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.

 

INTRODUCTION.
Prefatory

Variolation
The Precursor of Vaccination,
Immediate Triumph of Vaccination,
Jenner's Procedure
Horsegrease Cowpox

Rejection of Jenner's Prescription

Jenner's Transformation

Horsegrease Cowpox kept out of Sight

Spurious Cowpox,

Horse Virus Vindicated,

Which shall it be ?

Smallpox Cowpox,

Condemnation of Smallpox Cowpox

Cowpox Revived

A Cowpox Charlatan

A Decorous Unanimity

Jenner's Successive Disclaimers

Smallpox made milder

Punctures, one or several

Mr. Rigby's Protest

Mr. (Marks) Marson

Mr. Alexander Wheeler's Researches

Mr. Enoch Robinson's Opinion

Cruelty of Marking

Revaccination Introduced

Vaccinisation
Absurdity of Revaccination

The Reduction of Smallpox

Has Vaccination saved Life

Who are the Unvaccinated
Unvaccinated Death-rates

Nurses exempt from Smallpox

Pock-marked Faces

Vaccinia a real Disease

Vaccinal Fatalities

Vaccinia Modified in its Recipients

Vaccinia plus other Disease

Statistical Evidence of extra Disease

Vaccinia aggravates Disease

Origin of Compulsory Vaccination

Resistance, Inflexible Resistance

Compulsory Education and Vaccination

Conditions of the Conflict
A Word for the Author

L'Envoi,          

Dr. Garth Wilkinson's Catechism

I.—VARIOLATION.

I.—Cotton Mather and Zabdiel Boylston
2 —Lady Mary Wortley Montagu
3.—Maitland's Experiments

4.—The First Opponents of Inoculation

5.—Collapse of Inoculation

6.—Revival of Inoculation

7.—Triumph of Inoculation

8. —Inoculation Abroad

9.—Inoculation superseded and suppressed

10.—As to the  Prevalence  of   Smallpox in the  18th Century

II.—VACCINATION

1.—Jenner's Earlier Years

2.— Jenner's Inquiry, 1798
    JENNER'S DESCRIPTION OF COWPOX.
    GENERATION  OF  COWPOX  IN  HORSEGREASE.
    THE  VARIOLOUS  TEST.

3.—Jenner in 1798 

4.—Pearson's Inquiry

5.—Woodville, Pearson, and Jenner

6.—Jenner's Further Observations

7.—Operations in London, 1800

8.—Triumph of the New Inoculation

9.—A Dishonourable Transformation

10.—Jenner before Parliament, 1802

11.—Pearson's Examination

12.—Observations on the Position in 1802

13.—The Royal Jennerian Society
    ORIGIN  OF  THE  TERM  VACCINATION.

14. —Application to Parliament for Jenner's Belief, 1806

15.—Report of the Royal College of Physicans

16. --Jenner Relieved, 1807

17.—Vaccination Established and Endowed

18.—Horsegrease as a source of Vaccine
19.—John Birch

20.—Goldson and Brown

21.—Moseley, Rowley and Squirrel

22.—William Cobbett

23.—The Grosvenor Case

24.—Dr. John Walker

25.—Jenner's Later Writings

26.—Baron's Life of Jenner

27— The Medical Position in 1823

28.—Introduction of Vaccination to the United States

29.—Introduction of Vaccination to India and the East
30.—Diffusion of Vaccination throughout Europe

31.—Sweden, Denmark and Iceland

32.—Newcastle Smallpox : a Common Story

33.—The Norwich Epidemic—1819

34.—Smallpox Displaced and Replaced: Dr. Watt's Discovery—Glasgow, 1813

35.—The National Vaccine Establishment—1808-40
       
FAILURE OF VACCINATION.
        VARIOLATION.
        DEVELOPMENT OF A FABULOUS SALVATION.

        POCK-MARKED PACES.

36.—The National Vaccine Establishment—1841-50

37.—Vaccination Enforced—1853

38.—Universal Compulsion Demanded—1855
39.—John Gibbs's Letter—1855
40.—Simon's Defence and Hameruik's Judgment

41.—Compulsion Intensified—1861 and 1867

42.—The Gathering Movement, 1867-70

43.—House of Commons Committee, 1871

44.—The Struggle for Freedom

 

NOTES—ORIGIN  OF  THE  TERM  VACCINATION.

Vaccination a Statistical Question

 

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 hoereditas 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 exited. 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 drove the vaccinators from post to post (cursed as they did so as malignant false witnesses possessed by 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, treatise much more spoken of than read, wherein he distinctly set forth the origin of his chosen prophylactic. If 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 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 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 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 my 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 s 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 not to be envied.

WHICH  SHALL  IT  BE?

Jenner died in 1823, and at that date three kinds virus were in use; first, cowpox from horsegrease or horsepox; second, cowpox; third, horsepox. These of course were subject to inscrutable modification in transition 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 is'nt 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 ecclesiastics.

SMALLPOX COWPOX.

Jenner was pleased to describe cowpox as a mild form of smallpox; but for what reason, outside his pleasure, 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 led ?   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.' Then 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 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 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 order; 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 practiced.    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 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 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 peoples 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 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 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 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, father, 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 soc fresh artifice was essential. It was hard to surrender the original claim of the equivalence of vaccination to small pox; 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.

 

1. One of these is the reduction of smallpox.    It is said “Smallpox was once a common disease, and is now 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?

2.—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. Kobert 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 ?

3.—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 un vaccinated.

 

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 been 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 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, diarrhoea, would exhibit a higher rate of mortality than vaccinated; but would it therefore be safe to argue that vaccination was not only good against smallpox, but against measles, pneumonia, and diarrhoea ? Yet it in, 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.

4.—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 small 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, 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.

5.—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 noon. 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 pyoemia, or diarrhoea, 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, pyoemia, diarrhoea, or similar sequelae ? 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 results 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 Souse 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 pre-disposes 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 diarrhoea is its commonest sequence ; and given erysipelas and diarrhoea, 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 preventable; 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 in-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 1.---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.

 

1. Philosophical Transactions, No. 338, 1714.

2. Nova et Tata 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.

 

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 whole-some operation, for after it "feeble, crazy, consumptive people, grew hearty, and got rid of their former maladies." 1

 

To be poxed was to be rejuvenated.

 

1. Philosophical Transactions, Vol. xxxii. p. 35.

 

Cotton Mather's own account of the Boston  experience is worth reading.  He wrote—

 

March 10th, 172½ .

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 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 public 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 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.1

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.2   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 of thousands by it; and make further improvements in it; 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 ; 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, in 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."

 

1. Letter to Dr. Jurin by Isaac Massey.    London, 1723

2.  An Historical Account of the Smallpox inoculated in New England upon all sorts of persons, Whites, Blacks, and of all Ages and Constituions. By Zabdiel Boylston. London, 1726.

 

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 5,759 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—1

 

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.2

 

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. 3

 

1. An Historical Account, p. 39.  2.  Ibid. p. 38.    3.  Ibid. p. 40.

 

In the knowledge of the emptiness of this bounce, it nay 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.1

 

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 Cyclopœdia, 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.

 

1. An Historical Account, p. 1.

 

CHAPTER 2.

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.1

 

1. Literary Studies, Vol. i. p. 248.

 

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 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 which 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 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 their 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 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 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 romancing so triumphantly to Miss Sarah Chiswell she despatched this note to her husband—

 

Sunday, 23rd March, 1717-18.

The boy1 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.

 

1.* Born in Yorkshire, 1713.

 

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.”1

 

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 it has been known in other parts of the East, a hundred, or, aught we know, some hundreds of years before.2

 

1. Account of Inoculating for Smallpox.    London, 1722.
2.  A Short Account of Inoculation.    London, 1723.

 

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 practiced 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 mouth 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.1

 

1. Account of Inoculating for Smallpox p4

 

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.

CHAPTER 3. 

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, 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, 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 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 faculty 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.1

 

1.  Letters and  Works of Lady Mary Wortley Montagu.    Vol. i. pp. 88-90.    Ed. 1861.

 

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 NOETH,   .        .        .       Aged 36 years.

2.  ANNE TOMPION,                                  25 years

3.  ELIZABETH HARRISON,                      19 years

4.  JOHN CAWTHERY,                                25 years 

5.  JOHN ALCOCK,                                       20 years

6.  EICHARD EVANS,                                   19 years

 

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.1

 

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.2

 

1. On Smallpox and Measles.   By Dr. Mead.    London, 1747.

2.  Mr. Maitland's Account of Inoculating the Smallpox.    2nd. ed.   London, 1723.

 

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. 1

 

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.

 

1.  A Letter to Dr. Freind showing the Danger and Uncertainty of Inoculating the Smallpox. By W. Wagstaffe, M.D. London, 1722.

 

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.1

 

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. 2

 

1.  An Account of Inoculation by Sir Hans Sloane, Bart., given to Mr. Ranby to be published, 1736. Philosophical Transactions, Vol. xlix. p. 516.

2.  Isaac Massey to Sir Hans Sloane, 1722.

 

He had not the proper craft of the 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 he 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.1

 

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.2

 

1.  Maitland's Account, p. 27.

2.  Ibid. p. 33.

 

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.1

 

1.  Maitland's Account, p. 27.

 

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.

 

CHAPTER  4.

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.1

 

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. 2

 

1. Letters and Works of Lady M. W. Montagu, Vol. i. p. 468, edition 1861.

2. Ibid. Vol. ii. p. 161.

 

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 pharmacopoeia 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.1

 

1.   A Short and Plain Account of Inoculation.    By Isaac Massey. London, 1724.

 

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 hotter argument for this practice than the cry, Inoculation! and King George for ever! 1

 

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.2

 

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. 3

 

1. Letter to Mr. Maitland.    By Edmund Massey.    London, 1722,
2.  A Short and Plain Account of Inoculation, p. 1.        
3. Ibid. p. 21.

 

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. 1

 

1. Letter to Dr. Jurin.    By Isaac Massey.    London, 1723.
2. Letter to Dr. Freind.    By W. Wagstaffe, M.D., P.R.S., one of the physicians of St. Bartholomew's Hospital.    London, 1722.

 

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.2

 

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

  1,095

1702

19,481

     311

1703

20,720

     898

1704

22,684

  1,501

1705

22,097

  1,095

1706

19,847

     721

1707

21,600

  1,078

1708

21,291

  1,687

1709

21,800

  1,024

1710

24,620

  3,138

1711

19,833

    915

1712

21,198

  1,943

1713

21,057

  1,614

1714

26,569

  2,810

1715

22,232

  1,057

1716

24,436

  2,427

1717

23,446

  2,211

1718

26,523

  1,884

1719

28,347

  3,229

1720

25,454

  1,440

1721

26,142

  2,375

1722

25,750

2,167

 

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 1 in 14.1

 

1.  A Letter to  Caleb Cotsworth,   M.D.    By James Jiirin,  M.D. London, 1723.

 

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, swine-pox, 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.1

 

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.2

 

1. Letter to Dr. Jurin.    London, 1723.

2. Ibid.

 

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.1 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.2

 

1.  Mr. Maitland's Account of Inoculating the Smallpox Vindicated. London, 1722, p. 20.
2. Letter to Dr. Jurin, p. 12.

 

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 ! 1

 

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.2

 

1.  Jurin's Yearly Account of Inoculation, p. 13.
2.  Letter to Mr. Maitland in Vindication of the Sermon against Inoculation,
London, 1722.

 

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.

CHAPTER  5.

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 Society1 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.2

 

1. Philosophical Transactions, No. 375, 1723.
2.  An Account of Inoculation in
Scotland.   By A. Monro.   Edin., 1765.

 

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 Society1—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 Bochdale, a small neighbouring market town, 177 have had the distemper, and 88 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.2

 

1.  Philosophical Transactions, No. 370, 1722.
2.  Letter from Dr. Nettleton to Dr. Jurin, dated Halifax, 16th June, 1722.

 

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 in 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.1

 

The publication of these conditions was little short of a practical surrender, and the opponents of inoculation wore 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.2

 

1. An Account of the Success of Inoculating the Smallpox in Great Britain. By James Jurin, M.D.
2.  Reasons Against the Inoculation of the Smallpox. By Francis How-grave, Apothecary. London, 1724.

 

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.1

 

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.2

 

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 3 the cases and results of these years, 1721-28, as follows—

 

Age

No. operated upon

Successfully inoculated.

Had imperfect Smallpox.

Did not take.

Died

.

 

 

 

 

 

 

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

 

1.  Remarks on Dr. Jurins Last Yearly Account of the Success of Inoculation. By Isaac Massey. London, 1727.
2. Ibid. p. 5.

3. An Account of the Success of Inoculating the Smallpox in Great Britain. By John Gasper Scheuchzer, M.D. London, 1729.

 

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 over 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.1

 

1. Danger and Uncertainly of Inoculating the Smallpox, p. 64.

 

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."1

 

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 Maitiand; 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 Kobinson inoculated five children in Dublin in 1725, and was the death of two of them.2

 

1. Massey's Remarks, p. 18.
2. Scheuchzer and Massey.

 

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.

CHAPTER 6.

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 £5,000 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 £5,000 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 3,000 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.1

 

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. 2

 

1. Medical Works of Dr. Mead, Vol. ii. p. 146.   Edinburgh ed., 1765.
2. Ibid, p. 149.

 

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 sequelae 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, 1752,1 which excited considerable attention.

 

1.  A Sermon before the Governors of the Smallpox Hospital.    Isaiah 1viii. 7.    London, 1752; second ed., 1753.

 

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 3,588 in 1752; declined to 774 in 1753; and rose to 2,359 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.1

 

1.  An Analysis of Inoculation, 2nd ed. 1761, p. 145.

 

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." 1  It would not be difficult to cite scores of confessions of gratitude to God for inoculation, but to what purpose ?

 

1. Analysis of Inoculation, p. 348.

 

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.1  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 clown 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 schoolfellows 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. 2

 

Thus was inoculation revived and established, and smallpox with it—established and diffused.

 

1.  Gentleman's Magazine, March, 1753.

2.  Kirkpatrick's Analysis of Inoculation, p. 359.

 

CHAPTER 7.

TRIUMPH  OF  INOCULATION.

IT having come to pass, according to the boast of Dr. K irkpatrick, 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 blod 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 lie operated on 2,514 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 2,000 guineas, and in 1765 his receipts were £6,300.  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,     .        .        .    1,029
      „              1765,     .        .        .      4,347
                      1766,     .        .        .      7,816
                                                          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.1

 

1.  Sermon preached at Ingatestone, 12th October, 1766, in defence of Inoculation, with App. on the present state of Inoculation, Lond., 1767.

 

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.1.

 

1. Medical Transactions, vol. ii. art. xix.

 

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.1

 

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, Dirnsdalc was strongly opposed to the trade therein passing to xm-authorised 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.2

 

1. Tracts on Inoculation, p. 126.

2.  Ibid. p. 107

 

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 safeguards.  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 5,554 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 all Diseases

From Small pox.

 

Burials from all Diseases

From Small pox.

1744

1345

167

1754



1215



104

1745

1463

   141

1755



1187



  89

1746

17121

   128

1756

1,316

126

1747

1200

     71

1757

1,267

113

1748

1286

   167

1758

1,001

  52

1749

1132

   192

1759.

1,136

232

1750

1038

     64

1760

1,128

  66

1751

1241

   109

1761

   903

    6

1752.

1187

   147

1762.

1,305

274

1753

1105

     70

1763.

1,160

123

 

12,709

1,256

 

11,613

1,185

 

1. Monro accounts for the excessive mortality of this year by the presence of regiments in Edinburgh after the suppression of the rebellion of 1745.

 

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 ease 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.

 

CHAPTER   8.

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.1

 

1.  Humphries's Life of General Putnam, p. 151.

 

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 via naturœ 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 2,000 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.1

1. These letters of Benjamin Waterhouse, M.D., Professor of Physic at Cambridge, Mass., appear in Haygarth's Plan to Exterminate Smallpox. London, 1793.

 

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—

 

1.—The Republic of Geneva contains about 35,000 inhabitants, of whom 20,000 dwell in the city, and 9,000 in the adjacent country.

2.—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 1,200 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.

3.—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.

4.—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,

5.—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.

6.—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 Scot-. land.    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.1

 

1. The History of the Smallpox.   By James Moore.   London, 1815.   P.288.

 

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.1

 

1. Diderot and the Encyclopœdists.    By John Morley.    Vol. ii. p. 114.

 

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 had 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.”1  The Grand Duke was inoculated on the 30th October, and by the 22nd November had perfectly recovered."

 

1.  Dimsdale: Tracts on Inoculation.

 

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 substantiate 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.

 

CHAPTER 9.

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.1

 

1. Serious Reasons for Uniformly Objecting to the Practice of Vaccination. By John Birch. London, 1806.

 

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 he 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, that 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.1

 

1. Birmingham Medical Review, January, 1874.

 

Mr. May recognised the fact and concealed it: a duller man would have ascribed the death mechanically to erysipelas or pyœ mia.  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." 1  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.

 

1.  The facts are set forth in Vaccination Tracts, No. 14, p. 7.

 

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 sequelae 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 Cow-pox 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 firebrand 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 Pereceval'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 grandmotherly legislation.  Among its provisions was the enactment that whenever an inoculation took place, the clergyman of the parish should receive notice, and that rod 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 1881 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.1

 

Gradually the inoculating practitioner ceased, and the practice remained in the hands of " ignorant and unqualified persons, old women, and itinerant quacks;" 2 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.

 

1. Life of John Walker, M.D.    London, 1831, p. 326.

2.  Letter of Poor Law Commissioners, 20th August, 1840.

 

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.1

 

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.2

 

1. Lectures on Eruptive Fevers.    London, 1843, p. 39.
2. Ib., p. 93.

 

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 2,000 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.

 

CHAPTER   10.

AS  TO  THE  PREVALENCE  OP  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 Tables 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 Towel 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 cause 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 due to the judgment they pronounce.1

 

1. "On the Uses and Defects of Parish Registers."   By G. M. Burrow M.D.    In London Medical Repository, No. 58, October, 1818.

 

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—

 

Year.

 

Burials from all Diseases.

 

From Smallpox.

 

From Fevers.

 

1736

  27,581

  3014

  3361

1740

  30,811

  2725

  4003

1746

  28,157

  3236

  4187

1749

  25,536

  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-

Year

Burials from all Diseases

From

Smallpox

From Fevers

1745

21,296

 1,206

  2,690

1750

23,727

 1,229

  4,294

1751

21,028

    998

  3,219

1753

19,276

    774

  2,292

1773

21,656

 1,039

  3,608

1780

20,517

    871

  2,316

1782

17,918

    636

  2,552

1786

20,454

 1,210

  2,981

1788

19,697

 1,101

  2,769

1795

21,179

 1,040

  1,947

1797

17,014

    522

  1,526

1799

18,134

 1,111

  1,784

 

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 3,548 died.  I yield to none in detestation of smallpox as a preventable 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.1

 

1.  Nichols's Illustrations of Literary History, vol. iv. p. 499.

 

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 wore 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 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."1

 

1. The Times, 23rd Oct. and 4th Dec., 1879.

 

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.1

 

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.2

 

1. Baron's Life of Jenner, vol. i. p. 107.

2. An Appeal to the Public on Vaccination.    By John Birch.

 

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 2,075 than in the second thirty years during which Inoculation had acquired some stability, and greater by 8,115 than in the last thirty years during which Inoculation was the established practice of most prudent families.1    We are therefore unjustly accused.     These figures leave no doubt that smallpox decreasing, and we claim that the decrease is due to our practice."

 

1.  Dr. Adams in Medical Journal, 1810, p. 31.    Dr. Gregory in treatise on Eruptive Fevers, 1843, cites and endorses this argument.

 

The decrease was certain, but I cannot allow that was due to Inoculation;  on the contrary I assume 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 are cruelly unkind to theorists, sentimentalists, 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 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." 1

 

1. Article, "Vital Statistics: Epidemics," in M'Culloch's Statistical Account of the British Empire.

 

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 today, 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.1

 

1.  Domestic Medicine. Chap. 1vi.    Concerning the Diet of the Common People.

 

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 he 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 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.1

 

1.  Baron's Life of Jenner, vol. ii. pp. 348 and 410.

 

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 un-frequently 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.

 

PART 2.-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 Cinchonœ, 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.1

 

1. Autobiography of Sir B. C. Brodie, p. 38.

 

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 1,000 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. Kendall, 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.1

 

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 cow-pox is reputed to prevent smallpox, but we know that it does not, and that should end the matter."2

 

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.3

 

1. Simon's Papers on Vaccination, p. xii.
2. Baron's Life of Jenner, vol.i. pp. 48 and 126.
3. Ib., vol. i. p. 127.

 

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,"1 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 no I. see miracles, it is because we do not choose to look for them.

 

1.  Thus described by Gardner.    Baron's Life, of Jenner, p. 15.

 

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.1

 

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."2

 

1.  Baron's Life of Jenner, vol. i., pp. 127-129.
2. Ibid., p. 135.

 

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.1

 

1. Baron's Life of Jenner, vol. i., p. 131.

 

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.1

 

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.2

 

1. Jenner's Inquiry, case i., p. 9.

2. Baron's Life of Jenner, vol. i., p. 297.

 

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 horse-grease 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 mo of the truth of my assertion heyond the possibility of a denial. 1

 

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.2

 

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."3  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.

 

1. Baron's Life of Jenner, vol. i, p. 136.
2. Ibid. p. 141.
3. Study of Medicine, vol. iii. p. 59, 3rd ed,    London, 1829.

 

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, assemble I 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.

 

CHAPTER 2.

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 Variolœ Vaccinœ, 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.

 

1.—JOSEPH MERKET, 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.

 

2.—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.

 

3.—JOHN PHILLIPS, Tradesman.
Had Cowpox when nine years old.  Was inoculated with Smallpox by Jenner at the age of 62 without effect.

 

4.—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.

 

5.—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 !

 

6.—SABAH 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.

 

7.—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 Cow-pox.  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.

 

8.—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."

 

9.—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.

 

10.—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.

 

11.—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."

 

12.—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. 7., 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 he applied,1 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.)

 

1. Such timely remedies were solutions of sulphate of zinc or sulphate of copper—a hint for those in quest of antidotes for Vaccination.

 

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 Cow-pox were not treated as protected (as were those who had had Smallpox) but were " cut" with their neighbours —as, in Case 12., 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 Cow-pox 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.

 

13.—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 ?

 

14.—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.

 

15.—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.

 

16.—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—

 

17.—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 farther 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.

 

18—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.

 

19.—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.

 

20.—WILLIAM PEAD, aged eight.

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

 

21.—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."

 

22.—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.

 

23.—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 onr 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.1

 

1. Remarks on Certain Medical Principles.    London, 1882.

 

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 Cow-pox 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 Horse-grease 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 Cow-pox 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 Cow-pox, 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 Cow-pox 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."1

 

1. Baron's Life of Jenner, vol. i. p. 380.

 

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.

 

CHAPTER  3.

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."1

 

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.2

 

1. Baron's Life of Jenner, vol. i. p. 154.       2. Ibid. p. 155.

 

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

 

Why so much ado about nothing!  You recommend that horse-grease cowpox he 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. Ingen-housz, 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, Ingen-housz 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 Horse-grease 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.1

 

1. Baron's Life of Jenner, vol. i. p. 159.

 

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.1 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.

 

1. 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.

 

And in a more decided strain on 13th November—

 

I wish you could secure me matter for inoculation, because, depend upon it, a thousand inaccurate 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.

 

CHAPTER 4

PEARSON'S INQUIRY.

 

DR. PEARSON'S Inquiry concerning the History of the Cowpox1 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.

 

1.  An Inquiry concerning the History of the Cowpox, principally with a view to supersede and extinguish the Smallpox.  By George Pearson, M.D., P.K.S., Physician to St. George's Hospital, etc. London, 1798, 8vo., pp. 116.

 

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 Cow-pox, 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 1,000 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 he 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 newcomer 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 3,000 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 Cow-pox 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 Cow-pox, 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.

 

CHAPTER 5.

 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 he 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.1

 

1.  Reports of a Series of Inoculations for the Variolœ Vaccinœ or Cow-pox. London, 1799.

 

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.1  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."

 

1. S. C. Wachsel in London Medical Repository, 1819, p. 257.

 

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, 13th 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.E.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 he 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 counteraction—

 

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.1

 

1.  Examination of Report of Committee of House of Commons, 1802.

 

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 810 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.1

 

1.  Further Observations on the Variolœ Vaccinœ, 1799.

 

Others maintained that the cowpox which saved milkmaids from smallpox was a much severer affection than that induced by Jermer'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.1

 

1. On Vaccine Inoculation.    By Robert Willan, M.D.    London, 1806.

 

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 2,000 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.

 

CHAPTER 6.

JENNER'S FURTHER OBSERVATIONS.1

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.2

 

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 Variola 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.)

 

1.  Further Observations on the Variolœ Vaccinœ. 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.

2. Baron's Life of Jenner, vol. i. p. 322.

 

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 Horse-grease 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 18. 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 Horse-grease 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 Cow-pox 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 Horse-grease 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 Cow-pox. (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.1  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 Horse-grease 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.

 

1.  Baron's Life of Jenner, vol. i. p. 315.

 

CHAPTER   7. 

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 4,000 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 2,000 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 cow-pox 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 he 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.1

1.  Baron's Life of Jenner, vol. i. p. 360.

 

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 cow-pox 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;1 and only resorted to cowpox when he found horse-grease cowpox unattainable.  Mr. Anthony Highmore, surgeon, speaking over Woodville's grave in 1805, exclaimed—

 

1.  Rees’s Cyclopœdia, vol.  38.     London,  1819.    The writer of the article himself inoculated Woodville with the Grease.

 

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 Variolœ Vaccinœ—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 cow-pox. 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."1

 

1.  Mr. Cooke's letter was reprinted in  the Medical and Physical Journal, vol. i. p. 322.  London, 1799.

 

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 Vaecinæ, 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,1 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.

 

1. By and by controversy with the Smallpoxers waxed hot, and then the Cowpoxers averred that thousands of lives were annually lost by their practice.

 

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.1

 

1.  Examination of Report of Committee of House of Commons.    London, 1802.

 

CHAPTER   8. 

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.1

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

 

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

 

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 manoeuvres of sordid and self-interested men."1  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.2

 

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. Bing'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. 3

 

1. A Treatise on the Cowpox containing the History of Vaccine Inoculation. By John Ring. Part i. p. 297. London, 1801.
2. Ib.    Part ii. p. 720.    London, 1803.
3.  The Beauties of the
Edinburgh Review, alias the Stink-Pot of Literature. By John Ring. London, 1807. P. 49.

 

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 preventable 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 1,300 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.1

 

1. Treatise on the Cowpox, p. 520.   London, 1801.

 

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, hut 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.

 

CHAPTER 9.

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.1

 

1.  Baron's Life of Jenner, vol. i., p. 140.

 

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 manoeuvre 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 he 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 Cow-pox."  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.1

 

1. Baron's Life of Jenner, vol. i., p. 448.

 

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."

 

CHAPTER  10.

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 be 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; (8) 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 over 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 3,000 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 Buttons 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 1,500 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, Borne 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 TAYLOK, 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 KING, 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 cow-pox 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 3,000 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 John 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 80s. 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. WlNDHAM 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 £6,000 in the propagation of his discovery, and if he had £10,000, he would be left with no more than £4,000.  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 small-pox, 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! 1

 

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.2

 

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.

 

1. Medical Journal, January, 1802.

2. Ib. July, 1802.

 

CHAPTER 11.

PEARSON'S EXAMINATION.1

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 4,000 persons had been inoculated by Dr. Woodville, myself, and our correspondents.

 

1. 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.

 

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 Cow-pock, also contrary to Dr. Jenner.1  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.

 

1. 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.

 

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 £6,000, 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 farther 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 Horse-grease 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 Cow-pox ; 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, 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 report1 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.

 

1.  Edinburgh Medical and Surgical Journal, October, 1805.    P. 513.

 

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,
THOS. NELSON,

Physicians

FRAS.  RIVERS
Ev. A. BRANDE
Ph. De BRUYN

Visiting Apothecaries

T. KEATE,
T. FOSTER,

Consulting Surgeons

JOHN HEAVISIDE,
THOMAS PAYNE,

 

Treasurers

J. C. CARPUE,
J. DORATT,

Surgeons

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

1709.—Further Observations.

1800.—Continuation of Observations.

Slackens off from Horse-grease Cowpox; ascribes its efficacy to common repute; and recommends escharotics to  arrest its virulence

1801. Origin of Vaccine Inoculation

1802.  Petition to Parliament

 

Claim of discovery and use of Cowpox, previously 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 Horse-grease 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 Cow-pox for Smallpox was a trifle for which to pay £10,000 and dissolve in ecstasies of admiration.

 

CHAPTER   12.

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, 3,000, 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 3,000 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 3,992 in 1772 and falling as low as 522 in 1797— the extremes of the century.  Why did 4,000 never die in any year, or 7,000, or 10,000?  When a fire is extinguished, we know it has met with a check; and if smallpox caused 3,992 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 3,000 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 Smallpox

The Inoculated Smallpox.

 

The Inoculated Cowpock.

 

I.  The natural Smallpox is a loathsome, infectious, painful, and fatal  disease.  It is confined to no climate, but rages in every quarter of the world, and destroys a tenth part of mankind.

I.  The inoculated Smallpox also is loathsome, infectious, painful, and sometimes fatal; and, when partially adopted, spreads the contagion, and increases the mortality of the disease.

I.  The inoculated Cowpock scarcely deserves the name of a disease.  It is not infectious; and, in the opinion of the most experienced practitioners has never proved fatal.

II.  Those who survive the ravages of that dreadful distemper, often survive only to be the victims of other maladies, or to drag out a miserable existence worse than death.

II.   It sometimes occasions the same maladies as the natural Smallpox.

 

II.  It occasions no other disease.  On the contrary, it has often been known to improve health, and to remedy those diseases under which the patient before laboured.

III.  This cruel and lamentable disorder leaves behind it pits, scars, and other blemishes  and bodily deformities which embitter life.

 

III. It frequently leaves behind it the same blemishes and deformities as the natural Smallpox, which are the more deplorable as they are brought on by a voluntary act.

 

III.  It leaves behind no blemish, but a Blessing—one of the greatest ever bestowed on man—a perfect security against the future infection of the 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 3,000 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 £1,000 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 £1,000 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 13.

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 EOYAL 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 he 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 1,173; in 1804 they were only 622. The contrast will appear still greater when it is considered that the deaths amounted to 2,409 in the year 1800; and that the annual average of deaths for fifty years previously was 2018.1

 

1. Baron's Life of Jenner, Vol. i. p. 577.

 

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.

 

Years.

Burials from all Diseases.

From
Smallpox.

From
Fevers.

From
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

2,707

 

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 80,000 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.

 

Years.

Burials from all Diseases.

From

Smallpox

From

Fevers

From

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

10,680

1163

1066

106

1810

19,893

1198

1139

1031

 

185,787

12,534

16,204

5,680

 

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 be 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.1

 

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.2

 

1. History and Practice of Vaccination, p. 212.    By James Moore. London, 1817.
2.  Life of John Walker, M.D., p. 88.   By John Epps, M.D.   Lond., 1831.

 

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.1

 

1.  History and Practice of Vaccination, pp. 213-215.

 

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.1

 

1. Baron's Life of Jenner, vol. ii., p. 336.

 

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 Small-pox 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.

 

CHAPTER 14.

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.1

 

1.  Baron's Life of Jenner, vol. ii. p. 162.

 

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.1

 

1.  Baron's Life of Jenner, vol. ii. p. 55.

 

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 1789, 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 1,811 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. WILBERFOKCE 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 he 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.

 

CHAPTER  15.

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 ? 1

 

1. Review of Report on Vaccination. 1808. By Benjamin Moseley.   London.

 

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 retraction 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 Cow-pox by Jenner.

 

First, in the Inquiry of 1798, he described Spurious Cowpox as eruptions on the cow underived from horse-grease, 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.  1,100 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 1,100 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 164,881.

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 1306 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 11 i vine 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.

 

CHAPTER 16.

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. STUEGES 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   17.

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