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Project Gutenberg's The Story of a Great Delusion, by William White This eBook is for the use of anyone anywhere in the United States and most other parts of the world at no cost and with almost no restrictions whatsoever. You may copy it, give it away or re-use it under the terms of the Project Gutenberg License included with this eBook or online at www.gutenberg.org. If you are not located in the United States, you'll have to check the laws of the country where you are located before using this ebook. Title: The Story of a Great Delusion In a series of Matter-Of-Fact Chapters Author: William White Release Date: April 12, 2020 [EBook #61809] Language: English Character set encoding: UTF-8 *** START OF THIS PROJECT GUTENBERG EBOOK THE STORY OF A GREAT DELUSION *** Produced by MFR, John Campbell and the Online Distributed Proofreading Team at https://www.pgdp.net (This file was produced from images generously made available by The Internet Archive) TRANSCRIBER’S NOTE Footnote anchors are denoted by [number], and the footnotes have been placed at the end of each Chapter. Some minor changes to the text are noted at the end of the book. Original cover T H E STO RY OF A GR E AT D E LUS IO N . E D WA R D J E N N E R . From the statue by Monteverde. T H E STO RY OF A GREAT DELUSION IN A SERIES OF MATTER-OF-FACT CHAPTERS. By WILLIAM WHITE. All the world assenting, and continually repeating and reverberating, there soon comes that singular phenomenon, which the Germans call Swarmery, or the “Gathering of Men in Swarms,” and what prodigies they are in the habit of doing and believing, when thrown into that miraculous condition.... Singular, in the case of human swarms, with what perfection of unanimity and quasi-religious conviction the stupidest absurdities can be received as axioms of Euclid, nay as articles of faith, which you are not only to believe, unless malignantly insane, but are (if you have any honour or morality) to push into practice, and without delay see done, if your soul would live!—Thomas Carlyle. LO N DO N : E. W. ALLEN, 4 AVE MARIA LANE. 1885. GLASGOW: HAY NISBET AND CO., PRINTERS, STOCKWELL STREET. CONTENTS. INTRODUCTION. PAGE Prefatory, ix Variolation, x The Precursor of Vaccination, xi Immediate Triumph of Vaccination, xii Jenner’s Procedure, xiii Horsegrease Cowpox, xiv Rejection of Jenner’s Prescription, xiv Jenner’s Transformation, xv Horsegrease Cowpox kept out of Sight, xvi Spurious Cowpox, xvi Horse Virus Vindicated, xvii Which shall it be? xviii Smallpox Cowpox, xix Condemnation of Smallpox Cowpox, xx Cowpox Revived, xxi A Cowpox Charlatan, xxii A Decorous Unanimity, xxiii Jenner’s Successive Disclaimers, xxiv Smallpox made milder, xxvi Punctures, one or several, xxvi Mr. Rigby’s Protest, xxvi Mr. (Marks) Marson, xxviii Mr. Alexander Wheeler’s Researches, xxix Mr. Enoch Robinson’s Opinion, xxx Cruelty of Marking, xxx Revaccination Introduced, xxxi Vaccinisation, xxxii Absurdity of Revaccination, xxxii The Reduction of Smallpox, xxxiii Has Vaccination saved Life? xxxiii Who are the Unvaccinated? xxxiv Unvaccinated Death-rates, xxxv Nurses exempt from Smallpox, xxxvi Pock-marked Faces, xxxvii Vaccinia a real Disease, xxxix Vaccinal Fatalities, xl Vaccinia Modified in its Recipients, xli Vaccinia plus other Disease, xlii Statistical Evidence of extra Disease, xliii Vaccinia aggravates Disease, xlv Origin of Compulsory Vaccination, xlv Resistance, Inflexible Resistance, xlvi Compulsory Education and Vaccination, xlvii [Pg v] [vi] Conditions of the Conflict, xlviii A Word for the Author, xlix L’Envoi, l Dr. Garth Wilkinson’s Catechism, l I.—VARIOLATION. Chapter I.— Cotton Mather and Zabdiel Boylston, 1 II.— Lady Mary Wortley Montagu, 8 III.— Maitland’s Experiments, 12 IV.— The First Opponents of Inoculation, 21 V.— Collapse of Inoculation, 29 VI.— Revival of Inoculation, 36 VII.— Triumph of Inoculation, 45 VIII.— Inoculation Abroad, 56 IX.— Inoculation superseded and suppressed, 66 X.— As to the Prevalence of Smallpox in the 18th Century, 76 II.—VACCINATION. Chapter I.— Jenner’s Earlier Years, 91 II.— Jenner’s Inquiry, 1798, 103 III.— Jenner in 1798, 127 IV.— Pearson’s Inquiry, 136 V.— Woodville, Pearson, and Jenner, 145 VI.— Jenner’s Further Observations, 152 VII.— Operations in London, 1800, 159 VIII.— Triumph of the New Inoculation, 171 IX.— A Dishonourable Transformation, 177 X.— Jenner before Parliament, 1802, 183 XI.— Pearson’s Examination, 197 XII.— Observations on the Position in 1802, 208 XIII.— The Royal Jennerian Society, 218 XIV.— Application to Parliament for Jenner’s Relief, 1806, 230 XV.— Report of the Royal College of Physicians, 235 XVI.— Jenner Relieved, 1807, 243 XVII.— Vaccination Established and Endowed, 250 XVIII.— Horsegrease as a source of Vaccine, 259 XIX.— John Birch, 274 XX.— Goldson and Brown, 283 XXI.— Moseley, Rowley and Squirrel, 289 XXII.— William Cobbett, 303 XXIII.— The Grosvenor Case, 317 XXIV.— Dr. John Walker, 322 XXV.— Jenner’s Later Writings, 333 XXVI.— Baron’s Life of Jenner, 349 XXVII.— The Medical Position in 1823, 363 XXVIII.— Introduction of Vaccination to the United States, 370 XXIX.— Introduction of Vaccination to India and the East, 383 XXX.— Diffusion of Vaccination throughout Europe, 395 XXXI.— Sweden, Denmark and Iceland, 408 XXXII.— Newcastle Smallpox: a Common Story, 424 XXXIII.— The Norwich Epidemic—1819, 431 XXXIV.— Smallpox Displaced and Replaced: Dr. Watt’s Discovery.—Glasgow, 1813, 439 XXXV.— The National Vaccine Establishment—1808-40, 453 XXXVI.— The National Vaccine Establishment—1841-50, 470 XXXVII.— Vaccination Enforced—1853, 477 XXXVIII.— Universal Compulsion Demanded—1855, 491 XXXIX.— John Gibbs’s Letter—1855, 500 XL.— Simon’s Defence and Hamernik’s Judgment, 510 XLI.— Compulsion Intensified—1861 and 1867, 526 XLII.— The Gathering Movement, 1867-70, 540 XLIII.— House of Commons Committee, 1871, 552 XLIV.— The Struggle for Freedom, 573 Notes—Origin of the Term Vaccination, 229 Vaccination a Statistical Question, 596 Index, 597 ILLUSTRATIONS. Edward Jenner from Statue by Monteverde, Frontispiece. John Gibbs, 508 [vii] [viii] INTRODUCTION. PREFATORY. 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— Why that I cannot tell, said he, But ’twas a famous victory. 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. VARIOLATION. 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. THE PRECURSOR OF VACCINATION. 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 [ix] [x] [xi] [xii] 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. IMMEDIATE TRIUMPH OF VACCINATION. 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. JENNER’S PROCEDURE. 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. HORSEGREASE 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. REJECTION OF JENNER’S PRESCRIPTION. 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 [xiii] [xiv] [xv] 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. JENNER’S TRANSFORMATION. 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. HORSEGREASE COWPOX KEPT OUT OF SIGHT. 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. SPURIOUS COWPOX. 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? HORSE VIRUS VINDICATED. 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. [xvi] [xvii] [xviii] 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. WHICH SHALL IT BE? 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. SMALLPOX COWPOX. 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. CONDEMNATION OF SMALLPOX COWPOX. 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 [xix] [xx] [xxi] smallpox.” Thus the virus current in England, and credited with miraculous virtue by Simon, is denounced as dangerous and its use unlawful in Ireland! COWPOX REVIVED. 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.” A COWPOX CHARLATAN. 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? A DECOROUS UNANIMITY. 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! JENNER’S SUCCESSIVE DISCLAIMERS. 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 [xxii] [xxiii] [xxiv] 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. SMALLPOX MADE MILDER. 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. PUNCTURES, ONE OR SEVERAL. 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? MR. RIGBY’S PROTEST. 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 [xxv] [xxvi] [xxvii] 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. MR. (MARKS) MARSON. 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. MR. WHEELER’S RESEARCHES. 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. MR. ROBINSON’S OPINION. 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. CRUELTY OF MARKING. 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.” [xxviii] [xxix] [xxx] [xxxi] 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...

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