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

CHAPTER XXXII.

NEWCASTLE SMALLPOX: A COMMON STORY.

To examine the statistics of the larger English towns in order to determine whether vaccination has had any influence on the abatement of smallpox, would involve us in discussion interminable. For our immediate purpose it may suffice to select three examples; 1st, Newcastle-on-Tyne, as an instance of a common story; 2nd, Norwich, as an instance of a smallpox epidemic; and 3rd, Glasgow, as an instance of smallpox displaced and replaced as a factor of mortality.

THE NEWCASTLE DISPENSARY.

We often hear of “the statistics of the Anti-Vaccinators;” to which the summary answer is that Anti-Vaccinators have no statistics. Their statistics are the statistics of the Vaccinators, in which they provide the material for their own condemnation; which is probably the reason why the so-called statistics of the Anti-Vaccinators are so intensely disliked, avoided, and unanswered.

The Newcastle Dispensary in 1877 completed its hundredth year, having been founded in 1777, and Dr. Monteith prepared a concise history of the institution, which was published in 1878 by order of the Committee.[267] The report is especially valuable as a record of the comparative incidence of disease in a large industrial population, where, if anywhere, smallpox might be expected to show itself in severe form. In 1781 the population of Newcastle was estimated at 23,000; in 1821 it had risen to 41,794; in 1851 to 87,784; and in 1871 to 128,443; and through all these years and changes, the Dispensary continued in active operation, the percentage of the patients to the population being maintained with remarkable uniformity. It is needless to add that the majority of the patients have been from the ranks of the poor, among whom smallpox has always its chief seat. As Dr. Monteith observes—

Before turning to the Dispensary’s record of a century of smallpox, it may be well to observe that Variolation was practised in Newcastle with great assiduity, and that the Dispensary took a lead in the business, the surgeons inoculating any one who applied. Dr. Monteith relates—

As soon as Vaccination came into vogue, Variolation was denounced as the chief cause of the existence of smallpox. It was said that what was done to avert the disease from the individual diffused it among the multitude. Vaccinators long maintained that they could easily exterminate smallpox, if only Variolators would refrain from keeping it alive. Variolation gradually ceased, and was formally prohibited in 1840, and by and by Vaccination was made compulsory. Nevertheless, the confident prophecy of the Vaccinators remains unfulfilled, for smallpox is not exterminated.

The change from Variolation to Vaccination at the Newcastle Dispensary was immediate. Dr. Monteith says—

For this decline various reasons were assigned, such as the increase of the private practice of vaccination, and the disposition to undervalue every benefit, however great, that is purely eleemosynary. It is forgotten that Vaccination fell off as its illusory character became more and more manifest, and as the promises made on its behalf were, one and all, indisputably belied. When Jenner died in 1823, he passed away amid indifference, if not contempt. His bubble had burst. The furore for vaccination witnessed in the present generation is by no means a continuation of the original furore. That passed away. Our furore is a revival, dating from the popularity of sanitary reform, to the back of which a new generation of medical men contrived to attach vaccination!

In the hundred years, 1777 to 1877, the Dispensary had to deal with 2,616 cases of smallpox, of which 428 terminated fatally, which as to years and mortality may be thus classified—

The progressive reduction in mortality is, of course, ascribed to vaccination having made the disease milder; though the report informs us that “the mortality from smallpox reached its highest point—33·3 per cent. in the five years from 1802 to 1807,” the very time when enthusiasm in favour of the Jennerian rite was at its acme. We, on the other hand, would attribute the lower mortality, as did Dr. Andrew Combe, to better modes of treatment, even neglect being preferable to much of the old-fashioned regimen for smallpox. Considering the figures, Dr. Monteith observes—

Here we have an honourable confession from out the bonds of professional prejudice, and a reluctant exposure of the legend of a world decimated by smallpox, and ceasing to be decimated after the advent of Jenner. There is nothing singular in the Newcastle evidence that has awakened distrust in the mind of Dr. Monteith. Similar evidence is found wherever facts are available. The legend to the contrary has become established, like many other legends, by dint of repetition, until those who venture to question it are regarded with suspicion and dislike.

The Report of the Newcastle Dispensary illustrates another truth, namely, that the abatement or cessation of smallpox is by no means equivalent to a reduction of death; that evil conditions of life remaining unchanged, a fall in smallpox is compensated for by a rise in some cognate form of zymotic disease. Thus Dr. Monteith remarks:

Of Scarlatina, the Dispensary record stands thus—

Of Measles it is said, “the disease has somewhat increased in numbers, whilst the proportion of deaths to cases has not varied much.” Thus the record stands—

Of Whooping Cough it is observed—

Smallpox, Scarlatina, Measles, and Whooping Cough may be regarded as convertible forms of infantile zymotic disease. Conditions of existence remaining equal, one may be the substitute of the other, maintaining thereby a common death-rate. Diarrhœa is sometimes placed in the same category; and, like erysipelas, it is to a large extent a consequence of vaccination. It should never be forgotten that vaccination induces a constitutional disturbance or fever, which illness is offered to Nature as a propitiation for smallpox; with which propitiation, say the vaccinators, Nature is satisfied, and withholds the infliction of smallpox. Vaccination, as an illness, however, is frequently attended with diarrhœa, and the increase of that affection, pari passu, with the increase of infant vaccination, is marked. Thus stands the record of Diarrhœa—

Dr. Monteith observes—

Any explanation is welcome that will preserve vaccination from reproach, yet what medical man is ignorant of the fact that diarrhœa is one of the commonest sequences of vaccination? Nature thus endeavouring to throw off the effects of the virus infused into the blood.

Taking, then, these five diseases in the order of their mortality, they range thus—

In the course of a century the Newcastle Dispensary had dealt with a total of 250,637 cases, of which no more than 2,616 were of smallpox, or about 1 in 96. The total deaths during the century were 14,088, of which no more than 428 were due to smallpox, or about 1 in 33; whilst from scarlatina they were 1 in 18, from diarrhœa 1 in 30, and from whooping-cough 1 in 35. It may be said, the record of the Dispensary does not account for the population of Newcastle. True; but it accounts for the lower strata of the population, and, therefore, for an excessive proportion of smallpox. The complete statistics of the city would exhibit smallpox as a still lighter affliction. And, we repeat, there is nothing singular about the record of the Newcastle Dispensary. It is a common story. Whenever we get out of the region of romance, and tread the ground of matter-of-fact, it is to discover that the wilder horrors and ravages of smallpox have been originally evolved from imagination, and are perpetuated in ignorance from hearsay.