

  Navy, introduction of vaccination, 398;
    medal to Jenner, 398.

  Negroes, variolated, 56;
    curiosity of Waterhouse as to vaccination, 379.

  Neighbour, James, evidence House of Commons’ committee, 1871, 568.

  Nelmes, Sarah, Jenner’s first vaccinifer, 101, 116, 120.

  Nettleton, Dr. Thomas, Halifax smallpox, 27;
    practice as variolator, 30.

  Newbury, variolation restricted to residents, 44.

  Newcastle Smallpox, 424-430.

  New England, absence of smallpox in 1787, 84, 374.

  Newman, Prof. F. W., abridgement of Siljeström, 418;
    account of opposition to vaccination, 544-546.

  Newgate, London, variolation of six felons, 15;
    and Christ’s Hospital, 524.

  Nichols, Simon, produces cowpox from horsegrease, 107.

  Nichols, Dr. T. L., 590.

  Noailles, the Countess De, account of connection with anti-vaccination
          movement, 546-548;
    liberal support of London Society, 580.

  Nonconformists and church-rates, 542.

  Northampton clear of smallpox for years, 83;
    Dr. Pearce holds debate on vaccination, 541;
    speech of Charles Gilpin, 542;
    dislike of vaccination, 555.

  Norwich Smallpox Epidemic, 1819, 431-439;
    rarity of smallpox, 433;
    introduction of vaccination, 432-433;
    bribery practised, 434;
    vulgar treatment of smallpox, 437;
    variolation disused, 1815, and no smallpox, 463.

  Nottingham Vaccine Institution, 225.

  Nurses in smallpox hospitals never catch smallpox, 497.


  Oaths, compulsory, 593.

  Orleans, Duke of, children variolated, 60.


  Paget, Hon. Arthur, Vienna, 384.

  Paine and Walker, 330.

  Paisley, vaccination introduced, 151.

  Pakington, Sir John, confessed ignorance, 482-483.

  _Pall Mall Gazette_, smallpox localised in London, 209.

  Palmerston, Lord, 483.

  Paris, vaccination found useless in 1825, 520;
    Anti-Vaccination Congress, 1880, 581.

  Parry, Dr. C. H., Letter from Jenner on Tartar Emetic, 348.

  Paytherus, T., 102, 147.

  Patent, Jenner could not have obtained one, 207, 260, 278.

  Paterson, Dr., Montrose, praise of Dr. Pearson, 162.

  Pearce, Dr. Charles T., 541-542;
    evidence House of Commons’ committee, 1871, 554.

  Pearce, Thomas, case of horsegrease, 115.

  Pearson, Dr. George, associates himself with Jenner, 134;
    publishes _Inquiry_, 136;
    Jenner’s note thereon, 153;
    discovers prevalence of faith in cowpox, 137-139;
    subjects London dairymen to variolous test, 140;
    denies equine origin of cowpox, 142;
    conjectures that inoculation is applicable to other diseases,
          143-144;
    discovers cowpox in London, uses and distributes it, and lectures,
          146-147;
    sets aside Jenner’s doctrine, 153, 158, 472, 512;
    considered horsegrease like to damn the whole thing, 158, 260, 336,
          375;
    founds Vaccine Pock Institution, 1799, 159, 251;
    refusal of Jenner’s assistance, 160-161;
    success of Institution, 168;
    application from French Consulate, 168;
    public reception of cowpox, 170;
    Pearson heard with impatience by House of Commons’ committee, 193;
    publishes _Examination_, 197;
    his own and Woodville’s claims, 197;
    that he corrected Jenner’s assertions, 198;
    developed practice, 198;
    established Vaccine Pock Institution, 199;
    impossibility of Jenner making a secret of vaccination, 199;
    his pecuniary claims absurd, 199;
    what he did and for what he might have been rewarded, 199-200;
    merits of _Examination_, 200;
    Pearson failed to recognise strength of his own position and
          Jenner’s imposture, 201-203;
    Pearson and Woodville really introduced cowpox to Europe and America,
          151, 203, 260-261, 352, 360, 375, 404;
    Jesty invited to London, 204-205;
    offers reward for smallpox after cowpox, 258;
    held revaccination impossible, 205, 259, 303;
    estimate of Jenner, 225;
    Pearson as seen by De Carro through Jenner, 265, 266.

  Pease, Sir Joseph, advocates limitation of penalties, 577.

  Peel, Sir Robert, adverse to compulsion, 476, 480, 485.

  Pegge, Sir Christopher, 176.

  Peking, vaccination in, 394.

  Pennington, Sir Isaac, horsegrease, 142.

  Pepys, Sir Lucas, 255.

  Perceval, Mr., 72;
    moves that Jenner have £10,000, 243, 247.

  Percival, Dr., Manchester, letter to Jenner, 133.

  Persia, variolation and vaccination, 394.

  Peru and Mexico, 321, 322, 401-403.

  Petition, Jenner’s, 184;
    discussed, 185-186.

  Peto, Sir Morton, 529.

  Petty, Lord Henry, brings Jenner’s case before House of Commons,
        231-232, 234, 243, 245, 253, 257, 454.

  Philadelphia, variolation, 38;
    letter from Jenner, 341-342;
    cowpox accounted indelicate, 374.

  Phillips, Sir Richard, son vaccinated by Jenner takes smallpox, 312.

  Phipps, James, first person cowpoxed by Jenner, 101, 116, 119, 120.

  Physicians, London, College of, approve of variolation, 43;
    report on vaccination, 235;
    decline to receive Jenner without examination, 361.

  Pickering, John, starts _Anti-Vaccinator_, 574;
    exposes fraudulent statistics in Leeds, 575.

  Pitman, Henry, labours and suffering in opposition to vaccination,
        544, 545, 574.

  Pitt, William, 184, 215, 231.

  Plague stayed by vaccination, 359.

  Playfair, Sir Lyon, 546, 553, 578, 583.

  Plett, Holstein, inoculated with cowpox, 1791, 94.

  Pock-Marked Faces, 468;
    disappearance avouched by National Vaccine Establishment, 469-470.

  Poor Law Authorities, vaccination committed to, 471.

  Post Office conveyed correspondence of Royal Jennerian Society gratis,
        275.

  Potato introduced, 88-89;
    denounced by Cobbett, 316, 317.

  Pouschin, 63.

  Prague Hospital, 520, 521.

  Priessnitz, treatment of smallpox, 508, 509.

  Prig, Betsy, 240.

  Prince, Rev. T., Boston smallpox, 1752, 373.

  Procter, Edmund, 590.

  Prussia, vaccination introduced, 405;
    revaccination proved useless in army, 520.

  Pulteney, Dr., cowpox, 131, 136, 138.

  Putnam, Dr., Boston, uses smallpox cowpox, 76.

  Pylarini, 1, 7, 10.


  Quakers and vaccination, 228;
    their Institution and pox preferred, 457-458;
    church-rates, 560;
    oaths, 593.


  Ramsay, Dean, 51.

  Ranby, Sergeant, variolator, 41, 59.

  Ratcliffe, Dr., 199.

  Red gum deadens vaccine virus, 340.

  Redesdale, Lord, 572.

  _Rees’s Cyclopædia_, 163.

  Rendall, Mrs., cowpoxer, 94.

  Rennie, Dr., smallpox and vaccination in Peking, 394.

  Revaccination treated as impossible, 159;
    Dr. Pearson’s opinion, 198, 259, 303;
    recommended, 1844, 473;
    pronounced superfluous by National Vaccine Establishment, 1851, 473;
    proved useless in armies of Prussia and Wurtemburg, 520.

  Reynolds’s _System of Medicine_, 66.

  Rhazes, 521.

  Richardson, Dr. B. W., 547.

  Ricord, M., invaccination of syphilis, 310.

  Riddiford, Abraham, smallpox after horsegrease, 115.

  Rigby, Miss, death from variolation, 34.

  Rigby, Mr., surgeon, Norwich, 434.

  Ring, John, Jenner’s henchman and bully, 172;
    gets up medical testimony, 172, 174;
    his publications, 173;
    Jenner in Portman Square, 176;
    witness for Jenner, 190;
    recommended for Chief Vaccinator and result, 255, 455;
    Birch on his failures, 280;
    attack on _Edinburgh Review_, 290, 303;
    libels Walker, 324-330;
    brutality to Goldson, 351;
    compliments Dr. Waterhouse, 378;
    “wit,” 379;
    ruthless and untruthful, 578.

  Ringwood, smallpox after vaccination, 252, 308, 313.

  Robinson, Dr. Bryan, 34.

  Robinson, Enoch, _Can Disease protect Health?_ 582.

  Roby, Dr., Boston, 5.

  Rochdale smallpox, 30.

  Rodway, William, smallpox after cowpox, 106.

  Rolph, Mr., surgeon, common Gloucestershire faith in cowpox, 137.

  Rome, variolation introduced, 62.

  Rose, George, moves vote for National Vaccine Establishment, 252, 254,
        255, 308.

  Rous, Lord, 192.

  Rowan, Miss Frederica, 418.

  Rowlandson’s caricatures, 298.

  Rowley, Dr. William, 187, 290, 361;
    opponent of vaccination, 297;
    evidence of subsequent smallpox and injuries, 298;
    delirium of vaccinators, 299;
    his character, 299.

  Royal Society, 1, 2, 7, 30, 37.

  Royal Jennerian Society, 218-229;
    admit smallpox after cowpox, 293;
    Cobbett’s remarks, 305, 307, 312;
    wreck and salvage, 322;
    annexed by London Vaccine Institution, 323;
    union disliked by Jenner and Ring, and denounced, 324, 326, 329;
    Society wrecked by Jenner’s jealousy and intrigue, 453, 455, 456.

  Ruskin and Cobbett, 304.

  Russia, vaccination introduced and prescribed, 406;
    tolerated resistance, 407.

  Russian Emperor Alexander cautioned by Jenner against Walker, 329;
    an unprofitable interview, 362.


  Sacco, Dr., Milan, uses horsegrease, 264, 267, 336, 512,
      and supplies De Carro of Vienna, 265, 405;
    his cowpox transmitted through De Carro to India, 385;
    exploits as vaccinator, 403-404, 406.

  Salvani, vaccine missionary, 401.

  Salivation, 519.

  Sanitation, new faith, 448, 474, 477.

  Sancho, William, 258.

  Sangrado, 571.

  Scarlet fever inoculated, 359;
    in Newcastle, 428, 430;
    increased and intensified since vaccination, 448;
    in England and Wales, 1838-40, 505, 506.

  Scheuchzer, Dr., variolation, 1721-28, 32.

  Schleisner, Dr., Icelandic smallpox, 420-421.

  Schultz, Dr., 62.

  Sclater-Booth, G., 576.

  Scotland, smallpox and variolation in 18th century, 50;
    smallpox an infantile disorder, 51;
    smallpox among vaccinated, 1818-19, 366;
    statistics of smallpox, 1859 to 1872, 534;
    Compulsory Act, 1863, 563.

  Scott, Dr. Helenus, 385, 388, 392.

  Scott, Dr. John, 591.

  Scott, Sir Walter, 371.

  Scrofula excited by variolation, 166, and vaccination, 515.

  Scurvy, prevalence in 18th century, 87;
    influence on smallpox, 521.

  Seaford, Sussex, 83.

  Seaton, Dr. E. C., _Handbook of Vaccination_, smallpox cowpox, 75;
    mendacious letter, 485-497;
    ruling spirit of Epidemiological Society, 486;
    intrigues for place and power, 495;
    evidence House of Commons’ committee, 1871, 568-570;
    ruthless, untruthful, mercenary, 578.

  Sebright, Sir John, 247.

  Seville, fatalities from vaccination, 401.

  Sewell, Mr., attempts to produce cowpox from horsegrease, 335.

  Sewell’s Point, Boston, 58.

  Shaftesbury, Lord, neglected vaccination, 481;
    improved houses might exterminate smallpox, 482.

  Sherborne, Lord, 183, 184, 185.

  Shrapnell, Mr., 171, 269.

  Sievier, statue of Jenner, 363.

  Siljeström, P. A., smallpox in Sweden, 417-419.

  Simmons, Mr., Manchester, experiments with horsegrease, 133, 155.

  Simon, John, recitation of Jennerian legend, 103;
    Jenner’s masterpiece, 124, 142, 155, 156, 158, 333;
    _Papers on History and Practice of Vaccination_, 510-519;
    terrible tales, 511;
    London smallpox, 511-512;
    cowpox derived from smallpox and infallible prophylaxy thereof,
          512-513, 525;
    mis-statement of Jenner’s prescription, 513, 525;
    _all_ vaccination assumed effective, 514;
    drawbacks unfairly stated, 515;
    scrofula, 515;
    admitted dangers, 515;
    qualities of virus unknown, 516;
    syphilis, 516;
    difficulties of vaccination, 516;
    sickly children, 517;
    selection of virus, 517;
    an ideal rarely realised, 518;
    questions addressed to 500 medical men, 518;
    answers predetermined, 519;
    value and characteristics, 524-525;
    evidence House of Commons’ committee, 1871, 557;
    unscrupulous character, 558;
    ruthless, untruthful, mercenary, 578.

  Simonds, Professor J. B., cowpox a questionable disease, 272.

  Simpson, James, 189.

  Sims, Dr., 187, 226, 331.

  Skey, Dr., 189.

  Sloane, Sir Hans, 15, 23;
    Newgate experiment, 17;
    cautious counsels, 17.

  Smallpox an infantile disease in Scotland, 51, 242, 445;
      epidemic, 1818-19, 367;
        in China, 394;
        in Sweden, 409-410;
        in Norwich, 436;
        in Glasgow, 440;
      disease of young and poor, 26, 437, 440, 445, 470.
    An alternative of other diseases, in Sweden, 415-417;
      in Newcastle, 428;
      in Glasgow, 439-444;
      the fact enforced by Dr. Farr, 447-451;
        by John Gibbs, 504-506;
        by Professor F. W. Newman, 546;
        by Dr. Bakewell, 560;
        by Malthus, 570;
      the disease to be studied with its congeners, 511;
      epidemic of 1871, 570-571.
        In London, 1701-1722, 24-25;
        18th century, 77-87;
        1791 to 1820, 346;
      development of fabulous salvation, 466-468;
      decline prior to vaccination, 86, 211, 466-467.
      In England and Wales, conjectural mortality, 25, 194, 208-209, 345;
      case according to John Gibbs, 505, 507;
      fabulous salvation, 526-528.
    In Boston, 3-6, 371-373;
      Chester, 69;
      China, 394;
      Edinburgh, 49-51, 366;
      Geneva, 61-62;
      Glasgow, 439-445;
      Newcastle, 424-430;
      New England, 1787, 84, 374;
      Norwich, 432-438;
      Sweden, 408-419.
    Declining prior to introduction of vaccination in London, 86,
          222-225, 466-467, 487;
      over Europe, 368, 431, 446, 468, 476, 514;
      in Vienna, 369;
        Sweden, 410, 414-416;
        Italy, 404;
        Denmark, 419;
        Glasgow, 446;
      Dr. Farr’s evidence, 86, 211, 466-467.
    Exaggerated horrors, 76, 430, 570;
      Massey’s evidence, 23;
        Wagstaffe’s, 24;
        Monro’s, 50;
        Haygarth’s, 69;
        Birch’s, 85;
      multitudes never had smallpox, 65;
      unknown for years in some parts of England, 83;
      rarity in Norwich, 433;
      disease ever had _some_ limit, 210, 431;
      wild assertions of House of Commons’ committee, 212;
      terrible tale of Mexico, 511.
    Rate of mortality prior to vaccination in Boston, 3, 372;
      Christ’s Hospital, 23, 524;
        London, 24-25, 26, 31, 79-80, 373;
        Halifax, Rochdale, Leeds, 30;
        Edinburgh, 50;
        London Smallpox Hospital, 66;
        Newcastle 427;
        Glasgow, 440;
      according to Dr. Buchan, 66,
        and _Edinburgh Review_, 66.
    Increased by variolation, 69, 72, 236, 246, 390, 426, 431, 462-464.
    Intensified by maltreatment, 84, 427, 437, 521;
      by food, 87, 316, 521.
        Sporadic character, 209, 522, 568.
        Origin in horse according to Jenner, 97, 359, 513.

  Smallpox cowpox introduced, 75;
    connection with cowpox denied 273;
    cows contract smallpox from milkers, 378-379;
    Ceely and Badcock, 75, 272, 472, 514, 528;
    unqualified confidence of Simon, 512-513, and Robert Lowe, 528.

  Smith, Dr. Southwood, absolute faith in sanitation, 478, 556.

  Smith, William, cowpox after cowpox, 106.

  Smith, William, exaltation of Jenner, 247.

  Spain, escaped variolation, 62;
    vaccination introduced, 400-401.

  Spencer, Earl, 397.

  Spencer, Herbert, increased vaccination and smallpox, 541.

  Squirrel, Dr., opponent of vaccination, 290, 301, 361.

  Stanhope, Earl, 73.

  Staunton, Sir George, 394.

  Steigertahl, Dr., 17.

  Stephens, Joanna, remedies for stone, 37.

  Stepney, 26, 27.

  Stevens, Dr., never saw injury from vaccination, 566.

  Stiles, Henry, smallpox after cowpox, 130.

  Stockholm, 417-418.

  Strickland, Sir George, opposes compulsion, 483, 485.

  St. Andrews, Jenner’s purchase of degree, 97;
    Ring’s sneer at same, 329, 330.

  St. Christophers, 38.

  St. Pancras guardians, 587.

  Stuart, Lady Louisa, fiction as to introduction of variolation, 13.

  Sunderland, Earl of, son variolated and killed, 34.

  Suttons, eminent variolators, 45, 179, 188;
    method of practice, 46.

  Sweden, variolation introduced, 62,
      but little practised, 408;
    Jenner’s pride in, 345, 392;
    sorely afflicted with smallpox, 408;
    influence of famine, 409;
    children chief sufferers, 409;
    disease aggravated by bad treatment, 410;
    steadily declining when vaccination was introduced, 410-411;
    vaccination made obligatory, 1816, 411;
    means of livelihood for clergy, 411;
    asserted extermination of smallpox, 413-414;
    Siljeström’s evidence, 417-419.

  Swarmery, 291.

  Swift’s city shower, 82.

  Swinepox, 98, 99, 262, 401.

  Sydenham, 448, 521.

  Syphilis, invaccination foreseen by Massey, 27,
      and Cobbett, 309;
    declared impossible, 68,
      by Simon, 516,
      by H. A. Bruce, 530,
      and by Sir Dominic Corrigan, 561;
    Ricord’s warning, Brudenell Carter’s experience, and Sir Thomas
          Watson’s ghastly risk, 310;
    inseparable from public vaccination, 503;
    Henley’s answer to Bruce, 531;
    W. J. Addison’s evidence, 556;
    dreaded in West Indies, 559;
    Jonathan Hutchinson’s cases, 567,
      and proof that it is latent and active in some vaccinifers, 568.


  Tanner, Thomas, got cowpox from horsegrease, 263.

  Tar water, 21.

  Tarleton, General, glory to Jenner, 246.

  Tartar emetic, letter from Hunter, 93;
    used for vaccine virus, 121;
    Jenner’s last effort, 348.

  Taupin, failed to invaccinate any disease, 522.

  Taylor, David, 190.

  Taylor, Peter Alfred, 553, 577, 580;
    reply to Dr. W. B. Carpenter, 588.

  Tea introduced, 89;
    denounced by Cobbett, 316.

  Tebb, William, 580, 587, 596.

  Temple, Sir Richard, smallpox and vaccination in India, 391.

  Terry, Dr., 15.

  Thiele, Dr., 1836, produces smallpox cowpox, 512.

  Thomson, Dr., Boston, 5.

  Thomson, Dr. John, smallpox epidemic in Scotland, 1818-19, 366;
    depressing experience with vaccination, 366-368;
    receives equine virus from Jenner, 368;
    absence of epidemic smallpox when vaccination was introduced, 369.

  Thornton, Dr., 190.

  Thorpe, Rev. R. A., 448.

  Thurlow, William, 590.

  Timoni, Emanuel, 1, 2, 7, 10.

  Tortworth, eight paupers cowpoxed, 107.

  Travers, Benjamin, 217, 218, 219.

  Trinidad, vaccination in, 559.

  Tronchin, Dr., variolator, 60.

  Trotter, Dr., smallpox in navy, 397;
    medal for Jenner, 398.

  Turgot, 59.

  Turkey, variolation, 1, 9, 11;
    malignity of smallpox, 12.

  Turner, Mr., experiments with horsegrease, 335.

  Turton, Sir Thomas, 250-251, 252.


  Underwood, Dr., 383.

  United States, vaccination introduced, 370-382.

  Urquhart, William, 34.


  Vaccination, origin of term, 229;
      vaccinium and vacciolation, 220, 222, 229.
    Precipitate approval of London physicians, 70, 173;
      Dr. Pearson’s work, 151, 170;
      acceptance by King and Court, 171;
      the heir of variolation, 174, 191, 249, 370, 395;
      received with acclamation, 274, 405;
      offered gratis, 236, 326-327;
      means by which promoted, 275;
      character of furore, 278, 299, 305;
      public goaded to belief, 286;
      fury of controversy, 290, 305;
      swarmery, 291;
      favoured by decline and absence of smallpox, 222-225, 369, 476,
            487, 514, 562.
    Tables of comparison and advantage, 214, 377.
    Disrepute in and around London (1805) 281, 293;
      abatement of faith under failure (1808) 308-309, 317, 453;
        (1822-23) 364-365, 426;
        (1825 and 1838) 520;
      Sir Henry Holland’s testimony (1839) 490;
      faith never so low as prior to enforcement of practice, 477-479;
      revival of delusion, 309, 426, 474-475.
    Reduction of claim to making smallpox milder, 238, 288, 313, 321,
            338, 566;
      security exactly equal to variolation, 339, 355.
    Opinion that prophylaxy wore out, Goldson, 284;
        Brown, 288;
      contested in _Edinburgh Review_, 302;
        by Thomson, 368;
      asserted by Lord Ellenborough, 353;
      denied by Jenner, 354;
      condemned by National Vaccine Establishment (1851), 473.
    Failure from reports of National Vaccine Establishment, 464-466.
    Easy art practiced by ladies and gentlemen, 276, 280, 305, 314, 489;
      Walker’s opinion, 324;
      practice in Sweden, 411-413;
      becomes difficult, 343;
      Simon’s ideal conditions of safety and success, 516-518.
    In Spanish America, 401-403;
      Austria, 404, 506;
      Bavaria, 596;
      Ceylon, 392-393;
      China, 393-395;
      Denmark, 419;
      Dublin, 242-243;
      Edinburgh, 241-242;
      Finland, 419;
      France, 169, 398;
      Glasgow, 441-446;
      Iceland, 420;
      India, 383-393;
      Ireland, 561;
      North Italy, 403-404;
      Newcastle, 426;
      Norwich, 432-434;
      Russia, 406;
      Scotland, 151, 534, 563;
      Spain, 400;
      United Kingdom (1853), 481-483;
      United States, 370-382;
      Vienna, 404.
    Adopted and enforced by State in England: Cobbett on projected
            compulsion (1803), 305-307,
        (1808), 310-311;
      established and endowed (1808), 250-258;
      paid for out of poor rate (1840), 470;
      enforced (1853), 480-485;
      vaccination office projected, 493-494, 496, 501,
        with compulsory revaccination (1855), 496;
      compulsion intensified (1861), 526;
      repeated penalties enacted (1867), 538, 540-541, 550;
      reported against by House of Commons’ committee (1871), 571;
      House of Commons concurs, 572;
      rejection by House of Lords and submission of Commons, 572-573;
      erratic and arbitrary administration of the law, 575-576;
      Evesham letter (1876), 576;
      subsequent attempts to modify law, 577.
    Law detested by the poor, 479;
      why abhorred, 501;
      cruel and despicable persecution, 590-592;
      hated in Lancashire, 591.
    Vaccination as a trade, 470, 479, 480, 485, 488-489, 493, 496, 518,
            519, 533, 536, 537, 580;
      public practice worth £100,000 a year, 583.

  _Vaccination Inquirer_, 580.

  _Vaccination Tracts_, 581.

  Vaccine girdle round the world, 401.

  Vaccine Pock Institution founded, 1799, 159, 251;
    Jesty’s visit, 205;
    reward offered for smallpox after cowpox, 258;
    consequently shut up, 259.

  Vaccine roses, 332.

  _Vaccine Scourge_, 325.

  Vaccinoff, a Moscow foundling, 406.

  Vantandillo, Sophia, prosecution, 462.

  Variolation practised in Turkey, 1, 9, 11;
      introduced to Boston, 2-7;
        to England, 12-14;
      experiment in Newgate, 15-17;
      on charily children, 17;
      children of Prince of Wales, 18;
      Maitland’s operations, 19-20,
        easy acceptance of practice, 22,28;
      opposition of Masseys, 23-28, 31-34;
      Dr. Nettleton’s practice, 30;
      Jurin’s precautions, 30-31;
      Dr. Scheuchzer’s tabulation of cases, 32;
      Dr. Wagstaffe’s observations, 33;
      disasters, 34;
      the position (1728), 35-36.
    Revival of practice under Dr. Mead (1748), 36-37, 39-40;
      in Smallpox Hospital, Cold Bath Fields, 40;
      sermon of Bishop Maddox, 40;
      theological opposition, 42;
      approval of London College of Physicians (1754), 43;
      etiquette of practice, 44;
      Mrs. Chapman’s procedure, 44;
      Jenner’s account of preparatory regimen, 45;
      Suttons’ methods, 45-47;
      Dr. Dimsdale’s, 47-49;
      Society for General Inoculation (1775), 49;
      extent of variolation, 52;
      Dr. Buchan’s evidence, 53-55;
      practice in New England, 56-59;
        France, 59-61;
        Geneva, 61-62;
      Empress Catharine, 62-65;
      fatalities, 66-69;
      cleared the way for vaccination, 70;
      Dr. Lettsom on dangers, 71;
      Wilberforce urgent for suppression, 71;
      denounced by Dr. Mathews, 71;
      by Sturges Bourne, 72, 246;
      by Jenner, 72;
      by Lord Henry Petty, 246;
      Lord Boringdon’s bill, 73;
      successful prosecution for exposure (1815), 73, 462;
      Dr. Epps (1831), 74;
      prohibited by Act of Parliament (1840), 74, 470, 464;
      Dr. Gregory’s regret, 74;
      revived by Ceely and Badcock (1839-40), 75-76.
    Practised in China, 16, 394,
      India, 392,
      Italy, 62,
      Persia, 394,
      Scots Highlands, 29,
      Wales, 29.
    Introduced to Barbados, 38;
      Boston, 2, 7, 11, 57-59, 371-374, 377;
      Florence, 62;
      France, 59;
      Geneva, 61;
      Germany, 62;
      Holland, 62;
      Ireland, 474;
      Newbury, 44;
      New England, 56;
      Newcastle, 445;
      Norwich, 435, 437;
      Paris, 60;
      Philadelphia, 38;
      Rome, 62;
      Russia, 62-65;
      St. Christophers, 38;
      Scotland, 50;
      Spain, 62;
      Sweden, 62, 408.
    Practised from arm to arm, 63, 120, 193;
      Jenner asserts its happy effects, 123;
      uncertainty of operation, 105, 108, 166, 212;
      cannot affect smallpox, Hamernik, 522;
      effects governed by mode and conditions, 150.
    A pest and a terror, 71, 72, 213;
      an excitant of scrofula, 123, 166;
      a cause of smallpox, 69, 236, 246, 390, 426, 431, 462-464.
    Contrasted with vaccination, 214, 377, 466;
      discredited by vaccination, 301, 514;
      led to acceptance of vaccination, 249, 370, 395.

  Variolous Test after swinepox, 98;
    description, 125;
    worked marvellously, 181, 212;
    exploded by variolators, 279;
    Brown’s evidence of futility, 287;
    evaded by Jenner and Vaccine Test preferred, 342-343;
    applied in Boston, 377.

  Venesection, 519, 584.

  Vere, Aubrey de, 566.

  Vicarious Mortality, Norwich, 438;
    law of, explained by Dr. Farr, 448,
      Dr. Woolcombe, 449;
      Dr. Gregory, 505-506;
      Malthus, 569-570.

  Vicarious Vaccination, 237;
    attested by Rev. Rowland Hill, 295;
    in London, 321, 324, 346, 488;
    in Vienna, 369, 404;
    in India, 388;
    in Northern Italy, 403-404;
    in Russia, 407;
    in Germany, 408;
    in Sweden, 414;
    in Denmark and Copenhagen, 419-420;
    in Glasgow, 446;
    in United Kingdom, 492, 514.

  Victoria, Queen, revaccinated, 564.

  Vienna, 232, 369, 404;
    vaccinated and equinated indistinguishable, 405.

  Villiers, Mr., 592.

  Voltaire, 59, 62, 65.


  Wachsel, J. C., 146, 280;
    experiments with horsegrease, 335.

  Wagstaffe, Dr., Newgate experiment, 16;
    various character of smallpox, 24, 238;
    dangers of variolation, 33.

  Wakley, Mr., 74.

  Wales, variolation practised, 29.

  Wales, Princess of (Caroline), 5;
    promotes variolation, 14-15, 17.

  Wales, Prince of (George iv.), 171, 219, 220, 221.

  Walker, Annie, 331.

  Walker, Dr., John, birth and adventures, 220;
    Royal Jennerian Society, 221;
    character and habits, 222, 225;
    differences with Jenner, 225, 226;
    resigns office, 226;
    London Vaccine Institution established, 227,
      and prospers, 453, 458, 460;
    interview with a duke, 228;
    public warned against, 250;
    at Surrey Chapel, 293;
    the great London vaccinator, 322;
    ease of vaccination, 324;
    a Quaker of Paine’s pattern, 330;
    attacked by Ring, 324-330;
    indifference to money, 330;
    reply to Moore, 331;
    practice and peculiarities, 332;
    death and character, 333;
    Jenner’s conduct toward, 307, 350;
    warns Emperor Alexander against him, 362;
    first cowpox missionary, 396;
    a fanatic, 457.

  Walkley, Hester, pregnant and variolated, 107.

  Waller, Prof., Prague, 523.

  Ward’s drop, 21.

  Ward, William Gibson, 589.

  Warren, Rev. T. A., 292.

  Washington’s soldiers variolated, 57.

  Waterhouse, Daniel Oliver, first vaccinated in New England, and put
        to variolous test, 376.

  Waterhouse, Dr., knowledge of smallpox and variolation in New England,
          57, 58;
    absence of smallpox in 1787, 58, 84, 374;
    introduces vaccination, 374, 376;
    his ready faith, 375;
    experiments, 376;
    advertisement, disasters, tactics, 377;
    compliments from Jenner, 378;
    vaccinates a cow, 378;
    vaccination good for weakly children and whooping-cough, 378;
    cows catch smallpox, 379;
    opinion of negroes, 379;
    Ring’s “wit,” 379;
    his cautions disregarded, 381;
    bewildered as to epidemics, 382.

  Watson, Sir Thomas, invaccination of syphilis, 310.

  Watson, Sir William, 146.

  Watt, Dr. Robert, discovery in Glasgow, 439-452;
    interdependence of forms of zymotic disease, 449, 504;
    evidence from West Indies, 560.

  Webb, Dr. Francis, 547.

  Weller, Richard, vaccinated by Cline, 128.

  Wellesley, Marquis, vaccination in India, 386, 389.

  Wellington, Duke of, 323.

  Wesley, John, interest in medicine, 37.

  West, Dr. Charles, evidence House of Commons’ Committee, 1871, 565.

  Westfaling, Thomas, 102.

  Westminster, Duke of, 209.

  Wheeler, Alexander, 586-587.

  Whitbread, Mr., 248.

  Whooping-cough, cured by vaccination, 378;
    in Newcastle, 429;
    in Glasgow, 439.

  Wilberforce, William, 184, 195, 232, 247, 254;
    urges prohibition of variolation, 71;
    Cobbett’s letter, 305, 317.

  Wilkinson, Dr. J. J. Garth, in Iceland, 422;
    account of his opposition to vaccination, 548, 549-550;
    evidence House of Commons’ committee, 1871, 554;
    _Vaccination Tracts_, 581-582;
    process of blood-making, 594-595.

  Willan, Dr., 66, 146;
    treatise _Vaccine Inoculation_, 266.

  Williams, Perrot, Welsh variolation, 29.

  Willis, Dr. C. J., Persia, 394.

  Wilson, Bishop, 81.

  Winchester, 40.

  Windham, Mr., 71, 194, 233, 247.

  Witchcraft and vaccination, 525.

  Witham, Mr., 173.

  Wollaston, Dr., 371.

  Wood, Dr. Alex., evidence as to Scotland House of Commons’ committee,
        1871, 563.

  Woodville, Dr. William, supposed derivation of smallpox from Animals,
        138;
    birth and career, 145;
    Anthony Highmore’s testimony, 163;
    experiments with horsegrease, 145, 163, 335;
    obtains cowpox in London, 145;
    smallpox eruptions follow its use, 146, 148, 149, 472;
      explanation, 149, 150, 151;
    difference from Jenner, 158;
    testifies for Jenner, 188;
    as seen by De Carro through Jenner, 265, 266;
    Jenner’s behaviour toward, 350, 352;
    visits Paris and vaccinates, 169, 398;
    work in conjunction with Pearson, 197, 198, 200, 203.

  Woodward, Dr., 1.

  Woolcombe, Dr., vicarious mortality, 449.

  Worcester, 189.

  Worgan, Dawes, 259.

  Worthington, Dr., 89, 102.

  Wright, Richard, variolation in Wales, 29.

  Wurtemburg, revaccination useless in army, 520.

  Wynne, Sarah, smallpox averts cowpox, 105-106.

  Wyld, Dr. George, debate with Alexander Wheeler, 586.


  York, Duke of, 126, 168, 171, 219.

  Young, William, 580, 581.


H. NISBET AND CO., PRINTERS, STOCKWELL STREET, GLASGOW.


       *       *       *       *       *


The LONDON SOCIETY for the ABOLITION of COMPULSORY VACCINATION,

114 VICTORIA STREET, WESTMINSTER, S.W.


OBJECTS OF THE SOCIETY.

  I.--The Abolition of Compulsory Vaccination.

  II.--The Diffusion of Knowledge concerning Vaccination.

  III.--The Maintenance in London of an Office for the Publication
  of Literature relating to Vaccination, and as a Centre of Action
  and Information.


ADDRESS OF THE SOCIETY.

Smallpox is a member of the group of diseases, described as zymotic
which originate in unwholesome conditions of life, and in common
are diminished and prevented by the reduction and removal of those
conditions.

In times when the laws of health were imperfectly understood,
it was believed that by poisoning the blood with the virus of
smallpox, or cowpox, a future attack of smallpox might be escaped.
While many kindred medical practices have been discredited and
forgotten, Vaccination, endowed by the State, has survived, and
has entered into legislation, and is enforced with fine and
imprisonment. It is in vain for Nonconformists to plead that
they do not believe that Vaccination has any power to prevent
or to mitigate smallpox, or that it is attended by the risk of
communicating foul diseases. They are told they may believe what
they like, but that vaccinated they must be, for the benefit of the
rite is settled beyond dispute, and that only fools and fanatics
venture to question what has been irrevocably determined.

It is to attack and overthrow this monstrous tyranny that the
LONDON SOCIETY has been established. The members desire to
enlighten the public mind as to the history of Vaccination, as to
its injury in communicating and intensifying other diseases, and as
to the failure of the compulsory law to stamp out or even diminish
the ravages of smallpox. Many too, whilst disinclined to discuss
Vaccination as a medical question, or to surrender confidence in
its prophylaxy, are opposed to its compulsory infliction. They
maintain that every remedy should be left to justify itself by
its own efficacy, and that of all prescriptions the last which
requires extraneous assistance is Vaccination; for its repute is
based on the fact that its subjects are secure from smallpox,
and in that security may abide indifferent to those who choose
to neglect its salvation. Even nurses in smallpox hospitals,
it is said, when efficiently vaccinated and revaccinated, live
unaffected in the variolous atmosphere. Therefore, they hold that
to compare an unvaccinated person to a nuisance, as is frequently
done, is to make use of an epithet that implicitly denies the
virtue asserted for Vaccination, a nuisance being a voluntary
danger or annoyance which another cannot conveniently avoid. They
also hold that to establish any medical prescription, and to
create interests identified with that prescription, is to erect
a bar to improvement; for it is obvious that any novelty in the
treatment of smallpox must, in the constitution of human nature,
meet with resistance from those whose emoluments are vested in the
established practice.

The LONDON SOCIETY, therefore, claims to enlist the energies, not
only of those who resist Vaccination as useless and mischievous,
but also of those who, true to their faith in liberty, would
leave its acceptance to the discretion of the individual. In the
controversy into which they enter, they propose to employ all the
familiar agencies wherewith in England revolutions are effected in
the public mind and in Parliament; and they appeal with confidence
for the sympathy and support of their countrymen. The Vaccination
Acts under which they suffer have not been enacted with the full
cognizance of the nation, but have been forced through indifferent
Parliaments by the persistency of medical faction. The members
of the SOCIETY are confident that, as soon as the truth about
Vaccination is fully known and appreciated, the freedom they
contend for will be conceded without fear, and that posterity will
view with amazement the outrage upon human right and reason that is
at present committed under the shadow of English liberty.


       *       *       *       *       *


Prejudice, which sees what it pleases, cannot see what is
plain.--AUBREY DE VERE.

He who knows only his own side of the case, knows little of
that.--J. STUART MILL.


The Vaccination Inquirer,

_The Organ of the London Society for the Abolition of Compulsory
Vaccination_.

Published Monthly, price 1d., or 1s. 6d. per annum, post free.


I would earnestly invite the attention of those who are concerned
for the repression of wrong, and the promotion of human welfare,
to the great and growing question of Vaccination. We hear on every
side that we cannot be secure from Smallpox unless we have our
blood poisoned with Cowpox in infancy, in adolescence, and at
stated periods throughout life. The prescription is so unnatural
that only custom renders it tolerable; it excites suspicion and
aversion wherever rationally considered; and dislike and disgust
are justified by inquiry. Smallpox is not averted by Vaccination;
and the virus introduced to the blood bears with it other diseases,
even the worst of diseases, and enfeebles and predisposes the
constitution to other maladies. In short, Vaccination under cover
of maintaining the common health inflicts upon it serious and
deadly injuries. And by a strange exercise of tyranny, this most
mischievous superstition is made compulsory and enforced by fine
and imprisonment; and Englishmen are dragged from their homes and
treated as convicts because they refuse to submit their children to
the abominable rite. Mr. BRIGHT says, “THE LAW IS MONSTROUS, AND
OUGHT TO BE REPEALED.” Yet is this monstrous law maintained!

Possibly you are opposed to Vaccination, or indifferent, or a
believer. In any case, I ask you to subscribe for the VACCINATION
INQUIRER. If you are opposed to Vaccination, it will stimulate
and inform your opposition; if indifferent, it will remove your
indifference; if you are a believer in the rite, it may convert you
to a better mind.

    WILLIAM YOUNG, _Secretary_,
    114 Victoria Street, WESTMINSTER.


       *       *       *       *       *


WORKS ON VACCINATION.

William White.


Sir Lyon Playfair taken to Pieces and disposed of: likewise Sir
Charles W. Dilke, Bart.: being a Dissection of their Speeches in
the House of Commons on 19th June, 1883, in defence of Compulsory
Vaccination. Second Edition. 6th thousand. 1s.

  “It is a very dainty pamphlet of two hundred pages, so printed
  that it is a luxury to read. There are six pages of index, which
  will give some idea of its fulness of matter. Mr. White does all
  his work in a workmanlike way, and this work is no exception. He
  gives the two speeches of Playfair and Dilke in full, and fully
  answers them. They are literally taken to pieces and disposed
  of. Read William White on Playfair and Dilke. It is the end of
  controversy. Reply is impossible.”--_Herald of Health._

  “Mr. White has done what has never been done before,--that is,
  he has taken to pieces Sir Lyon Playfair’s speech, analysed his
  arguments, and exposed much of what is untrustworthy. The book
  ought to be in the hands of all who desire to understand the
  question of Vaccination.”--_Newcastle Weekly Chronicle._

  “This is a clever and most reasonable criticism and overhauling
  of Playfair and Dilke’s opinions, of which the best idea can
  be gained from a study of the book itself, which will be found
  complete in every detail.”--_Brighton Gazette._

  “The official vindication of vaccination was contained in Sir
  Lyon Playfair’s speech backed up by Sir Charles Dilke, and Mr.
  White has taken the various points of both speeches, item by
  item, and has replied to them with a clearness and effectiveness
  which must go far to shake the foundation of vaccination itself;
  whilst, in our view, it effectually disposes of the plea for
  _compulsory_ vaccination.”--_Northamptonshire Guardian._

  “Anti-Vaccinationists will gloat over these pages. It is said
  that anything can be done with figures. We certainly at the time
  thought that Sir Lyon Playfair showed they were in favour of
  vaccination. On reading Mr. White’s book we are just as keenly
  impressed with an opposite view. We recommend the work to our
  readers.”--_Eastern Daily Press._

  “A remarkably well-written book by a practised hand. The subject
  is an unlovely one, and the proverbial ‘both sides’ have much
  to say; but this book ought to interest, amuse, and inform both
  sides. It everywhere tells of patient thought, industrious
  research, and a keen mind.”--_The Truthseeker._


Alfred Russel Wallace, LL.D.

  Author of _The Malay Archipelago, the Land of the Orang-Utan and
  Bird of Paradise_, 1869; _Contributions to the Theory of Natural
  Selection_, 1871; _The Geographical Distribution of Animals_,
  1876; _Island Life, or The Phenomena and Causes of Island Faunas
  and Floras_, 1880; _Land Nationalisation, its Necessity and
  Aims_, 1882; etc.

To Members of Parliament. FORTY-FIVE YEARS OF REGISTRATION
STATISTICS; proving Vaccination to be both Useless and Dangerous.
6d.


William Tebb.

COMPULSORY VACCINATION IN ENGLAND: with Incidental References to
Foreign States. 1s.

  “Not only crowds but Sanhedrims are infected with public
  lunacy.”--DRYDEN.

_Contents_:--Vaccination Results. Vaccination in the Workhouse.
Vaccination in Public Schools. Vaccination in the Post Office.
Vaccination in the Police Force. Vaccination in the Army.
Vaccination in the Navy. Vaccination in the Prisons. Vaccination in
Life Assurance. Vaccination amongst Emigrants.


P. A. Siljeström.

A MOMENTOUS EDUCATION QUESTION for the Consideration of Parents
and Others who desire the well-being of the Rising Generation.
Translated from the Swedish by Dr. Garth Wilkinson. 4d.


P. A. Taylor, late M.P. for Leicester.

CURRENT FALLACIES ABOUT VACCINATION. A Letter to Dr. W. B.
Carpenter, C.B. 1d.

SPEECHES of Mr. P. A. Taylor and Mr. C. H. Hopwood in the House of
Commons on 19th June, 1883. 6d.

PERSONAL RIGHTS. 6d.


Alexander Wheeler.

VACCINATION UNTIL 1883. 6d.

This Essay is dedicated to those whose minds are sufficiently
loyal to Science to be free to examine without prejudice, the most
prejudiced question of the day.


J. J. Garth Wilkinson, M.D., and Wm. Young.

VACCINATION TRACTS with Preface and Supplement. 2s. 6d.

  1. Letters and Opinions of Medical Men.

  2. Facts and Figures showing that Vaccination has failed to stamp
  out, arrest, or mitigate Smallpox.

  3 & 4. Opinions of Statesmen, Politicians, Publicists,
  Statisticians, and Sanitarians.

  5. Cases of Disease, Suffering, and Death reported by the Injured
  Families.

  6. The Vaccination Laws a Scandal to Public Honesty and Religion.

  7. Vaccination a sign of the Decay of the Political and Medical
  Conscience of the Country.

  8. The Propagation of Syphilis to Infants and Adults by
  Vaccination and Re-Vaccination.

  9. Vaccination evil in its Principles, false in its Reasons, and
  deadly in its Results.

  10. Vaccination subverts Dentition, and is the Cause of the
  prevalent Deformity and Decay of the Teeth.

  11. Compulsory Vaccination a Desecration of Law, a Breaker of
  Homes, and Persecutor of the Poor.

  12. Historical and Critical Summary in Three Parts. Part I.--The
  Imposture of the current Smallpox Lymph called Vaccine, and the
  new Imposture of Calf Lymph. Also, the Chaos of Statute Law
  dealing with Vaccine Substance.

  13. Part II.--The Cry of the People against Vaccination is
  seconded by the Registrar-General’s Returns, and justified by the
  Evidence of Pathology.

  14. Part III.--_Pro Aris et Focis._ The Religious Nature and
  Political Necessity of the Vaccination War.


E. W. ALLEN, 4 AVE MARIA LANE, LONDON, E.C.




  TRANSCRIBER’S NOTE

  Obvious typographical errors and punctuation errors have been
  corrected after careful comparison with other occurrences within
  the text and consultation of external sources.

  Except for those changes noted below, all misspellings in the text,
  and inconsistent or archaic usage, have been retained.

  Pg vi: ‘L’Envoi ... xlix’ replaced by ‘L’Envoi ... l’.
  Pg vii: ‘XV ... Physicans’ replaced by ‘XV ... Physicians’.
  Pg xiv: ‘afflicted with with what’ replaced by ‘afflicted with what’.
  Pg xxix: ‘records of the the Smallpox’ replaced by ‘records of the
  Smallpox’.
  Pg xxxiv: ‘In the the words’ replaced by ‘In the words’.
  Pg xxxviii: ‘two or or three’ replaced by ‘two or three’.
  Pg 3: The date of ‘March 10th, 1721/2’ reflects the fact that it is
        an Old Style (Julian) date.
  Pg 49: the term ‘efficiency’ here (and at the four other occurrences
         in the book) should probably be ‘efficacy’. These have not
         been changed.
  Pg 126: ‘did subequently fall’ replaced by ‘did subsequently fall’.
  Pg 148: ‘slow to repond’ replaced by ‘slow to respond’.
  Pg 175: ‘not everflow when’ replaced by ‘not overflow when’.
  Pg 221: ‘embarassments were’ replaced by ‘embarrassments were’.
  Pg 317: ‘un-unwearied exertions’ replaced by ‘unwearied exertions’.
  Pg 322: ‘CHARTER XXIV’ replaced by ‘CHAPTER XXIV’.
  Pg 350: ‘than sauvity’ replaced by ‘than suavity’.
  Pg 363: ‘13th February, 1823’ replaced by ‘13th January, 1823’ (see
          previous page 362, where it is stated that he died on the
          26th of January).
  Pg 376: ‘including a physican’ replaced by ‘including a physician’.
  Pg 410: ‘from 1774 to 1708’ replaced by ‘from 1774 to 1798’.
  Pg 468: ‘is tranferred to’ replaced by ‘is transferred to’.
  Pg 483: ‘medica practitioner.’ replaced by ‘medical practitioner.’.
  Pg 503: ‘and, inoculcated’ replaced by ‘and, inoculated’.
  Pg 519: ‘which, by resaon’ replaced by ‘which, by reason’.
  Pg 551: ‘repeatedy before’ replaced by ‘repeatedly before’.
  Pg 611-613: a few ‘----.’ replaced by ditto mark (”), for
              consistency.

  Footnote [261] (anchored on page 406): ‘History o Vaccination’
  replaced by ‘History of Vaccination’.





End of Project Gutenberg's The Story of a Great Delusion, by William White