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

CHAPTER VIII.

INOCULATION ABROAD.

Before proceeding to relate how Inoculation was superseded and ultimately suppressed in England, it may be expedient to make some notes on the prevalence of the practice in other lands.

And first in New England where, as we have seen, Cotton Mather had precedence in subjecting the reports of eastern inoculation to the test of western practice. Mather and his coadjutor, Boylston, did not propose to make inoculation habitual, but to reserve it for use in epidemics. Sometimes years elapsed in New England without smallpox: there were no dense urban populations to constitute seats of zymotic disease: and to provide perpetually against what was occasional was obviously unnecessary. Nevertheless the colonists shared the common disposition of the time for pottering in remedies, and their slaves afforded convenient opportunities for experiments in which temerity had the sanction of beneficence. With the Whites, cleanliness, ventilation, drainage, and pure water, were conditions of accident rather than of providence, but with the Blacks life was that of the stye, and the consequences in smallpox were thought to be sufficiently accounted for by the assertion that Negroes were constitutionally pre-disposed to that disorder. Wherefore the Blacks from Boston to the Spanish Main were from time to time remorselessly inoculated, and all of them who afterwards escaped smallpox had their immunity ascribed to their inoculation.

Jonathan Edwards, the prince of Calvinistic divines, was killed by inoculation. There was an epidemic of smallpox in New Jersey, and, for security, Edwards was inoculated. The result was the generation of smallpox in a severe form, of which he died, 22nd March, 1758, in his 54th year. In search of a superfluous safety was he slain. A man of the age of Edwards had little to fear from smallpox; for the disease, in the vast majority, was an affection of the young, concerning which, as having attained middle life, Edwards might have maintained comparative indifference.

The colonists usually ascribed any outbreak of smallpox to importation by shipping from Europe, if not manifestly, then covertly; for, it was held that smallpox could never be evolved spontaneously. Great pains were therefore taken to isolate patients, and Boston and other sea-ports had hospitals erected on sites remote from habitation, from which a flag was displayed whenever occupied by the sick. A physician who visited an hospital was required to take off his wig, to change his shoes, and to put on a gown which hung from his neck to his ankles; and, when he came out, to wash his hands, and be fumigated with frankincense. In setting forth these precautions, Professor Waterhouse of Cambridge, Massachusetts, observed in a letter to Dr. Haygarth of Chester—

During the war with England, smallpox broke out in the American army, and inoculation was so freely resorted to that scarcely a man escaped the lancet. Washington had his New England soldiers inoculated at Cambridge in 1776, and it was difficult to find men to keep guard over the sick; that is to say, men who had passed through smallpox and were not considered liable to infection, a curious evidence of the rarity of the natural disease in the communities from which the army had been recruited.[64]

Cotton Mather’s triumph over Boston was complete—complete beyond his intention; for it came to be as thoroughly inoculated as any town in these days is vaccinated. Dr. Waterhouse, writing on 28th October, 1788, said—

In another letter, dated 15th October, 1787, the Doctor said—

However it may have been elsewhere, inoculation was conducted in Boston with a formality and deliberation that might have satisfied Dimsdale himself. There was an inoculation hospital erected on Sewell’s Point, which juts into Charles River, remote by a mile and a half from the common road, and situated in pleasant grounds with trees and walks. Three weeks were devoted to inoculation and the subsequent sickness, and before dismissal, wrote Dr. Waterhouse—

It is a curious story, and stands in broad contrast to the rough and ready practice of Turkey, and of many inoculators in England and elsewhere. Dr. Waterhouse adds—

France was slow to accept inoculation. After its introduction in 1723, about thirty years elapsed without any serious movement in its favour, when Voltaire, Diderot, and their set began to recommend the practice, which had the merit of being English and disliked by those who held change and improvement in aversion. La Condamine read an eloquent paper on the advantages of inoculation before the Academy of Sciences; and Turgot, the ardent and sagacious lover of his kind, procured the inoculation of a child in Paris, 1st April, 1755; which was followed on 14th May by a young man, named Chastellux, submitting himself to the operation in the interest of the common welfare. Then Dr. Hosty was sent to London to investigate and report, and on his return issued these statements—

It would be superfluous to deal with the fallacies involved in these statements: they served to satisfy those who were disposed to be satisfied, and inoculation became the fashion among the scientific and enlightened. Dr. Tronchin, a well-known inoculator, was summoned from Geneva to Paris in 1756 to operate upon the children of the Duke of Orleans, and his success was pronounced decisive. Nevertheless inoculation did not extend beyond people of leisure and culture, and in 1763 an outbreak of smallpox in Paris made an end of the practice. An inquiry was instituted by the authorities, and the evidence left no doubt that the epidemic had been diffused, if it did not originate, with the artificially poxed; and inoculation was thenceforth prohibited in Paris. Any citizen who was resolved to have the induced disease had to retire to country quarters.

Here we may observe that the confidence of the inoculator was grounded on the assumption that whoever had once passed through smallpox, whether natural or artificial, could never again contract the disease. Nevertheless the inoculated did contract the disease, and the disaster was uniformly accounted for as due to some imperfection in the inoculation. There were also instances of smallpox after smallpox, but these, too, were discredited; the first smallpox could not have been smallpox, but chickenpox, measles, or some other eruptive disorder. There was a conspicuous confutation of these evasions in the case of Louis XV. He had smallpox unquestionably in his 14th year, and of unquestionable smallpox he died in 1774 in his 64th year. Notwithstanding, the assertion was perpetuated that there was no possibility of smallpox after smallpox, and it was only when it became necessary to maintain the credit of vaccination that the facts were admitted; and in this form—Smallpox after vaccination is no more common or extraordinary than smallpox after smallpox—a falsehood on the back of a former falsehood.

We have seen under what safeguards inoculation was practised in Boston, and now we shall turn to Geneva and discover how all the American precautions were set at naught in that city with apparent impunity. The details are from a letter of the Council of Geneva, dated 24th December, 1791, addressed to Dr. Haygarth in answer to his inquiries and suggestions. Des Gouttes, secretary to the Geneva Syndic, wrote—

This glimpse into old Geneva is not only instructive as concerns inoculation, but it is another exposure of the monstrous fable that represents European cities as decimated with smallpox until Jenner’s advent as saviour—a fable that vanishes like smoke whenever brought into contact with matter-of-fact.

Inoculation was introduced to Rome and Florence during a severe epidemic in 1754; and attention being drawn to the remedy, it was discovered that the Italian peasantry had long practised voluntary smallpox just as did the peasantry of Wales and the Highlands of Scotland. In Spain, inoculation made little headway: in the words of Moore—

In Holland and Denmark inoculation acquired a certain vogue among the upper classes, and in Germany the like was true to a less extent. In Sweden inoculation was encouraged by the Court, and Dr. Schultz was deputed to visit the London Hospital. His report was so favourable that in 1755 inoculation houses were opened in several parts of the kingdom, and the benefits of the practice were commemorated by a medal in 1757—a curious trophy of illusion under prepossession.

Perhaps the most notable event in the story of inoculation was its introduction into Russia: how it was brought about is thus described by Mr. Morley—

One day in the summer of 1768, at his house in Hertford, Dimsdale received an unexpected message from Pouschin, the Russian minister in London, to wait upon him; and in his presence he learnt that he was required to proceed at once to St. Petersburg to inoculate the Empress. There was of course some hesitation about undertaking so long a journey, but Pouschin had been authorised to overcome all obstacles. What would the Doctor require in the way of expenses? The Doctor discreetly answered that he would leave that to her Imperial Majesty, whereon Pouschin handed him £1000 to pay his way to St. Petersburg. Dimsdale summoned his son from his medical studies in Edinburgh, and the two set off for the North on the 28th of July.

At St. Petersburg Dimsdale was received with every mark of respect and liberal hospitality. He was introduced to the Empress, who was charming and gracious; and he was instructed to make the requisite preparations for the serious duty before him. He had to find pus, and to obtain pus he had to lay hands on a suitable sufferer from smallpox—a task which proved by no means easy. Having discovered a case to his mind, he had then to overcome an obstinate objection to the abstraction of virus. He had, at the same time, to find a couple of healthy young men, who had not had smallpox, on whom to raise secondary virus, for the Empress could not be expected to run the risk of smallpox without mitigation. His first attempt was a complete failure, and he had to report accordingly to his expectant patient. Catharine heard his report with philosophical equanimity, and left him to try again. At last he was successful, and at the palace of Czarscoe Selo on Saturday, 11th October, 1768, the Empress swallowed five grains of mercurial powder, and late on Sunday evening Dimsdale inoculated her with fluid matter by one puncture in each arm. She did well. From the time of the inoculation to the commencement of the eruption, she walked every day for two or three hours in the open air, and, on the 1st November, she returned to St. Petersburg “in perfect good health, to the great joy of the whole city.”[68] The Grand Duke was inoculated on the 30th October, and by the 22nd November had “perfectly recovered.”

The Empress having played, the nobility had to follow suit, and Dimsdale was requested to proceed to Moscow to take them in hand; but at this time there was a new difficulty. There was said to be no smallpox in Moscow, and as Dimsdale could not inoculate without fresh virus, he had to inoculate two girls in St. Petersburg, designing so to time their disorder that he should arrive with them in Moscow in prime condition for business. One girl was a failure, and mishaps and delays on the sledge journey almost made a failure of the other. He did, however, reach Moscow in time enough to communicate the requisite infection to fifty patients, and in Moscow he remained for two months operating and playing the lion. Then he set off for home, and on his route through St. Petersburg found Catharine suffering from pleurisy, for which he bled her, drawing eight ounces of imperial blood. Then came the reckoning. In substantials he had—

In honours he had the appointments of—

It was a barbarian’s style of recompense, paid under the eye of Europe. It cost Catharine nothing, for it is subjects who suffer for the extravagance of despots.

Dimsdale had plans for the systematic inoculation of Russia, but they resulted in little. Catharine’s purpose was sufficiently served in the display she had made; and possibly she came to consider Dimsdale an appendage of that deceiver Voltaire, whose busts, that had adorned her saloons and corridors, were by her orders thrown into the cellars when the French revolution opened her eyes to the consequences of French philosophy.

In perusing the literature of inoculation, nothing impresses a reader, enlightened by sanitary science, so much as the manner in which smallpox was regarded as something like hail or lightning that might be averted, but could not be prevented. So far, I have not met with even a hint in that literature that smallpox was either induced by unwholesome modes of life, or that it could be avoided by wholesome modes. In conjunction with this blindness was the amazing assumption of the inoculators, that every one inoculated was to be placed to their credit as saved from smallpox; as if (granting inoculation to be prophylactic) smallpox was ever a universal epidemic, and as if multitudes did not pass through life without smallpox before inoculation was heard of. The true problem to be set and solved in all epidemics, whether of influenza or smallpox, is why some are susceptible and some insusceptible, and whether it is not practicable so to modify conditions as to carry over the susceptible to the ranks of the insusceptible.