CHAPTER XIX.

JOHN BIRCH.

It is part of the Jennerian legend that the introduction of vaccination was resisted by prejudice, fury and fanaticism, and that the practice made its way by sheer force of its proven efficacy. The statement is widely at variance with facts. Vaccination was accepted with instant acclamation by the medical profession, the royal family, and the public as an infallible and harmless preventive of smallpox; and the subsequent course of experience was to disprove alike its harmlessness and infallibility. That in some cases vaccination was encountered with absurdity and violence lay in the nature of things, even as it was advocated with absurdity, violence and prevarication. It is always easy to raise a laugh by the exhibition of the extravagance of either side in a hot dispute, but to what purpose? It would have been no cause for surprise if some had been moved to scorn by the facile credulity with which Jenner’s magical prescription was so rashly accepted, but the world to which he appealed had no scientific acquaintance with the laws of health, and it was in nowise marvellous that, convinced of the prophylaxy of inoculated smallpox, they should have been overcome by the plausibility of inoculated cowpox. Yet were not all overcome, nor were all who resisted the popular craze furious. There was John Birch, for example, surgeon to St. Thomas’s Hospital, who with calmness and cogency steadily protested against the introduction of “the new disease styled cowpox;” and we may read his letters and pamphlets and fail to note a fiery epithet or unkindly imputation. People who talk as if all who opposed Jenner were steeped in ignorance and perversity can know nothing of John Birch.

Although satisfied with variolous inoculation, he had no objection to vaccination in itself. He thought it fair that experiments with cowpox should be tried, and the verdict of experience submitted to; but he complained that experience was anticipated and success proclaimed ere it was possible for the truth to be known, whilst every objector was overwhelmed with abuse. As an illustration of the unwarrantable persuasion that prevailed in favour of the new practice before there was time to justify it, Birch mentions that at the anniversary dinner at Guy’s Hospital in 1802, he was surprised to find the usual business set aside to secure signatures to Jenner’s petition for a vote of money from Parliament, and that after dinner toasts, songs, and compliments in honour of Vaccinia were the order of the day. Booksellers, he relates, declined to publish anything against vaccination, and editors of newspapers and magazines would not suffer a word to appear to its disparagement. Even the Post Office carried the cowpox and correspondence of the Royal Jennerian Society gratis until the collapse of the concern in 1806. Those who resorted to doctors and hospitals for inoculation with smallpox got cowpox instead in spite of assertions to the contrary. Church vied with chapel in recommending the new practice. The Archbishop of Canterbury was called upon to issue a letter directing the clergy to recommend vaccination from the pulpit, but, with the wariness of office, sent his chaplain to Birch to hear the other side, and the chaplain retired with the judicious observation, “His Grace must not commit the Church.” Many clergymen, however, not only preached vaccination, but practised it with restless assiduity. Erasmus Darwin was not without hope that baptism and vaccination might be associated. He wrote to Jenner from Derby, 24th February, 1802—

The Vaccine Disease so favourable to young children! The assertion affords a vivid glimpse of the prevalent enchantment. “The idea of connecting religious services with vaccination,” says Baron, “had occurred to several individuals in this country as well as on the Continent.”[160]

The women were not behind the clergy in diffusing vaccine salvation. They were Jenner’s most devoted allies. He took pains to teach ladies to operate with “a light hand” so as not to draw blood, and boasted that one of his pupils had ten thousand patients to her credit, rescued from the terror and peril of smallpox!

As Birch observed, it was not a question of medicine or of surgery that he and others had to deal with, but an outburst of enthusiasm in which the methods and arguments of science were swept heedlessly away. Any testimony to the credit of vaccination was accepted with alacrity, whilst the facts to its discredit were denied or explained away. This recklessness of procedure was most painfully manifest in the conduct of the Committee of the House of Commons which sat on Jenner’s first petition for money in 1802—

Birch wished to know what cowpox was. Jenner had said it was derived from horsegrease, but “that origin is proved to be erroneous, and is now given up, even by his best friends. On all hands it is admitted,” Birch continued, “that it is not a disease of the cow, but communicated to the cow by the milker. No cow that is allowed to suckle her own calf ever has the complaint.” What, then, is the disease in the milker? asked Birch. Is it smallpox? Is it lues venerea? Is it itch? A man came to St. Thomas’s Hospital from an adjacent dairy with a hand and arm covered with ulcerations. He said several of the milkers and the cows’ teats were affected in the same way, and he was told they had got cowpox. Birch called one of his country pupils and asked him what was wrong with the man. “It is itch—rank itch,” was his reply. A box of Jackson’s ointment for the itch was given to him, and at the end of a week he reappeared at the Hospital cured. If cowpox be itch, argued Birch—

Which was to say, that it was not probable that smallpox and itch could occur together, and that a person inoculated with itch would pass through the variolous test successfully. In this connection we may recall the fact that Jenner found it impossible to vaccinate a regiment at Colchester, the men with their women and children all being afflicted with itch.

Still farther to complicate the mystery of cowpox, Jenner began to describe it as genuine and spurious, but which was the one and which was the other he left in bewildering uncertainty. Said Birch—

Birch’s objection to spurious cowpox was forcible, but what in the innocence of his heart he took for a blunder was proved out of Jenner’s own mouth to be a deliberate dodge in 1807. Pressed by the Committee of the College of Physicians to explain what he meant by Spurious Cowpox, he had to own that he knew nothing of such a malady, and that he had only meant to describe irregular effects of cowpox on the arms of the vaccinated! In other words, when vaccination turned out badly, he had found it convenient to ascribe the disaster to spurious vaccine! The policy revealed in this shameless avowal was cynically justified by Dr. Maunsell, who, in a well known volume, wrote—

From out the muddle as to the origin of cowpox and its genuine and spurious varieties, Birch demanded, What had Jenner discovered? It is not that cowpox prevents smallpox; for that has been asserted by dairy-folk for generations, and has been disregarded by physicians because proved to be untrue. What then is it? Let him define his discovery that we may know how to respect it. Let him explain why it is forbidden to inoculate direct from the cow. Is genuine cowpox invisible and to be taken on trust? Or is the disease so virulent on its first communication that it has to be meliorated in the body of some victim ere it is fit for public use? Birch asked these questions as we continue to ask What is cowpox? Is it a disease of the cow? Or is it communicated to the cow by man or by horse? However definite the answers, the contradictions are equally definite, and the authorities equally trustworthy.

Practical men answered for Jenner, as they presume to answer at this day, “Whatever may be the origin of cowpox, we know that vaccination is harmless, and that it prevents smallpox; and more we neither demand nor care to inquire.” The credulity and conceit of such practical men is that stupidity against which, says Goethe, even the gods are powerless. It was practical men who “on the mere show of reason” accepted vaccination before it could be tested, and on most superficial evidence, said Birch—

The harmlessness of the practice was soon belied—

The non-fatality of the practice was also speedily confuted. The disorders it excited caused numerous deaths—from erysipelas especially. It was then said, as it continues to be said to this day, “Yes, but it was not vaccination, but erysipelas the patient died of”—a form of words that seems to satisfy many minds accounted rational. Birch mentioned three or four cases of death resulting from vaccination, and adds—

The Variolous Test, used so unscrupulously to win converts to vaccination, was proved by the Inoculators to be untrustworthy. They had no difficulty in variolating the vaccinated. When it was discovered that vaccination was no guard against smallpox, many of the vaccinated resorted to inoculation with smallpox, and they “took” as readily as did their unvaccinated acquaintance. Five in one family, the Hignells of Cheltenham, vaccinated by Jenner were variolated by Mr. Freeman, and smallpox resulted in the ordinary course. Nothing indeed became plainer than that the vaunted Variolous Test was a mere conjuring trick, and the more judicious vaccinators ceased to refer to it.

The promise that the vaccinated would remain for ever secure from smallpox Birch had no difficulty with. Londoners vaccinated by the most approved operators caught smallpox, and died precisely as did the unvaccinated. “Every post,” said Birch in 1804, “brings me accounts of the failures of vaccination.” As the failures multiplied, so did the excuses. There was the prime excuse of genuine and spurious cowpox. If vaccination failed, it could only be through the inadvertent use of spurious vaccine. Jenner had taught that one puncture was all-sufficient for protection, but as one was not found effective, it was asserted that two or three were requisite for absolute safety. Many, it was alleged, had been imperfectly operated upon, and the practice of the women and clergy and other busybodies was thrown into discredit, although at the outset their services and testimonies had been blazoned abroad as indisputable; but Birch made this conclusive answer—

Many, moreover, who had been vaccinated by Jenner fell victims to the disease, and he was so pestered with awkward questions, says Birch, “that to avoid the perplexing appeals that were made to him daily, and the messages that were perpetually sent requiring him to visit untoward cases, he retired from London.” Subsequently he had to forsake Cheltenham for the same reason. The convictions of quackery were too numerous for his endurance.

Having proved that vaccination did not prevent smallpox, whilst it was a frequent cause of illness and death, Birch held up to derision the fine promises wherewith its advocates had beguiled the people—

Those who take success as the test of truth may say that Birch was unsuccessful in his contention; but he was not unsuccessful. Vaccination in London was discredited, and the imposture abated, as the report of the College of Surgeons in 1807 attests. Where retained, it was not so much as a preventive as a mitigator of smallpox, its advocates being content to occupy the safe position that it made milder a disease the severity of which was unknown.

Birch died in 1815. His sister reprinted his papers against vaccination (from which have come my citations[162]), and erected a monument to his memory in St. Margaret’s, Rood Lane, Fenchurch Street, the inscription on which is noteworthy.

Jenner recognised Birch as a dangerous antagonist, and behaved toward him with his usual meanness. Writing from Berkeley, 11th October, 1812, to Moore in London, where smallpox was prevalent, he observed—

Birch a sad wicked fellow employing agents to spread pestilence in London, whilst the good Jenner, capable of arresting the dismal work of death, sat impotent at Berkeley! Comment is superfluous. Quack, malicious and impudent, is written at large.