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

CHAPTER V.

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 Society[40] 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.[41]

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 Society[42]—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—

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—

The publication of these conditions was little short of a practical surrender, and the opponents of inoculation were 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.[45] 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—

Emphatic likewise was his protest against the exaggeration of the inoculators.

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—

Prince Frederick and Prince William were among the inoculated of 1724.

Dr. Scheuchzer, in 1729 tabulated[48] the cases and results of these years, 1721-28, as follows—

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—

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—

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 Maitland 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 Robinson inoculated five children in Dublin in 1725, and was the death of two of them.[51]

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.