The Story of a Great Delusion in a Series of Matter-of-Fact Chapters

CHAPTER XX.

GOLDSON AND BROWN.

William Goldson, member of the London College of Surgeons, practising at Portsea, published a pamphlet in 1804[164] wherein he set forth a number of instances within his own experience of smallpox following vaccination by infection or inoculation. He did not turn against vaccination, but suggested that its prophylaxy might neither be so certain nor so enduring as at first asserted. Vaccination, he pointed out, had been carried into practice on a wave of enthusiasm, and it was not unreasonable to expect that on closer acquaintance some of the claims made for it should be subject to modification. Indeed so much was already admitted; for failures had led to the discrimination of spurious from genuine cowpox, and to the issue of new instructions as to the period of taking vaccine, “on which point, it was now said, depended the whole success of the operation.” Thus what was originally set forth as an operation for which any novice was competent, had developed into one of considerable delicacy with serious liability to miscarriage. Goldson, therefore, had fair reason to believe that his own observations and suggestions would meet with candid consideration, and, if verified, serve for general guidance in the practice of vaccination.

It is unnecessary to recite Goldson’s cases. Interesting at the time, they are now commonplace. He found that inoculation with smallpox was possible at an interval after vaccination, and that infection with smallpox was equally possible under the like circumstances. One case is noteworthy for its connection with Jenner. A seaman, named Clarke, was successfully vaccinated on 4th November, 1800, and, returning from a voyage to the West Indies was put to the variolous test on 24th March, 1802, when he sickened with smallpox and was sent to Haslar. To prove that his malady was really smallpox, several persons were variolated from him. The Committee of the House of Commons was sitting on Jenner’s first claim for public money, and Goldson wrote to Jenner to come to Haslar and see Clarke for himself; but Jenner was too astute to cumber himself with difficulties at a time when so much cash was in question. The case was mentioned to the Committee, but was treated as of no moment in presence of what they were pleased to regard as overwhelming evidence as to the perpetual virtue of vaccination.

Goldson’s was a modest pamphlet—conjectural rather than demonstrative. He ventured to think it was possible that the efficacy of vaccine might be weakened by transmission from arm to arm, and that security might be restored by reversion to the cow—

He likewise suggested that horsegrease might be inoculated on the nipple of the milch mare, and the virus used for equination. These and other points were advanced with a philosophic grace that ought to have commanded respect; but, on the contrary, his pamphlet was received with a howl of fury, and its author denounced as an ill-conditioned fellow—ignorant, prejudiced, pig-headed. It was safer to be pronounced anti-vaccinist than a vaccinator and harbour doubt as to any article of the Jennerian faith. Ring plied his bludgeon over the heretic, and Jenner wrote of him with malicious insolence—“All his reasoning is erroneous;” “his arrogance is increased by attention;” “he obstinately holds a veil before his eyes, and will not behold the vaccine light;” “one might as well contend with a blind man on the nature of a prism;” and so on. Goldson’s offence was that he laid his finger on some of the weaker points of vaccination; that his sight was too keen, and his reasoning too cogent. At this day the questions between him and Jenner are decided by vaccinators themselves in Goldson’s favour.[165]

Perhaps the most able attack on the practice of vaccination was delivered by Thomas Brown, surgeon, Musselburgh; and it is much to be regretted that his book, published in Edinburgh in 1809,[166] is so little known at this day. Brown had accepted vaccination, carried away, he admitted, by the common enthusiasm, and the unqualified audacity with which its claims were asserted—

An epidemic, in which his own perfectly vaccinated patients fell victims to smallpox, at last opened his eyes to the delusion in which he was walking, and to the perversity with which he and others had resisted the light of truth—

When Brown first saw the vaccinated prostrate with smallpox, he concluded that there must have been some mistake about their vaccination; “for after Vaccination it was impossible to contract Smallpox;” but the evidence of his senses gradually overcame the phantasy imposed upon him, and like an honest man he proclaimed his error, and verified the experiences whereby he had been reluctantly corrected. He set forth with all particulars forty-eight cases of smallpox following vaccination within his own immediate cognizance, and though aware of many cases outside that cognizance, he limited himself to what he could attest with personal assurance. He knew he would be told that the vaccinations had been imperfect, or that what he took for smallpox was some other eruption—

Nor did Brown rest satisfied with proving that vaccination did not prevent smallpox. He also showed the fallacy of the variolous test. He adduced twelve cases in which vaccinated persons had been variolated as if they had never been vaccinated. Also four cases in which vaccination and variolation were effected simultaneously, the diseases running their courses concurrently, proving there was no antagonism between them; and since they could occur together, what reason was left for supposing that one might not succeed the other?

Having found liberty in the truth, he reverted to Jenner’s writings, and reading them with opened eyes, he was not slow to detect and to demonstrate the laxity of statement, the contradictions, and absurdities with which they were pervaded. No reply was attempted: no reply, indeed, was possible. The surgeons of the Edinburgh Vaccine Institution issued An Examination of Mr. Brown’s Opinions and Statements,[167] but they merely carped over non-essential details, and left the main issues wholly unaffected. What they had to show was that Brown’s patients were either unvaccinated, or had not had smallpox; and unable to do this, they were unable to do anything.

Brown remained victor. He did not overthrow vaccination, nor restore variolation, but he did make an end in Scotland of confidence in vaccination as an omnipotent safeguard against smallpox. The rite continued to be practised on humbler terms: “it did no harm”: even Mr. Brown allowed that it might keep off smallpox for a time: and “there was reason to believe that it tended to make the disease milder when it did occur.” Thirty years after his first publication, in 1842, Brown reaffirmed his position in a series of letters[168] to Dr. George Gregory, a sympathetic friend, and advised a return to variolation in view of “the acknowledged defects of the Jennerian practice”—a dismal alternative. But it is in vain to expect any man to be much in advance of his time: it suffices for honourable distinction that he be in advance. When Brown commenced practice, smallpox and other fevers were regarded as inevitable as storms and earthquakes, and the knowledge with which we are now so familiar, that they are engendered in foul habits and habitations, was for practical purposes unknown. Our reproach is, that knowing so much better, we surrender ourselves to a superstitious observance conceived in days of darkness.