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

CHAPTER IX.

INOCULATION SUPERSEDED AND SUPPRESSED.

The illusory character of human testimony is graphically illustrated in the case of inoculation. Suppose an inquirer wished to ascertain the ratio of deaths to inoculations, he would be completely bewildered. We have seen what Dr. Buchan wrote—

John Birch, an eminent London surgeon, said—

In the Edinburgh Review, October, 1806, we read—

In Reynolds’s System of Medicine, it is stated by Marson that—

Scores of such testimonies might be adduced, twitching the reader from conclusion to conclusion; and in the conflict of authorities what is to be said? It is true that if we select what evidence we like, and call it sound, and reject what we dislike, and call it unsound, we may prove anything; but it is also true, that if we are to be fettered by evidence we shall stand paralysed amid contradictions. When men who are competent, and obviously honest, deliver varying testimony, we are driven to seek some method of reconciliation; and in this matter of Inoculation wherein our resort is to books, and about which we can have no immediate experience, we may derive much light from the corresponding practice of Vaccination. Thus, what is commoner than for vaccinators to assert, that never within their sphere of observation have they witnessed a single case of injury resulting from Vaccination—not one! Subject any dozen ordinary practitioners to judicial examination, and they would thus testify with scarcely a note of variation. On the other hand, take any dozen mothers of families, especially from among the poor, and they would tell of illness, disease, and death following the vaccinators’ lancets. The men are more or less competent and honest, and the women likewise, and how shall we account for their variance? In the first place, the men have been drilled from the outset of their profession into the conviction that Vaccination is absolutely harmless, and if any disaster follows, it is coincidence, not consequence. Occasionally a practitioner of more vigorous intelligence than the average, like Mr. Henry May of Birmingham, sees what the mothers see, but does he report accordingly? Not at all. In Mr. May’s own words—

Mr. May recognised the fact and concealed it: a duller man would have ascribed the death mechanically to erysipelas or pyœmia. Indeed, it is a commonplace with medical men, that no child dies of Vaccination; and hence Vaccination is not an admitted cause of death; and when the fact is insisted upon, there is no limit to the hardihood wherewith the truth is crushed down and covered up. Coroners refuse to hold inquests on children slain by Vaccination, and Dr. Lankester, as coroner for Middlesex, did not hesitate to authorise a false certificate of death in order, like Mr. May, “to preserve Vaccination from reproach.”[71] As for mothers, poor creatures, few of them have minds of their own, and if only they were adequately assured that it was for the good of their offspring that their noses should be slit, they would believe, weep, and submit.

But it will be pointed out that inoculators of the more reasonable sort admitted a certain mortality from the practice. It is so; but the admission was unavoidable. Inoculation communicated smallpox, and there was no evasion of the fact that occasionally the malady assumed a severe form, and the patient died. For such mishaps, however, there were always excuses. The patient was not in a suitable condition of body; he had been eating improperly; he had caught cold; and so on. There remained, nevertheless, the sequelæ of Inoculation, which were just as persistently denied as are those of Vaccination, although there were always clear-sighted observers who maintained that it was impossible to infect the blood with a complex organic virus, and that it should exhaust its effects in a single and definite issue. We all remember how we used to be assured with contemptuous emphasis that it was utterly impossible to communicate Syphilis by Vaccination, and that assertions to the contrary were the fables of ignorance and malice; yet, we see that what was fabulous a few years ago, is now accepted as medical matter-of-fact. Nowhere is scepticism so useful as among physicians; for whenever they protest most, suspect most.

With the close of the 18th Century, Inoculation with smallpox to avert smallpox was accepted as sound practice throughout England. Its safety and efficiency were extolled by medical writers in terms curiously identical with those applied to Vaccination. The objectors were few, and for pious rather than physiological reasons; and the question that exercised practical and benevolent minds was how to universalise the remedy, which, on account of its troublesome accompaniments, was chiefly confined to the upper and middle classes. On this point it may be well to cite the words of Dr. Haygarth of Chester, who, in a letter to the Council of Health of Geneva, dated 10th February, 1792, thus sets forth the position of affairs—

The strong objection to Inoculation was, that it diffused the disease generally which it was supposed to avert individually. Inoculators tried to minimise and deny the danger, but in vain; and nothing so contributed to the supersession of the practice by Vaccination as the expectation of escape from the artificially propagated disease. How extensive was that propagation, we leave the writer in the Edinburgh Review of 1806 to describe—

Unless this culture and this traffic in smallpox throughout the United Kingdom be realised, the potent cause of the immediate and extravagant success of Vaccination will be left out of reckoning. When we are harassed, anxious and impatient under some course of conduct, our ears are open to any promise of relief; and it was to a generation so afflicted and so receptive that Jenner in 1798 made his revelation of the virtue of cowpox. No more need, said he, to inoculate with smallpox. Substitute cowpox; and whilst it will protect as effectually, it will inflict no injury and diffuse no infection. The revelation was received with acclamation, and within eighteen months of its delivery (without due experience, and without any warrant that could pass muster in the severe realm of science) the leading physicians and surgeons of London subscribed and published the following manifesto in the newspapers of 1800—

I do not wish to anticipate the wondrous tale of Jenner—my present purpose is to show how Inoculation was set aside; and it suffices to state that cowpox rapidly made an end of inoculation with smallpox. Indeed, I question whether a revolution in practice was ever effected with similar facility. Within eight years of the delivery of Jenner’s revelation, the writer in the Edinburgh Review of 1806, already cited, was able to testify—

The resistance to Vaccination was almost entirely confined to the resistance of inoculators, who were too deeply compromised by their own disloyalty to Nature, to make effective resistance. They were steadily borne down by the vaccinators, many of whom had been energetic inoculators, and displayed the usual ardour of apostates in condemning what they had formerly approved. Indeed, when we consider how Inoculation was commended for its efficiency and harmlessness by the same medical authorities who, within a year or two after Jenner’s appearance, denounced the practice for its difficulties and dangers, their tergiversation appears little short of shameless. Dr. Lettsom had been an inoculator, yet on 2nd July, 1805, he felt warranted in writing—

How far the conquest of the inoculators by the vaccinators had advanced, appeared in a debate in the House of Commons in 1806, when Wilberforce urged that Inoculation should be suppressed, or at least that those who insisted on Inoculation should be compelled to place their patients in quarantine. Mr. Windham admitted the scandal of wretched and miserable subjects of Inoculation being carried about in the streets, but he hesitated to recommend coercive legislation until persuasion had been fully tried and had failed. Dr. Matthews, M.P. for Hereford, took occasion at the same time to run with the hounds. Inoculation, he said, was a frequent cause of disfigurement and of death in its most awful form; it was a magazine of the most dreadful evils; a magnifier of mortality; and a means of introducing scrofula, a more dangerous and pernicious disorder than smallpox itself—facts which it would have been more creditable to have proclaimed when Inoculation was in fashion. It is so easy to kick when a foe has fallen, and where all are kicking. Human nature is never so despicable as when thus engaged.

The question of restraining Inoculation came again before the House of Commons in 1807, when the practice of inoculating out-patients at the London dispensaries and hospitals was energetically condemned. “I think that the legislature,” said Mr. Sturges Bourne, “would be as much justified in taking a measure to prevent this evil by restraint, as a man would be in snatching a fire-brand out of the hands of a maniac just as he was going to set fire to a city.”

No one was more eager to suppress Inoculation by force than Jenner himself, and in July 1807, he sought an interview with the Premier for the purpose. In a letter to Dr. Lettsom he thus describes his mortification—

We are not accustomed to regard politicians of Perceval’s order as favourable to liberty; and yet it is refreshing to remark in even the Tories of the Georgian age a jealous regard for the personal freedom of Englishmen, and a hearty contempt for the plausible quacks who were always contriving to circumscribe it. Perceval was not opposed to Vaccination, but he would not consent to give it an illicit advantage over Inoculation. If it were the good thing it was asserted to be, it might be left to prevail by reason of its own quality.

Under medical and social pressure, the practice of Inoculation at public institutions was gradually abandoned. On 5th May, 1808, the inoculation of out-patients was discontinued at the London Smallpox Hospital, but not until 20th of June, 1822, did the inoculation of in-patients cease. In 1816 the Colleges of Surgeons of London and Dublin pledged themselves against the practice. A formal attempt at coercive legislation, often called for, was at last made by the directors of the National Vaccine Establishment. They framed and promoted a bill, which was introduced to the House of Lords in 1813 by Lord Boringdon, but it was ignominiously withdrawn in 1814—a choice example of grand-motherly legislation. Among its provisions was the enactment that whenever an inoculation took place, the clergyman of the parish should receive notice, and that red flags should be displayed from the house where the patient lay! As Earl Stanhope observed, instead of being a measure of humanity, it would, if passed into law, be one of the most troublesome, inconvenient, and mischievous ever enacted.

In the discussion on this foolish project, Lord Eldon pointed out that the common law was already sufficient to arrest the exposure of sufferers from infectious disease; and acting on the hint the Vaccine Establishment prosecuted a woman, 27th April, 1815, for carrying her inoculated child covered with pustules through the streets of her neighbourhood. Evidence was adduced that she had thus infected eleven persons with smallpox of whom eight had died. The Court of King’s Bench pronounced her conduct illegal and criminal, but as it was the first prosecution for such an offence, she was let off with a sentence of three months’ imprisonment.

A practice thus banned could not long survive in England, and by and by a medical man who would consent to inoculate became a rarity, or was accounted disreputable. Yet there remained old-fashioned folk who would have nothing to do with cowpox, and insisted on having genuine human pox for their children and grandchildren. Hence Dr. Epps writing in 1831 had to say—

Gradually the inoculating practitioner ceased, and the practice remained in the hands of “ignorant and unqualified persons, old women, and itinerant quacks;”[73] and then the end came. An Act of Parliament was passed in 1840 wherein it was enacted that—

The Government did not at first intend to make the prohibition absolute, but Mr. Wakley insisted that the time had arrived to suppress the nuisance summarily, and that not a voice would be raised in opposition. Nor was there any opposition. Mr. Goulburn expressed some hesitation, but the House was practically unanimous.

Outside the House few regrets were expressed. Dr. George Gregory, physician of the Smallpox Hospital at St. Pancras, was, however, a man of philosophic turn, and he did not see the old idol cast down unmoved.

Gregory was not blind to the extravagant claims made for Vaccination, and evidently had a lurking conviction that all was not gain in the substitution of the new practice for the old, saying—

Yet was not Inoculation abolished. Sometimes when we get the devil out at the door, he presently re-enters by the window; and thus while Parliament was making an end of Inoculation in one form, it was reviving in another.

It is to be understood that Jenner’s cowpox, whatever it might be, was an uncommon and erratic disease, and its discovery and maintenance difficult. To provide a substitute, cows were from time to time inoculated with smallpox, and the resulting virus was used instead of the Jennerian specific. Lest one should be accused of questionable witness, let us refer to Dr. Seaton’s Handbook of Vaccination. There we read—

Again, Sir John Cordy Burrows, a surgeon, speaking as a magistrate, at Brighton on 5th February, 1876, observed—

Thus, as asserted, has Inoculation been revived, and Jenner’s specific set aside. When Dimsdale had Russian nobles to operate upon, he tried to mollify the smallpox by passing it through healthy children. Cows have now taken the place of children, and the virus in its passage from arm to arm may still further be reduced in virulence, when it does not take up fresh malignities such as syphilis; but it is inoculation with smallpox all the same.