Doctors, vaccination, and utilitarianism

Contents

PAOB.

iNTRODirCTORY REMARKS

I. Who shall decide, when Doctors disagree ? 1

Introduction

strikes : Publicans want to sell adulterated gin without check ; Needy Politicians want to be paid for legislating ; Rich politicians want the privilege ol legislating to be confined to those who pay most money for it ; and so I might cro throuo’h the whole catalogue of political questions with few exceptions. Education perhaps, has not quite so much to do with money, and the ballot is comparatively pure ; it is only a bill to ensure the concealment of lies at elections.*

I repeat, then, that with the exception of questions of spiritual life and death none are .so important to the human race as those relating to bodily life and death, that i.s, to “ mere doctors’ questions,” especially as the two are so intimately connected.

Dr. Johnson said that amateur writers have no chance against professionals. I have no doubt, as a rule, he was rifrht. Still, the former have one advantage. Professionals must try to please their readers ; their bread and butter depends upon their doing so ; whilst a man to whom it does . not signify what the public thinks of his writings, says ^^hat he believes to be the truth, the whole truth, and nothing but the truth, simply because there is no rea.son why he should do otherwise.

=!= Voters consist of those who toll the truth about the way they vote aud those who tell lies. The Ballot of course is only lor the latter. Whether this measure is a good or bad one is ano er

question.

INTKODL'CTION.

vn

Tolling unpopular truth to the public never seems to have any effect. Still, unpopular truth should be told ; for some good may follow though one cannot tell how. It may be contradicted ; or it may find here and there a disciple ; or the author of it may be reviled ; or he may be held up to the scorn and ridicule of all right thinking persons, in some one of the journals that appear on the last day of every week. In one or other of these ways attention may be drawn to a subject, and thus some small contribution be made towards a better state of things.

I well know that any criticism this little publication may receive will and ought to point out its inartistic discursiveness. But, in the first place, I am not an artist, and in the second jilace, England is a comparatively free country where everyone may write as he likes so long as he harms no one. If anybody was obliged to read it, it would be another matter.

AthexjEuji Club.

Pall Mall.

November, 1872.

*

CHAPTER I. Who shall decide, when Doctoks disagree ?

CiRCU.MSTANCES that occiiiTed more than a year ago in my family have led me to turn my attention to the subject of Vaccination. Wishing to learn the truth about the matter, I gathered together a few facts and opinions upon the subject, from experiencd medical men. As the question of Y accination is just now, in consequence of the present small-pox epidemic, engaging a good deal of attention, I think it right to place these opinions and facts before the public. I may then perhaps venture upon a few comments of my own, although, as I am not a medical man, they are not likely to have much value. What I learnt was as follow'S ; —

(1) That statistics prove indisputably the extreme

utility of Vaccination, small-pox having much decreased since Vaccination has been general.

(2) That statistics prove indisputably the extreme

futility of Vaccination, small-pox having much increased since Vaccination has been general.

(3) That cases are constantly found where the

only unvaccinated member of a family alone of that family caught small-pox. •

R

How Doctors differ.

(4) That cases are constantly found where the only

unvaccinated member of a family alone of that family escaped small-pox.

(5) That in Sweden, small-pox has been ex-

tinguished by Vaccination ever since 18G3.

(6) That in 1866, in Sweden 5398 persons, all of

whom had been vaccinated, died of small-pox.

(7) That the complete absence of small-pox in

Ireland is due to Vaccination being well carried out in that country.

(8) That small-pox has been worse in Ireland than

in England.

(9) That Vaccination is unnatural and Avicked.

(10) That neglect of Vaccination is a crime.

(11) That most of the statements against V accination are lies.

(12) That most of the statements in favour of Vaccination are untrue.

(13) That a man who objects to having his younger chddren V accinated because theeldei ones have been killed by the operation should not be forced by penalties to consent.

(14) That children should be taken by force out of their mothers’ arms by policemen and Vaccinated, and the father, if he objects, should be treated as a felon.

(15) That the opponents of Vaccination being interested, their evidence is worthless.

(16) That the advocates of Vaccination being interested, their evidence is worthless.

(17) That Sir Cullen Eardey died from Vaccination.

(18) That although this is true, he would have died from the scratch of a pin or a tight boot.

(19) That tiie first Lieutenant and several men (all re-vaccinated) of H.M.S. Octavia, died of small-pox.

(20) That although they died, they had the disease in a mild form.

(21) That the treatment of small-pox being the same now as it was formerly, the diminution of deaths in those who are attacked cannot have anything to do with the treatment, but must be due to Vaccination.

(22) That whereas, formerly, small-pox was treated l>y copious bleeding, administration of brains of a cock-sparrow, the fat of a he-goat, blood of weasels, and crabs’ eyes, by the exclusion of fresh air, and by scarlet blankets, scarlet curtains, and a scarlet coat for the doctor to put on when he paid his visit ; at the present time the treatment is in some respects different.""

* I read a letter iu the Lancet the other day on a new mode of treating small-pox. The treatment consisted of washing the patient three times a day.

A few years ago, a Gennan physician announced to his friends that he had discovered a new remedy for disease, which was invaluable, not only as a cure, hut also as a preventative, and that he had proved it indisputably by carefully conducted experimeutalization on his own person. He kept it a secret for a long time, as medical men have sometimes most unjustifiably done in cases of new" and valuable discoveries ; but at length he w'as prevailed upon to give it to the world. He said, “ Ich wasche mich,”

(23) That Vaccination is the greatest blessing ever conferred upon the human race ; Christianity perhaps coming next.

(24) That Vaccination is the cause of all the ills of life, and that if a person is somewhat decrepid at ninety, and he can be shown to have been Vaccinated in infancy, the decrepitude is completely accounted for.

Thus far had I got in my investigations, when at length I began to see the error into which I had been led by my wish to arrive at an impartial judgment. Examining both sides of a question can possibly lead to nothing but confusion. So I decided to do what I ought to have done at first. I decided to examine and seek for only the opinions of the advocates for Vaccination. •

What I learnt was as follows ; —

(1) That Vaccination is an almost perfect safe-

guard against small-pox.

(2) That Vaccination has no protective effect

against severe small-pox.

(3) That lymph should only be taken from a

healthy child.

(4) That it is no matter whether the child be

healthy or not.

(5) The re- vaccination ought to be compulsory.

(6) That re-vaccination ought never to be resorted

(7) That this epidemic of small-pox was brought

from France by the emigrants.

(8) That it was in London before any emigrants

came.

(9) In England, that it was brought from the

Continent.

(10) On the Continent, that it was brought from England.

(11) That the more punctures the greater the protection.

(12) That one puncture is as good as a hundred. ♦

(13) That few doctors can Vaccinate well.

(14) That a doctor who cannot Vaccinate well, can do nothing well.

(15) That Vaccination has diminished small-pox enormously.

(16) That V accination has never been well enough performed to cause any diminution of small-pox.

(17) That all lymph comes originally from the greasy heels of diseased horses.

(18) That although this is true with regard to most of the lymph in use, some of it has come direct from the cow.

(19) That deaths from Vaccination are not nearly so numerous as is pretended.

(20) That in all deaths from Vaccination, either the child had a bad constitution, or the lymph was bad, or the lancet dirty, or the cow or the doctor in fault.

(21) That Dr. Eaul, in France, reported 450 cases of horrible diseases being communicated by Vaccination.

(22) That statements from hot-headed Frenchmen cannot be trusted.

(23) That impurity of lymph is easy to tell by the eyesight.

(24) That impurity of lymph canuot be discovered even with the strongest microscope.

(25) That Dr. Bakewell, M.D., is A^accinator General of Trinidad.

(26) That small-pox is not one of the diseases of Trinidad, such a thing being unknown there.

(27) That people oughtto be re-vaccinated because the effect only lasts 20 years.

Do.

do.

Do.

do.

Do.

do.

Do.

do.

year

(28) That parents object to their children being Vaccinated from conscientious motives.

(29) That parents object to their children being Vaccinated because they wish them to die of .small-pox in order to be saved the ex})ense of their maintenance.

(30) That re-vaccination is a perfect safeguard.

(31) That five re-vaccinated soldiers died this year of small-pox at the royal barracks in Ireland.

(32) That the medical profession pocket three million pounds a year in Vaccination fees.

(33) That this is overstated.

(34) That this is understated.

(35) That when Dr. A. kills a child, it is (says Dr. B.) because he does not know how to

Vaccinate.

(36) That when Dr. B. kills a child, it is (says Dr. A.) because he does not know how to V accinate.

(37) That lymph will not bear keeping.

(38) That lymph improves with keeping, like old port.

(39) A good many months ago, when Ireland was free from small-pox, that the fact was due to Ireland being effectually Vaccinated.

(40) Afterwards, when small-pox raged in Ireland, that the fact was due to Ireland being ineftectually Vaccinated.

I could fill volumes with similar contradictory opinions held by the advocates for Vaccination. It is really very disheartening to an earnest searcher for truth to find such hopeless difference amongst the doctors ; but I suppose there is no help for it.

A few years ago, I jotted down from the news- How the papers, opinions of the cattle doctors about the differed, cattle plague. A few of them were as follows : —

(1) On the Continent, that the cattle disease was imported from England.

(2) In England, that it was imported from the Continent.

(3) That the disease never attacked the lungs.

(4) That the lungs were always more or less

affected.

(5) That there was nc^ cure for the disease.

((3) That the only cure was homoeopathy.

(7) That the cure for it. was water slightly acidulated with tincture of sesquichloride of iron.

(8) That the disease being caused by insects, the

way to arrest its progress was to put niLisquito curtains in the cow sheds.

(9) That the disease being caused by drovers’

dogs, the way to arrest its progres was to tie up the dogs,

(10) That the way to cure the diseased animals, was to wash their faces and to wipe their eyes.

(11) That the best remedy was whisky and port wine given by the gallon.

(12) That thisreniedy being tried on Miss Burdett Courts’ cows, they all died, after sutiering first from “ excitement,”

(13) That the best remedy was a little weak beeftea every half-hour.

(14) That the best thing to do on the appearance of the disease was to inoculate all the healthy animals in the tail.

(15) That if this was judiciously done, the tail would frequently come off, but the life of a valuable animal would be saved.

C6) That the best precautionary measure with every healthy animal was to paint its nose with tar.

(17) That the disease was caused by the introduction, from the interior of Africa, of the insect called the Tsetse.”

(18) That if canvas bags filled with camphor were suspended from the necks of all healthy animals, there need be no further anxiety on their behalf.

(19) That the real cause of the disease was the bite of a small but malignant black spider, common in the steppes of Russia.

These are a few of the opinions of the cattle doctors, exactly as 1 copied them out of the newspapers. At that time I attributed this want of unanimity to veterinary ignorance, but I am beginning to see that it is a necessary condition of the art of healing. I now understand why lawyers have such an objection to medical witnesses in a law case.

They say not only that no two ever agree, but that no one doctor even ever seems to know what to think himself, so how puzzled the public must be.

I myself, am of a confiding, if not credulous disposition, and always anxious to believe what I am told. But what am I to think about Vaccination when I am told so many opposite things ? I can only try and make what I can of those facts, about which there seems to be no difference of opinion.

But they are very few.

In the first i)lace, then, it seems to be allowed bv

, ters agree

everybody, that whereas the only object of Vaccina- aj^out Vaction is to prevent small-pox epidemics, there has now been raging for a long time all over the United K ingdom, one of the most fearful epidemics of small-pox ever known, an enormous majority of the sufferers showing by marks on their arms, that they have been Vaccinated.

In the second place, all seem to agfree that Vaccina- Jenner’sideas tion, according to the meaning of the word as under- false, stood for the last seventy years, that is to say,

J enner s V accination, and J enner’s doctrines about

The new safe-^ard against small-pox.

it, for wliicli he received £30,000 from the government — that these things have completely broken down — they are proved to be false.

In consequence of this break-down, the medical profession have discovered some new safeguards against small-pox. They say, that if the Vaccination rite be performed in four or more difterent places instead of one, and if this be repeated every two, five, or ten years ; also, that if this new system be rendered compulsory by the government — that then the country will be safe. This new system of Vaccination will probably treble or quadruple the emoluments of the profession, and if a separate fee be charged for each puncture, the pecuniary again will of course be enormous ; but I am sure if the object sought for be gained, and there be no drawbacks to set off against the advantages, no right thinking person will grudge it,

I see it stated, that Sir W. J enner recommends annual re-vaccination. This would bring up the emoluments to a fabulous amount. But it is a mistake to suppose that all these sums of money would be a complete loss to the public, though they would of course be a complete gain to the doctors. A. great proportion would go back to the community , that is, to the tailors, and shoemakers, butchers, and bakers, in the doctors’ employ.

It seems that small-pox epidemics may be expected in the natural order of things, (supposing sanitary matters to remain the same,) perhaps three or four times in a century. It of course requires an epidemic to prove the truth or untruth, of any so called safeguard against epidemics. Therefore, in about thirty or so years, we may expect the new system of Vaccination to be te.sted.

Although only indirectly connected with the subject, I must mention one other point where unanimity seems to reign in the profession, 1 do so, because it always gives me so much pleasure to witness harmony and agreement. It seems then that all doctors agree in thinking that the government ought to aj>point more medical inspectors to see that V accination is effectually carried out in large towns ; and also that their salaries ought to be larger than they are.

What is the theory of Vaccination put into plain words ?

It is this, as I understand it.

That in the beginning God created the world and he thought it was very good ; and so it might have been but for one unhappy oversight. He had made no provision against small-pox. At length, after many ages, the Creator’s error was rectified by a countiy apothecary of the name of Jenner, who found out that, by taking some half putrid matter from a diseased cow and inoculating men with it, the consequences of the unhappy mistake made at the creation might be completely escaped for all future time, unless, indeed, like many other races of animals, cows became extinct, in which case, of

How doctors agree.

Theory of Vaccination in plain words.

According to the best authorities, lymph from au ulcer is “ Tissue that has undergone retrogi-ade metamorphosis or become partially decomposed.”

course, the human race would be reduced to its old sad predicament.

Now, T confess, the natural presumption in my mind is against this theory. But after all we must not go by mental presumptions, but by facts — plain unexaggerated facts. It is a pity people always weaken causes they take up by exaggeration. It is impossible for any impartial investigator into the question to doubt that great numbers of children are killed directly or indirectly by Vaccination. But that is no reason for attributing to it every evil that afflicts humanity. Saying such things only ends in creating ridicule, and therefore inattention to their cause. I know when people feel strongly, it is hard to avoid exaggeration. Nor do I expect parents who have lost their children by the rite to be cool and philosophical I know there are people with cold blood and flabby minds who can be so. But one might as well be a cod fish at once. No, I am too well acquainted with circumstances of a similar nature to expect anything so unreasonable. Still the fact remains, that the man who exaggerates injures his cause instead of forwarding it.

But what is the truth, and what are the facts ? Every one must judge for himself. Nine-tenths of statistics are worthless, for they are prepared by people who are in favour of one side or the other ; and we all know that, in such cases, any tricks can be played, even honestly, with facts, figures, and ingenuity.

Not being a medical man I am without experience ; and yet, even I know of three deaths from V accination, two all but deaths, and two cases of horrible sores commencing about the eighth day after the operation and lasting many years. In the latter cases, the parents (my own gamekeeper and his wife) being remarkably strong healthy people. Then what is the use of a doctor, with vast experience, coming and telling me he has V accinated a hundred thousand children— that no harm ensued in any of the cases — that not one of them has ever died since — that they all turned out exemplary Christians — and that some of them even lived to become very wealthy men ? Of course it all passes by me like the wind, and I care not whence it cometh nor wdiither it goeth.

One doctor tells me that no medical man of any Honorable repute has ever been opposed to Vaccination. And yet he is an honorable man.

Another tells me that nothing is of any use against small-pox except Vaccination — that cleanliness and purity of air are of no more avail than filth and impurity. He too is an honorable man.

Another doctor tells me that the stories about horrible diseases being imparted by Vaccination are completely without truth. He too is an honorable man.

All these are honorable men.

Then how are we to account for these statements, and innumerable others of a similar nature ? I think it can be done by discoveries philosophers have from time to time made in human nature.

Hobbes, of Malmesbury, says, that if it could be Hobbes of proved to be indisputably more universally advan-

I taofeous to the human race for 2 and 2 to make 5

O

Herbert

Spencer.

Hazzlit.

Rochefocault

Mr. Lecky.

Mr. J. Martineau.

than that they should make 4, 2 and 2 would make 5 and no one single person would have the slightest doubt about it.

Herbert Spencer says, that it is not intellect that rules in this world, but desires and character; that opinion does not arise from logic but from wishes.

Hazzlit says, that with the generality of mankind, belief on disputed topics is determined by considerations of personal ease and convenience in the teeth of logic. In fact, he says, “ people generally stick to an opinion that they have long supported, and that supports them.”

Rochefocault says, “ I’esprit est tonjours la dupe du coeur.”

Mr. Lecky says, that opinions are usually the result of numerous influences, of which self-interest is the most powerful. A man may pursue his enquiry in a most conscientious spirit, but the nature of his argument will always be determined by the secret bias of his wishes.

Mr. James Martineau says, that the smallest probability will outweigh the greatest if it fall in with our Avishes.

Loss of the power of judgment always, more or less, accompanies a life’s exclusive devotion to one pursuit. Some doctors seem to devote their lives to the one subject of Vaccination. Now nothing shoAVS a more stupid Avant both of charity and imagination, than that common accusation of dishonesty against these men in consequence of the extraordinary things they say upon the subject of this (as they seem to tliiiik it) almost religious rite. He who devotes his whole life to one subject gets gradually to lose all i)ower of seeing anything else in the universe. He gets to believe in nothing else, and to be unable to understand anything that is said against it, like that immortal Athenian tanner, who, when asked what a statue of some great leather, general should be made of, said “ there’s nothing like leather.” And 1 have not the slightest doubt that he honestly believed that a leathern statue would be more durable, and in every way more suitable than one made of either marble or broiiije.

A hair dresser once said to me, if ever I’m ill, sir, I gets my ’ead well brushed.” And I. doubt not he hone.stly believed in its complete efficacy to cure anvthing.

Jenner brooded over Vaccination till he seems to have gone rather mad about it. He wanted to A'accinate all the dogs in England ; and it is stated that he Vaccinated some of his own family to death.

Bishop Berkeley laughed at a mathematician for thinking the soul must be “ extension,” and at a musician for thinking it must be harmony.

Ask a lawyer what is to be done for any one of the ills of life. At once he says “ there’s nothing like leather.” Bring it into court and you will be made happy for ever. So it is in everything.

I look upon this peculiarity of human nature as a providential arrangement for the good of man. Whatever his hand finds to do, he soon learns to take an absorbing and exclusive interest in it, and

Safety valve fortheMedical conscience.

wherever there is absorbing interest there is almost always contentment and often happiness.

One of the causes why medical men are so often accused of dishonesty, arises from the impossibility of proof in cases of disease, and the consequent loop holes left for the conscience to get out of. To give an instance.

The boiler of a steam engine bursts, blows a man up and kills him.

An action is brought against the owner of the steam engine.

Dr. Thompson is the medical witness on the boiler’s side.

Dr. Thompson is in the witness box.

Counsel ; Now Dr. Thompson, can you state that the man was killed by the blowing up of the boiler ?

Dr. Thompson ; No, I cannot.

Now what loop hole can there be here for the doctor’s conscience ? Plainly this. He says to himself, “How can I state such a thing ? The man may for years have been subject to an affection of the heart. The complaint may have reached its height just at the time of the explosion of the.boiler, and he may have actually died of that most distressing complaint, angina pectoris, at the very moment when he was up in the air.

Another time a man’s head is turned into a pancake by the wheel of a railway engine. Action brought.

Dr. Thompson is now employed by the railway company.

Counsel : Now, Dr. Thompson, I suppose your evidence is to the effect that the engine killed the man ?

Dr. Thompson : No, it is not. Then he says to himself, it is impossible for anyone with so scrupulous a conscience as I have, to swear any such a thing. The man may, the moment before the engine reached him, have stumbled; fallen Avith his head on the rail and died of a fractured skull before the wheel touched him. Perjury is a fearful crime.

Another time it is a Vaccination case.

Counsel : Noav, Dr. Thompson, was that child killed by Vaccination ?

Dr. Thompson : No, it was not. Then he says to himself, the child died of erysipelas. Of course,

1 know that Avas caused by the V accination, but 1 am asked Avhat caused the death, not Av-hat caused the erysipelas. Now Plato says, that perjury is a Avorse crime than murder.'" jury-

Noav in all these three cases Dr. Thompson bears false Avitness, and yet, at the same time, his evidence is honest and conscientious. The mistake people make in judging others is to compare their conduct with ideal perfection. It is quite right that they

* When Plato says that a deliberate lie is worse than murder, he no doubt meant that instead of being merely brutal or animal it is diabolical. That is, it requires the combination of intellect with selfishness and absence of conscience, whereas murder only requires violent animal passions. I must say, I think undoubted peijury ought to be more severely dealt with by the law than it is. Nothing so much as penury and lies causes the defeat of justice. Now justice is the one thing that keeps society together and renders civilization possible.

C should do so, but their conclusions will be one-sided, and therefore defective, unless they also compare them with the other extreme. And what is the other extreme ? Medical gentlemen, disciples almost to a man, of Mr. Darwin, must say that the other extreme is the conduct of apes. From this point of view. Dr. Thompson’s evidence becomes admirable. For if he is really descended from an ape, that he should have a conscience of any kind is marvellous. Where did it come from ? The ape has none. But ex ndiilo nihil fit.” Indeed his whole conduct in the witness box becomes admirable. That he should attend carefully to the questions put to him, that he should stand decorously in the box instead of perching himself on the edge of it, or chattering gibberish, or scratching himself, or snatching off the wig from the head of the gentleman who is crossquestioning him, or seizing his brief, carrying it to a remote corner of the court, and tearing the leaves out gently, one by one — all this, from a scientific point of view, becomes very wonderful, and shows a development, an advance, and a progress that is simply astonishing.

These are merely instances to show what may take place in the minds of perfectly conscientious men.

The safety valve to the conscience in such cases, is the impossibility of absolute proof in all human matters. And thus we can account for otherwise unaccountable evidence sometimes given by doctors, certainly, as honorable a set of men as can be found in any profession.

I have no doubt tliat, if all evidence depended on interested ■witnesses, justice would be impossible, trials would be a farce, and society would collapse. What renders civilized society possible, is the fact that the generality of witnesses are not interested, or very slightly so, and thus, in no doubt most cases, justice prevails.

CHAPTER II. Impediments to Reform in Matters of Opinion

“ If ever I Rear anyone speak of an unalterable law, the only effect it has upon me is, to convince me that the speaker is an unalterable fool.”— Sidney Smith.

One great impediment to reform in matters of opinion, whether medical or otherwise, arises from that curious but common kind of pride which jirevents people from confessing that they have been wrong.

Illustrative An Irishman is being examined on a horse case, in a court of justice. He swears the animal was fifteen feet high ; But later on in the trial, he says “fifteen hands.” Why, says the counsel, a short time ago, you swore he was fifteen feet high. “ Did I,” replies Pat, “ then bedad 111 stick to it. The horse ivas fifteen feet high.”