SANITATION, NOT VACCINATION THE TRUE
Protection against Small-Pox
A Paper read before the Second International Congress of Anti- Vaccinators, held at Cologne, October 12, 1881,
By WILLIAM TEBB.
AT the first International Anti-Vaccination Convention, held last December at Paris, I had the honour of explaining the existing state of the opposition at that period to the Compulsory Vaccination Acts in England. My first thought on the present occasion was that I might appropriately continue the same theme, with a record of the important events which have occurred since our last convention, including the acceptance by Mr. P. A. Taylor, the leader of the Anti-Vaccination party in the House of Commons, of the position of President of the London Society for the Abolition of Compulsion, together with a glance at the conferences and public meetings in the metropolis and elsewhere, the public demonstrations at Brighton and Leicester, the considerable accessions of active support from influential quarters, the issue of important Parliamentary returns confirmatory of our position, and the publication and distribution of literature, at least five-fold that of any similar period in England, with other indications of encouraging progress, which, if detailed, would constitute an interesting chapter in the history of our agitation. I have preferred, however, to take a wider range, and to address you on the subject of "Sanitation versus Vaccination, as a preventive of Small-pox."
One of the most serviceable arguments in use by our opponents the pro-vaccinators is, that prior to Jenners discovery, small-pox was a scourge of the first magnitude, a relentless and fell decimater and destroyer of the human race. I shall not attempt to inquire how much of this is true, and how much is due to a lively imagination, except to mention one testimony, that of Dr. James Moore, who, in his "History of Small-pox (a work dedicated to Dr. Jenner), says that inoculation has occasioned the loss of millions of lives. These points have been dwelt upon by abler pens than mine, and their testimony is before you.
Sanitation, which has for its end the prevention of disease by the removal of the causes of disease, is a science which of late years in England, America, France, and Germany, and in other countries has engaged the attention of some of the ablest and most thoughtful minds. It is not, however, a new discovery. It was taught by the Jewish lawgiver, Moses, in numerous stringent regulations for the tent and camp, and by the Greeks and Romans, as their systems of baths, aqueducts, and drainage-works testify. In Rome the remains of the Cloaca Maxima are pointed out to every stranger as one of the sights of the city. With the decline of the Roman Empire, sanitation became one of the lost arts, and for many centuries plagues and epidemics carried off countless thousands in all the large centres of population, and were regarded as visitations of God with which it was presumptuous to interfere. Macaulay, in his "History of England," showing the conditions of life two centuries ago, says : "Cabbage-stalks and rotten fruit accumulated in heaps at the thresholds of the Countess of Berkshire and Bishop of Durham. Rubbish was shot into Lincolns-inn-fields, and St. Jamess-square was a receptacle for all the offal, dead cats and dogs of Westminster ; and these were deposited under the windows of the great magnates of the realmthe Norfolks, the Pembrokes, and the Ormonds." "Men died faster in the lanes of our towns than they now die on the coast of Guinea."
Other writers confirm this testimony. The streets were mostly unpaved, with open gutters, cesspools under houses, stagnant ditches, polluted streams, tainted wells; and the air was contaminated with effluvia arising from the decaying bodies of the dead, interred in close proximity to living urban populations.
Mr. BUcKLE says, that the smells in London were so bad that sweet herbs and perfumes were kept in the rooms to neutralise them. Nor were the interiors of our houses much more wholesome than their exterior surroundings. "The floors," says a writer of the sixteenth century, "generally are made of nothing but loam, and, are strewed with rushes, which, being constantly put on fresh, without a removal of the old, remain lying there, in some cases, for twenty years with fish-bones, broken victuals, the dregs of tankards, and impregnated with other filth underneath from dogs and men." Clothing was seldom changed, and was pervaded with unwholesome odours; linen and cotton were aristocratic luxuries; the food was coarse and badly cooked; two centuries ago there were no fresh vegetables grown in England, small quantities being imported from Holland for the exclusive benefit of the rich. These were days when the plague, sweating sickness, black-death, remittent fever, small-pox, and all forms of zymotic diseases, engendered by filthy habits and unwholesome surroundings, abounded. Violation of the laws of Nature breeds its own cure through manifold chastisements, but it was not until the severe visitation of cholera in 1831, that attention was awakened in England to the importance of the subject.
And in 1848 public opinion had sufficiently advanced to enable Parliament to pass what was called the "Nuisance Removal Act," as well as the "Public Health Act," by which was established the General Board of Health, and thenceforward the furtherance of sanitation became one of the recognised duties of the State. A series of amending Acts of Parliament have been passed relating to the public health, embracing cleansing of streets, removal of nuisances, construction of sewers, building of streets and houses, ventilation of public buildings, regulation of lodging houses, prevention of river pollution, and similar matters, and if the authorities had been content to fight disease by preventive measures of this kind alone, the zymotics might by this time have been deprived of their epidemic power; but, unfortunately, in an evil hour Parliament was induced to listen to a faction of the medical profession, who, unable to obtain the public acceptance of their theories on their own merits, determined to do so by the authority and assistance of the State, and were enabled to force upon everybody a disease called the cow-pox, because, as it had been pertinently said, somebody might catch the small-pox. In 1853 the Vaccination Acts were introduced by a private member, and passed into law, without notice or public discussion, and it is no exaggeration to say that a more wretched and obnoxious edict has not been foisted on the English-speaking race since the passage of the atrocious Fugitive Slave Law in America thirty-five years ago. Vaccination, which is a spreading of disease, became thenceforward, by a strange perversion of the fitness of things, officially associated with sanitation.
Several of the diseases I have mentioned have now practically disappeared, without any medical preventive, but solely by the effect of improved sanitation; yet small-pox, which vaccination promised to stamp out, is still raging, notwithstanding the lavish expenditure of millions among the medical profession; and the fell disease is a standing disproof of the Jennerian predictions. Reposing on a State-endowed remedy, which has been insolently called the greatest discovery in medical science, all special investigations into the causes of small-pox have been officially considered superfluous. During the present epidemic in London, June 10, 1881, a member of the English Parliament, Mr. Daniel Grant, asked in the House of Commons whether the Government would appropriate a sum of money to inquire into the causes of the outbreak. The President of the Local Government Board replied that the Board had no funds for that purpose; yet the official vaccination grants amount to over £100,000 a-year! Were it not for the determination to uphold vaccination at all hazards, the official excuse that the cause of small-pox lies in unfathomable mystery would long ago have been summarily set aside.
In a recent number of the Leicester Free Press, it is said :" So far as we are concerned in Leicester, a town containing 120,000 inhabitants, with many thousands of unvaccinated children, smallpox seems to be about the least dangerous of all diseases, and is not to be named by the side of scarlet fever, measles, whooping cough, diarrhoea, or even consumption. If a case of small-pox is discovered, instant isolation is adopted, and during the last five years we have hardly had five deaths. That being the state of the case, one need not wonder that the fear of the disease should disappear, or that resistance to vaccination should increase."
Dr. FARR, in his official report for 1876, says :" Experience has shown that the various forms of plague are influenced to a large extent by sanitary conditions. All zymotic diseases are most fatal in the densest districts, and although this may be due in part to contagion, it is certainly due in part to the concentrated impurities of towns."
And Professor PLAYFAIR says :" No epidemic can resist thorough cleanliness." Those who have intelligently watched the course of zymotic outbreaks, and noted the localities where they have arisen and the causes by which they are engendered, are convinced that it is within the power of Governments by means of scientific sanitary appliances and methods to stamp out small-pox altogether. Supposing vaccination to be abandoned, this revolution would be brought about, for it is the opinion of many of the ablest opponents of the vaccination laws in England that one cause of the perpetuation of small-pox in our midst is the application of this alleged remedy of vaccination. Every one now admits that a considerable portion of vaccination in England is variolation, i.e., small-pox matter passed through the cow, and that what is called vaccination is nothing but modified small-pox. In no part of England has submission been so rigorously enforced as in the English metropolis, where, in addition to the energetic efforts of vaccination officers and public vaccinators, stimulated by special awards, there has been inquisitorial house to house and school to school visitation; the remorseless cow-poxing in the work-houses even of infants scarcely a week old; the hunting of unvaccinated fugitives from parish to parish, like slave-hunting in the United States ; and the relentless prosecution of the parents of un-vaccinated children in every police-court in the metropolis. And what is the result? Has small-pox been stamped out, as all the Jennerian prophets in succession have loudly predicted? On the contrary, in proportion as public money and State machinery have been diverted from sanitation (the only scientific adversary of small-pox), to vaccination, or the unscientific treatment by poisoning the blood, the disease has spread with the result shown by the Registrar-General in his annual summary for the year 1880, which tabulates the small-pox mortality of London for the last thirty years as follows:
Estimated Mean Population Small-pox
1851-60 2,570,489 7,150
1861-70 3,018,193 8,34.7
1871-80 3,486,486 15,551
The last decade showing an increased small-pox mortality of 80 per cent. It must not be supposed, however, that this mortality is equally spread over the Metropolis, or that it exists in all classes of habitations alike. In the princely mansions of South Kensington, Hyde Park, and Regents Park, in the aristocratic districts of Bayswater, Notting Hill, Haverstock Hill, the open and airy slopes of Hampstead [Dr. EDMUND GWYNN reports (Lancet. Nov 5, 1881) the death-rate for Hampstead, with a population of 45,436, at 12.6 per 1,000 for 1880, as compared with 22.2 in the metropolis generally] and Highgate, in the salubrious suburbs of Ealing, Clapham, South Hornsey, [Dr. JACKMAN, Medical Officer of Health for the South Hornsey district, states that the death rate of the district is only 10.7 per 1,000 living, and the birth-rate is equal to 39.0 per 1,000. Special inspections of the houses in the district are made from time to tune by Mr. ABRAMS, the Sanitary inspector, and a proposal is now on foot to procure for the inhabitants a constant water supply.Lancet Nov.. ,1881] Sydenham Hill, Wimbledon, Chislehurst, and Finchley, cases of small-pox are of the rarest occurrence. The epidemic is found amongst the poor, ill-fed, uncleanly, intemperate, over-worked populations of Hackney, St. Giless, Bethnal-green, Poplar, Shadwell, Bermondsey, and Southwark, amongst those who live in the courts and alleys, in old and decayed habitations, and in the miasmatic atmosphere in which the neglected residuum of this immense city are reduced to dwell. Amongst the denizens of these tin-wholesome districts will be found the largest proportion of the specially unhealthy children, the offspring of the diseased and vicious to whom the so-called protection, vaccination, is prohibited by official instructions. These children have no vitality to resist small-pox and other zymotic diseases, hence it is that a larger number of the unvaccinated or unhealthy children die of small-pox than the general average. This pretended protection must needs be given not to the weak and sickly, who most require protection, but to those whose physical strength is itself an all-sufficing safeguard.
The British Medical Journal, an ardent pro-vaccinating advocate, in its issue of Oct. 23, 1880, says, "It is probable that a larger proportion of unvaccinated persons is to be found amongst the ignorant, dirty, and wretched inhabitants of the slums of London, and very few amongst the educated and better fed members of society. The disease is much intensified by over-crowding." Thus the highest vaccination medical authority vitiates and overturns the entire fabric of Dr. BUCHANANS figures which, both in England and Germany, seemed a few months ago to have galvanised the vanquished Jennerians into a spasmodic vitality. When Dr, SOUTHWOOD SMITH, Mr. EDWIN CHADWICK, Mr. H. D. DUDGEON, and other leading sanitarians, commenced their work thirty years ago, by showing that filth, bad drainage, impure water, and overcrowded dwellings were the causes of zymotic diseases, the rank and file of the medical profession ridiculed their theories with unsparing scorn. Evidence, nevertheless, as to the truth of the theory and contention accumulated, so rapidly indeed, that had not many of the doctors. relinquished their fatuous objections, they must have placed themselves outside the intelligence of the age. The vaccinators yielded to public opinion reluctantly, and so far as small-pox is concerned, many of them still audaciously defend their oft-exploded theories. One of the most striking proofs in support of my contention is that afforded in a letter written by our esteemed friend and colleague, the energetic sanitary reformer, Dr. OIDTMANN, illustrating the enormous advantages of sanitation in preventing small-pox in the German invading army, and the dangerous consequences of the neglect of these precautions in the French army ; the conditions as to vaccination being alike in both cases.
In the Natur-Arzt, published at Dresden in 1873, Dr. OIDTMANN says :" In my numerous marches and halts in the campaign of 1870-71, I directed my particular attention to the health statistics. After the taking of Verdun, I noticed that the rooms in which the French hospital patients were miserably decimated during the bombardment, were inexpressibly close and ill-smellingbreeding places of small-pox poison. The only German physician of the garrison being unwell, it fell to my lot to root out these filthy lurking-holes of pestilence. At a later period, after the battle of St. Quentin, I was physician of the garrison staff of that place, and all the statistics of the French, German, and International Hospitals for six weeks in succession passed through my hands. The number of French who, during that time, died in these hospitals of pyaemia (blood-poisoning) and phlegmonia (blood impurities) was so wonderfully great in proportion to the small death-rate of the German hospitals, that the vaccination statistics of your English newspapers can hardly admit of comparison with it. What then was the cause of the protection of our people from these two diseases? Had they been inoculated for pyaemia and phlegmonia? Certainly not. But, whereas in the French hospitals a veritable pest atmosphere reigned night and day, yet at Abbeville, on the contrary, where we had no French army doctors, and where the arrangements of the hospital were in the joint hands of myself and the medical men of the place, the statistics of recovery from small-pox were highly favourable, and indeed equal for French and Germans. The enormous difference between the small-pox mortality of the two armies, was caused by the crying neglect of hygienic precautions in the French military department, and by the excessive concentration of their system of stationary sick depots, as opposed to the freshness of the hygienic arrangements of the German hospitals, and the ambulatory movements of their scattered troops. No more decisive proof can exist of the correctness of my theory that the strength and spread of small-pox is both proportioned to and progressive with the fostering and shutting in of the small-pox vapourthan these statistics of the Franco-Germian War."
Proofs of the truth of the value of sanitation are, however, nearer at hand, and a satisfactory demonstration is afforded by the associations in London which have devoted their attention to improving the dwellings [Dr. SOUTHWOOD SMITH, referring to the improved conditions of the inhabitants of the model dwellings, at p.17 of his "Results of Sanitary Improvements." says.:There has been in the improved dwellings complete exemption of typhus, cholera, and, it may be added, small-pox; yet it must be admitted, that other forms of zymotic diseasescarlet fever, measles, whooping cough, and diarrhoeahave occurred, though rarely, and these maladies have in no instance spread."] of the poor. A wholesome habitation in a crowded district is shown to diminish the death-rate by a third or half, as compared with that of the occupiers of old houses in the same locality. I have before me a report of the thirty-sixth half-yearly meeting of the Improved Industrial Dwellings Company, held at the Mansion House, London, August 5, 188i. This association controls 3,681 tenements or habitations (with a population of 18,000 persons), nearly all of which are located in the denser parts of London, and the mortality is only 16.7 per thousand, while the death-rate of the adjoining houses is 30 to 35. Although the report is for a year when there was a severe epidemic of small-pox the secretary, Mr. JAMES MOORE, informs me that only one death from that disease occurred. The thirty-seventh report of another, the Metropolitan Association for improving the Dwellings of the Industrial Classes, read June 6, 1881, gives the death-rate of an average population of 5,675 at 155 per thousand. And as the average mortality of the entire metropolis is 23 per thousand, there has been a saving of life of seven or eight per thousand. In the last-named association there has not been one death from smallpox during the past ten years, while the surrounding habitations have often been the hotbeds of contagion. An equally satisfactory result has been achieved by the Victoria Dwellings Association, which has been in existence six years. Their buildings are situated at Kings Cross, a crowded centre of the Metropolis, and at Batter-sea, one of the outlying suburbs. The average population has been 2,500, out of which only twenty-four deaths occurred during the past twelve months, or less than half the Metropolitan death-rate, and not a single death from small-pox since the association was formed. The facts prove the truth of my contention, that sanitation is sufficient to prevent and stamp out all zymotic diseases including small-pox; and even if it could be shown that vaccination would do the same, it is nevertheless wholly unnecessary. Earl SPENCER, in opening the Sanitary Exhibition in London, on July 16, said that already in Great Britain the death-rate had been so much diminished during the past ten years that 300,000 lives have been saved, as compared with the previous decade, and this was largely due to improved sanitation. An official report on the sanitary condition for 1881, says that more than three-fourths of the reduction is due to the decrease of severe zymotic diseases, the product of filth, which good sanitation can remove.
It is clear, therefore, from the foregoing facts, that small-pox can be extirpated by means of sanitation alone, a remedy which, besides being absolutely efficacious, can be adopted by municipalities and by individuals with the certainty that it is attended with none of the dreaded evils inseparable from the compulsory injection of lymph of doubtful origin and unknown virulence and power. The testimony of Dr. FARR and Professor PLAYFAIR, both pro-vaccinators, and the evidence deduced from the death-rate of the various improved dwellings associations, leave Governments without excuse for continuing a system which, besides being of non-effect as a preventive, is often the cause of ineradicable mischief. Compulsory medicine, according to the testimony of Mr. MACLAREN, the late Lord Advocate for Scotland, and other high authorities, is opposed to the ancient constitution of England, and is, therefore, a gross infraction of the liberty of the Citizen and of parental rights. The work of our Congress is to assist in restoring the birthright of our citizens, to give back to parents their highest duty and privilegethe sacred right to protect and defend their offspring from evil, and to liberate the oppressed of many nations from an ignorant, unjust, and indefensible tyranny.
The laws which I arraign are overbearing, but being founded on injustice, must ere long crumble before a growing public opinion, which now demands, and will soon compel, their unconditional repeal ; and the pretended duty of experimenting upon our neighbours children will cease to supersede the real duty of protecting our own.
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