CHAPTER XXXV.
THE NATIONAL VACCINE ESTABLISHMENT—1808-40.
We shall now return to the current of our Story, nor turn aside until it is brought to a conclusion in the enactment of Compulsory Vaccination.
With £3000 a-year the National Vaccine Establishment was constituted by the House of Commons, on 9th June, 1808; sixty members voting for the project, and five against.
The reasons for the institution were somewhat complicated. The Royal Jennerian Society had been wrecked by Jenner’s jealousy and intrigue. The working and subscribing members seceded with Dr. Walker, and set up the London Vaccine Institution; and a variety of ornamental and influential folk, who paid little and did less, found themselves with Jenner on their hands, exigent, impecunious, and helpless, and they publicly committed to the patronage and diffusion of vaccination.
It was an awkward situation, and two operations for relief became necessary: first, to dispose of Jenner; and second, to escape from the maintenance of vaccination.
The first was effected by inducing the House of Commons to vote Jenner £20,000, and the second by the institution of the National Vaccine Establishment. Thus dexterously, fashionable and medical London contrived to get rid of Jenner and vaccination on terms satisfactory to all concerned.
The early furore for vaccination had spent itself. Scepticism had thriven by experience. Many of the vaccinated had taken smallpox, and explanations and excuses were becoming exhausted. It was easy to claim the benefit of mistakes when the operators were amateurs; but when the failures were the work of Jenner and his certified associates, it was hard for faith to hold out. Spurious cowpox served to account for many disasters; but when Jenner, pressed to define spurious cowpox, was driven to confess its non-existence, and that, when he had spoken of it, he had only meant any irregular action of cowpox on the persons of the vaccinated, it is easy to imagine how people who had respect for themselves were pleased to drop out of the connection. They might not care to express all they suspected, nor to proclaim their credulity, but it was a welcome deliverance to be no longer responsible for a practice and a character grown so questionable. On John Bull’s broad back was laid the burden.
In the project of the National Vaccine Establishment there was an explicit concession to the scepticism of the time. One of its purposes was alleged to be Investigation. Lord Henry Petty, in recommending the measure in the House of Commons, observed—“The evidence as to the infallible efficacy of vaccination is confessedly incomplete; and it is highly desirable that the truth should be ascertained by public inquiry, rather than by societies whose conductors are liable to the imputation of mercenary motives.” Jenner bitterly resented the indignity implied in placing vaccination under investigation. He held, and in a sense justly, that it was too late to speak of investigation when the reality of his discovery had been attested in the public honours and rewards conferred upon him. “Alas!” he exclaimed, “poor Vaccinia, how art thou degraded!” He was still further outraged by his exclusion from the Board of the Establishment, on the ground that the public might have assurance of impartiality. How much sincerity there was in the profession, I do not pretend to divine; it is sufficient to point out that matters had come to such a pass with vaccination that it was considered expedient to conciliate the taxpayers with the promise of inquiry for their money. Plainly the enthusiastic certainty of 1802 had given place to a widely different sentiment in 1808.
There were, however, wheels within wheels. “You may take it for granted,” said a Radical of those days, “that every vote of public money has an object in excess of the ostensible one, and covers jobs big or jobs little.” And so it was in the case before us. The discomfited residue of the Royal Jennerian Society had influence with the Government to take over their smashed-up enterprise; but their solicitation might have been ineffectual, had not the Government seen a way of providing for a certain claimant in the course of the operation. Sir John Moore was serving his country in the Peninsula; he had friends at the sources of power; and he had a brother named James, surgeon to the Life Guards, for whom a comfortable berth was wanted. Let us make Moore, they said, Director of this new Establishment, with a salary of £200 a-year; and the thing was done. Investigation was promised, Cowpox was endowed, and Moore was provided for.
Jenner had actively promoted the formation of the Establishment, under the conviction that he should be its governor; but when the organisation was revealed, he was profoundly disgusted. The management was assigned to a Board of eight members, consisting of the president and four censors of the College of Physicians, and the master and two governors of the College of Surgeons, with salaries of £100 a-year apiece. From this Board, as stated, Jenner was deliberately excluded, “so as to ensure impartial investigation.” It was at first proposed to hold Jenner subordinate to the Board, giving him the title of Director, with Moore as his working deputy; for it was clearly recognised by those who had had experience of him during his London career, that for regular duty he was good for nothing; and that with his sickly family resident in Gloucestershire, he was never to be reckoned upon for a day. When, however, the Board disregarded his nominations, especially that of his bully, John Ring, as “Principal Vaccinator and Inspector of Stations,” he at once severed his connection with the Establishment; “since,” in his own words, “he found that he was to have nothing to do, and that his office was only a name.” “My not being a member of the British Vaccine Establishment will,” he wrote, “astonish the world; and no one in it can be more astonished than myself”; but so far as can be discerned, the astonishment was chiefly limited to himself. Evanescent and futile is the astonishment of the world under most circumstances, and had the public opinion of the time been consulted, there is little doubt that it would have gone with the Board against Jenner.
Moore was, therefore, promoted to Jenner’s place as Director of the National Vaccine Establishment, in subordination to the Board of Physicians and Surgeons. Seven stations, with seven superintendent surgeons, were opened in London for vaccinating all who should apply, and for collecting and distributing virus.
At first [writes Moore] the applicants for Vaccination at the various stations were not numerous, not amounting to 3,000 a year; but, by continued exertions, and the declension of prejudice, the numbers regularly increased, and 7,771 persons were vaccinated in London in the year 1816.[275]
These numbers are significant, as indicating the extent of the collapse of vaccination, and how little the continuous decline of smallpox in London was due to its extension.
Moore was a shrewd tactician. He had the sense to recognise that if there was anything in vaccination, it was folly to stand at variance with Jenner; and by persuading him that he exaggerated the offence implied in the policy of the Board, he gradually soothed his feelings and led him into a long and confidential correspondence. Jenner, on his side, finding that nothing resulted from his sulks, relaxed, and from time to time favoured the Board with the light of his countenance and counsels.
The national endowment of vaccination affected prejudicially all other enterprises in the same line. What remained of the Royal Jennerian Society withered up, and the conductors of the London Vaccine Institution found the collection of subscriptions almost impossible. It was naturally objected by those solicited, “Why should we be asked to subscribe for what Government has already provided?” But with Dr. John Walker, the director of the London Institution, vaccination was a fanaticism, and he was ready to live on bread and water rather than withdraw from the promotion of what he was persuaded was a work of salvation. He therefore struggled on, in spite of discouragement and petty means, and as the inability of the Government Establishment to meet demands became manifest, whether from excess of dignity or apathy, the Quaker Institution, as it was called, began to thrive, to acquire the confidence alike of the medical profession and the public, and to rival in business the Establishment itself.
As for the investigation promised in the House of Commons, it was never even attempted. Jenner’s anxiety was superfluous. When a case of smallpox, or injury, or death after vaccination was reported, it was the recognised formula to assert either some defect in the operation, or the virus, or some cause, or any cause ab extra rather than allow the Jennerian principle to suffer. As an illustration of the procedure of the Board in this respect, we have the instance of Mr. Thomas Brown, surgeon, Musselburgh, as served up in Moore’s insolence—
The Vaccine was in two years spread over Scotland. After a time, however, one croaking voice was raised to disturb the general concord. Mr. Brown, who was fretting in obscurity at Musselburgh, published a book in 1809 to maintain that the Vaccine only possessed the property of preventing Smallpox temporarily; that in three years its influence declined; and in five or six, hardly any security against Smallpox remained.
Brown submitted his cases to the Board, but they met with no attention.
In this extremity [continues Moore] he wrote a scurrilous accusation of the National Vaccine Establishment to the Secretary of State, which was referred to the Board. When they met, the Registrar read it, and then tied it up with red tape among that mass of papers which are consigned to rest.[276]
Could more be expressed in less? Thus was Brown, the representative of true science and enlightened and honest inquiry, set at naught and traduced by a Board endowed for investigation! Nor, in saying so, do I speak simply as an antagonist of vaccination. Brown was no anti-vaccinist. What he contended for is now everywhere admitted by vaccinists. They allow that the protection afforded by vaccination is temporary, and that it is necessary to renew its prophylaxy from time to time. The practice of revaccination is based on the verity of Brown’s contention, and yet, according to Moore, he was a vain-glorious and scurrilous fellow, and by Jenner was pronounced “an object of commiseration rather than resentment.”
As purveyors of virus, too, the Establishment fell behind Walker’s Institution, and the Quakers’ pox had the preference among connoisseurs in the article. Jenner wrote to Moore, 5th March, 1816—
The Matter sent out by the National Vaccine Establishment is much complained of. I was applied to a few weeks since by the surgeons of the hospital at Gloucester for some Vaccine Matter, and their request was accompanied by the observation, “That after using thirty points sent from town, not a single pustule was produced.”
To account for such failures, it began to be reported that the virus was gradually losing its virtue in transit through many arms; but, continued Jenner—
Medical men are more expert than others in discovering causes without the fatigue of much thinking, and in the present instance they have all hit upon the wrong one—no great wonder. They attribute the lessened activity of the Matter, and its disposition to produce imperfect vesicles, to the great length of time which has elapsed since it was taken from the cow, and to the immense number of human subjects through whom it has passed. This is a conjecture, and I can destroy it by facts. The Matter may undergo a change that may render it unfit for further use by passing even from one individual to another; and this was as likely to happen in the first year of Vaccination as the twentieth. There are medical men who will take anything they can catch under the mere name of Vaccine Matter, or from pustules incorrect in character. It is from the spread of such Matter that the dissatisfaction of which I speak has arisen.[277]
When we refer to the record of the National Vaccine Establishment, there is little reason for surprise over its inefficiency. The House of Commons, having voted the endowment of £3,000 a-year, the Government committed the organisation of the Establishment and the administration of its funds to the heads of the Royal College of Physicians. How the £3,000 a-year was disposed of, came to light in 1822, when the accounts were published. The statement stood thus for 1821, representing what had gone on during the past twelve years—
| £ | £ | ||
| Physicians.— | Sir Henry Halford, Bart. | 100 | |
| Dr. Frampton | 100 | ||
| Dr. Thomas Hume | 100 | ||
| Dr. Charles Badham | 100 | ||
| Dr. R. Lloyd | 100 | ||
| —— | 500 | ||
| Surgeons.— | Sir Everard Home | 100 | |
| Sir W. Blizard | 100 | ||
| Henry Cline | 100 | ||
| —— | 300 | ||
| Registrar.— | James Hervey, M.D. | 300 | |
| Director.— | James Moore | 200 | |
| Secretary.— | C. Murray | 50 | |
| —— | 550 | ||
| Vaccinators.— | One at £150 | 150 | |
| Five ” 100 | 500 | ||
| One ” 75 | 75 | ||
| Six ” 50 | 300 | ||
| —— | 1,025 | ||
| Housekeeper | 40 | ||
| Messenger | 52 | ||
| Rent of furnished House, 18 Percy Street | 260 | ||
| —— | 352 | ||
| Printing, stationery, coal, candle, &c. | 183 | ||
| ——— | |||
| Total | £2,910 | ||
| ——— | |||
The accounts, though they revealed what was suspected, were widely denounced as scandalous. Parliament voted £3,000 a-year to extend vaccination among the poor, and here were a set of physicians and surgeons pocketing £800 of it, and muddling away the greater part of the remainder. They affected to regard vaccination as the deliverance of mankind from the scourge of smallpox, and yet they had not hesitated to appropriate the means provided for its diffusion! There was scarcely the pretence of work for wages. The Board met once a week, but the attendance was irregular, and at each member’s discretion. The eight hundred-a-yearers dropped in when convenient for gossip, and to ask what was doing. When set upon their defence, the argument was that the public were distrustful of vaccination, and that to inspire confidence it was necessary that the Establishment should have the benefit of the ostensible support of the College of Physicians and the College of Surgeons, for which the honorarium of £100 annually to each of their representatives was by no means excessive. In reply, it was pointed out that Dr. Walker, supported by voluntary contributions, collected with difficulty, and with less than the pay of many an artizan, had done more for vaccination in London and the country, and was more respected and trusted, than the Establishment with all the prestige of corporate authority.
As the result of many protests, the waste of public money was brought before the House of Commons by Joseph Hume. It was Mr. Hume’s distinction that, with strong good sense and invincible patience, he upheld the standard of honesty in public finance, holding that it was as wrong to defraud the nation as to defraud an individual; and that it was as foolish (not to say more wicked) to pay away the people’s money for nothing, as to throw away one’s own. The principle, so obviously indisputable, and yet so shamelessly violated in every department of the State, was enforced in detail by Mr. Hume with a persistency and success that has never been surpassed, and, I fear, never appreciated as deserved. He showed that patriotism is a practical virtue, instead of a sentimental pretext for public plunder, and taught honour to placemen to whom honour was unknown. Appropriately, therefore, Mr. Hume led the charge against the National Vaccine Establishment, and in 1827 the annual vote was reduced from £3,000 to £2,500, £300 of the £500 being saved by knocking off two useless physicians and one useless surgeon. Even then the extravagance that remained continued to excite indignation, the consequences of which are recorded in a “Report from the Select Committee on the Vaccine Board, with the Minutes of Evidence, ordered by the House of Commons to be printed, 28th August, 1833.” If space allowed, it would be easy to linger over the disclosures of this Committee. Suffice it to say, that Dr. George Gregory, of the Smallpox Hospital, held that the whole work of the Board might be done handsomely on £1,200 a-year. The Committee, however, shrank from such a severe exercise of economy, and recommended the provision of the following staff and expenses—
| Vaccinators at Stations in London (a sum which will probably admit of reduction) | £900 |
| Inspector } | { 200 |
| Registrar } Qualified on occasion to exchange duties | { 200 |
| Messenger | 55 |
| Offices, rent of | 100 |
| Incidental expenses | 150 |
| ——– | |
| Total | £1,605 |
The Committee observed that the Board might consist of two physicians and one surgeon, whose duties, not being onerous, might be discharged gratuitously. As the Committee was more loose-handed than Dr. Gregory, so the Commons were laxer than the Committee. The President and a Censor of the College of Physicians, and the President of the College of Surgeons, were suffered to continue their £100 a-year each, and the annual subsidy for the Establishment stood fixed at £2,200, until vaccination, under the disguise of sanitation, developed into the monstrous proportions with which we are at this day afflicted.
There is much talk prevalent in favour of “the endowment of research;” but what may come of such endowment, when not sharply looked after, is manifest in the example of the National Vaccine Establishment. The investigation, assumed to start with, was never pursued; and the guardianship of the public interest undertaken by the Colleges of Physicians and Surgeons was never anything but make-believe. Annual Reports were presented to Parliament, signed by the heads of the Establishment, but of research they bore no trace, and many of them might have been dashed off by the Registrar in the course of an hour. Destitute of any scientific merit, these reports yet afford some curious glimpses of what was going on from year to year, with indications of the chief points of resistance encountered by the practice of vaccination; and, in turning over the series from 1810 to 1840, I have made the following notes, which may be read, perhaps, with interest.
VARIOLATION.
The chief resistance proceeded from the inoculators with smallpox; indeed, with the exception of apathy, there might be said to be no other resistance. Hence we read under the several dates—
1810.—During 1809, the surgeons vaccinated 1,493 persons. We are sorry to have to relate a decline of Vaccination in the Metropolis, and an apparent indisposition to the practice of it; and to express regret that there should be evil-disposed persons, who are endeavouring to frustrate His Majesty’s intentions by alarming the misinformed with stories which they know to be false.
1812.—We have reason to ascribe the increase of Smallpox in London during last year to the rash and inconsiderate manner in which great numbers are still inoculated for the Smallpox, and afterwards required to attend two or three times a week at the place of inoculation in every stage of their illness. The practice of Inoculation is the great means whereby Smallpox is kept in existence, and its infection propagated to persons and places where it would not otherwise be seen.
1814.—The Board has with great regret to observe that, although the punishment of three months’ imprisonment was awarded against Sophia Vantandillo, for carrying her child, whilst under the influence of Smallpox, through the streets, (which infected many others, eight of whom died) the unwary are still enticed by the hand-bills of shameless empirics to submit their children to Variolous Inoculation. It is, however, to be hoped that the above sentence passed by the Court of King’s Bench, which the Board has taken every method of promulgating, may produce considerable benefit. The Board selected Sophia Vantandillo as a proper example on account of the extent of the mischief occasioned by her misconduct; and that this prosecution, followed by a lenient punishment, may prevent any further wilful exposure of inoculated persons, is its fervent wish. The Board at the same time prosecuted Mr. Burnet, who inoculated the child, and who has long circulated most mischievous and offensive hand-bills, offering to inoculate persons with Smallpox gratis, and stigmatising Vaccination as productive of the most loathsome disease. This practitioner having suffered judgment to go by default, has been sentenced by the Court of King’s Bench to six months’ imprisonment.
The whole of the expenses incident to this Establishment for 1814 have been defrayed by the vote of last year, but the Board regrets that in consequence of the recent prosecutions and convictions, and the measures adopted for the more effectual extension of the practice of vaccination throughout the Empire, an addition of £500 to the annual grant will be necessary.
1815.—In Edinburgh, Glasgow, and Norwich, Inoculation is disused, and, in consequence, the Smallpox is scarcely known. In the country about Aberystwith in Wales, and Bawtry in Yorkshire, it has entirely disappeared. The reverse is, unhappily, the case in Portsmouth, Bristol, and London. In the Metropolis alone the mortality may be estimated at 1,000 annually; perhaps throughout the United Kingdom it is not less than ten times that number. It appears to us that this waste of human life can be prevented only by such legislative enactments as will entirely put a stop to Inoculation with Smallpox.
That smallpox was increased by variolation we have no reason to doubt, notwithstanding the fact that toward the close of the last century, when variolation was most practised, smallpox was steadily falling-off; but to ascribe the existence and persistence of smallpox to variolation was absurd. Smallpox was a widely-diffused disease before variolation was introduced to anticipate and minimise it.
1817.—The pernicious practice of Smallpox Inoculation, now very generally relinquished by the medical profession, is only persisted in by a very few of the least creditable class of practitioners, and is usually carried on clandestinely; yet the Board are concerned to state that this destructive operation is now performed for gain by itinerant Empirics, Farriers, Publicans, Nurses, low, cunning people of both sexes, and of various descriptions. And such is the infatuation of the poor and ignorant, that many of them carry their infants to be inoculated by those who only know how to inflict, but not how to assuage, the violence of Smallpox. The consequence has been that many have perished under their management; and the disease in particular districts has been widely disseminated. As this iniquitous conduct has prevailed much in London, an epidemic of Smallpox was last year excited among those who were not secured by Vaccination, and 1,051 persons died of the disease.
1836.—Only 300 died of Smallpox in London in the course of last year; and it is probable that this mortality, however comparatively small, is owing to the continued partial practice of Inoculation, which is liable to disseminate far and wide its contagious influence, to the imminent danger of all who have not been protected by previous Vaccination, or by having had Smallpox already.
Variolation was made a penal offence in 1840, and became less available as an excuse for the persistence of smallpox in defiance of vaccination.
FAILURE OF VACCINATION.
Accepting Jenner’s revelation, the heads of the medical profession in London assured the public, in a manifesto in 1800, that “those persons who have had Cowpox are perfectly secure from the future infection of Smallpox.” It was a rash assertion. Proofs of its untruth were not slow to appear. At first they were denied, then explained away, and then admitted under qualifications more or less adroit. When, in 1808, the National Vaccine Establishment was constituted, the fact of the failure of Vaccination to answer to its original promise was generally recognised. Nevertheless, the reports of the Establishment exhibit much ingenious wriggling and attempts to out-lie Nature. For example—
1811.—That in some instances Smallpox has affected persons who have been most carefully vaccinated, is sufficiently established; nor ought we to be surprised at this, when we consider that Inoculation for Smallpox sometimes fails, and that several cases may be produced in which persons have been affected with the natural disease more than once in the course of life. The Board have infinite satisfaction in stating the two following important and decisive facts in proof of the efficacy and safety of Vaccination, namely, that in the cases which have come to their knowledge, Smallpox after Vaccination, with a very few exceptions, has been a mild disease, and that out of the many hundred thousand persons Vaccinated, not a single authenticated instance has been communicated to them of the occurrence of fatal Smallpox after Vaccination.
The Board have great pleasure in stating that the money granted by Parliament during the last session has been sufficient to defray the expenses of the year 1811, and they are of opinion that the same sum will be adequate to the expenditure of the current year.
There were 3,148 vaccinations effected under the Board in 1811, which was at the rate of about £1 a-head.
Moore, after reporting some cases of smallpox after vaccination, at St. Osyth, in Essex, went on to say—
1816.—Some very rare instances of failures in Vaccination, as exceptions to a general law, may be expected as long as Smallpox is prevalent; since it has been fully ascertained that when the air is strongly impregnated with the infectious vapour of Smallpox, some of those who have had the disease are attacked a second time.
1818.—From the foundation of this Establishment in 1808 to the present year there have been vaccinated 52,253 persons at the stations in London. Only four of these are yet known to have had Smallpox afterwards, and these were never very seriously ill.
1819.—The testimonies of some of our correspondents concur in showing that great numbers of persons who had been vaccinated have been subsequently seized with a disease presenting all the essential characters of Smallpox; but that in the great majority of such cases, the disease has been of comparatively short duration, unattended by symptoms of danger. In several of these cases, however, the malady has been prolonged to its ordinary period, and in eight reported cases it has proved fatal. It appears to us to be fairly established that the disposition in the vaccinated to be thus affected by the contagion of Smallpox does not depend upon the time that has elapsed after Vaccination, since some persons have been so affected who had recently been vaccinated, whilst others who had been vaccinated eighteen and twenty years have been variolated, and exposed to contagion with impunity.
1820.—It is true that we have received accounts from different parts of the country of numerous cases of Smallpox having occurred after Vaccination, and we cannot doubt that the prejudices of the people against this preventive are assignable (and not altogether unreasonably, perhaps) to this cause. These cases the Board have industriously investigated, and though it appears that many of them rest only on hearsay evidence, and that others seem to have undergone the Vaccine Process imperfectly, yet after every reasonable deduction, we are compelled to allow that too many still remain on undeniable proof to leave any doubt that the pretensions of Vaccination, to the merit of a perfect and exclusive security in all cases against Smallpox, were at first admitted too unreservedly.
1825.—That a considerable number of persons have had Smallpox after having been vaccinated, we are ready to admit; although of cases of this kind, a large majority are found on examination to be without that test of the operation being performed successfully and effectually, which all agree to be necessary to perfect security. Vaccination, therefore, it will be said, does not afford an absolute and perfect security. We do not present it to the world with that pretension, but we declare it to be the least imperfect of the resources we possess for encountering the disease.
1827.—It is true, cases are reported to us very often of the occurrence of Smallpox after Vaccination; but we have reason to believe that the number of those who fall into this safe, though sometimes severe disease, after Vaccination, is not greater than that of those who formerly died by Inoculation whilst that practice prevailed.
1833.—Of an equal number of persons vaccinated and variolated, only so many of the former will be capable of taking the Smallpox afterwards, and that in a safe degree of the disease, as are found to die by the latter.
1836.—If 300 children be vaccinated, one will be susceptible of Smallpox afterwards, but only in a mild and perfectly safe form, whereas if 300 be variolated, one will surely die.
As evolutions from inner consciousness, the statistics of Variolation and Vaccination under 1827, 1833, and 1836 are noteworthy. They illustrate the facility of the Board at the discovery of what was thought ought to be true.
DEVELOPMENT OF A FABULOUS SALVATION.
1811.—Previous to the discovery of Vaccination, the average number of deaths by Smallpox within the London bills of mortality was 2,000 annually; whereas during 1811, only 751 died of the disease, notwithstanding the increase of population.
1818.—During the year, 6,289 have been vaccinated in London and the vicinity; and the Board have much satisfaction in adducing unequivocal evidence of the increasing advantages of the Jennerian discovery; for it appears from the bills of mortality of London that, instead of 2,000 deaths by Smallpox, which was the annual average previous to the practice of Vaccination, there died in 1818 only 421.
That, previous to the introduction of vaccination, 2,000 was the average annual death-rate from smallpox in London is a statement that requires definition. At an early date the number is under the mark, and at a later it is over the mark. Dr. Farr delivers the truth in these words—
Smallpox attained its maximum mortality after Inoculation was introduced. The annual deaths from Smallpox in London, from 1760 to 1779, were on an average 2,323. In the next twenty years, 1780 to 1799, they declined to 1,740. The disease, therefore, began to grow less fatal before Vaccination was discovered, indicating, together with the diminution of fevers, the general improvement of health then taking place.
Bearing Dr. Farr’s figures in mind (and not forgetting the 2,000 adduced by the Board in the reports for 1811 and 1818), what does the reader think of the following audacious attempts on public credulity?—
1826.—From the quantity of vaccine lymph distributed, we are led to presume the practice of Vaccination is becoming daily more general; and the inference is still further confirmed by the fact that in 1826, only 503 deaths have occurred from Smallpox within the bills of mortality; whereas in the preceding year, 1,299 persons are recorded as having fallen victims to the loathsome disease. The whole of this difference ought not, perhaps, in candour to be attributed to the influence of Vaccination; for Smallpox during 1825 assumed a peculiarly malignant character; and there were more instances of the distemper occurring twice in the same individual than had ever been reported to us before. But when we reflect that before the introduction of Vaccination the average number of deaths from Smallpox in London was annually about 4,000, no stronger argument can reasonably be demanded in favour of the value of this important discovery. Nor can any more striking proof be given of the paternal care of the Government to protect the people at home and abroad from this destructive disease than the establishment and maintenance of this Board.
The bouncing falsehood, having passed muster, was repeated with enlargement at a suitable interval—
1834.—Only 334 deaths by Smallpox have been reported, a number considerably less than have died in any year since the introduction of Vaccination, and falling short by at least 4,000 of the average of deaths annually by Smallpox in London before the protecting influence of Cowpox was discovered and promulgated.
And again it appeared with a fresh touch of exaggeration—
1836.—The annual loss of life by Smallpox in the Metropolis before Vaccination was established exceeded 5,000, whereas, in the course of last year, only 300 died of the distemper.
Impunity being apparently assured, the fable came to be delivered as matter-of-course, thus—
1839.—Formerly 5,000 died annually of Smallpox within the London bills of mortality; but since Vaccination superseded Variolation, the number has gradually decreased, until it amounted to only 200 in the year 1837. In the course of the year that has terminated (during which Smallpox prevailed epidemically), there died 800; not one more, after all, than one-sixth of the number who died annually [that is to say, 4,800] during the prevalence of Variolation, notwithstanding the increased population of London and its environs. By a careful retrospect, we are, therefore, justified in stating that 4,000 lives are saved every year in London, since Vaccination so largely superseded Variolation.
The fall in smallpox that set in toward the close of last century was not confined to London, but extended to many European populations. It began before vaccination was heard of, and continued independently of it, though the vaccinators eagerly claimed the phenomenon as the result of their superfluous efforts. The claim was absurd as concerned London, for it plainly appears that vaccination during the years in question never overtook, or even approached, the metropolitan birth-rate. Here is the record of the vaccinations effected by the Establishment in five years—
| 1818 | 1819 | 1820 | 1821 | 1822 | Total. | |
| —— | —— | —— | —— | —— | ——— | |
| 5,490 | 7,874 | 6,054 | 6,627 | 8,230 | = | 34,275 |
The entire vaccinations in five years not equalling the London births in any one year! There were, we dare say, as many more vaccinated by voluntary effort; but the figures, however extended, cannot be got to cover the immense mass of lower-class Londoners, who then, as now, were the chief factors of smallpox. What I say emphatically is, the National Vaccine Establishment had as much influence on London smallpox as the Holy Alliance.
POCK-MARKED FACES.
One of the arguments for vaccination at this day runs thus—“How do you account for the absence of pock-marked faces? When I was young, forty years ago, nothing was commoner than countenances disfigured by smallpox.” Occasionally the reminiscence is transferred to a mother or grandmother, who is reported to have said that she remembered when every third or fourth person was pitted.
We need not take seriously the motherly or grand-motherly reminiscences, so apt to be touched with the glamour of years. Confining ourselves to living memories, the owners thereof may, perhaps, be surprised to learn that the transformation for which they personally avouch was effected before they were born, or were qualified observers; and before vaccination was sufficiently practised to have wrought the change; and here is the evidence, as set forth in the reports of the National Vaccine Establishment, and printed by order of the House of Commons. Under the following dates we read—
1822.—As a proof of the protecting influence of Vaccination, we appeal confidently to all who frequent theatres and crowded assemblies to admit that they do not discover in the rising generation any longer that disfigurement of the human face which was obvious everywhere some years since.
1825.—The deaths by Smallpox amounted to 1,299 in 1825, a much greater number than has been reported for some years past. From this melancholy statement it is impossible to avoid the conclusion that the lower orders of society continue to be prejudiced against Vaccination, and allow Smallpox to take its course.
And yet what argument more powerful can be urged in favour of Vaccination than the daily remark which the least observant must make, that in our churches, our theatres, and in every large assemblage of the people, to see a young person bearing the marks of Smallpox is now of extremely rare occurrence.
To what can the freedom from the vestiges of so loathsome a disease be attributed, but to the protecting influence of Vaccination? for Variolation has now been disused by all respectable practitioners for some time past.
1837.—The rarity of an example of disfigurement by Smallpox now to be found in the theatres, in churches, or in any large assemblage of the people, affords proof that Vaccination has lost none of its efficacy.
Pock-marked faces are by no means uncommon at this day in London, though their number has diminished through more careful nursing and the use of well-known means for preventing disfigurement; and whoever cares to pursue the inquiry will discover that the majority of the marked have been vaccinated and many re-vaccinated—a proof that it is not the rite which prevents the scars.
The general impression we derive from the reports of the Establishment, 1808-40, is that they proceeded from men who were committed to vaccination, but had no profound faith in its efficacy; who were averse from the admission of its impotence, and ultimately held by it as possibly the best available defence against smallpox. With ample means and opportunities for investigation, they made no discovery, nor achieved any advance in practice, nor apparently conceived that there was either discovery or advance to be made. They accepted smallpox as a mysterious ordinance of Nature, with cowpox for a probable antidote, and there stuck fast, thoughtless and helpless. They did not even observe that smallpox was specially a disease of the young and the poor, nor deduce conclusions therefrom. They had their money, and went through an appropriate routine, and there their action ended.