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

CHAPTER XXXVII.

VACCINATION ENFORCED—1853.

Vaccination, it will be objected, had no connection with sanitary reform. True: it had none; but the dull public when possessed with a new enthusiasm is not apt to discriminate; and those who had an interest in pushing vaccination found their operations facilitated by the rising faith in the preventibility of disease; their promise of saving the country from smallpox seeming of a piece with much else that had become credible.

Yet, strange to say, the credit of vaccination had never fallen lower than prior to its enforcement. The proof is written at large in the reports of the National Vaccine Establishment from 1831 to 1850, which it is difficult to peruse without perceiving them to be the testimonies of half-hearted officials to a generation grown sceptical and indifferent. The medical literature of the time reflects the same uncertainty and doubt. Vaccination was admitted to be no sure defence against smallpox: it might, it probably did, mitigate the disease when it occurred; and, in the absence of anything better, its practice was advisable; but on such terms, what scope was there for its advocacy! In the writings of Dr. George Gregory, this scepticism is so pronounced, that he scarcely hesitates to recommend a reversion to inoculation with smallpox. A like scepticism as to the virtue of vaccination with a like disposition to return to variolous inoculation, is exhibited by Dr. Copland in his Dictionary of Practical Medicine, 1844-58—a work of high repute, and the standard of medical opinion for the time. In short, vaccination was subject to general distrust; every claim made for it had been belied; and except for its endowment by the State, and the determination of sundry adventurers to have that endowment enlarged, the practice would gradually have fallen into disuse.

The same absence of confidence in vaccination was conspicuous in the school of sanitary reformers. It was of the essence of their revelation that smallpox was as preventible as other fevers, and by the same methods. I might, indeed, challenge any one to produce aught from the utterances of the early apostles of sanitation in deliberate or explicit praise of vaccination. The prescription might not be formally condemned; it might even be cursorily approved; but it was foreign to the tenor of their doctrine, and its recommendation must have died in their throats. Dr. Southwood Smith delivered two lectures in Edinburgh in 1855 on the Prevention of Epidemics, but of smallpox as preventible by vaccination he said not a word. On the contrary, this was his testimony, his all inclusive testimony—

Among the upper and middle classes distrust in vaccination was general. How, indeed, could it be otherwise? All were vaccinated, yet whenever smallpox was epidemic, recipients of the rite enjoyed no immunity. In one of Miss Mitford’s letters we find an experience and a judgment which were far from uncommon. Writing, 1st February, 1850, she observed—

Vaccination among the poor was (as it is) detested. Coaxed or forced into its reception without consideration or preparation, like sheep or cattle, they realised its mischiefs and misery in full measure; and naturally, whenever pressure was relaxed, avoided its acquaintance.

How then did vaccination come to be imposed upon a community thus affected? The answer is the usual one, illustrated continually in English politics: an organised interest, possessed with a definite intention, can always prevail over the public—careless, uninstructed, and without positive conviction. Under such circumstances, it is a mere question of management what may be achieved in Parliament at variance with the common welfare. Those there get, who know how to take.

All trades and professions fulfil the law of their being in striving after advantage and extension. The clergy and the clerically-minded laity are persuaded that to multiply churches and provide stipends, is to prepare for the millennium, and nothing save hopelessness prevents demands upon the national exchequer for the purpose. The sacrifices the army and navy would exact on their own behalf for security from foreign aggression are only limited by the public incredulity. The commercial classes are free-traders in principle; but if a protective bounty could be had for any manufacture, it would be instantly grasped at by those concerned, and most ingenious reasons invented to justify that particular departure from the rule of justice. This tendency of interests to aggrandise themselves, per fas et nefas, at the public expense, is recognised by all statesmen, and is only kept in check by perpetual vigilance.

What is true of all, is true of the medical profession, crowded with competitors eager for employment. Vaccination as a branch of business, capable of development and endowment at the public cost, was certain of vigorous promotion whenever there was opportunity; but not until 1853 did the way open for the compulsory infliction of the Jennerian rite. The undertaking was hazardous. The opposition to which Canning and Peel had given expression, had to be circumspectly encountered. It was a job that might easily be wrecked; and therefore it was considered inexpedient that the medical corporations should appear too openly in the transaction. Instead, a committee was formed in 1850 under the title of “The Epidemiological Society for the Investigation of Epidemic Diseases,” with a number of suitable decoys, and ostensible occupation; but chiefly designed as an instrument wherewith to operate on Parliament for the better establishment and more liberal endowment of vaccination.

It was resolved to proceed tentatively—to secure if possible the affirmation of compulsion, allowing the shock of innovation to subside before going on to provide the effective means of espionage and persecution. As it turned out, the caution exercised was superfluous. Much more might have been demanded and conceded of the ignorance and indifference of the legislature. Lord Lyttelton was selected to introduce what was called the Vaccination Extension Bill, and in moving the second reading in the House of Lords on 12th April, he ingenuously disowned any qualification for the task, saying—

Adding in proof of the manner in which he had been crammed by the said “able and learned persons”—

The statistics with which Lord Lyttelton supported the necessity for compulsion are interesting as indicating the extent and irregularity of vaccination among the English people. He said—

Strange to say, Lord Lyttelton made no attempt to complete his argument. He ought to have shown that in the places where vaccination was least practised there was most smallpox, and where most practised there was least smallpox. Had he made the attempt, his eyes might have been opened to the untrustworthy character of “the able and learned person” by whom he had been mendaciously primed.

Lord Shaftesbury, in supporting the measure, adduced similar instances of neglected vaccination as follows—

He, too, forgot to show that these places were “decimated” (that’s the word) with smallpox, whilst other places where vaccination was generally practised enjoyed exemption. On the contrary, with curious inconsequence, he went on to recommend a sure prescription of his own, namely, improved dwellings for the poor. These were his words—

Not a doubt of it; but if improved lodging-houses would “all but exterminate smallpox,” why resort to such a superfluity as vaccination?

There was no adverse discussion—indeed, no discussion whatever. Lord Ellenborough observed of the Epidemiological Society, under whose direction they were legislating, that he “would not adventure upon the extraordinary name by which the members are designated.” The bill was read for the third time, nem. diss., on 18th April, and was introduced to the House of Commons on 5th May, where its course was as uninterrupted as in the Lords. Sir John Pakington, in moving the second reading on 20th July, pleaded like Lord Lyttelton his own ignorance, and the evidence and authority of the Society with “the extraordinary name,” thus stating the case—

Here, too, we note the omission of proof, that where vaccination was neglected smallpox was prevalent, and where practised smallpox was absent. Lord Palmerston supported the second reading without hesitation. Sir George Strickland was the only dissentient, saying—

The bill was read, for the third time in the House of Commons without debate on the 13th, and received the royal assent on 20th August, 1853. In short, it passed through Parliament without opposition. What, it will be asked, were its provisions?

By the Act (16 and 17 Vict. cap. 100) it was required—

Thus from 1853 every English parent became liable to a fine of twenty shillings and costs who refused or neglected to have his child vaccinated within three months of birth. It may seem surprising that an Act so arbitrary, enforcing an indefinite medical prescription (for Vaccination was not defined, and Vaccination is a rite of several varieties) should have been passed so lightly; but we have to recollect the circumstances. The House of Commons in those days was the house of the upper and middle classes, and was as little affected as the House of Lords itself by the proposed legislation. It was an Act for application to the vulgar—to the prejudiced, whose prejudices were to be encountered, not with arguments, but with fines; an illustration of the levity with which the unconcerned can dispose of the opinions and feelings of those to whom they owe no allegiance. Since that time the working-classes have plainly discovered that they only obtain consideration in Parliament in so far as they can make their power felt in the constitution of Parliament. No rights are secure that cannot be enforced, nor any justice certain that cannot be vindicated. Those who hold their ground by any other tenure than their own intelligence and vigour are liable to continual imposition and depredation.

is the abiding social law, however veiled or elevated in application.

Again we have to recollect, that in 1853 there was no developed or scientific resistance to vaccination. As to the nature and value of the practice there was wide diversity of opinion, notwithstanding Lord Lyttelton’s affirmation of the complete unanimity of the medical profession; but although such scepticism was general, the rite constituted an established poll-tax among the respectable classes, which sort of thing is never readily surrendered. Hence it seemed less unreasonable to enforce the like observance on “the ignorant and prejudiced” at the cost of the poor-rate. When Canning refused to consent to compulsion in 1808, cowpox had a competitor in smallpox inoculation; and Peel in his later protest expressed the preference of an expiring generation for living English liberty over cut-and-dry subservience. Despotic philanthropy was coming into vogue, and it was no longer thought impracticable or inexpedient to do good to people in spite of themselves. There was therefore little to be said against the Act of 1853 beyond what Sir George Strickland expressed. The right of the prejudiced and ignorant to the enjoyment of their prejudice and ignorance had become obsolete and indefensible.

The report of the Epidemiological Society was taken as the warrant for the Act of 1853 alike by the Lords and Commons. Turning to that report,[282] it is difficult in a few words to convey an adequate idea of its untruthful character. Whoever, it is said, wills the end wills the means; and certain medical men having resolved to make vaccination compulsory whatever was requisite had to be accomplished; and Dr. Seaton undertook the operation, the Epidemiological Society, of which he was “the ruling spirit”,[283] playing the part of guarantee. For the persuasion of the Lords and Commons, an advocacy of vaccination without hesitation or qualification was deemed advisable, and the line was thus followed up—

All will recognise the authoritative air of the foregoing, so impressive where nothing better is known; but the indisputable proposition, “that no one has a right to put in jeopardy the lives of his fellow-subjects,” was curiously inconsistent with faith in the asserted prophylactic; for if the vaccinated were secure from smallpox, how could the unvaccinated place their lives in jeopardy? The style assumed was thus maintained—

As to the immunity of the vaccinated, it was disproved in every smallpox epidemic, and in every smallpox hospital, and by the precautions and terrors of those accounted secure. To sustain the proposition that smallpox had decreased in consequence of the introduction of vaccination, a variety of statistical tables were adduced, English and Continental; but had the Lords or Commons subjected them to scrutiny they would have discovered that the details were either irrelevant or adverse to the conclusion asserted. Many of the statistics, especially of last century, were not certainties, but conjectures and estimates, vitiated, too, with the bias of their compilers. When it is said that smallpox decreased in consequence of the introduction of vaccination, the answer is that smallpox was decreasing prior to its introduction in almost every country of Europe; and that the decrease continued irrespective of its influence, save in so far as it might have discouraged the culture of smallpox by inoculation. To illustrate this contention it may suffice to take the table of London Smallpox set forth by Dr. Seaton, in which the average of deaths from Smallpox in every 1000 deaths from all causes was contrasted in decennial periods for fifty years, prior and subsequent to the introduction of vaccination.

The figures are far from trustworthy, but taking them as they stand, and admitting the decline, where was the proof that it was due to vaccination? The introduction of that practice was one thing: its application quite another. There was no reason to believe that more Londoners were vaccinated in 1820 than in 1810, or in 1840 than in 1830; indeed, the available evidence went to the contrary, vaccination having fallen in repute after the furore of 1801-5, and the demonstration of its impotence and its injuriousness. Probably not ten per cent. of the births in London up to 1840 were accounted for as vaccinated; and notwithstanding the provision of vaccination at the cost of the poor-rate by the Act of 1840, not fifty per cent. in 1850. Yet to a cause so utterly inadequate, the steady decline in London Smallpox was ascribed! The same fallacy pervaded the statistics of other countries and cities, yet so strong was the prepossession in favour of the conclusion determined upon, that it was apparently neither seen nor suspected, obvious though it was.

Nor was it surprising that with a disposition so fixed and obtuse, no enlarged or philosophic views should have been entertained. “Smallpox,” said Dr. Seaton, “had decreased compared with mortality from other causes.” True; but what if mortality from other causes had compensated for the decrease of smallpox? and if such compensation had taken place, as, for example, in Glasgow, in what consisted the advantage? Again, no reference was made to illness and death resulting from vaccination, as if the rite were harmless as baptism. Allowing that the practice did in some occult fashion tend to the abatement of smallpox, it was still open to question whether the infliction of an acute specific disease on all sorts and conditions of infancy was not likely to be far more injurious to life than the smallpox it was supposed to avert. Such considerations, however, were foreign to Dr. Seaton and his Epidemiological Society with whom vaccination stood for little else than an extension of medical business at the public cost.

It is not to be forgotten that the Act of 1853 brought to fruition what was long hankered after by the trade spirit of the medical profession. The Act of 1840 endowed vaccination out of the poor-rate; but to make the rite compulsory and to ensure good pay for its performance was the consummation desired. The terms and conditions that ensued on the Act of 1840 are thus described by Dr. Seaton—

The better pay, the better vaccination! The object of the Epidemiological Society, as the stalking-horse of the medical trades-unions, lay in those fees. Vaccination was a pretext for a universal poll-tax, set at as high a figure as practicable, to be succeeded when possible by compulsory revaccination, with a correspondent tariff annexed. Recalling the early days of vaccination when the operation was described as simplicity itself, and when women, parsons, and busybodies inoculated and propagated “the benign fluid” under Jenner’s authority, it was remarkable to have the rite thus formalised and converted into the peculium of a priesthood. Nor can it be objected that when vaccination was thus practised, it was ineffective against smallpox; for whenever its virtue is brought into dispute, we are referred to those primitive times and that primitive practice for the most successful and unquestionable exhibitions of its power.

Caveat emptor is a well-recognised caution, which to avoid was the purpose of the Epidemiological Society. A mercantile transaction was carried out under the cloak of impartial science. No reader of Seaton’s report could suppose otherwise than that vaccination was universally regarded as an infallible preventive of smallpox, and that if by any means the English people could be subjected to its observance, they would obtain immunity from the disease. Evidence to the contrary was kept out of sight; and yet evidence to the contrary lay within the knowledge of every medical man; and proof might be adduced to weariness from contemporary medical literature to show that in this respect the Epidemiological report was contrived to blind and mislead Parliament. As a witness, none will impugn Sir Henry Holland, and writing in 1839 he observed—

In statements like these, Dr. Holland did no more than express the contemporary conviction of the medical profession. Vaccination was not surrendered: whilst it was allowed that it could not be trusted to prevent smallpox, it was held that it made the disease milder, and that whilst its prophylaxy wore out, it was renewable by revaccination. Obvious it was that vaccination thus qualified could never obtain legislative sanction; but such sanction being imperatively demanded, the Epidemiological Society provided what was thought requisite for Parliamentary conviction.

It is said that Vaccination was a medical question; but all questions are transformed when they ascend to politics. The origin, character, and action of varieties of animal virus are mysteries, and may remain mysteries with general indifference; but when it is claimed that the inoculation of such virus prevents smallpox, and that whoever refuses to submit his child to the said inoculation shall be fined 20s., then the matter is brought within the personal jurisdiction of every citizen, and he becomes entitled to information, to the exercise of his judgment, and the expression of his opinion. As a mystery, vaccination belongs to experts; but as a Parliamentary preventive of smallpox it is within the discrimination of all who can observe and appreciate the evidence of numbers. For a legislator like Lord Lyttelton to confess his ignorance, and that he moved under the dictation of certain “able and learned persons,” was to abandon his proper function, and surrender himself to imposture.