A History of Epidemics in Britain, Volume 2 (of 2) by Charles Creighton

explained the occurrence of smallpox among those recently inoculated with cowpox: “If a person who has been exposed to the contagion of smallpox for four or five days be then inoculated for this disease, the inoculation prevents the effects of the contagion, and the _inoculated_ smallpox is produced. But if the vaccine inoculation be employed in a case thus circumstanced, the smallpox is not prevented, although the tumour produced by the cowpox inoculation advance to maturation. It was not before the commencement of the present year [1800], that I ascertained that the cowpox had not the power of superseding the smallpox. For, though from the first trials that I made of the new inoculation it appeared that these diseases, as produced in the same subject from inoculation, did not interrupt the progress of each other; yet as the casual does not act in the same manner as the inoculated smallpox, and may be anticipated by the latter, I thought it still probable that the cowpock infection might have a similar effect. Numerous facts have, however, proved this opinion to be unfounded, and that the variolous effluvia, even after the vaccine inoculation has made a considerable progress, have in several instances occasioned an eruption resembling that of smallpox.” [1086] _European Magazine_, XLIII. 137. [1087] Bateman, u. s. 1819, Aug.-Nov. 1807: “In a court adjoining Shoe Lane, in the course of one month, twenty-eight persons had died of smallpox.” Autumn, 1812: “In one small court in Shoe Lane, seventeen have lately been cut off by this variolous plague.” Also in the summer of 1812, “perhaps universally through the metropolis.” [1088] Extracted from the Annual Reports of the Dispensary. [1089] Heysham to Joshua Milne, in the latter’s _Treatise on the Valuation of Annuities_. London, 1815. App. p. 755. [1090] Cross, 1819, u. i. p. 2. [1091] Most of these were brought to light by inquiries upon the alleged failures of cowpox to avert the epidemic. The serial numbers of the _Medical Observer_ contain frequent references to them. [1092] Letter to Joshua Dixon, in _Memoirs_, III. 368. [1093] Bateman, _Edin. Med. Surg. Journ._ VIII. 515. [1094] C. Stuart, _ibid._ VIII. 380. [1095] Rigby, _ibid._ X. 120. [1096] Joshua Dixon, _The Literary Life of William Brownrigg, M.D._ Whitehaven, 1801, pp. 238-9. [1097] Haygarth says: “With us in Chester, smallpox is seldom heard of except in the bills of mortality. _There_ its devastation appears dreadful indeed.” _Sketch of a Plan, &c._ 1793, p. 491. [1098] Barker and Cheyne, _Account of the Fever, &c._ 2 vols. 1821. I. 92. [1099] Francis Rogan, M.D., _Obs. on the Condition of the Middle and Lower Classes in the North of Ireland_. Lond. 1819, p. 17. He proceeds to say:--“The numerous cases, which came to my knowledge, of children in the neighbouring towns who had taken smallpox, after having been vaccinated by medical practitioners of high respectability, led me to pay particular attention to those whom I myself inoculated [with cowpox]; and, although they were numerous both in private practice and at the Dispensary, not one instance occurred among them.” It comes out however that he did not keep them long in sight; he saw them on the 7th day after vaccination, and again on the 11th; and as they were meanwhile almost daily exposed to contagion, without catching it, he concluded that his own cases never would do so. [1100] W. L. Kidd. “A concise Account of the Typhus Fever at present prevalent in Ireland, as it presented itself to the Author in one of the towns in the North of that country.” _Edin. Med. and Surg. Journ._ XIV. (1817), 144. He goes on: “A great number of those attacked were _reported_ to have been formerly vaccinated. At Londonderry, in particular, great numbers who were _said_ to have undergone vaccination were the subjects of smallpox; and, whether justly or not, vaccination has in that part of the country lost much of its credit as a preservative against smallpox.” [1101] Redhead (dated Ulverston, 3 July, 1816) in _Med. and Phys. Journ._ Jan. 1817, p. 3. [1102] James Black, “On Anomalous Smallpox.” _Ed. Med. and Surg. Journ._ Jan. 1819, p. 39. [1103] Henry Dewar, M.D., _Account of an Epidemic of Smallpox which occurred in Cupar in Fife in the Spring of 1817_. Lond. 1818. [1104] P. Mudie, M.D. to Thomson, 18 Oct. 1818: “Many of the cases occurring after vaccination so much resembled smallpox that, if my mind had not been prejudiced against the possibility of such an occurrence, I should have pronounced the eruption to have been of a variolous nature”--which, of course, it was. [1105] Thomson, _Account of the Varioloid Epidemic in Scotland, &c._ Edin. 1820. [1106] In Thomson, u. s. [1107] Thomas Bent, M.D., “Observations on an Epidemic Varioloid Disease lately witnessed in the County of Derby.” _Med. and Phys. Journal_, Dec. 1818, p. 457. One Jennerian, Dr Pew, of Sherborne, adopted an arrogant tone towards Bent (_Ibid._ April, 1819, and farther correspondence). Jenner employed Fosbroke, of Berkeley, son of his friend and neighbour the antiquary Fosbroke, to traverse the whole case of the epidemic of 1817-19, in a long paper in the _Medical Repository_ for June, 1819. The object of the paper appears to be to confuse the issues with a view to a verdict of _non liquet_. The _Edinburgh Review_ thought Thomson’s book on the epidemic of 1817-19 important enough for an article, which has been attributed to Jeffrey. The article pronounced vaccination to be a very great blessing to mankind, but not a complete protection. This was not enough for Jenner, who wrote of the article: “It will do incalculable mischief: I put it down at 100,000 deaths at least.” [1108] John Green Cross, _A History of the Variolous Epidemic which occurred in Norwich in the year 1819_. Lond. 1820. [1109] Cross, u. s. Appendix. [1110] W. Shearman, M.D., “Cases illustrating the Nature of Variolous Contagion and the Modifying Influence of Vaccine Inoculation.” _Lond. Med. Repos._ Dec. 1822. Case of a mother, with good vaccine marks, attacked with smallpox, which became dry and horny about the fifth day; case of her child, in which the eruption ran the full course of pustules, but also a mild case. [1111] _Lond. Med. and Phys. Journ._ May, 1818, p. 488: “By Mr Field’s report of Christ’s Hospital smallpox in a mild form has been frequent _post vaccinationem_.” [1112] Thomas Stone, F.R.C.S. “Table of Deaths from Smallpox in Christ’s Hospital, 1750 to 1850, with remarks,” in Appendix to _Papers on the History and Practice of Vaccination: Parl. Papers_, 1857. In 1761 there were four deaths from smallpox. For ten years, 1775 to 1784, there were none. In some other years of the latter half of the 18th century there were one or two deaths from that cause. There must have been some special reason for the four deaths in 1761. According to Massey (_supra_, p. 545), the apothecary in the beginning of the 18th century, not one death happened in forty attacks, the ages from five to eighteen being the most favourable of all for smallpox to fall in. In the present century scarlatina has displaced smallpox as an infectious cause of death in that school as in others. The deaths from scarlatina at Christ’s Hospital during the six years 1851-56 were nine. [1113] John Forbes, M.D., “Some Account of the Smallpox lately prevalent in Chichester and its Vicinity.” _Lond. Med. Repos._ Sept. 1822, p. 208. [1114] H. W. Carter, M.D., in _Lond. Med. Repos._ Oct. 1824, p. 267: “The cases which came to light of smallpox after vaccination were unfortunately numerous; some, it must be confessed, were exceedingly severe; others were exaggerated.” [1115] The vaccinations are given in Cleland’s _Rise and Progress of the City of Glasgow_. Glasgow, 1820. The smallpox deaths from 1813 to 1819 are given, on Cleland’s authority, in the _Edin. Med. and Surg. Journal_, XXVI. p. 177. [1116] R. Watt, M.D., Appendix to _Treatise on Chincough_. [1117] John Roberton, _Obs. on the Mortality, &c. of Children_. Lond. 1827, p. 59, _note_. [1118] Gregory, _Report of the London Smallpox Hospital for the year 1825_. Cited in the _Med. and Phys. Journ._ Feb. 1826, p. 176. [1119] Cross, u. s. [1120] Carter, u. s. [1121] T. Proudfoot, M.D., _Ed. Med. and Surg. Journ._ July, 1822. [1122] C. Stuart, u. s. [1123] Dr Stokes, of Chesterfield, _Med. and Phys. Journ._ v. 17. [1124] Benjamin Moseley, M.D., _A Review of the Report of the Royal College of Physicians on Vaccination_. 1808, p. 11. Jenner writing to James Moore, 18 Nov. 1812 (in Baron, II. 383), enumerates his various grievances against Pearson, “and finally, finding all tricking useless, his insinuations that vaccination is good for nothing.” [1125] The equality of the two methods in this respect comes out incidentally in two reports of the Whitehaven Dispensary. In the report for 1796, when smallpox matter was in use, it is said that “173 were inoculated, all of whom, soliciting little medical assistance, recovered.” In 1801, when cowpox matter had been substituted in every case, the same phrase is used: “We seldom find any medical assistance required in this disease.” [1126] _The Beneficial Effects of Inoculation._ Oxford University Prize Poem. Oxford, 1807. It seems probable that this was the “Oxford copy of verses on the two Suttons” that Coleridge (_Biographia Literaria_ (1817), Pickering’s ed. II. 89) professed to quote from in the following passage; at least it would be remarkable if there had been printed another Oxford poem on the same subject and in the same manner: “As little difficulty do we find in excluding from the honours of unaffected warmth and elevation the madness prepense of pseudopoesy, or the startling hysteric of weakness over-exerting itself, which bursts on the unprepared reader in sundry odes and apostrophes to abstract terms. Such are the Odes to Jealousy, to Hope, to Oblivion, and the like, in Dodsley’s collection and the magazines of the day, which seldom fail to remind me of an Oxford copy of verses on the two Suttons, commencing with ‘Inoculation, heavenly maid! descend!’” It appears that Coleridge himself contemplated a poem on Cowpox Inoculation, which was to have exemplified what poetry should be, just as the 18th century Oxford poem on Smallpox Inoculation exemplified what poetry should not be. It was clearly more than the difference ’twixt tweedle-dum and tweedle-dee. Writing to Dr Jenner on 27 Sept. 1811, from 7, Portland-place, Hammersmith, he said: “Dear Sir, I take the liberty of intruding on your time, first, to ask you where and in what publication I shall find the best and fullest history of the vaccine matter as the preventive of the smallpox. I mean the year in which the thought first suggested itself to you (and surely no honest heart would suspect me of the baseness of flattery if I had said, inspired into you by the All-preserver, as a counterpoise to the crushing weight of this unexampled war), and the progress of its realization to the present day. My motives are twofold: first and principally, the time is now come when the ‘Courier’ ... is open and prepared for a series of essays on this subject; and the only painful thought that will mingle with the pleasure with which I shall write them is, that it should be at this day, and in this the native country of the discoverer and the discovery, be even _expedient_ to write at all on the subject. My second motive is more selfish. I have planned a poem on this theme, which after long deliberation, I have convinced myself is capable in the highest degree of being poetically treated, according to our divine bard’s [Milton’s] own definition of poetry, as ‘_simple_, _sensuous_, (i.e. appealing to the senses by imagery, sweetness of sound, &c.) and _impassioned, &c._’” _The Life of Edward Jenner, M.D._ By John Baron, M.D. 2 vols. II. 175. [1127] _Edin. Med. and Surg. Journ._ I. 507. [1128] Jenner to James Moore, 26 Feb. 1810, in Baron, II. 367. [1129] Walker to Lettsom, 1 Sept. 1813, in Pettigrew’s _Memoirs of Lettsom_. Lond. 1817, III. 350. [1130] Dr Smith to Dr Monro, Dunse, 2 June, 1818, in Monro’s _Obs. on the different kinds of Smallpox_, 1818. There appears to have been some reluctance to face the facts. “Though I have seen,” says Smith, “a multitude of cases in which smallpox has in every possible shape taken place after vaccination, I feel myself placed in the painful situation [why painful?] of bringing forward many facts to which gentlemen of the first eminence in the profession will probably give little or no credit.” [1131] _Lond. Med. Repository._ Sept. 1822. [1132] J. J. Cribb, _Smallpox and Cowpox_. Cambridge, 1825. [1133] _Ibid._ Letter of Rev. R. Marks, of Great Missenden, 6 May, 1824: “The summer I came here the smallpox was introduced, and as the weather was very hot, and the confluent sort was what appeared, the people began to die almost as fast as they took the plague. Great prejudice prevailed against vaccination, in consequence of the parish having some years ago been vaccinated by a gentleman who knew nothing of the matter, and contaminated the people with decomposed virus, when it was good for nothing but to make ulcers and produced very wretched arms, and left them all liable to smallpox, which they were all inoculated for the same year.” This clergyman subsequently vaccinated 500 cases, and the parish surgeon 300: “and here,” says the former, “I had the happiness of seeing the plague and destruction of a most horrid smallpox completely stopped.” [1134] Robert Ferguson, M.D. _A Letter to Sir Henry Halford, proposing a method of Inoculating the Smallpox, which deprives it of all its Danger, but preserves all its Power of Preventing a Second Attack._ London, 1825. [1135] John Roberton, _Observations on the Mortality and Physical Management of Children_. London, 1827, p. 59, _note_. [1136] J. Dalton, “Smallpox as it prevailed at Bury St Edmunds in 1825.” _Lond. Med. and Phys. Journ._ May, 1827, p. 406. [1137] Cribb, u. s. [1138] “Observation on Smallpox as it has occurred in London in 1825.” _Med. and Phys. Journ._ Feb. 1826, p. 117. [1139] _Med. and Phys. Journ._ 1826, p. 122. “The general voice of the public satisfactorily showed that the upper ranks of society suffered during the past year from smallpox much less than the lower.” [1140] Gregory, _Report on the Smallpox Hospital_, 4 Dec. 1825. [1141] Farr, in the First Report of the Registrar-General (1839, p. 100), said: “It may be safely asserted that the parish clerks registered little more than half the deaths that occurred within the limits of the London bills of mortality.” Outside the limits of the bills there were large parishes, such as St Pancras, Marylebone, Kensington and Chelsea, which had large mortalities from smallpox in the first years of registration. [1142] Tables in Murchison’s _Continued Fevers of Great Britain_. [1143] _Med. Chir. Trans_, XXIV. 15. His other papers are: “Cursory Remarks on Smallpox as it occurs subsequent to Vaccination,” _ibid._ XII. 324; and “Notices of the Occurrences at the Smallpox Hospital during the year 1838,” _ibid._ XXII. 95. He contributed the treatise on Smallpox to Tweedie’s _Library of Medicine_, I. 1840, and indicated his final opinions (which are interesting) in his _Lectures on the Eruptive Fevers_, 1843. [1144] Kenrick Watson, “Medical Topography of Stourport and Kidderminster.” _Trans. Prov. Med. and Surg. Assoc._ II. 195. [1145] John Roberton, “On the Increasing Prevalence of Smallpox after Vaccination.” _Lond. Med. Gaz._ 9 Feb. 1839, p. 711. Roberton had been a warm supporter of the Jennerian method from as early a date as 1808, when he was resident in Edinburgh, and again in his book on _The Mortality of Children_, in 1827. The above cited paper is somewhat satirical, the disappointing facts of it being referred to the Island of Barataria. His conclusions are (p. 713): (1) “It is not fact, but conjecture, that the protective power of cowpox gradually ceases in the human system. (2) It is not fact, but conjecture, that a person successfully re-vaccinated is less liable to smallpox than he was before. (3) To affirm that, when re-vaccination fails in individuals, they are thereby proven to be secure from smallpox, is conjecture.” [1146] Cowan, “On the Mortality of Children in Glasgow,” _Glas. Med. Journ._ V. (1831), p. 358, does not give Cleland’s figures, but says: “No bills of mortality except those for the Royalty in the _Glasgow Courier_ are in existence for the period from 1812 to 1821”; and again: “Finding that the suburbs were excluded, and the Calton being the burying-place in which the greatest number of children are interred, I thought it needless to insert any tabular view of the deaths by measles since the date of Dr Watt’s tables.” Watt could have made no tables if he had not gone direct to the sixteen MS. volumes of burial registers, including those of the Calton. [1147] J. C. Steele, _Glas. Med. Journ._ N. S. I. 60: “From 1812 to 1835 it is much to be regretted that no record of the deaths from smallpox has been kept for even a limited period.” [1148] _Glas. Med. Journ._ I. 105: “There exists at present among the poorer classes an increasing carelessness and aversion to vaccination, from a belief that it does not afford adequate protection from the varioloid disease.” [1149] Andrew Buchanan, M.D. “Present Condition of the Poor in Glasgow.” _Glasg. Med. Journ._ III. (1830), 437. [1150] Chalmers had been urging the repeal of the Corn Law since 1819. In a letter to Wilberforce, Glasgow, 15 Dec. 1819, he says: “From my extensive mingling with the people, I am quite confident in affirming the power of another expedient to be such that it would operate with all the quickness and effect of a charm in lulling their agitated spirits--I mean the repeal of the Corn Bill.” Hanna’s _Memoirs of Dr Chalmers_, 1850, II. 250. [1151] J. Orgill, “Obs. on the Measles and Smallpox that prevailed epidemically in Stranraer, in the autumn of 1829.” _Glasg. Med. Journ._ IV. 351. [1152] McDerment, _ibid._ IV. 201. [1153] Howison, _ibid._ V. 256-7. [1154] J. C. Steele, _Glasg. Med. Journ._ N. S. I. 59. [1155] _Eleventh detailed Report of the Regr.-Genl. for Scotland_, 1865, p. xxxix. The Report says that vaccination was general during the above period, although there was no Vaccination Act for Scotland (until 1864). This was familiar knowledge in Scotland, so much so that the necessity for a compulsory law, on the English model, was not quite obvious in the medical circles of Edinburgh. See Christison’s address to the Social Science Association at Edinburgh in 1863 (p. 106). In my own recollection of Aberdeenshire, the vaccination of infants was as little neglected as their baptism; the law made no real difference. [1156] “An Enquiry into the Mortality among the Poor in the City of Limerick.” _Journ. Statist. Soc._ Jan. 1841, III. 316. [1157] _The Census of Ireland_, 1841. Parl. Papers, 1843. Report on the Tables of Deaths, by W. R. Wilde. [1158] From the Second Report of the Registrar-General, Lond. 1840, p. 180. [1159] 1840. 1st qr. 2nd qr. 3rd qr. 4th qr. Liverpool 172 184 90 85 Bath 25 42 22 8 Exeter -- -- 1 1 Bristol 6 54 49 76 Clifton 11 28 22 42 [1160] Douglass to Colden, 1 May, 1722, in _Massach. Hist. Soc. Collect._ Series 4, vol. II. p. 169. [1161] Philip Rose, M.D., _Essays on the Smallpox_. London, 1724, p. 76. [1162] Rev. R. Houlton, App. to _A Sermon in Defence of Inoculation_, Chelmsford, 1767, p. 59: “For, had the indictment been found, he would have assuredly nonsuited his enemies, and have proved beyond a possibility of doubt that he never brought into Chelmsford a patient who was capable of infecting a bystander, notwithstanding such person would convey infection by inoculation. However paradoxical this may seem, it is truth, and would have been proved to a demonstration.” [1163] Darwin, _Animals and Plants under Domestication_, II. 356: “From these facts we clearly see that the quantity of the peculiar formative matter which is contained within the spermatozoa and pollen-grains is an all-important element in the act of fertilization, not only for the full development of the seed, but for the vigour of the plant produced from such seed.” [1164] J. C. Lettsom, M.D., _A Letter to Sir Robert Barker, F.R.S. and G. Stackpoole, Esq. upon General Inoculation_. London, 1778, p. 8. [1165] W. Black, M.D., _Observations Medical and Political on the Smallpox, etc._ London, 1781, p. 103. [1166] “But, in the cowpox, no pustules appear, nor does it seem possible for the contagious matter to produce the disease from effluvia, or by any other means than contact, and that probably not simply between the virus and the cuticle; so that a single individual in a family might at any time receive it without the risk of infecting the rest, or of spreading a distemper that fills a country with terror.” [1167] _Parliamentary Papers_, 1807, 8th July. [1168] Bateman, _Reports etc._ 1819, p. 102. The principle of the Common Law on which the judgment rested was, “Sic utere tuo ut alienum non laedas.” [1169] Joseph Adams, _An Inquiry into the Laws of Epidemics, with Remarks on the Plans lately proposed for Exterminating the Smallpox_. London,