The Story of a Great Delusion

There are few matters among educated people upon which opinion is so absolute and so ill-informed as vaccination. They will tell you it has stopped smallpox and does no harm, and if you venture to question either assertion you are set down as an abettor of “those ignorant and fanatical anti-vaccinators.” If undeterred you inquire when smallpox was stopped, and which is the harmless variety of vaccination, you will probably be told that these are medical questions, whilst the facts are indisputable; the answer running in the line of Old Kaspar’s to Little Peterkin, inquisitive as to the good of Blenheim—

I am not complaining of this attitude of mind. We all accept more or less on bare authority. In the multiplicity and unsearchableness of knowledge, it is unavoidable. Some years ago a venerable friend urged me to write against vaccination, which, he said, was working endless mischief to the public health. He would have the book published, and provide whatever was requisite for my satisfaction. I pleaded prior engagements, and turned the conversation, thinking how sad it was that one so good, and, in other respects, so enlightened should be subject to so strange an illusion—I, then, taking vaccination on trust as one of the numerous blessings conferred upon mankind in the course of the present century.

I am therefore disposed to make large allowance for the credulous attitude of the public toward vaccination whilst at the same time insisting on its correction; and for this reason especially, that vaccination is no longer a matter of private concern. We are free to entertain what notions we please, but if we proceed to enforce them on unbelievers, we cannot complain if we are required to answer for our aggression or encounter rough usage. Enforced by the law of England, vaccination is related to the life and intelligence of every citizen, and it is consequently vain to claim for it exemption from vulgar discussion. Apart from its compulsory infliction, vaccination might be and remain an esoteric rite, the very mystery of mysteries; but with compulsion the privilege of sanctity is impossible.

It has been said that beliefs and observances in themselves most irrational wear a different aspect when viewed in the light of their origin and history. It is so with vaccination. Had it come upon the world as we know it, with failure and disaster, equivocation and apology, rejection would have been inevitable; but when we turn to the past we discover that our damnosa hæreditas has a tradition that goes far to account for, if not to excuse, the folly which remains.

Vaccination was the successor of Inoculation (or, more precisely, Variolation), entering into a possession already acquired in the human mind.

It had been observed from of old that some forms of disease rarely recur in the same person in a lifetime; and thus when scarlet fever, or measles, or smallpox broke out in a family, it was considered prudent to let the disease have its course, and thereby obtain immunity from fear of future infection.

It was this confidence, that smallpox once undergone was finally disposed of, that was the justification of the practice of inoculating the disease when introduced from the East in the first quarter of last century. Inasmuch, it was argued, as none can have smallpox more than once, why not induce it artificially, and pass through the illness at a convenient season? But Nature, though compliant, does not always accept the course we ingeniously prescribe for her. Smallpox as naturally developed (so to speak) is a crisis of impurity in the blood, and if the requisite conditions are absent, it cannot be adequately excited. Hence variolation was an uncertain and hazardous operation. It took with some and was indistinguishable from an attack of ordinary smallpox; it took partially, or not at all with others; and the operation was frequently followed by malaise, disorders of the skin, and grave constitutional derangements. Nor were the variolated secure from smallpox. They occasionally had smallpox with their neighbours, and then it was said, “There must have been some mistake about the inoculation; for it is impossible that anyone can be successfully inoculated and have smallpox.” Further, the variolated, while labouring under the induced malady, conveyed the disease to their attendants and visitors; and thus smallpox was propagated by the means intended to avert it.

At the close of last century, variolation had become the custom of the upper and middle classes of England. The trouble and the peril were disliked, but were accepted in the name of duty. The variolation of their children was an anxiety that weighed like lead on the hearts of affectionate parents; and glad and grateful they were when the operation was accomplished without serious mishap. Patients designed for variolation were dieted, purged, and bled; and smallpox from sufferers of sound constitution was diligently inquired for. Mild smallpox was in great demand and was propagated from arm to arm. When Dr. Dimsdale operated on the Empress Catharine he did not venture to convey smallpox direct to the imperial person. He looked out a case of “benign smallpox” with which he inoculated a strong young man, and from the young man the Empress. Unless we realise the inconveniences, the uncertainties, the disasters and the horrors of the practice of variolation, albeit minimised, excused and denied by its professors, we can never understand the enthusiasm with which vaccination was received as its substitute. The promise conveyed in vaccination was a relief inexpressible, bearing with it a show of reason that was well nigh irresistible. The argument ran thus: No one can have smallpox twice, and the mildest attack is as protective from subsequent attack as the severest. Therefore it is that in inoculation with smallpox we find security. But inoculation with smallpox is an uncertain operation with dangerous issues. Here, however, in cowpox is discovered a mild variety of smallpox, which may be inoculated with perfect ease, and with no possibility of harm. And inasmuch as the mildest smallpox is as preventive of future smallpox as the severest, it follows that this gentle cowpox must serve as a full equivalent for smallpox itself.

It was in this plausible shape that vaccination had an immediate triumph. The way was made straight for it and every difficulty removed by the existing practice of variolation. Dr. W. B. Carpenter says that vaccination was more strenuously resisted at the beginning of the century than it is at this day. He is completely mistaken. Vaccination came upon a generation prepared for it—which saw in it a prescription in full accord with common-sense. The entire medical profession, with a few exceptions, the King, Queen and court, were converted straight off, and parliament and society followed suit. It was, I confess, a natural development of opinion; and we need have little doubt that had we lived in those days we should have found ourselves shouting with the genteel mob. The limited resistance offered to vaccination was not based on physiological or sanitary science: such science did not then exist. It was the resistance of variolators who were satisfied with the established practice and resented its disturbance; professing at the same time immeasurable horror at the profanation to humanity by infection with bovine disease. Whilst we have no reason to identify ourselves with that resistance, we have to recognise the service rendered by the variolators in observing the results of vaccination—the persistency with which they traced and exposed its failure to prevent smallpox and the injuries and deaths it caused. So far as the maintenance of variolous inoculation was concerned, they fought a losing battle; but they drove the vaccinators from post to post (cursed while they did so as malignant false witnesses possessed of the devil) and at last compelled the admission that their infallible preventive could not be guaranteed to prevent, but only to make smallpox milder—a safe assertion because unverifiable, as disputable as indisputable in particular instances.

About the matter of this prophylactic there was from the first a curious confusion which continues to this day.

Jenner was a country doctor at Berkeley in Gloucestershire, a dairy country, where the maids believed that if they caught cowpox in milking they could never afterwards catch smallpox. Jenner when a young man was inclined to accept the dairymaids’ faith; but when he discussed it with his medical acquaintance, they ridiculed him. They said, “We know that such is the dairymaids’ faith, but we also know that it is untrue; for we know dairymaids who have had cowpox, and afterwards had smallpox notwithstanding their cowpox.” Jenner was convinced and said no more about cowpox.

To this point let me draw special attention. No man knew better than Jenner that cowpox as cowpox was no preventive of smallpox.

Toward middle-life he had what he conceived to be a happy thought. Cowpox as cowpox he had dismissed as impracticable; but there was a variety of cowpox which he resolved to recommend.

Cows in Gloucestershire were milked by men as well as by women; and men would sometimes milk cows with hands foul from dressing the heels of horses afflicted with what was called grease. With this grease they infected the cows, and the pox which followed was pronounced by Jenner to have all the virtue against smallpox which the dairymaids claimed for cowpox.

According to Jenner, then, the dairymaids were right, and they were wrong. They were right when the pox they caught was derived from the horse through the cow; they were wrong when the pox they caught originated on the cow without the horse. He thus discriminated a double pox—cowpox of no efficacy against smallpox, and horsegrease cowpox of sure efficacy.

Further, in this connection, it is to be observed, that farriers believed that when they got poisoned in handling horses with greasy heels, they too, like the dairymaids, were safe from smallpox.

It is not therefore for cowpox, but for horsegrease cowpox that Jenner is answerable. In cowpox he had not, and could have no faith.

In 1798 Jenner published his famous Inquiry, a treatise much more spoken of than read, wherein he distinctly set forth the origin of his chosen prophylactic. It was not, I repeat, cowpox: it was horsegrease cowpox. He carefully discriminated it from spontaneous cowpox, which, he said, had no protective virtue, being attended with no inflammation and erysipelas, the essential sequences of inoculation with effective virus.

I have said that the world gave a cordial and unhesitating welcome to Jenner’s revelation, but the observation requires a startling qualification. Jenner’s revelation as conveyed in his Inquiry was summarily and ignominiously rejected—was absolutely rejected. I wish to emphasise this point. Jenner published his Inquiry in order to recommend horsegrease cowpox, and what I have to say is, that the public declined to have anything to do with horsegrease cowpox. The origin of cowpox in horsegrease was scouted as an intolerable origin. It was disgusting. Why a diseased secretion from horses’ heels should be more repulsive than a similar secretion from cows’ teats was not explained; but, as we all know, there is no accounting for tastes. Various attempts were made to verify Jenner’s prescription by inoculating cows with horsegrease, but they ended in failure—fortunately, it was said, in failure; for as Dr. Pearson (chief among primitive vaccinators) observed, “The very name of horsegrease was like to have damned the whole thing.” What did Jenner do under these circumstances? Did he confront the public and assert the efficacy of horsegrease cowpox? Not he. He wanted money. He saw how the wind was blowing. He said not another word about horsegrease cowpox; and as the public were eager at any price to escape from the nuisance of smallpox inoculation, and disposed to substitute cowpox as a harmless substitute, why then he resolved to go in for cowpox, and pose as its discoverer and promoter.

I am not making what is called a constructive charge against Jenner, but simply setting forth plain, undeniable matter-of-fact. I ask any one in doubt as to what I say to read Jenner’s Inquiry, published in 1798, the prescription of which is horsegrease cowpox, and the condemnation of cowpox. Turn then to his petition for largess, addressed to the House of Commons in 1802, and what do we find? Not one word about horsegrease cowpox, but this audacious assertion:—

“That your Petitioner has discovered that a disease which occasionally exists in a particular form among cattle, known by name of Cowpox, admits of being inoculated on the human frame with the most perfect ease and safety, and is attended with the singularly beneficial effect of rendering through life the person so inoculated perfectly secure from the infection of Smallpox.”

Why, that was not Jenner’s discovery! It was the notion of the dairymaids, and, so far as concerned spontaneous cowpox, was known by Jenner to be untrue. Yet, strange to say, the claim was in a measure allowed by the House of Commons, and £10,000 awarded to the imposter, and subsequently £20,000 in 1807.

As evidence of how completely Jenner’s prescription of horsegrease cowpox was put out of sight, I may refer to the treatise of Dr. Willan On Vaccine Inoculation, published in 1806, wherein all that was thought important concerning the new practice was set forth; and although Jenner was freely cited, yet neither horsegrease nor horsegrease cowpox was referred to from the first page to the last. Instead, cowpox, after the fancy of the dairymaids, was exalted as the true prophylactic, apparently without a suspicion of its questionable character.

As I have said, Jenner not only offered no resistance to this amazing transformation, but conformed to it, and assumed the issue as his own. Since the public preferred cowpox to horsegrease cowpox, he saw no reason why he should object, especially as the same foolish public lusted after some one to worship for their deliverance from the plague of variolation. The world resounded with praises of the immortal Jenner, the saviour of mankind from smallpox. Enveloped in the smoke of such incense, it is scarcely surprising that the idol came to believe that his worshippers knew him better than he did himself.

The promise of vaccination, its absolute security and harmlessness, was speedily belied. The vaccinated caught smallpox; they fell sick after the operation; they were afflicted with eruptions and swellings; they died. These mishaps were at first denied—stoutly denied; and when denial was no longer possible, it was attempted to explain them away. The cowpox used could not have been genuine cowpox, but spurious; and for awhile spurious cowpox did yeoman’s service in the way of apology; but by-and-by the excuse began to work more harm than good. Mishaps were so numerous that people became afraid of this omnipresent spurious cowpox, and to ask what it was, and how it could be avoided. How can there be spurious pox? Whoever heard of spurious disease? Milkmen vend spurious milk, grocers spurious sugar, smashers spurious coin; but surely cows are not to be numbered with such malefactors as producers of spurious pox! The thing was absurd on its face, and absurd it proved. When Jenner was under examination by a committee of the College of Physicians in 1806, he was pressed hard for a definition of spurious cowpox, when he “owned up.” He knew nothing of spurious cowpox. The words had been employed, not to describe any irregularity on the part of the cow, but certain irregularities in the action of cowpox on the part of the vaccinated: which was to say that when the vaccinated recovered creditably and did not catch smallpox, the cowpox was genuine; but when the sequences were otherwise, why then it was spurious! Ingenious and convenient, was it not?

Reverting to Jenner’s suppression of the origin of cowpox in horsegrease, it may be suggested that he had changed his mind: but he had not changed his mind. As observed, various attempts were made to inoculate cows with horsegrease, and that these attempts were failures; but subsequent attempts were successful. Tanner, a veterinarian, of Rockhampton, Gloucestershire, succeeded to Jenner’s complete satisfaction. Dr. Loy of Whitby dispensed with the cow altogether, and inoculated with horsegrease, or horsepox, producing vesicles identical with those of cowpox. The great success, however, in this line was reserved for Sacco of Milan. From the hand of a coachman poisoned with horsegrease he inoculated nine children, and from the virus thus engendered operated on every side. Writing to Jenner in 1803, Sacco said—“It is now admitted and settled that grease is the cause of vaccine, and we cannot too soon alter the designation to equine.” De Carro of Vienna received this equine from Sacco, and used it so freely and successfully among the Viennese, that, in his own words, it became impossible to say which of the citizens were equinated and which vaccinated.

What did Jenner make of these confirmations? He was adjudged mistaken in asserting that the cowpox good against smallpox was derived from horsegrease. Did he appeal with triumph to the evidence of Sacco, and say, “You thought me wrong, but see, I was right!” Not he. He kept silence. He consented to be treated as in error. He stood by and allowed cowpox to be used in which he had no confidence whatever. Nay more. He consented to be rewarded and honoured as the discoverer of a pox (which he did not discover) in which he was without faith, and had at the outset of his career expressly rejected and condemned. He recognised that it was expedient that the connection between horsegrease and cowpox should be denied. He had his bill to settle with the English people, and it was not for him to make difficulties. When, however, he had obtained all he could expect from public favour, and had got clear of London and the oppression of its savants, why then he resumed the expression of his original opinion; and still further, like Sacco of Milan, he dispensed with the cow, and inoculated straight from the horse. He supplied the National Vaccine Establishment with horse virus; he sent it to Edinburgh; he distributed it among his medical acquaintances; he described it as “the true and genuine life-preserving fluid.” What more need I say? Such was Jenner; such were his tactics; and whoever assumes his defence will assume a task in which he is not to be envied.

Jenner died in 1823, and at that date three kinds of virus were in use; first, cowpox from horsegrease or horsepox; second, cowpox; third, horsepox. These of course were subject to inscrutable modification in transmission from arm to arm: it is the distinct sources we have to recognise. A patient intent on vaccination might have said to himself, Which shall it be? Shall I be cowpoxed? or, shall I be horsepoxed? or, shall I be horsepoxed cowpoxed? How such an inquirer would have been answered had he set his perplexity before his medical adviser, I can only conjecture. Probably he would have been rebuked for his intrusion into matters outside his province. The little girl who quenched the scepticism of her comrade with the dictum, “It is so, for ma says so; and if it isn’t so, it is so, if ma says so,” illustrates the manner of rebuff administered to those who pry into professional mysteries. It is for you to pay and for us to think is a formula by no means limited to ecclesiastics.

Jenner was pleased to describe cowpox as a mild form of smallpox; but for what reason, outside his pleasure, he did not explain. Nevertheless the suggestion has borne fruit. When virus has fallen short, it has been asked, Why, if cowpox be mild smallpox, should not cows be inoculated with smallpox, and a crop of virus be raised? Various such attempts have been made, in which Mr. Badcock of Brighton has been especially distinguished. Mr. John Simon, writing in 1857, said, “Mr. Badcock, from 1840 to the present time, has again and again derived fresh stocks of vaccine lymph from cows artificially infected by him; having vaccinated with such lymph more than 14,000 persons, and having forwarded supplies of it to more than 400 medical practitioners.” When it is remembered that virus for half a dozen or more vaccinations is taken from a single arm, and that this process of reproduction is repeated every week, some idea may be formed of the extent to which this smallpox cowpox has been diffused over the country.

The original assertion that vaccination conferred life-long immunity from smallpox was unwillingly abandoned under stress of experience, until no respectable practitioner pretended that the rite afforded more than a partial or temporary security. In promotion of smallpox cowpox, however, Jenner’s most extravagant claims were revived. In Mr. Simon’s words, for the recipient of smallpox cowpox, “Neither renewed vaccination, nor inoculation with smallpox, nor the closest contact and co-habitation with smallpox patients, will occasion him to betray any remnant of susceptibility to infection.” Untrue even of variolation, it is unnecessary to controvert such a figment: it suffices to place it on record.

The hypothesis was, that smallpox inoculated on the cow lost somewhat of its virulence; but if so, why should not such cowpox inoculated on man resume its virulence? We are apt to forget that the nature of things is not controlled by our wishes, and that our interest in the conversion of smallpox into cowpox, and its maintenance as cowpox, is no warrant for fulfilment. I may also remark that though smallpox cowpox has entered so largely into currency, there is no evidence to what extent it has displaced the preceding issues of horsegrease cowpox, cowpox and horsepox. So far as we know, they are all existent in the common blood, indistinguishable, the stronger surviving, the weaker dying out: nobody knows, nor can know.

That smallpox cowpox is in any sense cowpox is, however, widely disputed, much confidence being placed in the researches of the Lyons Commission in 1855, presided over by M. Chaveau. This Commission, says Dr. Charles Cameron, “proved incontestably that smallpox can no more be converted into cowpox by passing it through a cow than by stunting an oak it can be converted into a gooseberry bush.” Cowpox, it is held, is a disease of the cow, with no relation to smallpox. The vesicles of each may be apparently identical, as are the vesicles excited by the application of tartar emetic; but that is no proof of essential identity. According to Dr. George Wyld, “Smallpox inoculation of the heifer produces not vaccinia, but a modified smallpox, capable of spreading smallpox among human beings by infection;” and Dr. Cameron boldly attributes the recent increase of smallpox to the use of smallpox cowpox for vaccination.

Nor is Dr. Cameron singular in this opinion. Some time ago, the Galway Guardians ran short of virus for vaccination, when it was proposed to inoculate a calf with smallpox. As soon as the Local Government Board in Dublin became aware of the project, it was forbidden. Why? Here is the deliverance of the Secretary—“Because smallpox virus taken from the calf would communicate that disease to the human subject, and be thereby a fertile source of propagating the disease; and would, moreover, render the operator liable to prosecution under the Act prohibiting inoculation with smallpox.” Thus the virus current in England, and credited with miraculous virtue by Simon, is denounced as dangerous and its use unlawful in Ireland!

The constant disasters of vaccination, the certain and suspected communication of human diseases with the virus propagated from arm to arm, have induced a wide resort to cowpox under the designation of “animal vaccination,” in contempt of the fact that disease in cattle is as rife as among men, and inoculable. Still the dread of the invaccination of syphilis is so intense, and so justifiable, that other risks are encountered if that may be avoided.

This cowpox is commended as “pure lymph from the calf,” a sweet periphrase with a savour of Daphne and Chloe, of Flora and the country green—a periphrase used in craft or ignorance, “pure lymph” being as incapable of producing vaccinia as pure milk or pure saliva. The prescription takes us back to Jenner’s time and Jenner’s procedure. As has been said, the Gloucestershire dairymaids believed that after cowpox they were safe from smallpox, and that Jenner was much impressed with their belief until he discovered that it was untrue. Had he found it true, he might have advertised the prophylactic thirty years in advance of the publication of his Inquiry; but if anything was certain, this was certain, that cowpox did not avert smallpox. Satisfied that cowpox per se was of no avail against smallpox, he defined a variety of cowpox generated by the application of horsegrease, to which he was pleased to ascribe sovereign efficacy. Why, I ask, did he discriminate and prescribe that variety of cowpox if cowpox per se was effective? The question answers itself. I will not say the cowpoxers treat Jenner’s evidence with disrespect; for such is their ignorance, that I question if they are aware of its existence; moreover, that which is undesirable to know, is instinctively avoided and kept out of sight. They recommend their “lymph” as wonderfully mild, being attended with no erysipelas, the pest of arm-to-arm vaccination—a description that tallies exactly with Jenner’s of impotent cowpox. “The pustules,” says Jenner, “are of a much milder nature” than those of horsegrease cowpox. “No erysipelas attends them, and they are incapable of producing any specific effect on the human constitution.”

Yet, incredible as it may appear, it is with the praise of this impotent cowpox, attended with no erysipelas, that the public have been deafened, and for which the most extravagant assertions are made. Dr. Martin, one of the chief producers and vendors of the article, appeared at the British Medical Association in 1881, saying, “I am called upon at times, at the very shortest notice, to vaccinate whole cities; and when I left America, I had just completed the vaccination of the city of New Haven. The custom is to send for me, or my son, wherever smallpox breaks out, with orders to vaccinate at once the entire population of the city, town, or neighbourhood. It is done immediately, the result being that an epidemic is completely stopped in a week.”

Thus spoke the charlatan, with the acquiescence of the medical assembly. When churchmen deplore the scepticism of the age, and the decay of faith, it is to be observed that the habit of mind is limited to certain modes of opinion, and that in general we are as credulous as ever. Human nature in its structure is curiously immutable. Wherein is the advantage to disbelieve in witchcraft and to believe that epidemics of smallpox can be stopped with cowpox?

Such are the leading varieties of virus used for vaccination—starting with Jenner’s horsegrease cowpox, then cowpox, then horsepox, then smallpox cowpox, and finishing with cowpox revived; each of them inscrutably modified in transit from child to child and from beast to beast. We are continually hearing of miracles wrought by vaccination in the past and present—especially the past, at home and abroad—especially abroad, the assumption being that vaccination is, and has been, everywhere the same. On the contrary, the condition precedent to serious consideration of any vaccine miracle is a definition of the variety of vaccination practised. It is, we admit, convenient for the administrators of the rite that it should pass for uniform, however multiform; for the practice has become a great and lucrative business—a world-wide poll-tax; and whatever the internal differences of the priesthood, it is their obvious interest to exhibit a decorous unanimity in presence of their customers. Hence the uneasiness recently excited by indiscreet advocates of “pure lymph from the calf” has been judiciously allayed, not by resistance, but by concession and damnation with faint praise; the commercial instinct dictating caution, for if the public did get behind the professional screen, and discovered the mysteries of pox, what might not befall the craft of vaccination!

The story of vaccination is a story of failures, and as each failure has become manifest, it has been more or less artfully apologised for.

Much is given to assurance. People like infallible prescriptions. They prefer an unequivocal lie to an equivocal answer. This adventurers understand, and discourse accordingly. Hence when Jenner solicited Parliament for largess, he did so in no doubtful terms. He boldly declared that cowpox was “inoculated on the human frame with the most perfect ease and safety,” and was “attended with the singularly beneficial effect of rendering through life the person so inoculated perfectly secure from the infection of smallpox.” Again he said, “The human frame, when once it has felt the influence of genuine cowpox, is never afterwards, at any period of its existence, assailable by smallpox.”

It is needless to point out that Jenner was without warrant for his assertions. His experience did not cover more than a few years; and he could not, therefore, know that his specific would secure its subjects from smallpox for life. He believed, or affected to believe, his own assurance, and assurance being infectious, it widely spread. The inoculation of cowpox became fashionable among busybodies, male and female. Ladies especially were numbered among Jenner’s favourites and experts, operating, as he described, “with a light hand.” Cobbett relates, “Gentlemen and ladies made the beastly commodity a pocket companion; and if a cottager’s child were seen by them on a common (in Hampshire at least), and did not quickly take to its heels, it was certain to carry off more or less of the disease of the cow.”

It so happened that prior to the introduction of vaccination, a marked decline in the prevalence of smallpox had set in, and for the continuance of this decline the vaccinators took credit. “See,” they cried, “see what we are doing!” But they failed to observe that the decline prevailed among millions who did not participate in the cowpox salvation. Soon, however, cases of smallpox among the vaccinated began to be reported. At first they were denied. They were impossible. When the evidence became too strong for contradiction, it was said, “There must have been some mistake about the vaccination; for it is incredible that any one can be properly vaccinated and have smallpox: the human frame, when once it has felt the influence of genuine cowpox, is never afterwards, at any period of its existence assailable by smallpox.” Either some carelessness on the part of the vaccinator, or some defect in the cowpox served for a while to reassure the faithful; but ultimately these reassurances utterly broke down. Persons vaccinated by Jenner himself caught smallpox and died of smallpox. Then said Jenner, “I never pretended that vaccination was more than equivalent to an attack of smallpox, and smallpox after smallpox is far from being a rare phenomenon; indeed, there are hundreds of cases on record, and inquiry is continually bringing fresh ones to light.” True; very true; but what then of the assurance and prediction under which £30,000 of the people’s money had been pocketed—“The human frame, when once it has felt the influence of genuine cowpox, is never afterwards, at any period of its existence, assailable by smallpox”? Nay, more; Jenner descended even lower. He not only likened vaccination to smallpox, but to variolation, that is to the former practice of inoculation with smallpox; and as, he said, variolation was well known to be no sure defence against smallpox, why should people be offended when smallpox in like manner occasionally followed vaccination? Why, indeed! but then the promise ran—“The human frame when once it has felt the influence of genuine cowpox, is never afterwards, at any period of its existence, assailable by smallpox.” In a letter to his friend Moore in 1810, Jenner said, “Cases of smallpox after inoculation are innumerable.” And again, “Thousands might be collected; for every parish in the kingdom can give its case.” And he asked another correspondent, Dunning, in 1805, “Is it possible that any one can be so absurd as to argue on the impossibility of smallpox after vaccination!” And this from Jenner, who had deceived the nation in 1802 with the assurance that, “inoculated cowpox was attended with the singularly beneficial effect of rendering through life the person so inoculated perfectly secure from the infection of smallpox”!

Such was Jenner; such his inconsistency; and such the admissions he was driven to make under stress of failures many and manifest.

As vaccination failed to afford the protection originally guaranteed, various explanations were devised to enable those who had talked too loftily to eat humble pie without painful observation. One of the commonest excuses was that if vaccination did not prevent smallpox it made it milder: and inasmuch as no one knew, or could know, how severe any attack of smallpox would have been without vaccination, it was an assertion as indisputable as the reverse—namely, that vaccination not only made smallpox severer, but frequently induced the disease. There are many assertions with which there is no reckoning, for it would require omniscience to check them. Let us beware of such assertions. Let us neither make them, nor suffer ourselves to be imposed upon by them.

Another excuse was advanced in the report of the National Vaccine Establishment in 1814. It was said the failures in vaccination appeared to result from the practice Of making only one puncture for the insertion of virus. One puncture ineffective! Why, if one puncture were ineffective, how were the early miracles of vaccination to be accounted for, all of which had been effected by means of single punctures?

There was in those days a surgeon of eminence in Norwich, Edward Rigby, and he at once entered his protest against the novel doctrine. Writing to the Medical and Physical Journal of August, 1814, he said, “No physiological reason is assigned for this, and I believe it would be difficult to prove that a single perfect vesicle, which goes through the usual stages and exhibits the characteristic appearances of this singular disease, can be less the effect of a constitutional affection than any given number would be.... It cannot surely be doubted that a single perfect vesicle affords as complete security against Variola as any indefinite number; and, if so, there would seem to be an obvious objection to unnecessarily multiplying the vesicles, which in all cases go through a high degree of inflammation, are often attended with painful tumefaction and even suppuration in the axilla, and, if exposed in the later stages to any act of violence, are apt to assume a very disagreeable ulceration, more especially as young children, now the principal subjects of vaccination, are most liable to suffer in this way.” Rigby had the better side of the argument. As he observed, no physiological reason was assigned for the recommendation of plural punctures; nor was any such reason ever assigned. It is the rationale of vaccination that a virus is injected into the system which begets a fever equivalent to an attack of smallpox; and as smallpox rarely recurs in a lifetime, it is hoped that Nature may graciously recognise the substitute for the reality. Organic poisons such as vaccine operate like fire or ferment. Quantity is of no account. So that the fever be kindled, excess is waste. A scratch at a dissection is as deadly as a gash. One bite of a mad dog is as likely to beget hydrophobia as a dozen. The sting of a cobra may be almost invisible, but the puncture is enough for death. Sir James Paget says of vaccine virus that “inserted once, in almost infinitely small quantity, yet by multiplying itself, or otherwise affecting all the blood, it alters it once for all.”

Such is the rationale of vaccination, and if I were a vaccinator, I should hold the position assumed by Rigby, and maintain that one puncture is as effective as a dozen, inasmuch as with one it is possible to excite that fever which is the essential of vaccination; adding, in Rigby’s words, that as one puncture is in all cases attended with a high degree of inflammation, and often with painful tumefaction, and even suppuration in the arm-pits, which in case of violence are apt to pass into very disagreeable ulceration, especially in young children, it is most undesirable to increase the number of such dangerous wounds.

I do not know that the condemnation of single punctures at that time, seventy years ago, had much effect. Two punctures became common, chiefly to guard against the possible failure of one. It is of late years that the resort to many punctures has become fashionable. Mr. Robert Lowe, now Lord Sherbrooke, in the House of Commons in 1861 spoke of “the beautiful discovery which had been made, that the security of vaccination may be almost indefinitely increased by multiplying the number of punctures”! The chief author of this remarkable discovery was Mr. Marson, for many years surgeon of the Smallpox Hospital at Highgate. He estimated the efficacy of vaccination by marks, and made so much of marks that I usually think of him as Marks Marson. He said—“A good vaccination is when persons have been vaccinated in four or more places leaving good cicatrices. I define a good cicatrix in this way: a good vaccine cicatrix may be described as distinct, foveated, dotted, or indented, in some instances radiated, and having a well, or tolerably well, defined edge. An indifferent cicatrix is indistinct, smooth, without indentation, and with an irregular or ill-defined edge. When I find that a person has been vaccinated in at least four places, leaving good marks of the kind which I have described, that person invariably, or almost invariably, has smallpox in a very mild form.”

Reading a statement like this, we revert to the rationale of vaccination, and ask what can marks have to do with its efficacy? Remember, Marson offered no explanation of his statement. He was satisfied to say thus and thus have I observed, and you may take my word for it. But in science we take no man’s word. We must see, or, like Trelawney’s Cornishmen, we must know the reason why. Marson appeared before the House of Commons’ Vaccination Committee in 1871, and set forth his marks doctrine with all the qualifications and inconsistencies which characterise the victim of a fad in contact with facts which his fad fails to include or account for.

Fatal cases of smallpox are confluent cases, and in confluent cases vaccination marks rarely show up so as to answer to Marson’s description of marks distinct, foveated, dotted, or indented, with a well, or tolerably well-defined edge. And in this matter our acute and industrious friend, Mr. Alexander Wheeler, has explored the records of the Smallpox Hospitals, and proved that vaccination marks many or vaccination marks few have no influence whatever on the character or issue of smallpox. As Mr. Wheeler shows, the classification of smallpox into discrete and confluent is the only clue to the right estimation of the fatality of the disease. Smallpox in the discrete form, that is, when the pustules are distinct and separate, is not dangerous when uncomplicated with other disease, the overwhelming majority of patients recovering, vaccinated or unvaccinated. The contest between life and death is waged among the confluent cases, where the pustules are so close that they run together; and it is on these confluent cases, and the conditions and antecedents of the sufferers, that attention should be concentrated. There is a third form of smallpox, the malignant, chiefly confined to persons of irregular life, which is almost invariably fatal, and, as vaccinators themselves allow, vaccination in malignant smallpox affords no odds to its victims.

Nevertheless, as Mr. Enoch Robinson has pointed out, there is something to be said for what Marson called good vaccination marks. The bit of reality that constitutes the basis of the marks illusion is this, that a well-formed vaccine cicatrix represents a strong vitality with vigorous healing power; whilst an ill-formed cicatrix represents a contrary habit of body; and, pari passu, those who heal well under vaccination stand likely to make the best recoveries in the event of smallpox. Good marks are simply notes of good constitutions, and the rest follows. Aught beyond is mere medical rubbish, on a par with faith in omens and divination in tea-cups.

Vaccination, in whatever form, is bad, but this faith in marks aggravates its cruelty. Mr. Claremont, vaccinator for St. Pancras, operates on infants by the thousand, and inflicts on each four marks. At a recent inquest on an infant, the victim of his handiwork, I heard him say, “The mothers nearly always protest.” Of course they do. What kind of mothers would they be if they did not protest! Apart from the venom, the shock to an infant’s life from such wounds is very serious. Mr. Young was called the other day to see a dying infant vaccinated by this Claremont. Previous to vaccination it was perfectly healthy, but never afterwards. From the time of the operation it fell under a blight. “In its coffin,” said Mr. Young, “it lay like a child’s doll—the poor babe had wasted away.”

I was glad to see in the Times about a year ago a letter from Dr. Allnatt of Cheltenham protesting against the cruelty of vaccination as practised upon the children of the poor. He recalled the days when he was a pupil of Dr. Walker, in 1825-26, and his instructions were to dip the point of the lancet into the fresh lymph, and insert it tenderly without drawing blood, under the cutis of the forearm, and protect the wound with a slight compress. “But the case is altered now,” he says. “Some of the vaccinators use real instruments of torture. Ivory points are driven into the flesh, and wounds ensue which become erysipelatous, and in the delicate constitutions of weakly children fatal.”

The case is altered now, says Dr. Allnatt; but why is the case altered now? Why, because, under the old terms vaccination was more and more seen to be no defence against smallpox; and to preserve the rite, and the gains from the rite, the marks doctrine was invented, or, rather, revived, and hailed as a sort of revelation from heaven.

When vaccination was seen to be no preventive of smallpox, it was conjectured that it might require renewal, a suggestion which distressed Jenner exceedingly. It was calculated, he said, “to do unspeakable mischief,” depriving his discovery “of more than half its virtues.” But as experience continued to belie the claim made for vaccination as a permanent defence, it was natural that those interested in its performance should endeavour to retrieve its waning credit. Thus revaccination began to be practised. Between 1830 and 1835 there were 13,861 revaccinations effected in the army of Wurtemburg. Dr. Holland (subsequently Sir Henry) after recording the accumulating proofs of the futility of vaccination in 1839, recommended revaccination as a probable resource, and the recommendation gradually acquired authority. The London Medical Gazette in 1844 boldly proclaimed, “Revaccinate, revaccinate!” But so late as 1851 the National Vaccine Establishment protested against the innovation, saying, “The restriction of the protective power of vaccination to any age, or to any term of years, is an hypothesis contradicted by experience and wholly unsupported by analogy.” Whatever the experience, however, and whatever the analogy, there was the indisputable fact, that vaccination in most unimpeachable form did not avert smallpox, and that if the public faith and the public money were to be retained, some fresh artifice was essential. It was hard to surrender the original claim of the equivalence of vaccination to smallpox; but it needs must when the devil drives; and so it has come to be admitted that Jenner was mistaken, and the vaccine rite to be effectual must be renewed.

Dr. Colin expresses what is now the common medical opinion in saying, “We must not stop at a single vaccination. We must establish the firm conviction in the public mind, that vaccine prophylaxy is only real and complete when periodically renewed;” and Dr. Warlomont, chief of Belgian vaccinators, goes yet further in advising and practising what he calls Vaccinisation; which is, that every subject of the rite be vaccinated again and again until vesicles cease to respond to the insertion of virus. Then, and then only, can the victim be guaranteed from smallpox! Such are the shifts to which vaccinators have been reduced. If their insurance were valid, the premium would exceed the principal, whilst there is no reason to believe the new security is a whit better than the old. In these frantic prescriptions we see the quackery in its death-throes.

As for revaccination keeping off smallpox, it is absurd, and ought to be known for absurd. The chief incidence of smallpox is among the young, in whom it cannot be pretended that the influence of primary vaccination is exhausted. The subjects of revaccination are passing, or have passed out of the smallpox age; and as the statistics of the army and navy prove, our soldiers and sailors are no more exempt from smallpox than the unrevaccinated civil population of corresponding years. In this matter, the old words stand true, Populus vult decipi; decipiatur.

From whatever side regarded, the original and successive claims made for vaccination are seen to have broken down; but a practice endowed and enforced as a poll-tax for the benefit of the medical profession is not lightly surrendered. Instead a variety of defences, more or less ingenious, are thrown out.

I.—One of these is the reduction of smallpox. It is said, “Smallpox was once a common disease, and is now a comparatively rare one—How are we to account for this improvement otherwise than by the introduction of vaccination?”

The answer is, that smallpox was declining before vaccination was introduced, and that, too, in spite of the extensive culture of the disease by variolation; and the decline continued during the first part of the present century whilst as yet nine-tenths of the people were unvaccinated. Several diseases once common have abated or disappeared; and why should we attribute to an incommensurate cause a similar abatement in smallpox? Leprosy, once extensively prevalent in England, has disappeared. Why? It died out gradually; but suppose some rite, analogous to vaccination, had been brought into vogue contemporaneously with its decline, would not the rite have had the credit, and would not its practitioners have called the world to witness the success of their prescription?

II.—In the same line of defence, we have the claim made for an extraordinary salvation of human life. Thus Sir Spencer Wells in a recent speech observed, “Jenner is immortal as a benefactor of mankind. It may not be generally known, but it is true, that Jenner has saved, is now saving, and will continue to save in all coming ages, more lives in one generation than were destroyed in all the wars of Napoleon.”

The answer to such a statement is to call for proof of the lives saved. There is no proof. At the close of last century, 20 per cent. of the mortality of Glasgow was due to smallpox. Smallpox abated, but did mortality abate? Not in the least. Dr. Robert Watt in 1813 recorded the fact with amazement over it. And what was true of Glasgow was true of other cities and other populations. There may be a cessation of smallpox, but (unless the result of sanitary improvement) the work of death is merely transferred to cognate agencies. There is no saving of life. What was a mystery to Watt is less of a mystery since the development of sanitary science. Zymotic disease in its various forms is a definite evolution from definite insanitary conditions. It is not affected by medical repression, nor by the spontaneous substitution of one variety of fever for another. In the words of Dr. Farr, “To save people from smallpox is not enough whilst exposed to other forms of disease. Thus in a garden where the flowers are neglected, to keep off thistle-down merely leaves the ground open to the world of surrounding weeds.” To lower the zymotic death-rate it is necessary to reduce the conditions in which zymotic disease is generated. Citing Dr. Farr once more, “To operate on mortality, protection against every one of the fatal zymotic diseases is required; otherwise the suppression of one disease-element opens the way for others.” Dr. Watt and Dr. Farr alike believed that vaccination stopped smallpox, and alike realised that the disappearance of smallpox was accompanied with no saving of life. Sir Spencer Wells is of a contrary opinion, which he shares with a number of people who prefer the free, play of the prejudiced imagination to the sobriety of exact information.

III.—Then we are asked to believe that though vaccination may not keep off smallpox, it makes it milder, and in proof we are entertained with low rates of mortality among the vaccinated and high rates among the unvaccinated.

We reply, to make a fair comparison between the vaccinated and the unvaccinated, it would be necessary to compare class with class, physique with physique, age with age. In other words, the subjects of smallpox should be constitutionally equal, their difference being limited to vaccination present or vaccination absent. So much is obvious.

But when or where has such comparison been even attempted? Nor would it be easily practicable: for the vaccinated comprise the best portion of the community, physically; but who are the unvaccinated? They are the waifs and strays of civilisation, the offspring of the miserable and the vagrant, who, without fixed domicile, escape the attention of the vaccination officer. These, whatever their ailment, whether measles, pneumonia, diarrhœa, would exhibit a higher rate of mortality than the vaccinated; but would it therefore be safe to argue that vaccination was not only good against smallpox, but against measles, pneumonia, and diarrhœa? Yet it is these, the lowest physically and most neglected of the population, who drift into smallpox hospitals, who are exhibited as fearful examples of the neglect of vaccination. It might be added, they are unbaptised as well as unvaccinated, and probably the one defect may be as prejudicial as the other.

Our contention does not end here. Such is the prejudice in favour of vaccination that a bad case of smallpox is assumed to be an unvaccinated case. Over and over again has it been proved that vaccinated patients dead of smallpox have been registered as unvaccinated, their death being taken as evidence of the absence of the saving rite. Again in severe smallpox, when vaccination marks are invisible, the sufferer is frequently set down as unvaccinated. Dr. Russell, of the Glasgow Hospital, relates that patients entered as unvaccinated, showed excellent marks when detained for convalescence. Had they died, they would have gone to swell the ranks of fearful examples.

It is thus that the high death-rates of the unvaccinated are accounted for, the framers of hospital reports appearing to vie with each other in extravagance. We are continually adjured in the newspapers to confess our folly and repent, because 40 or 60 or 80 per cent. of the unvaccinated have perished in this or that hospital because unvaccinated. To us such statistics have fraud written on their face, and the more they are sworn to, the more unscrupulous do their vendors reveal themselves. When all were unvaccinated last century, the hospital death-rate of smallpox ranged about 18 per cent. Now we are asked to believe that death-rate has doubled, trebled, quadrupled, and for no other reason apparently than to make for the glory of vaccination.

IV.—It is further said that nurses in smallpox hospitals never contract smallpox because they are revaccinated.

To establish this assertion, it would be necessary to prove that prior to the introduction of vaccination, or rather of revaccination, it was common for nurses to fall victims to the disease. The attempt is not made, and wisely, for failure would be conspicuous. Jenner never recommended vaccination as a protective for nurses. Their general immunity, along with that of physicians, is noted throughout our older medical literature; nor is the reason far to seek. Smallpox is predominantly an affection of the young, and it is no more surprising that a nurse should be proof against it than that she should be proof against measles, whooping cough, or scarlet fever. Nurses occasionally incur these maladies, and they occasionally incur smallpox.

If revaccination preserves nurses from smallpox, to which they are exposed in the intensest form, it should much more preserve soldiers, sailors, policemen and postmen, whose exposure is incomparably less intense; yet these servants of the state (as already observed) are as liable to smallpox as their unrevaccinated fellow citizens of correspondent ages.

To speak plainly, the selection of a vocation so arduous and repulsive, marks off a smallpox nurse as unimpressionable, and little apt to catch anything. Smallpox, too, is like tobacco: custom fortifies the constitution against its immediate effects. If the atmosphere of a smallpox hospital is endured for a fortnight, it is likely to continue endurable. On the other hand, if a volunteer sickens on probation, she is not reckoned among nurses. Lastly, many nurses have entered hospitals as patients, and have accepted service in default of other occupation. On these grounds, the nurse argument breaks down irretrievably. At first sight, it seems something, but on scrutiny it proves nothing.

V.—Another favourite argument for vaccination is the disappearance of pock-marked faces. People say when they were young such faces were common, whilst now they are rare; and demand, What can have wrought the change if not vaccination?

A medical man at a public meeting tried to dispose of some statistics adverse to vaccination by saying that statistics could be made to prove anything; and presently went on to relate that when his mother was a girl every third person she met was pock-marked. She had told him so repeatedly, and there was no doubt about her accuracy. Thus statistics in general were untrustworthy, but his mother’s statistic was unquestionable.

We need not hesitate to allow that when smallpox was common and cultivated pock-marked faces were more numerous: but we must not forget that whether a patient is marked or not marked is very much a matter of treatment. Many at this day pass through smallpox, and severe smallpox, and escape unmarked, simply because those who have care of them observe certain precautions. It was different in former times. The treatment of smallpox was atrocious. The sick-room was made pestiferous by the exclusion of air and the maintenance of high temperature. The patient sweltered under bed-clothes. He was neither allowed to wash nor change his linen. He was drenched with physic and stimulants. In hospitals, patients were stuck two or three in a bed, and stewed together. If, under such circumstances, the sick were restored to life pock-marked, what wonder! Patients who were fortunate enough to be sufficiently let alone, stood the best chance of recovery.

Besides smallpox was not equally diffused. In some places it was endemic; in others it appeared at intervals; and in others it was hardly known. The smallpox death-rate of Glasgow was double that of London; and we may therefore infer that pock-marked faces were twice as numerous in Glasgow as in London. Hence when recollections are appealed to, they should be localised. What might be true of one population might be grossly untrue of another.

It has been observed that smallpox was falling off toward the close of last century, and the decline accelerated in the present century, irrespective of vaccination. An excellent illustration of this reduction of smallpox is furnished by the reports of the National Vaccine Establishment for 1822, 1825, and 1837, where the disappearance of pock-marked faces from London is triumphantly recorded and claimed as a result of vaccination. In 1831 Dr. Epps, director of the Royal Jennerian Society, made the like observation and the like claim, saying, “Seldom are persons now seen blind from smallpox. Seldom is the pitted and disfigured face now beheld;” adding, “but seldom do mankind inquire for the cause. It is vaccination. It is vaccination which preserves the soft and rounded cheek of innocence, and the still more captivating form of female loveliness.” Inasmuch as not ten per cent. of the population were vaccinated in 1831, the claim made for vaccination was absurd, whilst the disappearance of pock-marked faces was sufficiently explicable by the reduced prevalence of smallpox.

Where then is the argument for vaccination from the disappearance of pock-marked faces? When anyone under seventy proceeds to recite the legend, “There is no use in arguing against vaccination, for when I was young every third or fourth person was pock-marked,” etc., etc., the effect is droll. It shows how prone we are to fancy we have seen what we think we ought to have seen. Droller still it is when striplings of five-and-twenty and thirty profess the same experience—“When I was a lad,” and so forth and so forth. There is matter for reflection as well as for laughter in the hallucination.

Nevertheless, if pock-marked faces are not so common as they must have been a century ago, they are by no means rare; and if the argument for vaccination were valid, the pock-marked would be unvaccinated. But are they? Those who will take pains to inquire will find that almost invariably they have been vaccinated, and some of them repeatedly, the vaccination having as it were induced the smallpox.

Thus far we have chiefly dealt with vaccination as if its fault were limited to failure to prevent smallpox; but vaccination is more than an ineffective incantation. It is the induction of an acute specific disease. The prime note of vaccination is erysipelas. “The cowpox inflammation,” said Jenner, “is always of the erysipelatous kind.” He held that cowpox unattended with erysipelas was “incapable of producing any specific effect on the human constitution.” If it is supposed that Jenner is antiquated, we may refer to a distinguished contemporary. Mr. John Simon replying to the question, “Whether properly performed vaccination is an absolutely inoffensive proceeding?” answers decisively, “Not at all; nor does it pretend to be so.” The rationale of vaccination is that it communicates a mild variety of smallpox, and that with a little of the devil we buy off the entire devil. Dr. Ballard, Medical Officer to the Local Government Board, in his treatise, Vaccination: its Value and Alleged Dangers, says, “Vaccination is not a thing to be trifled with, or to be made light of; it is not to be undertaken thoughtlessly, or without due consideration of the patient, his mode of life, and the circumstances of season and of place. Surgeon and patient should both carry in their minds the regulating thought, that the one is engaged in communicating, the other in receiving into his system, a real disease—as truly a disease as smallpox or measles; a disease which, mild and gentle as its progress may usually be, yet, nevertheless, now and then, like every other exanthematous malady, asserts its character by an unusual exhibition of virulence.”

Here we have Vaccinia defined as disease with precautions for its safe reception; yet withal it is allowed it may assert itself with virulence. But where do we find any precautions exercised in the vaccination of the poor?—that is to say, of the vast majority. Precautions are not only disregarded, they are unknown, they are impracticable. Infants of all sorts and conditions are operated on as recklessly as sheep are marked. Whether they live or die is matter of official indifference, whilst each is warrant for an official fee. Sir Joseph Pease, speaking in the House of Commons, said, “The President of the Local Government Board cannot deny that children die under the operation of the Vaccination Acts in a wholesale way.” Vaccination conveys an acute specific disease (having a definite course to run like smallpox or other fever) which, whether by careless treatment, or superinduced, or latent disease, is frequently attended with serious and fatal issues. Hence it is that vaccination is dreaded and detested by the poor on whom it is inflicted without parley or mitigation; in itself a bearer of illness, it is likewise a cruel aggravation of weakness and illness. When the poor complain that their children are injured or slain by vaccination, they are officially informed they are mistaken. Dr. Stevens, a well-known familiar of the vaccination office, says he has seen more vaccination than any man, and has yet to witness the least injury from the practice. Variolators used to say the same of their practice until vaccinators arose and convicted them of lying. Coroner Lankester held that vaccination was not a cause of death “recognised by law,” and was therefore an impossible cause. Such prevarication is mockery. True it is that, if a child dies of vaccination, it dies of erysipelas, or pyœmia, or diarrhœa, and it is easy enough to ignore the primary cause and assert the secondary; but I would ask, How else can death ensue from vaccination than by erysipelas, pyœmia, diarrhœa, or similar sequelæ? If vaccination kills a child, how otherwise could it kill? Even should death occur directly from surgical shock, it would be said, the child did not die of vaccination, but from lack of vigour to sustain a trivial operation. The Sangrado of the Stevens pattern is never without a shuffle.

It is usual at coroners’ inquests on vaccination fatalities to produce children vaccinated at the same time from the same vaccinifer, and to assert that inasmuch as they have made good recoveries, it is impossible that the virus was at fault, and that something else than vaccination must have been the cause of death. The argument often impresses a jury, but it is grossly fallacious. Suppose a mad dog bit six men, and that five escaped injury beyond their wounds and fright, and that one died of rabies, would the escape of the five prove that the death of the sixth was unconnected with the dog? Or suppose an equal potion of gin were administered to six infants, one of whom died and five recovered, would the recovery of the five prove that gin did not kill the sixth? Mr. Stoker writes to the newspapers that he vaccinated twelve other persons with the virus he used for Miss Ellen Terry, and that as no untoward symptoms appeared in the twelve, therefore Miss Terry’s whitlow had no connection with her vaccination—and this in spite of the untoward symptoms falling due at the very time that vaccination accounted for them! Any reasons are good for those disposed to be convinced, and who have settled it in their minds that vaccination is invariably harmless.

No doubt there is virus used for vaccination that is virulent beyond other virus, as there is virus that is comparatively innocuous; but, as Dr. Mead observed more than a century ago, “It is more material into what kind of body smallpox is infused than out of what it is taken.” The same virus that one constitution may throw off with little effort, may induce disease and death in another. Dr. Joseph Jones, president of the Louisiana Board of Health, relates that “In many cases occurring in the Confederate Army, the deleterious effects of vaccination were clearly referable to the condition of the forces, and the constitution of the blood of the patients; for it was observed in a number of instances that the same lymph from a healthy infant inoculated upon different individuals produced different result’s corresponding to the state of the system; in those who were well fed and robust, producing no ill-effects, whilst in the soldiers who had been subjected to incessant fatigue, exposure, and poor diet, the gravest results followed.”

Some constitutions are peculiarly liable to injury from vaccine virus, just as some constitutions cannot endure drugs that others receive without inconvenience. Thus it is that fatalities from vaccination are frequent in certain families. Of these, neither the law nor medical men condescend to take account. Parents often plead in vain for exemption from the rite on the ground that they have already had children injured or slain by its performance; the brutal and unscientific argument running, “How can vaccination hurt your children when it does not hurt other people’s children?”

Nor is the case against vaccination yet complete. The virus used is not only Vaccinia, but more than Vaccinia; for it is impossible to propagate virus from child to child without taking up other qualities. This was clearly foreseen by the variolators when vaccination was introduced—they making it a point to take smallpox for inoculation from known and sound subjects. They maintained that cowpox transferred indiscriminately from arm to arm must acquire and convey constitutional taints; and their prognostication was speedily and grievously fulfilled in the item of syphilis. Notwithstanding, the fact was furiously contested. It was said that parents used vaccination as a screen for their own wickedness; and assertion alternated with denial even to our own day. At last the conflict is at an end. The evidence has grown too multitudinous and deadly for evasion. The invaccination of syphilis is admitted, and any question is reserved for the degree of frequency. Some are pleased to describe the risk as infinitesimal, but their pleasure stands for nothing but itself. Deeds are expressive beyond words. The wide resort to animal vaccination on the Continent and in the United States has but one interpretation. Doctors and patients do not abandon what is easy for what is troublesome, nor incur the risk of the communication of bovine disorders unless under the influence of over-mastering terror.

Relations of individual experience may be disregarded as untrustworthy, but the broad evidence of national statistics conveys authoritative lessons. Vaccination in England was made compulsory in 1853, stringently so in 1867, and systematically extended to the entire population. If therefore it were true that vaccination often communicates more than Vaccinia, and that it aggravates existent and excites latent disease, the proof must be manifest in the statistics of the Registrar-General. Thus argued Mr. C. H. Hopwood, and accordingly he moved in the House of Commons successively for three Returns, published as follows—Vaccination, Mortality, No. 433, 1877; Mortality (General and Infant), No. 76, 1880; and Deaths (England and Wales), No. 392, 1880.

These Returns, charged with curious and authentic information, are little known, and have been treated with significant silence by the press. Obscurantism is not confined to ecclesiastics. Our valiant journalists who mock at the Index Expurgatorius, and abhor the Russian censorship, are in their little way as ready to act the same part in favour of established prejudice. If facts adverse to the public confidence in vaccination are revealed, it is considered no more than decent to keep them out of sight.

What then is the evidence of Mr. Hopwood’s Returns? Briefly this: they clearly illustrate that vaccination does produce, intensify, excite and inoculate disease whose issue is death. The record of infant mortality from fifteen specified diseases related to vaccination stands thus—

Thus, while the population of England and Wales had increased from 18 to 23 millions, the deaths of infants from fifteen diseases had risen from 63,000 to 106,000. Had the mortality kept pace with the population, the deaths in 1875 would only have been 80,000; that is to say, in 1875 there perished in England 26,000 infants who would have lived had vaccination remained as little in vogue as in 1847! The result though startling in the gross is precisely what might have been predicted. The infancy of a country cannot be systematically diseased, that is vaccinated, without exciting and aggravating other maladies, and thereby enlarging the harvest of death.

The asserted connection of vaccination with other ailments, such as bronchitis, sometimes gives occasion to ignorant ridicule. “Bronchitis,” says Sir Lyon Playfair, “has about the same relation to vaccination as the Goodwin Sands have to Tenterden Steeple.” The answer is that the debility produced by vaccination predisposes to affections of the respiratory organs. The human body does not consist of isolated compartments, but is an organised whole, sympathetic in all its parts and functions. Erysipelas, as we have seen, is the primary symptom of inoculated Vaccinia, and diarrhœa is its commonest sequence; and given erysipelas and diarrhœa, what vigour may remain to assist and throw off other ailments? It is not said that certain maladies are communicated by vaccination, but that vaccination contributes to their fatality. An infant that would have survived bronchitis dies of bronchitis and vaccination; dies of teething and vaccination; dies of convulsions and vaccination; dies of whooping-cough and vaccination; and so on. Again disease kindles disease, and many a child might outgrow congenital scrofula or phthisis if the latent disorder were not roused by vaccination. For these reasons no doubt need be entertained that were vaccination abolished, the event would be immediately signalised by an extraordinary fall in infant mortality.

If vaccination were a voluntary superstition, its prevalence would be sufficiently deplorable; but when we think of it as inflicted on the nation, and pressed on those who know it for an injurious imposture, language is apt to arise which it is expedient to repress. It may be asked how it came to pass that legislation was ever compromised with a medical prescription, and the answer is not a reassuring one. The initial error was the endowment in 1808 of the National Vaccine Establishment, and the provision of vaccination fees in 1840 out of the poor rate. For the enforcement of vaccination, there never was any popular demand—never the slightest. The public had, however, learnt from sanitarians that a large part of the sickness from which they suffered did not come of fate, but was preventible; and under this novel persuasion the vast expenditure on sanitary works during the past fifty years has been cheerfully incurred. Availing themselves of this favourable disposition in the public mind toward projects in the name of health, certain medical place-hunters operating as the Epidemiological Society contrived to gain the ear of Government and to pass a compulsory Vaccination Act in 1853. The politicians who lent themselves to this transaction disowned any knowledge of vaccination. They acted, they said, under medical advice, and ran the bill through Parliament with little resistance. The Act did not personally concern M.P.’s. If they happened to believe in vaccination, their children received the rite with all recognised precautions. Its enforced application by contract at 1s. or 1s. 6d. per head was reserved for the unenfranchised and unconsulted multitude; whilst the administration of the Act provided place and pay for its ingenious promoters.

When an oppressive law is enacted, by whatever strategy or however corruptly, its repeal is no easy matter. The oppressors have won the nine points of possession. The antagonists of the Vaccination Acts nevertheless possess a certain advantage. Some bad laws can only be denounced as it were from a distance; but vaccination touches every household, and can be fought wherever a child is claimed as a victim for the rite.

We abhor the rite. We detest it as an imposture. We dread it as a danger. We refuse it on any terms. We encourage, we justify, we insist on the duty of rejection. Our contention extends and prospers. In various parts of the country resistance has been rewarded with success. The evil law has been broken down. Freedom has been recovered and freedom is enjoyed. In other parts the struggle for liberty proceeds, and as it proceeds, light is diffused and courage evoked for enlarged resistance. Elsewhere there are vindictive and cruel prosecutions, chiefly of humble folk. “Respected ratepayers,” to whom the law is objectionable and its penalties trivial annoyances, are discreetly passed over. Hard, however, is the lot of poor men, who for love of their children affront the dull animosity and ignorance of English Philistines whether as guardians or as magistrates on the bench of injustice. Shortly co-operation for defence and insurance against fines will enable the feeblest and most fearful to maintain his integrity and encounter his pursuers with undaunted front. Parliament, as our statesmen allow, is deaf to the aggrieved until they make themselves intolerable, and to raise ourselves to that pitch must be our end and aim.

Many good people are distressed over the operation of this extraordinary law, and sometimes in their perplexity adventure for excuse, “Surely since we compel parents to educate their children, it cannot be wrong to compel them to have their children vaccinated.”

We answer, education is compulsory so far as it is outside conscience. Compulsion is designed to overcome parental indifference and selfishness: where it confronts serious convictions it is arrested. By general consent the most important part of education is religion; and religion is precisely that part of education which is exempted from compulsion. The law does not even enforce some form of religion, so that parents who regard religion as superfluous may not be aggrieved.

What therefore the opponents of vaccination demand is, that the respect thus accorded to the religious conscience be extended to the scientific conscience—to those who are convinced that vaccination does not prevent smallpox or is an injurious practice. Even allowing it to be a harmless ceremony, resistance would be justifiable. It would be in vain to console a Baptist, forced to convey his child to the parish font, with the assurance that a few drops of water could do no harm. It is not in human nature to submit to the indignity of imposture; and to thousands of Englishmen vaccination is a cruel and degrading imposture, and to punish them for their loyalty to what they think right is every whit as tyrannical as it was for Catholics to persecute Protestants, and Protestants Catholics, and Catholics and Protestants Jews. There is no difference in the terms of intolerance; and there is no difference in the spirit with which this latter-day tyranny is confronted, and that spirit with which religious liberty was vindicated and won.

To some eyes the conflict is not only arduous; it is hopeless; but we are of a different mind. The conflict may prove even less arduous than it appears; and for these reasons. The law as it stands is perfunctorily defended. No politician answers for it without reluctance. Many allow that a serious mistake was made when legislation was enacted for medical advantage at medical dictation. The Gladstone government proposed to abolish repeated penalties. The central authorities at the Local Government Board make no secret of the insuperable difficulties which attend the administration of the law. They advise concession to its resolute adversaries. They do not reinstate the law where it has broken down. Legislation thus discredited is sure to collapse under broader pressure. The medical support is still weaker; and is chiefly confined to those who represent the trade element of the profession—men who would defend any abuse however flagrant if established and lucrative. It is the custom to laud the immortal Jenner and the salvation he wrought, but these are words of an old song. Those who have penetrated to the inception of the Jennerian rite; who know the absolute promise by which it prevailed and its absolute failure; who have followed its successive transformations and varieties with their respective injuries and fatalities; who are aware of the Babel of confusion and contradiction in which its venal practitioners are involved—these we say recognise how impossible it is for vaccination to be brought under discussion and survive. It is this consciousness which accounts for the reserve of the more prudent order of medical men. They excuse their acquiescence in the delusion (after the manner of ecclesiastics) by the exigencies of professional loyalty; and by the supposition that the harm of the practice is exaggerated, whilst it serves for the consolation of the vulgar. It is for such reasons that we consider the conflict less arduous than it appears. The fortifications are undermined; the bulwarks are rotten through and through. Over all, we place our confidence in the omnipotent favour of the truth. Goliath, mighty and vaunting, is evermore laid low by a smooth stone shapen in the waters of verity.

The Story of this Great Delusion, I have tried to tell concisely, keeping close to matter-of-fact, and with some exceptions adhering to English experience. When we venture abroad, we are apt to fall into inaccuracies and draw unwarrantable conclusions. I am told my animus is too pronounced, and that I should have done better had I adopted a more judicial tone. Ah well! we should always have done differently had we done differently. It seems to me a man does best when he is most truly himself; and I question whether I should have improved my case had I tried to conceal my real mind in order to make a more startling show of it at the close.

Lastly, a word to those who are accustomed to dismiss opponents of vaccination as fools and fanatics. It is related of Sydney Smith that calling on Lord Melbourne one morning, he found his lordship in an evil temper and cursing at large. Smith, urgent about his own affairs, at last observed that they should take everything for damned and proceed to business. For like reason I would suggest that the familiar tirade of fool and fanatic be taken as spoken, and that we proceed to discuss vaccination and compulsory vaccination on their merits.

To the Turks we owe little, and in the little is included the practice of inducing smallpox artificially. The practice was first brought under English attention by Emanuel Timoni in a letter, dated Constantinople, December, 1713, communicated to the Royal Society by Dr. Woodward, and published in the Society’s Transactions for 1714.[1] About the same time, Pylarini, Venetian consul at Smyrna, described the practice in a Latin pamphlet printed at Venice, 1715,[2] and reproduced in the Philosophical Transactions for 1716. Mr. Kennedy, an English surgeon, who had visited Turkey, also reported the practice under the designation of “Engrafting the Smallpox.”[3]

Timoni was a Greek physician, who had studied at Oxford and Padua, and then established himself in Constantinople. He described “smallpox by incision” as having been practised in Constantinople for forty years, and that it had been found uniformly successful in warding off smallpox as naturally developed. The variolous matter was usually taken from healthy boys suffering from the spontaneous disease, and was applied to persons of all ages and temperaments, causing them no more than temporary and trifling inconvenience. The only preparation requisite for incision was abstinence from flesh and broth for twenty or twenty-five days.

It so happened that when Woodward read Timoni’s letter to the Royal Society, he at the same time produced a selection from the correspondence of Cotton Mather of Boston, Massachusetts—a curious jumble of facts and fancies. Mather had been elected a Fellow of the Society, and the selections from his correspondence, and Timoni’s letter appeared in the same number of the Transactions, No. 338, 1714.

Cotton Mather is one of the marvels of biography—a choice specimen of Puritanism developed without check. He was a man of boundless energy and incessant industry, of intense piety and unlimited self-confidence; and thus, without hesitation, he set himself to extirpate witchcraft, shrinking from no atrocity, until the frightful Salem tragedy of 1692 shocked the colony into mercy and common-sense.

Mather was just the sort of character to be impressed with Timoni’s description of the short and easy way with smallpox; and he who had hanged warlocks and witches with sublime assurance, was not likely to have scruples about inoculating the community when inwardly satisfied it was for the public good. The audacity and tyranny of conscientious conceit are proverbial. He had, however, to exercise patience in awaiting an opportunity to test the Turkish remedy, for there had been no smallpox in Boston for nineteen years—a fact worth noting by those who imagine smallpox was an omnipresent ailment until the advent of Edward Jenner. In 1721 a serious outbreak occurred, the deaths rising in October to 100 a week in a population of 15,000. Mather convoked a meeting of physicians, and laid before them the new prescription, but they would not listen to it. Dr. Boylston, however, was persuaded, and inoculated two of his slaves, and then his sons, aged five and six; whereon he was summoned before the justices and severely reprimanded. Undeterred by the State, and supported by the Church, he persevered, and by the end of September had inoculated 80, and by the middle of December, 250.

His custom was to make a couple of incisions in the arms, into which bits of lint dipped in pox-matter were inserted. At the end of twenty-four hours the lint was withdrawn, and the wounds dressed with warm cabbage leaves. On the seventh day the patient sickened and pustules appeared, sometimes few, sometimes hundreds. Mather and Boylston maintained it was a most wholesome operation, for after it “feeble, crazy, consumptive people, grew hearty, and got rid of their former maladies.”[4] To be poxed was to be rejuvenated.

Cotton Mather’s own account of the Boston experiment is worth reading. He wrote—

Considering the developed evidence that awaits us as to the character and results of inoculation, it would be superfluous to discuss this singular report, but we may remark the consummate audacity with which Mather assumes and maintains his position. What a masterly touch of the quack have we in these words—

We can readily understand how the hand that could give so adroit a turn to awkward disasters could in other days frame irresistible indictments for witchcraft.

The precise truth as to the extent of the Boston epidemic is far from easy to ascertain: it was the temptation of the inoculators to magnify the numbers of the afflicted and of their antagonists to minimise. Thus we read—

Dr. Fleuart of Boston wrote to London that of 70 inoculated, 14 or 15 had died; and that at Roxbury, where there was no smallpox, 5 inoculated had died.[5]

Conflicting as are the testimonies, we must allow much to the natural aversion from an operation, not only novel, but disgusting; but taking the best that could be claimed for the new practice by an enthusiastic advocate, the benefit was trifling when seriously scrutinised. Dr. Boylston visited London after the Boston epidemic, and finding inoculation in high vogue he published an Account of the Smallpox inoculated in New England.[6] George I. and the Prince and Princess of Wales had taken Inoculation under their august patronage, and Boylston with loyal fervour burst forth—

Boylston in his Account recites his cases with, we think, general veracity. He performed 244 inoculations, and says, “there were in the towns near Boston about 36 persons more inoculated, which all did well; namely, by Dr. Roby about 11, and by Dr. Thomson about 25, which, together with my 244, make up the number of 280; out of which number died only 6 persons, notwithstanding all the difficulties the practice laboured under.”

Beyond measure extraordinary was the bland assurance wherewith Boylston, in common with Mather and others, assumed and argued that the 280 inoculated had been thereby delivered from the plague of smallpox and death. Accepting the improbable supposition that the 280 were a fair average of 15,000 Bostonians, of whom one-third took smallpox, we have to abstract two-thirds of the 280, or 186 as superfluously inoculated, leaving 93 saved from smallpox. If we then inquire how many of these were saved from death, and resort to Boylston’s statistics, who says,—

We find the number no more than 15, from which, if we deduct the 6 who died under his hand, his trophies are reduced to 9, to save whom he put 280 into serious sickness and jeopardy—so serious indeed in some instances (as appears from his own notes) that there was slight reason to prefer inoculated to spontaneous smallpox.

Viewed thus in his own light—a light most favourable, how vain, not to say impudent, was such boasting as this—

And, gaining courage through his own noise, he went yet farther, and proclaimed that smallpox was tamed and subdued—

In the knowledge of the emptiness of this bounce, it may seem malicious to withdraw it from forgetfulness; but it serves to point the truth that human nature in 1726 was much the same as human nature at this day, and that the same arts of audacious assertion and rowdy rhetoric were in practice then as now. Indeed, whoever is sufficiently wicked to presume on the natural trustfulness of mankind, and will lie loud enough and long enough, may attain an appalling success—as our story, alas! will prove.

One thing goes to Boylston’s credit: he did not propose to make poxing universal—to poison and sicken everybody, and inflict certain injury to avert future and uncertain danger from a few. He proposed to reserve inoculation for emergencies—

The narratives of Mather and Boylston are of special importance because we have in them the true lineage of inoculation as introduced from the eastern to the western world. Boylston tells us that when smallpox appeared in Boston—

For some inscrutable reason the true position of Cotton Mather in the history of inoculation is continually overlooked or mis-stated. For instance, in Mather’s biography in the excellent English Cyclopædia, it is said that he derived his information and impulse from the letters of Lady Mary Wortley Montagu; a statement repeated in the memoirs of that lady, which is entirely fabulous.

“As for History,” said the Duke of Marlborough, “I know that it is false;” and whoever has occasion to enter minutely into any historical question will be apt to concur with the Duke. Happening to refer to Walter Bagehot’s essay on Lady Mary Wortley Montagu, I found this passage—

Now Bagehot loved accuracy and abhorred credulity; and yet in these lines, delivered with as much confidence as a column of the multiplication table, there are exhibited about as much inaccuracy and credulity as could be packed into the space. Let us see what Lady Mary really did in the matter of inoculation.

Mr. Wortley Montagu was appointed ambassador to the Porte, and set out for Constantinople in the autumn of 1716 accompanied by his wife, then in her twenty-seventh year. The Ottoman Empire was in those days powerful and proud, disdaining to send representatives to Christian Courts, and receiving ambassadors as commercial agents, or as bearers of homage from their respective sovereigns. The English ambassador reached his destination early in 1717, and ere a month had passed, and ere Lady Mary had time to look around and appreciate the strange world into which she had entered, with sprightly audacity she wrote as follows to her friend Miss Sarah Chiswell—

In this letter there was material for a smallpox idyl—nothing easier, nothing surer, “smallpox made entirely harmless.” But idyls are deceptive; their paradisiacal effects are obtained by the sedulous exclusion of whatever is otherwise. About the time that Lady Mary was romancing so triumphantly to Miss Sarah Chiswell she despatched this note to her husband—

Why should the engrafting of the infant have been hindered because the nurse had not had smallpox? The answer to the question reveals a peril concealed from Miss Sarah Chiswell. Because the engrafted child would probably have communicated unmitigated smallpox to the nurse. Why not then engraft nurse and child? Because they would have sickened together, and mother Mary did not care to incur the risk. There was no danger, she said; none whatever, only a pleasant diversion; nevertheless she preferred discretion to her own voluble assurance.

In History we have always to suspect the picturesque, for mankind have a fatal preference for handsome error over uncomely fact; and Lady Mary Wortley Montagu as mother of English inoculation, and derivatively of vaccination, is ever so much more graceful than dull Timoni and Pylarini in the Philosophical Transactions, or Cotton Mather in New England. Few condescend to inquire whether Lady Mary, as primary inoculator, was acting independently, or whether she had advisers and prompters. “All of her self and by her self” is the heroic representation—“a woman’s wit against the world;” and judgment surrenders to fancy, as is the way with myths ancient and modern.

But it so happens that what in itself ought to be incredible—that a young Englishwoman should suddenly adopt the strange practice of a strange people—is demonstrably incredible. Lady Mary did not act alone. She had for counsellor and director, Charles Maitland, the physician to the embassy, who, familiar with the fame of inoculation, was glad to observe its practice experimentally. Maitland writes—

Here we may note, too, that Maitland was aware that inoculation did not originate in Turkey. He says—

It was Maitland who managed the inoculation of young Montagu, and he thus described the operation—

That is to say, almost simultaneously with the Ambassador’s arrival in Turkey.

The embassy returned to England in 1718, after a residence of little over a year in Constantinople. The dates are worth observation; for whilst it appears that the doctor and the lady were in common resolved to recommend the practice of inoculation to their countrymen, the dates prove with what inexperience and levity they assumed the grave responsibility. If quackery be assertion in absence of knowledge or of evidence, then we may accurately stigmatise Maitland and Montagu a couple of quacks. But so far as concerns Maitland we may go farther, for he expressly tells us—

Yet this same Maitland, who thus testified of the impotence of inoculation to mitigate and restrain smallpox in Turkey, came to England ready to assert its power to mitigate and restrain! It is difficult to find words of due severity for such impudent inconsistency. We shall see, however, in the course of this wonderful story, how every rule of evidence may be defied in the matter of smallpox, and how it is possible to shut one’s eyes and prophesy in the name of science, and have noise and hardihood accepted for veracity.

Lady Mary Wortley Montagu returned to England in 1718, but not until 1721 did she fulfil her intention of making war on the doctors, and incurring their resentment for the good of mankind. In the spring of 1721 she commenced action in earnest by the inoculation of her daughter—the infant that it was considered unsafe to “engraft” when at Pera in 1718. In Maitland’s words—

The learned physician here referred to was Dr. Keith, and the facility wherewith he adopted the novel practice supplies an instructive commentary on Lady Mary’s anticipation of the resentment of “the profession”—her first imitator coming from the ranks of the dreaded self-seeking obstructives. Furthermore, we have to observe how different is Maitland’s account from the heroic myth current of “the one woman confronting the prejudice and ill-will of the world.” Even Lady Louisa Stuart, who made it her business to correct many misconceptions as to her grandmother’s career, writes—

Thus is History written! An apothecary and three doctors, selected by the Wortleys at discretion, and admitted singly to view a private experiment, are converted into “four great physicians deputed by Government,” rancorous and dangerous! Thus are myths generated!

Lady Mary was a woman of mark in society, fashionable and literary, and her exploit was naturally the talk of the town. Among her friends was Caroline, Princess of Wales, a lady of more than ordinary strength of mind and intelligence, with a taste for theology and philosophy, the patron of Butler, and his sympathetic student. It has been said, “There never was a clever woman that was not a quack;” and Princess Caroline was an illustration of its truth. The new remedy for smallpox caught her fancy, and she determined to put it to the test. She begged of George I. that six felons should be pardoned on condition of their submission to inoculation, and the King was pleased to comply with the extraordinary request. Maitland was then called upon to exhibit his skill, but he hesitated to act as hangman’s substitute; whereon Sir Hans Sloane, the court physician, was appealed to. Sir Hans held counsel with Dr. Terry of Enfield, who had practised physic in Constantinople, and knew something of inoculation; and fortified with Terry’s assurance, he was enabled to overcome Maitland’s scruples, real or affected. Accordingly, on the 9th of August, 1721, writes Maitland—

On Wednesday morning, 9th August, he made incisions in both arms and the right legs of the six. Thursday passed and Friday passed without any indications of constitutional disturbance, and, despairing of success, he obtained fresh pox on Saturday from Christ’s Hospital, and repeated the inoculation in new incisions in the arms of five of them. He had no matter left for Evans, who, it appeared, had had smallpox in September, 1720, and who therefore escaped hanging unwarrantably. The disease now “took,” and progressed satisfactorily. Says Maitland—

Dr. Mead suggested another experiment—that cotton dipped in pox should be inserted in the nostrils; and a young woman sentenced to death received her life on condition of submitting to the operation. Here we have Mead’s own account of the transaction—

Finally, says Maitland—

So Maitland asserted, but others were of a different opinion. Dr. Wagstaffe, who visited the patients in Newgate regularly, maintained in a letter addressed to Dr. Freind—

Sir Hans Sloane and Dr. Steigertahl, physician to the King, to test the matter farther, “joined purses,” and had one of the women inoculated in Newgate sent to Hertford, where smallpox of a severe form was prevalent, to lie in bed with smallpox patients. This she did with impunity; but it was reasonably objected that many who were not inoculated did so likewise and escaped without harm.

The Newgate experiment, of course, caused great excitement, and induced many repetitions in town and country. The Princess of Wales was especially alive to the importance of “the great discovery;” and for her additional satisfaction, six charity children, belonging to the parish of St. James, were inoculated; and all but one “took” and did well; the exception being due to the craft of the child, who, for the sake of the reward, concealed the fact of having had smallpox.

The Princess Amelia, aged eleven, and Caroline, aged nine, were therefore inoculated on the 19th of April, 1722.

Let us return to Maitland, whose triumph for the moment appeared complete, and with it his assurance. To his detractors he professed boldly—

To divine Maitland’s character—to determine how far he was deceiver or deceived is not easy. He obviously made professions in vast excess of his knowledge. One of his contemporaries writes—

He had not the proper craft of this conscious rogue, for alongside his assertions of absolute competence and safety, he set forth such confessions of ignorance and disaster, that one is impelled to pronounce him a purblind enthusiast. For example, take this case, which he published without apparently any sense of its scope—

Thus at the outset, smallpox and death were the products of inoculation—the peril to be averted was incurred and multiplied. Yet the man who thus records his own infamous ignorance, had the impudence in the same pages to assert—

Words are wasted on such reckless folly: we perceive how true is Carlyle’s observation, “Stupidity intellectual always means stupidity moral, as you will, with surprise or not, discover if you look.”

Before leaving Maitland, we may take another leaf from his experience. He writes—

Verily, as Cobbett said, quackery is never without a shuffle. As we shall see, inoculation came to require a preparatory course of very strict regimen—so strict as to be impracticable for the rank and file of the world; but the practice was at first commended without any such conditions. What said Maitland’s patron, Lady Mary, in her famous letter from Adrianople?—

It was under cover of such seductive assurances that inoculation was introduced to England, and established in perversity and quackery.

As we have seen, it is part of the legend that the introduction of inoculation was fanatically resisted by physicians, clergy, and mob; but the resistance was neither fanatical nor extensive, and is chiefly the invention of the romancing biographers who represent Lady Mary Wortley Montagu as a heroine and martyr of science. To do that shrewd and brilliant woman justice, she made no pretence to the character imputed to her, and in her copious correspondence, there is not a hint of annoyance on the score of her patronage of the Turkish modification of smallpox. On the contrary, it would appear that inoculation brought her a large share of that veiled notoriety in which she had sincere pleasure. Writing to the Countess of Mar in 1723, she says—

Lady Mary understood her countrymen thoroughly, and, thirty years after her exploits in inoculation, she wrote to Mr. Wortley Montagu as follows—

Those who fancy there could be any wide or effective resistance to inoculation in 1721 misapprehend the conditions of the time. There was no scientific knowledge of the laws of health; diseases were generally regarded as mysterious dispensations of Providence over which the sufferers had little control; and a great part of medicine was a combination of absurdity with nastiness. It would not be difficult to compile a series of recipes from the pharmacopœia of that day which would alternately excite amusement, surprise, and disgust, and to describe medical practice from which it is marvellous that ever patient escaped alive; but so much must pass without saying. Suffice it to assert, that to inoculation there was little material for opposition, rational or irrational; and that what we might think the natural horror of transfusing the filth of smallpox into the blood of health, was neutralised by the currency of a multitude of popular remedies which seemed to owe their fascination to their outrageous and loathsome characteristics.

Moreover, as the dates prove, the interval was brief between the introduction of inoculation and its authoritative acceptance. The girl Montagu was privately inoculated in April, 1721, Dr. Keith’s boy on the 11th of May, the Newgate experiment took place on the 9th of August, a variety of experiments followed, and lastly the Princesses Amelia and Caroline were inoculated on the 19th of April, 1722—sharp work for one year. There was not time for opposition. The citadel of social approval was carried with a rush. As a contemporary observed—

The royal approval was assiduously worked, and there were not wanting hints that to question the goodness of inoculation was equivalent to disloyalty; and thus we find the Rev. E. Massey protesting in a letter to Mr. Maitland—

Bad reasons are often advanced against bad policy, and whilst it is probable that some silly things were uttered against inoculation, yet I think every candid mind would be impressed with the moderation of Maitland’s chief adversaries. There was Isaac Massey, for instance, apothecary to Christ’s Hospital, who published several pamphlets in opposition, wherein candour and good sense are throughout conspicuous. He defined—

He objected to the exaggerated dangers of smallpox wherewith the Inoculators operated on the public fears, and appealed to his own experience in Christ’s Hospital—

So lightly did he regard the peril of smallpox to the young that he delivered this challenge—

To appreciate Massey’s contention on this point, we have to remember that smallpox is the designation of a disease of many degrees of intensity; a consideration which Dr. Wagstaffe, another opponent of inoculation, thus enforced—

Of course the Bills of Mortality were appealed to in evidence of the extent and fatality of smallpox; and as it is matter of common belief that prior to inoculation and Jenner (there is always a haze about the date) people were mown down with smallpox, it may be worth while reviving the table of relative mortality in London during the first twenty-two years of the 18th century.

This large induction from London to universal mankind is noteworthy, because, as we shall see, it came to be often made, and involved a serious fallacy; for unless universal mankind dwelt in conditions similar to Londoners, it was idle to infer a common rate of disease and mortality. The population of London in 1701 was estimated at about 500,000 (there was no exact census), rising to about 600,000 in 1720. It was closely packed and lodged over cess-pools; the water supply was insufficient, and there was no effective drainage. The vast multitude was disposed, as if by design, for the generation and propagation of zymotic disease, and specially smallpox. Little attention was paid to personal cleanliness, and still less to ventilation, to light, to exercise. The condition of a large urban community a century ago is almost inconceivable at the present day. Londoners were then only slowly and blindly rising out of those modes of existence which made the Plague of 1665, and other plagues, possible. Hence we need not be astonished that smallpox was a common and persistent affliction; but it was less prevalent and less deadly than it is the custom to assert; and had the disease not been attended with injury to feminine beauty, there might have been no more fuss made about it than about any other form of eruptive fever.

It has also to be observed, that smallpox as a cause of death was probably much exaggerated in the Bills of Mortality; for as Isaac Massey pointed out—

Massey, in the same spirit of good sense, objected to generalisations about smallpox from the Bills of Mortality, as if all who died were slain by the disease and by nothing else.

Of course there lurks a fallacy in all statistics of disease wherein conditions of life are not discriminated. Whether patients survive or die from any zymotic ailment depends upon their breed, their circumstances, their habits, and their medical treatment and nursing—all essential particulars, yet difficult to define and register on a large scale. It would appear that in sound constitutions, and with fair treatment, smallpox in 1721 was by no means deadly, whilst in bad constitutions, and with exposure and neglect, it was extensively fatal. Yet of these differences, little account was taken by the Inoculators, and the malady was measured and discussed as though it were something uniform like water or gold. Massey in one year had 49 cases of smallpox and one death; in Stepney an equal number of cases might have shown a mortality of 20 or 30 per cent.; whilst Dr. Nettleton reported that of 1245 cases in Halifax and adjacent towns in Yorkshire, there died 270, or about 22 per cent.[36]

One of Massey’s fears in relation to inoculation was the risk of poisoning the blood with more than smallpox. He was not disinclined to experiment with “duly prepared children infected with smallpox by inspiration,” for then—

Massey’s prescience has been woefully verified; is indeed under perpetual verification in the pollution and destruction of multitudes of infants. The notion that virus with a complex of qualities can be transferred from one body to another, and operate with the single quality the operator is pleased to favour, is a notion that might pass muster in a manual of magic or folk-lore, but which never can have any warrant in human physiology.

Of course the chief strength of the opponents of inoculation (ere experience gave them stronger ground) lay in the assertion of the folly of incurring a certain injury for an uncertain advantage. Whatever the risk of smallpox to those who have it, yet large numbers, it was argued, pass through life untouched; and why should they make themselves sick, and risk their lives in order to obtain a superfluous security![38]

The frequent assertion that the clergy thundered against inoculation is untrue and invented for effect. The Rev. Edmund Massey, Lecturer of St. Alban, Wood Street, did preach a sermon against the new practice, and a fair sermon it was, according to the standard of sermons. Maitland published some remarks on the sermon, to which Massey rejoined; and if I select a passage from the rejoinder it will prove, better than any description, that the divine was more than a match for the surgeon. Said Massey to Maitland—

In short, nothing can be more unfounded than the assumption in literature, popular and professional, that Maitland and Montagu were confronted by a crowd of howling fanatics over whom they triumphed as light over darkness. Marvellous is the imbecility wherewith biographers and historians reproduce the fables of any inventive predecessor.

I shall now proceed to show that the practice of inoculation introduced by Cotton Mather to New England, and by Maitland to England, collapsed in a few years under stress of the mischiefs and fatalities which attended it; that it was revived in a subsequent generation; that it proved a curse wherever practised; and that finally it was abandoned with execration in the Western world.

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.

The practice of inoculation, thus discredited, revived, and not only revived, but prevailed. The revival was gradual, and may be said to have acquired definition about 1748, under the powerful approval of Dr. Mead. In the score of years from 1728 to 1748, it is not to be imagined that the practice was abandoned: there were always a few repeating the attempt to have smallpox without the penalties of smallpox, but success was not conspicuous or encouraging. Inoculation was introduced to a generation specially disposed to receive it; and it was only allowed to slip for a time under the compulsion of manifest disaster. Perhaps there never was a people with such a taste for dodges in favour of health as the English of last century: the common intelligence was invested in quackery. Even Wesley found time to dabble in medicine, and to compile a volume of prescriptions for his followers, entitled Primitive Physic—a piquant mixture of sense with absurdity and credulity. Our forefathers had no clear conception of the connection of physical well-being with physical well-doing, and many of the essential conditions of health were unknown to them. Their physical afflictions were regarded as mysterious dispensations to be endured with resignation or frustrated with medicines. The same attitude of mind is far from uncommon at the present day, and many will recollect how, ere sanitary science attained repute, it was considered profane to assert that typhus was subject to control, and that cholera might be suppressed; whilst a drug to subdue either would be heard of with gratitude. Superstition has rarely had any objection to the apothecary.

An incident passed over in histories, although far more inwardly characteristic of the mind of the 18th century than a multitude of the superficialities wherewith their pages are cumbered, is that of Joanna Stephens and her remedies for the stone. Her cures were so remarkable and (on evidence) so indisputable, that a general demand arose for the revelation of her secret for the public benefit. This revelation Mrs. Stephens agreed to make on receipt of £5000 as compensation; and a subscription was started, to which Fellows of the Royal Society, physicians, noblemen, bishops, ladies, and kindly folk of all orders set their names. Such, however, was the unanimity and anxiety to possess the Stephens secret, that it was pronounced a national concern, and Parliament was invoked to supply the requisite funds; whereon an Act was passed “for providing a reward to Joanna Stephens upon a proper discovery to be made by her of the medicines prepared by her for the cure of the stone.” The discovery was duly disclosed to appointed trustees, one of whom was Archbishop of Canterbury, and the £5000 was paid over in 1739; and here we have the heads of the precious revelation—

The public were apparently satisfied with the purchase, but with the usual levity of credulity forgot Mrs. Stephens and her marvellous cures in the pursuit of fresh nostrums. Fashions in medicine are on a par with fashions in dress, and have only occasional reference to the permanence and veracity of nature.

The revival of inoculation in England was stimulated by reports from abroad. For instance, in the Gentleman’s Magazine it was stated that in 1737 there were inoculated in Philadelphia—

and that out of the 128 only one Negro died. Again, in the same magazine for 1738 we read—

Such reports, whilst secure from examination, were none the less effective over the public imagination. There was a report published by Dr. Mead in 1747, which derived great credit from his endorsement, and which continues to be cited to the present day as proof for inoculation, but which is a model of convenient and circumstantial vagueness worthy of Defoe. Thus Mead’s story runs—

Mead held positions which later and more exact inquiry rendered untenable. He would not allow that the pus of smallpox could communicate any disease but smallpox, if taken from a proper subject—a condition that required supernatural assistance to fulfil. He maintained that inoculation generated true smallpox, and that as no one could have smallpox twice, therefore no one could have smallpox after inoculation, and that reports to the contrary were not credible. It now goes without saying that in this contention Mead was at fault, but at the time his confidence was not inexcusable; and whilst defending and recommending inoculation, he made admissions which fully justified those who resisted and condemned his counsels. Let us not forget that the following passage was published in 1747, and was the fruit of six-and-twenty years of experience in the best London practice. Thus Mead wrote—

How just are the judgments of Divine Order! These boils, swellings, and tumours, were the sequences of the violated harmony of the body—of the faithless anticipation, the meddling and muddling with its processes.

An extensive series of inoculations took place in 1742-45 in the south of England. Smallpox was prevalent in Winchester and adjacent towns, and Dr. Langrish operated freely on whoever resorted to him. In Portsmouth, Chichester, Guildford, Petersfield, and Winchester, it was said that at least 2,000 were poxed, and that only two pregnant women perished, who, as usual, “were inoculated contrary to the advice of their physician.” The ill results, wrote Bishop Maddox, “were only such as might reasonably be supposed to have been worse had those operated on had smallpox in the natural way”—such being the euphemism wherewith boils, tumours, and other sequelæ were accounted for.

The reviving favour for inoculation was indicated in this paragraph from the newspapers of 13th April, in 1744—

An important movement was made in 1746 with the opening of a Smallpox Hospital in Cold Bath Fields at which “the benefit of inoculation” was offered to the poor. At first those who applied were taken into the house, and nursed through their self-inflicted illness, but the proximity of the veritable smallpox, the regimen, and the seclusion were sufficient to deter applicants: those, however, who have a hobby to ride grow reckless in presence of obstacles, and by-and-by inoculation was offered to all comers, who were dismissed to recover and diffuse infection in their own homes.

With the revival of inoculation there was a revival of the controversy as to its lawfulness theologically. Dr. Isaac Maddox, Bishop of Worcester, preached a sermon on behalf of the Smallpox Hospital in St. Andrew’s, Holborn, on 5th March, 1752,[54] which excited considerable attention. He showed the necessity for such an hospital for the poor and forsaken of the great city—a necessity incontestable. He mentioned (and the remark supplies a curious note on the hygiene of the time) that ventilators were to be introduced, and it was expected that the access of fresh air might benefit the patients. The return of the Hospital for 1752 showed 344 admissions, with 262 recoveries, and 82 deaths—a proportion that does not contrast disadvantageously with 19th century hospitals, fortified with sanitary appliances. During the same year 112 inoculations were effected at the Hospital. The Bishop had been assured by three eminent surgeons that they had inoculated 1500 persons with only 3 fatalities, one of them (Sergeant Ranby) having accomplished one thousand without a mishap. The practice was without doubt lawful, for it averted a dangerous disease, and some risk was inseparable from all methods of cure. The practice had already done much to lessen smallpox, and, as it became commoner, it would do more. The result of the sermon was a subscription of £809 for the charity at the subsequent dinner in the Drapers’ Hall.

The Bishop was singularly at fault in his ascription of diminished mortality to inoculation, for, in 1752, smallpox was more than unusually rife in the Metropolis, and its prevalence was not unreasonably attributed to infection from the inoculated. In 1751 the deaths from smallpox in London were 998; they rose to 3538 in 1752; declined to 774 in 1753; and rose to 2359 in 1754.

Dr. Doddridge lent his powerful influence in favour of inoculation; and, considering the unqualified assertions of medical men as to its benefits and harmlessness, it cannot be said he was blameworthy. The audacious assurance with which many of them bore down opposition overcame the simple-minded, who argued as if the world were constituted after the pattern of their own innocent hearts. That smallpox frequently followed inoculation is now known beyond dispute, and yet Dr. Kirkpatrick wrote—

How could women and divines resist such evidence?

A voluble antagonist of inoculation was the Rev. Theodore Delafaye of Canterbury. He preached a sermon in that city on the 3rd of June, 1753, from the text, “Let us do evil that good may come” (Rom. iii. 8), and published it under the title of Inoculation an Indefensible Practice. He was in turn attacked by the inoculators, and in 1754 issued A Vindication of 200 pages, in which he returned more than he received with vigour rather than discretion. His conclusion was—

We sometimes read that inoculation was denounced as Atheism, and we are expected to reprobate or to smile at the bigotry; and, whilst we may not approve of the stigma, we may at the same time recognise the honest sense in which it might be affixed. Some who spoke of inoculation as Atheistic felt more vividly than they could otherwise describe, that it was an infraction of the deeper sanctity of Nature, where man’s hand cannot enter and prosper, and that those who made the attempt could have no proper sense of Him in whom they lived, and moved, and had their being. Moreover, if we are to admit that they who thus expressed themselves are blameable for excessive vehemence, what are we to say of the more numerous party who did not hesitate to pronounce inoculation a discovery effected in the human mind by God himself? If it was reasonable to speak of the practice as Theistic, why should it be fanatical to assert the contrary, and maintain that it involved a negation of Divine Providence? Dr. Kirkpatrick, with the sycophancy which was the custom of his age, praised George II. for “the benevolent, and even celestial disposition,” which induced him to patronise “the wonderful and probably Heaven-descended practice of inoculation;” and extolled “its equal simplicity and success” as demonstrating “to a reflective mind the goodness of Providence in making what may be so often necessary, so easily accomplished.”[56] It would not be difficult to cite scores of confessions of gratitude to God for inoculation, but to what purpose?

What we think good we necessarily ascribe to God; and we do well; but much that we think good is otherwise, or is only partially good; and what then? Why, we are undeceived and corrected by experience. We put our notion of what is good to the test of practice, and God answers us in the event—justifies, amends, or confounds us. Thus with inoculation. It was fair that those who thought it good should refer it to God, and thank him for it; and it was equally fair that those who thought it bad should say it was none of his—that it was at variance with his order, and a discredit to the intelligence of those who imputed it to Him. How was the issue to be determined? Only by God himself. And how would He speak? In the results of experience wherein his will would become manifest beyond equivocation.

In 1754 inoculation obtained full recognition from the London College of Physicians. It was declared “that experience had refuted the arguments urged against the practice; that it was now more extensively employed in England than ever; and that it was highly beneficial to mankind.” The fence of hesitation was thrown down, and to be inoculated became the distinction of all who wished to be numbered with the enlightened and prudent. That the Circassians were famous for their beauty, and that they practised inoculation, was a staple argument, and an irresistible, with a multitude of Englishwomen. Opposition was chiefly confined to the lower orders, who objected to have the inoculated at large among them, and in some places threatened to demolish the houses where inoculation was performed.[57] Occasionally a medical practitioner acquired reputation as an inoculator, and was resorted to by patients from a distance, and his operations were not regarded with much favour by his neighbours. Thus the physicians and surgeons of Newbury, Berks, were compelled by their townsmen to promise to inoculate no one who had not resided in Newbury at least two years.

The new practice created much business, and its distribution excited some jealousy. Physicians complained that surgeons inoculated without their assistance, and surgeons that apothecaries did so likewise. Dr. Kirkpatrick laid down the rule that every rightly conducted inoculation involved the employment of physician, surgeon, and apothecary—the physician to prepare and prescribe for the patient, the surgeon to cut, infuse, and dress, and the apothecary to make up the medicines. Some, however, dispensed with all three, and effected their own inoculations. A boy poxed fourteen of his school-fellows in sport, and amateur inoculators, male and female, multiplied. As an example of amateur procedure, Dr. Kirkpatrick relates that a gentleman of Kent sent his servant, Silvanus, a young man, to Mrs. Chapman, at Heathfield, to be inoculated. He had to ride thirteen miles, and arrived hot and fatigued at the house of the inoculatrix. As he had taken his preparatory physic at his master’s, Mrs. Chapman desired him to get ready at once for the operation, which he begged her to defer as he was in such a heat. She replied that he must be inoculated that very day, Tuesday, or remain until the following week, for Tuesday was her lucky day. The poor fellow allowed himself to be persuaded, and was then and there inoculated: severe smallpox ensued, and he died.[58]

Thus was inoculation revived and established, and smallpox with it—established and diffused.

It having come to pass, according to the boast of Dr. Kirkpatrick, that inoculation was regarded as “the most salutary practice ever discovered for restraining a very loathsome and destroying disorder, which it had nearly expunged from the catalogue of mortal diseases,” it was the aim of physicians and patients to reduce the trouble and hazard of the operation to the lowest terms possible. In the words of Dr. Jenner, “There was bleeding till the blood was thin, purging till the body was wasted to a skeleton, and starving on vegetable diet to keep it so;” and practitioners who promised to mitigate these rigours, placed themselves in the line of popularity and prosperity.

Among distinguished easy inoculators was a family named Sutton—“the Suttons” being a familiar name a century ago. Dr. Robert Sutton practised surgery and pharmacy at Debenham, in Suffolk, and went into inoculation with such energy that between 1757 and 1767 he operated on 2514 patients. His son, Robert, set up as inoculator at Bury St. Edmunds, where he did a large business; but a second son, Daniel, was the genius of the household. He had been acting as assistant to Mr. Bumstead at Oxford, and returned to his father in 1763 enthusiastic over a new plan of inoculation whereby the time of preparation was to be shortened, whilst the patients were to live in the open air. Old Sutton showed no favour for the projected innovation, whereon Daniel opened an inoculating house on his own account at Ingatestone, in Essex, advertising himself as inoculator on a new, safe, and sure method. The speculation answered. In 1764 he took 2000 guineas, and in 1765 his receipts were £6300. His fame spread throughout the country, and so many resorted to him that lodgings were scarcely to be had in and around Ingatestone. His practice in Kent was also extensive, and he was obliged to employ assistants. To crown his enterprise, he kept a parson—the Rev. Robert Houlton, to puff his skill and success. According to Houlton, the business of Daniel Sutton during three years was as follows—

to which number was added 6000 inoculated by Sutton’s assistants, making a total of 20,000, without, said Houlton, a single death.[59]

Sutton was denounced as a quack, and if to reserve as one’s own, and to traffic in what is proclaimed to be for the common advantage of mankind, constitutes a quack, Sutton was one. Nevertheless, he was successful, and his success begot so much jealousy that he was indicted at the Chelmsford quarter sessions, but acquitted with the thanks of the grand jury for the lesson he had taught the Faculty.

Much ingenuity was exercised in ferreting out Sutton’s secret. His secret, so far as it was anything, was an open one; and supposing it necessary to infect men’s blood with variolous pus, and then to operate for their recovery, there would be much to say for Sutton’s procedure. His patients were obliged to go through a strict preparatory regimen for a fortnight, during which every kind of animal food, with the exception of milk, and all fermented liquors and spices were forbidden. Fruit of all sorts was allowed, unless on days when purges were taken. In the course of a fortnight a powder was thrice administered at bed-time, and a dose of salts on the succeeding morning. When the days of preparation were accomplished, the patient was taken to the inoculating house, where in the public room was found an array of people in various stages of smallpox. From one of these sufferers, the operator selected a pustule to his mind, opened it with his lancet, and, turning to the patient to be poxed, raised the cuticle on the outer part of his arm with the moist lancet, and pressed it down with his finger. This was the entire operation: no plaster or bandage was applied: and from that moment the patient was pronounced proof against smallpox, even if he should lie in bed with one suffering from the disease. Of course there remained the variolous affection to be dealt with. The regimen of preparation was continued unchanged, and a pill was taken nightly until the fever came on. None were allowed to rest in bed, except for sleep, but had to walk abroad and enjoy fresh air, even in winter weather. If a patient was too sick to go alone, he was supported by attendants; and when the fever was at its height, he was encouraged to drink copiously of cold water.

Much more was attributed to Sutton’s pills and powders than to his regimen, and these were no more than preparations of antimony and mercury, with which practitioners of all orders were only too familiar. Sutton, however, contrived to maintain his mystery until he had no longer occasion for it, and lived to recognise a successor in Jenner. He removed to London in 1767 in hope of enlarging his income, but like many other provincial celebrities, discovered that he had better have remained where he shone without rivals and detractors.

The Sutton regimen, so far as it might be described as “cool,” came into general favour, whilst what was called the hot regimen of warm rooms, bed, and cordials was correspondingly discredited. Contrasting the two methods, Sir George Baker, writing in 1771, observed—

A famous inoculator was Dr. Thomas Dimsdale of Hertford, a Quaker of easy principles. He published in 1766 a treatise entitled The Present Method of Inoculating for the Smallpox—an exposition of the most approved practice of the time, which, by one of those curious felicities of circumstance, conferred on him a European reputation; and in 1781, Tracts on Inoculation—a record of his opinions and adventures at home and abroad.

Dimsdale desired to universalise inoculation, but with circumspection. He recommended that the inhabitants of a suitable district should be dealt with as a whole and at once. That the names of all should be taken, and on a certain day that everyone, who had not had smallpox, should be inoculated. That the district should then continue in quarantine for about three weeks, at the end of which the danger and the fear of smallpox would cease, until an unpolluted generation should afresh accumulate. The project was not mere dreaming. Dimsdale was a man of influence and energy, and effected several complete inoculations of villages and parishes in Hertfordshire according to his plan. In later years, he combined banking with medicine, and the firm of Dimsdale, Fowler, and Co. of Cornhill originated with him and perpetuates his name.

Dimsdale’s practice lay chiefly among the upper classes, to whom he made matters very comfortable. As he wrote—

He was satisfied with administering a powder on the evening of the day on which a patient was inoculated, consisting of calomel, tartar emetic, and crabs’ claws.

Whilst labouring to popularise inoculation, Dimsdale was strongly opposed to the trade therein passing to unauthorised hands—simple, safe, and salutary though he asserted it to be. Thus he averred—

How illiteracy should affect inoculation, he left to conjecture. He apparently forgot that the practice was derived from people who made no pretence to literature, and whose efficiency and success were, moreover, set forth as warrant and encouragement for English imitation.

In 1775 a Society was formed for General Inoculation, and an hospital was opened for the purpose at Battle Bridge, on the site of what is now the Great Northern Railway station, King’s Cross. Dr. Lettsom, a popular Quaker physician, issued an appeal on behalf of the enterprise, and having invoked Dr. Dimsdale’s approval, a lively controversy ensued between the brethren—personal rather than profitable. Dimsdale disapproved of indiscriminate inoculation: he was ready to inoculate the whole world, but systematically, and under strict safe-guards. He pointed out that whatever might be the advantage to the individual, unless the inoculated patient was rigorously secluded, he would diffuse the disease from which he sought to be delivered, and that the price of his life might be the destruction of many. Dimsdale’s warnings were, however, slightly regarded, and inoculation was pursued with criminal recklessness. As Pascal observes, of all the faculties given to man, the most awful in its consequences is the power of standing amid a number of facts, and seeing such as we please to see, and being blind to the rest.

Specially remarkable in connection with the smallpox of last century was the exaggerated terror expressed for it by professional inoculators, and the little real terror manifested by the multitude. It was by no means the most fatal of diseases, nor was it a large factor in the common mortality. Wherever we test the matter by unbiased contemporary evidence, we find the outcry factitious: the dreadful and desolating malady from which Jenner delivered his country is merely a fiction continued by the vaccinators from the inoculators. For proof let us turn to the evidence of Dr. Alexander Monro, Professor of Medicine and Anatomy in the University of Edinburgh. The Faculty of Medicine in Paris had appointed a commission to inquire into the advantages of inoculation, which in the course of duty applied to Monro, who in response produced and published in 1765 An Account of the Inoculation of Smallpox in Scotland. He reported that from the introduction of the practice by Maitland in 1726, there had been 5554 inoculations effected in Scotland with 72 fatalities; that is to say about 140 annually with deaths 1 in 78, according to the confession of the inoculators themselves. Monro further stated that the practice was disliked in Scotland as “a tempting of Providence,” an unwarrantable risk of life for an uncertain advantage. Our present interest, however, is in the statistics of deaths from smallpox in Edinburgh for a series of twenty years thus adduced by Monro.

Here we have a piece of valid experience with every advantage to the smallpox terrorist: for Edinburgh last century was a city contrived as if for the generation and perpetuation of smallpox. The population of 55,000 was lodged thickly in flats, in houses of many storeys, closely built in lanes and courts—a population densely compacted as any in Europe, with arrangements for cleanliness indescribable, at this day perhaps incredible. Yet in conditions so propitious to smallpox, we see before us the total outcome during a series of twenty years; and reprehensible as the result may appear to contemporary sanitarians, who hold, and rightly hold, that all zymotic diseases are preventible, yet it affected Monro with no anxiety or dismay: nor does the rate of mortality of old Edinburgh contrast unfavourably with that of the modern city. The case of Edinburgh, however, serves to show that in all cases when we hear of the ravages of smallpox before Jenner appeared as deliverer, our policy is to insist firmly upon the production of special and adequate evidence: it is monstrous that the assertions of common quacks, whether inoculators or vaccinators, should pass into tradition and be accepted as unquestionable verity.

We have, moreover, to observe that the mortality from smallpox in Edinburgh was infantile mortality: for as Monro testified—

Not only were the habits of the people contributory to the diffusion of eruptive disorders, but likewise their food, of which oatmeal was the staple, whilst vegetables were few, fruit rare, and tea unknown. Hence many maladies had free course; and as Dean Ramsay relates, a girl on her arrival at Mrs. Betty Muirheid’s boarding-school in the Trongate, Glasgow, when asked whether she had had smallpox, replied, “Yes, mem, I’ve had the sma’pox, the nirls [measles], the blabs [nettle-rash], the scaw [itch], the kink-host [whooping-cough], the fever, the branks [mumps], and the worm [toothache].”

A last word as to Lady Mary Wortley Montagu. After a residence of twenty years in Italy, she returned to England to die, 21st August, 1762. On the west side of the north door in Lichfield Cathedral, there is a female figure, in marble, leaning on an urn inscribed M. W. M. The inscription runs—

Whilst we do not resort to epitaphs for truth, we may discover in them what was taken for truth, or what was wished to be taken for truth. We have in the foregoing epitaph the legend which has caught the popular fancy, and which is likely to survive corrections innumerable. It is the custom of mankind to identify a common movement with some prominent or picturesque figure in the movement, and to suppress the rest. The practice is convenient, but it taints all history with fable.

It may be said that the practice of inoculation met with no active resistance in England during the last thirty years of last century. How widely and deeply it extended it would be difficult to determine. The probability is, that the mass of the population was untouched, and that inoculation was limited to the upper and middle classes, and to the lower so far as they came under the immediate influence of those above them. We have, perhaps, an index to the condition of affairs in Dr. Wm. Buchan’s Domestic Medicine, first published in 1769, which ran through eighteen editions, amounting to 80,000 copies, in the author’s life-time. It is not uncommon to refer contemptuously to Buchan, but his work was the production of a man of vigorous good sense with faith in the good sense of his readers—a book creditable to the author and to the people who appreciated him.

Buchan was an inoculator, a zealous advocate of inoculation, and earnestly laboured to universalise the practice. In the Domestic Medicine, ed. 1797, he wrote—

Consistently with this opinion, Buchan strongly advocated domestic practice, saying—

Having described the ordinary method of inoculation by incision with a lancet dipped in pus, he goes on to say—

Thus was smallpox made easy!

Buchan appealed to the clergy for co-operation as inoculators—

And as propagandists—

How familiar have vaccinators rendered this line of adjuration! If you do not comply with our prescription, and your children catch smallpox, then are you their murderers.

Here is another passage from Buchan, which with equal accuracy might apply to Vaccination—is indeed what is perpetually asserted to be the truth concerning Vaccination—

In this deliverance, Buchan did not lie, nor did he speak for himself alone, but expressed the medical opinion of his time, precisely as a physician of to-day testifies concerning Vaccination. Yet we all know that Buchan was completely at fault, and substituted what he wished to be true for what was true.

I cannot leave Buchan without a few words in his favour, for, according to his lights, he was a worthy fellow, and the words shall be his own. He wrote—

No: nor with half an inch of thread dipped in pox.

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.

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.

The exact truth as to the prevalence of smallpox in the 18th Century is not attainable; vital statistics were undeveloped; and in the absence of precision the imaginative revel. M.D.’s and M.P.’s shut their eyes, tilt their noses skyward, and prophesy concerning the frightful ravages, and the salvation wrought by the revered and immortal Jenner. Any extravagance, as to the ravages, or as to the salvation, is accepted as laudable zeal for humanity. “Decimation” is a favourite word in this connection without any sense of its definite meaning. “What family before 1800 ever escaped decimation from smallpox?” asks Dr. Granville. “Smallpox decimated the country in olden times,” says Dr. Chavasse; “it ravaged like a plague, whilst Inoculation caused the disease to spread like wild-fire;” adding as a sequence, “Vaccination is an important cause of our increasing population.” In the same temper, Lord Chief Justice Cockburn described an unvaccinated infant as “a centre of contagion;” and as the folly of the great is intensified in the little, Mr. Bompas, Q.C., informed the electors of Marylebone, that “a person not vaccinated is like a flaming fire-brand among the people.” Thus the infants of last century were “centres of contagion;” the adults were “flaming fire-brands;” whilst England was “decimated” with smallpox diffused like wild-fire by inoculation. What a picture of 18th Century England painted by Rant and illuminated by Delirium!

The tendency of excess on one side is to provoke to excess on the other, but the extravagance of these popular fables ought to put us in love with homely matter-of-fact—wherein indeed is the true extreme of these frantic inventions. What was the extent of smallpox in England last century is the question. With accuracy, we do not know. The common estimates (when not evolved from inner consciousness) are based on the London Bills of Mortality, and when these Bills are scrutinised we find nothing to justify the opinion that the community was harassed and devastated by smallpox over other ailments. In the first place, we have to remark that the exact population of the metropolis was unknown. Some say it was 500,000 in 1701, and others 700,000. In 1751 it was generally reckoned at 750,000, and in 1801 it was said to be 958,863. Then we have to consider that the increase, whatever it might be, lay only partially within the Bills of Mortality, for several rising quarters were outside the boundaries, and there were extensive exemptions within. Thus, so late as 1818, we find Dr. Burrows writing—

With omissions so serious, the Bills are obviously worth little as registers of the number of deaths in any year in London; and when we inquire how far they may be trusted as indicating the relative prevalence of certain forms of disease, we find them equally questionable. Dr. Burrows thus describes the method by which the causes of death were ascertained—

In presence of defects so grave as to the number of the dead, and of diagnosis so grotesque as to the causes of death, it would be unwise to argue with any confidence from the data of these Bills; yet, such as they are, we have nothing else to appeal to. The variations of mortality from year to year were of wide irregularity; and whatever influence smallpox might have had, it does not appear to have had much in magnifying the annual totals. Let us take a dozen years when smallpox was heaviest from the last seventy years of the century, and observe its relation to the entire mortality, and to that from fevers—

Again, let us take twelve years when the death-rate from smallpox was at its lowest. Here they are—

We thus see that in twelve years when the death-rate from smallpox was highest, as many died of fevers as of smallpox; and in twelve years when the death-rate from smallpox was lowest, there died thrice as many of fevers as of smallpox. Again, we have to remark, that, on an average of all the years, smallpox was accountable for something less than a tenth of the total mortality. Also we have to note, that the mortality from smallpox was in great part infant mortality, and that there is reason to believe measles was extensively confounded with smallpox. The infant mortality was prodigious. Rarely a year passed in which a fourth of the deaths was not set down to Convulsions—that is, to babes killed by improper feeding. In 1772 (the worst smallpox year of the century when 3,992 died) there were, 6,605 ascribed to Convulsions, the total mortality being 26,053.

Now I have no wish to minimise the London smallpox of last century, nor even to set 1797, when 522 died, against 1796, when 3548 died. I yield to none in detestation of smallpox as a preventible and therefore disgraceful affliction. Let so much pass for granted; but do not let us in any access of sanitary fury lose alike eyes and reason and rave like maniacs. If smallpox was bad, fevers were worse, and as both had a common origin, why should we make a wanton and unscientific distinction between them?

That smallpox should have been constantly present in London throughout last century was in nowise surprising. The citizens lived in a manner to invite and maintain fevers. I shall refer to their food and drink presently, and would now call attention to the fact that they were a stay-at-home generation almost beyond present-day belief. Cowper did not violate credibility when he sang—

They had no ready means of locomotion, and indeed did not think of fresh air and exercise. An apprentice or maid from the country entered London and was immured as in a prison. We know how the lower orders in our own time huddle together like pigs, unless so far as restrained by lodging-house law, but middle-class Londoners a century ago utilised their apartments, with more decency perhaps, but with equal ignorance of the virtue of oxygen. The Londoners were a densely compacted community, and at night the streets and lanes of the city were almost as thickly tenanted as a man-of-war, but without benefit of sea-air. A Quaker told me that he served his apprenticeship to a grocer in Cheapside between 1786 and 1793, that the shop was opened at seven in the morning and closed at ten at night, that he slept under the counter, that his ablutions were limited to his countenance, and that he never went out except to meeting on First Days; adding, that he had no sense of being hardly dealt with; it was the custom of the time, and he was as his fellows. Memoirs of the 18th century prove that he spoke the simple truth. Bishop Wilson of Calcutta records that he served in the house of a silk merchant in Milk Street from 1792 to 1797, that he was occupied from six or seven in the morning till eight at night; that there was supper at 8.30, followed by prayers, and that all went to bed at ten. An apprentice in the same house said that he never put on his hat for weeks together, and that more than three years elapsed before his first holiday was granted. William Cobbett in 1783 got into a lawyer’s office in Gray’s Inn where, he relates, “I worked like a galley slave from five in the morning till eight or nine at night, and sometimes all night long. I never quitted this gloomy recess except on Sundays when I usually took a walk to St. James’s Park.” Such instances might be multiplied to any extent; and in short it comes to this, that the Londoners of last century lived from year to year in their houses, and had no outdoor exercise. If they were careless about air, they were equally careless about light, and, but for the cost of candles, might have disregarded it altogether. Water was chiefly brought from wells or conduits, and was used sparingly; and it is needless to add, there were no water-closets. Even in well-ordered households, stenches were dreadful; and where there were slatterns, the condition of affairs may be faintly imagined. Horrible cesspools lay behind or beneath most of the houses, evolving pestiferous effluvia. Out of doors, the streets were scarcely less noisome. Rain was the chief scavenger. Swift, in his description of a City Shower, sets before us as graphically as Hogarth, the offices of the rain—

Nor in estimating the sanitary condition of 18th Century London is the influence of the dead on the living to be forgotten. The twenty thousand who died annually remained to poison the survivors. The city grave-yards were places of decomposition rather than of interment, and an odour of corpses pervaded many neighbourhoods. Mr. Samuel Gale wrote in 1736—

Church-goers were subjected to cadaverous influences from the dead in the yard without and from the dead in the vaults below; and pious thoughts acquired an indescribable savour of the sepulchre. Many illnesses originated in church; and families who led wholesome lives at home were brought into deadly peril when they turned out on Sundays to public worship.

It is necessary to enter into these details if we would know what manner of people the Londoners were who suffered from smallpox, and what sort of place London was wherein they suffered. Londoners have been taken for the standard of 18th century smallpox, in forgetfulness of the fact that there did not then exist in England a town of a hundred thousand inhabitants—perhaps only two or three of fifty thousand; whilst the rural population bore a far larger proportion to the urban than is the case at this day. In so far as the sanitary conditions of Bristol, Norwich, or York resembled those of London, the analogy between them held good; but to convert the London rate of smallpox into the common rate of England, of Europe, and of the world, and to use the appalling result as a whip of terror wherewith to enforce universal inoculation, and afterwards vaccination, was sheer absurdity, if not something worse.

Whilst smallpox was always present in London, its appearance in the country was irregular and usually epidemic. The Bills of Mortality of towns as large as Northampton were sometimes clear of smallpox for years. Sir Gilbert Blane, in his advocacy of Vaccination versus Inoculation, said, that previous to the practice of inoculation there were many parts of the country where smallpox was unknown for periods of twenty, thirty, and even forty years. Mr. Connah, a surgeon of Seaford, Sussex, with a population of 700, informed Dr. Haygarth in 1782, that one person had died of smallpox in Seaford about eleven years before, and he could not ascertain that any other death from the disease had occurred subsequently; and that there was reason to believe that a like immunity prevailed throughout the smaller towns and villages of the southern counties. Wherever we inquire, we are driven to the conclusion that the prevalence and fatality of smallpox in the 18th century were grossly exaggerated by quacks and panicmongers. Nor should we forget in this connection how Professor Waterhouse, of Boston, an ardent inoculator, had to write in 1787—

What we have to say of London smallpox during last century is, that prevalent as it was, our wonder is that it was not more prevalent; that the disease was bred in the circumstances and habits of the citizens; and that if it were possible to reproduce the same conditions, we should reproduce the same smallpox. On the contrary, say our valiant vaccinators, the same conditions might be reproduced, but if the citizens were universally and efficiently vaccinated and re-vaccinated, there would be no smallpox. Thus we are taught that people may eat and drink as they like, live in darkness, neglect personal cleanliness, take little exercise, breathe air polluted by respiration, filth, and putrefaction, and that whatever disease overtakes them, they will be proof against smallpox. The promise is deceptive, but it was the promise of the inoculator, and it is the promise of the vaccinator; and Dr. Drysdale, describes the practice which warrants the promise as “the greatest triumph of hygienic science—I repeat, by far the greatest triumph of positive hygienic science ever made.”[78]

Some share in the fatality of 18th century smallpox must be charged to the treatment of the disease. What was described as the cool regimen was no secret, yet its practice appears to have been limited to few; whilst with the multitude, patients were confined to close and heated rooms, under heavy bed-clothes, plied with hot drinks, cordials, and alcohol, and kept in foul linen until killed or cured. Frequently, when symptoms of smallpox appeared, bleeding, blistering, and purging were energetically resorted to. If a family of children were affected, they were commonly stowed away in one bed, and their skins would stick together with pus and sweat. It was much the same in hospitals and workhouses. “I have seen above forty children,” says Dr. Buchan, “cooped up in one apartment, all the while they had this disease, without any of them being admitted to breathe the fresh air.” The same course was pursued with other fevers, and the effluvia of the sick-room was overpowering. Take this instance from Jenner’s own household. His nephew, Henry, and a maid-servant, were seized with typhus, and Jenner wrote—

Indeed, the cleanliness and ventilation we consider so salutary were sedulously avoided. Cold air was accounted specially pernicious, and occasionally when the poor, afflicted with smallpox, were exposed to the weather, astonishment was expressed that recovery instead of death was the issue. It is related in Hutchins’s History of Dorset that Blandford was burnt down in 1731, and several patients in smallpox were laid under the arches of the bridge as a place of refuge, and, to the general surprise, all got well, although many had died in their beds before the fire. John Birch a London surgeon of high repute, writing in 1814, sums up the case for us on this head in saying—

We now come to an interesting question. If the reader refers to the list of twelve years of greatest smallpox, and to the list of twelve years of least smallpox in London, it will be observed that the years of least smallpox predominate in the last quarter of the century, and this in spite of the diffusion of the disease by Inoculation. The inoculators when charged with increasing smallpox appealed to the London Bills of Mortality. “Let us,” they said, “take the last ninety years of the century, and we shall find that there died in London of smallpox in the thirty years—

Here we see, that the number of deaths was greater in the first thirty years by 2075 than in the second thirty years during which Inoculation had acquired some stability, and greater by 8115 than in the last thirty years, during which Inoculation was the established practice of most prudent families.[81] We are therefore unjustly accused. These figures leave no doubt that smallpox is decreasing, and we claim that the decrease is due to our practice.”

The decrease was certain, but I cannot allow that it was due to Inoculation; on the contrary I assume that the decrease would have been greater but for the culture of the disease by the inoculators. The fact is extremely distressing to the more rabid vaccinators, and Dr. Corfield tries to curse it out of existence as “the falsest of falsehoods;” but there it abides. It is hard for those who represent Jenner as the saviour of mankind from smallpox to have it shown that Londoners, at least, were in process of salvation before his intervention; but facts, alas! are cruelly unkind to theorists, sentimentalists, and quacks of all sorts. In the words of Dr. Farr—

The decrease of smallpox towards the close of the century, says Dr. Farr, was due to “the general improvement of health then taking place;” but to what was that improvement due? No marked improvement had been effected in the sanitary arrangements of London—why then this change for the better? My answer is, that a great alteration was in progress in the popular diet.

Dr. George Cheyne, in his famous Essay of Health and Long Life, published in 1724, says—

And more than fifty years afterwards, in 1783, we have Dr. Buchan bearing similar testimony—

It is scarcely necessary to cite authority for what was so generally known and confessed; but in this question of smallpox and its prevention we have to deal with many who appear to be destitute of any historic sense; who argue as if what Englishmen are to-day, they always were; and who contend that as there was more smallpox in London before Jenner than since Jenner, therefore Jenner must be the cause of the diminution. It is necessary to condescend to such feeble folk.

The cause of the general scorbutic habit of the people was widely recognised by medical men, and Buchan merely repeated their common opinion in saying—

Cheyne said much the same at the earlier date. He complained that the upper classes gorged themselves with animal food, and slaked their thirst with wine, “which is now [1724] become common as water, and the better sort scarce ever dilute their food with any other liquor.” Beer had the place of wine among the middle and lower orders. In the words of Buchan—

He adds—

Were we to say that the diet of the English for the greater part of last century consisted of Bread, Beef, and Beer, we should not go far wrong. The London bread was then, as now, poor stuff; “spoiled,” says Buchan, “to please the eye, artificially whitened, yet what most prefer, and the poorer sort will eat no other.” Whenever it could be obtained, beer was the beverage that went with bread, and was drank by young and old. Salt beef and mutton, bacon, salt fish, and butchers’ offal completed the dietary of the multitude. The feeding of the poor in hard seasons exercised the beneficent severely, for the baker’s bill often went far to exhaust the working-man’s earnings.

It was easy to recommend the rich to get rid of their scurvy by a resort to vegetable food, but to the poor with their obstinate prejudices, shiftlessness, and ignorance, such a recommendation was a sort of mockery. Deliverance, however, came in a form recommended by pleasantness and economy, namely, in the potato. It is true the tuber had been known long before, but not as an article of free and ordinary consumption. Toward the middle of the century it was discovered that potatoes could be grown cheaply in large quantities, and supply and demand developed together. Women and children especially rejoiced in the new food, whilst the benevolent exulted in the liberal accession to the poor man’s fare. It became a point of duty with Lord and Lady Bountiful to recommend the culture and consumption of potatoes everywhere; and to see how far the substitution of potatoes for bread had extended early in the nineteenth century, we need only refer to the pages of Cobbett, who denounced the change with unwearied virulence as a degradation of humanity. Certainly potatoes are inferior to bread in nutritive value, but in food we have to look for more than mere nutriment; and the general use of the potato went far to purify and ameliorate the blood of the English people.

The appearance of the potato as a cheap constituent of common fare, was an argument wherewith Jenner endeavoured to allay apprehensions, that, having stopped smallpox, there would soon be more mouths than food to fill them. To Dunning he wrote, 10th February, 1805—

And again to Worthington, 25th April, 1810—

Nor was the change in the people’s diet limited to the introduction of the potato; with it came tea. Of course we know that tea was drank in England long ere George III. was King, but it was in his days that tea came into popular use. Here again we may refer to Buchan, who was strongly opposed to the innovation. He wrote—

What Buchan had not time to do, Cobbett subsequently did, and some of his most racy patches of vituperation were applied to tea and tea-drinkers. In Bacon, Bread and Beer, according to Cobbett, consisted the strength of the English working-man, whilst tea and potatoes he held in abomination.

To this partial substitution of potatoes and tea for salted animal food and malt liquor, we may justly attribute the reduction of the scorbutic habit of the people, and that improvement of health which were coincident with the close of last century and were continued into the present. What every student of vital statistics has to remember is, that conditions have to be identical to yield identical results. The lives of the majority of the English people last century, and notably so in London, were hard and sordid to a degree which in these times is difficult to realise. Their sanitary conditions have been indicated, and I would now enforce the observation, that they were ill fed and insufficiently fed; consequently their diseases were malignant, and smallpox not unfrequently scarred deeply its scorbutic victims. Wherefore to run a parallel between the Londoners of the 18th century and the English of the 19th in the matter of smallpox, and to ascribe any difference between them to Jenner’s specific, is to display ignorance that is inexcusable, or craft unscrupulous.

The competent biographer, it is said, must be an admirer of his subject, for only so far as he sympathises can he understand. Tout comprendre c’est tout pardonner. But I neither propose to write a Life of Jenner, nor do I believe it essential to insight to sympathise where compelled to reprobate. In Jenner’s case we have to deal with an accident rather than with a vigorous personification of evil. It was his fate to have a happy (or unhappy) thought, adapted to the humour and practice of his time, which was immediately caught up and carried to world-wide issues. In himself, he was as ordinary a character as was ever thrust into greatness. For the mischief of his thought, some of his contemporaries were as responsible as himself—some, indeed, more blameworthy. With Bishop Butler I may ask, “Why may not whole communities be seized with fits of insanity, as well as individuals?” and with him aver, “Nothing else can account for a great part of what we read in history.” The common mind passes at times into unwholesome conditions, wherein the words of Paul are exemplified, “For this cause shall God send them a strong delusion, that they should believe a lie.”

Edward Jenner, the son of a clergyman, was born at Berkeley, Gloucestershire, on 17th May, 1749. After the usual education of a youth of his class, he was apprenticed to Mr. Ludlow, surgeon and apothecary, of Sodbury, near Bristol; and on the completion of his time (1770) was sent to London, where he resided for two years with Dr. John Hunter, who increased his means for scientific inquiry by the reception of pupils, caring much more for his menagerie at Brompton than for patients, and utilising his pupils as assistants in his researches. Captain Cook returned from his first voyage of discovery in 1771, and his collection of specimens of natural history was assigned to Hunter for arrangement, who set Jenner to work upon them; and, it is said, he did his duty so well that he was offered the appointment of naturalist in Cook’s next expedition. Jenner was, however, eager to commence business as country surgeon, and in 1772, at the age of 23, he returned to his native vale, legally qualified by his experience at Sodbury, and his two years with Hunter, to practise at discretion on the good folk of Berkeley.

It may be said that Jenner’s was a poor sort of training for a medical man, but it is to be questioned if he lost much by his ignorance; for a century ago medical knowledge was largely absurdity, and practice mischief; and he did best who stood most frequently helpless in the presence of Nature. Sir Benjamin Brodie relates how he served when a young man with a general practitioner near Leicester Square—

Hunter’s name is often used as a sort of consecration of Jenner, but for no obvious reason. Hunter confirmed, if he did not beget in Jenner a strong liking for natural history; and when Jenner was settled in the country, he often availed himself of his services as observer and collector, writing to him for information about the habits of the cuckoo, the breeding of toads and frogs, and the sexes of eels; for cuckoos’ stomachs, crows and magpies’ nests, for bats, hedgehogs, blackbirds, lizards, hares, and fossils; for a cock salmon, for salmon spawn and fry, for a large porpoise, “for love or money;” for the arm of a certain patient when he dies; suggesting horrible experiments on hedgehogs, bats, and dogs, and describing one of special atrocity upon an ass. The most serious proposition in their correspondence was that Jenner should come to London as a teacher of natural history, but Hunter threw out the suggestion with hesitation, the qualification for the appointment being 1000 guineas down. Jenner had improved, or supposed he had improved, the preparation of tartar emetic, and Hunter wrote—

Hunter died in 1793, and there is no evidence that Jenner submitted to his judgment the question of Vaccination, if even we allow that prior to that date the project had occurred to Jenner himself. It is certain that he mentioned to Hunter that country folk believed that to catch cowpox was to be secure from smallpox, and that Hunter repeated the fact in his conversation and lectures; but there is no reference to the matter in Hunter’s writing and correspondence.

It is the habit of Jenner’s admirers to represent him as a patient investigator to whom a great thought dawned in boyhood, which was brought forth in the maturity of life. In conformity with this legend, it is related that when an apprentice at Sodbury, a young woman came to his master’s surgery, and smallpox being mentioned, she said, “I cannot take that disease, for I have had cowpox;” and her observation was pondered in his heart; whereon Dr. Baron, his biographer, ecstatically launches forth—

Against such a paragraph we may write, Sheer romance! Jenner was by no means reticent, and that the prevention of smallpox was for any length of time the burden of his soul, nowhere appears. The romance came into being after date in order to make much of little, and to justify payment in cash and reputation. For, taking Vaccination at the utmost, it was a slight advance upon existent knowledge and practice. In the first place, it was a notorious belief in many dairy districts, that to contract cowpox was equivalent to smallpox in averting a subsequent attack of smallpox. In the second place, inoculation with smallpox was the custom of the time; and if infection with cowpox prevented smallpox, why should not inoculation with cowpox do so as effectually as inoculation with smallpox? The intelligence requisite to reach a conclusion so obvious was not great, and therefore it was no cause for surprise that when Jenner’s claim as originator of Vaccination was brought forward, his priority should be disputed from several quarters; as by Benjamin Jesty of Yetminster, who inoculated his wife and sons with cowpox in 1774; by Nash of Shaftesbury; Mrs. Rendall, and others. Jenner was not insensible to the force of these claims, but evaded them under the plea that there was cowpox and cowpox, and that he had discovered and defined the right sort.

In parts of Holstein, too, cowpox was regarded as good against smallpox, and on more than one occasion was deliberately employed for the purpose. Plett, a village schoolmaster, near Kiel, inoculated three children with the disease in 1791, who were afterwards credited with resisting variolous infection in consequence of their vaccination.[86]

How thoroughly the asserted prophylaxy of cowpox was known, Jenner himself was accustomed to bear witness. He was a member of two clubs, the Medico-Convivial which met at Rodborough, and the Convivio-Medical which met at Alveston; and he used to bring cowpox so persistently under discussion, that, he said, he was threatened with expulsion if he did not desist. “We know,” said the jovial doctors, “that an attack of cowpox is reputed to prevent smallpox, but we know that it does not, and that should end the matter.”[87]

In pursuance of the tactics that would represent Vaccination as the outcome of the labour of many years, we have the following extraordinary narrative from Baron, Jenner’s biographer—

Many are the marvellous relations in ancient and modern history, but in the records of the supernatural it is questionable if there be anything to match the preceding. Painters depict the runaway apprentice listening on Highgate Hill to the bells as they pealed, “Turn again Whittington, twice Lord Mayor of London,” but they might find a finer subject in the young Gloucestershire surgeon, aged 31, habited “in blue coat and yellow buttons, buckskins, well polished jockey boots with handsome silver spurs, a smart whip with silver handle, and hair done up in a club under a broad-brimmed hat,”[89] with eye fixed in vision, contemplating his glorious destiny, through clouds of doubt and difficulty, full twenty years ahead; standing like another Aaron, censer in hand, between the living and the dead until the plague was stayed! Verily, if we do not see miracles, it is because we do not choose to look for them.

The chapter of the wonderful is not exhausted; yet greater things remain. Says Baron, and recollect the year was 1780 and Jenner aged 31—

Which is to say, that in 1780, Jenner, aged 31, had arrived at the conclusion which he offered to the world in 1798 at the mature age of 49; and in the meanwhile allowed mankind to perish from smallpox, he having their salvation in his hands!

The miraculous conversation, says Baron, was concluded by Jenner in words to the following effect—

Gardner, Jenner’s friend, who played the part of alter ego in the asseveration of an early date for Vaccination, was a dealer in wines and spirits. Charity believeth all things, but even charity would exhibit a sceptical countenance when what it is a man’s interest to prove and have placed to his credit, is in itself improbable; which, if true, might be proved by documents and witnesses; but which is merely supported by his own word and that of a friend. Let me repeat, there was never a vestige of evidence adduced for the revelations of 1780 beyond the bare assertions of Jenner and Gardner; and further, that they are radically at variance with the tenor and dates of Jenner’s first publication—The Inquiry of 1798.

The next date to which we come is 1787, in which year Jenner is represented as having taken his nephew, George, into a stable to look at a horse with diseased heels—

“There,” said he, pointing to the horse’s heels, “is the source of smallpox. I have much to say on that subject, which I hope in due time to give to the world.”[91]

Baron gives no authority for this anecdote. It is probably ante-dated six or seven years.

In 1788 Jenner married Catherine Kingscote. In his domestic relations, he was devotedly affectionate, even uxorious; ready to defer any duty and to surrender any advantage to the pleasures of home.

As the phrase ran, Jenner was a good hand at a “copy of verses,” and one of these, “Signs of Rain,” commencing—

has a place in nearly all poetical collections.

In 1792 Jenner applied to the University of St. Andrews for the degree of Doctor of Physic. It cost £15, and nothing more.

Hunter used to say to speculative pupils, “Don’t think, but try; be patient, be accurate;” and Jenner, in relation to cowpox, required the advice; for, by his own account, he was content to think of cowpox for at least a quarter of a century, whilst he knew by intuition its true origin, its magical efficacy, and future triumph without any trial. His first experiment was made in November, 1789, upon his son Edward, his first-born, an infant of eighteen months.

“He was inoculated with cowpox?”

O, no!

“Then with grease from a horse’s heel?”

Not at all!

“With what then?”

Why, with swinepox; and it answered!

The child sickened on the eighth day; a few pustules appeared; they were late and slow in their progress, and small, but they proved sufficient. The poor child was then put through what was styled the Variolous Test: not once or twice, but five or six times at various intervals, he was inoculated with smallpox without other obvious effect than local inflammation and erysipelas. Nothing ever claimed for cowpox turned out more satisfactorily than this experiment with swinepox—supposing we trust Jenner.

Arguing from the records (and we have nothing else to argue from) it was not until about 1795 that Jenner turned his attention with serious purpose to cowpox. This Baron allows, saying—

But Baron fails to specify what were the projected experiments, or the difficulties which hindered their performance. It is a common nuisance in “sympathetic” biographies to have unlimited drafts made upon one’s credulity. The evidence of example would go to prove that Jenner placed his trust in swinepox rather than cowpox, at least as late as 1789.

In April, 1795, a general inoculation took place at Berkeley on Dimsdale’s plan; that is to say, all in the district who had not had smallpox were inoculated with the disease, so that they might sicken together and do no mischief. Among the Berkeleyans was one Joseph Merret, who, 1770, had attended horses with greasy heels and at the same time milked cows, and from the cows had contracted cowpox. Jenner inoculated him repeatedly with smallpox on this occasion, but with no effect; whence he concluded that the attack of cowpox in 1770 had maintained Merret secure from smallpox for five-and-twenty years.[93]

Jenner’s aim was now directed to demonstrate that the common faith in cowpox as a defence against smallpox was well-founded; and to do so it was necessary to clear away two objections—

First, That some who had caught cowpox had subsequently suffered smallpox.

To which he answered—

Various eruptions occur on the teats of cows, which are confounded with cowpox, and infect the milkers; and these, I admit, do not protect from smallpox.

In a letter to Edward Gardner in 1798 he remarked—

Second, That some who had contracted true cowpox had nevertheless fallen victims to smallpox.

To which he answered—

Admitted: but then the milker had not received infection from the cow at the proper time, but at a stage of the eruption too early or too late.

If the reader will set these points clearly before him, he will have the measure of Jenner’s claim. It was a claim to define the truth there was in a popular belief—not to make an independent discovery.

Jenner at this juncture had staked his hope on the identification of horsegrease with cowpox. Yet even in this identification he does not seem to have been original.

It was a persuasion among the farmers that pox on the cows was derived from grease on the horse; and that infection with horsegrease was just as good against smallpox as infection with its derivative cowpox. The fact, however, of this derivation of cowpox from horsegrease was contested, but Jenner was positive. Writing in 1794 he said—

Challenged to produce direct evidence that grease from the horse produced pox in the cow, he met with considerable difficulty, so that on 2nd August, 1797, he had to write—

In the matter of horsegrease, it is to be observed as Dr. Mason Good informs us, “that for ages blacksmiths and farriers, who had been infected with grease, were considered as generally insusceptible of variolous contagion.”[97] Wherefore, to Jenner is not to be ascribed the discovery of horsegrease as good against smallpox; but merely that he held with certain farmers that it was the cause of cowpox, and one in constitution with cowpox; and thus endeavoured to combine the tradition of the stable with that of the dairy.

It was not until 1796 that Jenner made any experiment with cowpox—up to that date, whatever his visions, he was in Hunter’s phrase a thinker, not a trier. On 14th May of that year, he took matter from the hand of Sarah Nelmes, who had been infected by her master’s cows, and inserted it by two incisions in the arm of James Phipps, a child of eight years of age. The boy went through the disease in a regular manner, and on the 1st July was inoculated with smallpox without effect, to Jenner’s intense satisfaction. He communicated the event to Gardner in the following letter—

But the experiments could not be pursued, for, from July, 1796 till the spring of 1798, Cowpox disappeared from the dairies around Berkeley, and, as we have seen, horsegrease was also unattainable. Jenner had, however, resolved on publication. Life was advancing; he had made no mark in the world; and, as he wrote to Gardner—

At first he proposed to embody his views in a paper for the Royal Society, but on second thoughts determined to issue a pamphlet. Having read his manuscript to Dr. Worthington, Mr. Paytherus, and Mr. H. Hicks, assembled round the table of Mr. Thomas Westfaling, at Rudhall, near Ross, Herefordshire, and having secured their approval, the matter was put to press, and about the end of June, 1798, appeared—

These are the words of Mr. John Simon, and in them we have the Jennerian legend with the morsel of fact to the mass of fable which characterises legendary matter, ancient and modern. The recommendation to “study thoroughly that master-piece of medical induction,” Jenner’s Inquiry, is a mere flourish of panegyric; for, as Mr. Simon was well aware, the book had been out of print for half a century, and was practically inaccessible; whilst its reproduction has usually been considered undesirable in the interests of Vaccination, inasmuch as it reveals more than is expedient for common knowledge. An idol that is good to swear by is always fortified by a convenient obscurity.

The Inquiry is a quarto of less than seventy pages in large type, set in broad margins in the grand style of the period, and illustrated with four coloured plates. There are eight pages of Introductory Matter, followed by thirty-four pages of Cases, concluding with twenty-six pages of General Observations.

It is to the Cases as the ground of the argument, that I would first direct attention. They are twenty-three, and may be thus assorted—

13 of Cowpox communicated by accident.

  4 of Horsegrease communicated by accident and inoculated by design.

  6 of Cowpox inoculated by design or transferred from arm-to-arm.

It may be tedious, but I should like to go with the reader over these Cases, for they are highly instructive. Let us take the first twelve of Cowpox communicated by accident.

I.—Joseph Merret, Gardener.

In 1770 attended to Horses, milked Cows, and caught Cowpox. Afterwards his family had Smallpox, but he escaped. In 1795 Jenner repeatedly inoculated him with Smallpox without effect.

II.—Sarah Portlock, Farm Servant.

In 1771 had Cowpox. In 1792 nursed her child in Smallpox “conceiving herself secure,” and was at the same time inoculated with Smallpox in both arms without effect.

III.—John Phillips, Tradesman.

Had Cowpox when nine years old. Was inoculated with Smallpox by Jenner at the age of 62 without effect.

IV.—Mary Barge, Farm Servant.

In 1767 had Cowpox. In 1791 was inoculated with Smallpox without effect. Had also acted as nurse to Smallpox patients without catching the disease.

V.—Mrs. H——, Gentlewoman.

Had Cowpox when very young, contracted by handling dairy utensils. Was subsequently exposed to Smallpox, “where it was scarcely possible for her to have escaped;” and in 1778 was inoculated with Smallpox by Jenner without effect.

At this point, I would draw attention to the ages of the persons set forth in these Cases: they were past middle life when the susceptibility to Smallpox was either low or extinct. The reason given by Jenner for their production was that he “wished to show that the change produced in the constitution by Cowpox is not affected by time”—a claim which vaccinators at this day surrender, insisting on the necessity of re-vaccination to maintain “the benign influence;” but apart from that consideration, there was nothing extraordinary in resistance to inoculated Smallpox. Without the intervention of Cowpox, inoculators were constantly meeting patients who would not “take,” even with repeated attempts, and especially among elderly people; and some who obstinately resisted inoculated Smallpox, subsequently contracted the disease in the ordinary way. So much Jenner himself allowed, saying—

Yet he was pleased to refer this well recognised resistance to variolation in those who had had Cowpox to Cowpox, allowing nothing for habit of body!

VI.—Sarah Wynne, Dairymaid.

In 1796 had Cowpox in May, and “in so violent a degree, that she was confined to her bed, and rendered incapable for several days of pursuing her ordinary vocation.” On 28th March, 1797, she was inoculated with Smallpox by Jenner without effect.

Under this Case Jenner observes, that “among our dairy farmers those who have had Smallpox either escape Cowpox, or are disposed to have it slightly; and as soon as the complaint shows itself among cattle, assistants are procured, if possible, who are thus rendered less susceptible of it, otherwise the business of the farm could scarcely go forward.” At the farm where Sarah Wynne was employed, all had had Smallpox except Sarah, and all save Sarah, escaped.

VII.—William Rodway, Dairyman.

In 1796 had Cowpox. In 1797 was inoculated with Smallpox by Jenner without effect.

Under Rodway’s Case Jenner showed that the farmers were at fault in supposing that Smallpox kept off Cowpox. In the dairy where Rodway was employed, all the milkers had passed through Smallpox, except Rodway, and all contracted Cowpox; “but there was no comparison in the severity of the disease as it was felt by them and by Rodway. While he was confined to bed, they were able, without much inconvenience, to follow their ordinary business.” Thus Jenner argued that though Smallpox might not keep off Cowpox, it made Cowpox milder.

VIII.—Elizabeth Wynne, Dairymaid.

In 1759 had Cowpox slightly when 19 years of age. “As the malady had shown itself in so slight a manner,” observed Jenner, “and as it had taken place at so distant a period of her life, I was happy with the opportunity of trying the effects of variolous matter upon her constitution, and on the 28th of March, 1797, I inoculated her” without effect. Nevertheless in the following year, 1798, she again caught Cowpox, having a “large pustulous sore” accompanied with “general lassitude, shiverings, alternating with heat, coldness of extremities, and a quick and irregular pulse.”

IX.—William Smith, Farm Servant.

In 1780, when attending to Horses with sore heels, Smith conveyed the equine infection to Cows, “and from the Cows it was communicated to Smith. In 1791, the Cowpox broke out at another farm where he then lived as a servant, and he became affected with it a second time; and in 1794 he was so unfortunate as to catch it again. The disease was equally as severe the second and third time as it was on the first.” He was twice inoculated with Smallpox in 1795, and exposed to Smallpox without effect.

X.—Simon Nichols, Farm Servant.

In 1782 was employed in dressing the sore heels of Horses, and at the same time assisted in milking Cows, thereby infecting them and generating Smallpox. Changing his situation, he communicated the disease to other Cows, and was himself severely affected. Some years afterwards, he was inoculated with Smallpox by Jenner without effect.

XI.—William Stinchcomb, Farm Servant.

In 1782 had Cowpox severely on the same farm with Nichols. In 1792 he was inoculated with Smallpox along with a large party, but in his case without result. “During the sickening of some of his companions, their symptoms so strongly recalled to his mind his own state when sickening with the Cowpox, that he very pertinently remarked their striking similarity.”

XII.—Hester Walkley, Farm Servant.

In 1782 had Cowpox when she was attended by Jenner. In 1795 she, and seven other pauper women of Tortsworth, who also had had Cowpox, were inoculated with Smallpox by Henry Jenner without effect. “This state of security proved a fortunate circumstance,” observed Jenner, “as many of the poor women were at the same time in a state of pregnancy.” Why then, it might have been asked, did Henry Jenner try to variolate them?

These Twelve Cases illustrate Jenner’s procedure; and those familiar with scientific methods, and the scrutiny and caution requisite to arrive at trustworthy physiological data, will view with some astonishment his free and easy induction. In the majority of the Cases he was without proof that his subjects had suffered Cowpox; and the absence of this certainty was the more remarkable as he knew that the dairy-folk described as Cowpox several varieties of eruption. The same rural observers who held that Cowpox averted Smallpox, also held that Smallpox averted Cowpox; and yet Jenner had to show in Rodway’s Case No. vii., that they were mistaken; although, granting the thesis that Smallpox and Cowpox were equivalents and mutually preventive, the rural faith ought to have stood justified, and Smallpox shown to be good against Cowpox. Again Jenner allowed that an attack of Cowpox did not prevent a subsequent attack of Cowpox, saying—

Singular indeed! The observation in presence of the principle to be established was nothing short of imbecile. If Smallpox prevented Smallpox, and Cowpox was one with Smallpox, and Cowpox did not avert Cowpox, how was Cowpox to avert Smallpox? The insusceptibility of Jenner’s subjects to variolous inoculation was, as observed, of little account. Resistance to inoculated Smallpox was of common occurrence, and inoculators practised various dodges to overcome it. To have made such experiments approximately conclusive would have required the inoculation with Smallpox of subjects of corresponding ages and temperaments who had not passed through Cowpox; and the probability is that the results would not have been dissimilar.

We must not, however, proceed farther until Cowpox is described; and for that purpose I cannot do better than cite Jenner verbatim.

And Jenner might have added, with convulsions.

Having drawn this alarming picture of the effects of Cowpox, he interposes—

If Cowpox meant all this, some might prefer, at least, the risk of Smallpox; hence the judicious explanation—the irritation of the sores, and not the poison in the blood, was the cause of the distressing symptoms. Jenner went on—

It was this serious disease, this communicated Cowpox, which the subjects of the foregoing Cases were assumed to have passed through; and Jenner, in conformity with the opinion of the dairies, held that they were thereby rendered proof against Smallpox. Whilst his Twelve Cases make a show of inquiry, they bear no trace of extensive or critical research. In the general inoculations then prevalent, those who had undergone Cowpox were not treated as protected (as were those who had had Smallpox) but were “cut” with their neighbours—as, in Case xii., were the eight cowpoxed paupers of Tortworth. Yet Jenner was at no pains to collect and set forth the evidence of other Gloucestershire practitioners, who, in the course of duty, must have known as much of Cowpox as himself, and might have set scores of Cases alongside his perfunctory dozen.

Having perused Jenner’s description of Cowpox, let us now turn to his account of its origin.

This conception of the origin and progress of the disease was not Jenner’s specially: he shared it with the farmers to whom it was a novelty—

Thus Cowpox was to be extinguished by forbidding milkers to handle Horses’ greasy heels. Jenner himself tried to produce Cowpox in the manner described, but without success—

What was requisite for success, he concluded, was the limpid fluid from the Horse’s heel at an early stage of the disease, and that it should be applied to the Cow’s nipples at a certain season—

Whilst thus explicit as to what was requisite for the infection of the Cow by the Horse, Jenner did not succeed in producing Cowpox from Horsegrease. He had to write—

Yet without proof, he argued as if he had proof, saying—

Evidence adduced! Of evidence there was none. The farmers might be right in their opinion that Cowpox sprang from Horsegrease, but opinion was not evidence, nor even such assurance as this of Jenner’s—

But not even to this conviction did he adhere. “It was highly probable,” he thought, “that not only the heels of the Horse, but other parts of the body of that animal, are capable of generating the virus which produces the Cowpox”—

Spurious Cowpox! What was Spurious Cowpox? Here is Jenner’s answer—

Nothing could be more explicit. Cowpox was of two kinds—True and Spurious. The Spurious consisted of pustular sores which appeared spontaneously on the nipples of Cows, and was of no avail against Smallpox: the True Cowpox, on the other hand, was not a disease of the Cow, but of the Horse transmitted to the Cow.

It is of prime importance to bear this distinction in mind; for if it is not borne in mind, much that remains to be told must appear confused or unintelligible. As we have seen, it was the belief of the dairymaids that if they caught Cowpox they would never afterwards catch Smallpox. Medical men in practice in Gloucestershire ridiculed the dairymaids’ belief. They said—

“We know that such is the dairymaids’ faith, but it is mistaken; for we know dairymaids who have had Cowpox and afterwards had Smallpox in spite of their Cowpox.”

At this point Jenner intervened, saying—

“Let us distinguish. Eruptions contracted in milking are indiscriminately described as Cowpox by dairy-folk; but there is an eruption attended with erysipelas and fever which has all the virtue they claim for it. This variety of eruption does not originate on the Cow, but is communicated to the Cow from the Horse. Thus the dairymaids are right and they are wrong. They are right when the pox they catch is derived from the Horse through the Cow: they are wrong when the pox they catch originates on the Cow without the Horse. In short Cowpox proper is of no avail against Smallpox. It is Horsegrease Cowpox that is of sovereign and infallible virtue. Any maid who receives Horsegrease Cowpox into her veins is, as she believes, for ever after secure from the infection of Smallpox.”

Let us therefore bear in mind that Jenner’s prescription was not Cowpox but Horsegrease Cowpox. It is a point to be insisted upon; for, as we shall see, it was lost from sight, and kept out of sight, to the utter confusion of the question.

We now come to Jenner’s Cases of Horsegrease—for not only were farm-folk reputed secure from Smallpox by reason of Cowpox, but farriers likewise in consequence of infection with Horsegrease.

XIII.—Thomas Pearce, son of a Farrier.

In consequence of dressing Horses with sore heels at his father’s when a lad, had sores on his fingers which suppurated, and occasioned pretty severe indisposition. Six years afterwards, Jenner inoculated him repeatedly with Smallpox, but only produced slight inflammation, and exposed him to the contagion of Smallpox without effect.

On this Case Jenner observed—

XIV.—James Cole, Farmer.

Was infected with Horsegrease in the same way as Pearce. Some years afterwards was inoculated with Smallpox, but only a few eruptions appeared on his forehead, which passed away without maturation.

XV.—Abraham Riddiford, Farmer.

Was affected with very painful sores in both hands, tumours in each arm-pit, and severe and general indisposition, in consequence of dressing a Mare that had sore heels. He was attended by a surgeon, who recognising a similarity of the sores upon his hands with those of Cowpox, and knowing the effect of Cowpox on the human constitution, assured him that he never need fear Smallpox; but, twenty years afterwards, he caught the disease, which ran its regular course.

From these Cases Jenner drew this conclusion—

Which conclusion he repeated thus—

From this conclusion, Jenner at a subsequent period withdrew. The virus from the Horse was employed for inoculation without transmission through the Cow, and with results equally satisfactory. As we shall find, Jenner used and distributed Equine Virus neat, which he certified as “the true and genuine life-preserving fluid.”

So far the Cases set forth described no more than ordinary Gloucestershire experience; but we now come upon ground regarded as peculiarly Jennerian.

XVI.—Sarah Nelmes, Dairymaid.

In 1796 was infected with Cowpox, receiving the virus on a part of her hand scratched by a thorn. From the large pustulous sore on Sarah’s hand Jenner, on the 14th May, inoculated—

XVII.—James Phipps, eight years old.

Said Jenner, “The more accurately to observe the progress of the infection, I selected a healthy boy, about eight years old, for the purpose of Inoculation for the Cowpox.” The matter was inserted into his arm by two incisions, barely penetrating the cutis, each about half an inch long. The inoculation “took,” and was followed by a chill, loss of appetite, headache, and restless sleep. On the 1st of July, the poor lad was inoculated with Smallpox, and again several months afterwards, it is said, without effect.

About the latter end of February, 1798, William Haynes and Thomas Virgoe, having to wash a Mare with sore heels, were infected with Grease, and described their sensations as much the same as when they were inoculated with Smallpox. Their infection proved that if Grease was good against Smallpox, Smallpox was not good against Grease. Haynes was employed as a milker, and Pox broke out among his master’s Cows about ten days after he had first assisted in washing the Mare’s heels.

XVIII.—John Baker, five years old.

Inoculated, 16th March, 1798, with matter taken from a pustule on the hand of the aforesaid Thomas Virgoe poisoned with Grease from the Mare’s heels. “He became ill on the sixth day with symptoms similar to those excited by Cowpox, and on the eighth was free from indisposition.”

On this case of Horsegrease inoculation, Jenner observed—

Mark the assumption, “The virus from the Horse is not to be relied upon as rendering the system secure from variolous infection, but the matter produced by it on the nipples of the Cow is perfectly so!” Such was Jenner’s method of induction! How could he leave the question undecided? Why not have waited until little Baker recovered from his fever? or why not have inoculated another work-house child with Horsegrease? The true sons of science do not rush into print in such shameless deshabille.

XIX.—William Summers, aged five and a half.

Inoculated 16th March, 1798, from the nipple of one of the Cows infected with Horsegrease by Haynes. Subsequently inoculated with Smallpox without effect.

XX.—William Pead, aged eight.

Inoculated, 28th March, from Summers. Subsequently inoculated with Smallpox without effect.

XXI.—Hannah Excell, aged seven.

And several children and adults were inoculated from the arm of Pead on 5th April. “The greater part of them sickened on the sixth day, and were well on the seventh; but in three of the number a secondary indisposition arose in consequence of an extensive erysipelatous inflammation which appeared on the inoculated arms. By the application of mercurial ointment to the inflamed parts (a treatment recommended under similar circumstances in the inoculated Smallpox) the complaint subsided without giving much trouble.”

Excell was inoculated in three places on her arm. “This,” said Jenner, “was not done intentionally, but from the accidental touch of the lancet, one puncture being always sufficient.” The resulting pustules so much resembled those arising from inoculation with Smallpox, “that an experienced inoculator would scarcely have discovered a shade of difference.”

XXII.—Four Children.

On 12th April virus was taken from Hannah Excell and inserted in the arms of—

R. F. Jenner did not “take.” The arms of the others inflamed, and Jenner fearing erysipelas, as in the preceding cases, applied a caustic of soap and quick-lime to Marklove and James, “which,” he says, “effectually answered my intention in preventing erysipelas.” The disease was suffered to take its course in Pead, and no erysipelas appeared.

XXIII.—John Barge, aged seven.

Inoculated from Mary Pead, and successfully. Was subsequently inoculated with Smallpox without effect.

“These experiments,” said Jenner, “afforded me much satisfaction; they proved that the matter in passing from one human subject to another, through five gradations, lost none of its original properties, John Barge being the fifth who received the infection successively from Wm. Summers, the boy to whom it was communicated from the Cow.”

These are Jenner’s Cases. In them we have his “Masterpiece of Medical Induction”—the fruit of thirty years of incessant thought, of watching, and of experiment! Let us carefully observe the dates. Until 1796, when he operated on Phipps, he never made an experiment in Horsegrease Cowpox Inoculation; and not until the middle of March, 1798, a few weeks before going to press with the Inquiry, did he repeat the experiment; and though his later cases were complicated with erysipelas, he did not stay to dispose of the difficulty and alarm thereby excited. He got together his scratch lot of Cases, as if under some over-mastering compulsion, and consigned the concern, crude and incomplete, to the public. By-and-by the hasty performance came to be spoken of as the result of thirty years of incessant thought, of patient research, and of unwearied labour. It is unnecessary to argue the matter. Whilst there is nothing too great for the credulity of those who are in the disposition of belief, yet facts are facts, and there is the stone-wall of the Inquiry with its authentic details whereon to crack the skulls of romancers. In Jenner’s story as recited to the vulgar, we have the advantage of witnessing the development of myth in the light of our own age under our own eyes.

Taking Jenner’s Inquiry at the utmost, What was it? A suggestion to substitute Horsegrease Cowpox for Smallpox in inoculation. That was all. Beyond this there was no point of novelty. Some have credited Jenner with originating the transfer of virus from arm to arm; but in this respect he followed the example of many variolators. There was a mild form of Smallpox occasionally prevalent in London called “pearly pox,” and Dr. Adams and others kept it going from patient to patient; and the virus from the body of a healthy variolated child was in constant request by timid folk, who fancied the virulence of the original infection might thereby be abated in transmission.

So much for Jenner’s data. Now for a word or two as to the speculation that invested his prescription.

He considered that some of the diseases which afflict men are derived from their domestication of animals, and that thus several diseases might have a common origin. “For example,” he asked, “Is it difficult to imagine that measles, scarlet fever, and ulcerous sore throat with a spotted skin, have all sprung from the same source?”

About the imagination, there might be little difficulty: the difficulty lay in the production of proof that any disease in man was derived from disease in animals, and that disease so derived was variously manifested. Jenner wished to have it believed that a variety of Cowpox was generated from Horsegrease, which Cowpox was the source of Smallpox. He adduced no evidence, however, to connect outbreaks of Smallpox with Cowpox; nor did he ever suggest that dairymaids caught Smallpox from Cows, or farriers from Horses. His identification of Horsegrease Cowpox with Smallpox was the resemblance of their pustules, and on the ground of this resemblance he affirmed the equivalence of the diseases. Thus in describing his first inoculation of Cowpox, that of Phipps from the hand of Sarah Nelmes on the 14th of May, 1796, he wrote—

The similarity of the Cowpox and Smallpox pustules incontestably pointed out the close connection between the two diseases! The observation and the conclusion are worth notice, being characteristic of Jenner’s loose and illogical mind. He was familiar with Tartar Emetic, and he might have observed that it produced pustules on the skin exactly like those of Cowpox and Smallpox; wherefore would it have been fair to argue that the pustules being alike, their causes were incontestably identical? Dr. Hamernik of Prague observes—

Having identified Horsegrease Cowpox with Smallpox, by reason of similarity of pustules, he went on to assert that such Horsegrease Cowpox was equivalent to Smallpox for inoculation, and was attended with the like prophylaxy, saying—

And so on. The assurance was absolute, and the warrant for the assurance was the Cases adduced, and the similarity of Horsegrease Cowpox pustules and Cowpox pustules! But if the pustules were similar, the effects were not similar. Inoculation with Smallpox produced Smallpox, mild or otherwise, with pustules few or many; but inoculation with Horsegrease Cowpox was attended with no eruption beyond the points of incision—

Very good; but where are we? If similarity of pustule proved the identity of Smallpox and Horsegrease Cowpox, what did those graver dissimilarities between the diseases prove? That an objection so obvious should never have occurred to Jenner indicates the extent of his logical capacity.

Jenner’s expectation from the issue of the Inquiry had nothing of the prophetic character described by his enthusiastic biographers. It is only necessary to peruse its pages and note the dates in order to perceive the impossibility of the vision of 1780 described by Baron when Jenner exhibited to Gardner his future glory, and how he was destined to stand like Aaron between the living and the dead until the plague was stayed. Alas! how many similar fables may we entertain because the means of detection are not, as in Jenner’s case, available.

When Jenner was writing, the English people were committed to Smallpox Inoculation, or more accurately Smallpox culture, and it was in competition with Smallpox that he advanced Cowpox. “If asked,” he said, “whether his investigation be matter of mere curiosity, or whether it tend to any beneficial purpose,” he replied by setting forth the draw-backs to the existing practice, and contrasting them with the advantages of his own.

On the contrary, he said—

Inoculation was freely charged with exciting scrofula; thus Jenner observed—

Happily he had the grace to refrain from the explicit assertion that Cowpox was exempt from similar hazard; yet with characteristic inconsistency, was disposed to advance a claim for it as an expulsive irritant—

A reader of the Inquiry in 1798 could never have supposed that it was an attempt to displace the existing practice of Inoculation. Nor is there any sign that Jenner at the time contemplated such an issue. He referred to Variolous Inoculation with respect, and was satisfied to suggest that in certain cases inoculation with Horsegrease Cowpox might be substituted with advantage. As to the permanent existence of Horsegrease Cowpox he was doubtful. Since, he said, the farmers had traced the infection to the Horse, “the appearance of the Cowpox may either be entirely extinguished or become extremely rare.” It may be replied that this behaviour on the part of Jenner was due to reserve and tact, but the reserve and tact are invisible. The Inquiry was simply what it appears—a hasty performance, which, in other hands, developed to more, far more, than its author contemplated. Subsequently he, and his friends for him, laid claim to years of research under the influence of supernatural foresight; but, with the Inquiry before us, I ask where is the evidence? I take the date, 14th May, 1796, when Jenner inoculated Phipps from the hand of Sarah Nelmes, as the time when the project of inoculation with Horsegrease Cowpox began to assume form, and I maintain that the character, order and dates of the Cases set forth in the Inquiry plainly show that they were got together to sustain the conclusion then arrived at. When Mr. John Simon descants on Jenner’s thirty years of incessant thought, watching and experimenting which resulted in the production of that Masterpiece of Medical Induction—The Inquiry, the answer is, Peruse the Inquiry, and then say where the fruit of thirty years of labour is to be found. The assertion is too absurd for discussion, whatever it may be as an article of faith.

The single point of originality in the Inquiry was the definition of the disease for which prophylactic efficacy was asserted. The dairymaids said Cowpox: the farriers said Horsegrease. Jenner said neither Cowpox nor Horsegrease, but their combination in Horsegrease Cowpox, which variety of Pox alone ensured life-long security from Smallpox. We shall see as we proceed how this position was surrendered and resumed, modified and confused beyond recognition. Let it suffice at present to say that the note of Jenner’s Inquiry was Horsegrease Cowpox and nothing else. Strike out Horsegrease Cowpox, and the affair is reduced to nonentity.

What was called the Variolous Test worked wonderfully for Jenner; and as we shall have to refer to it repeatedly, it may be well to describe and dispose of it at once.

We have seen how the Test was practised in the Cases in the Inquiry. Those who had undergone Cowpox were inoculated with Smallpox, and as the Smallpox did not “take,” they were assumed to be proof against that disease. Hence the absolute conclusion proclaimed Urbi et Orbi, that none inoculated with Cowpox could ever afterwards contract Smallpox.

It was replied, that some who had suffered from Cowpox had contracted Smallpox, and that others had received the disease by inoculation; to which Jenner’s summary answer was, “There must have been some mistake about the Cowpox; for no one can have genuine Cowpox and subsequently incur Smallpox, either by infection or inoculation.”

Cowpox was inoculated and propagated from arm to arm; and, in proof that the constitution was fortified against Smallpox, it was common to inoculate with Smallpox, which usually did not “take”; whereon the operator exclaimed, “Behold! the patient is insusceptible of Smallpox for ever!”

Such was the Variolous Test. It was to multitudes absolutely conclusive; and to question its validity was to exhibit a contentious and unphilosophic disposition.

What shall we now say concerning it?

First, that failures were numerous in Variolous Inoculation apart from Vaccination, and that it was not supposed that when a patient did not “take,” he was therefore insusceptible of Smallpox; nor even when he did “take,” that he was thereby rendered proof against Smallpox. So many of the successfully inoculated did subsequently fall victims to Smallpox, that Variolators at the end of last century were compelled to argue (like Vaccinators at the end of this) that Variolation was a guard, but not an absolute guard; and that when it did not altogether avert Smallpox, it modified and mitigated an attack. The excuse for failure was as artful as the motive was urgent: Variolation was too good a trade to be imperilled for lack of a little ingenuity.

Nevertheless, if we make full allowance on the score of frequent incapacity to receive Variolation, we have yet to explain, on a candid view of the whole evidence, how it was that in numerous cases Inoculation with Smallpox was ineffective after Inoculation with Cowpox.

“What can you urge against the Variolous Test?” was a frequent and imperious demand.

The explanation in general lay in the fact, that Variolation was attempted before the complete subsidence of the vaccine fever. The inoculation with Cowpox had set up a serious constitutional disturbance, and during that disturbance the Smallpox virus could not develop its malign energy. Let me show what I mean from the testimony of Jenner himself.

On 15th March, 1800, the Duke of York requested Jenner to proceed to Colchester to the 85th Regiment. Jenner was unable to go, and sent his nephew, George, instead, who had to report a complete failure. The reason of the failure was, that the entire Regiment, with women and children, had the itch! Jenner was then driven to the conclusion which, says Baron, “he adopted and invariably maintained to the last hour of his life, namely, that any cutaneous disease, however slight in appearance, was capable of interfering with the regular course of the Cowpox and of preventing it from exercising its full protecting influence.”[100]

Just so: and mark how the same logic applies to the Variolous Test, which “nobody could get over.” If any cutaneous disorder, however slight, could nullify Cowpox, was it not equally probable that the cutaneous disorder induced by inoculated Cowpox would nullify inoculated Smallpox until the effects of the Cowpox had time to subside? When the itch at Colchester was cured, then inoculation with Cowpox was found to be practicable. Thus worthless was the Variolous Test on Jenner’s own principle; yet with such evidence under his eyes and among his fingers, he failed to discern its significance. Nor apparently did he inquire whether the influence of Cowpox was perpetuated over specified periods of six months, nine months, one year, two years, and so on. As trader and adventurer, it suited him better to be not over inquisitive, and to avow boldly that his specific conferred life-long immunity from Smallpox.

Vaccinators at this day rarely refer to the once famous Variolous Test: to do so would be absurd. The fact of Re-Vaccination, of Vaccination after Vaccination at short intervals, proves, that whatever the influence of the operation, it is transient and not permanent; and the cases of Smallpox after Vaccination, and of Smallpox in its most malignant forms after Re-Vaccination, as if induced thereby, leave the Variolous Test, which so widely impressed and imposed upon our forefathers, an exploded piece of jugglery.

Jenner, with his wife and daughter, left Berkeley for London on 24th April, 1798, in order to see the Inquiry through the press. He remained in London until 14th July, and failed, if he tried, to induce any inoculator to substitute cowpox for smallpox. In the Jenner legend, it is usual to find some touching remarks on this trip to town: genius unrecognised: truth turned from every door: the great soul abiding in patience and courage invincible. Dates, however, are again merciless. The Inquiry was not in the booksellers’ hands until the end of June, and, within a fortnight after publication, Jenner was on his way to Berkeley. There was no occasion for the virtues specified.

Among Jenner’s acquaintance was Henry Cline, teacher of surgery in St. Thomas’s Hospital; and with Cline he left some virus in a quill that he had taken from the arm of Hannah Excell, at Berkeley on 5th April. Cline had a patient, a child named Richard Weller, with an affection of the hip-joint, and intending to create an issue by way of counter-irritation, he inoculated the hip with Excell’s virus, and thus described the experiment in a letter to Jenner—

Cline then attempted to vaccinate with virus taken from Weller’s hip, but failed. He wrote to Jenner—

Jenner was unable to comply with Cline’s request: he had no cowpox to transmit: and readers of the Inquiry who addressed to him similar requests had to submit to similar disappointments, out of which some suspicion was naturally developed. The recommendation of a remedy whereof there was no available supply was not a passport to confidence.

Baron relates, that “Mr. Cline perceiving at once from the success of his first trial, what incalculable blessings were connected with the diffusion of the new practice, immediately advised Jenner to quit the country, and to take a house in Grosvenor Square, and promised him £10,000 per annum as the result of his practice; in which opinion Mr. Cline was supported by Sir W. Farquhar; but that all these splendid prospects of wealth and distinction could not move Jenner.”[101]

The story is either an invention, or it does little credit to Cline’s judgment. Jenner had neither the means for a house in Grosvenor Square, nor was there any likelihood of his earning £10,000 a year by cowpox. Nevertheless it would appear that at this juncture some one was advising him to try London (one’s vanity is never without a prompter), and that Jenner replied—

If his correspondent had been a man of sense, he might have replied—

But Jenner was not the unimpassioned man of science, who can leave truth to take care of itself, and submit when truth contradicts his prepossessions. Dr. Ingenhousz, an Anglicised Dutchman (born at Breda, 1730), with reputation as electrician and chemist, read the Inquiry with considerable amazement. He was himself an inoculator of mark, having been selected by the Empress Maria Teresa to operate upon the imperial family of Austria; and by her had been rewarded (after the pattern of Catharine of Russia and Dimsdale) with a pension of £600 a year, and the titles of Aulic Councillor and Imperial Physician. Naturally, therefore, Ingenhousz had a lively interest in Jenner’s project, and being on a visit to the Marquis of Lansdowne at his seat in Wiltshire, addressed him as follows—

The impression made on Jenner’s mind was simply one of annoyance. He fell back on the assertion that all was not cowpox that was supposed to be cowpox, and that Farmer Stiles could not have had the genuine distemper, or he would not have received smallpox by inoculation. It did not even occur to him that it was necessary to investigate and account for the evidence adduced by Ingenhousz, which was every whit as valid as much of his own. He was content to protest—

Could universal conclusion be deduced from more questionable premisses? and this, too, by one who had just exclaimed, “How very few are capable of conducting physiological experiments!” Always, as we shall see; ungenerous toward those who questioned his assertions, Jenner wrote to his friend, Gardner—

When, in fact, what provoked him was that Ingenhousz knew too much about cowpox, and had laid his finger on the point of error at the outset. Inquiry on the part of Ingenhousz brought to light several other instances of smallpox after cowpox; and Dr. Pulteney of Blandford reported that Dorsetshire inoculators were familiar with the one sort of pox after the other sort. Jenner’s constant answer to such objections was, “Yes; but it could not have been true cowpox to start with”—a style of argument maintained with parrot-like persistency when smallpox followed vaccination. “Ah!” it was said, “there must have been some mistake about the vaccination; for no one can be thoroughly vaccinated and have smallpox.”

Looking back on the final years of last century, it is much to be regretted that more pains were not taken to hold Jenner fast to his position that smallpox never followed cowpox, and to demonstrate beyond contention that it was not true. It certainly was not true; the evidence to that fact was indisputable; but few were disposed to follow Ingenhousz into the West of England and search for the requisite proof; and Ingenhousz was cut out of the controversy by his death at Bowood on 7th September, 1799. Presently Jenner managed to have the contention shifted from the experience of the dairies to vaccination from arm to arm and the illusory variolous test, and the advantage of a decision at the springs of fallacy was lost. In the general confusion which ensued Jenner came to be taken for a discoverer, and he posed diligently in the character, when he was nothing more than the advertiser of the vulgar opinion of his neighbourhood, with the modification that not Cowpox but Horsegrease Cowpox was the true and infallible specific. The fact is so clear, that he was a mere advertiser, that it would not be worth repetition, were it not so systematically treated as unseen. How distinctly it was at first recognised appears in a letter of thanks for a copy of the Inquiry addressed to Jenner by Francis Knight, a London surgeon, wherein he observed—

In these remarks of Knight, we have Jenner’s position accurately defined. He made himself responsible for “the general opinion among the dairymen”; and had some one at that time shown in perspicuous and emphatic fashion that the dairymen were wrong, Jenner would have been summarily disposed of. Vain, however, are such regrets; and we may find comfort in the reflection that there is an order in the universe which converts misfortune into means for greater and rarer good.

Another letter to Jenner from Dr. Hicks contains these remarks—

Everlasting security from smallpox! Such was the unqualified promise, and with how little warrant! In presence of a Socratic inquirer with his persistent, how do you know? Jenner must have stood confounded.

A letter to Jenner from Dr. Percival, also contains some remarks worth notice. He wrote—

The frequent statement that Jenner’s Inquiry was at first received with indifference is entirely untrue: on the contrary, it was read with interest from the outset, and the only check he met was due to his inability to supply the demands of correspondents for samples of the precious virus. Cowpox was absent for awhile from the dairies, and great was his relief and delight when toward the end of 1798 some matter was obtained from a farm at Stonehouse wherewith on the 27th November he vaccinated the children of his friend, Henry Hicks of Eastington; “the first gentleman,” says Baron, “who had the merit of submitting his own children to the new practice.”

Ere 1798 had passed away, Jenner had secured an energetic ally in Dr. George Pearson, F.R.S., Physician to St. George’s Hospital, London.[104] Pearson entered into the cowpox question with his whole heart, and constituted himself a sort of partner in Jenner’s project. He wrote to him—

And in a more decided strain on 13th November—

In the same letter he told Jenner what some were saying about the suggested practice—

Such observations were natural and to be expected. Jenner wrote to Gardner that “brick-bats and hostile weapons of every sort were flying thick around him,” but they were chiefly imaginary. His revelation was communicated to a ready world. It was no revolutionary project, but a seductive modification of existing practice. Inoculation with smallpox was the order of the day among all respectable people. The operation was troublesome and uncertain, perilous to patients and to those in contact with them; and, when all was done, it afforded no unquestionable security against the disease it was designed to avert. To a community thus harassed and anxious, came Jenner with his prescription and his promise—Substitute cowpox for smallpox and you will escape from this distress, danger, doubt. You will have a harmless fever without pustules and without risk of infection, and the security from smallpox will be absolute and perpetual. What wonder that in such circumstances Jenner’s message was heard gladly and accepted with grateful enthusiasm. That he should have encountered some resistance was inevitable, for what change is ever effected without opposition and ominous prediction? But the change Jenner proposed was the slightest of changes with the largest prospects of advantage. Unless these conditions are borne in mind, we shall never rightly understand the reception accorded by our forefathers to inoculation with cowpox.

Dr. Pearson’s Inquiry concerning the History of the Cowpox[105] is a remarkable proof of the alacrity and energy with which Jenner’s project was entertained. As observed, Jenner’s Inquiry was published at the end of June, 1798, and ere six months were over, in November, 1798, appeared Pearson’s Inquiry, a masterly review of Jenner’s; and not only a review, but a record of investigation, personal and by correspondence with country physicians and farmers; the entire work displaying a capacity for business to which Jenner was wholly unequal.

Cowpox did not come before Pearson as a novelty, nor Jenner in connection therewith. He relates—

The communication of Jenner to Hunter was nothing of a discovery. There was no secret in the existence of Cowpox, nor in the belief that inoculation therewith fortified the sufferer against Smallpox. Dr. Pulteney, of Blandford, informed Pearson that—

In the northern counties and in Wales, Cowpox was either rarely seen or unknown. In Cheshire, as much of a dairy county as Gloucestershire, where also men acted as milkers, the disease was never met with. Where, however, Cowpox was recognised, the faith in its efficacy against Smallpox appeared to be general, and inoculators regarded it as a bar to their success. Thus Mr. Giffard, surgeon, Gillingham, wrote to Pearson, 9th August, 1798—

At a milk-farm on the Hampstead Road, Pearson found a man who had often seen Cowpox in Wiltshire and Gloucestershire. He said that—

Mr. Rolph, surgeon, Peckham, who had practised in Gloucestershire, informed Pearson that—

Dr. Croft likewise told Pearson—

Nor did what was so widely believed escape mention in medical literature. Thus Dr. Beddoes, in Queries concerning Inoculation, had written in 1795—

And Dr. Adams, in his treatise on Morbid Poisons, 1795, observed—

And Dr. Woodville in his History of Inoculation, 1796, argued—

The belief, moreover, that Cowpox was good against Smallpox, had tempted several to court the disease. The Rev. Herman Drewe wrote to Pearson of himself and Mr. Bragge, surgeon, Axminster, 5th July, 1798—

Mr. Dolling of Blandford related that—

Dr. Pulteney of Blandford informed Pearson that—

These cases were examples of many; and if it be asked, why were not such inoculations repeated, we may take an answer from Mr. Fewster, surgeon, of Thornbury, who, in a practice of thirty years in Gloucestershire, inoculated thousands with Smallpox, and had known “numberless instances of Cowpox.” He wrote, 11th October, 1798—

To show still further how Jenner’s communication was “in the air” ready for descent. Mr. Downe, surgeon of Bridport, wrote to Pearson, 1st August, 1798—

Thus popular scandal anticipated what was called Jenner’s discovery!

Nor was Pearson content simply to inquire of others: he experimented himself, and put Cowpox to the test a week or so before the appearance of Jenner’s Inquiry. He wrote—

The result conformed to expectation: Edinburgh, Grimshaw, and Clarke did not take Smallpox, even though inoculation was repeated, whilst Kent and East did. Pearson set forth his experiments much more philosophically than Jenner, but his bias was pronounced, and it blinded him to some obvious considerations; and it is marvellous how easily we may accumulate details for which we have a fancy. Summing up the testimonies he had collected, he held that—

In this summary we perceive the limit and imperfection of Pearson’s Inquiry. Smallpox did follow Cowpox: it was well known that it did: and Dr. Ingenhousz ascertained the fact as soon as he looked for it. Moreover Pearson showed himself ignorant of Jenner’s position, who, recognising the fallacy of the rural superstition, was compelled to discriminate Cowpox as genuine and spurious—the genuine being the variety derived from Horsegrease.

Upon Jenner’s assertion that Cowpox was unaltered by transmission from arm to arm, Pearson remarked, “The fact remained to be proved.” That Cowpox produced a harmless ailment was not, he thought, to be hastily assumed. Dr. William Heberden had recently inoculated 800 poor persons at Hungerford without a mishap, and 1700 had passed through Dr. Woodville’s hands in the current year (1798) with only two deaths; yet how erroneous would be to argue that variolous inoculation was harmless from such special experience!

If Cowpox remained unchanged in transmission from arm to arm, it would be no harmless ailment; for the evidence was distinct that it was frequently a severe one. For example, Edinburgh told Pearson that when suffering from Cowpox he had to give up work and go into an hospital; and Grimshaw that the disease was uncommonly painful, with swellings in his armpits, sore to the touch; and the servant at Rhodes’s farm in the Hampstead Road, who had seen much Cowpox in Wiltshire and Gloucestershire, said the milkers were sometimes so ill that they had to keep their beds for several days, though none ever died of the Cowpox fever. If, however, by transmission from arm to arm, Cowpox became milder, it was not improbable that at the same time it would lose more or less of its protective efficacy.

Pearson might have seen and added, that resistance to inoculated Smallpox, when the constitution was in no humour for Smallpox, was no proof that the same constitution would resist Smallpox when epidemic, or in condition for the evolution of the disease.

Pearson likewise took objection to Jenner’s evidence (such as it was) that it was possible to take Cowpox after Cowpox, but not Smallpox after Cowpox; saying—

Here we see Pearson on the verge of discovery of the illusion, but with all his training and Yorkshire shrewdness he lost the scent, and allowed himself to be deceived; and not only deceived, but to become a prime mover in the deception of the world. Jenner felt the difficulty and replied—

This passage is commended to those who hold with Mr. John Simon that Jenner delivered to the world “a Master-piece of Medical Induction,” the fruit of thirty years of incessant thought, watching and experiment. It is plain that in 1798 the very elements of the problem were by him undetermined, and the most obvious objections unforeseen and unconsidered.

Pearson’s strongest opposition was reserved for the asserted origin of Cowpox in Horsegrease. He said—

In the opening of his Inquiry, Pearson was good enough to say of Jenner, “I would not pluck a sprig of laurel from the wreath that decorates his brow”; but, disputing the origin of genuine Cowpox in Horsegrease, he might have asked himself, what sprig of laurel he had left. That Cowpox originated in Horsegrease was not Jenner’s discovery. As Pearson ascertained in the London milk farms, “There was such a notion entertained in several parts of the country, whatever might be its foundation.” (P. 86.) But the definition of Horsegrease Cowpox as the form of Cowpox that justified the faith of the country-folk in the power of the disease to avert Smallpox, was Jenner’s solitary distinction—the principle and motive of his Inquiry, which, to prove fallacious, was to extinguish his title to regard. Cowpox apart from Horsegrease was clearly taught by Jenner to have no influence on the constitution, and to be attended with no erysipelas. “Let me call your attention,” he wrote to Pearson, 27th September, 1798, “to a similarity between the Smallpox and the Cowpox when inoculated. The symptoms of absorption first disturb the system, and, secondly, the system feels the consequences of the local sores. Exactly so with the Cowpox; and as the Cowpox inflammation is always of the erysipelatous kind, when it spreads over the skin to any great extent, it produces symptoms not unlike the confluent Smallpox.” (P. 100.)

Pearson foresaw that if the principle of inoculation with Cowpox were established it would lead to other applications—

Like Jenner, he also recognised in Cowpox a counter-irritant—a safe sort of fever that might be used to drive off other diseases—

Nor was the notion without warrant, for Smallpox itself was credited with a double action as a generator and exterminator of disease—

In one respect, Jenner showed himself superior to Pearson, namely, in offering some explanation of Cowpox. Pearson accepted the disease on the rural terms—as an eruption on Cows attended with no serious illness. If in any way such Pox was equivalent to Smallpox, it was inexplicable that it should be limited to the udder and teats of milch cattle, and that males, and females not in milk, should be exempt from infection. A disease so unique wanted accounting for; but Pearson made no attempt to account for it, nor gave any sign that he apprehended the difficulty. Jenner, on the other hand, accounted for Pox on the Cow by referring it to infection from the Horse conveyed by the milkers, which explanation Pearson rejected. But in giving Jenner credit for so much, let it not be for over much. Whilst he ascribed Cowpox to a credible cause, he did not recognise his advantage and summon gainsayers to explain how Cowpox, as described by them, could exist without Bullpox. On the contrary, as we shall see, Jenner submitted to be silenced on this point for reasons far from creditable.

Another early and earnest examiner of Jenner’s Inquiry was Dr. William Woodville, physician to the London Smallpox and Inoculation Hospital. He was a Cumberland man, born at Cockermouth, 1752; a member of the Society of Friends. An ardent botanist, he turned two acres of the ground around the Hospital at King’s Cross into a botanic garden, which he maintained at his own expense. He died of a chronic pulmonary complaint in 1805, and in his last illness had himself removed from his house in Ely Place to the Hospital for the sake of the garden and the country air.

Woodville was eager to try cowpox, but Jenner had no supply, nor could any be had elsewhere. He therefore resorted to horsegrease, but could make nothing of it. In his own words—

Thrice in person did Woodville submit to inoculation with horsegrease, but in vain. Others in London and elsewhere attempted to raise pox on cows in the same way without result save malediction on Jenner for originating such a troublesome quest.

Thus closed 1798 with many anxious to try the new prescription whenever there was a chance. Early in the new year, there was a cry in London, ’Tis found! ’tis found! In Harrison’s dairy, Gray’s Inn Road, close by the Smallpox Hospital, cowpox was discovered, and thither hastened Woodville, Pearson, Sir Joseph Banks, Sir William Watson, Dr. Garthshore, Dr. Willan, and other medical men; and in their presence, on 19th January, Woodville inoculated six patients with the pox.[107] The eruptions on the cows’ teats were diligently compared with the description and plates in Jenner’s Inquiry, and pronounced identical. Four-fifths of the 200 cows in the dairy became affected, those not in milk escaping the disease; likewise some of the milkers, the first being Sarah Rice, who had undergone smallpox in childhood—a proof that smallpox did not prevent cowpox. “At the same time,” wrote Dr. Pearson, “I received the agreeable intelligence that the disease was also raging in the largest stock of cows on the New Road, near Paddington, to which no one could gain admittance but myself.”

With cowpox thus provided in abundance, Pearson and Woodville set to work—Woodville at his Hospital, and Pearson in private practice. Be it observed, however, that this London cowpox was not Jenner’s cowpox. It was not horsegrease cowpox, but the variety stigmatised by Jenner as spurious. How Pearson and Woodville pressed forward with their enterprise appears from the following letter, enclosing cowpox threads, sent by Pearson to two hundred medical practitioners throughout the United Kingdom—

Jenner was of an indolent disposition, but the part Pearson was playing stung him to action. His nephew, Rev. G. C. Jenner, wrote to him from London, and thus roused his jealousy—

Jenner at once communicated the alarming intelligence to his friend Gardner with a sly suggestion for counter-action—

As human nature exists, it was not extraordinary that Jenner should feel anxious over the occupation of ground he considered his own; but at the same time it is obvious, that Pearson had done nothing wrong, nothing that was not allowable, nothing indeed that was not praiseworthy. He allowed Jenner full credit for having advertised the Gloucestershire faith in cowpox, and for the production of certain evidence for that faith; but he set aside Jenner’s prescription of horsegrease cowpox, and was making use of a form of cowpox that Jenner had explicitly condemned. Whilst Jenner, too, had excited curiosity, he did nothing, or could do nothing, to satisfy it; and it was idle to expect the world to await his convenience: nor was Pearson the man to rest content where action was possible. As he said—

Jenner was not slow to respond to his nephew’s summons to London. He left Berkeley on the 21st of March, and remained in town until the 11th of June, visiting medical men, asserting his own claims, and counter-acting the operations of Pearson and Woodville.

In Dr. Pearson’s circular, it will be observed, that he described inoculation with cowpox as attended with eruptions in some cases, which could not be distinguished from smallpox. So far as Pearson and Woodville were concerned, it was an unfortunate statement, and gave Jenner an advantage over them which he used unsparingly to their discredit.

Jenner’s claim for inoculation with cowpox was, that it excited a fever that was not infectious and was without pustular eruptions; and here was Dr. Pearson setting up as his critic, and Dr. Woodville assuming to develop his practice, and producing a disorder that was indistinguishable from smallpox! Such presumption and ignorance deserved to be hooted.

What was the explanation? Simply this: that Woodville conducted some of his cowpox inoculations in the variolous atmosphere of his Hospital, and that he thereby communicated smallpox and cowpox simultaneously. In a scientific sense, the experience was valuable; it proved that it was possible to have cowpox and smallpox at the same time—that neither disease superseded or nullified the other.

Woodville tried to vindicate himself, and in his failure magnified Jenner’s triumph still further. Yet he had much that was reasonable to say for himself. For example, he had transmitted to Jenner some of the virus from one of the first of his cowpox inoculations in January, and with it Jenner operated on twenty persons, reporting to Woodville—

Nevertheless, wrote Woodville—

Woodville also argued, that “Cowpox, as casually produced by milking infected cows, differs considerably from that which is the effect of inoculation”; which Jenner attested in saying—

Others maintained that the cowpox which saved milkmaids from smallpox was a much severer affection than that induced by Jenner’s lancet, and that it was folly to assume their equivalence. There was force in the argument; for every one then knew how much the issue of smallpox inoculation depended on the mode of its performance. The infection when communicated through the skin was usually much less severe than when communicated by incision; and Jenner related how a country inoculator, who liked to “cut deep enough to see a bit of fat,” was the death of his patients on every side. The human body is of infinite delicacy and complexity, and we are sure to find ourselves at fault when we deal with its mysteries according to our crude and inanimate logic. It is by experiment and not by syllogism that physiological truth is verified.

Whatever might be the perils, immediate or remote, of inoculation with cowpox, it was not attended with smallpox eruption; and at last it became manifest to Woodville himself, that the virus he had used, and the virus he had distributed, which had produced such eruption, was the virus of smallpox.

After much controversy and many experiments these conclusions were arrived at—

1. That when a person was inoculated with smallpox and cowpox about the same time, both inoculations proved effective. There was a pustular eruption on the skin from the smallpox, and the cowpox vesicle reached maturity in the usual number of days.

2. These effects took place, without much variation, in all cases where the interval between the two inoculations did not exceed a week; but—

3. When the smallpox matter was inserted on the ninth day after the inoculation with cowpox, its action seemed to be wholly precluded.[110]

That is to say, for a time—until the influence of the vaccine fever had worn off. Some fancied that smallpox when inoculated with cowpox generated a hybrid pox that was more efficacious than either. There was occasionally some interaction of the diseases, as of a subdued activity in each, but generally they proceeded together unaffected, the cowpox maintaining its characteristics in the midst of a crop of smallpox.

One point of great significance in Woodville’s experience was overlooked. He inoculated with cowpox in the Smallpox Hospital, and some of his patients there contracted smallpox, who certainly were not inoculated with smallpox, either accidentally or by design. The lesson of this experience was unperceived, and though it has been repeated again and again, is rarely acknowledged. Vaccination in presence of smallpox, or in an epidemic of smallpox, is often a means of inducing the disease it is intended to prevent. It lights the fire; and when the fire is lighted, it is said, “Ah! it must have been a-light before.” When we have a mind for an excuse, our sophistry is usually equal to the requisition.

The New Inoculation, as it was called, grew in favour daily. Woodville and Pearson did the real work of publicity and promotion—Pearson especially. Within seven months, January to August, 1799, they performed 2000 inoculations. In the Philosophical Journal, August, 1799, Pearson observed—

Nor did Pearson limit his efforts to his native land. He wrote—

Jenner regarded much of this activity with a jealous eye: it did not sufficiently make for his glory. He was anxious, fretful, helpless. “It is impossible for me, single-handed, to combat all my adversaries,” was his whine. “I am beset on all sides with snarling fellows, and so ignorant withal that they know no more of the disease they write about than the animals which generate it.” In order to keep his name to the fore, he published a second pamphlet in the spring of 1799, in which are several details of biographical interest.

This pamphlet appears to have been produced with many pains and extraordinary apprehensions. Jenner wrote to Gardner, 7th March, 1799—

These words betray excitement for which there was no warrant; and when we turn to the treatise that was to be weighed sentence by sentence in the nicest of balances, it is clearly seen that its author was a weak-minded creature. It is little more than a gossip about Cowpox without advance upon the statements of the Inquiry. Indeed, he sets out with the admission—

Sometimes when it is objected that the evidence adduced in the Inquiry was hastily collected, meagre and inconclusive, it is replied, “Yes, but recollect, it was merely a selection, if a poor one, from the author’s stores”—a reply which Jenner thus renders nugatory in recording—

Which is exactly what any perspicacious reader would infer from the cases adduced in the Inquiry. They were Jenner’s best and his all. Meanwhile, as observed, he had been able to do little in extension of the Inquiry; but if idle and helpless, Dr. Pearson had been active—

Here we have a distinct mis-statement. It was not Jenner’s “fact” that Cowpox protected the human body from Smallpox—that was a widespread superstition. His contribution to the question was a definition of the Cowpox effective against Smallpox, namely Horsegrease Cowpox, other Cowpox being adjudged spurious. Pearson so far from confirming Jenner’s position, deliberately set it aside. He not only accepted the rural faith in Cowpox (which Jenner knew to be unwarrantable), but, when he proceeded to practice, made use of Cowpox which owed nothing to Horsegrease. If therefore Pearson’s procedure was “highly flattering” to Jenner’s feelings, he was either easily pleased, or an adept in dissimulation.

The truth is, the publication of Further Observations was designed by Jenner to loosen himself from what was definite in the Inquiry, so that he might be able to appropriate whatever might result from the investigations and experiments then going on. He had defined prophylactic Cowpox as Horsegrease Cowpox, but Horsegrease did not meet with favour, nor appear likely to answer; and it might be expedient to drop it; and thus he described the ground of his attachment to that form of specific—

The boy inoculated with secondary Horsegrease was Baker, Case xviii. of the Inquiry. He died of fever in the parish workhouse before he could be subjected to the variolous test.

Jenner’s drift in the foregoing propositions was obviously to lighten his responsibility for the advocacy of Horsegrease as the origin of Cowpox; but in doing so he deprived himself of any vestige of claim as a discoverer. Cowpox and Horsegrease as preventives of Smallpox were in common repute; but their combination as Horsegrease Cowpox was supposed by some to be Jenner’s peculiar specific. “Not so,” he said. “It is the popular opinion throughout the country that Cowpox is begotten of Horsegrease;” and proceeded to justify his prescription by the popular authority. He produced a letter from Parson Moore of Chalford Hill to prove how in November, 1797, his Horse had the Grease, with which his boy-servant infected the Cow, which in turn infected the lad with Cowpox, although eighteen months before he had been inoculated, and severely too, with Smallpox; the parson adding—

To the objection that attempts to raise Cowpox from Horsegrease had, so far, proved failures, Jenner replied—

Having reached this point, I would beg the reader to pause and ask, What was Jenner’s discovery? It was not Cowpox; it was not Horsegrease; it was not Horsegrease Cowpox; all of which by his own admission were recognised by those familiar with them as preventives of Smallpox. What was it then?

Nothing is more conspicuous in the Further Observations than the condition of ignorance and imbecility they reveal. As we have seen, critics of the order of Mr. John Simon represent Jenner’s Inquiry as a Masterpiece of Medical Induction, the fruit of thirty years of incessant thought, observation and experiment; whilst the patience, the caution, and the modesty of the author are commended for imitation. Those who have been subjected to Mr. Simon’s homily cannot but suffer disenchantment when they come face to face with the facts. Not after his thirty years of asserted research could Jenner answer the simple question, What is Cowpox? Incredible as it may appear, the following was his deliverance in presence of the doubts excited by the discussion of his original communication—

Consider this declaration after thirty years of incessant thought, observation and experiment! The Masterpiece of Medical Induction with the essential fact undetermined! The discovery undiscovered! And the reputed discoverer sitting ready to appropriate any praise or profit from the execution by others of his proper business! Was there ever such an exhibition of self-satisfied futility?

Among the gossip adduced to show that the country folk called eruptions Cowpox that were not Cowpox, we learn that the affection induced by Horsegrease was thus designated—

Wherefore, he argued, many thus affected may fancy themselves secure from Smallpox, supposing they have suffered Cowpox, when they have undergone nothing but Horsegrease; and in the event of incurring Smallpox, would bring discredit on the virtue of true Cowpox. How easy it was to confound the two diseases, he illustrated from the case of William Morris, a servant, aged 32, who applied to him on 2nd April, 1798—

Thus Horsegrease sores so simulated those of Cowpox, or of Horsegrease Cowpox, as to be indistinguishable from them. At this time it was Jenner’s opinion that Horsegrease, per se, afforded no protection from Smallpox: it had to pass through the Cow to acquire its sovereign efficacy. The opinion is noteworthy in view of its absolute surrender at a later period, when the virus from the Horse’s heel came to be described by him as “the true and genuine life preserving fluid,” and was used by him for inoculation without any reference to the Cow.

One of the aims of Further Observations was “to enforce the precaution of subduing the inoculated pustule as soon as it had sufficiently produced its effect on the constitution.” True Cowpox, according to Jenner, was a serious affection. “The sores ate into the flesh.” (P. 77.) They were capable of producing violent effects. They were attended with erysipelas. “They closely resembled Smallpox of the confluent sort.” (P. 111.) To prolong such suffering he considered useless, for the virus conferred its protective influence on the constitution as soon as received—

The means for allaying the irritation were mercurial ointment, acetate of lead, caustic potash, or any suitable escharotic—

Horsegrease annoyed Pearson—it was like to damn the whole thing; and this treatment of the Cowpox pustule was scarcely less objectionable to him and to Woodville.[113] It gave the public, they thought, a sense of the virulence of Cowpox that was wholly unwarrantable; and they did not stay to consider whether what Jenner called Cowpox in Gloucestershire and what they called Cowpox in London were the same virus. Jenner’s virus was Horsegrease Cowpox; Pearson and Woodville’s was Cowpox; and such being the case, the diversity of symptoms might have been accounted for. Anyhow, the difference between Jenner and Pearson and Woodville, as to a detail so elementary, shows in what an unfinished condition the Cowpox prescription was shot upon the world, and affords a curious commentary on the Masterpiece of Medical Induction, the fruit of thirty years of incessant thought, observation and experiment. At the same time we have to do Jenner the justice of allowing that at this date, 1799, he made no pretence to a finished Masterpiece, but ingenuously ascribed the prevalent uncertainty to “the present early stage of the Cowpox Inquiry; for early,” he wrote, “it must be deemed.” (P. 115.) Early it was: not a point firmly determined: the reverse of what might have been expected after thirty years of incessant thought, observation and experiment.

Dr. Pearson was the chief actor in the formation of—

The Institution
for the Inoculation of the Vaccine Pock,
Warwick Street, Charing Cross.
Founded 2nd December, 1799.

In April, 1801, the Institution was removed to a more commodious house, 5 Golden Square. It was the first establishment of the kind in the world. In the conspectus of the Institution it was stated—

These statements are interesting as showing how early the rollicking tunes were set to which at this day we are expected to dance. The last paragraph is noteworthy as a confession under Pearson’s hand that vaccine poison had got confused with variolous, and that the mistake would henceforth be avoided. Jenner maliciously and persistently used this mishap, for which Woodville was responsible, to discredit Pearson and magnify his own pretensions; but, as Pearson observed, neither Jenner nor any one else knew that it was possible to have cowpox and smallpox simultaneously. The mistake was made, however; and, as is the function of mistakes, knowledge was enlarged. Pearson’s behaviour in the matter was as creditable to him as Jenner’s was otherwise.

The Vaccine Pock Institution was organised with a staff of physicians, surgeons, and apothecaries of the highest London respectability; and as it was desired to have the benefit of Jenner’s name (his active co-operation, as a resident in Gloucestershire, being out of the question) Pearson wrote to him—

The invitation was given stiffly, from duty more than inclination. Pearson knew very well why Jenner, furious with jealousy, had kept away from him; and he was thus answered—

Pearson’s reply to this absurd and thoroughly Jennerian letter does not appear. He might have thanked Jenner for having drawn his attention to cowpox, and have proceeded to point out that beyond that service he and his friends owed him nothing, nor in anywise admitted his guardianship. Their practice was at complete variance with his teaching. He had prescribed horsegrease cowpox in which they had no faith, having tried to produce it in vain. On the other hand, they were operating with cowpox per se, which he had condemned as useless, being attended with no erysipelas or constitutional effect; and that working with this condemned cowpox, they found themselves producing a much milder disease, and were under no necessity of following his advice and destroying the pustule formed at the point of inoculation with escharotics; adding, that if they had been bound to his horsegrease and caustics, they would have made no progress with the public whatever.

Vaccine Inoculation might be good for mankind, but it was to be something better for Edward Jenner. There was not the least reason, outside his jealousy and rapacity, why he should not have congratulated Pearson on his enterprise and promised his assistance. As to claiming the guardianship of Vaccine Inoculation, it was preposterous: it had passed wholly beyond his control. It was Pearson’s complaint that Jenner never did anything useful after the publication of The Inquiry. He left to others the discovery of virus, and the labour and responsibility of experimenting, and only appeared on the scene when there was some disaster whereat he could play the part of superior person, whilst insisting that all supposed improvements and successes should be assigned to his credit.

Jenner is all-in-all in the vaccinators’ hagiology, but he holds the place at the cost of justice to Pearson and Woodville. To prove that I am not making a fanciful assertion, let me cite unprejudiced contemporary evidence. Dr. Paterson of Montrose in a communication to the Medical and Physical Journal, dated 25th May, 1801, observed—

Here, we may observe afresh, that Pearson did not confirm Jenner’s “noble discovery.” On the contrary, his use of cowpox was at distinct variance with Jenner’s prescription of horsegrease cowpox, and with his condemnation of cowpox. Jenner, as we shall see, followed Pearson: Pearson did nothing to confirm Jenner.

Woodville lent his powerful influence as head of the Smallpox Hospital to establish the New Inoculation. He put Jenner’s prescription to the test with perfect sincerity and admirable courage, suffering himself to be thrice inoculated with horsegrease in order to come at the truth;[115] and only resorted to cowpox when he found horsegrease cowpox unattainable. Mr. Anthony Highmore, surgeon, speaking over Woodville’s grave in 1805, exclaimed—

Yet Pearson and Woodville, who made the New Inoculation practical and practicable, were pursued by Jenner with implacable animosity, stigmatising their mishaps and appropriating their apparent successes.

To publish a pamphlet for the detraction of Woodville, and if possible to upset Pearson’s Vaccine Pock Institution, Jenner left Berkeley for London on 28th January, 1800, taking Bath on his way, where also a Vaccine Pock Institution was in progress.

Early in 1800 appeared A Continuation of Facts and Observations relative to the Variolæ Vaccinæ—a quarto of 40 pages, Jenner’s third pamphlet. Like its predecessor, a trumpery collection of gossip, it was designed to manifest his advantage over Woodville, who had inadvertently confused cowpox with smallpox in his inoculations at the Hospital.

First, Jenner expressed satisfaction over the interest of Europe in Cowpox Inoculation—

He then went on to describe the accumulating mass of evidence—

“True,” Pearson might have observed, “but who inoculated the vast majority of the six thousand? Nor were they inoculated with the horsegrease cowpox you prescribed, but with the cowpox you condemned.”

The introductory reference to Woodville revealed Jenner’s disposition and tactics—

Woodville, whose experiments were as a hundred to one of his patronising critic, and informed with purpose too, must have received this languid commendation of his country acquaintance with some surprise, if not with fierier sentiment. Jenner as an investigator was never of much account. Of what constitutes scientific demonstration, he had little perception. Incapable and indolent, he nevertheless was ambitious, and had the craft to appropriate the research of others, and with assurance so ineffable that even the plundered fell under the persuasion that what he took was somehow his own. For example, the occurrence of smallpox and cowpox simultaneously in Woodville’s practice, which he had not foreseen, nor could any foresee, he first used as a pretext for lofty reprehension toward Woodville, and then converted into evidence of his own prescience, saying—

Mark the adroit oblivion and the adroit attachment. It was horsegrease that he assumed to be the origin of smallpox through cowpox; and the cowpox used by Woodville was Jenner’s condemned cowpox, underived from the horse; yet the inconvenient was passed over, and the convenient assumed!

Possibly cowpox and smallpox are forms of the same disease: possibly they are not: possibly all diseases are forms of one disease: possibly they are not: but whatever the fact, Jenner had not an iota of evidence to adduce for his conjecture that grease in horses, and pox from that grease in cows, was a modification of smallpox in men.

As we review these early days of the New Inoculation, nothing so stirs regret as what appears to have been the wilful shutting of men’s eyes to facts—to notorious facts. It was well known in Gloucestershire, that whilst the vulgar supposed that cowpox prevented smallpox, it did not do so. Indeed, it was under stress of this knowledge that Jenner rejected cowpox per se for horsegrease cowpox. In the Gloucester Journal of 9th May, 1799, Mr. C. Cooke wrote—

Yet in presence of such testimonies, which were neither examined nor exploded, Jenner prophesied in this strain—

Such was the evidence that he thought should satisfy every reasonable mind! How did he know that the said person had cowpox 53 years before, or had the right sort of cowpox, and in the right way? Inoculation with smallpox was continually unsuccessful (without reference to cowpox as cause of failure) and especially among elderly folk. When, however, there is a disposition to believe, the most indifferent reasons serve for conviction.

Cowpox and Smallpox, said Jenner, were modifications of the same disease; and Smallpox, whether contracted or inoculated, was a well-known excitant of scrofula; and Jenner was inclined to consider it probable that “the general introduction of the Smallpox into Europe had been among the most conducive means in exciting that formidable foe to health.” Then, it might be said, Cowpox as a modification of Smallpox must be liable to the like objection. “Not at all!” protested the smooth-spoken adventurer. “The diseases are the same, but unlike in the excitation of scrofula”—

Considering his limited experience, the asseveration as to the non-excitation of scrofula was sheer quackery, and of a piece with the wilder assurance that follows. In 1798 he had set forth cowpox as a useful alternative to smallpox for inoculation; but in 1800 the claim was thus magnified—

It is unnecessary to discuss these wild words—it is sufficient to record them as evidence of what it was possible to assert in the year 1800—and assert, too, whilst as yet the Cowpox that was to work the miracle was one thing in the hands of Jenner, and another in those of Pearson and Woodville!

The pamphlet published, Jenner’s other business in London was to undermine the institution for Vaccine Pock Inoculation. He went about insinuating and protesting that its founders and officers neither knew what was true Variolæ Vaccinæ, nor how to use it; that not only were they ignorant, but perverse; and that the immeasurable blessing he had been the means of conveying to mankind would never be rightly enjoyed until there was an Institution with Edward Jenner for its guide and director.

In playing this game Jenner had facilities and advantages. No one, not Pearson himself, contested his position as advertiser of the New Inoculation, and to the public he was its representative. He had attempted nothing and had no mishaps to account for: these attached to Woodville and other credulous and active experimenters.

Moreover he had no awkward information to contend with in those he addressed—they listened, were informed, were convinced. Jenner’s conduct at this juncture, in relation to Pearson and Woodville, has been stigmatised as mean, thankless, despicable. These be hard words. His tactics were the common tactics of men in whom self-love is predominant, and we have not the strength for the use of the appropriate epithets with the frequency that experience requires.

The poor were the chief sufferers from smallpox, and under the name of the poor Jenner advanced his project. He drew up the following memorandum, which he submitted to the Earl of Egremont, and circulated privately—

Then followed a scheme of the Institution, including “a Physician to be appointed to superintend the medical department.”

Whether from Jenner’s practical inefficiency, or because the time was not ripe, or because those who were more actively interested in cowpox were satisfied with Pearson’s Institution, the project lay in abeyance till 1803. He took nothing ostensibly by his intrigue save the withdrawal of the names of the Duke of York and Lord Egremont from the patronage of the existing establishment.

Meanwhile Pearson continued to operate with unabated energy, and his Institution became a recognised centre of inquiry, advice, and supply. It was designed, as he wrote, “1st, to be useful to the poor; but it had other objects, to wit, 2ndly, to ascertain the laws of the new poison for the extinction of smallpox; and 3rdly, to serve as a public office for the supply of the world with virus until supplies should become unnecessary.” One of the most flattering applications was received by Pearson from the French Consulate on 5th April, 1800. In a reply, dated 12th May, signed by the staff of the Institution, it was said—

The Frenchmen failed again with this virus, but Dr. Woodville soon after went to Paris, and effected what was desired.

Cow-Pock Dispensaries were opened in various towns throughout England, Bath and Manchester perhaps having the lead; and an Address to the Poor was drawn up as a common form to be issued from such Dispensaries. In a copy of this Address, widely circulated in and around Manchester in 1800, we read—

This manifesto is an illustration of the unscrupulous and unwarrantable assertions with which the New Inoculation was introduced to the world. There is no question that many who were active in circulating these mendacities did so honestly, justified, as they thought, by medical authority. What is marvellous is the survival of the primitive fictions to the present day. It would seem that when the human mind acquires a certain set, something like a surgical operation is requisite to reverse it.

We shall now see how the New Inoculation obtained this sudden popularity—a popularity so sudden that opposition had not time to organise itself. There were protests, and some raillery. In the Gentleman’s Magazine for August, 1799, we find a correspondent saying—

And Pearson writing in 1802, when the success of cowpox appeared secure, observed—

The House of Hanover has been reproached for indifference to literature, science and art, but an exception might be asserted on the score of variolous and vaccine inoculation. It was Caroline, Princess of Wales, who in 1721 promoted Maitland’s experiments; and Jenner found none so ready to hear and believe as George III. and his family. His first convert was the Duke of Clarence, subsequently William IV. The Duke’s surgeon happened to be Francis Knight, who had lived in Wilts and Gloucestershire, and was familiar with the country faith in cowpox, and received Jenner’s communication with a ready mind. In 1799 Knight was allowed to operate upon the Duke’s children by Mrs. Jordan, and the fact was noised abroad and passed to Jenner’s credit. Nor was the Duke’s service limited to this example. He made Jenner’s acquaintance, listened to his stories, and became his active partizan. Then the Duke of York, commander-in-chief of the army, was convinced, and enforced the new practice to the full extent of his power. He, moreover, acted as patron of the Vaccine Pock Institution until he was persuaded that Pearson, its founder, was injurious to Jenner. On 7th March, 1800, Jenner was presented to George III. at St. James’s Palace, and delivered The Inquiry bound in crimson to his majesty, who was pleased to accept the dedication of the second edition. On the 27th he had an interview with Queen Charlotte, who conversed about the new specific with all the curiosity of a grand-motherly quack. The Prince of Wales followed suit; and Jenner found himself invested with the full effulgence of the royal favour. It was a magical success; for, consider, not two years had elapsed since the publication of The Inquiry.

Jenner naturally became very popular. He wrote to Mr. Shrapnel—“I have not yet made half my calls in town, although I fag from eleven till four;” and, “Pray tell Tierney how rapidly the Cowpox is marching over the metropolis, and indeed through the whole island. The death of three children under inoculation with smallpox will probably give that practice the Brutus-stab.”

With little ability to make and maintain ground, Jenner, like many feeble folk, had the faculty of converting those he called his friends to his private advantage. He did not subdue them by will, but by weakness. Indeed, whoever chooses to observe will often have to mark with amaze how stronger natures suffer their means and energies to be appropriated by inferior organisms, and used with the thanklessness of rightful possession.

John Ring was a remarkable instance of this sort of possession. He was a surgeon in New Street, Hanover Square, London. In 1799 he entered into correspondence with Jenner, and his interest in cowpox and its advertiser developed into an enthusiasm without qualification by weariness or fear. Whatever Jenner asserted he swore to; whatever charge was brought against the New Inoculation he denied. He was ready for all comers with such voluble and hearty vigour that his outrages on propriety were laughed at and excused as “John Ring’s way.” Among his earlier services was the preparation of the Testimonial in favour of the New Inoculation which he carried from house to house and obtained the signature of nearly every London physician and surgeon of distinction. The Testimonial was published in the Medical Review and Medical Journal for July, 1800, and was reprinted in the newspapers. It ran as follows—

The first signatures comprised thirty-two physicians and forty surgeons, and the example being set, others hastened from town and country to record their adhesion. “I feel proud,” wrote Mr. Witham in sending his name, “that my little bark may, with others more illustrious,

The Testimonial had great effect on the public mind: to the majority it was irresistible. As Ring said, “It confounded the enemies of the new practice”—adding in his characteristic vernacular, “and it secured the triumph of reason over the scruples of prejudice and ignorance, and the base manœuvres of sordid and self-interested men.”[120] Thus early was it discovered that an opponent of Vaccination was an ignoramus or a rascal. Ring’s easy arrogance is concisely illustrated in this deliverance—

Jenner recognised his thorough-going supporter, and used his loyalty to strike at Pearson and others who failed to abide in like subservience. He wrote to a foreign physician—

Wonder is frequently expressed over the rapid conversion of England and the world to Vaccination, but, as I have before remarked, wonder is much reduced when we set the circumstances clearly before us. Inoculation with smallpox to avert smallpox was the practice of the time, and it was not a universal practice simply because it was troublesome and dangerous: everybody believed in the saving rite; and where evaded it was as onerous and perilous duties are always and everywhere evaded by the indolent and cowardly. Inoculation with cowpox was introduced to the public as a substitute for inoculation with smallpox, equally efficient or more efficient, and neither troublesome nor dangerous. Thus easy and seductive was the transition from the one practice to the other. Jenner had no serious battle to fight: the contest was decided in the years during which inoculation with smallpox struggled for prevalence. The warfare that subsequently cost him so much irritation was conducted by the conservatives of Inoculation, as experience revealed the inefficiency and mischiefs of Vaccination. Resistance such as is now offered to Vaccination on physiological grounds there was none, so far as I can discover. It had apparently occurred to no one that smallpox was a consequence of the transgression of the laws of health, and was preventible by submission to those laws. It was imagined that the disease came by the will of God, or the devil, or by force of fate, and that to dodge it by medical craft was the utmost that was practicable. Unless we bear in mind these conditions of the public intelligence, we shall misapprehend the demeanour of the people who so cordially welcomed Jenner’s advertisement. It is always a mistake to criticise the conduct of an earlier generation by the light of a later. We turn history to ill account when we use it to nourish our self-complacency; for the probability is that had we lived with our forefathers, we should have done exactly as they did.

Some will ask, How did it ever come to pass that so many doctors in 1800 signed Ring’s testimonial certifying that inoculation with cowpox was a sure and everlasting protection from smallpox when they had not, and could not have, any experience to warrant their assertion? True, but they had an illusory experience by which they were beguiled, namely, the Variolous Test. Hundreds were inoculated with cowpox and subsequently with smallpox, and were also exposed to smallpox contagion, and as the disease did not take, it was concluded it could never take, and that the subjects of the operation were fortified for ever. The fallacy is now manifest, but it was by no means manifest in 1800, and all manner of men received and propagated the fable with energetic sincerity. It was once admitted that a tub full of water did not overflow when a fish was slipped into it, and many explanations were current of the curious phenomenon until a sceptical spirit suggested that the experiment be tried. A like spirit might have suggested that it was expedient to wait and see whether cowpox was indeed a perpetual defence against smallpox, inasmuch as nature had an awkward habit of confuting prognostications apparently irrefragable.

The ease with which it was asserted cowpox inoculation could be performed, coupled with its harmlessness, not to say wholesomeness, and the absolute security it afforded against smallpox, induced benevolent busybodies to set up as vaccinators all over the country. What the kindly quack delights in is something cheap and handy with a touch of mystery and the promise of immeasurable advantage—conditions which the new practice completely fulfilled. The memoirs of the time, especially of the Evangelical party, abound with instances in which this good soul and that good soul had vaccinated so many hundreds or thousands, delivering them from the peril of an awful disease. Thus in the Gentleman’s Magazine, for December, 1800, we read—

And John Ring relates—

Of course medical practitioners had little favour for this sort of intrusion into their domain, but Jenner encouraged and boasted himself in the domestic diffusion of the discovery. By and by when disasters became common it was found extremely convenient to ascribe them to these unskilled operators; and ultimately vaccination was resigned entirely to the legally qualified practitioner, whose failures are rarely inquired into, and when proclaimed are, as professional matter of course, explicitly denied.

Jenner after six months of lionising left London on 23rd June, 1800, and on his way home passed through Oxford where he was introduced to Dr. Marlow, Vice-Chancellor of the University, and other dignitaries, who subscribed the following testimonial, drawn up by Sir Christopher Pegge, Reader in Anatomy—

When a prophet in the country turns out a prophet in London his country neighbours begin to believe in him; and thus it was with Jenner. His metropolitan reputation was reflected in Gloucestershire. Earl Berkeley wrote to the Duke of Beaufort—

And the sense of this obligation took shape in a service of plate presented in 1801 and bearing this inscription—

Presented by

THE NOBILITY AND GENTRY OF

THE COUNTY OF GLOUCESTERSHIRE

To their Countryman

EDWARD JENNER, M.D., F.R.S.

As a Testimony of the high sense they entertain of those
Eminent Abilities which discovered and that
Disinterested Philanthropy which
promulgated

THE VACCINE INOCULATION.

Honour was abundant, but honour is windy fare, and Jenner had an eye for something more substantial. Among his papers we read—

But how was the fond hope of enjoying independence to be realised? The question was discussed by Jenner and his friends, and it was finally decided to apply to the House of Commons for a reward. But in order to go to Parliament it was necessary to have a good case, and Jenner’s case was open to various objections. The Inquiry, published in 1798, was by no means a manual of practice. Its prescription was Horsegrease Cowpox; but such Cowpox was neither producible nor accounted tolerable. Cowpox that did not originate in Horsegrease, Jenner had adjudged spurious; and yet such spurious Cowpox had been adopted by Pearson and Woodville, and under their influence had obtained extraordinary popularity. It was therefore by no means improbable that any claim for cash wherewith to enjoy independence might be seriously contested. In this strait, what was to be done? The question was a grave one, and called for a heroic solution. Resolved therefore, that Horsegrease Cowpox be dropped, and with it the use of escharotics for the subjugation of the pustules produced thereby. Absolute silence should thenceforth be his rule as to Horsegrease. So much for the negative position: the positive was more difficult. To claim Cowpox as his own, with the modes of its exhibition devised by Pearson, was an evolution full of hazard, but unless prepared to surrender “the fond hope of enjoying independence,” it must be effected. He had advantages. His name was associated with the new practice: even Pearson had done him homage: neither the medical profession nor the public were likely to study the Inquiry critically, or to trouble their heads over obscure details: Cowpox was to them Cowpox: he had the world’s ear; and opposition would be set down as the ordinary behaviour of envy toward success. Anyhow the transformation must be attempted: otherwise, farewell to dreams of financial independence.

To initiate this transformation, Jenner came to London, and in May, 1801, published a quarto pamphlet of twelve pages, entitled The Origin of the Vaccine Inoculation.

First it was necessary to represent that his investigations had extended over many years—a fact of which there was no sign in the Inquiry, the evidence indeed being distinctly otherwise; and thus he shaped his statement—

Jenner’s design in the foregoing statement was manifest. It was to minimise the faith of the country folk, and to represent that by his own perspicacity he had discovered the virtue of Cowpox through his failures to inoculate with Smallpox. The inquiries of Pearson and others, however, showed conclusively that in many parts of the south of England, in Ireland, and on the Continent it was believed that to have suffered from Cowpox was to be secure from Smallpox; and the belief was entertained altogether independently of failures to inoculate with Smallpox; just as a similar belief prevailed among farriers as to the prophylaxy of Horsegrease. The faith in Cowpox was neither vague, nor new, nor confined to Jenner’s neighbourhood; and his assertion to the contrary showed with what hardihood he had undertaken to construct a case in his own favour.

In opposition to the rural faith, medical men maintained that it was possible to have Smallpox after Cowpox; and surgeons averred that they had successfully inoculated many who had suffered Cowpox. Indeed it was indubitable professional testimony to this effect that compelled Jenner to forsake his first fancy for Cowpox, and to report the true specific as Horsegrease Cowpox. Having, however, to sacrifice that discovery, and revert to the Cowpox he had discredited, a fresh manœuvre was requisite; and thus was it performed—

Here we have the trick before us at the very point of transformation. He consulted with medical practitioners, “who all agreed that Cowpox was not to be relied upon as a certain preventive of Smallpox.” True. What did he do next? He discovered that what Cowpox did not prevent, the variety derived from Horsegrease did. Such was the original revelation of 1798. In 1801 we have a different story, and his quest a different issue. Not a word about the discovery of the sure preventive in Horsegrease Cowpox—not one word! Although his ardour was damped by the medical evidence against Cowpox, he yet prosecuted his inquiry; and to his satisfaction ascertained that what the milkers called Cowpox was not always Cowpox, but that any sores whatever derived from the Cow were so designated. He therefore was led to form a distinction between the diseases, and to denominate one as true and the others as spurious Cowpox.

Thus the Horse, the obnoxious Horse, was got rid of, and the Cow represented as of herself yielding pox, which pox was the Cowpox that Pearson and Woodville (in contempt of Jenner’s 1798 revelation) had brought into fashion; and which it had become all essential for Jenner to claim as his own in order to realise his “fond hope of enjoying independence.”

In this connection the question occurs, Why should “some varieties of spontaneous eruptions” have been designated spurious Cowpox? Such eruptions were not Cowpox in any sense. Why then spurious? That Cows communicated a variety of sores to their milkers, described by them in common as Cowpox, was an assertion for which Jenner never adduced any evidence; which, too, (as we shall see) at a later date he disowned as a misapprehension. Nevertheless spurious Cowpox got the New Inoculation over many difficulties. When Smallpox, or any notable mischief, followed Cowpox it was said, “Ah! the Cowpox must have been spurious; for Smallpox, or any harm, is impossible after true Cowpox.” People did not stay to inquire whether spurious Cowpox (that was to say, matter “from a variety of sores on the Cow,” according to Jenner’s second version) could be propagated from arm-to-arm, even if taken from the Cow by mistake. The illusory Variolous Test and the Spurious Cowpox Dodge worked marvellously for the public deception.

Another point Jenner tried to score at the cost of Pearson and Woodville. When they began to inoculate they found they had to ascertain at what period the virus should be taken from the Cow, and from the arms of the inoculated. Jenner afforded them no guidance. Writing to John Ring, 1st July, 1801, he confessed—

Where Jenner had not learned to discriminate, the line became clear in the course of general practice; and Pearson was especially explicit as to the right time for taking virus; but to make good his claim to national consideration, Jenner fancied it necessary to exhibit himself as complete master of the art of Cowpox Inoculation, owing nothing to others; and he therefore proceeded to appropriate the fruit of the common medical experience, assigning it to a season when he alone was in the field. Referring to his separation of true from spurious Cowpox, he thus prosecuted his raid—

No one apparently thought it worth while to expose the fictitious character of these statements, invented by Jenner to justify his pretensions and to baffle objections. Any careful reader of the Inquiry of 1798, and the Origin of Vaccine Inoculation of 1801, cannot fail to perceive the radical inconsistency of the earlier and later narratives, and how a few hasty experiments enveloped in unverifiable conjecture and gossip, came to be magnified into years of arduous research.

He wound up his statement with this flourish and prediction—

For the end designed—to establish and exalt a claim with the purpose of exacting corresponding recompense, the Origin of the Vaccine Inoculation was an adroitly drawn document: its veracity is a different matter. A just man, not to say a generous, would have had some praise for Pearson, Woodville, and others to whom the extension of the New Inoculation was due; but Jenner was essentially a mean spirit; and for him to have stated his case truly would have been to jeopardise “the fond hope of enjoying independence.”

Jenner was timid and indolent, and, though eager for reward, required much prompting to use the means to the end on which his heart was set. He wrote to Lord Sherborne to speak for him to Prime Minister Addington; but Sherborne replied, 23rd April, 1801, that he did not know Addington even by sight. He would however try to see Mr. Pitt, adding for encouragement and direction—

Action had to be taken, and on 9th December, 1801, Jenner went to London to prepare a petition to the House of Commons and to canvass for support. Even at the last moment, Wilberforce had to warn him, 24th February, 1802, that no time was to be lost, or he would lose his chance for the year. After prolonged consultation with those accustomed to such business, the petition was got ready, and on 17th March, 1802, it was presented to the House of Commons.

Patriot Grattan asked for £100,000, was awarded £50,000, and took £47,500: “true patriot Jenner deserves more,” said Lord Sherborne; but Jenner had not courage for the demand. What, however, was undefined in cash was made up for in pretension.

As we read Jenner’s petition we note (1) the Discovery; (2) its Disclosure and Diffusion; (3) the Expense thereby incurred; and (4) the Prophecies; and under these heads it is to be observed—

1.—It was no discovery of Jenner’s that cowpox was inoculable and preventive of smallpox. That was a rural superstition. Nor, be it again repeated, did he ever become responsible for that rural superstition. Recognising its futility, he deliberately set it aside, and recommended a disease of the horse, transmitted through the cow, for inoculation. It was Pearson, who disliking Jenner’s prescription, brought cowpox into vogue; whereon Jenner, fearing that he might be cut out of the enterprise, dropped his specific, adopted the cowpox he had rejected, and claimed Pearson’s work as the development of his own.

2.—That he disclosed his discovery was true, but it was not the discovery set forth in the petition. Moreover the merit of disclosure in such a case is measured by the advantage of concealment; and what could Jenner have taken by concealment? The conditions of successful quackery were not present in the secret practice of inoculation with horsegrease cowpox.

3.—That the discovery occupied a considerable portion of Jenner’s life, and was attended with great expense and loss of practice, is answered by reference to his Inquiry. With what loss of time, loss of money, and loss of practice could the series of cases therein set forth have been attended? And after 1798, he confessed he was able to achieve little further.

4.—As for the prophecies about the absolute security afforded by cowpox with the final extermination of smallpox, we may estimate the worth of such vapouring by the asserted check at that time, 1801, administered to the disease, when as yet an insignificant fraction of the population had been subjected to the New Inoculation, and a fraction, too, least likely to suffer from smallpox.

Petitions are petitions, and not designed for over-much scrutiny. In them truth is rarely to be looked for otherwise than warped to personal ends. The policy of a petition is to claim in excess with a view to obtain a larger concession. Jenner’s petition was a more than usually flagrant instance of this policy, with the disadvantage that much of its untruth passed into currency as matter of fact.

The Prime Minister, Mr. Addington (afterwards Viscount Sidmouth), informed the House that he had taken the King’s pleasure on the contents of the petition, and that his Majesty recommended it strongly to the consideration of Parliament. It was referred to a committee, of which Admiral Berkeley, a zealous believer in Jenner, was appointed chairman. The points to which the committee chiefly directed their inquiries were—

I.—The utility of the discovery itself.

II.—The right of the petitioner to the discovery.

III.—The sacrifices of the petitioner in making the discovery.

As an investigation the work of the Committee was illusory. The points were decided in the petitioner’s favour from the outset. There was no opposition. Dr. Moseley, Mr. Birch, and Dr. Rowley, who became active opponents of the New Inoculation, were summoned, but the matter was new to them; they had not had time to collect evidence and formulate conclusions: a rite that was to protect for a lifetime and to annihilate smallpox, announced in 1798, was to be adjudicated upon in 1802! On the other hand, Jenner’s friends were influential and active, and used the opportunity to parade their whole strength in his favour. The medical testimony especially was unreserved and enthusiastic.

Dr. James Sims, president of the London Medical Society, laid before the Committee a unanimous resolution of the Society in Jenner’s favour. He said he was at first adverse to Vaccine Inoculation, but his confidence in it was increasing every hour. It introduced no other disease to the human frame, whilst it made an end of the possibility of smallpox, a disease that proved fatal to one in six of those it attacked. He had never heard of Cowpox before the publication of The Inquiry, and regarded the discovery therein communicated as the most useful ever made in medicine. If Jenner had kept and traded on his secret, he might have become the richest man in the kingdom.

Sir Gilbert Blane related how the New Inoculation had been introduced to the Navy. He had had the men on board the Kent, man-of-war, inoculated with cowpox, and then with smallpox, and not one took the latter disease. Of every thousand deaths in the country, smallpox was accountable for ninety-five. Taking London as the standard, 45,000 must perish annually from smallpox in the United Kingdom. As soon as the preventive discovered by Jenner became universal that large mortality would cease.

Dr. Lettsom, a popular physician, a member of the Society of Friends, and an enthusiastic supporter of Jenner, said he had paid much attention to smallpox statistics. Taking London and the out-parishes as containing nearly 1,000,000 inhabitants, he calculated that eight a day, or 3000 annually died of smallpox. Allowing Great Britain and Ireland to have a population of 12,000,000, that would give a mortality of not less than 36,000 per annum from smallpox. He had reason to conclude that about 60,000 persons had undergone the New Inoculation up to date. He did not think that the genuine cowpox when inoculated could ever prove fatal. Had Jenner kept his remedy secret he might have derived immense pecuniary profits from it, as did the Suttons by their improved practice of variolous inoculation.

Asked whether he had known any inoculated with smallpox subsequently contract smallpox, he replied that he had two relatives inoculated who afterwards had smallpox, and one of them died. He had recently attended two families, in each of which a child inoculated was laid up a year after the operation with smallpox.

Dr. Woodville, forgiving Jenner’s evil treatment, came, like a good Friend, to bear witness to the new practice. He had learnt to prefer vaccine to variolous inoculation at the Hospital. He had, up to January, 1802, operated with cowpox on 7,500 patients. About half of them had been subjected to the Variolous Test with satisfactory results.

Dr. Bradley, physician to the Westminster Hospital, said he looked on Jenner as the author of Vaccine Inoculation, and believed no medical man doubted it. As accidental inoculation with cowpox was proved to keep off smallpox for life, it was matter of course that intentional inoculation would do so also. Not less than 2,000,000 of persons had received Vaccine Inoculation, and he had never known an instance of any one dying of it. One in 300 died of smallpox inoculation in England, and not less than one in 150 throughout the rest of Europe, Asia, Africa and America. Had Jenner settled in London he might have made £10,000 per annum for the first five years, and double that sum afterwards.

Sir Walter Farquhar, physician to the Prince of Wales, had told Jenner that if he had come to London and kept his secret, he would have ensured him £10,000 a year. He had however divulged his secret and lost all chance of emolument. His remedy was a permanent security against smallpox, and had never proved fatal; whilst variolous inoculation, performed in the best manner, cost one life in three hundred.

Mr. Cline, surgeon to St. Thomas’s Hospital, corroborated the opinion that Jenner could have earned £10,000 a year in London by means of his secret. As smallpox was the most destructive of all diseases, its suppression was the greatest discovery ever made in the practice of physic.

Mr. John Griffiths, surgeon to the Queen’s Household and St. George’s Hospital, had inoculated upwards of 1500 persons with cowpox without any untoward symptoms.

Mr. James Simpson, surgeon to the Surrey Dispensary, had inoculated between fifty and sixty without any injury. Considered them perfectly secure from smallpox. A child of nine months covered with crusta lactea resisted all the usual remedies, but on the tenth day after he had inoculated it with cowpox, the crust began to disappear, and the twelfth day was entirely gone.

Dr. Joseph Marshall related his experience as a vaccine inoculator in the Navy and at Gibraltar, Malta, Palermo, Naples, Rome and Genoa. Everywhere was successful. Believed he had operated on 10,000, and never witnessed any ill consequences whatever. On the contrary, children in a weak state of health, after passing through the vaccine infection, began to thrive and become vigorous.

Mr. John Addington, surgeon, had used Jenner’s remedy since 1799 in eighty-one cases. One third of these he had inoculated with smallpox, and subjected to every method of infection he could devise, but found them perfectly proof against the disease.

Dr. Skey, physician to the Worcester Hospital, testified that in the spring of 1801 smallpox was epidemic in Worcester. He inoculated a number of children with cowpox, and none of them took smallpox although constantly exposed to contagion.

Dr. Thornton, physician to the Marylebone Dispensary, had inoculated a patient with cowpox, and afterwards with smallpox at twelve different times during the past three years without effect. He had even slept with a person in natural smallpox, who died, but took no harm. When at Lord Lonsdale’s in the North he had operated on upwards of a thousand, and had completely satisfied himself, and all the medical practitioners in that part of England, that cowpox was a mild disease, hardly deserving the name of a disease. It was not contagious; it never disfigured the person, never produced blindness, nor excited other diseases. It was equally safe whether during the period of pregnancy, or the earliest infancy, or extreme old age.

Dr. Baillie then gave his influential judgment. He thought cowpox an extremely mild disease, and when a patient had properly undergone it, he was perfectly secure from the future infection of smallpox: and further, if Dr. Jenner had not chosen openly and honourably to explain to the public all he knew upon the subject, he might have acquired a considerable fortune. In his opinion it was the most important discovery ever made in medicine.

Mr. David Taylor, surgeon of Wootton-under-Edge, had inoculated about two thousand persons with cowpox without a single failure, nor had he met with any ulcerations, tumours, or other diseases following the operation. He knew Jenner’s practice in Gloucestershire. It was in a very populous neighbourhood where there was not another physician within sixteen miles. He had surrendered an income of £600 a year to devote himself to the public service.

As a final specimen of this medical evidence I may cite Mr. John Ring, the petitioner’s henchman. He considered Jenner the author of Vaccine Inoculation, a discovery the most valuable and important ever made by man. It was a perfect and permanent security against smallpox. He had himself inoculated about 1200, of whom a thousand had exposed themselves to smallpox infection with impunity. There was no danger whatever from the New Inoculation unless from ignorance and neglect. One in every hundred inoculated with smallpox in London died, owing to the unwholesome atmosphere and the necessity of operating on children at an improper age. If Jenner had kept his discovery to himself he might have made £10,000 a year by it; for others had got as much or more by the practice of physic.

This evidence, better than any secondary description, will enable the reader to appreciate the prevalent furore as it affected the leaders of the medical world. At the same time it is to be borne in mind that the craze was superficial. Any radical change in conviction or practice is never accomplished thus easily or thus rapidly. The medical men who bore witness for cowpox had been bred to inoculation with smallpox, for which cowpox was substituted. The change was essentially trivial. The trouble, the danger, and the uncertainty of variolous inoculation were generally recognised, and when cowpox was recommended as a mild form of smallpox, it was not difficult to appreciate the asserted advantage: for, as it was argued, no one can have smallpox twice, and as the mildest attack of smallpox is as prohibitive of a second attack as the severest, therefore cowpox (which is smallpox in mild form) must protect as effectually when inoculated. With logic so admirable, it was in nowise wonderful that so many were carried away; but unfortunately, as so often happens, matter-of-fact did not correspond to the admirable logic.

The Duke of Clarence testified that he had availed himself of Jenner’s discovery from the outset. His children, his household and farm servants were all protected. A postillion positively refused to be operated on, and eighteen months after he caught smallpox in the most virulent form. Children who had undergone cowpox were constantly in the room where the lad lay and suffered no harm.

The Earl of Berkeley had his son inoculated with cowpox by Dr. Jenner at the age of six months. One of his maid-servants took smallpox and died, and the effluvia during her illness was so offensive that his servants had to move to another part of the house. To test the reality of his son’s protection, he sent for Jenner, and got him to inoculate the boy with pox from the maid. The child was found to be proof, for the inoculation had no effect—To illustrate the validity of the Gloucestershire tradition, he related how a man of 72 in his service had caught cowpox when a boy of 15 whilst milking, and in consequence always reckoned himself secure from smallpox, exposing himself to the disease with complete indifference.

Lord Rous gave similar evidence. His child had been inoculated with cowpox at the age of three months, and he was perfectly satisfied that he could never have smallpox.

Then there were lay practitioners, of whom Jenner’s nephew, the Rev. G. C. Jenner, may be taken as an example. He bore witness that he had inoculated 3000 with cowpox without a single unfavourable case, from the earliest infancy to eighty years of age, and under circumstances in which it would not be prudent to use variolous virus; as, for example, children during teething and women in every stage of pregnancy. Upwards of two hundred of his patients had been afterwards inoculated with smallpox matter, and an equal number exposed to variolous effluvia, and in no instance did smallpox ensue. He was satisfied that as soon as the new practice became universal, smallpox would be annihilated.

An early date being wanted for “the discovery,” Edward Gardner, wine and spirit dealer, was brought from Gloucester to affirm that he had known Jenner for more than twenty-two years, and had been in the constant habit of hearing his medical opinions and discoveries. It was in the month of May, 1780, that Jenner first informed him concerning the nature of cowpox as a sure preventive of smallpox, and of the theory he had formed on the subject; declaring his full and perfect confidence that the virus might be continued in perpetuity from one human being to another until smallpox was extinguished.

It is needless to stigmatise Gardner’s testimony afresh. It possibly had its foundation in Jenner discussing the familiar rural faith in cowpox. Sir Everard Home mentioned to the Committee that Jenner had brought a drawing to London in 1788 of Variolæ Vaccinæ as it appeared on the finger of a milker, and had shown it to John Hunter, who advised him to look further into the matter; but it was not pretended that he spoke to Hunter of the matured conviction revealed to Gardner eight years before.

The Committee heard evidence as to the knowledge and use of cowpox apart from Jenner, and their verdict was given as follows—

Thus the Committee disallowed Jenner’s claim, whilst indicating the only colourable point of novelty, namely, the transfer from arm to arm of virus. At the same time, it should not be forgotten that inoculation from arm to arm with “mild kinds of smallpox” was an existing practice, and there was little merit to speak of in Jenner doing the same thing with horse or cowpox.

There was no opposition—no devil’s advocate; but it may be held that Dr. Pearson assumed that office. He was heard with impatience, and afterwards delivered his mind in An Examination, to which we shall presently refer.

The Report to the House was brought up on the 2nd of June, 1802, and was conclusive as to the utility of the discovery. Indeed, the evidence on that head was only cut short because it threatened to be interminable. The judgment of the Committee reiterated the common persuasion—“As soon as the New Inoculation becomes universal, it must absolutely extinguish one of the most destructive disorders by which the human race has been visited.”

Admiral Berkeley, chairman of the Committee, commended the Report to the House. He considered the discovery as unquestionably the greatest ever made for the preservation of the human species. It was proved that in the United Kingdom 45,000 perished annually from smallpox; but throughout the world what was the desolation! Not a second struck but a victim was sacrificed at the altar of that most horrible of diseases. He should therefore move that a sum of not less than £10,000 be granted to the Petitioner, but if the House thought fit to adopt any larger sum, he should hold himself free to vote for it. Why, Dr. Jenner’s expenses in postage alone had been from 25s. to 30s. a day!

Sir Henry Mildmay did not think £10,000 at all adequate. Had Jenner kept his secret he might have made at least £100,000. He moved that he should have £20,000.

Mr. Windham said the petitioner had surrendered his discovery to his country, and was therefore entitled to remuneration. The discovery had been the labour of years and the fruit of extensive practice.

Sir James Sinclair Erskine was assured that Jenner had expended £6000 in the propagation of his discovery, and if he had £10,000, he would be left with no more than £4000. Besides, he had given up a practice of £600 a year to benefit his fellow-creatures.

Mr. Courtney observed that the evidence showed that 40,000 men would be annually preserved to the State by the New Inoculation. These would return £200,000 a year to the Exchequer, and if the Petitioner had only a tithe of that sum for one year, he was entitled to £20,000.

Mr. Wilberforce stated that Jenner had spent upwards of twenty years in completing his discovery. He was no adventurer seeking to push himself before the world. He had already attained to great celebrity in his profession, and had sacrificed his practice for the public good. In every view he thought the larger sum ought to be granted.

Mr. Grey thought £10,000 would be no more than an indemnity for expenses. He hoped the House would vote for £20,000.

Mr. Banks said there was no question as to the utility of the discovery. If he felt more niggardly than other members, it was because his paramount duty consisted in guarding the public purse. That purse was a large one, but it was not to be dipped into at pleasure. The strength of the country lay in economy and sound finance. He did not see that a case had been made out for so large a sum as £10,000. The discovery itself might be trusted to pay its author. He always looked on a Report of a Committee with jealousy, for it was controlled by the friends of the Petitioner, and there was no one with sufficient motive to provide the correctives required in the public interest.

Mr. Addington, Chancellor of the Exchequer, held that the value of the discovery was without example, and beyond calculation. So much, indeed, was not contested. The Petitioner had received the highest reward in the approbation, the unanimous approbation of the House; an approbation richly deserved, since it was the result of the greatest discovery since the creation of man. Whatever money the House might see fit to vote on some future occasion, his present duty was to recommend the smaller sum of £10,000. In doing so, he admitted, he surrendered his private inclination to his sense of public duty. He had, however, the satisfaction in knowing that this discussion had conferred on Dr. Jenner a reward that would endure for ever, whilst the comfort of his family would be amply ensured in the extension of practice that would follow the approbation of the House.

The question was then put that the words £10,000 do stand part of the resolution; when the Committee divided—Ayes 59, Noes 56, Majority 3.

The discussion in the House of Commons shows how wide was the general craze. Facts and figures were evolved at discretion and repeated indiscriminately. To rave about Jenner, the saviour from smallpox, was the mode. It was as if all had consented to go mad together. Mr. Dunning, a surgeon, otherwise rational, broke into prophetic fury—

Considering the value set on “the great discovery,” the award of £10,000 was not excessive. In the Medical Journal it stands recorded—

On the other hand, it is to be remembered that the times were dark and hard, cruelly hard, through war and scanty harvests; the quartern loaf selling at 1s. 11d., a significant index of the people’s misery.

A few weeks after the award of £10,000 to Jenner by the House of Commons, Dr. Pearson published An Examination of the report of the committee. He did not contest Jenner’s claim to consideration, but the ground on which it was advanced, and on which it was conceded; drawing attention to the manner in which the claims set forth in Jenner’s petition had been reduced to “inoculation from one human being to another,” whilst a new claim was invented for him, “to wit, the mode of transferring, indefinitely, the vaccine matter without any diminution of its specific power.”

What Pearson held, and rightly held, was, that the public acceptance of the New Inoculation was due to Woodville and himself, and not to Jenner—

Pearson also claimed to have cleared away difficulties created by Jenner’s statements, some of which were most prejudicial to the public acceptance of the New Inoculation—

One can only say of these statements of Pearson as against Jenner, that they are simple matters of fact, impugn them whoso list. It is impossible to controvert Pearson’s assertion—

They had to find out for themselves when to take virus from the cow, how to preserve it when taken, how to dress inoculated arms, when to take virus from the arm, and, in short, to do everything that constitutes the difference between a suggestion and an art.

Pearson, too, as we have seen, had a leading part in the formation of the first Institution for the Inoculation of the Vaccine Pock, with which Jenner had not only nothing to do, but would have nothing to do: concerning which wrote Pearson—

As to Jenner keeping the secret of Cowpox and making a great fortune out of it, Pearson replied, first, that he had not proved his remedy; second, that he would have had to persuade the public to believe in him; and, third, that too much was known about Cowpox to have made a secret possible. Moreover, the assertion that he might have earned £10,000 a year and a fortune of £150,000 was absurd—

When it was further said, that experiments in Vaccine Inoculation had occupied twenty years of Jenner’s life, that they had cost him £6000, and that he had surrendered a practice of £600 a year in the populous neighbourhood of Berkeley for the public benefit—he would not trust himself to characterise the allegations.

His own position, Pearson thus defined—

Pearson further indicated on what conditions he would have been satisfied to see Jenner rewarded—

Whilst willing that Jenner should be rewarded, for Woodville and for himself, Pearson wanted nothing: he simply maintained that the judgment of the House of Commons Committee should have recognised the facts of the situation. He observed—

Considering the injustice to which Pearson had been subjected, and the provocation he had received, it is impossible to refrain from admiration of the serene and impartial temper in which he composed his Examination. Had he sat as judge between Jenner and himself, he could not have stated the case with greater accuracy and absence of bias. He fell into no exaggeration; he indulged in no sarcasm; he descended to no abuse. He set forth the incidents of the New Inoculation with the imperial simplicity and dignity of truth. Where others had gone crazed, he preserved some degree of sanity. He held it to be premature to proclaim the extinction of Smallpox, or to say with Jenner that reports of failure and injury from inoculated Cowpox were beneath contempt. It was only time and experience that could warrant such absolute assertion and prediction.

It is said that in hurricanes of panic or enthusiasm, wise men go home and keep quiet until the sky clears, resistance being folly. For immediate effect resistance may be folly, but the protest of truth is sometimes imperative, whatever the disposition of the mob. Pearson took little at the time by his Examination: it entered into far too many details for general apprehension; and it was convenient to account for his opposition as due to jealousy and envy. Jenner attempted no reply, and assumed profound disdain. His silence was judicious, but it was not from disdain.

At this day it is easy to see that Pearson as against Jenner played his part badly, failing to recognise his proper advantage. Jenner’s prescription in the Inquiry of 1798 was not Cowpox. It was Horsegrease Cowpox. It was a disease of the horse inoculated on the cow. Cowpox per se he expressly rejected as useless, having no specific effect on the human constitution. Pearson and Woodville entertained Jenner’s prescription in good faith. They tried to generate pox on the cow with grease from the horse, but did not succeed. Reluctantly they abandoned Jenner’s prescription, and resorted to Cowpox.

Whilst Pearson and Woodville were without prejudice against Horsegrease Cowpox, it was otherwise with the public. The origin of Cowpox in Horsegrease was voted detestable, and had the origin been maintained, it is not improbable that the New Inoculation would have proved abortive.

This difficulty Pearson and Woodville, the chief promoters of the New Inoculation, cleared away. They had tried Horsegrease; they considered they had disproved Jenner’s assertion concerning it; and they were able to assure the public that they inoculated with Cowpox, and nothing but Cowpox, and had no connection with Horsegrease whatever. The public were satisfied; and Inoculation with Cowpox became the rage, fashionable and philanthropic.

What did Jenner do? Did he vindicate his prescription, the fruit of thirty years of incessant thought, observation and experiment? He did not. On the contrary he dropped it. He said not another word about it; and proceeded to claim Cowpox as employed by Pearson and Woodville as his discovery. In his petition to Parliament there was no mention of Horsegrease Cowpox; but Cowpox, with “its beneficial effect of rendering the persons inoculated therewith perfectly secure through life from the infection of Smallpox,” was set forth as the result of his most attentive and laborious investigation at the sacrifice of time, money, and professional advancement. We have to recollect that Jenner was inspired with what he called “the fond hope of enjoying independence,” and he was not slow to recognise, that if he stood by Horsegrease Cowpox his “fond hope” would be wrecked. The statement may seem incredible, but the fact of the transformation is manifest at large to any one who will take the trouble to compare Jenner’s Inquiry of 1798 with his Petition to the House of Commons in 1802.

Pearson failed to arrest the imposture. He might have said to Jenner, “Your discovery was not Cowpox: that was well known to every dairymaid in your neighbourhood. Your prescription was Horsegrease Cowpox. You condemned Cowpox, which Cowpox has nevertheless been brought into use by Woodville and me. Keep to your Horsegrease Cowpox; make what you can of it; and leave us alone.”

Had Pearson taken this course, he would have fixed Jenner to his discovery, such as it was, and have clearly defined and established his own and Woodville’s service in rendering the New Inoculation practicable and popular. But he failed to draw a firm line between Woodville and himself and Jenner, and to insist that they were operating, not only with a different pox, but with a form of pox by him rejected as useless. Through this default, he enabled Jenner to intrude into a province that was not his own, and to reap where he had not sown, and gather where he had not strawed. It is to be admitted that the facts as stated were all involved in Pearson’s Examination, but they were involved, and required picking out and sharper definition to give them effect. Truth is truth, but truth to have its rightful influence has to be made plain. It is of little avail to have a good cause at law if the means are wanting to place its goodness manifest and paramount over contention to the contrary.

This, too, may be observed: Pearson was not in condition to offer the manner of resistance specified. To have turned Jenner’s flank, it would have been necessary to discredit Cowpox; and Pearson was committed to Cowpox. Jenner had been familiar from youth with the dairymaids’ faith in Cowpox. Why then did he not advertise its virtue? Because it had been proved to him that the dairymaids’ confidence was illusory. His recommendation of Horsegrease Cowpox attested his distrust in Cowpox. If Pearson had asked himself, What induced Jenner to set aside Cowpox for Horsegrease Cowpox? the answer would have revealed to him a whole series of facts to the discredit of that prophylaxy of which he and Woodville had constituted themselves advocates. Thus, fettered by his own prepossession, Pearson was unable to deal effectually with Jenner without incurring a disenchantment fatal to his own enterprise.

When we recognise that Jenner’s prescription was a disease of the horse communicated to the cow, which Pearson and Woodville set aside for Cowpox, the controversy as to the originator of the use of Cowpox for inoculation loses significance. We have to assert peremptorily that Jenner had no claim to the use of Cowpox whatever. It is true that he advanced the claim in his Origin of the Vaccine Inoculation in 1801, and in his Petition to Parliament in 1802; but those who refer to his Inquiry of 1798 will require no further proof of his mendacity. That his claim to the use of Cowpox was entertained can only be ascribed to that indolence, ineptitude and ignorance on the part of the world whereon quacks presume and prosper.

It was Pearson and Woodville, I once more repeat, who diffused and popularised Cowpox; and Pearson’s inquiries left no doubt that the faith in Cowpox as a preventive of Smallpox was widely entertained; and that the substitution of Cowpox for Smallpox in inoculation was a mere question of time and accident. Mr. Downe of Bridport informed Pearson that a surgeon in his neighbourhood suffered discredit in practice because it was reported that he inoculated with Cowpox instead of Smallpox; and the papers of Mr. Nash, surgeon, of Shaftesbury proved that in 1781 he had the project of Cowpox Inoculation distinctly before him. The evidence of Benjamin Jesty, farmer of Downshay in the Isle of Purbeck, has usually been taken as most conclusive in relation to the immanence of the New Inoculation in the common mind. Jesty was invited to London by the conductors of the Original Vaccine Pock Institution, 44 Broad Street, Golden Square; and in August, 1805, they had him with his wife and two sons under examination. In their report[130] it is said—

It is to be observed that insusceptibility to Smallpox was by no means infrequent apart from Cowpox; and as fear of Smallpox predisposes to attack, so, on the other hand, confidence in security, whether by Cowpox or other charm, would tend to exemption.

Jesty’s reasons for his experiment were thus specified—

In these reasons we have the Cowpox doctrine as prevalent in Dorsetshire, which Jesty developed in family practice. The report proceeds—

It is curious how evidence conforms to prepossession. Dr. Pearson and his associates were persuaded that as no one could have Smallpox twice, neither could any one have Cowpox twice. Jesty had Cowpox when young, and when at three score they found him insusceptible, they took it for granted that re-vaccination was impossible. Robert Jesty, who had Cowpox thirty-one years before was at the same time inoculated with Smallpox, and as that likewise failed to take, the experiment enforced the desired conclusion.

Having turned out so well, praise and portraiture were bestowed on Jesty—

In the church-yard of Worth Matravers, Dorset, there is a grave-stone with this inscription—

Jesty is frequently played off against Jenner, as having anticipated him, but under a misapprehension. Jesty inoculated with Cowpox, sharing the dairymaids’ faith that it prevented Smallpox. Jenner knew that the dairymaids were wrong, and that Cowpox did not avert Smallpox. What he recommended was Cowpox produced by Horsegrease. Pearson and Woodville disregarded Jenner’s recommendation and made use of Cowpox like Jesty, which substitution Jenner did not resist; and not only did not resist, but claimed as the fulfilment of his programme! Jenner should never be suffered to get mixed up with Jesty, and the course of his procedure be thereby obscured.

I am explicit to iteration because the truth is not recognised and may be accounted incredible. In another way the facts may be thrown into relief if we inquire, How would Jenner have fared had he applied for a patent? Suppose his several publications were submitted to a patent-agent, In what manner could a tenable specification be evolved from these materials?

By no ingenuity could a valid patent be got out of these documents. If Horsegrease Cowpox were selected as the basis of claim, what of the repudiation of Cowpox? and if Cowpox, what of Horsegrease Cowpox? And if Horsegrease Cowpox, what of the ascription of its virtue to common repute? And if Cowpox, was not the committee of the House of Commons in 1802 compelled to disallow Jenner’s claim to the discovery, and to define and limit his merit to the propagation of its virus from arm to arm? It was, however, Pearson and Woodville who first propagated Cowpox from arm to arm: Jenner’s start being made with Horsegrease Cowpox. But allowing him so much credit, it is nevertheless to be remembered that it was at that time a frequent practice to inoculate with Smallpox from arm to arm; and the substitution of Cowpox for Smallpox was a trifle for which to pay £10,000 and dissolve in ecstasies of admiration.

One of my medical readers observes—

Put thus, it is as difficult to deal with the objection as it is to prove a negative. It is not for me to define the influence of cowpox over smallpox, but for those who believe in its prophylaxy. I should argue that as ill-health leads to ill-health, and as corruption breeds corruption, that inoculated cowpox would generate a habit of body favourable to smallpox, and at the same time tend to excite and intensify other forms of disease. I would also ask, What are the extravagances to be allowed for? When these are determined we may then proceed to discuss what are not extravagant. It is a common form of evasion to make a general confession of guilt in order to avoid the pain of specific and explicit condemnation. It is conceded that the House of Commons in 1802 “committed a variety of extravagances,” and under this appearance of candour the chief extravagance is implicitly re-asserted and carried forward, namely, that inoculated cowpox had an influence adverse to smallpox.

In the “variety of extravagances,” few, I suppose, would hesitate to include the asserted annual smallpox mortality of the United Kingdom. Sir Gilbert Blane pronounced it 45,000, while Dr. Lettsom gave it as 36,000—a wide difference in the play of fancy! Dr. Lettsom, who claimed to have paid much attention to figures connected with smallpox, was pleased to convert an extreme London mortality, namely, 3000, into the ordinary mortality, although in some years it fell under 1000. Then estimating the population of London at one million, and the population of the United Kingdom as twelve millions, he multiplied 3000 by 12, and evoked the astounding national death-rate of 36,000 annually from smallpox, all of whom were to be saved by Jenner’s prescription! But whether he had taken the average or even the lowest metropolitan mortality, the computation would have remained grossly fallacious. London overcrowded and pestiferous, was no standard for the general population, urban or rural; and the assumption was monstrous that smallpox, a notoriously sporadic disease, was constant and equally diffused over the land. We are without comprehensive vital statistics for the time in question, but arguing from the London of to-day in continual connection with the provinces, to the London of 1802 in comparative isolation, what do we find? Why, smallpox prevalent in London with little or no smallpox in the country! In the Pall Mall Gazette of 31st May, 1878, we read—

We find similar illustrations of the sporadic character of smallpox wherever we can get at the facts. In 1874 there died in London 735 of smallpox, but not one in Birmingham; 386 in Liverpool, but not one in Plymouth; 347 in Salford, but not one in Nottingham; 190 in Manchester, and but 1 in Sheffield; 24 in Bristol and 4 in Leeds; and so on. What reason is there to believe that what is true of smallpox within our own experience was otherwise in the experience of our forefathers?

I said that few would hesitate to include Dr. Lettsom’s 36,000 and Sir Gilbert Blane’s 45,000 among the extravagances of 1802, but I forgot myself. We have a National Health Society with the Duke of Westminster for President and all manner of notables, aristocratic, philanthropic, scientific, and literary, among its committee and members. Now this Society issues a hand-bill of advices and warnings relating to smallpox, approved too by the Local Government Board, and there we find set forth as unquestionable matter of fact—

We thus see how hard it is for a convenient fable to die, even when known to be false, and how respectable people will keep repeating it as long as they fancy it is for good.

Absurd as was the extension of the ratio of London smallpox to the populations of the United Kingdom, of Europe, and of the world, the London disease itself afforded little warrant for the extreme terms of horror and dismay with which it was described. Smallpox did not increase the death-rate of London: when smallpox was most prevalent and least prevalent, the total mortality was but slightly affected. As long as the sanitary conditions of the great city remained unchanged, fevers replaced smallpox and smallpox replaced fevers, and whether deaths were from one form of disease or another, so that the people died the same, what did it matter? Smallpox when most prevalent was never accountable for much more than 10 per cent. of the total London mortality, and in some years for less than 3 per cent.; and it is to be remembered that the larger portion of that mortality was infantile mortality—smallpox being in the great majority of cases a disease of the young; none the less objectionable on that account, but less chargeable than some other forms of zymotic disease with striking down the adult bread-winner and enlarging misery and pauperism.

Again, in much of the talk about smallpox, it was assumed that the disease had no limits—that it was something like fire, and might spread to any extent if unchecked. But what was there to justify such an assumption? Assuredly nothing in London experience. Smallpox was always present in London, waxing and waning under some unknown law; the deaths rising as high as 3992 in 1772 and falling as low as 522 in 1797—the extremes of the century. Why did 4000 never die in any year, or 7000, or 10,000? When a fire is extinguished, we know it has met with a check; and if smallpox caused 3992 deaths in 1772 and 522 in 1797, and smallpox be like fire, there was, we see, a check; and I ask, What was that check? There may be answers, but none for unreserved acceptance. What is certain is, that in London smallpox was never an illimitable affliction. It had limits, and it was only in the rhetoric of alarmists that it had none.

And the check to the disease (whatever it was) lay in the bodies of the citizens, and not in their therapeutics. Isolation was rarely attempted, and in their crowded habitations was impracticable. Moreover they had not only the smallpox appropriate to their evil conditions to contend with, but the disease as propagated and diffused by the inoculators. What we have to say is, that whilst in the London of last century we behold smallpox endemic and cultivated, yet in no year did the mortality therefrom exceed 4,000; and further, that with so much to favour and stimulate the disease it was a diminishing quantity. In the words of Dr. Farr—

We shall see as we proceed how the natural check to smallpox (whatever it was), the immunity of the majority from infection, and the decline of the disease were all claimed as the blessed results of Jenner’s prescription; and now-a-days it has passed into common-place, for which evidence is thought superfluous, that without that prescription smallpox might have illimitable extension. If anywhere a variolous epidemic is slight, it is said that but for vaccination it would have been severe; and if severe, that its intensity would have been doubled or trebled save for the action of the same prophylactic. We have a remarkable illustration of this style of prophecy in the Report of the Select Committee of the House of Commons upon the Vaccination Act of 1867, dated 23rd May, 1871, where we read—

What is beyond evidence is beyond refutation; and the imaginations of M.P.’s, dull though they be, not unfrequently prevail over their intelligence.

To set aside the mass of testimony adduced by Jenner’s friends before the Commons’ Committee in 1802 is sometimes described as a hopeless undertaking; but the answer to such a boast is, that experience has nullified the essential part of that testimony, and that there is little left to account for. No well-informed medical practitioner now believes what the Committee was led to believe, that to be inoculated with cowpox was to be secure from smallpox for life. The security, where still credited, is subject to so many qualifications that the primitive inoculators with cowpox would have thought such protection not worth paying for, still less of exulting over as the greatest discovery ever made in medicine. Nor would many now admit the validity of the Variolous Test which then carried conviction with irresistible force. Inoculation with smallpox was in itself an uncertain operation, and that it should fail after inoculation with cowpox, ere the poisoning of the blood had been worked off, was in nowise surprising. The exposure of vaccinated subjects to smallpox infection was in like manner deceptive; and it was conveniently forgotten that all manner of people were exposed to contagion with impunity in the usual circumstances of life. Taking a year of exceptional smallpox in London, such as Dr. Lettsom set forth as ordinary, when 18,000 were affected and 3000 died (that is one in six), there were in the million of inhabitants 982,000 who escaped. How did they escape? A multitude must have come into immediate contact with the sick: How did they remain unscathed? The question is simple, but it is crucial. If smallpox were like fire, and men, women, and children like fuel, why did not all burn? Under what prophylaxy did they abide secure? Again in this connection, we must not lose sight of the magic of faith. Things being equal, two persons exposed to smallpox, one confident that he was invulnerable through vaccination, and the other apprehensive of danger, the chances are, that the fearful would be attacked whilst the fearless would have his faith justified in immunity.

In considerations thus obvious it is not difficult to understand how the testimony delivered to the Committee had a semblance as of veracious Nature. Any one who has studied the history of remedies, or the various quackeries within his own observation, will know how easy it is to conjure up testimony, with asseverations presumptuous to question, which by-and-by are gradually discredited and ultimately disappear in forgetfulness. I have, therefore, no disposition to be hard on the men of 1802. From our vantage of experience we see how they were led astray, and recognise the pressure of the influences under which they acted. Moreover a remedy that bore the promise of relief from the pest of smallpox inoculation came with strong seduction. What a pest that inoculation was, how it was loathed, and how it was submitted to under the persuasion of duty are written at large in the domestic memoirs of last century. Every mother among the upper and middle classes was persuaded that it was necessary for her children to undergo the variolous ordeal—an ordeal that involved the deliberate introduction of smallpox into her household. It was hateful, it was intolerable, and yet it had to be endured! The doctors minimised the risks to the uttermost, but what they really believed plainly appeared when vaccination presented itself as an alternative. Then smallpox inoculation was denounced by its former practitioners with a fervour that contrasted painfully with their antecedent professions; whilst parents heard with indescribable satisfaction that absolute life-long security from smallpox was henceforward insured at the price of a trifling operation attended by no peril whatever, and with distinct benefit to health. To make the contrast clear I subjoin copy of a hand-bill that was posted on walls and circulated by thousands in London and the country at the time of which I write, 1801-2.

A TABLE SHEWING THE ADVANTAGES OF
VACCINE INOCULATION.

From this faithful statement of the advantages attending Vaccine Inoculation, it must appear evident to every unprejudiced person, that it is the duty as well as the interest of every parent, of every individual, and of every nation, to adopt the practice, and to hasten

THE EXTERMINATION OF THE SMALLPOX.

It was thus that Vaccination was introduced to the English people, not by men accounted quacks, but by leaders of the medical profession; and whatever the illusions and mischiefs of the new practice, we must allow it the credit of discouraging and ultimately superseding the grosser practice of inoculation with smallpox. As for the various items in the bill, we have had, and shall have them before us, and I would only now recall attention to the initial statement that “Smallpox destroys a tenth part of mankind.” The summary answer to the statement is that the number of mankind was unknown, likewise their diseases, and the proportion in which they were fatal. It was a repetition of Dr. Lettsom’s unwarrantable extension of a bad year of London smallpox to the whole earth. Even in an occasional year when upwards of 3000 died in London of smallpox, the total average mortality was not seriously affected thereby. The deaths, as we have observed, were merely taken out in smallpox instead of in some other form of fever. That nothing can permanently reduce the death-rate of any community save improved sanitary conditions and personal habits was unrevealed in 1802.

Notwithstanding the exultation over Jenner, “the saviour of the world from smallpox,” and over “the greatest discovery since the creation of man,” the suspicion is unavoidable that it was largely factitious—“from the teeth outwards,” as Carlyle would have said. The vote of £10,000 to the miraculous benefactor of the human race was carried by a majority of three in a Parliament to which no more than 115 members could be whipped up, and neither Pitt or Fox thought it worth while to be present. Nor was Jenner treated as if his asserted services to mankind were soberly credited. “Yes,” it may be said, “the world never recognises its true benefactors;” but the observation does not apply, for Jenner was profusely recognised, and received praise from his contemporaries which posterity hesitates to repeat. Nevertheless the praise, though profuse, was little more than verbal. Some expressed indignation at the paltry award of £10,000, and proposed to start a national subscription, but no one took the initiative, and the national gratitude was not put to the test. Even the £10,000 was paid tardily. Writing to a friend on 3rd June, 1804, Jenner had to relate that—

When at last the money was paid, nearly £1000 was deducted for fees, etc.; and, having the repute of the money, he was considered public property. As Dr. Baron records—

So much was matter of course, but Jenner had worse to encounter. He took the fine talk of his medical and political friends au sérieux, bade farewell to Berkeley, and set up as London physician in Hertford Street, May Fair. The result we have in his own words—

His fees did not amount to £350 a year, and he presently found himself nothing the better for the parliamentary grant, and involved in grave financial difficulties. He wrote to a friend, 2nd November, 1804—

And to another correspondent—

It was hard! People who attributed to Jenner the greatest discovery ever made, the preservation of from 36,000 to 45,000 lives annually in the United Kingdom, and the salvation of the human race from smallpox, were indeed entitled to have dealt with him more handsomely. He had sympathisers and candid friends. “Your liberality and disinterestedness every one must admire,” wrote Mr. Benjamin Travers, “but you are sadly deficient in worldly wisdom. If you had undertaken the extinction of the smallpox yourself, with coadjutors of your own appointment, I am confident, you might have put £100,000 in your pocket; and the glory would have been as great and the benefit to the community the same.” How that £100,000 was used to tantalise him! and yet, as Dr. Pearson pointed out, never any one showed on what practicable terms the immense sum could have been earned by means of cowpox.

Jenner, jealous of Pearson, was anxious to supersede the Institution for the Inoculation of the Vaccine Pock established by him in 1799; but Jenner was what Scots call “a feckless creature,” whose wishes rarely issue in fruit. After his success in Parliament, he did not remain in London to improve his opportunities, but retreated to domestic quiet at Berkeley and Cheltenham. His friends, however, were mindful of him, and Dr. Hawes, Mr. Addington, surgeon, Benjamin Travers, and Joseph Leaper met in Queen Street, City, 3rd December, 1802, and resolved to establish a “Jennerian Society for the Extinction of the Small-Pox.” Mr. Addington transmitted the resolution of the meeting to Jenner, saying—

Joseph Fox of Lombard Street, dentist and enthusiastic promoter of the new inoculation, also wrote to him, 4th December, soliciting his co-operation—

But the ease-loving Jenner was not to be drawn. He wrote to Mr. Addington from Berkeley, 10th December, 1802—

The letter describes the man. He did not like to be troubled—not even when action stood for the advancement of his own glory. As Pearson observed, “If Vaccination had been left to Jenner, it would never have come to anything.” Benjamin Travers also wrote to him at the same time urging the necessity of his presence in London, but he was put off with similar excuses and with expectations of assistance from the public purse—

As Jenner was not to be had, the promoters set to work without him, and their triumph was complete when at a meeting in the London Tavern on 17th February, 1803, it was announced that his Majesty had graciously condescended to become the patron of “The Royal Jennerian Society for the Extermination of the Smallpox:” that her Majesty had with great benignity acquiesced in the request to become patroness: that his Royal Highness the Prince of Wales and their Royal Highnesses the Duke of York, the Duke of Clarence, and the Duke of Cumberland, had evinced, in a most flattering manner, their willingness to accept the office of vice-patrons: that his Grace the Duke of Bedford had consented to fill the office of president; and that many prelates, noblemen, and gentlemen of the highest rank and respectability had agreed to be vice-presidents of the Society.

The approval of the Prince of Wales was conveyed in a letter of the Earl of Egremont, over which Baron, Jenner’s biographer (writing when the Prince had blossomed into George IV.), bursts into worship in capitals, as follows—

Subscriptions flowed in freely. The Corporation of London gave £500, the East India Company £100, the Duke of Bedford £50, and guineas ten, five, two and one were contributed with a liberality that attested the fervour of the common credulity. But it was much easier to get money than to administer it with a nice adjustment of means to ends. The Jennerians, too, were over-organised. There were a Medical Council and a Board of Directors. The Medical Council consisted of twenty-five Physicians and twenty-two Surgeons of the first eminence in London, with Jenner for president and Lettsom for vice-president. Such mechanism could never work, and at the point where real business was to be transacted, an officer was selected of extraordinary character.

John Walker was born at Cockermouth in 1759, and was a school-fellow of Woodville, subsequently physician to the London Smallpox Hospital. After a rambling career as blacksmith, engraver, and school-master, he turned his attention to medicine, graduated at Leyden, associated with French revolutionists in the guise of a member of the Society of Friends; then accompanied Dr. Marshall in a vaccinating cruise to the Mediterranean, from whence, after a variety of adventures in war and weather, he appeared in London in 1802, habited as a Quaker with a long beard—an apparition in a clean shaven community. Joseph Fox, the dentist of Lombard Street, gave him the use of a part of his house, and there, in his own words, “I set up my Vaccinium for the glorious cause.” As soon as the Jennerian Society was initiated, Walker was put forward by Joseph Fox and other Friends as inoculator-in-chief, and Walker made application in the following terms—

When the day of election arrived, four, out of many, were selected as candidates, one of them being Dr. Domeier, a German, strongly recommended by the Queen and Prince of Wales; but the Friends stood by their man, and Dr. Walker was appointed Resident Inoculator at the Central House of the Society in Salisbury Square with a salary of £200 a year, coal and candles, and liberty to take fees for private “vacciolation.”

The promoters of the Society, operating under the prestige of Jenner’s name, resolved to hold their annual festival on his birthday, the 17th of May; and at the first dinner in 1803 he was subjected to flatteries enough to turn any man’s head who does not know the reckless insincerity that prevails on such occasions. It was the adulation connected with the formation of this Society that as much as anything induced Jenner to set up as west-end physician. The attempt of the middle-aged country doctor was the occasion of much grim humour, and his consequent embarrassments were the concern of his friends for many a day. Apart from the inherent difficulties of the enterprise (social rather than medical) Jenner was constitutionally deficient in method and assiduity. Wrapped up in his wife and family, business was always set aside when they claimed his affectionate regard; and to leave London for Gloucestershire for some domestic cause was in his eyes procedure that required no defence—all which might be amiable, but it constantly annoyed and frustrated his associates; and it is not thus encumbered that any man can expect to make way in the world. When the anniversary in 1804 came round, Jenner was at Berkeley, and when pressed to attend he wrote—

If Jenner was idle and self-indulgent, Walker was the reverse. He was a fine specimen of the Genus, Fanatic. Possessed with a lust for what he called Vacciolation, he had a brow of brass, nerves of steel, and habits like clockwork. Thirteen stations were opened in London where cowpox was inoculated gratis, and in eighteen months Walker was able to announce that 12,288 patients had been operated on, and that 19,352 charges of virus had been dispatched to the country and foreign parts; whereon Baron observes—

The passage is noteworthy as representative of many similar passages in the literature of Vaccination. It might be described as dishonest, but the craft is so transparent that the epithet would be extravagant. The probable explanation is, that Vaccination had come to be regarded as so unquestionably beneficial that anything might be asserted in its favour, and that anything was true. Else a child might have asked how 12,000 or 24,000 vaccinations could by any possibility affect an immediate diminution in the deaths from smallpox in a population of eight or nine hundred thousand. Baron would also lead his readers to suppose that the low mortality of 1804, namely 622, was unexampled, though with the Bills of Mortality before him, he might have seen that the deaths in 1797 fell to 522; and he knew that the low figure of 1804 was not maintained, but rose to 1685 in 1805. But as remarked, any statement, if only it be favourable to Vaccination, is expected to pass muster as veracious, and the public credulity justifies the expectation.

Let us look at the London Bills for ourselves, taking the last ten years of the 18th and the first ten years of the 19th Centuries, and try to discover what they teach.

It is to be observed, that we have not here the record of the deaths in the whole of London, but merely the number of intramural interments, which diminished as a number of graveyards became gorged beyond capacity of decomposition and assimilation, and relief was sought in the cemeteries of extra-mural parishes, such as St. Pancras and Marylebone. It is only thus that the diminishing number of burials (which ranged from 25,000 to 30,000 during many years of the 18th Century) is to be accounted for. In this light we have to consider the following table, where we note fewer burials, less smallpox, less fevers, but more measles.

From whatever cause there was an abatement of smallpox, but it was a continuous abatement which had set in before Jenner was heard of; and at the same time we must repeat that at this day (when all swear by the unity of Nature and the correlation and convertibility of her forces) it is grossly unscientific to pick out smallpox from the zymotic diseases and deal with it as an independent entity. It is a fever among fevers, bred and propagated in the same conditions, and can never be studied apart from its associates without serious misunderstanding.

These Bills of Mortality, as compared with the more accurate statistics of our own time, are of little value; but, such as they are, they are constantly referred to, and their items used, as by Baron, as pretexts for most unwarrantable assertions. Any influence of Vaccination on the smallpox mortality of 1801-10 was practically nothing. Vaccination was limited to a few thousands, and those chiefly of the classes least subject to the disease. The great seething mass of metropolitan squalor, in which smallpox and typhus were endemic, was untouched by the vaccine lancet. If the new practice did good, it was in discrediting and discouraging the culture of smallpox in variolous inoculation.

To return to the Royal Jennerian Society. Its halcyon-days were of brief duration. Enthusiasm abated, subscriptions fell off, cases of smallpox after vaccination came to be heard of, and serious illness and death consequent upon “the benign and harmless operation.” Opponents waxed bold and could not be silenced. Then jealousies and dissensions began to operate within the Society. The financial secretary strove with the medical secretary. Dr. Walker’s habits and eccentricities, viewed at first with amusement, excited irritation and disgust, whilst Jenner’s easy-going mode of life and impecuniosity were a source of scandal and distrust. The climax was reached in 1806 when Jenner and Walker were set openly at loggerheads, and a fight to the death ensued.

Walker, it is to be said, never treated Jenner with respect. Like Pearson he took stock of his merits, and did not rate them highly, and would not listen to his dictation. “Vaccination,” he used to observe, “is extremely simple as to facts, while, as to causes, it is entirely out of the reach of medical men with all their theories.” Jenner, as president of the Medical Council, thought he had a right to be obeyed, but Walker was the last man in the world to yield obedience when he had formed an opposite conviction—

Of course such forbearance could not last long, and instructions issued by Walker to the Nottingham Vaccine Institution in March, 1806, were made the occasion of an open rupture. Jenner brought Walker’s conduct under the consideration of the Medical Council, and secured his condemnation. The question was then referred to the General Court of the Society on the 25th of July, when a motion that Walker he dismissed from his office was negatived by a majority of three, Walker being supported by Sir Joseph Banks and Jenner by Dr. Sims. But the victory was not satisfactory to Walker, and on the 8th of August he put an end to the strife by sending in his resignation.

Baron’s solemn account of the contest must appal every ingenuous reader. Jenner, it is written, regarded Walker’s proceedings as of “the most dangerous character,” as “placing in peril the safety of the practice,” and “as likely to wreck the Society”; so that had he not retired Jenner would have been compelled to withdraw his countenance from Salisbury Square. As we read we exclaim, Whatever did the dreadful Doctor do? Here is Baron’s answer—

Moore states the offence plainly—

Turning to the Life of Walker, by Dr. Epps, we have the difference ’twixt Tweedledum and Tweedledee still further illustrated—

As in brawls and wars generally, the ostensible offence is rarely the true or entire offence, so when we revert to the events of 1805-6 we discover that Vaccination was being found out, and that Walker served Jenner’s purpose opportunely as scape-goat. Walker’s behaviour, too, constituted him a convenient victim. Many who cared nothing for his mode of “taking lymph” had been hurt by his scorn of their self-importance, and were ready to assist Jenner in effecting his humiliation. Mr. Cline, the surgeon, after listening to many speeches against Walker, summed up the indictment, “All they complain of are his dress and address.” A naval officer, meeting Walker on 25th July, said, “I came to town to-day to hold up my hand in your support. You and Jenner do not agree over some trifles, and your enemies wish to turn the fact to your hurt, but they have been beaten. Is the man who launches a vessel the only one who can navigate her? If Jenner were to live for fifty years to come, he could never have the authority of your experience.”

Jenner’s victory over Walker was utterly disastrous: it destroyed the Royal Jennerian Society. The substantial supporters of the Society were the adherents of Walker, and with him they seceded, secured another house in Salisbury Square, and established The London Vaccine Institution with Walker for manager. The remnant of the Jennerian Society appointed James Sheridan Knowles, a young Irish surgeon, as Walker’s successor, and for distinction purchased him the degree of M.D. from St. Andrews. He had the suavity that Walker disdained, and little else beside. He neglected his duties, and soon the traffic in the “benign fluid” was transferred to the new establishment. Ultimately the lease, fixtures, and furniture of the Jennerian house were disposed of, and a retreat effected to humbler offices, until in 1813 what remained of the Society was incorporated in Walker’s concern.

Walker obtained much assistance from members of the Society of Friends, and the fact affords Moore (Jenner’s apologist) occasion for certain sneers. He describes the meetings in Salisbury Square as—

Dismissed he was not, and the peace that ensued on his resignation was destruction. The success of Walker’s Institution (necessarily dependent on subscriptions) he accounts for by an anecdote like this—

It is not to be imagined, however, that the collapse of the Royal Jennerian Society disposed of Jenner and his party. There was Jenner to provide for: he could not with decency be forsaken: and there was a stock of vaccine virus to be kept up, for which pride forbade dependence on Walker’s dispensary. It was in vain to appeal afresh to a benevolent public, whose confidence had gone elsewhere, and whose suspicions were excited. It was therefore determined to resort to Government for help. The political influence of the Jennerian party was considerable, and we shall see to what purpose it was exerted.

A new practice wants a new name, and it was some time before one was found for Inoculation with Cowpox. Dr. Walker made use of Vacciolation and to Vacciolate in 1802; but it was Richard Dunning, surgeon, of Plymouth, who introduced Vaccination and to Vaccinate. Jenner writing to Dunning, 2nd April, 1804, observed—

Vaccination is not as yet a term accepted everywhere. Among the uneducated we hear of being “cut for the cowpock,” or simply of being “cut.”

Whilst Vaccination was a useful word, it was, and is, often misapplied. Jenner’s prescription of Horsegrease Cowpox was Equination rather than Vaccination; and when virus from the horse was employed neat, Equination was the accurate designation without question. Again, when virus was generated from Smallpox on heifers, the subsequent inoculation of the human subject was not Vaccination but Variolation, or at least Variolous Vaccination. The virus in public use at this day derived from Horsegrease Cowpox, Cowpox, Horsepox, Smallpox, Smallpox Cowpox, etc., etc., inoculated from arm-to-arm, in series prolonged and unsearchable, is called Vaccination; but it is Vaccination in faith or fancy, evidence to anything but uncertainty being unattainable.

Baron relates an instance of Jenner’s personal shyness and the mental torture he endured in prospect of a festival of the Royal Jennerian Society in which he was expected to take part. Speaking to Baron he said—

Something of this timidity was no doubt due to his consciousness of playing a deceitful part, and to the appropriation of honour and reward to which he had no just claim. Like many shy men, Jenner could be insolent with pen and ink—it was face to face courage to which he was unequal; and this timidity, with other reasons, accounted for his failure as a London physician—as “the Cowpox Doctor,” as he was commonly described. Those whose encouragement had helped to lead him to disaster, those who were pleased to believe that he had taught mankind how to escape from smallpox, and several of his professional brethren, were all concerned to help him out of his difficulties, and, if possible, at the public expense. The Duchess of Devonshire wrote to Mr. Angerstein—

At the same time Jenner himself was not inactive, and managed to advance his own interest effectually. He came to London, 10th May, 1805, and at once saw Lord Egremont, and enlarged upon the losses he had incurred in the public service; the result being a determination to appeal afresh to the liberality of the House of Commons. Moreover he succeeded in winning over the Chancellor of the Exchequer in the manner he thus describes—

Lord Henry brought Jenner’s case before the Commons on the 2nd of July, and recited the fabulous matter communicated to him with the force of personal conviction. Vaccination was a preventive of smallpox, that loathsome disease which spreads death throughout the world. It was in 1777 that Jenner obtained some obscure knowledge of the peculiar virtue of Vaccine; and from that period he meditated profoundly on the subject, accumulated information, and instituted cautious and decisive experiments. At length he perfected his discovery, and published it for the benefit of mankind. Lord Henry then proceeded to relate the triumphs of Vaccination, not only throughout Europe, but China and India! Wherever the practice was introduced, there smallpox diminished and vanished. There was Vienna, for instance, where the average mortality from smallpox was 835 annually. Vaccination was commenced in 1799, and the mortality dropped in 1802 to 61, in 1803 to 27, and in 1804 to 2. Thus in Vienna there was an annual salvation of 833 human beings. This undoubted fact had made a deep impression on his mind [as well it might!] But, alas! what was doing so much good abroad was neglected and distrusted at home. In the City of London the deaths from smallpox had been on an average 1811 annually, and this mortality had been gradually reduced by Vaccination to 629. Through the diffusion of the disease by variolous inoculation, the deaths last year (1805) had been raised from 629 to 1685. This dreadful destruction of life, especially shocking when a certain preventive existed, demanded their most serious attention, and in the situation he felt bound to propose a plan to bring forward a mass of evidence, to elicit the truth, and enlighten the public. He would therefore move—

Should this report from the Physicians corroborate the favourable opinion of Vaccination entertained by foreign nations, it must greatly tend to subdue those prejudices against the practice which have been fomented here. And in that case, the House may consider whether the ingenious Discoverer has been remunerated conformably to the liberal spirit and character of this country.

Dr. Mathews seconded the motion, and contrasted the safety of the vaccine with the dangers of variolous inoculation. He had no doubt the country would hasten to testify still further its gratitude to the learned physician to whom they owed this inestimable benefit.

Mr. Wilberforce did not approve of the reference to the College of Physicians. He would have preferred an investigation by a committee of the House, and another committee of the House of Lords. The opinions of such unbiased persons would be more congenial to the feelings of the people, and far more satisfactory than any medical report from the College of Physicians. The latter might be suspected of being influenced by professional motives, whereas a report from the Lords and Commons would be universally received as proceeding from a pure desire to promote the general good. It did not surprise him that Vaccination had made less progress at home than abroad. The resistance was due to that curious principle in the human mind which accepts what comes from afar with admiration whilst what is familiar is neglected and despised. The remedy would be found in diffusing information as to the complete success of Vaccination in foreign countries. They would thus disperse those absurd prejudices which are engendered and fostered by certain selfish and interested individuals.

Mr. Windham did not concur in the advice of Mr. Wilberforce to refer the matter to a parliamentary committee. It was a question for medical men. To a committee of the House the adage might be applied, Ne sutor ultra crepidam. Let them enforce with their approval the report of the physicians, and then let them proceed to remunerate that meritorious individual to whom society owed the utmost gratitude. He could not help thinking he had not yet received what was due for the expense and trouble the discovery had cost him.

Mr. Banks was of a sceptical turn. He wished the motion had been made earlier in the session, for then he should have supported the suggestion of Mr. Wilberforce. They wished to know whether Vaccination really did afford reasonable security from smallpox. It was not a question for medical men for which the House was incompetent. They were as capable of determining the point, and setting it clearly before the public, as the most learned body that ever existed. He wished too, since the motion would be carried, that the Royal College of Surgeons might be united with the Physicians in the production of the report. As for Dr. Jenner, if Vaccination were as efficacious as asserted, he might be left to find his reward in its practice.

Lord Henry Petty in summing up the debate expressed his satisfaction with the general approval extended to his motion. He did not think the House competent to form a judgment on Vaccination. They could not decide whether cowpox was genuine or spurious, or whether the affection resulting from its inoculation was regular or otherwise; nor could they determine whether eruptions that might break out after Vaccination were induced by the operation, or were due to other causes. Such delicate questions could only be solved by medical men. As for the proposal to annex the Royal College of Surgeons to that of the Physicians, it was superfluous. The College of Physicians would not only consult the Surgeons, but the Medical Colleges of Scotland and Ireland likewise. If the report should prove favourable, it would then be his duty to propose that remuneration be awarded to Dr. Jenner for his inestimable discovery.

The motion was then put from the Chair and agreed to unanimously.

It is needless to remark that the report of the College of Physicians was a mere formality toward a vote of credit for Jenner’s relief. He lay heavy on many hands, and none were more anxious to be relieved from the pressure than certain influential members of the College whose report was solicited. The operation was skilfully planned for the end designed, and Lord Henry Petty allowed himself to be primed and applied with singular facility: but public men have often to deliver as of themselves what is communicated by others, and to stand responsible for absurdities of which they are unconscious.

The Report of the Physicians appeared on the 10th April, 1807, a verbose document, wherein assertion and conjecture were awkwardly intermingled. As to the extension of the practice, it was said—

From the Report it appeared that the opposition to Vaccination proceeded from the Inoculators; and the document may be described as a charge against the old practice as much as a positive defence of the new—

Some Inoculators asserted that Vaccination produced “new, unheard-of, and monstrous diseases,” and made use of pictures to excite terror and disgust—

Whatever the character of Vaccination—had the claim made in its favour been a true claim, still the chief resistance to its practice would have consisted in the common apathy—

The suggestion was, however, made that Vaccination should be offered gratis, but at the same time it was the opinion of the College that until Variolous Inoculation was superseded or prohibited, “it would be impossible to prevent the constant recurrence of Natural Smallpox.”

The recommendation of Vaccination gratis provoked the wrath of Dr. Moseley—

The Report of the College is interesting as a historic confession and a mark of progress. The physicians who drew it up were the same men who in 1800 professed their unlimited confidence in Vaccination, whilst as yet they knew little about it, proclaiming in the newspapers that they considered it their duty to declare—

From a profession so unqualified an absolute retractation was not to be expected; but experience had begotten caution, and it is instructive to remark with what qualifications the retreat from the original position was attempted. Thus—

The Report was not the deliverance of men possessed with the confidence of 1800: throughout there was manifest the failing conviction which evades responsibility and seeks for confirmation from sources external to itself. After a reference to the Variolous Test, the Report ran on—

The liability to confound coincidence with cause was not unknown in 1807, and might have been suggested as a possible explanation of the cessation of a variolous epidemic contemporaneously with Vaccination; although at the present day Vaccination, when Smallpox is epidemic, is known to do little else than invite and extend the malady.

How the general (that was to say partial) Vaccination of certain towns and country districts secured universal exemption from Smallpox, the Physicians failed to explain. Extraordinary tales of Vicarious Vaccination were current and piously received. If a fraction of an urban or rural community happened to be vaccinated (usually a fraction least likely to be troubled with Smallpox in any event) and Smallpox did not break out, or did not widely prevail, the salvation of the community was ascribed to the Vicarious Vaccination. The phenomenon has, strange to say, escaped the attention of theologians, although medical men constantly attest its occurrence.

Ruefully was it conceded that Vaccination was not an absolute preservative from Smallpox, but the pain of concession was softened with the plea of mitigation—

It goes without saying, that such a statement was quackish romance. How could a physician know that any case of Smallpox had been made milder by Vaccination? for how could he know how severe the disease would have been without Vaccination? Any ground of comparison was wanting. Smallpox is an eruptive fever of wide degrees of intensity—slight as to be a trivial ailment, severe as to be inevitably fatal. “So true,” wrote Dr. Wagstaffe in 1722, “is that common observation, that there is one sort in which a nurse cannot kill, and another which even a physician cannot cure.” Yet every case of mild Smallpox after Cowpox came into fashion was placed to the credit of Vaccination!

The analogy of Nature was a treacherous support, whilst the Physicians did not foresee the time when their successors would plead the fact of the temporary security of Vaccination as a reason for systematic Re-Vaccination.

It is not difficult to discern between the lines of the Report a spirit of doubt and hesitation. Those who framed it had gone too far to turn back; there was Jenner on their hands; and a public ready to hoot if there was any open apostasy. The outlook at home was not encouraging, but there was the Continent, yea more, the wide world itself wherein to cover the reproach of failure—

The vast Continents of Asia and America! A fine phrase—a very fine phrase, with more comfort in it than scoffers might imagine.

In the Report we detect one good service, namely, the explosion of Jenner’s fiction about Spurious Cowpox. When Vaccination was first brought forward, cases were adduced of Smallpox after Cowpox. Jenner at once asserted that the Cowpox in such instances must have been spurious, for Smallpox after genuine Cowpox was impossible; and Spurious Cowpox was thenceforward freely used to baffle inquirers and to account for failures. Spurious Cowpox served the ends of the Vaccinators magnificently, but by and by it began to have awkward consequences. Genuine Cowpox was said to be harmless—it was the Spurious that was ineffective or worked mischief; and the Inoculators plied the terror of Spurious Pox against Vaccination. It therefore became necessary to clear Spurious Cowpox out of the way, and Jenner, before the College of Physicians, pressed upon the point, “owned up,” as Americans say, and authorised the following explanation—

Mark! Here was a third definition of Spurious Cowpox by Jenner.

First, in the Inquiry of 1798, he described Spurious Cowpox as eruptions on the cow underived from horsegrease, producing no erysipelas when inoculated on the human subject, and without effect against Smallpox. True Cowpox was generated from horsegrease, and from horsegrease only.

Second, in the Origin of the Vaccine Inoculation of 1801 all reference to horsegrease was dropped for commercial reasons, whilst the existence of Spurious Cowpox was reasserted “as some varieties of spontaneous eruptions upon the cow.”

Third, before the Physicians in 1807, he removed the spurious disease from the cow altogether, saying, nothing more was meant by Spurious Cowpox than variations in the form and progress of vaccine pustules on the arms of the vaccinated!

In short, to vary the phrase of Betsy Prig, “There never was no Spurious Cowpox.” Slippery, very slippery, was the immortal Jenner.

With the report of the Royal College of Physicians were delivered reports from the London College of Surgeons, and from the Edinburgh and Dublin Colleges of Physicians and of Surgeons.

The report from the London College of Surgeons was considered most unsatisfactory, and could its tenor have been foreseen, the Jennerians might never have asked for it. 1100 circulars were dispatched on 15th December, 1806, to all the members of the College whose addresses were known in the United Kingdom, submitting the following questions—

To the 1100 circulars only 426 replies were received. Why nearly two-thirds of the members kept silent when at the outset they were converted in multitude to Vaccination, was left unexplained. The replies were thus summarised by the Board on 17th March, 1807—

Vaccination, in the greater number of Counties from which reports have been received, appears to be increasing: in the Metropolis it is on the decrease.

The principal reasons assigned for the decrease are—

The report of the Edinburgh College of Physicians disowned acquaintance with Vaccination, the practice being entirely in the hands of surgeons and other practitioners—

The report of the College of Surgeons, dated 3rd March, 1807, left nothing for the Jennerians to desire. The Edinburgh surgeons were satisfied from their own experience that Vaccination constituted a permanent security from Smallpox, and they had observed no ill consequences from the practice. Vaccination commenced in Edinburgh in 1801, and was now so general in the city—

Rare, unless in some quarters about a year ago! We turn to the report of the Edinburgh Dispensary for 1805, and there we read—

And this coincidently with extensive Vaccination to which apparently there was no active opposition! We have also to remember in this connection the statement of Professor Alexander Monro in 1765, that “the inhabitants of Scotland generally have Smallpox in their infancy or childhood; very few adults being seen in this disease”; and that in Edinburgh, with conditions strongly favourable to Smallpox, the mortality from the disease was on an average little more than a hundred a year. The Edinburgh physicians knew nothing practically of Vaccination, and we see how the Surgeons, who did know, shaped their evidence.

The Dublin College of Physicians echoed the fashionable opinion “that Cowpox Inoculation was safe, and fully answered its purpose.” They were “willing to allow that doubtful cases had occurred of Smallpox after Vaccination, but on minute investigation, these supposed instances originated generally in misrepresentation, or the difficulty of discriminating between Smallpox and other eruptions.” Rather awkwardly, seeing how the opposite opinion was in vogue, they professed their faith in Variolous Inoculation—

The Dublin College of Surgeons showed themselves more fully abreast of the time. They had nothing to say for Inoculation, but testified their confidence in Vaccination, and how its practice was increasing in Ireland. From 1800 to 1806 a total of 14,335 had been “inoculated with vaccine infection” at the Dublin institutions, and many elsewhere—

Arisen from accidental circumstances! Thus was the divine illumination of experience veiled and denied!

Fortified with this budget of questionable evidence, the Government proceeded to claim from the House of Commons a second endowment for Jenner.

Whilst the Royal College of Physicians were preparing their report, there was perturbation in the political world. Dull and bigoted George III. refusing on the pretext of his oath to concede to Roman Catholics the rights of citizens, a change of administration ensued, and Mr. Perceval, a man after the King’s own heart, replaced Lord Henry Petty as Chancellor of the Exchequer, and proceeded to give effect to the plan for relieving Jenner; a purpose for which the report “On the State of Vaccine Inoculation in the United Kingdom” was merely a blind.

On the 29th July, 1807, the House of Commons being in Committee of Supply, Mr. Perceval moved that Dr. Jenner be awarded a second sum of £10,000 for his matchless discovery. Smallpox was one of the greatest afflictions of mankind, from which hardly any one escaped. For this dreadful malady, Jenner had invented a preventive, unknown before, or if known, which had never been published. He did not therefore think the Committee would consider his proposal extravagant; indeed it was rather an act of justice than of liberality. Those who had read the Report of the Physicians would recognise the immense advantages of the new practice. As for its inconveniences, they were as nothing to those which attended Variolous Inoculation, and the few mistakes recorded were due to ignorance and carelessness. It might be objected by those who adhered to Mr. Malthus, that nothing was gained by saving lives from pestilence; for deaths were not losses where means of subsistence were inadequate; but for his part he would disregard the argument even if it were true. It was much better to follow the dictates of their hearts, and preserve life whenever it was within their power. He had often heard that the true riches of a state were its inhabitants. But he would not attempt to measure Jenner’s award by the number of lives that his invention would preserve to the world. If he did so, what sum would they have to offer! All he need say was, that the £10,000 proposed represented no more than a moderate acknowledgment of labour and genius devoted to the service of humanity.

Mr. Shaw Lefevre opposed the motion. He had thought the former application for £20,000 excessive, and had concurred with those who reduced it to £10,000. He had moreover acquiesced in the smaller sum by reason of his faith in the report of the Committee of the House on the New Inoculation, but he now discovered that many of the statements in that report were erroneous. It attested that Vaccination was an infallible preventive of smallpox, whilst the report of the Surgeons now admits 56 failures! The first report stated that no disease followed Vaccination, whilst now it is confessed that scrofula and other alarming symptoms are its occasional sequences! The report thus prejudicial to Vaccination nevertheless argues in its favour, and he would like to call witnesses to the bar of the House who would make manifest still further its inconsistencies and inaccuracies. At this late period of the session, it was not right to vote away such an amount of public money. [Such “late periods” are, however, always selected for jobs.] Besides, it was generally known that Benjamin Jesty of Worth in Dorsetshire discovered the use of cowpox long before Jenner, and if the House was resolved to be liberal, the reward should be shared with Jesty, or with Jesty’s family. He should oppose the vote, but he did not say that he would always do so. His purpose was to gain time for more careful inquiry.

Lord Henry Petty, who had first moved in the matter, came to his successor’s support. He had no doubt as to the efficacy of Vaccination, nor as to Jenner being its discoverer. His difficulty was to find a rule for the justice of the case; for whoever considered the value of the discovery must perceive that it would be impossible for them to deal generously with the discoverer. His service to mankind was entirely beyond any financial estimate. It was objected that Vaccination was not infallible. He replied that absolute, never-failing perfection ought not to be expected from any human device: they should rest well satisfied in the approximation to infallibility that belonged to Vaccination. Its daily benefits were numberless. Multitudes of seamen, soldiers, and citizens of every description had been saved by it, and in contemplating its future effects on the human race, the mind was lost in amazement and gratitude. How then should they presume to talk of liberality towards Jenner, the benefactor! They should recollect how he stands in the estimation of the world, how they were acting in view of all nations, and how their own characters were at stake in their demeanour towards him. As to Malthus there was a misapprehension. He had taught nothing that forbade the extinction of an infectious disease which so greatly reduced human happiness. In their concern for Vaccination, the House should not forget the mischief that was still wrought by inoculation with smallpox. Zealous as he was for the new practice, he had no wish to meddle with what others might imagine (however absurdly) tended to their own preservation and that of their families, but no one had a right to endanger the lives of others. It was proved beyond dispute that those who were inoculated with smallpox diffused the fatal contagion by going abroad, or being carried abroad. He thought, therefore, it was not only the right, but the duty of the State to oblige those who were infected with smallpox to keep within doors until complete recovery. He would not move an amendment to the resolution, but would have no hesitation in acceding to a larger sum.

General Tarleton could not withhold his tribute of praise from the author of this blessing to mankind. To his knowledge, it had saved the lives of many in his Majesty’s service. Soldiers could march and perform every military duty when under the process of vaccination. It had been said that gentlemen in the army had no respect for anything save success in war, but he thought that many officers knew how to admire Jenner, the preserver of millions, and to allow that in future ages his glory would exceed the renown of the greatest warriors.

Mr. Sturges Bourne denounced the practice of inoculating out-patients at the Smallpox Hospital whereby the disease was systematically perpetuated and diffused throughout the community. He thought the legislature would be as much justified in taking measures to prevent this evil by restraint, as a man would be in snatching a firebrand out of the hands of a maniac just as he was going to set fire to a city.

Mr. Hawkins Browne confessed with shame that he had voted for £10,000 instead of £20,000 in 1802; but at that time he little knew the extent of Jenner’s service to the human race.

Mr. Edward Morris did not think that even what had been said sufficiently set forth their debt of gratitude to Jenner. His discovery afforded a reasonable expectation of the extermination of smallpox, and the merit of the transcendent discovery was all his own. Inoculation in the old mode mitigated the disease in a few, and spread it in full fury over many. It was therefore a curse to mankind instead of a blessing. The Smallpox Hospital in its practice of inoculation, was a source of pestilence and a multiplier of victims to this deplorable distemper. The pre-eminent distinction of Vaccination was that it preserved its subject and injured no one. This unspeakable blessing they owed to Jenner, nor had the least improvement been effected upon his original and carefully matured prescription. They were bound to consider how he had abandoned the lucrative pursuit of his profession, and surrendered many years of his life for the good of his country and mankind. He would therefore submit an amendment to the resolution before the Committee, that the grant be £20,000 instead of £10,000, to mark their sense of Jenner’s merits and to place him in a state of independence.

The amendment was warmly supported by Mr. Wilberforce, Mr. Windham, Sir John Sebright, and Mr. Herbert.

Mr. Perceval, as Chancellor of the Exchequer, stood to his resolution, but with indifferent arguments. It was without precedent that a vote recommended by Government should be thus increased. He admitted that Jenner was entitled to much more than they could afford, but it was also without precedent that so great a sum as £30,000 (inclusive of the former vote) should be bestowed on any discoverer.

Mr. William Smith would not submit to these objections. He recited the triumphs of Vaccination in Asia and America, and said it was true as of old that a prophet had no honour in his own country. [An observation singularly inapplicable to Jenner.] He urged the Committee to vote for the larger sum, and said that whilst the Chancellor of the Exchequer might in his public capacity protest, yet in his secret heart he would not be displeased if overborne by the sentiment of the House, of the country, and of the world.

Mr. Whitbread begged the Committee to bear in mind that Jenner had scorned to monopolise Vaccination, and had thereby sacrificed a great fortune. He called on the House to vote for the larger sum. Vaccination furnished the means for lessening the poor rate. Reduced smallpox signified fewer deaths, fewer orphans, fewer widows. Vaccination meant better health for the poor and more money in the pockets of the rich. They would excuse this appeal of his to the cupidity of the landed interest inasmuch as he had been anticipated in the exhibition of loftier considerations. He also wished to relieve the House from a renewal of this question. Let them reward Jenner once for all, and liberally: and remember that what was called economy in this connection, if practised by the House, would be, in the eye of the world, their disgrace.

Others spoke in a similar strain, and when the House divided, 60 voted for Mr. Morris’s amendment, and 47 against it, £20,000 being carried by a majority of 13. Including the £10,000 voted in 1802, Jenner was thus awarded £30,000 of public money, in times, too, of war and scarcity.

The debate, it will be observed, was conducted in a House of 107 members at a late period of the session, and the variations among the speakers consisted in degrees of extravagance and credulity. The fabulous matter as to Jenner personally affords curious evidence of the manner in which legends originate in the presence of contemporaries, and how they come to be repeated with the fervour of good faith by men whose competence and honesty might be taken for unimpeachable. Jenner’s party had whipped up their adherents, and the issue was sedulously arranged for; but because they had their way it need not be assumed that it was necessary to circumvent any active adversaries. Apathy was their chief difficulty. There was little to be got out of cowpox by the ordinary politician; and then, as now, the average M.P. rarely committed himself to any project that did not obviously make for his popularity. As for the enthusiasm for Vaccination displayed by the speakers in the House, we have to recollect that they were not converts to the practice per se. No really new discovery was ever received with such an instant chorus of approbation by the mob, educated or uneducated. They were one and all bred under the severe and dangerous practice of Variolous Inoculation, whereof Vaccination was no more than a modification with a seductive promise of equal or greater security from smallpox, and exemption from its perils and annoyances. Unless this prepossession be allowed for, the conduct of Parliament toward Jenner cannot be rightly understood. There was not a word uttered against Vaccination from the ground which physiologists at this day occupy, for that ground, in a scientific sense, was as yet unknown. Smallpox was a mysterious visitation to be mysteriously dealt with—dodged, if possible, by medical artifice; and not, as we are persuaded, a crisis of impurity in the blood induced by foul conditions of life, which cannot be better disposed of than in the course of nature by eruptive fever. If we could suppress smallpox (in any other way than by the removal of its causes) we should merely alter its manifestation and have to accept it in some other and aggravated form of disease.

Jenner provided for, his adherents had yet another end to achieve, namely, their own release from the burden of the Royal Jennerian Society, paralysed by the secession of Dr. Walker and the Friends and the establishment of the London Vaccine Institution. At first they had endeavoured to discredit the new Institution, even to the extent of distributing hand-bills like the following in the streets—

It was all in vain. Walker was preferred to Sheridan Knowles backed by Jenner, whose friends had no liking for the support of the Society out of their own pockets. It was therefore planned to resort to Parliament for an annual subsidy so as dispense with the necessity of subscriptions. The managers of the London Vaccine Institution, learning what was on foot, naturally argued that if Government was to be thus propitious, it was they who had the better claim to assistance, and therefore prepared a petition setting forth their exertions in spreading Vaccine Inoculation. This interference with their scheme filled the Jennerians with fury, and Mr. John Fuller undertook to speak their mind in the House of Commons. When, therefore, on 2nd June, 1808, Sir Thomas Turton presented the petition, Fuller sprang to his feet and denounced it, saying a grosser forgery had never been submitted to the House.

The Speaker interposed. The petition had not been read. When it was, the House would be enabled to judge of its contents. Mr. Fuller resumed his seat amid general laughter. The petition having been read—

Mr. Fuller apologised for his abruptness. The petition was a gross cheat, a wicked trick to swindle the public; or, if it was not absolute swindling, it went very near the wind. When they came to solicit his subscription, he thought they represented some respectable corporation, but what did they turn out to be? A parcel of Quakers, or Presbyterians, or whatever else they were called. They had got five guineas from him, but the moment he detected them, he threatened them with a Bow Street officer and a charge of swindling, which soon frightened them into a re-delivery of his money. What a shame it was to see the cause of such fellows espoused by any man in that House! He did not suppose the Honourable Baronet shared in their gains, and he might laugh as he pleased, and spout like a lawyer, but it was a poor way to show himself off for the sake of a little notoriety among such despicable sectaries. He hoped the House would not lend any countenance to the imposture.

Sir Thomas Turton good humouredly replied, that the Jennerian Society, in whose interest the preceding speaker exhibited so much untempered zeal, was not instituted till 1803. The original Vaccine Pock Institution was established by Dr. Pearson in 1799. The Institution to which the petition referred was established in 1806, chiefly by members of the Society of Friends, a sect to whose virtuous principles and behaviour it was his privilege to bear testimony. Since 1806 the Institution had communicated the vaccine matter to 81,000 persons in every situation of life. The petitioners only desired to have the facts they adduced inquired into, and hoped for public aid only in the event of being entitled to it on public grounds.

This application for assistance by Walker’s Institution rendered its concession to the Jennerian Society impossible: it was not for the Government to get into hot water by showing favour to either; and as both could not be subsidised, it was determined to vary the application, and to ask the House of Commons to provide means for the maintenance of a new and independent institution from which “the Genuine Vaccine Virus could be distributed without expense throughout the British dominions.” Mr. George Rose, Treasurer to the Navy, took charge of the measure, which he introduced to the House on 9th June, 1808. After dealing with a notorious failure of Vaccination at Ringwood, he proceeded to observe, that whilst it could no longer be said that Vaccination was a certain security against Smallpox in all cases, yet the evidence showed that the failures were not one in 300. He would therefore move that the House having the testimony of the Colleges of Physicians and Surgeons of London, Edinburgh, and Dublin, that Vaccination was salutary and generally effective, it is desirable that a Central Institution be formed for the provision and distribution of Real Vaccine Matter, and that its administration be committed to the Royal Colleges of Physicians and Surgeons in London. The expense would not be more than £2500 or £3000 per annum.

Mr. Davies Giddy said he should not oppose the resolution, but it would have been much better to have refrained from interference. The people would neglect inoculation, and then smallpox would break out with tenfold severity.

Mr. Fuller observed that Smallpox had been annihilated in Calcutta by systematic and enforced Vaccination, and he believed the same result was attainable in this country. He thought that even those who hesitated to resort to general compulsion, would not object to the Vaccination of all children in workhouses.

Sir T. Turton would have preferred a committee of investigation. There were already three Institutions in London for the express purpose of propagating cowpox, and the object Mr. Rose had in view was more likely to be attained by private subscriptions and by assistance from Government than by a special Institution formed and endowed by the State.

Lord Henry Petty contended that as the evidence was now confessedly incomplete as to the infallible efficacy of Vaccination, it was highly proper that investigation should be persevered in under the eye of the public instead of by a number of small institutions which were not perhaps altogether exempt from the imputation of being guided by mercenary motives.

Sir Francis Burdett said Vaccination appeared before them with a complexion widely differing from that originally assumed. A short time ago they were assured it was an infallible preventive of Smallpox, and that its practice was so simple that any old woman was equal to it. Now they were told that it was a very nice operation requiring great judgment and skill, the want of which was held to account for the many failures which had occurred. Thus there was neither that simplicity nor security which was originally asserted. Considering these manifest discrepancies between promise and practice, it was, he thought, most unwise for the House to intervene in order to help what appeared to be a failing experiment. They ought to be cautious—they ought not to prop up what might prove to be pernicious error. Government in this free country cannot compel people to submit to the prescriptions of physicians, or the operations of surgeons, or anything except the laws; and it was doubtful whether science itself would be benefitted if placed under Government direction. They were referred to the reports of the Medical Colleges, but as he read these reports he detected much hesitation and evasion, and anything but the assurance displayed on behalf of Vaccination by several members of the House. Many instances of failure were admitted, and such instances might safely be doubled. As for Spurious Cowpox he wished to know what it was. It was used to account for all mishaps, and it was, he suspected, a mere shift, shuffle, and get-off. [Sir Francis need not have spoken thus dubiously, for the Report of the Physicians admitted what he suspected.] He would much prefer a committee of investigation, and hoped the resolution would not be pressed.

Mr. Wilberforce brought up the foreign argument. There might be failures at home, but these could be satisfactorily accounted for. It was for them to consider the magnificent successes of Vaccination in other lands [Omne ignotum pro magnifico est], concerning which there was no room for doubt. He saw no surer method of inspiring the public with confidence in Vaccination than by the establishment of the proposed Institution.

Mr. Rose explained that he merely wished to bring the House to a resolution, leaving it to his Majesty [that was to say, himself for the Government] to give it effect.

Mr. George Canning, Secretary of State for Foreign Affairs, declared that though he considered the discovery of Vaccination to be of the greatest importance, yet he could not imagine any circumstances whatever that would induce him to follow up the most favourable report of its infallibility with any measure for its compulsory infliction.

This declaration of Canning is well worth attention and commemoration. It serves to mark the reverence for personal liberty, which was the fine distinction of the former order of English statesmen, and separated, when little else did, the English from the Continental Tory. The noble tradition of this liberty meets with scant favour in these times, and Canning’s avowal in the new House of Commons would be heard as an anachronism. Nearly every adventurer who has a prescription for the moral and physical welfare of his fellow creatures hopes to have it enforced by legislation; and since, under penalty of fine and imprisonment, our babes are cut and poisoned to save them from smallpox, there is no infraction of personal liberty, however outrageous, that can now be pronounced impossible.

When the House divided there were 60 for the motion and 5 against it—again a small House for so critical a matter.

With the permission to spend £3000 a year, the National Vaccine Establishment was constituted, Jenner being consulted in its organisation. A Board was formed, consisting of the President and four Censors of the Royal College of Physicians, and the Master and two senior Wardens of the College of Surgeons. The Board met on 8th December, 1808, and proceeded to business. Jenner, as was his fatality on important occasions, was absent, being detained at Berkeley by family affliction. He wrote to Moore—

Jenner was elected Director, but not a member of the Board, and immediately began to protest that he was disregarded and subjected to indignity. “The Board,” he said, “appointed me Director, but they soon contrived to let me feel that I was to be a Director directed.” The arrangement he had made with Mr. Rose and Sir Lucas Pepys, the President of the College of Physicians, was, he held, altogether different—

Sir Lucas of course was jeering, but Jenner’s head was so turned with vanity and flattery that he could not distinguish mockery from sincerity. He had constructed for himself a fool’s paradise, out of which the Board pitched him unceremoniously. He recommended his bludgeon bearer, John Ring, for Chief Vaccinator and Inspector of Stations, but the Board declined to have anything to do with him, and added insult to contempt; for in Jenner’s words, written in the third person—

Subsequently he sent in a list of seven names for Sub-Vaccinators, of which the Board rejected five, which brought matters to a crisis, and he resigned. In the memorandum, from which I have quoted, he wrote—

To those who did not know Jenner, or who accepted him at his own estimate, the treatment to which he was subjected might appear reprehensible; but the Board understood their man, and only cared to have the benefit of his name, for little else was worth having. What could be made of a character indolent and untrustworthy; who disliked London and was off to Gloucestershire on any pretext; whose sickly family had from him the supreme consideration of an affectionate mother! He wrote to Moore—

He was mistaken. The world, so far as it thought at all, considered he was handsomely rewarded with his £30,000, and with so much public money in his pocket might have looked for a better disposition on his part. When his nominations were disregarded, he declined even to come to London, and thus excused his sulking at Berkeley—

In the discussion in the House of Commons it was stated by his friend, Lord Henry Petty, that one of the objects of the Establishment would be investigation, and it was absurd for Jenner to pretend that the fact came upon him as a revelation; and, unless completely blinded by conceit, he must have recognised that the general faith in Vaccination exhibited in 1801 had been much shaken by the experience of the succeeding seven years. But it is idle to argue the matter. When Jenner could say that he single-handed had conducted the whole concern for years and spread Vaccination round the globe, he could assert anything. The letter is interesting chiefly as an exhibition of character.

We shall return to the National Vaccine Establishment and its management—a curious story. Suffice it for the present to observe, that its immediate effects were adverse to Vaccination. The annual endowment was consumed in salaries, and many ceased to subscribe to the Cowpox Societies since Vaccination was so well provided for. The essential mischief consisted in the recognition of the evil practice by the State, whereby it has been perpetuated to the common injury to our own day.

The national endowment of Vaccination afforded a convenient pretext for closing this Institution, founded by Dr. Pearson and his friends in 1799; but some said the true reason was involved in the following resolutions—

The offer attested the sincerity of the conductors of the Institution, but so many patients, it is said, laid claim to Five Guineas that it was not without satisfaction that a reasonable cause was afforded for shutting up.

Dr. Pearson held that it was impossible to be re-vaccinated. He argued that since no one could have Smallpox twice, no one could have the equivalent of Smallpox, namely Cowpox, twice. It was a logical contention; but facts did not correspond to the logic. Pearson also objected to the Variolous Test, or inoculation with Smallpox after inoculation with Cowpox to prove that the constitution was fortified against attack. He preferred Cowpox to Smallpox for the purpose, as milder and less liable to dangerous results. He found that after Cowpox it was impossible to have Cowpox—at least immediately. Hence he was confirmed in his opinion that Cowpox after Cowpox was impossible; just as others argued on the same grounds that Smallpox after Cowpox was impossible. Yet at this day none doubt that Pearson was in error; for all believe in the possibility of re-Vaccination, or Cowpox after Cowpox; likewise of Smallpox after Cowpox.

In order to complete the account of Jenner’s awards and the adoption of Vaccination by Parliament, I have passed over several matters of interest and significance, which I shall now proceed to deal with, commencing with the tactics of our hero in relation to Horsegrease.

In his Inquiry, published in 1798, Jenner set forth Horsegrease as the origin of that form of Cowpox, which, when inoculated on the human subject, ensured life-long security from Smallpox. Many attempts were consequently made to produce pox on the teats of cows by inoculating them with Horsegrease, but in vain; and the possibility became discredited. Moreover, the notion of inoculation with Horsegrease, either immediately or through the cow, was disliked intensely. It was pronounced repulsive. Why virus from horses’ heels should be more repulsive than virus from cows’ teats was not explained; but, as we know, there is no accounting for tastes. Many who eat beef with relish would start with disgust from horse-flesh. A story is told of a Wesleyan who rebuked a sister for wearing feathers in her hat, and was sharply referred to the existence of flowers in her own. “Yes, sister dear,” was the cogent reply, “but we must draw the line somewhere, and it is drawn at feathers.” The line was drawn at Horsegrease, and the origin of Cowpox as asserted by Jenner and his country acquaintance was conveniently denied. Jenner was not slow to perceive how the wind of opinion was blowing, and let Horsegrease drop. He said not a word about it in his petition to Parliament in 1802, nor did he again advance it as a reason for consideration.

Now, why was this? Was it because he had ceased to believe that Cowpox originated in Horsegrease? Not at all! Why, then, did he not vindicate his opinion and confront vulgar prejudice? Simply because he had the wit to discern, that whilst he might get something out of the national purse for the Cowpox recipe, he could get nothing for the Horsegrease one. As Dr. Pearson observed, “The very name of Horsegrease was like to have wrecked the whole concern”—an observation that Dr. Mason Good confirms in saying, “The mere idea of using the matter of grease from the horse’s heel excited from the first so deep and extensive a disgust that Cowpox Inoculation had nearly fallen a sacrifice from the supposed union of the two diseases.”

It is not to be supposed that I am censuring Jenner as a tradesman.[142] If any of us had two patents for sale, we should be great fools if we declined to take £30,000 for one without the other, or suffered one to prejudice the other, or tried to inflict any doctrine about them upon the purchaser. It is for those who go to market to adapt themselves to the market, and remember that sellers were made for buyers, and not buyers for sellers. Since then the public were ready to pay for Cowpox, whilst they shuddered at Horsegrease, it was not for Jenner to force Horsegrease upon them.

Such is mercantile logic; and on its own conditions it is irrefragable; but it is not the custom to deal with Jenner as a tradesman, but as a man of science, and to range him with great discoverers, inventors, and benefactors of mankind; and here it is that I decidedly demur. What, I ask, did he discover? He did not discover that Cowpox prevented Smallpox: that was the dairy-maids’ faith. He did not discover that Horsegrease prevented Smallpox: that was the farriers’ faith. He did not discover that Horsegrease on milkers’ hands begot pox on cows’ teats: that was the farmers’ belief. He did not discover that inoculated virus could be conveyed from arm to arm: that was an existing practice. What then did he discover? He discovered nothing. He did no more than take the vulgar opinion of his neighbourhood to the London market. He made a few perfunctory experiments by way of confirmation, advertised them in a book, and by good or ill luck the notion was caught up, and worked to practical issues, chiefly by Pearson, who thereby incurred the full malignity of Jenner’s jealousy.

The distinction between a man of science and a tradesman is this, that the mind of the one is set on the extraction of truth and the other on the extraction of profit. The man of science does not inquire what the public may be pleased to know and pay for, but he ascertains and defines what is fact, and leaves the public to adjust themselves thereto as they may find convenient. If they recognise the truth communicated, it is well for them; if they dislike or deny the truth, it is ill for them; but well or ill, the man of science is the disinterested expositor of what he knows to be true; not unfrequently, when his revelation vitally affronts popular prejudice, realising the blessing of those who are persecuted for righteousness’ sake.

What therefore I maintain concerning Jenner is, that the truth (as we may presume he regarded it) he did not fully reveal; that what he did reveal, he suffered to be derided and denied; that he was content to take credit for so much of it as was marketable; whilst his private conviction about Horsegrease remained unaffected, not only in theory, but in deliberate practice.

It is for me to establish these assertions.

First, I say, he did not fully reveal what he knew. In 1789 Jenner inoculated his son, Edward, an infant of 18 months, not with Cowpox, or with Horsegrease, but with Swinepox; and, according to the evidence of his own papers, the result was perfectly satisfactory. The child was subsequently inoculated with Smallpox on five or six different occasions, and always without effect. According to the well-known variolous test, he was proof against Smallpox. In short, there was nothing that Jenner ever adduced in favour of Cowpox that was not equally valid of Swinepox. And this Swinepox experiment was made nearly ten years prior to his advertisement of Cowpox and Horsegrease. Why, I ask, did he keep back the truth about Swinepox? When Cowpox was scarce, and every cow-house was explored for virus, why did he not recommend Swinepox as an alternative? Why, too, did he refrain from the obvious generalisation, that Cowpox, Horsegrease, Swinepox, and probably other sorts of pox, generated fevers, during the prevalence of which inoculation with Smallpox was not apt to take? The answer is plain, Because he had something to sell rather than something to teach.

In conformity with this conduct he suffered the origin of Cowpox in Horsegrease, and the specific virtue of grease to be derided and denied. “It was fortunate for Dr. Jenner, and the triumph of his discovery,” wrote Dr. Mason Good, “that a minuter attention to the subject gave sufficient proof that there was no foundation for his opinion that Cowpox originated in Horsegrease, nor that any connection existed between the diseases.”[143] Such was the convenient medical verdict, which Jenner did not venture to disturb, though all the while persuaded of its error. There were failures to inoculate cows with Horsegrease, but Thomas Tanner, veterinary surgeon, of Rockhampton, Gloucestershire, “had the merit,” says Dr. Baron, “of proving the truth of Jenner’s statement.”[144] He succeeded in communicating the disease to the cow from the heel of the horse, producing on the cow’s teat a complete vaccine pustule. “From handling the cow’s teats,” said Tanner, “I became myself infected and had two pustules on my hand, which brought on inflammation, and made me unwell for several days. The matter from the cow, and from my own hand, proved efficacious in infecting both human subjects and cattle.”[145] Jenner distributed the virus from Tanner, and it operated precisely like Cowpox. But the proof did not rest with Tanner: others repeated his experiment with similar issues. Dr. Loy of Whitby published in 1801 Some Observations on the Origin of the Cowpox, in which he confirmed Jenner’s country tales, and described how (dispensing with the cow) he managed to inoculate patients with Horsegrease, producing pustules identical with those from Cowpox, and subjecting the persons thus equinated to the variolous test with complete impunity. Yet, with so much to fortify him, Jenner kept silent. He preferred to be adjudged mistaken rather than risk the forfeit of public favour and pay. Nor might I blame him, had he frankly reasserted the integrity of the Gloucestershire faith, and allowed that since the public were ready to accept Cowpox without Horsegrease, it was not for him to stand in the way of their preference by an obstinate defence of what was non-essential in practice.

But the case for Horsegrease was yet stronger than I have stated. Dr. Sacco of Milan was sometimes described as “the prince of vaccinators” by reason of his enthusiasm, his professional attainments, and the facilities that were accorded to him in the Cisalpine Republic of those days for universal vaccination. He tried to generate pox on the cow with grease from the horse, but failed, and in 1801 reported to Jenner his failure. In 1803, however, he cried, Eureka! A coachman presented himself at the Milan Hospital suffering from an eruption contracted in grooming a horse with greasy heels. He was at once led off by Sacco to the Foundling Asylum, where nine children were inoculated from the vesicles on his hands. On three of the children the inoculation took, producing vesicles which were pronounced to be the same as those resulting from Cowpox. The virus was propagated from arm to arm, and distributed in all directions. Dr. Sacco from thenceforth avowed himself a Horsegreaser. “It is now admitted and settled,” he wrote to Jenner from Milan, 25th March, 1803, “that grease is the cause of vaccine, and we cannot too soon alter the designation to equine.”

Was the designation changed to equine? It was not, nor was the attempt made. Those chiefly concerned in promoting vaccination in England would not hear of Horsegrease, and many were ready to swear that in the matter of pox, the horse and the cow had no connection whatever, and that Jenner had too hastily assumed the truth of a vulgar west country opinion.

Dr. De Carro of Vienna, who described himself as Jenner’s friend and first apostle, having effected the first vaccination on the Continent and transmitted the first charge of vaccine to India, was also a Horsegreaser. Whilst Jenner was judiciously holding his tongue about Horsegrease in England, he wrote to De Carro congratulating him on his success in conveying Cowpox to the East, and ascribing the failure of the English attempts to the absurd prejudice against Horsegrease, which Dr. Loy had, however, completely annihilated. Here are his words under date, 28th March, 1803—

How the clamorous opposition to Horsegrease had deprived Hindoos of the earlier blessing of vaccination, we are left to conjecture. Perhaps he meant that Horsegrease would have borne transit to India better than Cowpox, or that the Hindoos themselves might have resorted to horses with greasy heels.

In reply, 22nd April, 1803, De Carro wrote to Jenner commending his moderation in maintaining silence toward his antagonists—little apprehending the motives of that silence. Pearson’s conduct, he thought, bordered on insanity. “I am extremely glad,” he continued, “that you have treated it with the contempt it deserves, though I am happy to see that your friends have exposed his ridiculous and malevolent designs.”

De Carro was intimate with Sacco of Milan, and from him received virus derived from Horsegrease, which he used indiscriminately with Cowpox, until in Vienna it was unknown who were vaccinated and who equinated.[147]

De Carro was also in correspondence with Dr. La Font, a French physician, established at Salonica, who was likewise a Horsegreaser. He discovered that the Macedonian farriers recognised three sorts of grease in horses, called in general javart, and discriminated as l’écrouelleux, le phlegmoneux, et la variolique.[148] With the variolous grease, La Font inoculated two boys, and from them other children, reproducing the experience of Loy of Whitby and Sacco of Milan. De Carro in communicating La Font’s success to Jenner, 21st June, 1803, observed, “These particulars, I hope, will silence all those who still doubt the truth of your doctrine as to the connection of Grease, Cowpox, and Smallpox”—Jenner holding that Smallpox was a malignant variety of Cowpox, whilst Cowpox came out of Horsegrease.

Notwithstanding these confirmations and his boast that the opposition of Pearson and Woodville was silenced for ever, Jenner suffered judgment to go against him. He recognised that it was expedient that the connection between Horsegrease and Cowpox should be denied. He had his bill to settle with the English public, and it was not for him to make difficulties. A curious evidence of how thoroughly the unpopular truth was suppressed is furnished by Dr. Willan’s treatise On Vaccine Inoculation, published in 1806. There is not a word or hint in it concerning Horsegrease. The treatise was the work of a competent physician, who set forth what was known of vaccination (from the standpoint of belief) with fulness and clearness, accompanied with an appendix of letters and reports from Jenner himself, from Pearson and other experts in the new practice—but as to Horsegrease, the silence was absolute. How the disagreeable truth was so effectually covered up is more than I can account for. It was not mentioned in the debates in Parliament, nor was it referred to in the reports of the Colleges of Physicians and Surgeons, nor did the opponents of vaccination use it with the force that might have been expected. One explanation is, that Jenner’s Inquiry never entered into general circulation, that no popular edition ever appeared, and that it was chiefly known at second hand. The leading representatives of vaccination, moreover, so boldly disowned Horsegrease and Jenner’s authority in ascribing Cowpox to its parentage, that there was little use in charging them with it; whilst all the while Jenner offered no open resistance to those who contemned him for one mistake, but exhausted the language of adulation on his imputed merit. Thus we suppose it came to pass that at the end of twenty years Dr. Mason Good, as the exponent of orthodox medical faith, felt justified in asserting that there was no foundation for the opinion that Cowpox originated in Horsegrease, nor that any connection existed between the diseases, and that it was fortunate for Jenner and the triumph of his discovery that the fact was so.

Jenner was silenced, but was he convinced? How could he be convinced? Horsegrease as the origin of Cowpox might be voted detestable and impossible, but there was the evidence of the country folk, confirmed by Tanner, Loy, Sacco, De Carro, and La Font; and though a weak man may be put down, or think it worth while to be accounted mistaken, yet, in the stillness of his mind, he knows that facts are facts whatever may be said to the contrary. When, therefore, Jenner had filled his purse, obtaining all he could expect from public favour, and was clear of London, and the oppression of its savants, he reverted to his first opinion as true—true and untrue, true with a distinction, which I shall presently define. Writing to James Moore, Director of the National Vaccine Establishment, from Berkeley, on 23rd July, 1813, he observed—

And in a subsequent note of 1st August, he repeated—

To Moore again he wrote from Cheltenham, 27th October, 1813—

Then we have a memorandum of Jenner’s, dated 1st April, 1817, wherein he thus traces the course of the virus—

Which was to say, that they were subsequently inoculated with Smallpox without effect. Among Jenner’s papers, there were other entries to the same purpose, thus—

This equine virus from Jane King was extensively diffused. It was, we see, sent to London; it was also sent to Edinburgh;[154] and Dr. Baron says he had supplies of it for use in the Gloucester Infirmary. Baron relates that in the following year he was able to return the gift, having obtained virus from the hands of a boy infected directly from the horse. Here is Jenner’s acknowledgment of the present, dated 25th April, 1818—

It is surely unnecessary to adduce further evidence of what was Jenner’s mature faith and deliberate practice. Further, it is manifest that to the end of his career he held that pox in the cow was not only derived from grease in the horse, but that it was exclusively derived from the horse, and, that apart from the horse, Cowpox would cease to exist. Owing to the multiplication of vaccination failures, it began to be conjectured that vaccine might be worn out by transmission from arm-to-arm, and that a reversion to the cow might be expedient; and discussing the question in a letter to Moore, dated 5th March, 1816, Jenner advanced the objection—

Why did not Moore rejoin, Where is the difficulty? Suppose pox driven from the herds, what conceivable reason was there for anxiety when the cow had become a demonstrated superfluity?—when, in Jenner’s own words, “the true and genuine life-preserving fluid” might be drawn direct from horses’ heels? Except for the perpetuation of imposture, the cow in the case had ceased to have any value whatever. But, as so often happens with quacks, their minds become so saturated with their own humbug that there is nothing left of common-sense.

Having thus proved my assertions concerning Jenner, it may be reasonably asked, How was it that some got Cowpox by means of Horsegrease when others could not? for, it may be argued, that if Cowpox issued straight and invariably from inoculated Horsegrease, not even the most resolute prejudice against Horsegrease could have permanently kept back the truth.

The answer is, that Cowpox never came out of what is commonly known as Horsegrease. The statement made by Jenner in his Inquiry of 1798 that—

infected cows and begot pox was a blunder, which he explicitly reversed fifteen years afterwards in his letter to Moore of 27th October, 1813, already cited—

Jenner, we have always to remember, was a slovenly investigator, not apt to take pains, but apt to eke out observation with invention. His friend, “honest Jack Baron of Gloucester,” who himself inoculated with horse virus unmodified by the cow, actually wrote Jenner’s life in two volumes, and not until the work was ready for the binder did he discover that he was in error in common with his master in ascribing Cowpox to Horsegrease! Such was the intellectual muddle in which these prophets of vaccination operated! In a note stuck at the end of the second volume, we have the following amazing confession, made, remember, in 1838, fifteen years after the chief conjurer’s death—

Here we have the secret and desired explanation. It was out of Horsepox, and not out of Horsegrease, that Cowpox was derived, and in confounding grease with pox, Jenner mystified himself and others, and obscured the whole doctrine of vaccination. The Macedonian farriers who in 1803 informed La Font that they recognised three sorts of grease, and one of them variolous, were more accurate observers than the Gloucestershire farriers and farmers whose opinion Jenner lazily retailed. Whether he had any clear apprehension of his own blunder is not apparent. We have seen how long it took his biographer, Baron, to find it out. This is certain, that he made no public attempt to set right what he had so egregiously set wrong, nor to withdraw the statement in his Inquiry that Horsegrease only acquired its efficacy against Smallpox after inoculation on the cow.

Lastly, we may inquire what is the present state of opinion as to Horsegrease and Cowpox? When difficult questions are asked, we usually turn to our cyclopædias, and taking down Hooper’s Lexicon Medicum, 8th ed. 1848, Art. Cowpox, we read—

Genuine Cowpox communicated by a horse is surely a bull of the first magnitude! The Encyclopædia Britannica, 8th ed. 1860, Art. Vaccination, illuminates us thus—

An established fact, indeed!—established in quicksand!

Some say the Gloucestershire farmers and Jenner were correct in attributing Cowpox to Horsegrease, and that they can only he charged with mistake in nomenclature. When they said Horsegrease, they meant Horsepox, not discriminating between maladies that sometimes occurred together. No one now believes that the affection recognised by veterinarians as “grease” ever originated Cowpox. The same rural authorities, including Jenner, held that where there was no Horsepox, there could be no Cowpox; but, so far as I can make out, that conclusion is surrendered. Pox on the horse may generate pox on the cow, but the cow may have pox without the horse.

At this point comes the tug of war. If cows have pox, how do they contract the malady? Speaking at the London Conference on Animal Vaccination in December, 1879, Professor J. B. Simonds, Principal of the Royal Veterinary College, said—

Professor Simonds and others believe that Cowpox as described by Jenner was a parasitic affection of Smallpox, probably communicated by milkers; and that Ceely, Badcock, and others did intentionally, what milkers had done inadvertently, when they inoculated cattle with Smallpox in order to create virus for vaccination. On the other hand, those who assert the independent existence of Cowpox, hold no terms with this heresy. As Dr. Cameron says, “We can no more make Smallpox into Cowpox than by stunting an oak-tree we can make it a gooseberry bush.” Fortunately I have no call to pronounce judgment on the controversy. The more it rages, the better I like it, and if the combatants disposed of each other as did the Kilkenny cats, I might not be very sorry.

A last word as to Horsepox. There seems to be little doubt that when inoculated on man it gives rise to vesicles indistinguishable from those raised by Cowpox. In 1863 Professor Bouley of Alfort produced pox on a cow by inoculating it with pox from a horse, and children were successfully vaccinated with the virus. In the Transactions of the Clinical Society, Vol. X., Mr. John Langton, describes the case of a groom who came to St. Bartholomew’s Hospital, 20th March, 1877, with an eruption caught from a horse exactly like that induced by vaccination; and there could be no question, says Mr. Langton, that the disease was the same as that described by Jenner as grease.

There is much virus in currency as vaccine that is equine, and many of us are equinated who suppose ourselves vaccinated; and it might be argued that we have been saved from Smallpox by reason of our equination. Why with all the notorious failures of vaccination, and of re-vaccination, some of the more audacious medical quacks do not recommend Horsepox as an infallible alternative, is not easy to understand. It would be a Napoleonic stroke; nor is it improbable that before vaccination is surrendered the attempt will be made. How easily it might be asserted that vaccination is a failure in so far as it has lost the original virtue of equination, that the remedy is to dismiss the cow and revert to the horse, from whose poxy heels, as the immortal Jenner observed, there issues “the true and genuine life-preserving fluid.” The oracle might be worked thus—

“Let us hear no more of pure lymph from the calf, too often, alas! an illusion. Sure and certain salvation from Smallpox can only be guaranteed to those inoculated with pure pox from the horse. Come then to the horse, the horse with pox! Come quickly! Come yourselves! Come with your wives! Come with your children! Come and be saved by Horsepox from the loathsome pestilence that decimates the human race and brings myriads to untimely graves!”

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.

William Goldson, member of the London College of Surgeons, practising at Portsea, published a pamphlet in 1804[164] wherein he set forth a number of instances within his own experience of smallpox following vaccination by infection or inoculation. He did not turn against vaccination, but suggested that its prophylaxy might neither be so certain nor so enduring as at first asserted. Vaccination, he pointed out, had been carried into practice on a wave of enthusiasm, and it was not unreasonable to expect that on closer acquaintance some of the claims made for it should be subject to modification. Indeed so much was already admitted; for failures had led to the discrimination of spurious from genuine cowpox, and to the issue of new instructions as to the period of taking vaccine, “on which point, it was now said, depended the whole success of the operation.” Thus what was originally set forth as an operation for which any novice was competent, had developed into one of considerable delicacy with serious liability to miscarriage. Goldson, therefore, had fair reason to believe that his own observations and suggestions would meet with candid consideration, and, if verified, serve for general guidance in the practice of vaccination.

It is unnecessary to recite Goldson’s cases. Interesting at the time, they are now commonplace. He found that inoculation with smallpox was possible at an interval after vaccination, and that infection with smallpox was equally possible under the like circumstances. One case is noteworthy for its connection with Jenner. A seaman, named Clarke, was successfully vaccinated on 4th November, 1800, and, returning from a voyage to the West Indies was put to the variolous test on 24th March, 1802, when he sickened with smallpox and was sent to Haslar. To prove that his malady was really smallpox, several persons were variolated from him. The Committee of the House of Commons was sitting on Jenner’s first claim for public money, and Goldson wrote to Jenner to come to Haslar and see Clarke for himself; but Jenner was too astute to cumber himself with difficulties at a time when so much cash was in question. The case was mentioned to the Committee, but was treated as of no moment in presence of what they were pleased to regard as overwhelming evidence as to the perpetual virtue of vaccination.

Goldson’s was a modest pamphlet—conjectural rather than demonstrative. He ventured to think it was possible that the efficacy of vaccine might be weakened by transmission from arm to arm, and that security might be restored by reversion to the cow—

He likewise suggested that horsegrease might be inoculated on the nipple of the milch mare, and the virus used for equination. These and other points were advanced with a philosophic grace that ought to have commanded respect; but, on the contrary, his pamphlet was received with a howl of fury, and its author denounced as an ill-conditioned fellow—ignorant, prejudiced, pig-headed. It was safer to be pronounced anti-vaccinist than a vaccinator and harbour doubt as to any article of the Jennerian faith. Ring plied his bludgeon over the heretic, and Jenner wrote of him with malicious insolence—“All his reasoning is erroneous;” “his arrogance is increased by attention;” “he obstinately holds a veil before his eyes, and will not behold the vaccine light;” “one might as well contend with a blind man on the nature of a prism;” and so on. Goldson’s offence was that he laid his finger on some of the weaker points of vaccination; that his sight was too keen, and his reasoning too cogent. At this day the questions between him and Jenner are decided by vaccinators themselves in Goldson’s favour.[165]

Perhaps the most able attack on the practice of vaccination was delivered by Thomas Brown, surgeon, Musselburgh; and it is much to be regretted that his book, published in Edinburgh in 1809,[166] is so little known at this day. Brown had accepted vaccination, carried away, he admitted, by the common enthusiasm, and the unqualified audacity with which its claims were asserted—

An epidemic, in which his own perfectly vaccinated patients fell victims to smallpox, at last opened his eyes to the delusion in which he was walking, and to the perversity with which he and others had resisted the light of truth—

When Brown first saw the vaccinated prostrate with smallpox, he concluded that there must have been some mistake about their vaccination; “for after Vaccination it was impossible to contract Smallpox;” but the evidence of his senses gradually overcame the phantasy imposed upon him, and like an honest man he proclaimed his error, and verified the experiences whereby he had been reluctantly corrected. He set forth with all particulars forty-eight cases of smallpox following vaccination within his own immediate cognizance, and though aware of many cases outside that cognizance, he limited himself to what he could attest with personal assurance. He knew he would be told that the vaccinations had been imperfect, or that what he took for smallpox was some other eruption—

Nor did Brown rest satisfied with proving that vaccination did not prevent smallpox. He also showed the fallacy of the variolous test. He adduced twelve cases in which vaccinated persons had been variolated as if they had never been vaccinated. Also four cases in which vaccination and variolation were effected simultaneously, the diseases running their courses concurrently, proving there was no antagonism between them; and since they could occur together, what reason was left for supposing that one might not succeed the other?

Having found liberty in the truth, he reverted to Jenner’s writings, and reading them with opened eyes, he was not slow to detect and to demonstrate the laxity of statement, the contradictions, and absurdities with which they were pervaded. No reply was attempted: no reply, indeed, was possible. The surgeons of the Edinburgh Vaccine Institution issued An Examination of Mr. Brown’s Opinions and Statements,[167] but they merely carped over non-essential details, and left the main issues wholly unaffected. What they had to show was that Brown’s patients were either unvaccinated, or had not had smallpox; and unable to do this, they were unable to do anything.

Brown remained victor. He did not overthrow vaccination, nor restore variolation, but he did make an end in Scotland of confidence in vaccination as an omnipotent safeguard against smallpox. The rite continued to be practised on humbler terms: “it did no harm”: even Mr. Brown allowed that it might keep off smallpox for a time: and “there was reason to believe that it tended to make the disease milder when it did occur.” Thirty years after his first publication, in 1842, Brown reaffirmed his position in a series of letters[168] to Dr. George Gregory, a sympathetic friend, and advised a return to variolation in view of “the acknowledged defects of the Jennerian practice”—a dismal alternative. But it is in vain to expect any man to be much in advance of his time: it suffices for honourable distinction that he be in advance. When Brown commenced practice, smallpox and other fevers were regarded as inevitable as storms and earthquakes, and the knowledge with which we are now so familiar, that they are engendered in foul habits and habitations, was for practical purposes unknown. Our reproach is, that knowing so much better, we surrender ourselves to a superstitious observance conceived in days of darkness.

It may be well to devote a chapter to those antagonists of Vaccination who, though right in their contention against cowpox, did more or less to discredit their cause by scurrility and extravagance. The faults of these men are frequently adduced as evidence of the absurd and brutal resistance with which Vaccination was encountered, but it is forgotten how intense was their provocation, and how the bad on one side was matched by the bad on the other. It was a contest between Smallpoxers and Cowpoxers, alike ignorant of the conditions of physical well-being. It is plain, however, in the light of our later experience, that much that was asserted by the Smallpoxers of the uselessness and harmfulness of cowpox must have been exactly and painfully true, though persistently and ferociously denied.

In the Edinburgh Review for October, 1806, appeared an article entitled “Pamphlets on Vaccine Inoculation,” which may be taken as a reflection of the state of the controversy at that date, and as an index to the chief offenders against propriety. The article was written by the editor, Francis Jeffrey, and was a product of that perspicuous intelligence, which reduced to order whatever was subjected to its action, in much the same way that a housemaid “sets to rights” a library by ranging the books according to their sizes and bindings, and assorting the papers so that they lie neatly disposed. As is the habit of able editors, a view of the variolous controversy was evolved that might be comfortably accepted and confidently repeated by his readers—the evolution of such rational mirage being regarded for the time as veracious matter-of-fact.

First we may take the reviewer’s evidence as to the extent and fury of the controversy—

Furious was the controversy, but why was it furious? There are often great fights over little matters, but the reason is that the little matters are vitally related to the self-love of the combatants; and thus it was with the Cowpoxers and the Smallpoxers. The Cowpoxers set out with the absolute assertion that whoever submitted to their prescription would be secure from smallpox for life. Without proof, or with powerful sham proof, the assertion was endorsed by the mass of the medical profession, and there followed the conversion of the community in that sort of faith-panic which is described by Carlyle as Swarmery—

People thus enchanted do not like to be brought to their senses; and medical men, who in 1800 attested the perpetual prophylaxy of cowpox, were naturally very unwilling to be proved deceivers and deceived. When cases of smallpox were reported as following vaccination, they at first denied the possibility, saying that either there had been no vaccination, or that the smallpox was not smallpox. On the other hand, the Smallpoxers who had been snuffed out by the Cowpoxers, revived in presence of the discovered impotence of the new practice, and stoutly maintained, and cruelly demonstrated that unquestionable vaccinations were followed by unquestionable smallpox. It needs little acquaintance with human nature to see unlimited elements of bitterness in these conditions. To be convicted of imposture does not beget equanimity, nor contradiction as to plain matter-of-fact; and thus convicted were the Cowpoxers and thus contradicted were the Smallpoxers.

The Edinburgh reviewer described Dr. Moseley’s treatise on cowpox as blending “the ravings of Bedlam with the tropes of Billingsgate.” Some Billingsgate I concede, but not Bedlam at all. Much however depends on the point of view. Vaccination if regarded as a blessing in which the inspiration of heaven was consummated in the salvation of the human race from smallpox,[170] resistance thereto might appear, as Carlyle observes of creatures under enchantment, as “malignantly insane.”

Dr. Moseley’s book,[171] it is to be allowed, was singularly exasperating. He had spoken against cowpox from the outset, and was charged with condemning that of which he knew nothing; to which he cogently replied that he could scarcely know less than the gang of medical men who attested its perpetual efficacy in the newspapers in 1800 before they had any proper experience of it whatever. If his scepticism was premature, what was their credulity? Moseley had patience: no argument could be heard in the rage that set in for the new salvation. “Cowpox, I admit, is not contagious,” he said, “but cow-mania is.” When, however, in process of time it was seen in hundreds of cases that cowpox conferred no immunity from smallpox, he published in 1804 Lues Bovilla—a somewhat pompous treatise, with frequent touches of superfluous learning, and permeated with the irritating superiority of the true prophet—“You see it has turned out just as I predicted.” Nor was he content to make general assertions: he specified the names and addresses of those who had been correctly vaccinated, or had taken cowpox from the cow, and had subsequently suffered from smallpox with their neighbours; also of cases of severe illness, injury, and death resulting from vaccination. Bluster was idle in presence of such facts. Even the Royal Jennerians had to eat humble pie, for in their Report, dated 2nd January, 1806, we read—

With so much admitted by such furious fanatics, what might not be inferred!

Moseley was held in high esteem alike by the profession and the public, and his judgment enforced by so much serious evidence contributed heavily to the discredit of vaccination, and unfortunately to the resumption of variolous inoculation. That the reaction was extensive, especially in London, appears from numerous contemporary testimonies, which Moseley confirms in saying—

Rowland Hill was a religious and philanthropic notable in those days, and in common with many of his kind, was an enthusiastic vaccinator. A leading spirit in the Royal Jennerian Society, he had the school-room of Surrey Chapel constituted a vaccination station whereat Dr. Walker officiated. Nor was he content to patronise the practice, but was himself an energetic operator. Speaking at the annual meeting of the Jennerian Society, 17th May, 1806, he said—

Hill and Jenner were great friends. Hill visited Jenner at Berkeley, and Jenner heard Hill when he preached at Cheltenham. Introducing Jenner to a nobleman, Hill remarked—

“Allow me to present to your Lordship my friend Dr. Jenner, who has been the means of saving more lives than any other man.”

To which Jenner, being of a pious turn, sighed with meek effusion—

“Ah! would I, like you, could say souls.”[172]

So committed and so possessed, Hill naturally resented the growing distrust of vaccination. It cut him deeply to be supposed a quack; and in 1806 he issued a pamphlet[173] relating his experiences as a Jennerite, defending his practice, and denouncing those who treated it despitefully. Moseley especially was subjected to severe and contemptuous condemnation. Hill’s sanctimony and virulence, his vigour and venom compose a piquant mixture, and if we could tarry for amusement we might produce it abundantly from a variety of elegant extracts. Consider, for instance, this his adjuration, and its pitiful object—

Hill’s latent assumption throughout his discourse was—

First, that all must have smallpox; and

Second, that all the vaccinated who escaped smallpox, owed their salvation to their Jennerisation.

It never apparently occurred to him that before Jenner was heard of, many passed through life exempt from smallpox; nor, consequently, did he inquire how they escaped; nor why, when vaccination was introduced, escape should be placed to its credit.

The belief in the vicarious influence of vaccination comes out strongly, too, in Hill’s pamphlet. Of Londoners there were then over 1,000,000, and of these, he says, at least, 100,000 had been vaccinated, and with this effect—

Thus one in ten being vaccinated, smallpox was reduced throughout the unvaccinated 9-10ths; and as soon as the vicarious operations dropped, up went the rate of mortality! Nor was Hill singular in this persuasion. He cited his friend Dr. Lettsom as writing to him, 25th March, 1806—

And again I find Lettsom wrote to Moseley, November, 1808—

Talk evidently sincere, and widely repeated, but with how little consideration for truth!

To return to Moseley. He was not the man to endure Hill’s aggression submissively, and in a pamphlet entitled An Oliver for a Rowland,[174] he made a terrific reprisal. The public were delighted with it, and in the course of a few months it ran through ten editions. Hill was generally regarded as a clerical mountebank, with more impudence than piety, and to see him knocked over, kicked, and rolled in the mire, was sport that carried many sympathisers. Moseley’s opening address gives the key to the whole performance—

Paid he was with interest—gross and Rabelaisian; and Hill, when he had picked himself up and recovered his senses, discreetly retired from the combat.

Spite of his pomposity and buffoonery, there was good sense and humour in Moseley, and his resistance to the Jennerian mania was not ineffective. As he wrote in 1808—

In Dr. Munk’s Roll of the Royal College of Physicians we read, that Dr. Moseley was appointed physician to Chelsea Hospital in 1788, “an office which he filled with the highest éclat for more than thirty years”—until his death in 1819—

Are they? For what else is Dr. Moseley remembered? So that a man does his duty in the world, whether he be forgotten or remembered is not worth a thought; but Moseley’s early and steadfast resistance to the Cowpox Imposture will long constitute his title to grateful recollection.

Dr. William Rowley, Physician to the Marylebone Infirmary, also left his mark in medical history as a determined opponent of vaccination. He had seen the profession and the public go mad about so many absurd novelties, that it did not surprise him that they should go mad about cowpox: and after due experience and investigation he delivered judgment on the craze and its pernicious effects in a pamphlet entitled Cowpox Inoculation no Security against Smallpox,[177] containing two coloured engravings representing the Cowpoxed Ox-Faced Boy, and the Cowpoxed Mangey Girl. Much ridicule was expended on these pictures, and to this day whoever wishes to be funny and create giggle over the early resistance to vaccination tells how one Dr. Rowley maintained that Jenner’s benign virus induced the face of an ox on a boy; but like the majority of comic anecdotes, it is untrue. The engraving represents a comely lad with a swelling on the upper part of his left cheek, which was thought to give that side of his face an ox-like expression. Many a medical practitioner among the poor would at this day have little difficulty in presenting living examples of affliction answering to Rowley’s pictures—and worse. It was, moreover, the fear or fancy of many at the time that inoculation with cowpox might beget bovine characteristics in the human species, and the fear or fancy was turned to inevitable account in jest and earnest. The jest is visible in some of Rowlandson’s caricatures, and stories like this got into circulation—

In order to discredit Rowley, it is thought fair policy to connect him with such nonsense, and to have it supposed that he rested his case upon “the cowpoxed ox-faced boy:” it was far otherwise. He diligently tracked the vaccinators, and accumulated 504 cases of smallpox and injury after vaccination with 75 deaths, particulars being accurately specified. Nor was he content merely to report what he had ascertained. “Come and see,” was his forcible argument. “I have lately had under my care,” he wrote, “some of the worst species of malignant smallpox in the Marylebone Infirmary, which many of the faculty have examined and know to have been vaccinated.” His trust in “Come and see,” he still more powerfully exemplified in an exhibition of the injuries inflicted by vaccination in his Lecture Room in Savile Row in October, 1805. “Knowing,” he said, “the caviling character of the Cowpoxers, I determined to leave them no hole for retreat”; and therefore he brought together Joules, “the ox-faced boy, who also had a terribly diseased elbow-joint”; Marianne Lewis, the mangey girl, “who was covered with blotches like a leopard”; “a load of children in a cart from the south of London,” and others accompanied by their parents, and displaying their various maladies, said, “Behold the effects of the new disease that has been taken from the cow and implanted in humanity!” This painful exposition was continued over two days, and as he records, “the scene was truly affecting and distressing to all who witnessed it.” An antagonist like Rowley is a serious factor in any controversy, and we may estimate the havoc he wrought by the extreme anxiety of the Jennerites to have him estimated by the supposed absurdity of the ox-faced boy.

To a man of practical temper like Rowley, the enthusiasm with which vaccination was at first advocated appeared akin to delirium—

The fury had subsided in 1805, and Rowley held that many medical men were deeply ashamed of the extravagance into which they had been committed, but lacked courage to make frank confession.

Rowley died in 1806, and the regard in which he was held was manifest in the crowds who flocked to his funeral. In the Roll of Physicians, Dr. Munk observes—

The obstacles interposed were matters-of-fact, and as matters-of-fact were recognised and prevailed.

The controversy that followed the introduction of Vaccination “gave birth,” says the Edinburgh reviewer, “to an infinite number of publications of all descriptions” from which he could only select the most characteristic. Among these we find Dr. Squirrel, whose book is described “as the most entertaining of the whole”—

Turning up Squirrel’s pamphlet[178] I find little or nothing to warrant this description. It is not ill-written, if judged by the standard of medical literature, and the “springiness” is a conceit of the reviewer’s to sport with the Doctor’s name. My own impression is that Squirrel was a dull fellow, jealous of cowpox as injurious to the trade in smallpox inoculation, and that he availed himself of the depression in the vaccination business to assert its superiority. He admits, indeed, that he kept silent during the Jennerian furore, “but the overwhelming torrent being gradually reduced to a feeble current,” he reckoned that he “might now promulgate his opinion with a reasonable hope of success.” He cites Jenner’s account of the origin of cowpox in the greasy heels of horses, and proceeds to argue that the disease is scrofula, which its inoculation is certain to diffuse, whilst affording no protection from smallpox. He then adduces a number of cases in proof that inoculated cowpox had not averted smallpox, and had in several instances brought on serious and fatal ailments.

Jenner in a letter to Moore from Berkeley, 28th February, 1810, thus refers to Squirrel—

Jenner’s contempt was of a miraculous quality, operating insensibly upon those to whom it was applied. Some might fancy it was his idleness and others his cowardice; but he knew that it was his contempt, and that it blasted his adversaries in much the same way that vaccination blasted smallpox.

There is the woeful monotony of truth in these old pamphlets, not merely in the occurrence of smallpox after vaccination, but in the sadder stories of acute and chronic blood-poisoning. We recognise the narratives as true, for they are reproduced among us continuously by the same means, with the same miseries and agonies, and with the same death for grateful release.

It is clear from the testimony of Moseley, Rowley and Squirrel, confirmed too by others and by the Jennerites themselves, that the extension of vaccination met with a decided check in London. It was proved to many in a fashion that did not admit of dispute, that vaccination conferred no security from smallpox, whilst it was attended with dangers to health, certain if as yet undefinable. Variolous inoculation was again reverted to, but by diminished numbers; for that practice never had prevailed with popular good-will, but through sedulous medical persuasion as duty of dire necessity. Vaccination afforded excuse for hesitation, and, between rival claims, many contrived to elude either form of pollution. Thus indirectly as it were, vaccine inoculation set aside variolous, and when in 1840 the latter was forbidden by law, there was little of the practice left, whilst at the same time the majority of the population existed without Jennerian protection.

It is not to be forgotten that the early resistance to vaccination proceeded entirely from inoculators with smallpox. It was as yet unimagined that smallpox and other fevers were preventible, that their causes lay within control, and that health was the best defence of health. The world as yet lay in darkness as to those truths which we now recognise as laws of health, hygiene, and sanitary science; nor has the darkness rolled away, but is rolling away, and the time is not distant when to be vaccinated in order to be safe from smallpox will be accounted the drollest of absurdities.

Going back to the Edinburgh Review, we remark with curious interest how the chief position then asserted was the abiding efficacy of vaccination. Inoculators were ready to concede that it might possess a temporary prophylaxy, inasmuch as until one blood fever had subsided another was unlikely to supervene; but this view Jeffrey declined to entertain—

Yet what in 1806 was accounted “contrary to all analogy,” and “completely refuted and discredited by facts,” is precisely what vaccinators now admit. Hence their cry for re-vaccination—septennially, triennially, annually. Dr. Lionel Beale, a great authority in the matter, recently owned to having been vaccinated ten times, and in terror of an epidemic was about to be vaccinated once more—a striking exemplification of contemporary theory and practice. To have foreseen such an issue would have confounded the early vaccinators. When re-vaccination was mentioned to Dr. Pearson, he denied its possibility; “for,” said he, “Vaccination is equivalent to smallpox, which cannot recur. If a child can be re-vaccinated, then it can take smallpox; ergo vaccination is not an equivalent for smallpox; and where then is the good of it?” Where indeed!

The Edinburgh reviewer was sufficiently impartial to recognise violence alike among Cowpoxers and Smallpoxers, and specified John Ping, Jenner’s bully, as an offender, describing his Treatise on Cowpox as “one thousand and forty chaotic pages in defence of the new practice.” Ring verified the criticism by issuing a pamphlet, The Beauties of the Edinburgh Review alias the Stink-Pot of Literature; reminding us of the man who writing to his wife from an inn-parlour remarked, “I must conclude, for an unmannerly Irishman is looking over my shoulder and reading every word I write;” an observation that was immediately clenched with, “You are a liar, sir; a liar!”

Everybody appeals to common-sense, but what is common-sense? It is a question difficult to answer; and yet, as I propose to show that Cobbett’s opposition to vaccination was justified by common-sense, I am bound to give some definition of the term.

Common-sense is reason as evolved from common experience. What the multitude of men have found to be true in the course of life, that is common-sense, which to question or resist is folly or fanaticism. This vulgar and vigorous rationality is often summoned to service where it has no vocation. For example, when it was first taught that the earth was a sphere and that its inhabitants had antipodes, the revelation was denounced as contrary to common-sense; but it is obvious that in such a case (which represents myriads) it was wrongly invoked; the form of the earth being at the time outside common cognisance. As soon, however, as it was realised by experience that the earth was spherical and inhabited in all its quarters, then its rotundity became incorporated in the constitution of common-sense.

The realm of common-sense I therefore hold to be limited by its origin in common experience, and in matters above or beyond that experience, its dicta are illegitimate, and synonyms for presumption and prejudice.

William Cobbett was essentially a man of common-sense. His power lay in his community with the experience and reason of his countrymen; and, like all of us, he had the defects of his virtue. He continually applied his vulgar judgment to the criticism of men and matters beyond the range of his competence, and the result was a luxuriance of arrogance and contempt for which at this day we must resort to Mr. Ruskin for a parallel.

Such being the case, we have to inquire, What was the worth of Cobbett’s opinion in the matter of vaccination? The attempt is sometimes made by vaccinators to withdraw their practice from popular discussion. They say it is a medical question for medical men; but the assertion provokes suspicion rather than confidence, for mystery is an invariable note of imposture. It is fair, I allow, to say of any abstruse knowledge that it can only be apprehended by those whose faculties are trained for its apprehension; but what is there abstruse about vaccination? With little trouble, everybody may know as much about it as anybody. It is the simplest of surgical operations. It is almost as easy as taking pills—instead of putting poison down the throat it is inserted into the skin. The operation may result in any number of pathological complications, but whether such complications be admitted or denied, what vaccination is prescribed for, namely, the prevention of smallpox, comes within the range of common observation. What, therefore, I have to answer is, that Cobbett’s common-sense was competent to deliver judgment upon vaccination.

Moreover, the circumstances of the time compelled an opinion: silence or neutrality was impossible. England was swarming with vaccinators. All the fussy folk who had a taste for doing much good at little cost were plying the cowpox lancet. Encouraged by Jenner, they got vaccine, inoculated a victim, and propagated the virus from arm to arm. Here I may let Cobbett speak for himself—

Nor was vaccination merely forced on Cobbett’s attention as a popular craze. He had to deal with it as a possible compulsory infliction. At a public meeting in 1803, Wilberforce and Dr. Clarke advocated the prohibition of smallpox inoculation and the enforcement of vaccination; and Cobbett, in a letter addressed to Wilberforce, rebuked the arbitrary project in a strain impressive and dignified as that of Burke himself. He wrote—

He then aptly applied the repudiated recommendation of inoculation with smallpox as cause for hesitation in assenting to inoculation with cowpox—

Then turning upon Wilberforce in his favourite character of constitutional Englishman, he proceeded—

Lastly came these remarks which at this day have force and application greater even than when written—

Cobbett, be it observed, thus addressed Wilberforce in 1803, when vaccination was as yet imperfectly tested, and its advocates were in the full blast of enthusiastic persuasion that to be Jennerised was to be made proof against smallpox for ever. When Cobbett had again occasion to write about cowpox, six years had passed away, bearing with them the phantastic certainty with which vaccination had been imposed upon public credulity. Nevertheless the practice was not abandoned: quackery once alive and lucrative, dies hard: but it was discredited, and its apologists exercised their ingenuity in devising explanations and excuses for its manifest failures. The Royal Jennerian Society had split between Jenner and Walker, and application to Parliament was resolved upon for two purposes—first, to save Jenner from poverty; and second, to provide funds for the maintenance of vaccination, voluntary subscriptions having fallen off irretrievably. In short, vaccination had broken down, and the House of Commons was called upon to save it from extinction. There were wire-pullers in the House and out of the House who were compromised by their patronage of Jenner and his imposture, and they had the craft and the power to transfer the responsibility of which they were sick to the national exchequer. With this explanation, we shall understand the following article from the Register of 18th June, 1808. Cobbett wrote—

Whilst Cobbett could not arrest the action of Parliament, he was short-sighted in considering that the proposed endowment of vaccination was merely a question of the loss of a few thousands a year. We are saddled with vaccination at this day, its costs and mischiefs, by reason of the vote for the National Vaccine Establishment in 1808. As soon as an annual subsidy is placed on the estimates, interests are created, which not only perpetuate themselves, but constantly tend to enlargement; and such interests, once created, can only be got rid of when proved useless by agitation out of doors and persistent pressure on the House of Commons.

Referring to a notorious outbreak of smallpox among a vaccinated population at Ringwood in Hampshire, Cobbett continued—

A prophecy, it will be said, that has not been fulfilled. True: but in Cobbett’s time it advanced far to fulfilment. All the unqualified promises under which vaccination was brought into practice, were one by one surrendered under the compulsion of experience. The mass of the people remained unvaccinated; the zeal for vaccinating the poor abated; and the practice continued among the middle and upper classes on the humblest pretexts—as something that might hinder or mitigate smallpox, and in any case do little harm. We have to recollect that the mania for vaccination which now prevails is a revival of a prescription which our forefathers had tested and found wanting. Vaccination fell into neglect, not because there was indifference to smallpox, but because it did not prevent that disease.

The excuse for the first failures of vaccination was, that spurious cowpox must have been employed—spurious cowpox being the artful invention of Jenner to cover disasters; artful, and yet absurd, for how could cowpox exist spuriously any more than smallpox? The precise fact, that spurious cowpox was the dodge of an unscrupulous quack was unknown to Cobbett, but he was sharp enough to recognise imposture, and thus wrote—

In this latter warning, we have to remark Cobbett’s prescience. He knew that it was impossible to transfer organic virus from arm-to-arm without transferring more than was intended, inclusive of the dreadful disease he indicated. Vaccinators naturally denied the possibility of such extra transmission; for if they had admitted the possibility, they must have ceased to vaccinate. M. Ricord has put the alternative plainly—

The clear demonstration demanded by M. Ricord has been abundantly supplied; and what at one time was conveniently considered questionable, is now openly confessed. Mr. Brudenell Carter, writing in the Medical Examiner, 24th May, 1877, testifies—

And we have Sir Thomas Watson’s memorable declaration in the Nineteenth Century, June, 1878—

Thus belated, thus after infinite mischief to the public health, the Nestor of Medicine appears and solemnly allows that the warning of William Cobbett, given seventy years before, was a true warning, and that worthy of praise are the wise parents who give it heed.

Cobbett, grateful for escape from compulsory vaccination, overlooked, I said, the danger perpetuated through the endowment of the practice. He was overjoyed at Canning’s emphatic declaration, that “he could not imagine any circumstances whatever that would induce him to follow up the most favourable report of the infallibility of vaccination with any measure for its compulsory infliction.” Hence he continued—

What Cobbett thought would be “curious enough” we witness daily. English liberty, if it has advanced in some directions, has gone back in others since Cobbett wrote. Parents are now haled before magistrates, fined and imprisoned, because (knowing that vaccination cannot avert smallpox, whilst it may seriously injure the health of their children, and even cost them their lives) they refuse to submit to the infliction. Never, perhaps, was there a more impious invasion of liberty than compulsory vaccination, and yet we have free and enlightened Englishmen who excuse and defend it! These are the Pharisees of Liberalism, blatant over tyranny, extinct or foreign, but dull to similar tyranny within their own domain. They garnish the sepulchres of the prophets of freedom, but (in their petty measure) repeat the deeds of those who persecuted and slew them.

Lastly, in the article from which I have been quoting, Cobbett assumed that the resort to the House of Commons for money was evidence that the enthusiasm for vaccination was abating. He wrote—

The fact was, that as vaccination failures multiplied, Jenner tried, more suo, to make a scape-goat of Walker, the Resident Inoculator of the Royal Jennerian Society. There was a dreadful row, and a secession of the better part of the members with Walker, who set up the London Vaccine Institution. Those who adhered to Jenner were not of the philanthropic and subscribing order, but they had political influence, and used it to get rid of their liabilities, first in obtaining a vote of £20,000 for Jenner, and second in the establishment of a National Vaccine Establishment with a subsidy of £3,000 a year.

So far Cobbett in his Register, where he had no occasion to discuss vaccination again; but toward the end of his life, 1829-30, he produced a series of papers entitled Advice to Young Men, in which he reiterated and enforced his protest against the Jennerian imposture—

Such was Cobbett’s case against vaccination, and I ask, Was he not justified in his opposition? He saw vaccination introduced to the world as an infallible preventive of smallpox, and he lived to see the claim gradually minimised until reduced to that of making smallpox milder! Even thus abated, he had to stigmatise the claim as a last shuffle of quackery. It is asserted to this day, that vaccination makes smallpox milder, but the pretence is exploded whenever we demand, How do you know? In any case, or in any number of cases of smallpox, Who can define the severity that has been reduced by vaccination? any more than if I were to assert that vaccination intensifies smallpox, it would be impossible to confute me. We can only meet unverifiable assertion with indifference or contempt. If it pleases people to believe in metempsychosis or the constitution of the moon in green cheese, the wise leave them to the enjoyment of their humour. On the other hand, I have to remark, that smallpox is a disease of wide range of intensity, from an ailment almost trivial to one invariably fatal; and this wide range of intensity was as characteristic of the disease before as since the introduction of vaccination. On what pretext then are mild cases of smallpox attributed to the influence of vaccination? There are mild and malignant cases of smallpox alike among the vaccinated and unvaccinated, and not unfrequently when the vaccinated and unvaccinated are found in approximate conditions, as in the same household, it is the unvaccinated who are most lightly afflicted, or who make the better recovery.

It often helps to a clearer apprehension of a position if we endeavour to conceive its opposite. We have seen Cobbett as an opponent of vaccination: let us try to think of him as its advocate. Suppose he had joined with the polite and educated mob in hailing Jenner as the saviour of mankind from smallpox, and assured the readers of the Register that they would be secure from the disease for ever if inoculated with cowpox—an easy and harmless operation. Then after a while imagine him reporting that he had been misled—that the operation was not so easy as represented, nor always so harmless. By and bye he would be the bearer of a more serious revelation. Some of the vaccinated, warranted secure, had taken smallpox, but such misadventures, he would explain, were due to the use of a wrong sort of cowpox, of which there was a spurious variety. But the suggestion of spurious cowpox creating alarm and discouragement of vaccination, it would be necessary for him to counteract the declaration with the avowal that by spurious cowpox was not meant spurious cowpox, but simply irregularities in the action of the genuine virus on the arms of the vaccinated. But even these excuses would be insufficient. It was not difficult to ascribe smallpox after vaccination to careless practice, or to virus that was not the right sort of cowpox; but when smallpox was found to occur in numerous instances after Jenner’s own vaccinations and those of the most accomplished practitioners, What was to be said? Why, what was said, that when vaccination did not prevent smallpox, it made it milder!

Imagine, if we can, Cobbett’s honest and vigorous intelligence retreating through this slush of apology and prevarication! Yet through such slush every follower of Jenner had to trudge.

I am not intent on setting Cobbett forth as a model of wisdom. I simply maintain that his common-sense was adequate to the judgment of vaccination, and that it was correctly exercised. Of physiology and hygiene he was as ignorant as his contemporaries; but if a lotion were sold to prevent toothache, and it did not prevent toothache, it would be safe to denounce its vendors as quacks, even though the vendors happened to be the Royal College of Physicians and the Royal College of Surgeons. The causes of disease were unconsidered in Cobbett’s days. It was not asked why people suffered from smallpox and other fevers, nor whether fevers were avoidable. Such maladies were accepted like bad weather, and encountered by medical dodges, or by charms like vaccination, the more irrational and nasty being taken for the more effective. Cobbett himself, if he did not believe in vaccination, believed in inoculation with smallpox. He had his children poxed in infancy, and when he argued against vaccination, it was in the confident possession of a surer prophylactic. Taking smallpox for a probable calamity that could only occur once in a lifetime, it seemed to him expedient to incur the disease when convenient, and to have done with the dread of it. How far he was mistaken in this course I need not stay to debate. Suffice it to say, that he thought he could make sure that smallpox was smallpox, whilst what cowpox might be none could tell, especially after transmission through arms and constitution unnumbered and unknown.

The causes of smallpox, I said, were unconsidered in Cobbett’s days. It never even entered into Jenner’s head that the disease might be a consequence of bad conditions of life; nor did he try to explain why the malady was on the decrease ere he appeared with his magical prescription. The decrease was claimed for vaccination, but it had set in before vaccination was heard of, and was continued among those who never received it. No sanitary improvements had been effected to account for the abatement of the disease. To what, then, was it due? I answer, in part at least, to a progressive change in the diet of the people—to the substitution of tea for malt liquors, and to the displacement of arid fare by potatoes. The food of city folk up to the close of last century was closely akin to that of men at sea, and their scorbutic habit of body was notorious—a habit that rendered acute or chronic whatever disorders they were subject to. The remedy came of inclination and necessity rather than of intention. Tea was instinctively preferred by women, and the dearness of provisions compelled resort to the potato, easily grown and grateful to the palate as a mitigant of the saltness of beef, bacon, and fish. If any are disposed to dispute the fact of this revolution in the popular dietary, they may be referred to Cobbett. He witnessed the change, and persistently denounced it. Tea-drinking was to him an abomination. It was a slatternly indulgence, costly to the poor, and innutritious. Potatoes were as detestable. They were trash as compared with bread; wasteful, dirty, and unfit to satisfy a man’s appetite. It is true that tea and potatoes are poor forms of food, but the one as a substitute for beer, and the other as an antiscorbutic, were eminently useful. It is not said that smallpox is caused or prevented by food, proper or improper, but that the character of food may predispose to disease, and intensify it; as is manifest on ship-board. Hence it is (in the absence of other adequate influences) that I am disposed to ascribe the abatement of smallpox which set in toward the close of last century to the better blood of the people ameliorated by that increased consumption of tea and potatoes, against which Cobbett so blindly and vainly testified.

A last word about Cobbett. His prejudices had nearly always a creditable root. He hated potatoes because they were strenuously recommended by Wilberforce and other good and goody people as cheap food for the poor. Cobbett’s contention was, that not cheap food, but political justice was the true remedy for popular misery. It was very nice of Wilberforce and his friends to be kind to the poor, but, said Cobbett, if they were first just, the poor might dispense with their kindness. If the poor had their own, they might have beer instead of tea, and bread and beef and bacon instead of potatoes, with much else besides. Cobbett was often enough in error, but behind all his perversities lay ardent good-will for the welfare of the greatest number of his countrymen; and the consideration now enjoyed by the working classes is largely due to his dauntless spirit and unwearied exertions in presence of what appeared at the time to be omnipotent opposition.

It may be asked, Why, if Vaccination was proved useless and injurious, was it not entirely discontinued? but the question implies a logical consistency which is rarely exemplified in human experience. Vaccination was discontinued, but it was not entirely discontinued: it was chiefly continued among the upper and middle classes where fees were to be had for its performance. It was admitted that the rite might not prevent smallpox, but it would make it milder. The last thing a medicine man admits is, that he is helpless and can do nothing. Even in presence of that for which there is no remedy, it tends to his importance, and the satisfaction of the patient, and those around the patient, to make believe to do something. Now for smallpox, there was no preventive. Its causes were unknown. It broke out, and it disappeared, none knew how. Jenner’s household was devastated with fever, but he never asked, why? As observed disease was accepted like so much bad weather. Whether fevers were avoidable, or whether they were consequences of ill living, were questions as yet outside cognizance. The predominant thought about smallpox was, that it might be dodged, be it from God or devil. Inoculation with smallpox was a dodge with disagreeable accompaniments: inoculation with cowpox was a dodge on easier terms: by a trick, that left every evil circumstance unaffected, smallpox was to be got rid of. In the nature of things, the dodge was ineffective—mercifully ineffective; for who that is wise would care to have the consequences of evil abated save by the putting away of evil? The dodge proved illusory in the presence of those who recommended it, but whilst a manifest failure as to the main intention, they had the craft to shift its efficacy to rendering the disease milder—a claim as to which no test was immediately available. Moreover, vaccination had the merit of action, which the quack, whether lay or professional, insists on at all hazards. To confess ignorance and inability is self-denial for which the quack’s mind is unequal, as whoever is ailing and has friends may perceive. All come bearing advice and prescriptions for the control of nature, when, with simple quiescence and a right disposition of circumstances, nature is instant to effect recovery.

The failures of vaccination to prevent smallpox were chiefly visible among the poor, smallpox being predominantly an affliction of poverty; but in 1811 a case occurred in aristocratic life which produced more talk and dismay than scores of similar cases among trades-folk and artizans. Robert Grosvenor, son of Earl Grosvenor, vaccinated by Jenner in 1801 when a puny babe of a month old, fell ill on 26th May, 1811; in a few days smallpox developed, became confluent, and the lad narrowly escaped with life. There was no mistake about the vaccination; the mark on the boy’s arm indicated “the perfect disease”; he was attended by Sir Henry Halford and Sir Walter Farquhar, and was visited by Jenner, who happened to be in town; and, in short, the evidence of the impotence of vaccination to avert smallpox was complete and indisputable. The commotion was intense, and in a letter from Jenner to Baron we see how it affected his mind. He wrote—

The defence, therefore, was, that as an attack of smallpox did not always avert a second attack, it was not reasonable to expect that vaccination should be more effective; and to make good this position, a diligent search was instituted for cases of repeated smallpox. Many were found, though they were generally regarded as rarities, whilst their reality was frequently disputed; but whatever their number or genuineness, they were insignificant in comparison with the instances of smallpox subsequent to vaccination. Moreover, the Jennerites were taunted with their late discovery of smallpox after smallpox. Why had they not stated from the outset that smallpox might follow vaccination as smallpox followed smallpox? Why, on the contrary, had they asserted vaccination to be an absolute and life-long defence against smallpox? Why had they abused as fools or denounced as liars all the early reporters of smallpox after vaccination? And why did it require evidence, that could not possibly be wriggled out of, to bring them to an acknowledgment of the truth?

But even in presence of such evidence, Jenner persisted in his asseverations as if he had lost the very sense of truth. Writing to Miss Calcraft on 19th June, 1811, he actually claimed that he had foreseen and predicted such disasters as had occurred in the Grosvenor family! Here are his words—

Obviously had such been his uniform testimony, the Grosvenor incident would have excited neither surprise nor alarm; and mark this additional hardihood—

Whilst thus he maintained that it was far more extraordinary that young Grosvenor had smallpox after vaccination than that others should have smallpox after smallpox, he went on to assert that vaccination had saved the lad’s life!

Such was the mot d’ ordre. If Grosvenor had not been vaccinated, he would have perished! The National Vaccine Board reported on the case to the same effect, and the faithful suffered themselves to be re-assured.

In connection with 1811 and London smallpox, there is a letter to Dr. Lettsom which throws still farther light on Jenner’s temper and philosophy. He wrote—

Was there ever a more delicious bit of self-revelation! The wicked newspapers! The base, murderous and bad minded enemies of vaccination! The smallpox of London reduced by vicarious vaccination in spite of its ingratitude! The consolation derived from the survey of the countries of Europe and the vast empires of Asia and America with inexpressible delight from Mexico and Peru! Not Mrs. Jellyby herself lost in an atmosphere of Borrioboola-Gah is more piquant.

Jenner’s references to the good effects of vaccination in London were curiously inconsistent. That vaccination in which he professed to rejoice was chiefly the work of Dr. John Walker, whose practice he had denounced as so widely at variance with what he considered correct, that even the wreck of the Royal Jennerian Society was not thought too heavy a price to pay for deliverance from complicity with him. The London Vaccine Institution, established in 1806 by Walker and his friends, was responsible for the large majority of vaccinations effected in the metropolis. Walker was a pure enthusiast, of boundless energy, with a craze for vaccinating. Adverse results had no effect upon him: he did not deny, but simply did not recognise them, and held on prophesying and practising with mechanical persistency. Nevertheless, he ran aground. The income of the Institution had dwindled to less than £100 a year when Andrew Johnstone, a Cumberland man, a school-fellow of Walker, came to his assistance. With a commercial eye he surveyed the situation. He perceived that though vaccination had fallen into disrepute, there remained many believers who only required stirring up and solicitation to provide funds to keep Walker going and to yield the collector a satisfactory commission. As the Royal Jennerian Society had ceased to exist for any active purpose in 1810, nothing remaining “but a Patronage, a Presidency, and an unorganised body of Subscribers and Governors,” it occurred to him that it would be good policy to annex these to the revived enterprise, and in due course a union was effected, and the London Vaccine Institution and Royal Jennerian Society became the title to conjure with. An attempt was made to secure Jenner for President, but that was too bold a stroke. He thus answered the application—

Highly impressive were the Reports of the reconstituted Institution under the patronage of the Corporation of the City of London with the City Arms on the covers. Subsequently the King, George IV., appeared as patron, and the City Arms gave place to the Royal Arms. Among the presidents were the Archbishop of Canterbury, four or five Dukes (one of them Wellington), half a dozen Marquises and as many Bishops, about a score of Earls, with M.P.’s and pious and philanthropic notables many. So much was due to the tact of Andrew Johnstone, who understood the use of names, who never dropped one of the least influence, and, spite of Jenner’s ill-will, dealt with his honours and countenance as though they belonged to the Institution. Business is business, he would have said, and holds no reckoning with pique and dislike. Nevertheless the financial results did not correspond with the overpowering patronage. The income of the Institution never attained £1000 a year, whilst the bills for advertising and printing sometimes approached £500. In the Report for 1827 we find the operations thus summarised—

The income of the Institution in 1826 was £620 15s., and the expenditure £715 12s., leaving a deficit of £94 17s.

The figures are interesting, for they afford some idea of the extent of London vaccination during a quarter of a century. The operations of the Vaccine Institution lay chiefly among the poor—the vast majority in London as in every city; and if we allow that in the course of five-and-twenty years, 350,000, in a population of upwards of 1,000,000 in the flux of life and death, were operated on, we give a liberal estimate in favour of vaccination. That even so many could have much effect on the prevalence of smallpox (except for aggravation) is incredible, unless the vicarious action of vaccination be seriously asserted. Turning over Walker’s report it is amusing to observe how any abatement in London smallpox was attributed to vaccination, and any increase to its neglect—an ingenuous exemplification of the fable of the Fly and the Wheel.

The appointed inoculators of the Institution were a numerous body—250 names and addresses are given in one of the Reports. They were chiefly London tradesmen with a taste for doing what they thought “good.” As vaccination came to be regarded as professional work, these “unqualified practitioners” gave cause for offence, but Walker held stoutly to his opinion, which he shared with Jenner, that vaccination might be performed by any man or woman. In Walker’s words, “It is easier to perform the whole business of vaccination than it is to thread a needle—yea, it is easier.”

The annexation of the remains of the Royal Jennerian Society by Walker was much disliked by Jenner and his associates; and when the revived enterprise showed signs of prosperity, their dislike developed to open enmity, and John Ring’s services as bravo and satirist were called into requisition. He first tried his hand, anonymously, in a volume of doggerel, published in 1815, entitled The Vaccine Scourge,[185] in which Walker is represented as singing—

The verses, extending over a hundred pages, are wretched stuff, vulgar and malevolent, and a few extracts from the Preface will indicate the animus of the entire performance. Ring’s assumption was, first, that Walker was a rogue from whom the public required to be protected; second, that his Institution was superfluous; and third, that if greater facilities for vaccination were wanted in London, it should be left to the Government to provide them—

Many of the agents of the London Vaccine Institution were chemists and apothecaries, and these, according to Ring, had an interest in the propagation of smallpox—

The Vaccine Scourge producing little effect, Ring returned to the charge in the following year, 1816, with A Caution against Vaccine Swindlers and Imposters.[186] The Caution is a series of libels, the puerility and extravagance of which were their own nullification. A motto was taken from the New Monthly Magazine for the title-page, as follows—

Ring delivered his mind unequivocally. Walker was an imposter, and the London Vaccine Institution prospered by his frauds—

These were words of envy and malice, and came with odious inconsistency from the spokesman of Jenner, who had instructed and encouraged his acquaintances, male and female, to practise vaccination. We may, however, take Ring’s evidence as to Walker’s activity in London—

Those who continued to believe that Vaccination was an easy and harmless operation, could see nothing but good management in the multiplication of Walker’s agencies, nor anything but meanness in Ring’s sneers at tradesmen. His assertion that the use of the title of the Royal Jennerian Society was fraudulent, had no justification, yet it was his persistent reproach—

Lastly, he appealed to the members of the Jennerian Society, demanding—

But they did submit, and why not? Enthusiasm for Vaccination had passed away. It had been found out; it was everywhere distrusted; and those who held by it had to see it pushed on the same terms as any other quack prescription. What then was there to object to in Walker s procedure? The reason for Ring’s libels lay in Jenner’s jealousy. Walker was Jenner’s abhorrence. He had joined in the conspiracy to oust Walker from the Jennerian Society in 1806, but the operation proved fatal to the Society, whilst Walker conveyed the confidence and subscriptions of the faithful to his new Institution. What wonder, then, that Jenner disliked the eccentric Quaker! Even worse; Walker accurately appraised Jenner’s share in “the vaccine discovery,” which came, he said, from Jenner as a hint, and was developed by Pearson and Woodville in practice—a fact that was as gall and wormwood to Jenner. Moreover, Walker had written a Jenneric Opera in which Jenner was represented as a country apothecary riding up to London on a cow, and going round a-begging among the nobility and gentry. Wherefore says Ring—

Ring was an awkward champion. He sneered at Walker’s diplomas certifying fitness to act as vaccinator—

Forgetful that it was from St. Andrews that Jenner purchased his M.D.!

With equal recklessness, he denounced Walker as a vaccinator, saying—

Concerning the consequences of Walker’s operations, Ring, no doubt, testified truly. Many continue to rue the day when they listen to the flattering tale of the vaccinator. But the testimony came strangely from a Jennerite, who was ready to swear that any abatement of smallpox in London was due to the vaccinations effected in great part by “that desperate adventurer,” Walker!

Ring was implacable, the more so, perhaps, as Walker and his friends were apparently indifferent to his abuse. He burst forth afresh in the London Medical Repository for 1821, where among much else we find the following—

The diplomas which thus moved Ring’s wrath were imposing documents, certifying that the holder was authorised to vaccinate, intended to be framed and exhibited in the shop or parlour. There was a picture of something like an arch of Waterloo Bridge with London in the background and the Royal Arms overhead; Jenner standing on a pier with a dead serpent hanging in limp folds over his arm, with the inscription, Per omnia littora vincitur variola; a woman milking a cow with a group of children around her, drinking milk out of porringers, as if milk were cowpox; whilst the bed of the Thames was blocked with the names of the great and good who had testified in favour of vaccination—an allegorical style of representation then much in vogue and considered impressive.

In order to create prejudice, Ring had much to say of Walker’s religious and political principles. He was a Quaker of the Thomas Paine pattern, and like Paine had associated with the French revolutionists; but whilst dressing as a Friend, and associating with Friends, he was too unconformable a personality for their Society, and was never received into membership. Ring’s imputations of rapacity and avarice were grossly absurd as applied to Walker. He cared for nothing beyond support in his work as vaccinator. It was said he would take a £5 note, fold it, stick a pin through it, write an address on the back, and post it. He would rarely vaccinate the well-to-do. If they came to his office, he would ask, “Who is thy medical attendant?” and wrapping up some fresh matter on glasses would say, “Take this with my compliments to thy medical attendant, and he will do what is requisite quite as well as myself.” When he did call at a house to vaccinate, he never asked for a fee, and his biographer, Dr. Epps,[187] observes that he was only known on one occasion to express a wish for remuneration. Meeting a merchant in St. Paul’s Churchyard, whose household he had vaccinated at some inconvenience, he observed, “Friend, if thou has sent by thy servant a draft for my services to thy family, he has either robbed me or deceived thee.” When money was brought to him, he usually called his wife to receive it, she having the undivided care of all that pertained to him apart from vaccination. Of this good woman, Annie, he was in the habit of speaking with an admiration and unreserve that constituted one of his numerous oddities. For example, when Dr. Moore in his History of Vaccination observed somewhat maliciously—

Walker good-humouredly replied, that Moore as a Glasgow man naturally preferred his own University to that of Leyden, but he too had cause to love Glasgow—

Walker was obstinate, but not vindictive. Dr. James Sims offered him £1000 in 1806 to prosecute his adversaries for conspiracy, but he left them to their devices, and proved his quality by outworking and superseding them. He replied to Moore’s flippant version of the causes that led to the division and destruction of the Royal Jennerian Society with perfect self-control and manifest truthfulness, but at the same time with a simplicity not of this world.[189] Jenner’s spite, Ring’s abuse, and the sneers of the superfine did him little harm; and, if vaccination were beneficial, I should have nothing but praise for the good people, who, recognising the sincerity of his work, disregarded trivialities of manner, and supported him loyally as a faithful servant.

Walker was nothing but a vaccinator. Day after day, in rain or sunshine, his lank figure, and self-complacent visage under a white broad-brimmed hat were to be seen making the round of the vaccine stations. When he entered a room, he first glanced at the table on which he expected to find his books. If any mothers had placed their children’s bonnets or garments thereon, they were at once swept off. He then ranged the company in order against the wall like a schoolmaster, and delivered a short address on the protection he was about to confer. The children’s names were taken down with a preliminary caution to speak distinctly. When women muttered or gabbled, the Doctor grew irritable, and would sometimes make a troublesome woman spell her infant’s name half-a-dozen times, adding, “Now thou wilt know how to speak plainly.” Having got the names, he had next to look out for virus. The few mothers who had ventured to return with their vaccinated babes for examination, would perhaps lose courage and attempt to escape, when Walker would dart to the door and arrest the fugitive, saying, “Thou foolish woman! If thou wilt not do good to others, I will bless thy little one,” and would proceed to gather what he called his “Vaccine Roses.” He pursued his operations calmly indifferent to the screams of the children and the complaints of the mothers, and as he disposed of each case pronounced the illusory benediction, “Thy child is safe: fear not: fare thee well.”

Walker died in 1830, aged seventy-one, after a short illness, in which “he refused to take any medicine though himself a physician.” In the Report of the London Vaccine Institution for 1831 we read—

Toward the end of his life, he used to boast that he had performed upwards of one hundred thousand vaccinations. So far as vaccination prevailed in London, it was chiefly through Walker’s exertions; and he was just the character, being set going, to keep going whatever the adverse evidence or obloquy. He had his plans and his methods, and those who tried to modify them took nothing by their pains. He was a man to have his own way, and those who did not like him might leave him. Whether from incapacity or affectation, he made no attempt at politeness, and said precisely what he thought without accommodation. He was a piece of mechanism rather than of genial humanity.

Jenner’s later writings were chiefly apologies for the failures of vaccination. His position was one of much difficulty, and its peculiarity is rarely, if ever, recognised. For example, how few know that his Inquiry published in 1798, “that master-piece of medical induction,” according to Mr. John Simon, was kept out of print and referred to as rarely as possible after 1801-2.

“Why?”

The answer to the question is so important that at the risk of repetition I give it explicitly.

The Inquiry was suppressed because of its ascription of cowpox to horsegrease.

It was the belief of dairy-maids in Gloucestershire that to have had cowpox was to be secure from smallpox. Jenner was much impressed by the rustic superstition, and brought it so persistently before his medical brethren at their convivial assemblies, that they threatened to expel him if he bored them any longer with the subject. “It is true,” they said, “that the maids believe an attack of cowpox keeps off smallpox, but we know they are wrong; for we are all familiar with cases of smallpox after cowpox.”

Thus frustrated, Jenner’s ingenuity took another turn. It was the belief of farriers that if infected in dressing horses’ greasy heels, they too were secure from smallpox. The area of this conviction was narrower than that of the dairy-maids, farriers being neither so numerous, nor so observant of their beauty: but Jenner entertained their faith and converted it to his purpose.

Horsegrease protected from smallpox, if cowpox did not. But might there not be one sort of cowpox that answered to the dairy-maids’ faith, if another sort did not? Happy thought! The defensive sort was derived from the horsegrease which protected the farriers: the non-defensive originated spontaneously on the cows. Men, fresh from handling horses’ greasy heels, milked cows and communicated to them the horses’ disease. Milkmaids, who in turn contracted from the cows that sort of pox, were like the farriers secure from smallpox, yea securer; whilst milkmaids who contracted pox spontaneously developed on cows were not secure. The milkmaids’ superstition was therefore justifiable: they were right and they were wrong—right when they got pox through the cow from the horse; wrong when they got pox from the cow simply.

Why then, it may be asked, did not Jenner dismiss the cow from consideration? Why did he not base his prescription on the farriers’ experience, and use and recommend horsegrease exclusively for inoculation? The question is an obvious one, but it is not easy to make out Jenner’s answer with precision. His assertion was, that—

which was to say that horsegrease attained its highest prophylaxy after transmission through the cow.

Such was the doctrine of the Inquiry, “that master-piece of medical induction.”

When the doctrine came to be reduced to practice, difficulties arose. Cowpox was considered wholesome and credible, whilst horsegrease was repulsive and incredible. Still fact was fact; and many were ready to accept horsegrease through the cow, or without the cow, if such indeed were the source of the new salvation. Cowpox proved to be a rare commodity, whilst horsegrease was common, and numerous attempts were made to produce cowpox by means of grease, but ineffectually. At some attempts, Jenner officiated. Marshall records that—

To this discomfiture Jenner had to submit. His ascription of cowpox to horsegrease was stigmatised as an error of which the less that was said the better. It is true that other experimenters were more successful, and that Loy of Whitby and Sacco of Milan dispensed with the cow as a superfluity and used matter direct from the horse for inoculation, passing the virus from arm to arm into general circulation until what was equine was lost sight of and indistinguishable from what was vaccine; but Jenner did not care to be justified at the risk of his popularity and the money on which he had set his heart. He saw how the wind of public favour was blowing, and went with it. Since horsegrease was disliked, he consented to its oblivion. Pearson, the chief promoter and organiser of vaccination, scoffed at horsegrease, and used spontaneous cowpox, which Jenner knew was of no avail against smallpox; but he entered no protest upon that score. On the contrary, he let the futile practice go on; he claimed it as his own; and he set about manufacturing excuses for the failures which were imminent.

Spurious cowpox was one of the most dexterous of these excuses. If injury or smallpox followed vaccination, the disaster was ascribed to spurious cowpox. Jenner’s Further Observations, published in 1799, was designed to teach “how to distinguish with accuracy between that peculiar pustule which is the true Cow Pock and that which is spurious;” and in his Origin of the Vaccine Inoculation in 1801 even greater stress was laid on the distinction. By and bye, however, the excuse worked more harm than advantage. People got terrified with the mischiefs ascribed to spurious cowpox, and as which was genuine and which spurious was only discoverable in their consequences, they began to decline to have either. It then became expedient to deny spurious cowpox, which Jenner did. He confessed to the Royal College of Physicians that there was not a true and a false cowpox; and that by spurious cowpox he “meant nothing more than to express irregularity in the form and progress of the vaccine pustule from which its efficacy is inferred.”

In view of facts like these, there is little cause for surprise that the publication of Jenner’s Inquiry with its two supplements was not continued. What he set forth as essential was treated as illusory, whilst the cowpox in which he had taught there was no security had been brought into use everywhere. Why therefore embarrass himself with proclamations of his own blunders? The believers in vaccination were good-natured and incurious, and he had their homage, which was agreeable and profitable, and why should he dissipate it? The Inquiry was printed for the third time in 1801, but “this master-piece of medical induction” has never been republished; and the probability is, that if ever reproduced, it will be to prove to the world the emptiness of its author’s pretensions.

Jenner’s original promises of immunity from smallpox by inoculation with horsegrease cowpox were absolute. Thus he wrote—

Experience was not slow to demonstrate the futility of these assurances. At first the facts were flatly denied: it was impossible for smallpox to succeed cowpox. The evidence, however, grew too strong to be outsworn, and then it was said the cowpox must have been spurious. As failures accumulated over the operations of Jenner himself and his choice disciples (who were naturally presumed to know and avoid spurious cowpox) they began to lay great stress on the fact that smallpox itself did not always avert a subsequent attack; and if smallpox did not save from smallpox, why, they demanded, should cowpox be expected to do more?[194] Why, indeed! Still the cases of smallpox after cowpox were as scores to those of smallpox after smallpox, and then the argument was reduced to a competition between variolation and vaccination. “You inoculators with smallpox,” said the vaccinators, “are continually having smallpox after variolation, and why should we be expected to be more successful?” Why, indeed! The inoculators with smallpox in turn denied that after efficient variolation smallpox ever occurred, or could possibly occur; and thus the wrangle went on. One thing was plain and certain—the original claim of Jenner for the absolute infallibility of Horsegrease Cowpox as a preventive of Smallpox was reduced and surrendered bit by bit until it came to this at last—it made Smallpox milder!

These repeated surrenders were, however, never ingenuous. Mistakes are inevitable, and they are forgiven when frankly confessed; but frank confession was not Jenner’s habit. When vaccination failures had become notorious in 1808, he had the hardihood to assert, that from the outset he had recognised that as smallpox did not always avert smallpox, neither did he expect cowpox to do so; and cited as proof of his prescience this passage from Further Observations in 1799—

Here Jenner made a bold draft on his reader’s ignorance. It was his claim for horsegrease cowpox that it conferred an absolute security from smallpox without any qualification whatever. The assumed prescience in 1799 is completely belied when we refer to his arrogant manifesto of 1801. These are his words—

Cowpox was thus set forth as a prophylactic with powers hitherto unknown and unique; so that Jenner was cut off from the claim of its equivalence with smallpox in character and consequences. He knew in 1799, as we have seen, that infection with smallpox did not render the constitution proof against the subsequent influence of the disease; but in 1801, as we see, it was his express contention that what smallpox failed to do that cowpox did—it protected the constitution perfectly and for ever from smallpox, and nothing to compare with it had ever appeared in the Annals of Medicine. It was only under the pressure of exposure and defeat that he humbled himself to write to Dunning, 1st March, 1806—

To this pass was the infallible preservative from smallpox, with nothing to match it in the Annals of Medicine, reduced within the experience of seven years!

The most thorough-going and far-reaching of Jenner’s excuses for vaccination failures were herpetic affections of the skin. In his journal we read—

To Mr. Dunning he wrote from Cheltenham, October 25th, 1804—

And again to the same correspondent, 23rd December, 1804—

Having thus detected an all-sufficient explanation of the failure of vaccination to prevent smallpox, he communicated his discovery to the Medical and Physical Journal, August, 1804, in a paper entitled, “On the Varieties and Modifications of the Vaccine Pustule occasioned by an Herpetic State of the Skin,” but he complained to Dunning “that it seemed not to have excited the slightest interest.” In order to call attention afresh to the subject, he had the article reprinted as a pamphlet at Cheltenham in 1806 and at Gloucester in 1819, but in vain. He complained to Baron in 1817 that he could not get the Board of the National Vaccine Establishment to attend to his cautions touching the interference of cutaneous diseases with the progress of the vaccine vesicle. “I am afraid,” he observed, “that the extreme ignorance of medical men on this subject will destroy the advantages which the world ought to derive from the practice.”[201]

What of course medical men with the least common sense perceived was, that the excuse provided for vaccination failures was too liberal to be worth anything. If the least cutaneous eruption was sufficient to frustrate vaccination, what operation could be pronounced efficient? for it could scarcely be intended that every patient should be stripped to the skin and minutely examined for herpetic vesicles. There was nothing transitory in Jenner’s opinion about herpes: he harped upon its mischiefs and omnipresence to the close of his life. William Dillwyn of Walthamstow having asked him for any observations that occurred to him on the practice of vaccination for the benefit of Friends in Philadelphia, Jenner replied in a letter dated Berkeley, 19th August, 1818, in which we find these remarks—

These complaints of the indifference of the medical world to his prophesying, show how completely the business of vaccination had passed out of Jenner’s hands. The influence of herpes on vaccination, although declared by him to be of the utmost importance, even to the extent of imperilling the advantages of the practice, was disregarded as unworthy of serious attention.

Another of Jenner’s apologetics was a pamphlet in 1808[203] designed to explain away the failure of the variolous test—the test that deceived so many in the early days of vaccination. The inoculated with cowpox were inoculated with smallpox, and when the smallpox did not “take,” it was said, “Behold the perfect protection!” The smallpox inoculators complained bitterly of the hocus-pocus. “No wonder,” they said, “that when the system is in a fever with bestial corruption, that human pox will not ‘take,’ but try after awhile.” And they did try after awhile, and it was found that the vaccinated could be inoculated with smallpox like the unvaccinated. Indeed, when it was seen that the vaccinated fell victims to smallpox, many who had been vaccinated resorted to the smallpox inoculators for their supposed superior protection, and received it without hindrance from their previous vaccination. It therefore became judicious to disown the variolous test; but neither in this case was the surrender frankly made, but with prevarication that deprived it of all grace. What the smallpox inoculators maintained, Jenner had to allow, but after this fashion—

For the variolous he recommended the substitution of the vaccine test; saying—

Which was to say that vaccination immediately after vaccination would be found impossible—the later practice of periodical re-vaccination being unforeseen.

Jenner might have perceived that after his proclamation of the influence of herpes on vaccination, there was nothing to be said for the variolous test. When he consented to run vaccination on the same terms as variolation, and admitted that it would be wrong to expect more from the one practice than from the other, he was bound in consistency to allow that if vaccination was frustrated by eruptions of the skin, it was matter of consequence that variolation should be frustrated by the fever of vaccination. He informed Dillwyn that he destroyed cutaneous eruptions by the application of unguentum hydrargyri nitrati, and then vaccinated with success. The smallpox inoculators did so likewise. When the irritation induced by vaccination had had time to subside, they too variolated with success.

The letter to Dillwyn, 1818, contains some other points which it is instructive to note. For example, the following passage proves two things, first, how notorious had become vaccination failures; and, second, how vaccination, from an easy art that any one might practise, had been converted into a mystery to which even “an eminent surgeon” might be unequal. Jenner says—

A report having got abroad that Jenner had renounced his faith in vaccination, he replied to Dillwyn—

In presence of such a declaration, it is easy to understand why the Inquiry with its supplements was kept out of print, and never referred to. His confidence in vaccination not in the least diminished! In the words cited, he surrendered afresh the claim with which he started, and for which he was paid, namely, that inoculation with cowpox rendered the constitution proof against smallpox for life, and that the protection thus afforded was without precedent in medical experience.

Having thus, under stress of necessity, reduced vaccination to the level of variolation, and tried to shelter the failures of the one practice under those of the other, the spirit of the old quack surviving, he went on to prophesy in the familiar strain—

With Jenner’s turn for romance, there is no need for dealing with a statement like the foregoing seriously, else we might ask what was the prevalence of smallpox in Gloucestershire before vaccination? and to what extent had it been cultivated by inoculators? Throughout England there was a remarkable subsidence of smallpox precedent to the introduction of vaccination (for which vaccination obtained the credit), which subsidence was no doubt accelerated by the cessation of variolation. Jenner resumes—

There was no checking Jenner when he rose into rhodomontade about the myriads of Asia and the vastness of America, but descending to the definite in Ceylon and Sweden we can test him with precision, and as to both we shall find his statements at wide variance with facts. For the present, however, let us keep to our own country, and note especially what he had to assert of London in 1818—

In London in 1818 the deaths from smallpox were low (421); but a single year is of little account, and must be viewed in relation to preceding years. Here we have a statement for the decade, 1811-20, taken from the metropolitan Bills of Mortality.

From this statement we see that the decrease in London smallpox that set in toward the close of the 18th Century was maintained; but that vaccination had aught to do with the decrease there is no reason to believe—unless in so far as the new practice discouraged variolation. How, we ask, could the vaccination of one-tenth of the Londoners (if so many) reduce the smallpox among nine-tenths? We have also to observe that mortality from fevers abated in common with smallpox; and it cannot be pretended that that abatement was also due to vaccination! The rational assumption is, that what diminished fevers in London, likewise diminished smallpox. Nor should we overlook the fact, that as the deaths from smallpox declined, those from measles increased; nor the probability that many deaths formerly ascribed to smallpox were derived from measles, and that part of the decline in one column is accounted for by the increase in the other.

Jenner’s assertion, that the national mortality from smallpox had been reduced from more than 40,000 to less than 6000 annually, had no basis whatever in reality. As we know, the 40,000 deaths were got by multiplying the deaths of a bad year of London smallpox by the population of the United Kingdom—as if London were the standard of England, Ireland, and Scotland! How he obtained the reduced number of 6000 we are left to conjecture. In reviewing Jenner’s writings we are startled with his inconsistencies, and scarcely less with the carelessness and credulity of his adherents. He set out with the common knowledge that cowpox did not prevent smallpox, and for that reason he substituted pox generated by horsegrease on the cow. Horsegrease cowpox could not, however, be procured on demand; and was, moreover, disliked on the score of its origin; and cowpox was resorted to by Pearson and Woodville, and diffused everywhere with acclamation; and Jenner did not only not object, but took credit, and actually was allowed to take credit for the pox he had described as ineffective for the purpose designed! By and bye cowpox from horsegrease, or horsepox, according to the original recipe, was obtained and brought into circulation with Jenner’s sympathy, if without his open approval—he discerning that praise and pay were not to be had from that notion. After a while, horsegrease, or horsepox, was used for inoculation without the intervention of the cow; and that too entered into currency as vaccine, Jenner himself employing and distributing it, although according to his Inquiry it was not to be trusted to prevent smallpox.

I repeat these facts, even at the risk of tedium, because it is essential to have them clearly apprehended. For at least three descriptions of virus Jenner stood responsible, namely—

I.—Horsegrease Cowpox—the virus warranted in his Inquiry.

II.—Cowpox, known by Jenner to be ineffective in preventing smallpox, but favoured by the medical profession and the public.

III.—Horsegrease (said to have been horsepox), also described by Jenner as ineffective, but latterly used and diffused by him.

To which of these did he attribute the success claimed for vaccination? Apparently to all indifferently; but if one were as good as the others, why did he not say so, and proceed to explain how it was that cowpox did not save the Gloucestershire milk-maids, nor horsegrease the farriers from smallpox? Was it that the power to put such questions, and to answer them, does not consist with the quack’s intelligence; and that in his lucre he rests content? Observe, too, how when credit was to be had for London vaccination, Jenner took it, though at mortal enmity with the chief agent in the work, repudiating Walker’s practice as subversive of principles he considered essential to success.

Jenner’s final publication in 1822 had nothing to do with vaccination, but was a bid for fame in a new direction.[204] It was an attempt to originate a new method of cure by irritating the skin with tartarated antimony. He had dabbled with the chemical when a young man, and John Hunter had suggested that his preparation should be sold and puffed as Jenner’s Tartar Emetic. In his last years he returned to it, and produced a series of cases to prove how many diseases might be alleviated and removed by using it as a counter-irritant—just as in the Inquiry he recommended cowpox inoculation with the same intention. The matter does not concern us further than to observe that the vesicles and scars produced by tartarated antimony are almost indistinguishable from those of vaccination; and that Hufeland, the German Nestor of Medicine, taught and proved that tartar emetic was every whit as effective against smallpox as cowpox—an opinion from which I see no reason to dissent.

We owe much to Baron’s Life of Jenner, but as a collection of evidence rather than as an organic biography. It is verbose and loosely put together, and would never be read unless by some one in quest of information, or with nothing better to do. Fortunately Baron was reverent and not critical. Jenner was to him a sacred being, admirable in all relations, whose only contention was with “the blindness and wickedness of his traducers.” Lives written in this temper are often most instructive. Tales are told and letters produced in pious simplicity that biographers of the judicious order discreetly suppress.

Baron made Jenner’s acquaintance in the summer of 1808 when he was living at Fladong’s Hotel, Oxford Street, revelling in a fool’s paradise as to his importance in the formation of the National Vaccine Establishment. Baron had recently come from Edinburgh, and says,—

The passage is a long one, but it has some value in itself, and exhibits Baron’s habitual attitude toward his hero. In his private relations, Jenner was amiable, but it is with his public life that we are concerned, and find so reprehensible. Mischievous leaders and teachers are frequently distinguished by private graces; and austere personal virtue is frequently associated with bland indifference to conventional immoralities; and we need not go far to discover counterparts of Jenner in ordinary life. Nothing is commoner than suavity combined with self-love that is malignant and mendacious when thwarted. All is pleasant as long as admiration prevails, but with dissent or resistance the sunny temper vanishes, and clouds of contempt and fury overspread the spiritual sky. A sharp test of character is a man’s disposition to his adversaries; and Jenner was never magnanimous. His conduct to Pearson, Woodville, and Walker has been sufficiently described; and similar jealousy and spitefulness were displayed to whoever dared to impugn his infallibility in the prevention of smallpox. No one, for instance, could have brought forward the fact that smallpox occasionally succeeded vaccination with more simple good faith than Goldson; yet Jenner wrote of him with insufferable insolence—an insolence that is thrown into stronger relief by the knowledge that what Goldson testified is accepted at this day, even by vaccinators, as indisputable matter-of-course. His bully, too, John Ring, attacked Goldson, and Jenner, in writing to Dunning, 23rd December, 1804, thus excused his brutality—

In the same spirit he wrote to Baron, 6th November, 1810, of Brown of Musselburgh, who had reported certain cases of smallpox after vaccination in a London newspaper—

As applied to Brown, sagacious and sincere, this was the very ecstasy of abuse. Even Brown’s adversaries within his own neighbourhood, ultimately yielded to his contention. In the Edinburgh Medical and Surgical Journal of July, 1818, we read—

In short, calm discussion of vaccination with Jenner was never possible. Inquiry was borne down with clamour, and scepticism denounced as malevolence. “He could not altogether escape,” says Baron, “from the annoyance occasioned by the blindness and wickedness of his traducers”[208]—and all were traducers who were not believers. Indeed, Baron could only account for the perversity of those who did not recognise Jenner as the saviour of mankind from smallpox by a resort to the doctrine of inbred depravity, saying—

Purified and strengthened, and the affinity with falsehood dissolved, it became possible for the understanding to appreciate the virtue of cowpox and the veracity of its advertiser!

Jenner, it may be said, instinctively resented investigation. He was uneasy in conscious duplicity. He knew there was no safety in vaccination as practised; for the cowpox employed was not the horsegrease cowpox he had commended as efficacious. What he had prescribed was disregarded; what he had condemned was approved; but, strange to say, he was praised and rewarded by the world as if cowpox had been his specific! Jenner accepted the situation, and possibly came to believe (after a fashion) that he was enjoying no more than his own; but under the circumstances it was not surprising that he shrank from criticism, kept his early publications out of the way, and resorted to scolding and shrieking whenever scrutiny appeared imminent.

Worse even than his behaviour to investigators and opponents was his treatment of those who converted vaccination to practice. The Inquiry was no handbook, and Pearson, Woodville, and other early vaccinators, had to make their own way, not only unassisted, but with Jenner ready to appropriate their successes and to reproach them with their failures. Baron avers that nothing in the art of vaccination was due to any one but Jenner himself, qualifying this praise with a slight exception in favour of Dr. Bryce of Edinburgh, who made the discovery that if a subject under vaccination is re-vaccinated, the subsequent inoculation is caught up and brought to maturity with the precedent—a phenomenon that as Bryce’s Test was used to ascertain whether true vaccine fever was operative. But even Bryce received scant acknowledgment, and Baron tries to make out that Jenner was possessed of the fact ere it was announced.[210] Jenner’s meanness toward those who displayed any intelligent independence in co-operation with him is written at large in Baron’s biography, but with such innocence that it would be absurd to describe it as indecent. His good faith is perfect, and it is only a critical reader that finds out how he is identified with Jenner, seeing merit nowhere save in his abject servitors and feminine claque.

Vaccinators at this day allow that the influence of vaccination wears out and ought to be renewed; yet Jenner would not listen for a moment to such a modification of its perpetual prophylaxy. Baron writes—

When in 1813 Lord Boringdon introduced his bill to Parliament for the restriction of variolation, Lord Ellenborough observed—

In this declaration the Chief Justice was not singular, but expressed the general conviction of the public who held by vaccination in spite of the manifest failure of the early promises made for it. Nevertheless Jenner was extremely annoyed: it was to him as the formal deliverance of judgment. Baron says—

Thorough was Baron in his defence of Jenner: no inconsistency appalled him. He records in capitals (as produced) the following as Jenner’s solemn and final testimony, written, a few days before he expired, on the back of a letter, bearing the post-mark, 14th January, 1823—

Self-deception after this pattern is far from uncommon, and is proof against evidence and death itself; but Jenner was not quite so crazy as his words imply. From his first opinion about vaccination, and its absolute efficacy against smallpox (unlike anything hitherto known in medical experience) he had retreated considerably. Even so early as 1804 he had reduced his claim for vaccination to equality with variolation. In that year he observed—

And again Baron cites him as saying—

Jenner presumed freely on the forgetfulness of those he addressed. In a document so well known as his petition to the House of Commons in 1802, he expressly claimed that a person inoculated with cowpox was thereby “rendered perfectly secure from the infection of smallpox through life”; nor would the furore which attended the introduction of the practice have been possible had it been set forth as no more than a milder form of variolation. That cowpox was equivalent to smallpox for inoculation was laughed at by the variolators; but that a vaccinated person was as safe from smallpox as one who had passed through the disease, was true in no other sense than that Jenner wished it to be true, and prophesied accordingly. It was by such contrivances that he broke his own fall, and alleviated the disenchantment of the credulous.

Oddly enough Jenner’s fiction, that vaccination was as good against smallpox as smallpox itself, was revived in the innocence of ignorance by Sir William Gull before a committee of the House of Commons in 1871. “Vaccination is as protective against smallpox as smallpox itself,” said the fashionable physician. Confutation was, however, at hand. Mr. Marson (for thirty-five years resident surgeon of the Highgate Smallpox Hospital) attested that cases of smallpox after smallpox were comparatively rare—not 1 per cent.; whilst 84 per cent. of those admitted to the Hospital in 1864 were vaccinated. An instructive contrast between the logic of fancy and matter of fact!

Baron, with unscrupulous disregard of evidence, complains that vaccination should ever have been represented as an infallible preventive of smallpox; so that as pointed out in the Report of the Royal College of Physicians in 1807, “the fate of the new practice was made to hang on the occurrence of a single case of smallpox”; and goes on to observe—

The summary answer to this statement is, that it is untrue. Jenner anticipated no failures. On the contrary, he vehemently denied them; and when denial could no longer avail, he invented a variety of excuses, such as spurious cowpox and omnipresent herpes, to account for their occurrence; though always ready (as we have seen) to hark back to his original assertion that vaccination was “an infallible preventive of smallpox.” Baron did not like the word “infallibility.” He writes—

Whether he did make use of the word “infallible” is of slight importance. There are various modes in which the same meaning may be conveyed, and Jenner’s was unequivocal. It was in 1801 that appealing to the rigid scrutiny that had taken place in the first professional circles of Europe, he deliberately proclaimed it as certain—

When Lord Ellenborough in 1813 described vaccination as affording no more than a temporary security from smallpox, he merely expressed the diminished confidence of the community in the practice; but it is the habit of adventurers to ascribe adverse manifestations of public feeling to petty causes; and thus Jenner held that the Chief Justice was indulging a personal grudge when he threw doubt on the perpetual efficacy of his prescription. On one occasion, so ran the story, Ellenborough was relating in a company at St. James’s how Jenner had so little faith in cowpox that he had used smallpox to inoculate his own child, when he was suddenly confronted by an irate personage, who exclaimed, “I am Dr. Jenner, and what you have stated is not true!” whereupon Ellenborough slunk aside in confusion. The fact of the rencontre in the sensational form, we may credit as we please; but about the variolation of Jenner’s child there is no doubt whatever. We have the circumstance recorded by himself with such explanation as he considered adequate.

Turning to the Inquiry, we find under Case XXII. that Robert F. Jenner, aged eleven months, was vaccinated on 12th April, 1798, and that he did not receive the infection. The operation was not repeated, and he remained unvaccinated. Some time afterwards, whilst Jenner was residing at Cheltenham, Mr. Cother, a surgeon, happened to drop in, and having taken the child in his arms, mentioned in the course of conversation, that he had just left a family suffering from smallpox. “Sir,” cried Jenner, “you know not what you are doing! That child is not protected.” What was to be done? “There was no doubt on my mind,” says Jenner, “that the boy was infected;” and having none of the precious horsegrease cowpox in his possession, he held that he was without alternative, and by Mr. Cother the lad was immediately inoculated with smallpox.

The fact in due course got abroad, and, as Baron relates, was made the most of by the opponents of vaccination—

Such talk was very natural, nor was it without justification. Jenner ought to have proved his sincerity by the vaccination of his son; and he who denounced variolation and variolators with such bitterness might have accepted the risk of infection from Mr. Cother rather than have compromised himself so injuriously. Moreover (as was asked at the time) if the child was infected, what was the use of inoculation? Variolation and vaccination (it was argued) may be serviceable in keeping off smallpox, but are of no avail after infection.

Vaccination has been described as a remarkable survival of superstition in hygiene—many, who disowning all other dodges for the maintenance of health, holding by it. Of course Jenner knew nothing of hygiene in the scientific sense—it was revealed after his time; but it is noteworthy that in none of his publications or letters is there any anticipation of the truth that has proved so fruitful in our experience, namely, that ill-health indicates ill-living, and that the misery of disease is only remediable in so far as we come out of the conditions of disease. Whilst of such truth he knew nothing, he might have known something. It lay plainly before him that smallpox was an affliction of the poor, and of the prosperous in so far as they shared the conditions of the poor, but he never recognised the fact. On the contrary, he cherished the fantasy that various diseases were derived from association with animals; and that thus smallpox originated in cowpox, which in turn came from horsegrease. “There,” said he to his nephew, pointing to a horse with greasy heels, “there is the source of smallpox.”[220] To entertain such an opinion was to be stone-blind to the true causes of disease, and therefore we have no reason for surprise that the Jenner household lived in chronic ill-health, piously submissive to what they supposed the divine will. Typhus fever was recurrent in the household without a suspicion that anything was amiss on the human side. There was a genius named Dawes Worgan, whom Jenner received into his family as tutor to his son, but ere a year had elapsed the poor fellow had two attacks of typhus, and finally succumbed to pulmonary consumption in 1809, in his nineteenth year. Chantry Cottage, Jenner’s residence at Berkeley, was no temple of Hygeia: on the contrary, such a place at this day would be a terror to a respectable neighbourhood, and subject to the attention of the sanitary inspector.

The principle of vaccination conceded—that health may be purchased by disease, it was not surprising that it was thought that measles and scarlet fever could be extirpated by similar treatment. Sir Humphry Davy suggested that hydrophobia might be anticipated by the inoculation of another animal virus, but Jenner held that cowpox should be tried—“nothing like leather.” It was reported from Constantinople that the plague itself was stayed by vaccination, and that experiments, exactly like those used to demonstrate its power against smallpox, had been repeated with complete success. There was not, however, enterprise in the East for the development of the quackery.

Jenner taught that distemper in dogs was preventible by vaccination, and accumulated a variety of “first-rate evidence” in proof. It was no transitory whim. He vaccinated twenty of the King’s staghounds in 1801, and in 1809 contributed a paper to the Medico-Chirurgical Society on the subject, wherein he expressed the opinion that the disease had only existed in England for the past half century. Several great fox hunters had their hounds vaccinated, and the results were pronounced satisfactory.[221] Why, then, was the practice not continued? Why is not distemper exterminated? May we not say the reason is plain? The first-rate evidence was illusory. Men are apt to create the facts they wish for, but as desire subsides, they recover their normal eyesight. Cowpox, we are persuaded, was as good against distemper in dogs as against smallpox in human beings, and but for extraneous causes, it would have been abandoned for the one as for the other.

For Jenner it has to be said, that if deceived, he had much to excuse his self-deception. There are men possessed of convictions which they maintain in the face of an indifferent or antagonistic world, but Jenner was not such a man. If his Inquiry had gone the way of waste-paper, he would have offered no resistance; but instead, it was proclaimed by Pearson as worthy of universal attention, and the hour being propitious, the middle-aged country doctor suddenly found himself treated as the deliverer of mankind from smallpox, whilst Pearson, his promoter, was swept aside as a half-hearted worshipper of the new divinity. Adulation was administered without measure, and if Jenner took it for true, and was led to imagine that he had more in him than he ever imagined, what marvel! He became the centre of a European craze of a character and intensity that is perhaps without parallel. Emperors and kings, statesmen and philanthropists, men of science, and in short the whole educated world conspired to do him reverence. The craze gradually abated, and the abatement was most decided in the country of its origin, and chiefly in London where cowpox and its advertiser were most closely scrutinised. Jenner abhorred London. There he had proposed to flourish as a West-End physician, and there he had encountered a dismal failure. There, too, his antagonists were active, and their demonstration of the futility of his assertions most conclusive. We see his temper toward London in such a passage as the following from a letter to Dunning, dated Cheltenham, 21st February, 1806—

Whilst the doors of almost every scientific corporation in the world were thrown open to receive him, the Royal College of Physicians of London maintained an honourable reserve; and when in 1814 his claim to admission was strongly urged, the majority insisted that, if received, he should submit to the usual examination—a sufficient check in Jenner’s case.[223] The College has been reproached for its treatment of “the immortal benefactor of the human race,” but it is forgotten how intimately the leading members were acquainted with his immortality, and with what disgust they must have received his confession in 1807 as to the non-existence of spurious cowpox.

Toward the close of his life, Jenner rarely appeared in London. His last visit took place in 1814, when he was presented to the Emperor of Russia. “I am happy to think,” said Alexander, “that you have received the thanks, the applause, and the gratitude of the world;” to which Jenner made answer, “I have received the thanks and the applause, but not the gratitude of the world”—the absent gratitude being a periphrase for absent cash, and a hint to the Czar that he might repeat the superb munificence of his grandmother, Catharine, to her inoculator Dimsdale. The Emperor, however, gave nothing, and Jenner retired keenly disappointed. Whatever the imperial disposition, Jenner did little to render it more propitious by using his audience to denounce Walker and the Friends by whom vaccination was at that time chiefly promoted; for as Alexander said, “I love the good Quakers: they are my friends, indeed;” and whoever slandered them was not likely to advance in his favour.

With all he got Jenner reckoned himself ill-paid; and taking the words of his admirers for sincere, he was ill-paid. Many a successful slayer of his kind had much more from the House of Commons with less fuss than their ideal preserver; but there is often a measure of sincerity within insincerity, and many of those who praised Jenner most rapturously felt that he had not been dealt with illiberally as the advertiser of cowpox.

Jenner’s wife died in 1815, an ailing, pious, affectionate woman, and thenceforth he dwelt in retirement until his death on the 26th of January, 1823, at the age of seventy-four. “Never,” he wrote to his friend Gardner on 13th January, a week before his demise, “Never was I involved in so many perplexities.” Hailed with acclamation in 1800-2 as the saviour of mankind from smallpox, during the remaining twenty years of his life he underwent a steady course of discredit as failure after failure was recorded and attested against vaccination. Appropriate therefore was his farewell to the world in 1823, “Never was I involved in so many perplexities.” There was not enthusiasm left to effect the interment of his remains in Westminster Abbey, and the funeral took place at Berkeley. An attempt was made to obtain a grant from Parliament for a monument, but the proposal fell flat. Baron then set on foot a subscription for the purpose, but it met with little encouragement. The only public bodies which contributed anything were the Edinburgh Colleges of Physicians and Surgeons, the first sending £50 and the second £10. With much difficulty sufficient was scraped together to order a statue from Sievier, which was set up at the west end of the nave of Gloucester Cathedral. The front panel of the pedestal originally bore the dates of birth and death, but Baron had them removed, considering the word Jenner all significant.

In latter times, in 1859, a statue was erected to his memory in Trafalgar Square, London, close by the College of Physicians, but it was felt to have an air of possible quackery about it, and by and bye was quietly removed to a corner in Kensington Gardens. There is, as I have remarked, a measure of sincerity even in insincerity; and it is impossible for any one with a lively sense of veracity to know Edward Jenner and entertain for him any respect.

When Jenner died in 1823, the judgment of the majority of the people was pronounced against cowpox inoculation; but medical men, who are expected to know something, and do something, against every ailment, rarely surrender a prescription until it can be replaced by another. The doctors therefore held by vaccination, but on modified terms; and the position to which they had been reduced is set forth in an article in the Edinburgh Review, for November, 1822, concerning which Jenner wrote to Gardner, 13th January, 1823, a week before his death—

What an extraordinary article! working mischief incalculable, and bad for at least one hundred thousand deaths! A criticism in the Quarterly is said to have killed Keats, upon which Byron remarked—

If, however, Jenner was right, it will be allowed, I think, that the murder of a poet was exceeded in atrocity by the slaughter of at least one hundred thousand ordinary mortals. Wherefore, to discover the manner of the great iniquity, I looked up the Edinburgh Review and discovered the diabolical article. It is entitled “Vaccination and Smallpox”; is obviously written by the editor, Jeffrey; and the rock of offence was at once apparent. Doubt is thrown on the efficacy of vaccination to prevent smallpox; ergo, vaccination thus discredited will be neglected; ergo, vaccination thus neglected will enlarge the domain of smallpox; ergo, at least one hundred thousand persons will perish. Q.E.D. But it will be asked, “What did Jeffrey say?” The article thus opens—

The Report of the Vaccine Pock Institution for 1803 is cited, as follows, to show how absolute was the confidence in vaccination in the days of inexperience—

As time went on, cases of smallpox after vaccination kept multiplying, and the various excuses to account for their occurrence, though obstinately asserted, utterly broke down. There remained no doubt whatever that to be vaccinated in the most approved fashion afforded no guarantee against smallpox. In 1820, said Jeffrey, the Board of the National Vaccine Establishment was compelled to make the following melancholy admission—

The significance of a confession like the foregoing is not to be estimated literally. It was exacted under irresistible pressure of facts, numerous, definite and undeniable, after every method of excuse and prevarication had been exhausted. In short, it was an authoritative retractation of the flaming medical testimony with which vaccination had been commended to the public in 1800, when the heads of the profession thought it their duty to declare in the newspapers—

And of Jenner’s emphatic assurance—

The occasion of Jeffrey’s article was the publication by Dr. John Thomson of a treatise on a violent epidemic in Edinburgh, and other parts of Scotland, in 1818-19.[224] The disease differed from ordinary smallpox in respect of the smallness of the pustules, which contained a milky fluid, and began to dry up on the fourth or fifth day. In Thomson’s words—

Whether this epidemic was smallpox or chickenpox, was the question. It was chickenpox said some. It was modified smallpox said others. It probably was chickenpox said Thomson; and if so, he argued, chickenpox should be accounted a variety of smallpox. The chief cause of uncertainty was, that the vaccinated constituted the majority of sufferers—

Thomson reported 556 cases in Edinburgh of which—

310 had been Vaccinated;
  41 had had Smallpox; and
205 had neither been Vaccinated nor had Smallpox.

And William Gibson, surgeon at Robert Owen’s mills, New Lanark, had 322 cases, of which—

251 had been Vaccinated.
  11 had had Smallpox, spontaneous or inoculated.
  57 had neither been Vaccinated nor had Smallpox.
    3 had had Smallpox and Cowpox simultaneously.

As is usual in epidemics of smallpox, it was the young who were the majority of sufferers; Thomson saying—

Thomson supported his opinion that chickenpox and smallpox were interchangeable varieties of variola with much cogent evidence and argument. He cited instances in which they occurred together, one constitution bringing forth chickenpox where another brought forth smallpox, whilst the infection of one appeared at times in the manifestation of the other. The controversy is not one on which it is necessary to pronounce judgment beyond saying that the whole drift of philosophic pathology is now in Thomson’s favour; and indeed at the time he wrote, his position would not have been seriously contested, save for the discredit it accumulated upon vaccination. One of Thomson’s correspondents, P. Mudie, M.D., of St. Andrews, stated the difficulty with artless force. He wrote, 18th October, 1818—

Notwithstanding his experience, Thomson held firmly by vaccination. Whilst compelled to admit that it did not avert either form of variola, he maintained with curious fervour that it made the disease milder, as if to excuse his partial surrender of faith. We all see more or less according to our prepossessions, and we need not blame Thomson if with his perspicacity he was unequal to the entire truth. The vaccinated belonged to classes who were better housed, better fed, and better cared for than the unvaccinated; and if their ailment had been measles or pneumonia in place of chickenpox, they would have all the same made better recoveries. Precisely the same error is made at this day: what is due to kindlier conditions of life is ascribed to vaccination.

Some tried to account for the manifest failure of vaccination on the supposition that the original virus had lost its force in transmission from arm to arm, but Thomson would not allow that it had deteriorated. He said—

The latter words are noteworthy. When Jenner’s ascription of the origin of Cowpox in Horsegrease is referred to, the answer frequently is, that Jenner was mistaken, and that he did not persist in his opinion. It is true that he did preserve a judicious silence about horsegrease when he saw that it would mar rather than make his fortune. But when he obtained all he was likely to get, he resumed the expression of his original opinion, and used and diffused what he described as horsegrease; and the vesicles raised by the virus, and the cicatrices which remained were identical with those induced by so-called Cowpox.

Another point developed in Thomson’s evidence was the mistake made crediting vaccination with the prevention of smallpox where there was no smallpox to prevent. The victories ascribed to vaccination were victories either over an imaginary or a retreating enemy. We cannot too firmly insist upon this point in presence of the claim continually advanced for the subjugation of smallpox by vaccination. For some cause undefined, and, probably in its full extent, undiscoverable, a subsidence of smallpox over the whole of Europe set in toward the close of last century, and continued during the early years of the present; and to this subsidence the favour that vaccination met with was largely due. The decline in the disease concurrently with the introduction of vaccination, was ascribed to vaccination, although the decline prevailed among an overwhelming majority who had never received vaccination. To make good the claim for vaccination it would have been necessary to maintain that the vaccine rite, as applied to 2 or 3 per cent. of Europeans, effected the salvation of 98 or 97 per cent. For example, a great point was made by Jenner and his friends of the extinction of smallpox in Vienna, according to the following table—

Yet it was never pretended that in these years more than a fraction of the Viennese were vaccinated, or that the death-rate of the city was reduced by the disappearance of smallpox. The like fatuity characterised the whole of the vaccinators’ statistics. Smallpox had declined, therefore, they argued, vaccination is the cause of the decline, and multitudes were convinced by the illicit logic. When vaccination was, however, brought to the test of epidemic smallpox, its inefficacy became manifest, and thus Thomson had to avow, as the result of his experience in the Edinburgh epidemic of 1818-19—

Such was the article which Jenner “put down for 100,000 deaths at least.” Yet neither Jeffrey nor Thomson renounced vaccination. They agreed that whilst it could no longer be trusted to prevent smallpox, it made the disease milder in those it attacked. When a cherished belief is surrendered, it is rarely unconditionally: it is only by degrees that full concession is made unto truth.

Leaving England for awhile, let us see how it fared with vaccination in some other countries.

As before observed, the introduction of vaccination to practice is sometimes described, as having been a labour of difficulty, a strife with prejudice, a victory of light over darkness; but there was nothing in reality answering to such magniloquence. The battle was won for vaccination by variolation, for which it was exhibited as a harmless and more efficient substitute. Unless the entrance of vaccination into the place of variolation be recognised, its quick and easy triumph is inexplicable. A novelty that King George and Queen Charlotte, the Prince of Wales, and the Royal Dukes accepted without hesitation or reserve, could not in the nature of things have required the exercise of much intelligence. Any serious resistance proceeded from the variolators, who considered their craft in danger when parsons, women, and tradesmen were approved of as vaccinators by Jenner himself. Such opposition to vaccination as is common at this day was not possible in the early years of the present century. We know that health is the best defence of health, and that illness is proof of ill-living; but, to our forefathers, illness was a mysterious dispensation to be encountered with submission, relieved by prescriptions, magical and natural. Hence not only dull Royalty was involved in the cowpox craze, but men of science like Davy, Wollaston, and Darwin, with the whole troop of men of letters, of whom Sir Walter Scott may be taken for spokesman. Describing Queen Caroline in “The Heart of Midlothian,” he says—

For credulity thus expressed there was large excuse. What else, indeed, could one in Scott’s position have been expected to believe? It was only through the hard disenchantment of experience that vaccination did not prevent smallpox, nor mitigate its severity, nor was in itself harmless, that the early delirium abated, and a less rabid persuasion supervened.

The wave of conviction spread from England over the world, and nowhere was the substitution of vaccination for variolation welcomed more enthusiastically than in New England. As Boston led the way in 1721 in the practice of smallpox inoculation, so from Boston in 1800 was announced the project for the extermination of smallpox by cowpox. But ere advancing farther, it may be well to say a word about Boston smallpox.

Boston was an extremely unhealthy town. For fifty years, from 1701 to 1750, the births were exceeded by the deaths. In a population of about 15,000, the annual death rate ranged from 30 to 70 per thousand. There were epidemics of fever and of smallpox; the latter occurring in general at intervals of ten years, when large numbers died, the smallpox as usual displacing other forms of fever, but nevertheless raising the mortality of the year. The most deadly outbreak of smallpox was that of 1721, the year in which Cotton Mather and Zabdiel Boylston introduced variolation. The mortality of that year was 1102, of which 884 were ascribed to smallpox. In 1752 there was an extraordinary epidemic, but how much of its prevalence was due to circumstance and how much to contrivance, it is impossible to divine. Here are the figures, which are of singular interest—

Boston in 1752. Population 15,684.

Under these heads the entire population of 15,684 was accounted for, with the important exception of the discrimination of the 5998, whose immunity was presupposed, into subjects of induced and spontaneous smallpox. The deaths, 569, were less numerous than in 1721, when 884 died, but the disease was more widely diffused, upwards of one-third of the inhabitants, 5545, being attacked. The epidemic exhausted itself within four months, the record standing thus—

The diffusion of the epidemic was largely due to the extensive variolation that went on, no fewer than 2124 having been inoculated in the panic, and they moving freely about in the assurance of safety, spread the distemper on every side. For every five who had the smallpox, so to say, naturally, two had it artificially, and the one sort was almost as “catching” as the other. It was an instance of a community (excepting the 1843 who fled) rushing into smallpox to escape from smallpox. The deaths of 24 Whites and 6 Blacks from variolation gave rise to much concern, and by some they were spoken of as so many murders. Against this fatality was, however, set the low death rate of the regular sufferers, 539 out of 5545, or less than 1 in 10. The Rev. T. Prince, who communicated an account of the epidemic to the Gentleman’s Magazine for 1753, p. 413, was puzzled to account for the variation from the London standard—

The difference was broader than Prince perceived. An outbreak of smallpox in which a third of the population was affected never occurred in London, and a mortality proportionate with that of Boston among a third of the Londoners would have appeared like a recurrence of the Plague. I am in nowise concerned to minimise the ravages of smallpox when conditions are prepared, as of design, for its development; but I do insist on their accurate definition. Boston suffered severely, but was by no means “decimated”—the invariable rhetorical phrase. The deaths were at the rate of 1 in 27, and, as observed, smallpox replaced other forms of fever. The 539 deaths from smallpox were not extra deaths; the excess was less than half that number, and might fairly be attributed to the extraordinary energy displayed in propagating the disease by inoculation.

Spite of such adverse experience, variolation continued to be a common, though intermittent, practice in America, and especially in New England, where the habit of doctoring for the cure of present ailments, and the prevention of anticipated ones, was established and inveterate. In Boston the practice became systematised, and the inoculated were confined for three weeks to an hospital situated on a promontory in the Charles River, where they were treated as veritable centres of infection—a course widely different from that pursued in the epidemic of 1752. Nevertheless, it is not to be supposed that smallpox was ever endemic in New England as it was in London. Dr. Waterhouse writing in 1787 observed—

The disease broke out now and then, and was always traced to some wayfarer, or ship, or parcel of goods—never to bad drainage, or no drainage, or the stenches that pervaded the domestic interiors of last century, whether in America or Europe. In this matter, the exercise of a little imagination is requisite to realise the historic facts: they are disagreeable; but if people will insist on comparing the smallpox of the 18th century with that of the 19th, it may become necessary to be explicit as to certain domestic details concerning which there is a conventional reserve.

It was by Dr. Benjamin Waterhouse, Professor of the Theory and Practice of Physic in the University of Cambridge, Massachusetts, that vaccination was introduced to America. He described the new rite in the Columbian Centinel of 12th March, 1799, as “Something Curious in the Medical Line”; and formally promulgated the novelty a year afterwards in a pamphlet thus entitled—

Kine-Pox! Why Kine-Pox? The reason is stated by the Doctor—

There we have it: More delicate! If it had been bull-pox the objection might have been insuperable. Writing to Jenner, 24th April, 1801, Waterhouse says—

The pamphlet on Kine-Pox set forth the mystery of the new inoculation as received from England with a significant omission—there was not a word in it about Horsegrease! Waterhouse was in correspondence with Pearson, and Pearson may have told him how not only the asserted generation of Cowpox in Horsegrease was discredited, but “how it was like to damn the whole thing”; which might have been true enough, but if true, Where then stood Jenner? He knew that cowpox did not prevent smallpox: the fact was notorious among the medical men in cowpox districts: and he had expressly pledged his faith in the Inquiry to Cowpox begotten from Horsegrease and to nothing else. But Horsegrease Cowpox did not suit the market, and it was withdrawn with Jenner’s tacit assent, and spontaneous Cowpox advanced in its stead, and accepted as Jenner’s veritable discovery. It might be good business to drop the horse out of the case, but what was it else?

Cowpox, testified Waterhouse, was unknown in New England, but he received the revelation concerning it at once—but not, be it repeated, Jenner’s revelation: that he suppressed. He had long suspected that smallpox was communicated from brutes to the human race; and now his suspicion was confirmed. And, such being the origin of variola, it seemed to him not unreasonable that the disease as it existed in a mild form in kine might be used for inoculation with all the advantages pertaining to smallpox, whilst attended with neither injury to the inoculated, nor with risk of infection to those about them—

How incautious, to say the least, was the acceptance of this prophecy of perpetual security! With less than three years’ experience an absolute prediction was delivered, received, and repeated over the whole earth as if by parrots. Such, however, is the habit of mankind when possessed by a strong delusion.

In justice to Waterhouse it has to be said that he did not commit himself openly until he had gone through the illusory experiments that were then fashionable in England. He had much difficulty in obtaining a supply of active virus. Several remittances failed, but at last he had one, an inch and a-half of infected thread, from Dr. Haygarth which proved, it was thought, effective.[226] His first patient was his son, Daniel Oliver, aged five; then another child aged three; then a servant lad aged twelve; then a weaned infant of one year—all five successful, whilst two domestics failed “to take”—seven experiments in his own household. Then he had the children taken to the Smallpox Hospital, where they were inoculated by Dr. Aspinwall, and issuing scatheless from the test, the truth was taken as demonstrated, and there was no need for further hesitation. Four gentlemen, including a physician, offered themselves for public encouragement—

Waterhouse then appealed to the pride of his countrymen—

Following this prophecy came a frank request for business—

After an English pattern he published the following table—

The operations, so hopefully begun, came speedily to grief. In a letter addressed by Waterhouse to Jenner, 24th April, 1801, we read—

Waterhouse continued to correspond with Jenner, and was regarded as his accredited representative in New England. Writing to Dr. Lettsom, 16th November, 1802, he says—

Waterhouse was a man of an ingenious turn of mind. When troubled with ill-results from his operations at the end of 1800, he tried what has since been called retro-vaccination, probably for the first time. Here are his words from his letter to Jenner, 24th April, 1801—

A sentence which follows is too characteristic to be passed over. Says Waterhouse—

And this after less than twelve months’ experience!

Waterhouse had also to relate a case of cows having smallpox—

Waterhouse had inquiries from Virginia, and wished Jenner to let him have, if possible, a picture of the vaccine vesicle on the negro—

“Some in this country, as well as in England,” observed Waterhouse, “having had all their objections to Kine-Pox obviated, persist in asking, ‘Who can tell what may be the consequences in the lapse of years of introducing a bestial humour into the human frame?’ I answer them as does Mr. Ring with a spirit and wit worthy of Franklin, ‘Who can tell what may be the consequences in the lapse of years of introducing milk, beef steaks, or mutton chops, into the human frame?’”

The pertinacity with which this “wit” was employed by the early vaccinators leads us to suppose that they found it effective; but was ever argument by analogy more absurdly misapplied? Milk or steaks from a cow, or chops from a sheep known to be suffering from pox would be rejected with loathing; nor was it ever proposed to cook and eat cowpox; and yet corruption, mere association with which, would render milk, or steaks, or chops loathsome, it was not thought abominable to infuse into the blood!

“The first political and literary characters in our nation are warm advocates of the practice,” said Waterhouse; and it was so. President Adams was quite of a mind with King George in that respect; and Jefferson not only approved of the practice in common with Queen Charlotte, but, as soon as he could obtain virus, set to work with his sons-in-law, and vaccinated their families and neighbours to the number of two hundred. There is a letter from Jefferson to Jenner in 1806, which is remarkable as an absolute confession of faith at a date when much had occurred to shake faith. The President wrote—

That smallpox should be erased from the calendar of human afflictions, and be known only in history as extirpated by Jenner, were vain expectations; but to recognise their vanity did not lie within Jefferson’s possibilities. He had been bred in the belief that inoculation with smallpox prevented smallpox, and it came forth as a corollary, that as cowpox was an equivalent for smallpox, if all were cowpoxed, the disease must be extirpated. His expectations, therefore, were not without plausibility. Nor was it possible for Jefferson in the light of his time to see that smallpox was no specific entity that could be got rid of per se whilst all else remained unaffected. We know that if even vaccination made an end of smallpox, and did no harm of itself, we should reduce neither illness nor mortality (supposing no other change in the conditions of existence were effected), but should have our due allotment of disease in other forms. To attack smallpox as smallpox, and suppose that if suppressed we should be in anywise advantaged, is mere illusion. Zymotic diseases, to be dealt with effectually, must be dealt with as forms of a common malady; to get rid of one, we must get rid of all; and with a graver sense of the difficulties to be encountered we, too, believe with Jefferson, that smallpox may be extirpated, but in company with much else, and by practice that has no affinity with the creation of disease implied in vaccination.

Of all people the English are most abandoned to medical quackery, said Lady Mary Wortley Montagu; and the English characteristic was reproduced and exaggerated in New England. The first resistance to vaccination being overcome, there was a run upon the practice—

Whilst such doings discredited vaccination in one way, they served it in another: they made it easy to conceal its failures and injuries by ascribing them to the use of spurious virus. Everything is to be gained for truth in the question of vaccination by taking it in what its believers allow to be its unexceptionable form, so as to leave no room for evasion. Smallpox in America as in England soon showed itself indifferent to the art of the vaccinator, and then it was settled that at least it made the disease milder; and under cover of the convenient fiction, it continued to be practised where fees were to be had for the performance.

The attitude of the medical mind to epidemics, and the ignorance of what we now regard as the first elements of sanitary science, are illustrated with touching sincerity in a letter addressed by Dr. Waterhouse, in 1817, to the surgeons of the United States army. Said the Jenner of the New World—

Well might he be weary! He does not say so, but neither does he make any reserve in favour of vaccination; and, after seventeen years’ trial of it, the old physician must have included it in his cry of Vanitas Vanitatum!

The enthusiasm for cowpox in England was reproduced with fury among the English in India. It is always so. What is the fashion at home is an intenser fashion abroad.

When we say India, we speak as of a country when we are dealing with a continent—of not one but many peoples, of races numerous and tongues various: wherefore, in naming India, I would be understood as limiting my remarks to the portion designated, and to the population affected by English influence. In several parts of India smallpox is endemic—begotten in permanently unwholesome conditions of life, and cultivated and propagated by inoculation. When, therefore, it was heard that cowpox might be substituted for smallpox, and that the mild served every purpose of the severe disease, there arose a demand among the English for the virus, alike for their own and for native use. Dr. Underwood, writing to Jenner from Madras, 28th Feb., 1801, observed—

It was easier to ask than to obtain. There was no cowpox to be heard of in India, and the long voyage round the Cape, and the tropical heat were fatal to its transmission. Repeated attempts were made, but all ended in failure. Jenner proposed to place a number of picked men on board an East Indiaman, and to have them successively vaccinated in the course of the voyage, so as to land with fresh virus in Bombay or Calcutta; but the East India Company declined the proposal. An attempt was then made to raise a subscription for the purpose, Jenner putting his name down for 1,000 guineas; though it was difficult to imagine where the 1,000 guineas were to come from, unless out of the pockets of some of his admirers.[232]

These efforts were, however, superseded by the energy and ingenuity of Dr. De Carro, of Vienna. Lord Elgin, British ambassador to the Porte, had made acquaintance with De Carro, and had received virus from him with which his infant son and others were vaccinated at Constantinople. The news spreading abroad, Lord Elgin was entreated to meet the Indian demand, sending the vaccine overland to Bombay by way of Bagdad and Bussora. He made several futile attempts, and thereon determined to place the matter in the hands of De Carro; and for that purpose addressed himself to the Hon. Arthur Paget, British ambassador at Vienna, saying—

De Carro accepted the commission with alacrity. He had already had an application from Bagdad, and, dismissing the vehicles which had been tried and failed, such as lancets of steel, silver, gold, and ivory, and threads enclosed in quills, he saturated lint with virus, and, placing it between glasses, in one of which was a cavity for its reception, tied them together, sealed the edges, and, taking them to a wax chandler, had them dipped until enclosed in a ball of wax, which was packed in a box stuffed with shreds of paper. In this manner virus was conveyed through Constantinople, across the deserts to Bagdad, where it was received on 31st March, 1802, still liquid, and was used “with complete success.” The like success was reported from Bussora, Muscat, and Bushire. From Bussora virus was conveyed to Bombay, arriving, after a three weeks’ voyage, early in June. Twenty or thirty were inoculated with the Vienna virus, but only one “took,” namely, Anna Dusthall, a child about three years of age, who was operated upon by Dr. Helenus Scott. The progress of the case was watched with intense anxiety, and correspondent satisfaction when the symptoms developed according to the recognised description. On the eighth day five children were vaccinated from Dusthall’s arm, and loud was the rejoicing when it was known that for India was secured the genuine Variolæ Vaccinæ. From Bombay “the precious fluid” was in due course conveyed to Ceylon, Madras, Calcutta, and wherever English influence prevailed. De Carro was naturally elated with his success. The virus he transmitted was originally obtained from the stock of Dr. Sacco, of Milan, who had it off some Lombard cows.[234]

Jenner wrote to De Carro to congratulate him, 28th March, 1803—

The imported cowpox was diffused and recommended with energy and with fraud. Jenner, writing to Dunning, 2nd November, 1804, observed—

Here is the paper which sets forth the energetic policy pursued—

Much of this policy was due to the Marquis Wellesley, the Governor-General, whose habit it was to convert conviction without delay into performance. To what extent it was found practicable to substitute vaccination for variolation among the natives does not clearly appear. It was comparatively easy to operate upon those immediately dependent upon their conquerors; but it was a different matter to disarm the aversion of the external myriads. Supposing the variolators preferred their ancient practice because it was more lucrative, a number of them were brought to Calcutta, and inquiry made as to the amount of their gains, which ascertained, they were offered double pay if they would adopt vaccination. The offer was readily accepted, and other variolators, hearing of it, volunteered their services on similar terms, and were instructed and enrolled as official vaccinators. A declaration was drawn up and signed by twenty-six of these converted variolators, recommending vaccination to the Eastern world. The declaration was published in the Calcutta Gazette, printed in four languages, and widely circulated throughout India.[236]

So much was possible to Government; but other means of persuasion were not neglected. It was at first imagined that pox from the cow would exactly suit people who held that animal in reverence; but, on the contrary, the fact was converted by the Brahmins into an argument against its use, they contending, and justly, that cowpox was impure. To meet this difficulty, various pious frauds were attempted. It was pretended that vaccination was no novelty in India, and that it was known, sanctioned, and practised from time immemorial. Baron, Jenner’s biographer, relates these details without animadversion—

The Sanscrit work from which this passage was asserted to be taken was never forthcoming, and by competent authorities was pronounced “nothing more than a well-meant device for the reduction of ignorant prejudices,” the native physician who put the leaves into the hands of Mr. Gillman being included in the fiction. Baron continues—

These impostors were not priests, but medical men; not Jesuits, but Protestants; not Levantines, but Englishmen in the service of the Honourable East India Company. To what extent their frauds were operative is not related. They were probably too contemptuous of native acumen. For good and for evil the Hindoo listens to English advice courteously and without contradiction, but persists in his accustomed way of life with the equanimity of indifference. That vaccination was an ancient practice in India came to be repeated in Europe and seriously believed, when, Jenner’s originality being impugned, the truth came out, that old Indian vaccination was a device limited to Indian circumstances, and never designed for Western acceptance.

In Madras vaccination was practised with much energy. Jenner, writing on 7th May, 1808, said, “Wonderful to relate, the numbers vaccinated in that Presidency in the course of last year amount to 243,175.”[238] In Bombay it was claimed that smallpox was extirpated; Dr. Helenus Scott reporting, 5th December, 1806, that “in this island, swarming with mankind, no loss from smallpox has been suffered for several years since the introduction of vaccine inoculation.”[239] It was not pretended that all the inhabitants of Bombay had been vaccinated, or even a considerable portion of them; but the early vaccinators appear to have regarded vaccination as a sort of charm, the possession of which kept off smallpox; that by the vaccination, say, of one-tenth of any population, the unvaccinated nine-tenths were protected. This faith in the vicarious efficacy of vaccination was not expressly avowed, but was implied in the numerous reports of extirpated smallpox in circumstances where no attempt was made, or was indeed possible, to effect universal vaccination.

Confuted and frustrated in England, it was Jenner’s habit to sigh, and turn from his ungrateful country to the vast realms of Europe and Asia and America. Writing to Dunning, on 23rd December, 1804, he observed—

Mark the words—Smallpox totally exterminated in some of the largest cities in 1804; that was to say, after, at the utmost, five years’ acquaintance with vaccination! A miraculous time—was it not? Jenner went on—

Omne ignotum pro magnifico est. What inference worth a straw could Jenner or anyone else draw from the introduction of vaccination to India? The number of the various Indian peoples was unknown; and the periods and prevalence of smallpox among them; also the extent to which they practised variolation. In the absence of such elementary information, tales of the triumphs of vaccination in India were so much romance.

So far as vaccination displaced variolation, it might be taken as the substitution of a less evil for a greater; and much is accounted for in some of the early records of vaccination when it is remembered that the new practice was welcomed as a deliverance from the inconveniences and horrors of the old; and that the discredited practice was frequently abandoned without resort to its successor. A cessation of variolation was a cessation of the culture and diffusion of smallpox; and vaccination had often the credit of the reduction of smallpox when the credit was due to the abatement of variolation. As to the propagation of smallpox by variolation, no one was more emphatic than Jenner, as for example—

If then it be taken as conceded that variolation spread smallpox wherever practised, can it be fair to omit the consideration of the consequences of its abatement when estimating the results of the introduction of vaccination? Yet scarcely an advocate of vaccination permits the fact to enter into his reckoning!

The gratitude of the English in India to Jenner did not evaporate without substantial expression. A subscription was started, and between 1806 and 1812 he received remittances to the amount of £7,383, the contributors being—

An amusing instance of Jenner’s ignorance of India is found in a letter to Dunning, 14th March, 1807, wherein he ascribes his English money from India to the gratitude of Hindoo women—

Jenner, in returning thanks to Dr. Fleming, of Calcutta, for the first remittance of cash in 1806, took occasion to communicate some English news, which is not without interest at this day. He wrote—

These prints were, many of them, intended for fun, and could have no serious influence. The decline of faith in vaccination was due to the general discovery that it did not prevent smallpox, and that it did excite other ailments. “It made smallpox milder” was the apology even then coming into vogue. As for the epidemic of smallpox raised in London and the whole island by the neglect of vaccination and a return to variolation, it was a creation of Jenner’s fancy. There was less smallpox in London in 1806 than in 1805; but if there was not more, the bold Jennerian would answer, there ought to have been, and it could only be through the mercy of Providence that there was not.

Throughout the century, the English in India have spared no pains to diffuse and enforce vaccination among the inhabitants, numerous medical men finding place and pay in the futile occupation. Smallpox can only be overcome by systematic sanitation, which is laborious and difficult; and among peoples whose conditions and habits of life freely generate zymotic disease, vaccination is as likely to be effective as any other sort of incantation. Sir Richard Temple states the position at this day in these words—

We now come to Ceylon, in which vaccination was held to have had a perfect triumph. “To Sweden and to Ceylon,” says Baron, “Dr. Jenner was in the habit of pointing when he wished to prove what his discovery might accomplish; or when he lamented that fatal obstinacy of his fellow-creatures which, with such examples before them, could induce them to reject blessings within their reach.”[246] Sweden we shall discuss in another chapter, and of Ceylon I may observe that a portion of the island was taken by the British from the Dutch in 1795, and that in several parts it was extremely unhealthy. Smallpox was a frequent and deadly epidemic, but to what extent there is no evidence save hearsay and estimates from hearsay. The Dutch did not concern themselves with the health of the natives, but when the English took over their settlements in 1800 in the midst of a severe epidemic, they opened hospitals for smallpox and for inoculation with smallpox under the supervision of Dr. Christie.[247] He, hearing the glad tidings of vaccination, resolved to introduce the practice, and having in 1802 received virus from Dr. Scott, of Bombay, he set to work with systematic energy and perseverance. Supported by the authority of successive Governors, he closed the hospitals, forbade variolation, organised a staff of vaccinators, and kept them employed, until the greater part of the population under English influence was vaccinated. In the words of Moore, writing in 1816—

That smallpox had been exterminated by vaccination in Ceylon was set forth by vaccinators as something indisputable; but there were two observations to make—first, that smallpox was often suppressed in the sense that for a time there was no smallpox in a certain population, and especially subsequent to a severe epidemic; and second, that variolation was suppressed. Granted that smallpox ceased in Ceylon coincidently with the introduction of vaccination, it may be fairly held that the exhaustion induced by the preceding epidemic, and the cessation of variolation, were sufficient to account for the phenomenon. What remains to be said of Ceylon, I shall leave Dr. George Gregory, physician of the London Smallpox and Vaccination Hospital, to say for me. He wrote—

Vaccination was introduced to China from the English factory at Canton, and Sir George Staunton translated into Chinese a tract on Cowpox, and had it printed at Canton in 1805, the translator’s name and the foreign origin of the practice being suppressed. Jenner, writing to Dunning, 10th December, 1806, said—

The Chinese had their own system of variolation, namely, the use of pulverised smallpox scabs as snuff; but some of them accepted vaccination, tried it, and dropped it when they found it did not keep off the disease as warranted. Smallpox in China is almost exclusively a disease of childhood, and is little dreaded. Dr. D. F. Rennie, medical officer to the British Embassy at Peking in 1861-62, says of that city—

Persia was sometimes referred to in the ravings that went on as to the triumphs of vaccination in the East; but what was known of Persia? The practice was introduced where Europeans were resident, but it never became general. Dr. C. J. Willis has recently described surgery and medicine in Persia as extremely rude and superstitious, and that “vaccination is not in favour, whilst inoculation, or the direct communication of the disorder, by placing the patient in the same bed with one suffering from smallpox of the most virulent type, is the method pursued.”[251]

It was natural enough for Jenner, in presence of failure and contempt in England, to appeal to success in the East, and to try to overwhelm his adversaries with evidence which they could not overtake; but any one of judicial temper must have perceived that if vaccination was to be vindicated, data of a very different order would have to be forthcoming. Where the number of the population in a distant region was unknown, where the ordinary prevalence of smallpox among the people was undefined, where the extent of artificial variolation was unspecified, and the existence and intensity of related forms of zymotic disease were undescribed, what conclusion could be drawn as to the efficacy of vaccination that a man of science was bound to respect? Why should certain knowledge in England be surrendered for assertion from abroad.

Vaccination was accepted as a revelation, and diffused as a religion, and was almost everywhere received gladly. We have to bear in mind, however, that the way had been made straight for it by the practice of inoculation with smallpox; which practice, after a struggle prolonged over many years, had become an established part of medical art, and was only limited in its application by the inconvenience and risks that attended it. The promise of the primitive vaccinators was, that the security which resulted from inoculation with smallpox was to be had from inoculation with cowpox, with absolute certainty, absolute safety, and absolute permanence. The argument was, that since no one could have smallpox twice (however slight the attack), and as cowpox was a mild form of smallpox, it sufficed to be inoculated with cowpox to be safe from smallpox through life; and if only the infliction of cowpox were made universal, smallpox would be extirpated. Such was the plausible doctrine; so plausible that it had only to be stated to command assent; whilst so great was the elation over the discovery (as much, perhaps, for deliverance from inoculation with smallpox as from smallpox itself) that it was accounted a sacred duty to diffuse its benefits over the whole earth. Greater good on easier terms it was difficult to imagine. With a scratch of a needle one of the worst penalties attached to over-crowding, to filth, and to ill-living, might be avoided and done away with for ever.

The first cowpox missionaries were Dr. Marshall and Dr. Walker. £100 was teased out of the Admiralty, and £100 out of the War Office toward their expenses, and placed on board the Endymion, they proceeded, on 1st July, 1800, to the Mediterranean. At Gibraltar, Minorca, and Malta, they vaccinated soldiers and sailors, first operating on orphans and foundlings to give the gallant fellows courage. Then Walker accompanied Sir Ralph Abercrombie to Egypt, from whence, after a variety of adventures, he returned to London to serve as domestic apostle, and vex Jenner for the remainder of his life. Marshall proceeded to Sicily and Naples. In Palermo, in the preceding year, 1799, there had been an epidemic, in which, it was said, 8,000 had perished, and Marshall appeared on the scene as a belated messenger of salvation. At Naples he had a cordial reception from the wretched Ferdinand IV. and his wretched court, who, with general indifference or enmity to what was good, were ready to show themselves gracious toward cowpox. Marshall went through the customary performances of the variolous test and the exposure of the vaccinated to infection; and without further ado an hospital was opened, and all who would be saved from smallpox were entreated to hasten and receive the new inoculation.

When Marshall was at Gibraltar, Lord Keith issued the following memorandum to the fleet—

I may observe, in passing, that there was little delay in introducing vaccination to the British navy. Sir Gilbert Blane was urgent, Earl Spencer, first Lord of the Admiralty, acquiescent, and Dr. Trotter, physician to the fleet, enthusiastic. So early as 9th December, 1800, Trotter was prophesying—

Smallpox was one of the pests of the service. Trotter, writing 20th February, 1801, said—

These outbreaks were invariably referred to an origin external to the ship; as if anywhere smallpox could have had a more congenial breeding-place than the crew of a man-of-war! As Dr. Johnson observed, “When you look down from the quarter-deck to the space below, you see the utmost extremity of human misery; such crowding, such filth, such stench!”[252] Incited by the enthusiastic Trotter, the medical officers of the Fleet subscribed for a gold medal, and presented it to Jenner. On the obverse, Apollo was represented introducing a young seaman recovered from cowpox to Britannia, who, in return, extended a civic crown, on which was inscribed Jenner; above were the words, Alba nautis stella refulsit, and below the date, 1801. On the reverse was an anchor and over it Georgio Tertio Rege, and under it Spencer Duces. The medal was presented to Jenner in February, 1801.

The dates are worth noting afresh. Jenner’s Inquiry was published in the summer of 1798; and thus we see that within three years his prescription for the prevention and extermination of smallpox was adopted in a branch of the public service where obstinate conservatism was the ruling temper; and an assertion that only time could test was accepted without hesitation as verified and certain. If vaccination had answered to the claim made for it, the haste wherewith it was acknowledged would have been unjustifiable, and wholly unlike the struggle that truth has commonly to pass through in order to obtain supremacy in the intellect and practice of mankind.

The first attempts to inoculate with cowpox in France proving futile, Dr. Woodville went over to Paris in 1800 to show in practice the method of operation. He had a warm reception, and the Quaker was overwhelmed with the exuberant attentions to which he was subjected. In the Moniteur he was described as “a learned man, animated with generous zeal, and worthy of gratitude and praise;” who had inoculated six thousand children with invariable success; and that cowpox as a preventive of smallpox could only be spoken of as something miraculous. A house was opened as a vaccine station, and men, women, and children, flocked thither to receive the benign fluid and life-long protection from a dreadful malady.

When the negotiations for the peace of Amiens were in progress, 1802, an address was presented with much pomp to the Marquis Cornwallis by the Medical Committee of the Somme, claiming brotherhood with the physicians of England, eulogising Jenner, denouncing his detractors, stigmatising variolators as acting neither from the love of truth nor for the glory of their profession, but, from avarice and hatred of improvement; whilst, as the result of numerous experiments, “the discovery made in England had been stamped with the seal of infallibility in France.”

At first, vaccination in France was left to voluntary effort, and made little progress in face of a strenuous resistance developed by alarmed variolators; but a severe smallpox epidemic in 1802 incited the Government to action. A medical commission was appointed to investigate and report, and in 1804 it was determined to spare no effort to extend vaccination over the whole of France. A Central Committee for Vaccination was constituted, and appeals and commands were addressed to the clergy and officials of all orders to have those under their authority and influence inoculated with cowpox. Some préfects were content to recommend and warn, but others adopted more vigorous measures, such as the exclusion of the unvaccinated from schools, from employment, from charities—in short, anticipating much legislation that has come into force, or that fanatics wish to bring into force. Nevertheless, the progress made did not satisfy Napoleon, and seeing that until vaccination was everywhere paid for by the State, its performance must remain irregular and perfunctory, a manifesto was issued to the effect that his Majesty the Emperor and King had learned from the reports of the Central Committee that the preservation and increase of his vast dominions were immediately related to systematic and universal vaccination; wherefore, his Majesty, wishing to give a signal mark of his paternal solicitude for his subjects, had granted to his Excellency the Minister of the Interior, an annual special credit, destined to provide for the expenses necessary for extending the new practice, and for forming centres of issue of vaccine virus in twenty-four of the chief cities of the Empire—these, then, including Brussels, Florence, Parma and Turin. And his Majesty had also, out of his paternal benevolence, provided annual prizes as incentives to emulation in propagating vaccination, so that the scourge of smallpox might be completely banished from his territories.

It would be idle to speculate as to how much serious faith lay within this apparent zeal for vaccination; for, as Professor Seeley observes, “Napoleon seemed to care for no opinion, though he adopted, with studied artificial vehemence, every fashionable opinion in turn.” There might be, I dare say, something piquant to his theatrical genius in opposing his odious contempt for human life to the rigorous enforcement of what was considered a supreme prescription for its preservation. Jenner availed himself of the Emperor’s histrionic instinct in soliciting the release of English travellers detained in France. To one of these occasions we owe the artless anecdote of the arrest of Napoleon’s refusal by the interposition of Josephine, who exclaimed, “Jenner!” The Emperor paused and said, “Jenner! ah, we can deny nothing to that man!” It is sad to relate, the favour was not reciprocated. When Jenner, at the suggestion of Baron Corvisart, appealed to the British Government for similar indulgence to a Frenchman, he had to report that there was no charm in his intervention among his countrymen.

That vaccination should have a welcome in Spain was not surprising, after its reception in Naples. The craze was universal, and diffused through the lowest intelligences. Cowpox was introduced to Madrid with the certificate of France under that of England; and, spite of the distractions of the time, excited much attention. Mr. Allen, secretary to Lord Holland, writing to Jenner from Madrid in 1803, observed—

There were philosophising doctors in Madrid who did not see why cowpox should possess a singular efficacy, and induced the King, in 1804, to order that all the children in the foundling hospital should be inoculated with goatpox. They did not, perhaps, know that Jenner had inoculated his son with swinepox, and that the child underwent the variolous test on several occasions with impunity.

The great event in connection with Spain was the expedition of Dr. Francis Xavier Balmis, physician to his Catholic Majesty. He obtained a concession to introduce vaccination to the colonies in America and Asia, and to defray expenses by freely trading in merchandise. He sailed from Corunna, 30th November, 1803, with twenty-two children for the propagation of virus. The Canary Islands were first visited, then Porto Rico, and at Caracas the party divided, Don Francis Salvani proceeding to Peru and Chili, whilst Balmis attended to Cuba and Mexico, crossing the Pacific to the Philippines with twenty-six children to maintain the succession of the virus, and proceeding from thence to Macao and Canton. Having circumnavigated the globe as vaccinator and trader, Balmis re-appeared in Madrid with great éclat, and kissed the King’s hand on 7th September, 1806. Philanthropy and business were successfully combined, for as Moore, writing in 1817, observes—

The expedition of Balmis naturally excited much attention, and its progress and results were described in terms of inflated rhetoric. Thus, we read in Baron’s Life of Jenner—

Thus not only the Spanish Americans were brought under the dominion of cowpox, but the Indians, yea, all the Indians; and not reluctantly, but joyfully, and became experts in the practice of the rite! Baron continues—

Indian and savage statistics in connection with smallpox and vaccination are usually little else than exercises in imaginative desire—less what is true than what is wished to be true, or to be taken for true. We know the difficulty of vaccinating populations dwelling within defined limits and under highly organised governments, and we can therefore estimate the claims made for Balmis and his partners as roving traders and quacks in the territories occupied by Spaniards and Indians. Yet it was with yards of mythical rubbish of this sort that English vaccinators tried to divert the attention of their countrymen from the failures of vaccination within their own experience; and when worried with ever-recurring disasters at home, it was in turning to Mexico and Peru that Jenner professed to find consolation.

Dr. Sacco, of Milan, was described as “the apostle of vaccination in Northern Italy,” and “unquestionably the greatest vaccinator in the world.”[256] His operations received the sanction of the Napoleonic administration, and as early as 1801 he was appointed Director of Vaccination to the Cisalpine Republic. “Strong measures,” writes Moore, “were adopted; proclamations were read from every pulpit; vaccination was practised in every church; and the clergy gave such effectual aid, that the Professor and his associates in three years vaccinated 70,000 persons, and extinguished smallpox in Lombardy.”[257] In other words, the vaccination of 70,000 persons extinguished smallpox in a population of several millions! Baron enlarges the numbers, saying that Dr. Sacco and his assistants in the course of eight years vaccinated 1,300,000 persons; and cites a letter from Sacco, dated from Trieste, 5th January, 1808, with the following extraordinary statement—

Moore’s 70,000 is a credible number, whatever may be thought of its vicarious operation; but Sacco’s 600,000 by his own hand in eight years! Ah, well! when we are lost in the fabulous, it is unnecessary to waste our strength in the discrimination of the greater from the less in falsehood. Nevertheless, taking Sacco’s figures, we have to observe that the vaccination of 1,300,000 saved 6,000,000 from smallpox. That Italy was freed from smallpox is true, and the exemption of the population, whether vaccinated or unvaccinated, was prolonged over nearly thirty years. The disappearance of the disease had, however, set in before vaccination was heard of, but the subsidence was claimed for Sacco, although it extended to millions of Italians who owed nothing to the new prophylactic. As already observed, from some cause undefined, the area and intensity of smallpox was signally diminishing toward the close of last century, and this in spite of the stimulus applied to the disease by variolous inoculation. It may have been so stimulated as to have been worked out—forced, as it were, to exhaustion, after the habit of much else, good and bad, when developed to the extremity of existence.

As a grand vaccinator Dr. De Carro, of Vienna, was scarcely less distinguished than Sacco. He was a Swiss from Geneva, who had studied and graduated at Edinburgh, and settled in Vienna. He performed the first vaccination on the Continent, in 1799, with virus conveyed on a couple of threads from Dr. Pearson; and in 1802 he succeeded in transmitting the first effective virus to India. De Carro conducted his operations with great energy and tact, and in 1802 he induced the Austrian Government to issue an ordinance conferring on vaccination Imperial sanction and recommendation. Concurrently with this activity, smallpox was abating, and post hoc was converted into propter hoc. De Carro was credited with the extinction of smallpox in Vienna; but as no more than a portion of the citizens had been vaccinated, Vienna thus supplied another instance of the vicarious influence of the Jennerian rite.

Sacco and De Carro corresponded with Jenner, and it is worth noting that both concurred with him in the opinion that cowpox originated in horsegrease; and, further, that horsegrease was as good against smallpox as horsegrease cowpox itself. Indeed, Sacco set up a stock of virus derived from horsegrease, operated with it, and supplied De Carro, who used it so freely in Vienna that, as he said, he could not tell the vaccinated from the equinated. Writing to Jenner, on 21st June, 1803, De Carro observed—

The favour shown for vaccination by the English Court facilitated its adoption throughout Germany; and yet it might be said the craze went of itself, compelling patronage and exacting advocacy. The King of Prussia opened a Royal Inoculation Institute in Berlin, and tracts and medals, speeches and sermons, were brought into requisition to recommend the new rite. From the furore created, many were led to believe that all Prussia was vaccinated, and as smallpox ceased to prevail, cowpox had the credit. To vaccinate a nation, however, is far from easily accomplished, and when we refer to the official accounts, we discover that, notwithstanding great ado, the numbers operated upon constituted less than a tithe of the people. Jenner cites a report of Professor Avelin, of Berlin, in a letter to Moore, 15th February, 1812, as authority for these statistics—

Supposing a million had been vaccinated in Prussia in the course of ten years, let me ask once more, how could they have saved the remaining millions from smallpox? Yet, with knowledge of these figures, Moore, the Director of the National Vaccine Establishment in London, did not hesitate to write—

Russia, of course, followed suit in cowpox inoculation. At the coronation of Alexander in Moscow in 1801 a foundling was operated on, christened Vaccinoff, pensioned for life, and dispatched to St. Petersburg to serve as a source of virus for other foundlings. Then followed imperial decrees prescribing vaccination, and Dr. Crichton was directed to organise a medical staff for the performance of the rite in each province of the Empire. In 1811 a ukase was issued commanding all Russians to be vaccinated within three years. As measuring the possibilities of despotism in such a matter, we learn from Dr. Crichton that between 1804 and 1812 there were 1,235,597 vaccinations performed in Russia—a similar number to that which Sacco professed to have accomplished in Northern Italy in the same time. It was estimated in Russia that of every seven children born, one perished of smallpox, and therefore Crichton argued the lives of 176,514 had (up to 1812) been saved by vaccination. The calculation illustrates the facility with which the early vaccinators deceived themselves—first, as to the certainty of their prophylactic; second, as to its vicarious efficacy; and, third, in assuming that a reduction in smallpox represented a reduction in mortality.

From Crichton, too, we learn that there were anti-vaccinists in Russia in those days—

To complete this rapid survey of the diffusion of vaccination throughout Europe, there remain Sweden with Finland, and Denmark with Iceland; but as the case of Sweden is specially interesting and instructive from the fulness and precision of its vital statistics, coupled with the claim made by vaccinators that Sweden affords irrefutable evidence of the efficacy of their prescription, I reserve it for a special chapter. There is nothing pleasanter than finding the strongholds of one’s antagonists, capturing, and occupying them.

Jenner was in the habit of pointing to Sweden and Ceylon as proofs of what vaccination might accomplish. We have seen how badly Ceylon answered to his reference; and I now proceed to inquire whether Sweden served his purpose any better.

The decline of smallpox in some communities, contemporaneously with the introduction of vaccination, might be ascribed to the cessation of inoculation with smallpox—virtually the culture of that disease; but in Sweden little had to be accounted for in that way. Spite of strong recommendations, variolation was rarely practised, and never became popular. The very year that vaccination was introduced, Dr. Acksell, of Kalmer, stated in an official report, dated 30th March, 1801, “that it is impossible to convince the lower classes of the advantages of inoculation. Dr. Colliander and I have had it announced to the people from the pulpit, that, we were ready to give our services, gratis, in inoculating their children, but not a single person applied.” And such undoubtedly was the state of things throughout the kingdom.

Sweden last century was sorely afflicted with smallpox, and, considering the repute of variolation in other lands, it is surprising how the people refrained from its vaunted protection. It is thought dreadful that in London one death in ten should have been due to this disease, but in Sweden the ratio stood as high as one in seven. To give some idea of the extent of the mischief at its highest and its lowest, let us look at eighteen years in the latter half of the century—

In these figures we see how wide were the variations in smallpox mortality prior to the introduction of vaccination; and also how indifferent was its influence on the general mortality, much smallpox not raising the death-rate, nor little smallpox lowering it.

Among the factors of mortality in Sweden were scarcity and famine. At this day, when the ends of the earth are drawn together, we are apt to forget the struggle, the misery, and the sickness that prevailed when a deficient harvest in one country, or parts of the same country, could not be made good from the sufficiency of others. Population in Northern Europe did little more than maintain existence through several centuries against the severity of Nature, with food scant and bad, and raiment and shelter inadequate. Of the latter fifty years of last century, at least fifteen were years of dearth in Sweden, and consequently of increased mortality.

The chief sufferers from deficient and unsuitable food are the young, their suffering having form in various ailments, and among them smallpox. I have repeatedly had to point out how smallpox is especially an affection of childhood, and how in Scotland, for instance, it used to be almost exclusively confined to the young, like measles and whooping-cough. The like was true of Sweden; for of the deaths from smallpox from 1774 to 1798—

a total of 85·60 per cent, being mere children. Or, to put it otherwise—