VII. OPERATIONS IN LONDON, 1800
Dr. Pearson was the chief actor in the formation of--
The Institution for the Inoculation of the Vaccine Pock, Warwick Street, Charing Cross. Founded 2nd December, 1799.
In April, 1801, the Institution was removed to a more commodious house, 5 Golden Square. It was the first establishment of the kind in the world. In the conspectus of the Institution it was stated--
Of above 4000 persons who have had the inoculated Cowpock one only has died. There is, however, good ground for believing that the proportional mortality will be even less than here stated.
Not a single well-attested instance has been produced among more than 2000 inoculated with Cowpock, and subsequently with Smallpox, of the Smallpox being taken, although many were exposed to the infectious effluvia of that disease. Traditionally the fact is established from time immemorial that after Cowpox there is no Smallpox.
It may be fairly affirmed, that the inoculated Cowpock is generally a much slighter disease than the inoculated Smallpox; and that the proportion of severe cases in the latter is to the former as at least ten to one.
It does not appear the genuine Vaccine Pock can be propagated like the Smallpox by effluvia from persons labouring under it. Hence if the Vaccine Inoculation should be universally instituted in place of the Smallpox, it is reasonable to conclude, that this most loathsome and fatal malady will be extinguished; and, like the Sweating-Sickness, the Plague, certain forms of leprosy, etc., be known in this country only by name.
It does not appear that the Vaccine Poison, like that of the Smallpox, can be conveyed so as to produce the disease indirectly from diseased persons, by adhering to clothes, furniture, bedding, letters, etc. Hence no danger of its propagation in these channels is to be apprehended from the universal practice of the inoculation of the Cowpock.
It has been found that a person, whose constitution has distinctly undergone the Vaccine Disease, is in future insusceptible of the same disorder. [Thus re-vaccination was treated as impossible.]
Experience shows, that there is no reason to apprehend the smallest chance of deformities of the skin from the Vaccine Inoculation.
The extensive practice of the Vaccine Inoculation in the present year, and the accounts of the disease in the casual way do not show that any other disease will be excited subsequently.
A further considerable public benefit expected is, that a stock of efficacious Vaccine Matter, free from contamination by the Smallpox, will by this Institution be preserved for the use of the public.
These statements are interesting as showing how early the rollicking tunes were set to which at this day we are expected to dance. The last paragraph is noteworthy as a confession under Pearson’s hand that vaccine poison had got confused with variolous, and that the mistake would henceforth be avoided. Jenner maliciously and persistently used this mishap, for which Woodville was responsible, to discredit Pearson and magnify his own pretensions; but, as Pearson observed, neither Jenner nor any one else knew that it was possible to have cowpox and smallpox simultaneously. The mistake was made, however; and, as is the function of mistakes, knowledge was enlarged. Pearson’s behaviour in the matter was as creditable to him as Jenner’s was otherwise.
The Vaccine Pock Institution was organised with a staff of physicians, surgeons, and apothecaries of the highest London respectability; and as it was desired to have the benefit of Jenner’s name (his active co-operation, as a resident in Gloucestershire, being out of the question) Pearson wrote to him--
LONDON, 10th December, 1799.
We have made some progress in the institution of a charity for inoculating the Vaccine Pock. I do not know that I can confer any honour on you by proposing you (if I am able) to the directors of our establishment, nor do I well know what to propose to you. It occurs to me that it might not be disagreeable to you to be an extra corresponding physician.
No expense will be attached to your situation except a guinea a year as a subscriber; and indeed I think you ought to be exempt from that, as you cannot send any patients: but you may depute some proxy in town.
I confess I was surprised that you neither called nor sent for me for the last two months you were in town. However, if it was because you were too much occupied, I certainly excuse you.
The invitation was given stiffly, from duty more than inclination. Pearson knew very well why Jenner, furious with jealousy, had kept away from him; and he was thus answered--
BERKELEY, 17th December, 1799.
SIR,--I received your letter of the 10th instant, and confess I felt surprised at the information it conveys.
It appears to me somewhat extraordinary that an institution formed upon so large a scale, and that has for its object the inoculation of the Cowpox, should have been set on foot and almost completely organised without my receiving the most distant intimation of it. The institution itself cannot, of course, but be highly flattering to me, as I am thereby convinced that the importance of the fact I imparted is acknowledged by men of the first abilities. But at the same time allow me to observe that if the Vaccine Inoculation, from unguarded conduct, should sink into disrepute (and you must admit, Sir, that in more than one instance has its reputation suffered) I alone must bear the odium. To you, or any other of the gentlemen whose names you mention as filling up the medical departments, it cannot possibly attach.
At the present crisis I feel so sensibly the importance of the business that I shall certainly take an early opportunity of being in London. For the present I must beg leave to decline the honour intended me.--I remain, Sir, your obedient Servant,
E. JENNER.[114]
Pearson’s reply to this absurd and thoroughly Jennerian letter does not appear. He might have thanked Jenner for having drawn his attention to cowpox, and have proceeded to point out that beyond that service he and his friends owed him nothing, nor in anywise admitted his guardianship. Their practice was at complete variance with his teaching. He had prescribed horsegrease cowpox in which they had no faith, having tried to produce it in vain. On the other hand, they were operating with cowpox per se, which he had condemned as useless, being attended with no erysipelas or constitutional effect; and that working with this condemned cowpox, they found themselves producing a much milder disease, and were under no necessity of following his advice and destroying the pustule formed at the point of inoculation with escharotics; adding, that if they had been bound to his horsegrease and caustics, they would have made no progress with the public whatever.
Vaccine Inoculation might be good for mankind, but it was to be something better for Edward Jenner. There was not the least reason, outside his jealousy and rapacity, why he should not have congratulated Pearson on his enterprise and promised his assistance. As to claiming the guardianship of Vaccine Inoculation, it was preposterous: it had passed wholly beyond his control. It was Pearson’s complaint that Jenner never did anything useful after the publication of The Inquiry. He left to others the discovery of virus, and the labour and responsibility of experimenting, and only appeared on the scene when there was some disaster whereat he could play the part of superior person, whilst insisting that all supposed improvements and successes should be assigned to his credit.
Jenner is all-in-all in the vaccinators’ hagiology, but he holds the place at the cost of justice to Pearson and Woodville. To prove that I am not making a fanciful assertion, let me cite unprejudiced contemporary evidence. Dr. Paterson of Montrose in a communication to the Medical and Physical Journal, dated 25th May, 1801, observed--
While we are irresistibly led to join the wondering, the grateful throng, in paying the just tribute of applause to Dr. Jenner, the immortal discoverer, we must, at the same time, confess how much we are indebted to the ingenious and benevolent Dr. Pearson for bringing, in such a handsome manner as he did, the business before the public; thereby exciting, all at once, a universal, an unparalleled quest of investigation, and furnishing, by innumerable and satisfactory experiments, a complete confirmation of the noble discovery.
Here, we may observe afresh, that Pearson did not confirm Jenner’s “noble discovery.” On the contrary, his use of cowpox was at distinct variance with Jenner’s prescription of horsegrease cowpox, and with his condemnation of cowpox. Jenner, as we shall see, followed Pearson: Pearson did nothing to confirm Jenner.
Woodville lent his powerful influence as head of the Smallpox Hospital to establish the New Inoculation. He put Jenner’s prescription to the test with perfect sincerity and admirable courage, suffering himself to be thrice inoculated with horsegrease in order to come at the truth;[115] and only resorted to cowpox when he found horsegrease cowpox unattainable. Mr. Anthony Highmore, surgeon, speaking over Woodville’s grave in 1805, exclaimed--
Who that have felt the benefits of Vaccination will not teach their children, and their children’s children, to bless the name of Woodville when they bless the name of Jenner.
Yet Pearson and Woodville, who made the New Inoculation practical and practicable, were pursued by Jenner with implacable animosity, stigmatising their mishaps and appropriating their apparent successes.
To publish a pamphlet for the detraction of Woodville, and if possible to upset Pearson’s Vaccine Pock Institution, Jenner left Berkeley for London on 28th January, 1800, taking Bath on his way, where also a Vaccine Pock Institution was in progress.
Early in 1800 appeared A Continuation of Facts and Observations relative to the Variolæ Vaccinæ--a quarto of 40 pages, Jenner’s third pamphlet. Like its predecessor, a trumpery collection of gossip, it was designed to manifest his advantage over Woodville, who had inadvertently confused cowpox with smallpox in his inoculations at the Hospital.
First, Jenner expressed satisfaction over the interest of Europe in Cowpox Inoculation--
I have the pleasure, too, of seeing that the feeble efforts of a few individuals to depreciate the new practice are sinking fast into contempt beneath the immense mass of evidence which has risen up in support of it.
He then went on to describe the accumulating mass of evidence--
Upwards of six thousand persons have now been inoculated with the virus of Cowpox, and the far greater part of them have since been inoculated with that of Smallpox, and exposed to its infection in every rational way that could be devised, without effect.
“True,” Pearson might have observed, “but who inoculated the vast majority of the six thousand? Nor were they inoculated with the horsegrease cowpox you prescribed, but with the cowpox you condemned.”
The introductory reference to Woodville revealed Jenner’s disposition and tactics--
It was very improbable that the investigation of a disease so analogous to the Smallpox should go forward without engaging the attention of the Physician of the Smallpox Hospital in London.
Accordingly, Dr. Woodville, who fills that department with so much respectability, took an early opportunity of instituting an inquiry into the nature of the Cowpox. This inquiry was begun in the early part of 1799, and in May, Dr. Woodville published the result, which differs essentially from mine in a point of much importance. It appears that three-fifths of the patients inoculated were affected with eruptions, for the most part so perfectly resembling the Smallpox, as not to be distinguished from them. On this subject it is necessary that I should make some comments.
Woodville, whose experiments were as a hundred to one of his patronising critic, and informed with purpose too, must have received this languid commendation of his country acquaintance with some surprise, if not with fierier sentiment. Jenner as an investigator was never of much account. Of what constitutes scientific demonstration, he had little perception. Incapable and indolent, he nevertheless was ambitious, and had the craft to appropriate the research of others, and with assurance so ineffable that even the plundered fell under the persuasion that what he took was somehow his own. For example, the occurrence of smallpox and cowpox simultaneously in Woodville’s practice, which he had not foreseen, nor could any foresee, he first used as a pretext for lofty reprehension toward Woodville, and then converted into evidence of his own prescience, saying--
In my first publication I expressed an opinion that the Smallpox and the Cowpox were the same disease under different modifications. In this opinion, Dr. Woodville has concurred. The axiom of the immortal Hunter, that two diseased actions cannot take place at the same time in one and the same part, will not be injured by the admission of this theory.
Mark the adroit oblivion and the adroit attachment. It was horsegrease that he assumed to be the origin of smallpox through cowpox; and the cowpox used by Woodville was Jenner’s condemned cowpox, underived from the horse; yet the inconvenient was passed over, and the convenient assumed!
Possibly cowpox and smallpox are forms of the same disease: possibly they are not: possibly all diseases are forms of one disease: possibly they are not: but whatever the fact, Jenner had not an iota of evidence to adduce for his conjecture that grease in horses, and pox from that grease in cows, was a modification of smallpox in men.
As we review these early days of the New Inoculation, nothing so stirs regret as what appears to have been the wilful shutting of men’s eyes to facts--to notorious facts. It was well known in Gloucestershire, that whilst the vulgar supposed that cowpox prevented smallpox, it did not do so. Indeed, it was under stress of this knowledge that Jenner rejected cowpox per se for horsegrease cowpox. In the Gloucester Journal of 9th May, 1799, Mr. C. Cooke wrote--
I not only very much doubt that the Cowpox is a permanent preventive of Smallpox, but I am confirmed in this opinion by occurrences in my own practice, by conversing with many medical men on the subject, and by Dr. Beddoes, who writes, “I have a case where the Smallpox was taken after the Cowpox had been twice gone through.”[116]
Yet in presence of such testimonies, which were neither examined nor exploded, Jenner prophesied in this strain--
Some there are who suppose the security from the Smallpox obtained through the Cowpox will be of a temporary nature. This supposition is refuted, not only by analogy with respect to diseases of a similar nature, but by incontrovertible facts, which appear in great numbers against it. A person had the Cowpox 53 years before the Smallpox was tried upon him, and as he completely resisted it, I conceive every reasonable mind must be satisfied that he was secure from the disease during the intervening time.
Such was the evidence that he thought should satisfy every reasonable mind! How did he know that the said person had cowpox 53 years before, or had the right sort of cowpox, and in the right way? Inoculation with smallpox was continually unsuccessful (without reference to cowpox as cause of failure) and especially among elderly folk. When, however, there is a disposition to believe, the most indifferent reasons serve for conviction.
Cowpox and Smallpox, said Jenner, were modifications of the same disease; and Smallpox, whether contracted or inoculated, was a well-known excitant of scrofula; and Jenner was inclined to consider it probable that “the general introduction of the Smallpox into Europe had been among the most conducive means in exciting that formidable foe to health.” Then, it might be said, Cowpox as a modification of Smallpox must be liable to the like objection. “Not at all!” protested the smooth-spoken adventurer. “The diseases are the same, but unlike in the excitation of scrofula”--
Having attentively watched the effects of the Cowpox in this respect, I am happy in being able to declare, that the disease does not appear to have the least tendency to produce this destructive malady.
Considering his limited experience, the asseveration as to the non-excitation of scrofula was sheer quackery, and of a piece with the wilder assurance that follows. In 1798 he had set forth cowpox as a useful alternative to smallpox for inoculation; but in 1800 the claim was thus magnified--
When scrutiny has taken place, not only among ourselves, but in the first professional circles in Europe, and when it has been uniformly found in such abundant instances--
That the Human Frame when once it has felt the influence of the genuine Cowpox is never afterwards, at any period of its existence, assailable by the Smallpox,
May I not with perfect confidence congratulate my country and society at large on their beholding in the mild form of the Cowpox, an antidote that is capable of extirpating from the earth a disease which is every hour devouring its victims; a disease that has ever been considered as the severest scourge of the human race!
It is unnecessary to discuss these wild words--it is sufficient to record them as evidence of what it was possible to assert in the year 1800--and assert, too, whilst as yet the Cowpox that was to work the miracle was one thing in the hands of Jenner, and another in those of Pearson and Woodville!
The pamphlet published, Jenner’s other business in London was to undermine the institution for Vaccine Pock Inoculation. He went about insinuating and protesting that its founders and officers neither knew what was true Variolæ Vaccinæ, nor how to use it; that not only were they ignorant, but perverse; and that the immeasurable blessing he had been the means of conveying to mankind would never be rightly enjoyed until there was an Institution with Edward Jenner for its guide and director.
In playing this game Jenner had facilities and advantages. No one, not Pearson himself, contested his position as advertiser of the New Inoculation, and to the public he was its representative. He had attempted nothing and had no mishaps to account for: these attached to Woodville and other credulous and active experimenters.
Moreover he had no awkward information to contend with in those he addressed--they listened, were informed, were convinced. Jenner’s conduct at this juncture, in relation to Pearson and Woodville, has been stigmatised as mean, thankless, despicable. These be hard words. His tactics were the common tactics of men in whom self-love is predominant, and we have not the strength for the use of the appropriate epithets with the frequency that experience requires.
The poor were the chief sufferers from smallpox, and under the name of the poor Jenner advanced his project. He drew up the following memorandum, which he submitted to the Earl of Egremont, and circulated privately--
PROPOSAL FOR A PUBLIC INSTITUTION FOR VACCINE INOCULATION.
Having now pursued the inquiry into the nature of the Cowpox to so great an extent as to be able positively to declare that those who have gone through this mild disease are rendered perfectly secure from the contagion of the Smallpox; and being convinced from numberless instances that the occupations of the mechanic or the labourer will meet with no interruption during its progress, and the infected and uninfected may mingle together in the most perfect safety, I conceive that an Institution for the Gratuitous Inoculation of the lower classes of society in the Metropolis would be attended with the most beneficial consequences, and that it might be so constituted as to diffuse its benefits throughout every part of the British Empire.
EDWARD JENNER.
London, 16th March, 1800.
Then followed a scheme of the Institution, including “a Physician to be appointed to superintend the medical department.”
Whether from Jenner’s practical inefficiency, or because the time was not ripe, or because those who were more actively interested in cowpox were satisfied with Pearson’s Institution, the project lay in abeyance till 1803. He took nothing ostensibly by his intrigue save the withdrawal of the names of the Duke of York and Lord Egremont from the patronage of the existing establishment.
Meanwhile Pearson continued to operate with unabated energy, and his Institution became a recognised centre of inquiry, advice, and supply. It was designed, as he wrote, “1st, to be useful to the poor; but it had other objects, to wit, 2ndly, to ascertain the laws of the new poison for the extinction of smallpox; and 3rdly, to serve as a public office for the supply of the world with virus until supplies should become unnecessary.” One of the most flattering applications was received by Pearson from the French Consulate on 5th April, 1800. In a reply, dated 12th May, signed by the staff of the Institution, it was said--
We are not surprised that you have not yet found the disease among the cows of France, it being on the whole a rare disease in England; nor are we surprised at your want of success with the matter sent to you, because from experience we know that it very frequently fails, unless used immediately from the subject.
Vaccine matter may be conveyed in various ways: we have sent it to you in three, namely, on threads, on lancets, and on glass.
If you try the matter sent on thirty patients immediately, we think you cannot fail to excite the disease in some of them, and then you will please to preserve the succession by inoculation as we do in England, having had no fresh matter from the cow since January and February of last year, 1799.
The Frenchmen failed again with this virus, but Dr. Woodville soon after went to Paris, and effected what was desired.
Cow-Pock Dispensaries were opened in various towns throughout England, Bath and Manchester perhaps having the lead; and an Address to the Poor was drawn up as a common form to be issued from such Dispensaries. In a copy of this Address, widely circulated in and around Manchester in 1800, we read--
The experience of several years has fully proved that inoculation for the Cowpox is a certain preservative against the Smallpox; and is, besides, so mild and safe a disorder, when compared with the inoculated Smallpox, that it has been generally introduced among the better informed and more wealthy inhabitants, both of this kingdom and of various parts of Europe.
Inoculation for the Cowpox has been practised for several years [less than three] with constant success, in various parts of the Kingdom.
It has never failed to prevent the infection of the natural Smallpox.
It may be communicated with safety to persons of every age and sex, and at all times and seasons of the year, with equal advantage.
It does not produce eruptions, which scar and disfigure the face; and it is seldom, if ever, attended with any other marks of the disease than what appear on the arms from inoculation.
So far from proving hurtful, delicate and sickly children are often improved in health by having passed through this complaint.
Scarcely any remedies or attendance are required for the Cowpox, nor is there any necessity for a course of physic before or after the inoculation.
The prejudices of the poor against inoculation for the Smallpox, by which thousands of lives have been annually saved,[117] have been often lamented; but if they suffer unjust prejudices to prevent their laying hold of the advantages now offered to them by the inoculation of the Cowpox, they will neglect the performance of a duty they owe to themselves, to their families, and to society at large. For surely it is little less than criminal to expose their helpless children to the attack of so terrible and fatal a malady as Smallpox when it may be readily avoided by the inoculation of so mild, simple, and safe a disease as that of the Cowpox.
N.B.--All poor persons, whose affection for their families leads them to embrace this favourable opportunity, may have their children inoculated for the Cowpox at the Hospital and Dispensaries every day in the week (Sunday excepted) throughout the year. No time ought to be lost by the poor in freeing their families from the apprehension of the Smallpox, which daily increases in frequency and malignity throughout this town.
This manifesto is an illustration of the unscrupulous and unwarrantable assertions with which the New Inoculation was introduced to the world. There is no question that many who were active in circulating these mendacities did so honestly, justified, as they thought, by medical authority. What is marvellous is the survival of the primitive fictions to the present day. It would seem that when the human mind acquires a certain set, something like a surgical operation is requisite to reverse it.
We shall now see how the New Inoculation obtained this sudden popularity--a popularity so sudden that opposition had not time to organise itself. There were protests, and some raillery. In the Gentleman’s Magazine for August, 1799, we find a correspondent saying--
There is a plan to mitigate Smallpox in the human species by passing it through a Cow. Now as everyone is not in possession of a Cow, I propose to pass it through animals that most people possess. I mean Cats; and I shall call it the Catpox. When my plan is matured, the ingenious shall hear further concerning it.
And Pearson writing in 1802, when the success of cowpox appeared secure, observed--
How the new practice was sneered at by some: how it was reprobated as a gross and mischievous imposition: how it was stigmatised with the appellation of the Gloucestershire bubble: and how the Inquirers were considered by many persons as fit candidates for a certain asylum: to say nothing of the villainous jests made on the occasion, are recent in our memory.[118]
FOOTNOTES:
[114] Baron’s Life of Jenner, vol. i. p. 360.
[115] Rees’s Cyclopædia, vol. 38. London, 1819. The writer of the article himself inoculated Woodville with the Grease.
[116] Mr. Cooke’s letter was reprinted in the Medical and Physical Journal, vol. i. p. 322. London, 1799.
[117] By and by controversy with the Smallpoxers waxed hot, and then the Cowpoxers averred that thousands of lives were annually lost by their practice.
[118] Examination of Report of Committee of House of Commons. London, 1802.
VIII. TRIUMPH OF THE NEW INOCULATION
The House of Hanover has been reproached for indifference to literature, science and art, but an exception might be asserted on the score of variolous and vaccine inoculation. It was Caroline, Princess of Wales, who in 1721 promoted Maitland’s experiments; and Jenner found none so ready to hear and believe as George III. and his family. His first convert was the Duke of Clarence, subsequently William IV. The Duke’s surgeon happened to be Francis Knight, who had lived in Wilts and Gloucestershire, and was familiar with the country faith in cowpox, and received Jenner’s communication with a ready mind. In 1799 Knight was allowed to operate upon the Duke’s children by Mrs. Jordan, and the fact was noised abroad and passed to Jenner’s credit. Nor was the Duke’s service limited to this example. He made Jenner’s acquaintance, listened to his stories, and became his active partizan. Then the Duke of York, commander-in-chief of the army, was convinced, and enforced the new practice to the full extent of his power. He, moreover, acted as patron of the Vaccine Pock Institution until he was persuaded that Pearson, its founder, was injurious to Jenner. On 7th March, 1800, Jenner was presented to George III. at St. James’s Palace, and delivered The Inquiry bound in crimson to his majesty, who was pleased to accept the dedication of the second edition. On the 27th he had an interview with Queen Charlotte, who conversed about the new specific with all the curiosity of a grand-motherly quack. The Prince of Wales followed suit; and Jenner found himself invested with the full effulgence of the royal favour. It was a magical success; for, consider, not two years had elapsed since the publication of The Inquiry.
Jenner naturally became very popular. He wrote to Mr. Shrapnel--“I have not yet made half my calls in town, although I fag from eleven till four;” and, “Pray tell Tierney how rapidly the Cowpox is marching over the metropolis, and indeed through the whole island. The death of three children under inoculation with smallpox will probably give that practice the Brutus-stab.”
With little ability to make and maintain ground, Jenner, like many feeble folk, had the faculty of converting those he called his friends to his private advantage. He did not subdue them by will, but by weakness. Indeed, whoever chooses to observe will often have to mark with amaze how stronger natures suffer their means and energies to be appropriated by inferior organisms, and used with the thanklessness of rightful possession.
John Ring was a remarkable instance of this sort of possession. He was a surgeon in New Street, Hanover Square, London. In 1799 he entered into correspondence with Jenner, and his interest in cowpox and its advertiser developed into an enthusiasm without qualification by weariness or fear. Whatever Jenner asserted he swore to; whatever charge was brought against the New Inoculation he denied. He was ready for all comers with such voluble and hearty vigour that his outrages on propriety were laughed at and excused as “John Ring’s way.” Among his earlier services was the preparation of the Testimonial in favour of the New Inoculation which he carried from house to house and obtained the signature of nearly every London physician and surgeon of distinction. The Testimonial was published in the Medical Review and Medical Journal for July, 1800, and was reprinted in the newspapers. It ran as follows--
Many unfounded reports have been circulated, which have a tendency to prejudice the public against the Inoculation of the Cowpox: we, the undersigned physicians and surgeons, think it our duty to declare our opinion, that those persons who have had the Cowpox are perfectly secure from the future infection of the Smallpox, provided the infection has not been previously communicated.[119]
We also declare that the inoculated Cowpox is a much milder and safer disease than the inoculated Smallpox.
The first signatures comprised thirty-two physicians and forty surgeons, and the example being set, others hastened from town and country to record their adhesion. “I feel proud,” wrote Mr. Witham in sending his name, “that my little bark may, with others more illustrious,
Attendant sail, Pursue the triumph, and partake the gale.”
The Testimonial had great effect on the public mind: to the majority it was irresistible. As Ring said, “It confounded the enemies of the new practice”--adding in his characteristic vernacular, “and it secured the triumph of reason over the scruples of prejudice and ignorance, and the base manœuvres of sordid and self-interested men.”[120] Thus early was it discovered that an opponent of Vaccination was an ignoramus or a rascal. Ring’s easy arrogance is concisely illustrated in this deliverance--
It is no want of candour to affirm that those who are hostile to Vaccine Inoculation, are total strangers to it; those who are doubtful, are almost total strangers to it; and I defy the whole world to produce one single instance of a person that has had any experience of the disease, who is not a decided friend to the practice.[121]
Jenner recognised his thorough-going supporter, and used his loyalty to strike at Pearson and others who failed to abide in like subservience. He wrote to a foreign physician--
The discovery which I had the happiness to announce to the world is much indebted to Mr. Ring’s ardent zeal and indefatigable exertions for the rapid progress it has made; while some of those who vainly conceived themselves instrumental in promoting its adoption have in reality from their ignorance and indiscretion, rather retarded than accelerated its progress.[122]
Wonder is frequently expressed over the rapid conversion of England and the world to Vaccination, but, as I have before remarked, wonder is much reduced when we set the circumstances clearly before us. Inoculation with smallpox to avert smallpox was the practice of the time, and it was not a universal practice simply because it was troublesome and dangerous: everybody believed in the saving rite; and where evaded it was as onerous and perilous duties are always and everywhere evaded by the indolent and cowardly. Inoculation with cowpox was introduced to the public as a substitute for inoculation with smallpox, equally efficient or more efficient, and neither troublesome nor dangerous. Thus easy and seductive was the transition from the one practice to the other. Jenner had no serious battle to fight: the contest was decided in the years during which inoculation with smallpox struggled for prevalence. The warfare that subsequently cost him so much irritation was conducted by the conservatives of Inoculation, as experience revealed the inefficiency and mischiefs of Vaccination. Resistance such as is now offered to Vaccination on physiological grounds there was none, so far as I can discover. It had apparently occurred to no one that smallpox was a consequence of the transgression of the laws of health, and was preventible by submission to those laws. It was imagined that the disease came by the will of God, or the devil, or by force of fate, and that to dodge it by medical craft was the utmost that was practicable. Unless we bear in mind these conditions of the public intelligence, we shall misapprehend the demeanour of the people who so cordially welcomed Jenner’s advertisement. It is always a mistake to criticise the conduct of an earlier generation by the light of a later. We turn history to ill account when we use it to nourish our self-complacency; for the probability is that had we lived with our forefathers, we should have done exactly as they did.
Some will ask, How did it ever come to pass that so many doctors in 1800 signed Ring’s testimonial certifying that inoculation with cowpox was a sure and everlasting protection from smallpox when they had not, and could not have, any experience to warrant their assertion? True, but they had an illusory experience by which they were beguiled, namely, the Variolous Test. Hundreds were inoculated with cowpox and subsequently with smallpox, and were also exposed to smallpox contagion, and as the disease did not take, it was concluded it could never take, and that the subjects of the operation were fortified for ever. The fallacy is now manifest, but it was by no means manifest in 1800, and all manner of men received and propagated the fable with energetic sincerity. It was once admitted that a tub full of water did not overflow when a fish was slipped into it, and many explanations were current of the curious phenomenon until a sceptical spirit suggested that the experiment be tried. A like spirit might have suggested that it was expedient to wait and see whether cowpox was indeed a perpetual defence against smallpox, inasmuch as nature had an awkward habit of confuting prognostications apparently irrefragable.
The ease with which it was asserted cowpox inoculation could be performed, coupled with its harmlessness, not to say wholesomeness, and the absolute security it afforded against smallpox, induced benevolent busybodies to set up as vaccinators all over the country. What the kindly quack delights in is something cheap and handy with a touch of mystery and the promise of immeasurable advantage--conditions which the new practice completely fulfilled. The memoirs of the time, especially of the Evangelical party, abound with instances in which this good soul and that good soul had vaccinated so many hundreds or thousands, delivering them from the peril of an awful disease. Thus in the Gentleman’s Magazine, for December, 1800, we read--
Two respectable families near Manchester have within these few months inoculated upwards of 800 of the neighbouring poor from two months old to twenty years with uniform success. Twenty of them were subjected to the variolous test, and all were found proof against the disease.
And John Ring relates--
Dr. Jenner lately met in a large party of fashion a lady of Portman Square, who, with another lady, has inoculated 1300 in the north of England. The rural swain, when he receives the blessing of Jenner’s discovery from such a fair hand, must conclude that the Goddess of Health has adopted the practice.[123]
Of course medical practitioners had little favour for this sort of intrusion into their domain, but Jenner encouraged and boasted himself in the domestic diffusion of the discovery. By and by when disasters became common it was found extremely convenient to ascribe them to these unskilled operators; and ultimately vaccination was resigned entirely to the legally qualified practitioner, whose failures are rarely inquired into, and when proclaimed are, as professional matter of course, explicitly denied.
Jenner after six months of lionising left London on 23rd June, 1800, and on his way home passed through Oxford where he was introduced to Dr. Marlow, Vice-Chancellor of the University, and other dignitaries, who subscribed the following testimonial, drawn up by Sir Christopher Pegge, Reader in Anatomy--
We, whose names are undersigned, are fully satisfied upon the conviction of our own observation, that the Cowpox is not only an infinitely milder disease than the Smallpox, but has the advantage of not being contagious, and is an effectual remedy against the Smallpox.
When a prophet in the country turns out a prophet in London his country neighbours begin to believe in him; and thus it was with Jenner. His metropolitan reputation was reflected in Gloucestershire. Earl Berkeley wrote to the Duke of Beaufort--
Every father of a family owes the greatest obligation to Dr. Jenner for preventing the dreadful effects of the smallpox.
And the sense of this obligation took shape in a service of plate presented in 1801 and bearing this inscription--
PRESENTED BY THE NOBILITY AND GENTRY OF THE COUNTY OF GLOUCESTERSHIRE TO THEIR COUNTRYMAN EDWARD JENNER, M.D., F.R.S. AS A TESTIMONY OF THE HIGH SENSE THEY ENTERTAIN OF THOSE EMINENT ABILITIES WHICH DISCOVERED AND THAT DISINTERESTED PHILANTHROPY WHICH PROMULGATED THE VACCINE INOCULATION.
FOOTNOTES:
[119] Meaning thereby, as happened under Woodville at Battle Bridge Hospital where Smallpox and Cowpox were incurred simultaneously.
[120] A Treatise on the Cowpox containing the History of Vaccine Inoculation. By John Ring. Part i. p. 297. London, 1801.
[121] Ib. Part ii. p. 720. London, 1803.
[122] The Beauties of the Edinburgh Review, alias the Stink-Pot of Literature. By John Ring. London, 1807. P. 49.
[123] Treatise on the Cowpox, p. 520. London, 1801.
IX. A DISHONOURABLE TRANSFORMATION
Honour was abundant, but honour is windy fare, and Jenner had an eye for something more substantial. Among his papers we read--
While the vaccine discovery was progressive, the joy I felt at the prospect before me of being the instrument destined to take away from the world one of its greatest calamities, blended with the fond hope of enjoying independence and domestic peace and happiness, was often so excessive that, in pursuing my favourite subject among the meadows, I have sometimes found myself in a kind of reverie. It is pleasant to me to recollect that these reflections always ended in devout acknowledgments to that Being from whom this and all other mercies flow.[124]
But how was the fond hope of enjoying independence to be realised? The question was discussed by Jenner and his friends, and it was finally decided to apply to the House of Commons for a reward. But in order to go to Parliament it was necessary to have a good case, and Jenner’s case was open to various objections. The Inquiry, published in 1798, was by no means a manual of practice. Its prescription was Horsegrease Cowpox; but such Cowpox was neither producible nor accounted tolerable. Cowpox that did not originate in Horsegrease, Jenner had adjudged spurious; and yet such spurious Cowpox had been adopted by Pearson and Woodville, and under their influence had obtained extraordinary popularity. It was therefore by no means improbable that any claim for cash wherewith to enjoy independence might be seriously contested. In this strait, what was to be done? The question was a grave one, and called for a heroic solution. Resolved therefore, that Horsegrease Cowpox be dropped, and with it the use of escharotics for the subjugation of the pustules produced thereby. Absolute silence should thenceforth be his rule as to Horsegrease. So much for the negative position: the positive was more difficult. To claim Cowpox as his own, with the modes of its exhibition devised by Pearson, was an evolution full of hazard, but unless prepared to surrender “the fond hope of enjoying independence,” it must be effected. He had advantages. His name was associated with the new practice: even Pearson had done him homage: neither the medical profession nor the public were likely to study the Inquiry critically, or to trouble their heads over obscure details: Cowpox was to them Cowpox: he had the world’s ear; and opposition would be set down as the ordinary behaviour of envy toward success. Anyhow the transformation must be attempted: otherwise, farewell to dreams of financial independence.
To initiate this transformation, Jenner came to London, and in May, 1801, published a quarto pamphlet of twelve pages, entitled The Origin of the Vaccine Inoculation.
First it was necessary to represent that his investigations had extended over many years--a fact of which there was no sign in the Inquiry, the evidence indeed being distinctly otherwise; and thus he shaped his statement--
My inquiry into the nature of the Cowpox commenced upwards of twenty-five years ago. My attention to this singular disease was first excited by observing that among those whom in the country I was frequently called upon to inoculate, many resisted every effort to give them the Smallpox. These patients I found had undergone a disease they called the Cowpox, contracted by milking Cows affected with a peculiar eruption on their teats. On inquiry, it appeared it had been known among the dairies from time immemorial, and that a vague opinion prevailed that it was a preventive of the Smallpox. This opinion I found was comparatively new among them; for all the older farmers declared they had no such idea in their early days--a circumstance that seemed easily to be accounted for, from my knowing that the common people were very rarely inoculated for the Smallpox till that practice was rendered general by the improved method introduced by the Suttons: so that the working people in the dairies were seldom put to the test of the preventive powers of the Cowpox.
Jenner’s design in the foregoing statement was manifest. It was to minimise the faith of the country folk, and to represent that by his own perspicacity he had discovered the virtue of Cowpox through his failures to inoculate with Smallpox. The inquiries of Pearson and others, however, showed conclusively that in many parts of the south of England, in Ireland, and on the Continent it was believed that to have suffered from Cowpox was to be secure from Smallpox; and the belief was entertained altogether independently of failures to inoculate with Smallpox; just as a similar belief prevailed among farriers as to the prophylaxy of Horsegrease. The faith in Cowpox was neither vague, nor new, nor confined to Jenner’s neighbourhood; and his assertion to the contrary showed with what hardihood he had undertaken to construct a case in his own favour.
In opposition to the rural faith, medical men maintained that it was possible to have Smallpox after Cowpox; and surgeons averred that they had successfully inoculated many who had suffered Cowpox. Indeed it was indubitable professional testimony to this effect that compelled Jenner to forsake his first fancy for Cowpox, and to report the true specific as Horsegrease Cowpox. Having, however, to sacrifice that discovery, and revert to the Cowpox he had discredited, a fresh manœuvre was requisite; and thus was it performed--
In the course of the investigation I found that some of those who seemed to have undergone the Cowpox, nevertheless, on inoculation with the Smallpox, felt its influence just the same as if no disease had been communicated to them by the Cow. This occurrence led me to inquire among the medical practitioners in the country around me, who all agreed in this sentiment, that the Cowpox was not to be relied upon as a certain preventive of the Smallpox. This for a while damped, but did not extinguish my ardour; for as I proceeded I had the satisfaction to learn that the Cow was subject to some varieties of spontaneous eruptions upon her teats, that were all capable of communicating sores to the hands of the milkers, and that whatever sore was derived from the animal was called in the dairy the Cowpox. Thus I surmounted a great obstacle, and, in consequence, was led to form a distinction between these diseases, one of which only I have denominated the true, the others the spurious Cowpox, as they possess no specific power over the constitution.
Here we have the trick before us at the very point of transformation. He consulted with medical practitioners, “who all agreed that Cowpox was not to be relied upon as a certain preventive of Smallpox.” True. What did he do next? He discovered that what Cowpox did not prevent, the variety derived from Horsegrease did. Such was the original revelation of 1798. In 1801 we have a different story, and his quest a different issue. Not a word about the discovery of the sure preventive in Horsegrease Cowpox--not one word! Although his ardour was damped by the medical evidence against Cowpox, he yet prosecuted his inquiry; and to his satisfaction ascertained that what the milkers called Cowpox was not always Cowpox, but that any sores whatever derived from the Cow were so designated. He therefore was led to form a distinction between the diseases, and to denominate one as true and the others as spurious Cowpox.
Thus the Horse, the obnoxious Horse, was got rid of, and the Cow represented as of herself yielding pox, which pox was the Cowpox that Pearson and Woodville (in contempt of Jenner’s 1798 revelation) had brought into fashion; and which it had become all essential for Jenner to claim as his own in order to realise his “fond hope of enjoying independence.”
In this connection the question occurs, Why should “some varieties of spontaneous eruptions” have been designated spurious Cowpox? Such eruptions were not Cowpox in any sense. Why then spurious? That Cows communicated a variety of sores to their milkers, described by them in common as Cowpox, was an assertion for which Jenner never adduced any evidence; which, too, (as we shall see) at a later date he disowned as a misapprehension. Nevertheless spurious Cowpox got the New Inoculation over many difficulties. When Smallpox, or any notable mischief, followed Cowpox it was said, “Ah! the Cowpox must have been spurious; for Smallpox, or any harm, is impossible after true Cowpox.” People did not stay to inquire whether spurious Cowpox (that was to say, matter “from a variety of sores on the Cow,” according to Jenner’s second version) could be propagated from arm-to-arm, even if taken from the Cow by mistake. The illusory Variolous Test and the Spurious Cowpox Dodge worked marvellously for the public deception.
Another point Jenner tried to score at the cost of Pearson and Woodville. When they began to inoculate they found they had to ascertain at what period the virus should be taken from the Cow, and from the arms of the inoculated. Jenner afforded them no guidance. Writing to John Ring, 1st July, 1801, he confessed--
In the early part of my inoculations I had not learned to discriminate between the efficacy of the virus taken at an early and at a late period of the pustule.[125]
Where Jenner had not learned to discriminate, the line became clear in the course of general practice; and Pearson was especially explicit as to the right time for taking virus; but to make good his claim to national consideration, Jenner fancied it necessary to exhibit himself as complete master of the art of Cowpox Inoculation, owing nothing to others; and he therefore proceeded to appropriate the fruit of the common medical experience, assigning it to a season when he alone was in the field. Referring to his separation of true from spurious Cowpox, he thus prosecuted his raid--
This impediment to my progress was not long removed before another, of far greater magnitude in appearance, started up. There were not wanting instances to prove that when the true Cowpox broke out among the cattle at a dairy, the person who had milked an infected animal, and had thereby gone through the disease in common with others, was liable to receive the Smallpox afterwards. This, like the former obstacle, gave a painful check to my fond and aspiring hopes; but reflecting that the operations of Nature are generally uniform, and that it was not probable the human constitution (having undergone the Cowpox) should in some instances be perfectly shielded from the Smallpox, and in many others remain unprotected, I resumed my labours with redoubled ardour. The result was fortunate; for I now discovered that the virus of Cowpox was liable to undergo progressive changes from the same cause precisely as that of Smallpox, and that when it was applied to the human skin in its degenerated state, it would produce the ulcerated effects in as great a degree as when it was not decomposed, and sometimes far greater; but having lost its specific properties, it was incapable of producing that change upon the human frame which is requisite to render it insusceptible of the variolous contagion: so that it became evident a person might milk a Cow one day, and having caught the disease, be for ever secure; while another person, milking the same Cow the next day, might feel the influence of the virus in such a way as to produce a sore, or sores, and, in consequence of this, might experience an indisposition to a considerable extent; yet, as has been observed, the specific quality being lost, the constitution would receive no peculiar impression....
This observation will fully explain the source of those errors which have been committed by many inoculators of the Cowpox. Conceiving the whole process to be extremely simple, as not to admit of a mistake, they have been heedless about the state of the Vaccine Virus; and finding it limpid, as part of it will be, even in an advanced state of the pustule, they have felt an improper confidence, and sometimes mistaken a spurious pustule for that which possesses the perfect character.
No one apparently thought it worth while to expose the fictitious character of these statements, invented by Jenner to justify his pretensions and to baffle objections. Any careful reader of the Inquiry of 1798, and the Origin of Vaccine Inoculation of 1801, cannot fail to perceive the radical inconsistency of the earlier and later narratives, and how a few hasty experiments enveloped in unverifiable conjecture and gossip, came to be magnified into years of arduous research.
He wound up his statement with this flourish and prediction--
The distrust and scepticism which naturally arose in the minds of medical men, on my first announcing so unexpected a discovery, has now nearly disappeared. Many hundreds of them from actual experience, have given their attestations that the inoculated Cowpox proves a perfect security against the Smallpox; and I shall probably be within compass if I say thousands are ready to follow their example; for the scope that this Inoculation has now taken is immense. An hundred thousand persons, upon the smallest computation, have been inoculated in these realms. [May, 1801.] The numbers who have partaken of its benefits throughout Europe and other parts of the globe are incalculable; and it now becomes too manifest to admit of controversy, that the annihilation of the Smallpox, the most dreadful scourge of the human species, must be the final result of this practice.
For the end designed--to establish and exalt a claim with the purpose of exacting corresponding recompense, the Origin of the Vaccine Inoculation was an adroitly drawn document: its veracity is a different matter. A just man, not to say a generous, would have had some praise for Pearson, Woodville, and others to whom the extension of the New Inoculation was due; but Jenner was essentially a mean spirit; and for him to have stated his case truly would have been to jeopardise “the fond hope of enjoying independence.”
FOOTNOTES:
[124] Baron’s Life of Jenner, vol. i., p. 140.
[125] Baron’s Life of Jenner, vol. i., p. 448.
X. JENNER BEFORE PARLIAMENT, 1802
Jenner was timid and indolent, and, though eager for reward, required much prompting to use the means to the end on which his heart was set. He wrote to Lord Sherborne to speak for him to Prime Minister Addington; but Sherborne replied, 23rd April, 1801, that he did not know Addington even by sight. He would however try to see Mr. Pitt, adding for encouragement and direction--
If patriot Grattan gets £50,000 for his patriotism, the true patriot Jenner deserves more: I am sure not less; and less would be perfectly shabby to think of. I perfectly recollect Grattan’s business. It was settled among his friends to propose £100,000 for him, determining to ask enough; and fearing that sum would not be granted, one of his particular friends was to get up afterwards and propose £50,000, which was immediately granted, and he took £47,500 for prompt payment.
Action had to be taken, and on 9th December, 1801, Jenner went to London to prepare a petition to the House of Commons and to canvass for support. Even at the last moment, Wilberforce had to warn him, 24th February, 1802, that no time was to be lost, or he would lose his chance for the year. After prolonged consultation with those accustomed to such business, the petition was got ready, and on 17th March, 1802, it was presented to the House of Commons.
The humble Petition of EDWARD JENNER, Doctor of Physic,
SHEWETH,
That your Petitioner having discovered that a disease which occasionally exists in a particular form among cattle, known by the name of the 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 persons so inoculated perfectly secure from the infection of the Smallpox.
That your Petitioner after a most attentive and laborious investigation of the subject, setting aside considerations of private and personal advantage, and anxious to promote the safety and welfare of his Countrymen and of Mankind in general, did not wish to conceal the Discovery he so made of the mode of conducting this new species of Inoculation, but immediately disclosed the whole to the public; and by communication with medical men in all parts of this Kingdom, and in Foreign Countries, sedulously endeavoured to spread the knowledge of his discovery and the benefit of his labours as widely as possible.
That in this latter respect the views and wishes of your Petitioner have been completely fulfilled; for to his high gratification he has to say that this Inoculation is in practice throughout a great proportion of the civilised world, and has in particular been productive of great advantage to these Kingdoms, in consequence of its being introduced, under authority, into the Army and Navy.
That the said Inoculation hath already checked the progress of the Smallpox, and from its nature must finally annihilate that dreadful disorder.
That the series of experiments by which this discovery was developed and completed have not only occupied a considerable portion of your Petitioner’s life, and have not merely been a cause of great expense and anxiety to him, but have so interrupted him in the ordinary exercise of his profession as materially to abridge its pecuniary advantages without their being counter balanced by those derived from the new practice.
Your Petitioner, therefore, with the full persuasion that he shall meet with that attention and indulgence of which this Honourable House may deem him worthy, humbly prays this Honourable House to take the premises into consideration, and to grant him such remuneration as to their wisdom shall seem meet.
Patriot Grattan asked for £100,000, was awarded £50,000, and took £47,500: “true patriot Jenner deserves more,” said Lord Sherborne; but Jenner had not courage for the demand. What, however, was undefined in cash was made up for in pretension.
As we read Jenner’s petition we note (1) the Discovery; (2) its Disclosure and Diffusion; (3) the Expense thereby incurred; and (4) the Prophecies; and under these heads it is to be observed--
1.--It was no discovery of Jenner’s that cowpox was inoculable and preventive of smallpox. That was a rural superstition. Nor, be it again repeated, did he ever become responsible for that rural superstition. Recognising its futility, he deliberately set it aside, and recommended a disease of the horse, transmitted through the cow, for inoculation. It was Pearson, who disliking Jenner’s prescription, brought cowpox into vogue; whereon Jenner, fearing that he might be cut out of the enterprise, dropped his specific, adopted the cowpox he had rejected, and claimed Pearson’s work as the development of his own.
2.--That he disclosed his discovery was true, but it was not the discovery set forth in the petition. Moreover the merit of disclosure in such a case is measured by the advantage of concealment; and what could Jenner have taken by concealment? The conditions of successful quackery were not present in the secret practice of inoculation with horsegrease cowpox.
3.--That the discovery occupied a considerable portion of Jenner’s life, and was attended with great expense and loss of practice, is answered by reference to his Inquiry. With what loss of time, loss of money, and loss of practice could the series of cases therein set forth have been attended? And after 1798, he confessed he was able to achieve little further.
4.--As for the prophecies about the absolute security afforded by cowpox with the final extermination of smallpox, we may estimate the worth of such vapouring by the asserted check at that time, 1801, administered to the disease, when as yet an insignificant fraction of the population had been subjected to the New Inoculation, and a fraction, too, least likely to suffer from smallpox.
Petitions are petitions, and not designed for over-much scrutiny. In them truth is rarely to be looked for otherwise than warped to personal ends. The policy of a petition is to claim in excess with a view to obtain a larger concession. Jenner’s petition was a more than usually flagrant instance of this policy, with the disadvantage that much of its untruth passed into currency as matter of fact.
The Prime Minister, Mr. ADDINGTON (afterwards Viscount Sidmouth), informed the House that he had taken the King’s pleasure on the contents of the petition, and that his Majesty recommended it strongly to the consideration of Parliament. It was referred to a committee, of which Admiral Berkeley, a zealous believer in Jenner, was appointed chairman. The points to which the committee chiefly directed their inquiries were--
I.--The utility of the discovery itself.
II.--The right of the petitioner to the discovery.
III.--The sacrifices of the petitioner in making the discovery.
As an investigation the work of the Committee was illusory. The points were decided in the petitioner’s favour from the outset. There was no opposition. Dr. Moseley, Mr. Birch, and Dr. Rowley, who became active opponents of the New Inoculation, were summoned, but the matter was new to them; they had not had time to collect evidence and formulate conclusions: a rite that was to protect for a lifetime and to annihilate smallpox, announced in 1798, was to be adjudicated upon in 1802! On the other hand, Jenner’s friends were influential and active, and used the opportunity to parade their whole strength in his favour. The medical testimony especially was unreserved and enthusiastic.
Dr. JAMES SIMS, president of the London Medical Society, laid before the Committee a unanimous resolution of the Society in Jenner’s favour. He said he was at first adverse to Vaccine Inoculation, but his confidence in it was increasing every hour. It introduced no other disease to the human frame, whilst it made an end of the possibility of smallpox, a disease that proved fatal to one in six of those it attacked. He had never heard of Cowpox before the publication of The Inquiry, and regarded the discovery therein communicated as the most useful ever made in medicine. If Jenner had kept and traded on his secret, he might have become the richest man in the kingdom.
Sir GILBERT BLANE related how the New Inoculation had been introduced to the Navy. He had had the men on board the Kent, man-of-war, inoculated with cowpox, and then with smallpox, and not one took the latter disease. Of every thousand deaths in the country, smallpox was accountable for ninety-five. Taking London as the standard, 45,000 must perish annually from smallpox in the United Kingdom. As soon as the preventive discovered by Jenner became universal that large mortality would cease.
Dr. LETTSOM, a popular physician, a member of the Society of Friends, and an enthusiastic supporter of Jenner, said he had paid much attention to smallpox statistics. Taking London and the out-parishes as containing nearly 1,000,000 inhabitants, he calculated that eight a day, or 3000 annually died of smallpox. Allowing Great Britain and Ireland to have a population of 12,000,000, that would give a mortality of not less than 36,000 per annum from smallpox. He had reason to conclude that about 60,000 persons had undergone the New Inoculation up to date. He did not think that the genuine cowpox when inoculated could ever prove fatal. Had Jenner kept his remedy secret he might have derived immense pecuniary profits from it, as did the Suttons by their improved practice of variolous inoculation.
Asked whether he had known any inoculated with smallpox subsequently contract smallpox, he replied that he had two relatives inoculated who afterwards had smallpox, and one of them died. He had recently attended two families, in each of which a child inoculated was laid up a year after the operation with smallpox.
Dr. WOODVILLE, forgiving Jenner’s evil treatment, came, like a good Friend, to bear witness to the new practice. He had learnt to prefer vaccine to variolous inoculation at the Hospital. He had, up to January, 1802, operated with cowpox on 7,500 patients. About half of them had been subjected to the Variolous Test with satisfactory results.
Dr. BRADLEY, physician to the Westminster Hospital, said he looked on Jenner as the author of Vaccine Inoculation, and believed no medical man doubted it. As accidental inoculation with cowpox was proved to keep off smallpox for life, it was matter of course that intentional inoculation would do so also. Not less than 2,000,000 of persons had received Vaccine Inoculation, and he had never known an instance of any one dying of it. One in 300 died of smallpox inoculation in England, and not less than one in 150 throughout the rest of Europe, Asia, Africa and America. Had Jenner settled in London he might have made £10,000 per annum for the first five years, and double that sum afterwards.
Sir WALTER FARQUHAR, physician to the Prince of Wales, had told Jenner that if he had come to London and kept his secret, he would have ensured him £10,000 a year. He had however divulged his secret and lost all chance of emolument. His remedy was a permanent security against smallpox, and had never proved fatal; whilst variolous inoculation, performed in the best manner, cost one life in three hundred.
Mr. CLINE, surgeon to St. Thomas’s Hospital, corroborated the opinion that Jenner could have earned £10,000 a year in London by means of his secret. As smallpox was the most destructive of all diseases, its suppression was the greatest discovery ever made in the practice of physic.
Mr. JOHN GRIFFITHS, surgeon to the Queen’s Household and St. George’s Hospital, had inoculated upwards of 1500 persons with cowpox without any untoward symptoms.
Mr. JAMES SIMPSON, surgeon to the Surrey Dispensary, had inoculated between fifty and sixty without any injury. Considered them perfectly secure from smallpox. A child of nine months covered with crusta lactea resisted all the usual remedies, but on the tenth day after he had inoculated it with cowpox, the crust began to disappear, and the twelfth day was entirely gone.
Dr. JOSEPH MARSHALL related his experience as a vaccine inoculator in the Navy and at Gibraltar, Malta, Palermo, Naples, Rome and Genoa. Everywhere was successful. Believed he had operated on 10,000, and never witnessed any ill consequences whatever. On the contrary, children in a weak state of health, after passing through the vaccine infection, began to thrive and become vigorous.
Mr. JOHN ADDINGTON, surgeon, had used Jenner’s remedy since 1799 in eighty-one cases. One third of these he had inoculated with smallpox, and subjected to every method of infection he could devise, but found them perfectly proof against the disease.
Dr. SKEY, physician to the Worcester Hospital, testified that in the spring of 1801 smallpox was epidemic in Worcester. He inoculated a number of children with cowpox, and none of them took smallpox although constantly exposed to contagion.
Dr. THORNTON, physician to the Marylebone Dispensary, had inoculated a patient with cowpox, and afterwards with smallpox at twelve different times during the past three years without effect. He had even slept with a person in natural smallpox, who died, but took no harm. When at Lord Lonsdale’s in the North he had operated on upwards of a thousand, and had completely satisfied himself, and all the medical practitioners in that part of England, that cowpox was a mild disease, hardly deserving the name of a disease. It was not contagious; it never disfigured the person, never produced blindness, nor excited other diseases. It was equally safe whether during the period of pregnancy, or the earliest infancy, or extreme old age.
Dr. BAILLIE then gave his influential judgment. He thought cowpox an extremely mild disease, and when a patient had properly undergone it, he was perfectly secure from the future infection of smallpox: and further, if Dr. Jenner had not chosen openly and honourably to explain to the public all he knew upon the subject, he might have acquired a considerable fortune. In his opinion it was the most important discovery ever made in medicine.
Mr. DAVID TAYLOR, surgeon of Wootton-under-Edge, had inoculated about two thousand persons with cowpox without a single failure, nor had he met with any ulcerations, tumours, or other diseases following the operation. He knew Jenner’s practice in Gloucestershire. It was in a very populous neighbourhood where there was not another physician within sixteen miles. He had surrendered an income of £600 a year to devote himself to the public service.
As a final specimen of this medical evidence I may cite Mr. JOHN RING, the petitioner’s henchman. He considered Jenner the author of Vaccine Inoculation, a discovery the most valuable and important ever made by man. It was a perfect and permanent security against smallpox. He had himself inoculated about 1200, of whom a thousand had exposed themselves to smallpox infection with impunity. There was no danger whatever from the New Inoculation unless from ignorance and neglect. One in every hundred inoculated with smallpox in London died, owing to the unwholesome atmosphere and the necessity of operating on children at an improper age. If Jenner had kept his discovery to himself he might have made £10,000 a year by it; for others had got as much or more by the practice of physic.
This evidence, better than any secondary description, will enable the reader to appreciate the prevalent furore as it affected the leaders of the medical world. At the same time it is to be borne in mind that the craze was superficial. Any radical change in conviction or practice is never accomplished thus easily or thus rapidly. The medical men who bore witness for cowpox had been bred to inoculation with smallpox, for which cowpox was substituted. The change was essentially trivial. The trouble, the danger, and the uncertainty of variolous inoculation were generally recognised, and when cowpox was recommended as a mild form of smallpox, it was not difficult to appreciate the asserted advantage: for, as it was argued, no one can have smallpox twice, and as the mildest attack of smallpox is as prohibitive of a second attack as the severest, therefore cowpox (which is smallpox in mild form) must protect as effectually when inoculated. With logic so admirable, it was in nowise wonderful that so many were carried away; but unfortunately, as so often happens, matter-of-fact did not correspond to the admirable logic.
The DUKE OF CLARENCE testified that he had availed himself of Jenner’s discovery from the outset. His children, his household and farm servants were all protected. A postillion positively refused to be operated on, and eighteen months after he caught smallpox in the most virulent form. Children who had undergone cowpox were constantly in the room where the lad lay and suffered no harm.
The EARL OF BERKELEY had his son inoculated with cowpox by Dr. Jenner at the age of six months. One of his maid-servants took smallpox and died, and the effluvia during her illness was so offensive that his servants had to move to another part of the house. To test the reality of his son’s protection, he sent for Jenner, and got him to inoculate the boy with pox from the maid. The child was found to be proof, for the inoculation had no effect--To illustrate the validity of the Gloucestershire tradition, he related how a man of 72 in his service had caught cowpox when a boy of 15 whilst milking, and in consequence always reckoned himself secure from smallpox, exposing himself to the disease with complete indifference.
LORD ROUS gave similar evidence. His child had been inoculated with cowpox at the age of three months, and he was perfectly satisfied that he could never have smallpox.
Then there were lay practitioners, of whom Jenner’s nephew, the Rev. G. C. JENNER, may be taken as an example. He bore witness that he had inoculated 3000 with cowpox without a single unfavourable case, from the earliest infancy to eighty years of age, and under circumstances in which it would not be prudent to use variolous virus; as, for example, children during teething and women in every stage of pregnancy. Upwards of two hundred of his patients had been afterwards inoculated with smallpox matter, and an equal number exposed to variolous effluvia, and in no instance did smallpox ensue. He was satisfied that as soon as the new practice became universal, smallpox would be annihilated.
An early date being wanted for “the discovery,” EDWARD GARDNER, wine and spirit dealer, was brought from Gloucester to affirm that he had known Jenner for more than twenty-two years, and had been in the constant habit of hearing his medical opinions and discoveries. It was in the month of May, 1780, that Jenner first informed him concerning the nature of cowpox as a sure preventive of smallpox, and of the theory he had formed on the subject; declaring his full and perfect confidence that the virus might be continued in perpetuity from one human being to another until smallpox was extinguished.
It is needless to stigmatise Gardner’s testimony afresh. It possibly had its foundation in Jenner discussing the familiar rural faith in cowpox. Sir EVERARD HOME mentioned to the Committee that Jenner had brought a drawing to London in 1788 of Variolæ Vaccinæ as it appeared on the finger of a milker, and had shown it to John Hunter, who advised him to look further into the matter; but it was not pretended that he spoke to Hunter of the matured conviction revealed to Gardner eight years before.
The Committee heard evidence as to the knowledge and use of cowpox apart from Jenner, and their verdict was given as follows--
The disorder itself, and its specific property of securing against Smallpox infection, was not a discovery of Dr. Jenner’s; for in various parts of England, in Gloucestershire and Devonshire particularly, there was an opinion of that sort current among the common people employed in dairies, which the observations of the inoculators for the Smallpox tended to confirm. It appears not improbable that in some very rare instances this knowledge was carried one step farther, and that the Cowpox was communicated either by handling the teat, or by inoculation from the animal, for the purpose and with the intention of securing against the danger of Smallpox; but the practice of which Dr. Jenner asserts himself to be the original Inventor is, the inoculation from one human being to another, and the mode of transferring indefinitely, the vaccine matter without any diminution of its specific power, to which it does not appear that any person has ever alleged a title.
Thus the Committee disallowed Jenner’s claim, whilst indicating the only colourable point of novelty, namely, the transfer from arm to arm of virus. At the same time, it should not be forgotten that inoculation from arm to arm with “mild kinds of smallpox” was an existing practice, and there was little merit to speak of in Jenner doing the same thing with horse or cowpox.
There was no opposition--no devil’s advocate; but it may be held that Dr. Pearson assumed that office. He was heard with impatience, and afterwards delivered his mind in An Examination, to which we shall presently refer.
The Report to the House was brought up on the 2nd of June, 1802, and was conclusive as to the utility of the discovery. Indeed, the evidence on that head was only cut short because it threatened to be interminable. The judgment of the Committee reiterated the common persuasion--“As soon as the New Inoculation becomes universal, it must absolutely extinguish one of the most destructive disorders by which the human race has been visited.”
Admiral BERKELEY, chairman of the Committee, commended the Report to the House. He considered the discovery as unquestionably the greatest ever made for the preservation of the human species. It was proved that in the United Kingdom 45,000 perished annually from smallpox; but throughout the world what was the desolation! Not a second struck but a victim was sacrificed at the altar of that most horrible of diseases. He should therefore move that a sum of not less than £10,000 be granted to the Petitioner, but if the House thought fit to adopt any larger sum, he should hold himself free to vote for it. Why, Dr. Jenner’s expenses in postage alone had been from 25s. to 30s. a day!
Sir HENRY MILDMAY did not think £10,000 at all adequate. Had Jenner kept his secret he might have made at least £100,000. He moved that he should have £20,000.
Mr. WINDHAM said the petitioner had surrendered his discovery to his country, and was therefore entitled to remuneration. The discovery had been the labour of years and the fruit of extensive practice.
Sir JAMES SINCLAIR ERSKINE was assured that Jenner had expended £6000 in the propagation of his discovery, and if he had £10,000, he would be left with no more than £4000. Besides, he had given up a practice of £600 a year to benefit his fellow-creatures.
Mr. COURTNEY observed that the evidence showed that 40,000 men would be annually preserved to the State by the New Inoculation. These would return £200,000 a year to the Exchequer, and if the Petitioner had only a tithe of that sum for one year, he was entitled to £20,000.
Mr. WILBERFORCE stated that Jenner had spent upwards of twenty years in completing his discovery. He was no adventurer seeking to push himself before the world. He had already attained to great celebrity in his profession, and had sacrificed his practice for the public good. In every view he thought the larger sum ought to be granted.
Mr. GREY thought £10,000 would be no more than an indemnity for expenses. He hoped the House would vote for £20,000.
Mr. BANKS said there was no question as to the utility of the discovery. If he felt more niggardly than other members, it was because his paramount duty consisted in guarding the public purse. That purse was a large one, but it was not to be dipped into at pleasure. The strength of the country lay in economy and sound finance. He did not see that a case had been made out for so large a sum as £10,000. The discovery itself might be trusted to pay its author. He always looked on a Report of a Committee with jealousy, for it was controlled by the friends of the Petitioner, and there was no one with sufficient motive to provide the correctives required in the public interest.
Mr. ADDINGTON, Chancellor of the Exchequer, held that the value of the discovery was without example, and beyond calculation. So much, indeed, was not contested. The Petitioner had received the highest reward in the approbation, the unanimous approbation of the House; an approbation richly deserved, since it was the result of the greatest discovery since the creation of man. Whatever money the House might see fit to vote on some future occasion, his present duty was to recommend the smaller sum of £10,000. In doing so, he admitted, he surrendered his private inclination to his sense of public duty. He had, however, the satisfaction in knowing that this discussion had conferred on Dr. Jenner a reward that would endure for ever, whilst the comfort of his family would be amply ensured in the extension of practice that would follow the approbation of the House.
The question was then put that the words £10,000 do stand part of the resolution; when the Committee divided--Ayes 59, Noes 56, Majority 3.
The discussion in the House of Commons shows how wide was the general craze. Facts and figures were evolved at discretion and repeated indiscriminately. To rave about Jenner, the saviour from smallpox, was the mode. It was as if all had consented to go mad together. Mr. Dunning, a surgeon, otherwise rational, broke into prophetic fury--
With pride, with just and national pride, we boast a Newton and a Harvey; posterity will boast a Jenner![126]
Considering the value set on “the great discovery,” the award of £10,000 was not excessive. In the Medical Journal it stands recorded--
We have never witnessed a more unanimous and general disappointment than that which has been expressed, not only by the profession, but by the public at large, at the smallness of the remuneration.[127]
On the other hand, it is to be remembered that the times were dark and hard, cruelly hard, through war and scanty harvests; the quartern loaf selling at 1s. 11d., a significant index of the people’s misery.
FOOTNOTES:
[126] Medical Journal, January, 1802.
[127] Ib. July, 1802.
XI. PEARSON’S EXAMINATION.[128]
A few weeks after the award of £10,000 to Jenner by the House of Commons, Dr. Pearson published An Examination of the report of the committee. He did not contest Jenner’s claim to consideration, but the ground on which it was advanced, and on which it was conceded; drawing attention to the manner in which the claims set forth in Jenner’s petition had been reduced to “inoculation from one human being to another,” whilst a new claim was invented for him, “to wit, the mode of transferring, indefinitely, the vaccine matter without any diminution of its specific power.”
What Pearson held, and rightly held, was, that the public acceptance of the New Inoculation was due to Woodville and himself, and not to Jenner--
The Cowpock Inoculation (after Dr. Jenner’s book was published in June, 1798, which contained seven or eight cases, the whole result of his experience) was not practised by any person that I know of, till January, 1799, neither Dr. Jenner, nor any person that I could find being in possession of matter; but, in January, 1799, in consequence of a general inquiry, which I had instituted immediately after Jenner’s publication, information was given of the Cowpock Disease breaking out in two Cow-stables near London, and from these sources Dr. Woodville and myself collected matter, by which, in the course of three months, 300 persons (not fewer, I think) were inoculated for the Cowpock in addition to the seven or eight cases of Dr. Jenner, then the whole stock of facts of Inoculation before the public. Besides carrying on the Inoculation ourselves in this manner, we disseminated the matter throughout the country, in particular to Dr. Jenner himself; and especially, I within that time issued a printed letter, directed to upwards of two hundred practitioners in different parts of the kingdom, containing thread impregnated with the Cowpock matter.... By the close of 1799 about 4000 persons had been inoculated by Dr. Woodville, myself, and our correspondents.
Pearson also claimed to have cleared away difficulties created by Jenner’s statements, some of which were most prejudicial to the public acceptance of the New Inoculation--
I published experiments of inoculating persons with the Cowpock to show that they could not take the Cowpock after the Smallpox, contrary to Dr. Jenner. Secondly, experiments to show that persons could not take the Cowpock who had already gone through the Cowpock, also contrary to Dr. Jenner.[129] Thirdly, many persons had at this period made experiments to show that the Cowpox did not originate in the grease of Horses’ heels, as Dr. Jenner had asserted. In the spring of 1799, a second publication appeared from Dr. Jenner recommending caustic or escharotics to the inoculated parts in Cowpox, which we found wholly unnecessary in practice; and I consider that the distinctive characters of the Cowpock were better understood by some of us than by Dr. Jenner himself.
One can only say of these statements of Pearson as against Jenner, that they are simple matters of fact, impugn them whoso list. It is impossible to controvert Pearson’s assertion--
That the whole of Jenner’s experience extended to seven or eight cases, and a part only of these--namely, four--were from human subject to human subject; and not until long after Dr. Woodville and myself had published several hundred instances of vaccine virus transmitted from arm to arm, had he any experiments to set alongside ours.
They had to find out for themselves when to take virus from the cow, how to preserve it when taken, how to dress inoculated arms, when to take virus from the arm, and, in short, to do everything that constitutes the difference between a suggestion and an art.
Pearson, too, as we have seen, had a leading part in the formation of the first Institution for the Inoculation of the Vaccine Pock, with which Jenner had not only nothing to do, but would have nothing to do: concerning which wrote Pearson--
The Vaccine Inoculation was next considerably established by the Cowpock Institution, of which I was one of the founders, commencing at the close of 1799; which Institution has been the principal office for the supplying the world in general, and the Army and Navy in particular, with matter; and where a regular register is kept of each of the cases inoculated.
As to Jenner keeping the secret of Cowpox and making a great fortune out of it, Pearson replied, first, that he had not proved his remedy; second, that he would have had to persuade the public to believe in him; and, third, that too much was known about Cowpox to have made a secret possible. Moreover, the assertion that he might have earned £10,000 a year and a fortune of £150,000 was absurd--
Such a fortune no one ever acquired by physic in this or any other country--far exceeding the greatest ever known, those of Sir Theodore Mayerne in the first half of the 17th century, and of the still greater one of Dr. Ratcliffe in the early part of last century.
When it was further said, that experiments in Vaccine Inoculation had occupied twenty years of Jenner’s life, that they had cost him £6000, and that he had surrendered a practice of £600 a year in the populous neighbourhood of Berkeley for the public benefit--he would not trust himself to characterise the allegations.
His own position, Pearson thus defined--
I have admitted that Dr. Jenner first set on foot the inquiry into the advantages of Vaccine Inoculation; but I apprehend that the practice has been established almost entirely by other practitioners; and that his new facts, or which I consider to be new, have been, in my opinion, disproved by subsequent observers; and that in consequence of those facts being disproved, together with the very ample experiences of other persons, we owe the present extensive practice of the Vaccine Inoculation.
Pearson further indicated on what conditions he would have been satisfied to see Jenner rewarded--
A much more dignified and more just ground of claim, and an equally favourable one for remuneration, would have been in terms denoting that the Petitioner had proposed a new kind of Inoculation, and actually furnished some instances of the success of it, founded upon facts; of which some were brought to light and use, which heretofore had only been locally known to a very small number of persons; and others were discoveries of the Author: further, that in consequence of considerable subsequent investigation, by the Author and others, such a body of evidence had been obtained, and such further facts had been discovered, as demonstrated the advantages of the new practice.
Whilst willing that Jenner should be rewarded, for Woodville and for himself, Pearson wanted nothing: he simply maintained that the judgment of the House of Commons Committee should have recognised the facts of the situation. He observed--
I have some authority for stating that the members of the Committee did not unanimously think such exclusive claims were just. I had some reason to expect that the representation of the Committee in their Report would have been such as to have satisfied the expectations, not exorbitant, of Dr. Woodville and myself; such as would have cost the Petitioner nothing, to wit, a mere acknowledgment of services. The most unqualified and exclusive claims having been decreed, this bounty of course has been withheld, either because it was judged to be not owing, or from some other motive which I will not name; but it is fitting that I disclaim any insinuation of unworthy motives actuating those with whom judgment was invested.
Considering the injustice to which Pearson had been subjected, and the provocation he had received, it is impossible to refrain from admiration of the serene and impartial temper in which he composed his Examination. Had he sat as judge between Jenner and himself, he could not have stated the case with greater accuracy and absence of bias. He fell into no exaggeration; he indulged in no sarcasm; he descended to no abuse. He set forth the incidents of the New Inoculation with the imperial simplicity and dignity of truth. Where others had gone crazed, he preserved some degree of sanity. He held it to be premature to proclaim the extinction of Smallpox, or to say with Jenner that reports of failure and injury from inoculated Cowpox were beneath contempt. It was only time and experience that could warrant such absolute assertion and prediction.
It is said that in hurricanes of panic or enthusiasm, wise men go home and keep quiet until the sky clears, resistance being folly. For immediate effect resistance may be folly, but the protest of truth is sometimes imperative, whatever the disposition of the mob. Pearson took little at the time by his Examination: it entered into far too many details for general apprehension; and it was convenient to account for his opposition as due to jealousy and envy. Jenner attempted no reply, and assumed profound disdain. His silence was judicious, but it was not from disdain.
* * * * *
At this day it is easy to see that Pearson as against Jenner played his part badly, failing to recognise his proper advantage. Jenner’s prescription in the Inquiry of 1798 was not Cowpox. It was Horsegrease Cowpox. It was a disease of the horse inoculated on the cow. Cowpox per se he expressly rejected as useless, having no specific effect on the human constitution. Pearson and Woodville entertained Jenner’s prescription in good faith. They tried to generate pox on the cow with grease from the horse, but did not succeed. Reluctantly they abandoned Jenner’s prescription, and resorted to Cowpox.
Whilst Pearson and Woodville were without prejudice against Horsegrease Cowpox, it was otherwise with the public. The origin of Cowpox in Horsegrease was voted detestable, and had the origin been maintained, it is not improbable that the New Inoculation would have proved abortive.
This difficulty Pearson and Woodville, the chief promoters of the New Inoculation, cleared away. They had tried Horsegrease; they considered they had disproved Jenner’s assertion concerning it; and they were able to assure the public that they inoculated with Cowpox, and nothing but Cowpox, and had no connection with Horsegrease whatever. The public were satisfied; and Inoculation with Cowpox became the rage, fashionable and philanthropic.
What did Jenner do? Did he vindicate his prescription, the fruit of thirty years of incessant thought, observation and experiment? He did not. On the contrary he dropped it. He said not another word about it; and proceeded to claim Cowpox as employed by Pearson and Woodville as his discovery. In his petition to Parliament there was no mention of Horsegrease Cowpox; but Cowpox, with “its beneficial effect of rendering the persons inoculated therewith perfectly secure through life from the infection of Smallpox,” was set forth as the result of his most attentive and laborious investigation at the sacrifice of time, money, and professional advancement. We have to recollect that Jenner was inspired with what he called “the fond hope of enjoying independence,” and he was not slow to recognise, that if he stood by Horsegrease Cowpox his “fond hope” would be wrecked. The statement may seem incredible, but the fact of the transformation is manifest at large to any one who will take the trouble to compare Jenner’s Inquiry of 1798 with his Petition to the House of Commons in 1802.
Pearson failed to arrest the imposture. He might have said to Jenner, “Your discovery was not Cowpox: that was well known to every dairymaid in your neighbourhood. Your prescription was Horsegrease Cowpox. You condemned Cowpox, which Cowpox has nevertheless been brought into use by Woodville and me. Keep to your Horsegrease Cowpox; make what you can of it; and leave us alone.”
Had Pearson taken this course, he would have fixed Jenner to his discovery, such as it was, and have clearly defined and established his own and Woodville’s service in rendering the New Inoculation practicable and popular. But he failed to draw a firm line between Woodville and himself and Jenner, and to insist that they were operating, not only with a different pox, but with a form of pox by him rejected as useless. Through this default, he enabled Jenner to intrude into a province that was not his own, and to reap where he had not sown, and gather where he had not strawed. It is to be admitted that the facts as stated were all involved in Pearson’s Examination, but they were involved, and required picking out and sharper definition to give them effect. Truth is truth, but truth to have its rightful influence has to be made plain. It is of little avail to have a good cause at law if the means are wanting to place its goodness manifest and paramount over contention to the contrary.
This, too, may be observed: Pearson was not in condition to offer the manner of resistance specified. To have turned Jenner’s flank, it would have been necessary to discredit Cowpox; and Pearson was committed to Cowpox. Jenner had been familiar from youth with the dairymaids’ faith in Cowpox. Why then did he not advertise its virtue? Because it had been proved to him that the dairymaids’ confidence was illusory. His recommendation of Horsegrease Cowpox attested his distrust in Cowpox. If Pearson had asked himself, What induced Jenner to set aside Cowpox for Horsegrease Cowpox? the answer would have revealed to him a whole series of facts to the discredit of that prophylaxy of which he and Woodville had constituted themselves advocates. Thus, fettered by his own prepossession, Pearson was unable to deal effectually with Jenner without incurring a disenchantment fatal to his own enterprise.
* * * * *
When we recognise that Jenner’s prescription was a disease of the horse communicated to the cow, which Pearson and Woodville set aside for Cowpox, the controversy as to the originator of the use of Cowpox for inoculation loses significance. We have to assert peremptorily that Jenner had no claim to the use of Cowpox whatever. It is true that he advanced the claim in his Origin of the Vaccine Inoculation in 1801, and in his Petition to Parliament in 1802; but those who refer to his Inquiry of 1798 will require no further proof of his mendacity. That his claim to the use of Cowpox was entertained can only be ascribed to that indolence, ineptitude and ignorance on the part of the world whereon quacks presume and prosper.
It was Pearson and Woodville, I once more repeat, who diffused and popularised Cowpox; and Pearson’s inquiries left no doubt that the faith in Cowpox as a preventive of Smallpox was widely entertained; and that the substitution of Cowpox for Smallpox in inoculation was a mere question of time and accident. Mr. Downe of Bridport informed Pearson that a surgeon in his neighbourhood suffered discredit in practice because it was reported that he inoculated with Cowpox instead of Smallpox; and the papers of Mr. Nash, surgeon, of Shaftesbury proved that in 1781 he had the project of Cowpox Inoculation distinctly before him. The evidence of Benjamin Jesty, farmer of Downshay in the Isle of Purbeck, has usually been taken as most conclusive in relation to the immanence of the New Inoculation in the common mind. Jesty was invited to London by the conductors of the Original Vaccine Pock Institution, 44 Broad Street, Golden Square; and in August, 1805, they had him with his wife and two sons under examination. In their report[130] it is said--
We think it a matter of justice to Mr. Jesty, and beneficial to the public, to attest, that among other facts he has afforded decisive evidence of his having vaccinated his wife and two sons, Robert and Benjamin, in the year 1774; who were thereby rendered insusceptible of the Smallpox, as appears from the frequent exposure of all three to that disorder during the course of 31 years, and from the inoculation of the two sons for the Smallpox 15 years ago.
It is to be observed that insusceptibility to Smallpox was by no means infrequent apart from Cowpox; and as fear of Smallpox predisposes to attack, so, on the other hand, confidence in security, whether by Cowpox or other charm, would tend to exemption.
Jesty’s reasons for his experiment were thus specified--
He was led to undertake the novel practice in 1774 to counteract the Smallpox, at that time prevalent at Yetminster, from knowing the common opinion of the country ever since he was a boy (now 60 years ago) that persons who had gone through the Cowpock naturally, that is to say by taking it from cows, were insusceptible of the Smallpox.
By himself being incapable of taking the Smallpox, having gone through the Cowpock many years before.
From knowing many individuals who after the Cowpock could not have the Smallpox excited.
From believing that the Cowpock was an affection free from danger; and from his opinion that by the Cowpock Inoculation he should avoid engrafting various diseases of the human constitution, such as “the Evil, madness, lues, and many bad humours,” as he called them.
In these reasons we have the Cowpox doctrine as prevalent in Dorsetshire, which Jesty developed in family practice. The report proceeds--
The remarkably vigorous health of Mr. Jesty, his wife, and two sons, now 31 years subsequent to the Cowpock, and his own healthy appearance, at this time 70 years of age, afford a singularly strong proof of the harmlessness of that affection; but the public must, with particular interest, hear that during the late visit to town, Mr. Robert Jesty submitted publicly to inoculation for the Smallpox in the most rigorous manner; and that Mr. Jesty also was subjected to the trial of inoculation for the Cowpock after the most efficacious mode, without either of them being infected.
It is curious how evidence conforms to prepossession. Dr. Pearson and his associates were persuaded that as no one could have Smallpox twice, neither could any one have Cowpox twice. Jesty had Cowpox when young, and when at three score they found him insusceptible, they took it for granted that re-vaccination was impossible. Robert Jesty, who had Cowpox thirty-one years before was at the same time inoculated with Smallpox, and as that likewise failed to take, the experiment enforced the desired conclusion.
Having turned out so well, praise and portraiture were bestowed on Jesty--
The circumstances in which Mr. Jesty purposely instituted the Vaccine Pock Inoculation in his own family, namely, without any precedent, but merely from reasoning upon the nature of the affection among cows, and from knowing its effects in the casual way among men, his exemption from the prevailing popular prejudices, and his disregard of the clamorous reproaches of his neighbours, will entitle him, in our opinion, to the respect of the public for his superior strength of mind. Further, his conduct in again furnishing such decisive proofs of the permanent anti-variolous efficacy of the Cowpock, in the present [1805] discontented state of mind in many families, by submitting to Inoculation, justly claims at least the gratitude of the country.
As a testimony of our personal regard, and to commemorate so extraordinary a fact as that of preventing the Smallpox by inoculating for the Cowpock 31 years ago, at our request, a three-quarter length picture of Mr. Jesty is painted by that excellent artist, Mr. Sharp, to be preserved at the Original Vaccine Pock Institution.
GEO. PEARSON, } LAW. NIHELL, } Physicians. THOS. NELSON, }
T. KEATE, } _Consulting T. FOSTER, } Surgeons_.
J. C. CARPUE, } J. DORATT, } Surgeons.
FRAS. RIVERS, } EV. A. BRANDE, } _Visiting PH. DE BRUYN, } Apothecaries_.
JOHN HEAVISIDE, } THOMAS PAYNE, } Treasurers.
WILLIAM SANCHO, Secretary.
6th September, 1805.
In the church-yard of Worth Matravers, Dorset, there is a grave-stone with this inscription--
SACRED TO THE MEMORY OF BENJAMIN JESTY, OF DOWNSHAY, WHO DEPARTED THIS LIFE APRIL 16TH, 1816, AGED 79 YEARS.
He was born at Yetminster, in this County, and was an upright honest man, particularly noted for having been the first person known that introduced
THE COWPOX BY INOCULATION,
and who, from his great strength of mind, made the experiment from the Cow on his Wife and two Sons in the year 1774.
Jesty is frequently played off against Jenner, as having anticipated him, but under a misapprehension. Jesty inoculated with Cowpox, sharing the dairymaids’ faith that it prevented Smallpox. Jenner knew that the dairymaids were wrong, and that Cowpox did not avert Smallpox. What he recommended was Cowpox produced by Horsegrease. Pearson and Woodville disregarded Jenner’s recommendation and made use of Cowpox like Jesty, which substitution Jenner did not resist; and not only did not resist, but claimed as the fulfilment of his programme! Jenner should never be suffered to get mixed up with Jesty, and the course of his procedure be thereby obscured.
I am explicit to iteration because the truth is not recognised and may be accounted incredible. In another way the facts may be thrown into relief if we inquire, How would Jenner have fared had he applied for a patent? Suppose his several publications were submitted to a patent-agent, In what manner could a tenable specification be evolved from these materials?
1798.--The Inquiry. { Prescribes Horsegrease { Cowpox.
{ Slackens off from { Horsegrease Cowpox; { ascribes its 1799.--Further Observations. { efficacy to common 1800.--Continuation of Observations. { repute; and recommends { escharotics to arrest { its virulence.
{ Claim of discovery and 1801.--Origin of Vaccine Inoculation. { use of Cowpox, previously 1802.--Petition to Parliament. { condemned as spurious, { and Horsegrease Cowpox { dropped.
By no ingenuity could a valid patent be got out of these documents. If Horsegrease Cowpox were selected as the basis of claim, what of the repudiation of Cowpox? and if Cowpox, what of Horsegrease Cowpox? And if Horsegrease Cowpox, what of the ascription of its virtue to common repute? And if Cowpox, was not the committee of the House of Commons in 1802 compelled to disallow Jenner’s claim to the discovery, and to define and limit his merit to the propagation of its virus from arm to arm? It was, however, Pearson and Woodville who first propagated Cowpox from arm to arm: Jenner’s start being made with Horsegrease Cowpox. But allowing him so much credit, it is nevertheless to be remembered that it was at that time a frequent practice to inoculate with Smallpox from arm to arm; and the substitution of Cowpox for Smallpox was a trifle for which to pay £10,000 and dissolve in ecstasies of admiration.
FOOTNOTES:
[128] An Examination of the Report of the Committee of the House of Commons on the Claims of Remuneration for the Vaccine Pock Inoculation: containing a Statement of the Principal Historical Facts of the Vaccinia. By George Pearson, M.D., F.R.S. London, 1802. 8vo. Pp. 196.
[129] Such was the logic, but such was not the fact. If no one could have Smallpox twice, and if inoculated Cowpox was equivalent to Smallpox, no one could have Cowpox twice. Such was the argument. Pearson did not foresee its systematic refutation exemplified in Re-Vaccination, septennial, triennial, annual.
[130] Edinburgh Medical and Surgical Journal, October, 1805. P. 513.
XII. OBSERVATIONS ON THE POSITION IN 1802
One of my medical readers observes--
The House of Commons in 1802 was committed to a variety of extravagances, but, allowing for these, you have to account for certain evidence that Cowpox had some influence over Smallpox; for you surely do not mean to contend that it had no influence over that disease, and that the evidence before the Committee was a uniform tissue of illusion and delusion.
Put thus, it is as difficult to deal with the objection as it is to prove a negative. It is not for me to define the influence of cowpox over smallpox, but for those who believe in its prophylaxy. I should argue that as ill-health leads to ill-health, and as corruption breeds corruption, that inoculated cowpox would generate a habit of body favourable to smallpox, and at the same time tend to excite and intensify other forms of disease. I would also ask, What are the extravagances to be allowed for? When these are determined we may then proceed to discuss what are not extravagant. It is a common form of evasion to make a general confession of guilt in order to avoid the pain of specific and explicit condemnation. It is conceded that the House of Commons in 1802 “committed a variety of extravagances,” and under this appearance of candour the chief extravagance is implicitly re-asserted and carried forward, namely, that inoculated cowpox had an influence adverse to smallpox.
In the “variety of extravagances,” few, I suppose, would hesitate to include the asserted annual smallpox mortality of the United Kingdom. Sir Gilbert Blane pronounced it 45,000, while Dr. Lettsom gave it as 36,000--a wide difference in the play of fancy! Dr. Lettsom, who claimed to have paid much attention to figures connected with smallpox, was pleased to convert an extreme London mortality, namely, 3000, into the ordinary mortality, although in some years it fell under 1000. Then estimating the population of London at one million, and the population of the United Kingdom as twelve millions, he multiplied 3000 by 12, and evoked the astounding national death-rate of 36,000 annually from smallpox, all of whom were to be saved by Jenner’s prescription! But whether he had taken the average or even the lowest metropolitan mortality, the computation would have remained grossly fallacious. London overcrowded and pestiferous, was no standard for the general population, urban or rural; and the assumption was monstrous that smallpox, a notoriously sporadic disease, was constant and equally diffused over the land. We are without comprehensive vital statistics for the time in question, but arguing from the London of to-day in continual connection with the provinces, to the London of 1802 in comparative isolation, what do we find? Why, smallpox prevalent in London with little or no smallpox in the country! In the Pall Mall Gazette of 31st May, 1878, we read--
The degree in which the Smallpox epidemic of the last seven years has been localised in London is very remarkable. The Lancet points out that during the week ending 25th May, 51 fatal cases were registered in London and its suburban districts, whereas not one was recorded in any of the nineteen large provincial towns having an aggregate population about equal to that of London. Since the beginning of the year the fatal cases of Smallpox within fifteen miles of Charing Cross have been 1,134, while but 8 have occurred in the nineteen other large towns.
We find similar illustrations of the sporadic character of smallpox wherever we can get at the facts. In 1874 there died in London 735 of smallpox, but not one in Birmingham; 386 in Liverpool, but not one in Plymouth; 347 in Salford, but not one in Nottingham; 190 in Manchester, and but 1 in Sheffield; 24 in Bristol and 4 in Leeds; and so on. What reason is there to believe that what is true of smallpox within our own experience was otherwise in the experience of our forefathers?
I said that few would hesitate to include Dr. Lettsom’s 36,000 and Sir Gilbert Blane’s 45,000 among the extravagances of 1802, but I forgot myself. We have a National Health Society with the Duke of Westminster for President and all manner of notables, aristocratic, philanthropic, scientific, and literary, among its committee and members. Now this Society issues a hand-bill of advices and warnings relating to smallpox, approved too by the Local Government Board, and there we find set forth as unquestionable matter of fact--
“Before the introduction of Vaccination Smallpox killed 40,000 persons yearly in this country.”
We thus see how hard it is for a convenient fable to die, even when known to be false, and how respectable people will keep repeating it as long as they fancy it is for good.
Absurd as was the extension of the ratio of London smallpox to the populations of the United Kingdom, of Europe, and of the world, the London disease itself afforded little warrant for the extreme terms of horror and dismay with which it was described. Smallpox did not increase the death-rate of London: when smallpox was most prevalent and least prevalent, the total mortality was but slightly affected. As long as the sanitary conditions of the great city remained unchanged, fevers replaced smallpox and smallpox replaced fevers, and whether deaths were from one form of disease or another, so that the people died the same, what did it matter? Smallpox when most prevalent was never accountable for much more than 10 per cent. of the total London mortality, and in some years for less than 3 per cent.; and it is to be remembered that the larger portion of that mortality was infantile mortality--smallpox being in the great majority of cases a disease of the young; none the less objectionable on that account, but less chargeable than some other forms of zymotic disease with striking down the adult bread-winner and enlarging misery and pauperism.
Again, in much of the talk about smallpox, it was assumed that the disease had no limits--that it was something like fire, and might spread to any extent if unchecked. But what was there to justify such an assumption? Assuredly nothing in London experience. Smallpox was always present in London, waxing and waning under some unknown law; the deaths rising as high as 3992 in 1772 and falling as low as 522 in 1797--the extremes of the century. Why did 4000 never die in any year, or 7000, or 10,000? When a fire is extinguished, we know it has met with a check; and if smallpox caused 3992 deaths in 1772 and 522 in 1797, and smallpox be like fire, there was, we see, a check; and I ask, What was that check? There may be answers, but none for unreserved acceptance. What is certain is, that in London smallpox was never an illimitable affliction. It had limits, and it was only in the rhetoric of alarmists that it had none.
And the check to the disease (whatever it was) lay in the bodies of the citizens, and not in their therapeutics. Isolation was rarely attempted, and in their crowded habitations was impracticable. Moreover they had not only the smallpox appropriate to their evil conditions to contend with, but the disease as propagated and diffused by the inoculators. What we have to say is, that whilst in the London of last century we behold smallpox endemic and cultivated, yet in no year did the mortality therefrom exceed 4,000; and further, that with so much to favour and stimulate the disease it was a diminishing quantity. In the words of Dr. Farr--
London Smallpox attained its maximum mortality after inoculation was introduced, and the disease began to grow less fatal before vaccination was discovered.
We shall see as we proceed how the natural check to smallpox (whatever it was), the immunity of the majority from infection, and the decline of the disease were all claimed as the blessed results of Jenner’s prescription; and now-a-days it has passed into common-place, for which evidence is thought superfluous, that without that prescription smallpox might have illimitable extension. If anywhere a variolous epidemic is slight, it is said that but for vaccination it would have been severe; and if severe, that its intensity would have been doubled or trebled save for the action of the same prophylactic. We have a remarkable illustration of this style of prophecy in the Report of the Select Committee of the House of Commons upon the Vaccination Act of 1867, dated 23rd May, 1871, where we read--
Smallpox unchecked by Vaccination, is one of the most terrible and destructive of all diseases as regards the danger of infection, the proportion of deaths among those attacked, and the permanent injury to the survivors.
Your Committee believe that if Vaccination had not been general, the epidemic [then prevalent] would have become a pestilence, raging with the destructive force of the Plague of the middle ages.
What is beyond evidence is beyond refutation; and the imaginations of M.P.’s, dull though they be, not unfrequently prevail over their intelligence.
To set aside the mass of testimony adduced by Jenner’s friends before the Commons’ Committee in 1802 is sometimes described as a hopeless undertaking; but the answer to such a boast is, that experience has nullified the essential part of that testimony, and that there is little left to account for. No well-informed medical practitioner now believes what the Committee was led to believe, that to be inoculated with cowpox was to be secure from smallpox for life. The security, where still credited, is subject to so many qualifications that the primitive inoculators with cowpox would have thought such protection not worth paying for, still less of exulting over as the greatest discovery ever made in medicine. Nor would many now admit the validity of the Variolous Test which then carried conviction with irresistible force. Inoculation with smallpox was in itself an uncertain operation, and that it should fail after inoculation with cowpox, ere the poisoning of the blood had been worked off, was in nowise surprising. The exposure of vaccinated subjects to smallpox infection was in like manner deceptive; and it was conveniently forgotten that all manner of people were exposed to contagion with impunity in the usual circumstances of life. Taking a year of exceptional smallpox in London, such as Dr. Lettsom set forth as ordinary, when 18,000 were affected and 3000 died (that is one in six), there were in the million of inhabitants 982,000 who escaped. How did they escape? A multitude must have come into immediate contact with the sick: How did they remain unscathed? The question is simple, but it is crucial. If smallpox were like fire, and men, women, and children like fuel, why did not all burn? Under what prophylaxy did they abide secure? Again in this connection, we must not lose sight of the magic of faith. Things being equal, two persons exposed to smallpox, one confident that he was invulnerable through vaccination, and the other apprehensive of danger, the chances are, that the fearful would be attacked whilst the fearless would have his faith justified in immunity.
In considerations thus obvious it is not difficult to understand how the testimony delivered to the Committee had a semblance as of veracious Nature. Any one who has studied the history of remedies, or the various quackeries within his own observation, will know how easy it is to conjure up testimony, with asseverations presumptuous to question, which by-and-by are gradually discredited and ultimately disappear in forgetfulness. I have, therefore, no disposition to be hard on the men of 1802. From our vantage of experience we see how they were led astray, and recognise the pressure of the influences under which they acted. Moreover a remedy that bore the promise of relief from the pest of smallpox inoculation came with strong seduction. What a pest that inoculation was, how it was loathed, and how it was submitted to under the persuasion of duty are written at large in the domestic memoirs of last century. Every mother among the upper and middle classes was persuaded that it was necessary for her children to undergo the variolous ordeal--an ordeal that involved the deliberate introduction of smallpox into her household. It was hateful, it was intolerable, and yet it had to be endured! The doctors minimised the risks to the uttermost, but what they really believed plainly appeared when vaccination presented itself as an alternative. Then smallpox inoculation was denounced by its former practitioners with a fervour that contrasted painfully with their antecedent professions; whilst parents heard with indescribable satisfaction that absolute life-long security from smallpox was henceforward insured at the price of a trifling operation attended by no peril whatever, and with distinct benefit to health. To make the contrast clear I subjoin copy of a hand-bill that was posted on walls and circulated by thousands in London and the country at the time of which I write, 1801-2.
A TABLE SHEWING THE ADVANTAGES OF VACCINE INOCULATION.
_The Natural _The Inoculated The Inoculated Smallpox. Smallpox. Cowpock.
I. The natural Small- I. The inoculated I. The inoculated pox is a loathsome, Smallpox also is Cowpock scarcely infectious, painful, loathsome, infectious, deserves the name of and fatal disease. It painful, and sometimes a disease. It is not is confined to no fatal; and, when infectious; and, in climate, but rages in partially adopted, the opinion of the every quarter of the spreads the contagion, most experienced world, and destroys a and increases the practitioners has tenth part of mankind. mortality of the never proved fatal. disease.
II. Those who survive II. It sometimes II. It occasions no the ravages of that occasions the same other disease. On the dreadful distemper, maladies as the contrary, it has often often survive only to natural Smallpox. been known to improve be the victims of other health, and to remedy maladies, or to drag those diseases under out a miserable which the patient existence worse than before laboured. death.
III. This cruel and III. It frequently III. It leaves behind lamentable disorder leaves behind it the no blemish, but a leaves behind it pits, same blemishes and Blessing--one of scars, and other deformities as the the greatest ever blemishes and bodily natural Smallpox, bestowed on man--a deformities which which are the more perfect security embitter life. deplorable as they against the future are brought on by a infection of the voluntary act. Smallpox.
From this faithful statement of the advantages attending VACCINE INOCULATION, it must appear evident to every unprejudiced person, that it is the duty as well as the interest of every parent, of every individual, and of every nation, to adopt the practice, and to hasten
THE EXTERMINATION OF THE SMALLPOX.
It was thus that Vaccination was introduced to the English people, not by men accounted quacks, but by leaders of the medical profession; and whatever the illusions and mischiefs of the new practice, we must allow it the credit of discouraging and ultimately superseding the grosser practice of inoculation with smallpox. As for the various items in the bill, we have had, and shall have them before us, and I would only now recall attention to the initial statement that “Smallpox destroys a tenth part of mankind.” The summary answer to the statement is that the number of mankind was unknown, likewise their diseases, and the proportion in which they were fatal. It was a repetition of Dr. Lettsom’s unwarrantable extension of a bad year of London smallpox to the whole earth. Even in an occasional year when upwards of 3000 died in London of smallpox, the total average mortality was not seriously affected thereby. The deaths, as we have observed, were merely taken out in smallpox instead of in some other form of fever. That nothing can permanently reduce the death-rate of any community save improved sanitary conditions and personal habits was unrevealed in 1802.
Notwithstanding the exultation over Jenner, “the saviour of the world from smallpox,” and over “the greatest discovery since the creation of man,” the suspicion is unavoidable that it was largely factitious--“from the teeth outwards,” as Carlyle would have said. The vote of £10,000 to the miraculous benefactor of the human race was carried by a majority of three in a Parliament to which no more than 115 members could be whipped up, and neither Pitt or Fox thought it worth while to be present. Nor was Jenner treated as if his asserted services to mankind were soberly credited. “Yes,” it may be said, “the world never recognises its true benefactors;” but the observation does not apply, for Jenner was profusely recognised, and received praise from his contemporaries which posterity hesitates to repeat. Nevertheless the praise, though profuse, was little more than verbal. Some expressed indignation at the paltry award of £10,000, and proposed to start a national subscription, but no one took the initiative, and the national gratitude was not put to the test. Even the £10,000 was paid tardily. Writing to a friend on 3rd June, 1804, Jenner had to relate that--
The Treasury still withholds the payment of what was voted to me two years ago; and now there are new officers, and it may yet be very long before a guinea reaches me from that quarter.
When at last the money was paid, nearly £1000 was deducted for fees, etc.; and, having the repute of the money, he was considered public property. As Dr. Baron records--
The people of England seemed to think that the fee-simple of his body and mind had been purchased by the TEN THOUSAND POUNDS; and many an unjust and ungenerous intimation of this feeling was conveyed to him. To a mind like his, this was no small annoyance. He was called upon for explanations and opinions by every person who thought a direct communication with the Author of Vaccination an honour worth seeking, while they might have obtained all the information they wanted in his published writings.
So much was matter of course, but Jenner had worse to encounter. He took the fine talk of his medical and political friends au sérieux, bade farewell to Berkeley, and set up as London physician in Hertford Street, May Fair. The result we have in his own words--
Elated and allured by the speech of the Chancellor of the Exchequer, I took a house in London for ten years, at a high rent, and furnished it; but my first year’s practice convinced me of my own temerity and imprudence, and the falsity of the Minister’s prediction. My fees fell off both in number and value; for, extraordinary to tell, some of those families in which I had been before employed, now sent to their own domestic surgeons or apothecaries to inoculate their children, alleging that they could not think of troubling Dr. Jenner about a thing executed so easily as vaccine inoculation. Others, who gave me such fees as I thought myself entitled to at the first inoculation, reduced them at the second, and sank them still lower at the third.
His fees did not amount to £350 a year, and he presently found himself nothing the better for the parliamentary grant, and involved in grave financial difficulties. He wrote to a friend, 2nd November, 1804--
The London smoke is apt to cloud our best faculties. I do not intend to risk the injury of mine in this way, unless occasionally for the transaction of business. The public has not the smallest right to require such a sacrifice of me. I have received no reward for showing them how to remove one of the greatest obstacles to human happiness; but, on the contrary, am loaded with a tax of more than £400 a year!
And to another correspondent--
I have now completely made up my mind respecting London. I have done with it, and have again commenced as village doctor. I found my purse not equal to the sinking of a £1000 annually (which has actually been the case for several successive years) nor the gratitude of the public deserving such a sacrifice. How hard after what I have done, the toils I have gone through, and the anxieties I have endured in obtaining for the world a greater gift than man ever bestowed on the world before (excuse this burst of egotism), to be thrown by with a bare remuneration of my expenses.
It was hard! People who attributed to Jenner the greatest discovery ever made, the preservation of from 36,000 to 45,000 lives annually in the United Kingdom, and the salvation of the human race from smallpox, were indeed entitled to have dealt with him more handsomely. He had sympathisers and candid friends. “Your liberality and disinterestedness every one must admire,” wrote Mr. Benjamin Travers, “but you are sadly deficient in worldly wisdom. If you had undertaken the extinction of the smallpox yourself, with coadjutors of your own appointment, I am confident, you might have put £100,000 in your pocket; and the glory would have been as great and the benefit to the community the same.” How that £100,000 was used to tantalise him! and yet, as Dr. Pearson pointed out, never any one showed on what practicable terms the immense sum could have been earned by means of cowpox.
XIII. THE ROYAL JENNERIAN SOCIETY
Jenner, jealous of Pearson, was anxious to supersede the Institution for the Inoculation of the Vaccine Pock established by him in 1799; but Jenner was what Scots call “a feckless creature,” whose wishes rarely issue in fruit. After his success in Parliament, he did not remain in London to improve his opportunities, but retreated to domestic quiet at Berkeley and Cheltenham. His friends, however, were mindful of him, and Dr. Hawes, Mr. Addington, surgeon, Benjamin Travers, and Joseph Leaper met in Queen Street, City, 3rd December, 1802, and resolved to establish a “JENNERIAN SOCIETY for the Extinction of the Small-Pox.” Mr. Addington transmitted the resolution of the meeting to Jenner, saying--
We look to your direction and assistance, and feel very desirous of knowing when it is probable we may have the pleasure of seeing you in town.
Joseph Fox of Lombard Street, dentist and enthusiastic promoter of the new inoculation, also wrote to him, 4th December, soliciting his co-operation--
The plan which is in agitation is of the most extensive and liberal kind. It is even expected that the Royal countenance will be gained; but much depends upon thee. All are looking toward thee as the proper person to lay the foundation-stone. It would be well if this could be done in the course of the present year, particularly as it is the memorable time when the practice received parliamentary sanction.
But the ease-loving Jenner was not to be drawn. He wrote to Mr. Addington from Berkeley, 10th December, 1802--
Your very obliging letter found me just returned with my wife and children to our pleasant home, where I promised myself a few weeks of domestic comfort after some years spent in constant anxieties.
This is the pull on one side. On the other is the delightful prospect held up to my view of an Establishment for the promotion of Universal Vaccine Inoculation--an establishment to which I have for years been looking forward with a longing eye.
I need not go farther into explanation, and shall only say, that if it be incompatible with the generous design to suffer me to remain here for the time I had allowed myself, I will certainly comply with the wishes of my friends and go to town. Yet it must be observed that I humbly conceive and ardently hope that my presence will not be absolutely necessary. I have written to my friend Dr. Lettsom and requested him to have the kindness to be (as far as such a thing is admissible) my representative. In his judgment on the present occasion I can place every confidence.
The letter describes the man. He did not like to be troubled--not even when action stood for the advancement of his own glory. As Pearson observed, “If Vaccination had been left to Jenner, it would never have come to anything.” Benjamin Travers also wrote to him at the same time urging the necessity of his presence in London, but he was put off with similar excuses and with expectations of assistance from the public purse--
Government, I have no doubt, will give due support to so just and laudable an undertaking. I am warranted in this suggestion by a long conversation I had with Mr. Abbott, Speaker of the House of Commons, who said that after the investigation of the Parliamentary Committee he thought it became a public duty to form Institutions for Gratuitous Inoculation.
As Jenner was not to be had, the promoters set to work without him, and their triumph was complete when at a meeting in the London Tavern on 17th February, 1803, it was announced that his Majesty had graciously condescended to become the patron of “THE ROYAL JENNERIAN SOCIETY for the Extermination of the Smallpox:” that her Majesty had with great benignity acquiesced in the request to become patroness: that his Royal Highness the Prince of Wales and their Royal Highnesses the Duke of York, the Duke of Clarence, and the Duke of Cumberland, had evinced, in a most flattering manner, their willingness to accept the office of vice-patrons: that his Grace the Duke of Bedford had consented to fill the office of president; and that many prelates, noblemen, and gentlemen of the highest rank and respectability had agreed to be vice-presidents of the Society.
The approval of the Prince of Wales was conveyed in a letter of the Earl of Egremont, over which Baron, Jenner’s biographer (writing when the Prince had blossomed into George IV.), bursts into worship in capitals, as follows--
The gracious and beneficent mind of the Illustrious writer is displayed in every line; and the whole is truly characteristic of those great qualities which continue to add lustre to his still more EXALTED STATION and shed so much of real glory on his REIGN.
Subscriptions flowed in freely. The Corporation of London gave £500, the East India Company £100, the Duke of Bedford £50, and guineas ten, five, two and one were contributed with a liberality that attested the fervour of the common credulity. But it was much easier to get money than to administer it with a nice adjustment of means to ends. The Jennerians, too, were over-organised. There were a Medical Council and a Board of Directors. The Medical Council consisted of twenty-five Physicians and twenty-two Surgeons of the first eminence in London, with Jenner for president and Lettsom for vice-president. Such mechanism could never work, and at the point where real business was to be transacted, an officer was selected of extraordinary character.
John Walker was born at Cockermouth in 1759, and was a school-fellow of Woodville, subsequently physician to the London Smallpox Hospital. After a rambling career as blacksmith, engraver, and school-master, he turned his attention to medicine, graduated at Leyden, associated with French revolutionists in the guise of a member of the Society of Friends; then accompanied Dr. Marshall in a vaccinating cruise to the Mediterranean, from whence, after a variety of adventures in war and weather, he appeared in London in 1802, habited as a Quaker with a long beard--an apparition in a clean shaven community. Joseph Fox, the dentist of Lombard Street, gave him the use of a part of his house, and there, in his own words, “I set up my VACCINIUM for the glorious cause.” As soon as the Jennerian Society was initiated, Walker was put forward by Joseph Fox and other Friends as inoculator-in-chief, and Walker made application in the following terms--
TO THE JENNERIAN SOCIETY.
Friends,--Perhaps there is not any individual who has greater reason to be gratified with the interest ye are taking in the Vacciole Inoculation than myself.
Of late years, the practice of it has been the chief business of my life, and I am partly indebted, during some of the last months, to the zeal of individual members of your Society for being enabled to continue it. They have sent patients to me from remote and distant parts of this extensive City, when, for want of notoriety, I might otherwise have been unemployed.
May I offer to you my services in this way: during the infancy of your Institution, you cannot do me a greater pleasure than to increase my number of patients; for where I now vacciolate tens, I could easily do the same for hundreds.
After this declaration, I hope you will consider the present address as neither unseasonable nor intrusive, but rather as a mark of unwavering zeal in the happy cause in which ye are now embarking.
Respectfully, JOHN WALKER.
54 Lombard Street, 29. xii., 1802.
When the day of election arrived, four, out of many, were selected as candidates, one of them being Dr. Domeier, a German, strongly recommended by the Queen and Prince of Wales; but the Friends stood by their man, and Dr. Walker was appointed Resident Inoculator at the Central House of the Society in Salisbury Square with a salary of £200 a year, coal and candles, and liberty to take fees for private “vacciolation.”
The promoters of the Society, operating under the prestige of Jenner’s name, resolved to hold their annual festival on his birthday, the 17th of May; and at the first dinner in 1803 he was subjected to flatteries enough to turn any man’s head who does not know the reckless insincerity that prevails on such occasions. It was the adulation connected with the formation of this Society that as much as anything induced Jenner to set up as west-end physician. The attempt of the middle-aged country doctor was the occasion of much grim humour, and his consequent embarrassments were the concern of his friends for many a day. Apart from the inherent difficulties of the enterprise (social rather than medical) Jenner was constitutionally deficient in method and assiduity. Wrapped up in his wife and family, business was always set aside when they claimed his affectionate regard; and to leave London for Gloucestershire for some domestic cause was in his eyes procedure that required no defence--all which might be amiable, but it constantly annoyed and frustrated his associates; and it is not thus encumbered that any man can expect to make way in the world. When the anniversary in 1804 came round, Jenner was at Berkeley, and when pressed to attend he wrote--
Though a post-chaise might bring up my body, my mind would be left behind. One cause of my absence, among many others, is the sad state of Mrs. Jenner’s health. I cannot leave her even for a day with any comfort to my feelings. My friends, who honour the glorious cause of Vaccination by assembling on the 17th, will, I trust, admit my apology. It is my intention to collect a few staunch Vaccinists on that day at my cottage. I shall give them some roast beef, not forgetting a horn or two of good October. We shall close the day with bumpers of milk-punch to the health of the Friends of Humanity at the Crown and Anchor; and if it were not for the indisposition of my poor wife, we should roar like bulls.
If Jenner was idle and self-indulgent, Walker was the reverse. He was a fine specimen of the GENUS, Fanatic. Possessed with a lust for what he called Vacciolation, he had a brow of brass, nerves of steel, and habits like clockwork. Thirteen stations were opened in London where cowpox was inoculated gratis, and in eighteen months Walker was able to announce that 12,288 patients had been operated on, and that 19,352 charges of virus had been dispatched to the country and foreign parts; whereon Baron observes--
The effect of these exertions was immediately perceived by a striking diminution of the number of deaths from smallpox within the Bills of Mortality. In 1803 they amounted to 1173; in 1804 they were only 622. The contrast will appear still greater when it is considered that the deaths amounted to 2409 in the year 1800; and that the annual average of deaths for fifty years previously was 2018.[131]
The passage is noteworthy as representative of many similar passages in the literature of Vaccination. It might be described as dishonest, but the craft is so transparent that the epithet would be extravagant. The probable explanation is, that Vaccination had come to be regarded as so unquestionably beneficial that anything might be asserted in its favour, and that anything was true. Else a child might have asked how 12,000 or 24,000 vaccinations could by any possibility affect an immediate diminution in the deaths from smallpox in a population of eight or nine hundred thousand. Baron would also lead his readers to suppose that the low mortality of 1804, namely 622, was unexampled, though with the Bills of Mortality before him, he might have seen that the deaths in 1797 fell to 522; and he knew that the low figure of 1804 was not maintained, but rose to 1685 in 1805. But as remarked, any statement, if only it be favourable to Vaccination, is expected to pass muster as veracious, and the public credulity justifies the expectation.
Let us look at the London Bills for ourselves, taking the last ten years of the 18th and the first ten years of the 19th Centuries, and try to discover what they teach.
Burials from From From From Years. all Diseases. Smallpox. Fevers. Measles. 1791 18,760 1747 2013 156 1792 20,213 1568 2236 450 1793 21,749 2382 2426 248 1794 19,241 1913 1935 172 1795 21,179 1040 1947 328 1796 19,288 3548 1547 307 1797 17,014 522 1526 222 1798 18,155 2237 1754 196 1799 18,134 1111 1784 233 1800 23,068 2409 2712 395 ------- ------ ------ ---- 196,801 18,477 19,880 2707
It is to be observed, that we have not here the record of the deaths in the whole of London, but merely the number of intramural interments, which diminished as a number of graveyards became gorged beyond capacity of decomposition and assimilation, and relief was sought in the cemeteries of extra-mural parishes, such as St. Pancras and Marylebone. It is only thus that the diminishing number of burials (which ranged from 25,000 to 30,000 during many years of the 18th Century) is to be accounted for. In this light we have to consider the following table, where we note fewer burials, less smallpox, less fevers, but more measles.
Burials from From From From Years. all Diseases. Smallpox. Fevers. Measles. 1801 19,374 1461 2908 36 1802 19,379 1579 2201 559 1803 19,582 1202 2326 438 1804 17,038 622 1702 619 1805 17,565 1685 1307 523 1806 17,938 1158 1354 530 1807 18,334 1297 1033 452 1808 19,954 1169 1168 1386 1809 16,680 1163 1066 106 1810 19,893 1198 1139 1031 ------- ------ ------ ---- 185,737 12,534 16,204 5680
From whatever cause there was an abatement of smallpox, but it was a continuous abatement which had set in before Jenner was heard of; and at the same time we must repeat that at this day (when all swear by the unity of Nature and the correlation and convertibility of her forces) it is grossly unscientific to pick out smallpox from the zymotic diseases and deal with it as an independent entity. It is a fever among fevers, bred and propagated in the same conditions, and can never be studied apart from its associates without serious misunderstanding.
These Bills of Mortality, as compared with the more accurate statistics of our own time, are of little value; but, such as they are, they are constantly referred to, and their items used, as by Baron, as pretexts for most unwarrantable assertions. Any influence of Vaccination on the smallpox mortality of 1801-10 was practically nothing. Vaccination was limited to a few thousands, and those chiefly of the classes least subject to the disease. The great seething mass of metropolitan squalor, in which smallpox and typhus were endemic, was untouched by the vaccine lancet. If the new practice did good, it was in discrediting and discouraging the culture of smallpox in variolous inoculation.
To return to the ROYAL JENNERIAN SOCIETY. Its halcyon-days were of brief duration. Enthusiasm abated, subscriptions fell off, cases of smallpox after vaccination came to be heard of, and serious illness and death consequent upon “the benign and harmless operation.” Opponents waxed bold and could not be silenced. Then jealousies and dissensions began to operate within the Society. The financial secretary strove with the medical secretary. Dr. Walker’s habits and eccentricities, viewed at first with amusement, excited irritation and disgust, whilst Jenner’s easy-going mode of life and impecuniosity were a source of scandal and distrust. The climax was reached in 1806 when Jenner and Walker were set openly at loggerheads, and a fight to the death ensued.
Walker, it is to be said, never treated Jenner with respect. Like Pearson he took stock of his merits, and did not rate them highly, and would not listen to his dictation. “Vaccination,” he used to observe, “is extremely simple as to facts, while, as to causes, it is entirely out of the reach of medical men with all their theories.” Jenner, as president of the Medical Council, thought he had a right to be obeyed, but Walker was the last man in the world to yield obedience when he had formed an opposite conviction--
Jenner [writes Baron] considered it his duty to admonish him, and repeatedly represented to him, in the most friendly manner, the mischievous tendency of his innovations. These remonstrances were unavailing, and he ceased to have any communication with Dr. Walker after the summer of 1805; submitting rather to lament in silence the fate of the Society than come before it as a public accuser.
Of course such forbearance could not last long, and instructions issued by Walker to the Nottingham Vaccine Institution in March, 1806, were made the occasion of an open rupture. Jenner brought Walker’s conduct under the consideration of the Medical Council, and secured his condemnation. The question was then referred to the General Court of the Society on the 25th of July, when a motion that Walker he dismissed from his office was negatived by a majority of three, Walker being supported by Sir Joseph Banks and Jenner by Dr. Sims. But the victory was not satisfactory to Walker, and on the 8th of August he put an end to the strife by sending in his resignation.
Baron’s solemn account of the contest must appal every ingenuous reader. Jenner, it is written, regarded Walker’s proceedings as of “the most dangerous character,” as “placing in peril the safety of the practice,” and “as likely to wreck the Society”; so that had he not retired Jenner would have been compelled to withdraw his countenance from Salisbury Square. As we read we exclaim, Whatever did the dreadful Doctor do? Here is Baron’s answer--
It is unnecessary to mention the specific instances of misconduct which were established. They regarded even the very name of the affection; the method of managing the pustules; the characters of correct vaccination; the precautions to be observed in conducting the practice, etc., etc.
Moore states the offence plainly--
Walker’s method of taking lymph was to cut open the vesicles, and to wipe out the contents with lint, in order to procure the fresh secretion. This harsh treatment of infants was the reverse of that which he was directed to employ; and as he was unalterable in his resolution, it was at length deemed necessary to remove him.[132]
Turning to the Life of Walker, by Dr. Epps, we have the difference ’twixt Tweedledum and Tweedledee still further illustrated--
Two different modes have been adopted in taking the matter of inoculation from the vaccinated subject: one, by making punctures round the outer part of the pock, Dr. Jenner’s mode; the other, by removing the crust or scab from the centre of the pock, wiping out the fluid beneath it, and then taking the matter, indiscriminately, from any part of the whole substance of the pock, Dr. Walker’s mode.[133]
As in brawls and wars generally, the ostensible offence is rarely the true or entire offence, so when we revert to the events of 1805-6 we discover that Vaccination was being found out, and that Walker served Jenner’s purpose opportunely as scape-goat. Walker’s behaviour, too, constituted him a convenient victim. Many who cared nothing for his mode of “taking lymph” had been hurt by his scorn of their self-importance, and were ready to assist Jenner in effecting his humiliation. Mr. Cline, the surgeon, after listening to many speeches against Walker, summed up the indictment, “All they complain of are his dress and address.” A naval officer, meeting Walker on 25th July, said, “I came to town to-day to hold up my hand in your support. You and Jenner do not agree over some trifles, and your enemies wish to turn the fact to your hurt, but they have been beaten. Is the man who launches a vessel the only one who can navigate her? If Jenner were to live for fifty years to come, he could never have the authority of your experience.”
Jenner’s victory over Walker was utterly disastrous: it destroyed the Royal Jennerian Society. The substantial supporters of the Society were the adherents of Walker, and with him they seceded, secured another house in Salisbury Square, and established THE LONDON VACCINE INSTITUTION with Walker for manager. The remnant of the Jennerian Society appointed James Sheridan Knowles, a young Irish surgeon, as Walker’s successor, and for distinction purchased him the degree of M.D. from St. Andrews. He had the suavity that Walker disdained, and little else beside. He neglected his duties, and soon the traffic in the “benign fluid” was transferred to the new establishment. Ultimately the lease, fixtures, and furniture of the Jennerian house were disposed of, and a retreat effected to humbler offices, until in 1813 what remained of the Society was incorporated in Walker’s concern.
Walker obtained much assistance from members of the Society of Friends, and the fact affords Moore (Jenner’s apologist) occasion for certain sneers. He describes the meetings in Salisbury Square as--
Shaded with the Quakers’ broad-brimmed hats; for their schismatic assiduity was most conspicuous, though their primitive meekness was indiscernible. In support of their friend, they argued slyly, wrangled tumultuously, and voted almost unanimously. Yet, in spite of this contentious pertinacity, the turbulent Quaker, on the motion of Dr. Jenner, was dismissed from his office, and peace was restored.
Dismissed he was not, and the peace that ensued on his resignation was destruction. The success of Walker’s Institution (necessarily dependent on subscriptions) he accounts for by an anecdote like this--
A noble Duke informed me that on a sultry day a steaming, squab, broad-faced man, in a Quaker’s garb, with his hat on his head, entered his room, saying, “Friend, I am come on a charitable mission to request thy mite.” The Duke, amused with the oddness of the salutation, desired him to be seated, and to explain his business. The Quaker wilily suppressed all mention of disputes in the Jennerian Society, and of the dismissal of Dr. Walker, which were the real causes for soliciting this subscription; and enlarged tediously on the utility of vaccination, and by awkward encomiums on Dr. Jenner, led the Duke to believe that the subscription was solicited for a Society approved by him. This cunning harangue drew forth the Duke’s purse, which the Quaker spying, unrolled his list, and added his Grace’s name as a decoy for others; and saying, “Friend, fare thee well,” strutted out with an uncouth gait and an air of uprightness. By such artifices a large subscription was raised from those who prefer paying to inquiry; and in the meantime the Jennerian Society diminished in numbers, and, undermined by calumnies, declined to its downfall.[134]
It is not to be imagined, however, that the collapse of the Royal Jennerian Society disposed of Jenner and his party. There was Jenner to provide for: he could not with decency be forsaken: and there was a stock of vaccine virus to be kept up, for which pride forbade dependence on Walker’s dispensary. It was in vain to appeal afresh to a benevolent public, whose confidence had gone elsewhere, and whose suspicions were excited. It was therefore determined to resort to Government for help. The political influence of the Jennerian party was considerable, and we shall see to what purpose it was exerted.
* * * * *
ORIGIN OF THE TERM VACCINATION.
A new practice wants a new name, and it was some time before one was found for Inoculation with Cowpox. Dr. Walker made use of Vacciolation and to Vacciolate in 1802; but it was Richard Dunning, surgeon, of Plymouth, who introduced Vaccination and to Vaccinate. Jenner writing to Dunning, 2nd April, 1804, observed--
The useful terms Vaccination and to Vaccinate, are undoubtedly yours, and as such I pronounced them at a meeting of the Royal Jennerian Society, when an M.D. present mentioned them as imported from the Continent.[135]
Vaccination is not as yet a term accepted everywhere. Among the uneducated we hear of being “cut for the cowpock,” or simply of being “cut.”
Whilst Vaccination was a useful word, it was, and is, often misapplied. Jenner’s prescription of Horsegrease Cowpox was Equination rather than Vaccination; and when virus from the horse was employed neat, Equination was the accurate designation without question. Again, when virus was generated from Smallpox on heifers, the subsequent inoculation of the human subject was not Vaccination but Variolation, or at least Variolous Vaccination. The virus in public use at this day derived from Horsegrease Cowpox, Cowpox, Horsepox, Smallpox, Smallpox Cowpox, etc., etc., inoculated from arm-to-arm, in series prolonged and unsearchable, is called Vaccination; but it is Vaccination in faith or fancy, evidence to anything but uncertainty being unattainable.
FOOTNOTES:
[131] Baron’s Life of Jenner, Vol. i. p. 577.
[132] History and Practice of Vaccination, p. 212. By James Moore. London, 1817.
[133] Life of John Walker, M.D., p. 88. By John Epps, M.D. Lond., 1831.
[134] History and Practice of Vaccination, pp. 213-215.
[135] Baron’s Life of Jenner, vol. ii., p. 336.
XIV. APPLICATION TO PARLIAMENT FOR JENNER’S RELIEF, 1806
Baron relates an instance of Jenner’s personal shyness and the mental torture he endured in prospect of a festival of the Royal Jennerian Society in which he was expected to take part. Speaking to Baron he said--
I can compare my feelings to those of no one but Cowper, the poet, when his intellect at last gave way to his fears about the execution of his office in the House of Lords. It was reading Cowper’s Life, I believe, that saved my own senses by putting me fully in view of my danger. For many weeks before the meeting I began to be agitated, and, as it approached, I was actually deprived both of appetite and sleep; and when the day came, I was obliged to deaden my sensibility and gain courage by brandy and opium. The meeting was at length interrupted by a dissolution of Parliament, which sent the leading people to the country; and what was at first merely postponed was ultimately abandoned to my no small delight and satisfaction.[136]
Something of this timidity was no doubt due to his consciousness of playing a deceitful part, and to the appropriation of honour and reward to which he had no just claim. Like many shy men, Jenner could be insolent with pen and ink--it was face to face courage to which he was unequal; and this timidity, with other reasons, accounted for his failure as a London physician--as “the Cowpox Doctor,” as he was commonly described. Those whose encouragement had helped to lead him to disaster, those who were pleased to believe that he had taught mankind how to escape from smallpox, and several of his professional brethren, were all concerned to help him out of his difficulties, and, if possible, at the public expense. The Duchess of Devonshire wrote to Mr. Angerstein--
I had not forgot your kind interest about Jenner. I spoke to the Duke, the Prince, and Morpeth, and they will all do what you think best; but Morpeth has undertaken to make inquiries whether it is not possible to bring his case again before Parliament. He thinks if that could be done, it would be more satisfactory than any subscription. I desired him to find out how Pitt was really inclined in the matter, and I only waited the result of these inquiries to write to you.
At the same time Jenner himself was not inactive, and managed to advance his own interest effectually. He came to London, 10th May, 1805, and at once saw Lord Egremont, and enlarged upon the losses he had incurred in the public service; the result being a determination to appeal afresh to the liberality of the House of Commons. Moreover he succeeded in winning over the Chancellor of the Exchequer in the manner he thus describes--
During my residence in town in the summer of 1805, Lady Crewe happened in conversation to tell me how much Lord Henry Petty wished for a conference with me on the vaccine subject; and that she would like to bring us together. We met at her villa at Hampstead, and went so fully into the matter that his Lordship, convinced of the injury I had sustained, expressed his determination to bring something forward in the ensuing session. Before the session arrived Mr. Pitt died, and Lord Henry Petty became Chancellor of the Exchequer. In the early part of 1806, I again saw his Lordship, and found that his ardour in my cause had suffered no abatement. This was soon after proved by his Lordship’s motion in the House.[137]
Lord Henry brought Jenner’s case before the Commons on the 2nd of July, and recited the fabulous matter communicated to him with the force of personal conviction. Vaccination was a preventive of smallpox, that loathsome disease which spreads death throughout the world. It was in 1777 that Jenner obtained some obscure knowledge of the peculiar virtue of Vaccine; and from that period he meditated profoundly on the subject, accumulated information, and instituted cautious and decisive experiments. At length he perfected his discovery, and published it for the benefit of mankind. Lord Henry then proceeded to relate the triumphs of Vaccination, not only throughout Europe, but China and India! Wherever the practice was introduced, there smallpox diminished and vanished. There was Vienna, for instance, where the average mortality from smallpox was 835 annually. Vaccination was commenced in 1799, and the mortality dropped in 1802 to 61, in 1803 to 27, and in 1804 to 2. Thus in Vienna there was an annual salvation of 833 human beings. This undoubted fact had made a deep impression on his mind [as well it might!] But, alas! what was doing so much good abroad was neglected and distrusted at home. In the City of London the deaths from smallpox had been on an average 1811 annually, and this mortality had been gradually reduced by Vaccination to 629. Through the diffusion of the disease by variolous inoculation, the deaths last year (1805) had been raised from 629 to 1685. This dreadful destruction of life, especially shocking when a certain preventive existed, demanded their most serious attention, and in the situation he felt bound to propose a plan to bring forward a mass of evidence, to elicit the truth, and enlighten the public. He would therefore move--
That an humble Address be presented to His Majesty, praying that he will be graciously pleased to direct His Royal College of Physicians to inquire into the state of Vaccine Inoculation in the United Kingdom, and to report their opinion as to the progress it has made, and the causes which have retarded its general adoption.
Should this report from the Physicians corroborate the favourable opinion of Vaccination entertained by foreign nations, it must greatly tend to subdue those prejudices against the practice which have been fomented here. And in that case, the House may consider whether the ingenious Discoverer has been remunerated conformably to the liberal spirit and character of this country.
Dr. MATHEWS seconded the motion, and contrasted the safety of the vaccine with the dangers of variolous inoculation. He had no doubt the country would hasten to testify still further its gratitude to the learned physician to whom they owed this inestimable benefit.
Mr. WILBERFORCE did not approve of the reference to the College of Physicians. He would have preferred an investigation by a committee of the House, and another committee of the House of Lords. The opinions of such unbiased persons would be more congenial to the feelings of the people, and far more satisfactory than any medical report from the College of Physicians. The latter might be suspected of being influenced by professional motives, whereas a report from the Lords and Commons would be universally received as proceeding from a pure desire to promote the general good. It did not surprise him that Vaccination had made less progress at home than abroad. The resistance was due to that curious principle in the human mind which accepts what comes from afar with admiration whilst what is familiar is neglected and despised. The remedy would be found in diffusing information as to the complete success of Vaccination in foreign countries. They would thus disperse those absurd prejudices which are engendered and fostered by certain selfish and interested individuals.
Mr. WINDHAM did not concur in the advice of Mr. Wilberforce to refer the matter to a parliamentary committee. It was a question for medical men. To a committee of the House the adage might be applied, Ne sutor ultra crepidam. Let them enforce with their approval the report of the physicians, and then let them proceed to remunerate that meritorious individual to whom society owed the utmost gratitude. He could not help thinking he had not yet received what was due for the expense and trouble the discovery had cost him.
Mr. BANKS was of a sceptical turn. He wished the motion had been made earlier in the session, for then he should have supported the suggestion of Mr. Wilberforce. They wished to know whether Vaccination really did afford reasonable security from smallpox. It was not a question for medical men for which the House was incompetent. They were as capable of determining the point, and setting it clearly before the public, as the most learned body that ever existed. He wished too, since the motion would be carried, that the Royal College of Surgeons might be united with the Physicians in the production of the report. As for Dr. Jenner, if Vaccination were as efficacious as asserted, he might be left to find his reward in its practice.
Lord HENRY PETTY in summing up the debate expressed his satisfaction with the general approval extended to his motion. He did not think the House competent to form a judgment on Vaccination. They could not decide whether cowpox was genuine or spurious, or whether the affection resulting from its inoculation was regular or otherwise; nor could they determine whether eruptions that might break out after Vaccination were induced by the operation, or were due to other causes. Such delicate questions could only be solved by medical men. As for the proposal to annex the Royal College of Surgeons to that of the Physicians, it was superfluous. The College of Physicians would not only consult the Surgeons, but the Medical Colleges of Scotland and Ireland likewise. If the report should prove favourable, it would then be his duty to propose that remuneration be awarded to Dr. Jenner for his inestimable discovery.
The motion was then put from the Chair and agreed to unanimously.
It is needless to remark that the report of the College of Physicians was a mere formality toward a vote of credit for Jenner’s relief. He lay heavy on many hands, and none were more anxious to be relieved from the pressure than certain influential members of the College whose report was solicited. The operation was skilfully planned for the end designed, and Lord Henry Petty allowed himself to be primed and applied with singular facility: but public men have often to deliver as of themselves what is communicated by others, and to stand responsible for absurdities of which they are unconscious.
FOOTNOTES:
[136] Baron’s Life of Jenner, vol. ii. p. 162.
[137] Baron’s Life of Jenner, vol. ii. p. 55.
XV. REPORT OF THE ROYAL COLLEGE OF PHYSICIANS
The Report of the Physicians appeared on the 10th April, 1807, a verbose document, wherein assertion and conjecture were awkwardly intermingled. As to the extension of the practice, it was said--
During eight years which have elapsed since Dr. Jenner made his discovery public, the progress of Vaccination has been rapid, not only in all parts of the United Kingdom, but in every quarter of the civilised world. In the British Islands some hundred thousands have been vaccinated; in our possessions in the East Indies upwards of 800,000, and among the nations of Europe the practice has become general.
Professional men have submitted it to the fairest trials, and the public for the most part have received it without prejudice. The testimony in its favour has been most strong and satisfactory, and the practice of it, though it has received a check in some quarters, appears to be upon the increase in most parts of the United Kingdom.
From the Report it appeared that the opposition to Vaccination proceeded from the Inoculators; and the document may be described as a charge against the old practice as much as a positive defence of the new--
However beneficial the inoculation of the Smallpox may have been to individuals, it appears to have kept up a constant source of contagion, which has been the means of increasing the number of deaths by what is called the natural disease. It cannot be doubted that this mischief has been extended by the inconsiderate manner in which great numbers of persons, even since the introduction of Vaccination, are every year inoculated with Smallpox, and afterwards required to attend two or three times a-week at the place of inoculation, through every stage of their illness.
Some Inoculators asserted that Vaccination produced “new, unheard-of, and monstrous diseases,” and made use of pictures to excite terror and disgust--
Publications with such representations have been widely circulated, and though they originated either in gross ignorance, or wilful misrepresentation, yet have they lessened the confidence of many, particularly of the lower classes, in Vaccination.
Whatever the character of Vaccination--had the claim made in its favour been a true claim, still the chief resistance to its practice would have consisted in the common apathy--
The lower orders of society can hardly be induced to adopt precautions against evils which may be at a distance; nor can it be expected from them, if these precautions be attended with expense. Unless, therefore, from the immediate dread of epidemic Smallpox, neither Vaccination or Inoculation appears at any time to have been general, and when the cause of terror has passed by the public have relapsed into indifference. It is not easy to suggest a remedy for an evil so deeply implanted in human nature.
The suggestion was, however, made that Vaccination should be offered gratis, but at the same time it was the opinion of the College that until Variolous Inoculation was superseded or prohibited, “it would be impossible to prevent the constant recurrence of Natural Smallpox.”
The recommendation of Vaccination gratis provoked the wrath of Dr. Moseley--
Gratis! [he exclaimed]: Why, every person knows that for years past in almost every street of London, signs or boards on the sides of houses, or on Methodists’ shops, or in apothecaries’ windows, have invited the ignorant multitude to gratuitous Vaccination. I have seen as many gratis Cowpox hand-bills, gratis puffs, gratis pathetic sermons and addresses, and gratis station advertisements as would load an ox. What does the College think of the mountebank Jennerian placard, dispersed on walls and alleys, and among all the blackguard public houses in town and country, and hung up in the shop or parlour of every Cowpoxer in England with Their Majesties’ Names and those of Their August Family audaciously emblazoned upon it?[138]
The Report of the College is interesting as a historic confession and a mark of progress. The physicians who drew it up were the same men who in 1800 professed their unlimited confidence in Vaccination, whilst as yet they knew little about it, proclaiming in the newspapers that they considered it their duty to declare--
That those persons who have had the Cowpox are perfectly secure from the future infection of the Smallpox.
From a profession so unqualified an absolute retractation was not to be expected; but experience had begotten caution, and it is instructive to remark with what qualifications the retreat from the original position was attempted. Thus--
The security derived from Vaccination if not absolutely perfect is as nearly so as can perhaps be expected from any human discovery; for among several hundred thousand cases, with the results of which the College has been made acquainted, the number of alleged failures has been surprisingly small, so much so as to form no reasonable objection to the general adoption of Vaccination.
The Report was not the deliverance of men possessed with the confidence of 1800: throughout there was manifest the failing conviction which evades responsibility and seeks for confirmation from sources external to itself. After a reference to the Variolous Test, the Report ran on--
It appears from numerous observations communicated to the College, that those who have been vaccinated are secure from the contagion of epidemic Smallpox. Towns and districts of country in which Vaccination had been general, have afterwards had Smallpox prevalent on all sides of them without suffering from the contagion. There are also in the evidence a few examples of epidemic Smallpox having been subdued by a general Vaccination.
The liability to confound coincidence with cause was not unknown in 1807, and might have been suggested as a possible explanation of the cessation of a variolous epidemic contemporaneously with Vaccination; although at the present day Vaccination, when Smallpox is epidemic, is known to do little else than invite and extend the malady.
How the general (that was to say partial) Vaccination of certain towns and country districts secured universal exemption from Smallpox, the Physicians failed to explain. Extraordinary tales of Vicarious Vaccination were current and piously received. If a fraction of an urban or rural community happened to be vaccinated (usually a fraction least likely to be troubled with Smallpox in any event) and Smallpox did not break out, or did not widely prevail, the salvation of the community was ascribed to the Vicarious Vaccination. The phenomenon has, strange to say, escaped the attention of theologians, although medical men constantly attest its occurrence.
Ruefully was it conceded that Vaccination was not an absolute preservative from Smallpox, but the pain of concession was softened with the plea of mitigation--
In almost every case where Smallpox has succeeded Vaccination, the disease has varied much from its ordinary course; it has neither been the same in violence, nor in the duration of its symptoms, but has, with very few exceptions, been remarkably mild, as if the Smallpox had been deprived, by the previous vaccine disease, of all its usual malignity.
It goes without saying, that such a statement was quackish romance. How could a physician know that any case of Smallpox had been made milder by Vaccination? for how could he know how severe the disease would have been without Vaccination? Any ground of comparison was wanting. Smallpox is an eruptive fever of wide degrees of intensity--slight as to be a trivial ailment, severe as to be inevitably fatal. “So true,” wrote Dr. Wagstaffe in 1722, “is that common observation, that there is one sort in which a nurse cannot kill, and another which even a physician cannot cure.” Yet every case of mild Smallpox after Cowpox came into fashion was placed to the credit of Vaccination!
Some writers [the Report continues] have greatly undervalued the security Vaccination affords, while others have considered it to be of a temporary nature only; but if any reliance is to be placed on the statements laid before the College, its power of protecting the human body from Smallpox, though not perfect indeed, is abundantly sufficient to recommend it to the prudent and dispassionate. The opinion that Vaccination affords but a temporary security is supported by no analogy in Nature, nor by the facts which have hitherto occurred.
The analogy of Nature was a treacherous support, whilst the Physicians did not foresee the time when their successors would plead the fact of the temporary security of Vaccination as a reason for systematic Re-Vaccination.
It is not difficult to discern between the lines of the Report a spirit of doubt and hesitation. Those who framed it had gone too far to turn back; there was Jenner on their hands; and a public ready to hoot if there was any open apostasy. The outlook at home was not encouraging, but there was the Continent, yea more, the wide world itself wherein to cover the reproach of failure--
They could not be insensible [said the Physicians] to the confirmation they receive not only from the introduction of Vaccination into every part of Europe, but throughout the vast Continents of Asia and America.
The vast Continents of Asia and America! A fine phrase--a very fine phrase, with more comfort in it than scoffers might imagine.
In the Report we detect one good service, namely, the explosion of Jenner’s fiction about Spurious Cowpox. When Vaccination was first brought forward, cases were adduced of Smallpox after Cowpox. Jenner at once asserted that the Cowpox in such instances must have been spurious, for Smallpox after genuine Cowpox was impossible; and Spurious Cowpox was thenceforward freely used to baffle inquirers and to account for failures. Spurious Cowpox served the ends of the Vaccinators magnificently, but by and by it began to have awkward consequences. Genuine Cowpox was said to be harmless--it was the Spurious that was ineffective or worked mischief; and the Inoculators plied the terror of Spurious Pox against Vaccination. It therefore became necessary to clear Spurious Cowpox out of the way, and Jenner, before the College of Physicians, pressed upon the point, “owned up,” as Americans say, and authorised the following explanation--
Some deviations from the usual course have occasionally occurred in Vaccination, which the Author of the practice has called Spurious Cowpox, by which the public have been misled, as if there were a true and a false Cowpox; but it appears that nothing more was meant than to express irregularity or difference from that common form and progress of the vaccine pustule from which its efficacy is inferred.
Mark! Here was a third definition of Spurious Cowpox by Jenner.
First, in the Inquiry of 1798, he described Spurious Cowpox as eruptions on the cow underived from horsegrease, producing no erysipelas when inoculated on the human subject, and without effect against Smallpox. True Cowpox was generated from horsegrease, and from horsegrease only.
Second, in the Origin of the Vaccine Inoculation of 1801 all reference to horsegrease was dropped for commercial reasons, whilst the existence of Spurious Cowpox was reasserted “as some varieties of spontaneous eruptions upon the cow.”
Third, before the Physicians in 1807, he removed the spurious disease from the cow altogether, saying, nothing more was meant by Spurious Cowpox than variations in the form and progress of vaccine pustules on the arms of the vaccinated!
In short, to vary the phrase of Betsy Prig, “There never was no Spurious Cowpox.” Slippery, very slippery, was the immortal Jenner.
With the report of the Royal College of Physicians were delivered reports from the London College of Surgeons, and from the Edinburgh and Dublin Colleges of Physicians and of Surgeons.
The report from the London College of Surgeons was considered most unsatisfactory, and could its tenor have been foreseen, the Jennerians might never have asked for it. 1100 circulars were dispatched on 15th December, 1806, to all the members of the College whose addresses were known in the United Kingdom, submitting the following questions--
1st. How many persons have you vaccinated?
2nd. Have any of your patients had Smallpox after Vaccination?
3rd. Have any bad effects occurred in your experience in consequence of Vaccination? and if so, what are they?
4th. Is the practice of Vaccination increasing or decreasing in your neighbourhood? if decreasing, to what cause do you impute it?
To the 1100 circulars only 426 replies were received. Why nearly two-thirds of the members kept silent when at the outset they were converted in multitude to Vaccination, was left unexplained. The replies were thus summarised by the Board on 17th March, 1807--
The number of persons stated in such letters to have been vaccinated, is 164,381.
The number of cases in which Smallpox had followed Vaccination is 56.
The Board think it proper to remark under this head, that, in the enumeration of cases in which Smallpox has succeeded Vaccination, they have included none but those in which the subject was vaccinated by the surgeon reporting the facts.
The bad consequences which have arisen from Vaccination are--
66 cases of eruption of the skin, and 24 of inflammation of the arm, whereof 3 proved fatal.
Vaccination, in the greater number of Counties from which reports have been received, appears to be increasing: in the Metropolis it is on the decrease.
The principal reasons assigned for the decrease are--
Imperfect Vaccination, Instances of Smallpox after Vaccination, Supposed bad consequences, Publications against the practice, Popular prejudices.
The report of the Edinburgh College of Physicians disowned acquaintance with Vaccination, the practice being entirely in the hands of surgeons and other practitioners--
With a view, however, to publish their conviction of the immense benefits which have been, and which will in future be derived to the world, from Inoculation for the Cowpox, they had spontaneously and unanimously elected Dr. Jenner an honorary Fellow of their College, a mark of distinction which they very rarely confer, and which they confine almost exclusively to Foreign Physicians of the first eminence.
The report of the College of Surgeons, dated 3rd March, 1807, left nothing for the Jennerians to desire. The Edinburgh surgeons were satisfied from their own experience that Vaccination constituted a permanent security from Smallpox, and they had observed no ill consequences from the practice. Vaccination commenced in Edinburgh in 1801, and was now so general in the city--
That for two or three years past, Smallpox has been reckoned rather a rare occurrence, even among the lower order of the inhabitants, unless in some particular quarters about twelve months ago. Among the higher ranks of the inhabitants the disease is unknown.
Rare, unless in some quarters about a year ago! We turn to the report of the Edinburgh Dispensary for 1805, and there we read--
The loathsome disease has unfortunately been very prevalent in several quarters of the city.
And this coincidently with extensive Vaccination to which apparently there was no active opposition! We have also to remember in this connection the statement of Professor Alexander Monro in 1765, that “the inhabitants of Scotland generally have Smallpox in their infancy or childhood; very few adults being seen in this disease”; and that in Edinburgh, with conditions strongly favourable to Smallpox, the mortality from the disease was on an average little more than a hundred a year. The Edinburgh physicians knew nothing practically of Vaccination, and we see how the Surgeons, who did know, shaped their evidence.
The Dublin College of Physicians echoed the fashionable opinion “that Cowpox Inoculation was safe, and fully answered its purpose.” They were “willing to allow that doubtful cases had occurred of Smallpox after Vaccination, but on minute investigation, these supposed instances originated generally in misrepresentation, or the difficulty of discriminating between Smallpox and other eruptions.” Rather awkwardly, seeing how the opposite opinion was in vogue, they professed their faith in Variolous Inoculation--
The Smallpox is rendered a much less formidable disease in Ireland by the frequency of Inoculation for it, than in other parts of His Majesty’s dominions, where prejudices against Inoculation have prevailed. Hence parents, not unnaturally, object to the introduction of a new disease, in the shape of Vaccination, preferring to trust to the practice with the mildness and safety of which they are well acquainted.
The Dublin College of Surgeons showed themselves more fully abreast of the time. They had nothing to say for Inoculation, but testified their confidence in Vaccination, and how its practice was increasing in Ireland. From 1800 to 1806 a total of 14,335 had been “inoculated with vaccine infection” at the Dublin institutions, and many elsewhere--
Cowpox has been found to be a mild disease, and rarely attended with danger, or any alarming symptom, and the few cases of Smallpox which have occurred in Ireland after supposed Vaccination, have been satisfactorily proved to have arisen from accidental circumstances.
Arisen from accidental circumstances! Thus was the divine illumination of experience veiled and denied!
Fortified with this budget of questionable evidence, the Government proceeded to claim from the House of Commons a second endowment for Jenner.
FOOTNOTE:
[138] Review of Report on Vaccination. By Benjamin Moseley. London, 1808.
XVI. JENNER RELIEVED--1807
Whilst the Royal College of Physicians were preparing their report, there was perturbation in the political world. Dull and bigoted George III. refusing on the pretext of his oath to concede to Roman Catholics the rights of citizens, a change of administration ensued, and Mr. Perceval, a man after the King’s own heart, replaced Lord Henry Petty as Chancellor of the Exchequer, and proceeded to give effect to the plan for relieving Jenner; a purpose for which the report “On the State of Vaccine Inoculation in the United Kingdom” was merely a blind.
On the 29th July, 1807, the House of Commons being in Committee of Supply, Mr. PERCEVAL moved that Dr. Jenner be awarded a second sum of £10,000 for his matchless discovery. Smallpox was one of the greatest afflictions of mankind, from which hardly any one escaped. For this dreadful malady, Jenner had invented a preventive, unknown before, or if known, which had never been published. He did not therefore think the Committee would consider his proposal extravagant; indeed it was rather an act of justice than of liberality. Those who had read the Report of the Physicians would recognise the immense advantages of the new practice. As for its inconveniences, they were as nothing to those which attended Variolous Inoculation, and the few mistakes recorded were due to ignorance and carelessness. It might be objected by those who adhered to Mr. Malthus, that nothing was gained by saving lives from pestilence; for deaths were not losses where means of subsistence were inadequate; but for his part he would disregard the argument even if it were true. It was much better to follow the dictates of their hearts, and preserve life whenever it was within their power. He had often heard that the true riches of a state were its inhabitants. But he would not attempt to measure Jenner’s award by the number of lives that his invention would preserve to the world. If he did so, what sum would they have to offer! All he need say was, that the £10,000 proposed represented no more than a moderate acknowledgment of labour and genius devoted to the service of humanity.
Mr. SHAW LEFEVRE opposed the motion. He had thought the former application for £20,000 excessive, and had concurred with those who reduced it to £10,000. He had moreover acquiesced in the smaller sum by reason of his faith in the report of the Committee of the House on the New Inoculation, but he now discovered that many of the statements in that report were erroneous. It attested that Vaccination was an infallible preventive of smallpox, whilst the report of the Surgeons now admits 56 failures! The first report stated that no disease followed Vaccination, whilst now it is confessed that scrofula and other alarming symptoms are its occasional sequences! The report thus prejudicial to Vaccination nevertheless argues in its favour, and he would like to call witnesses to the bar of the House who would make manifest still further its inconsistencies and inaccuracies. At this late period of the session, it was not right to vote away such an amount of public money. [Such “late periods” are, however, always selected for jobs.] Besides, it was generally known that Benjamin Jesty of Worth in Dorsetshire discovered the use of cowpox long before Jenner, and if the House was resolved to be liberal, the reward should be shared with Jesty, or with Jesty’s family. He should oppose the vote, but he did not say that he would always do so. His purpose was to gain time for more careful inquiry.
Lord HENRY PETTY, who had first moved in the matter, came to his successor’s support. He had no doubt as to the efficacy of Vaccination, nor as to Jenner being its discoverer. His difficulty was to find a rule for the justice of the case; for whoever considered the value of the discovery must perceive that it would be impossible for them to deal generously with the discoverer. His service to mankind was entirely beyond any financial estimate. It was objected that Vaccination was not infallible. He replied that absolute, never-failing perfection ought not to be expected from any human device: they should rest well satisfied in the approximation to infallibility that belonged to Vaccination. Its daily benefits were numberless. Multitudes of seamen, soldiers, and citizens of every description had been saved by it, and in contemplating its future effects on the human race, the mind was lost in amazement and gratitude. How then should they presume to talk of liberality towards Jenner, the benefactor! They should recollect how he stands in the estimation of the world, how they were acting in view of all nations, and how their own characters were at stake in their demeanour towards him. As to Malthus there was a misapprehension. He had taught nothing that forbade the extinction of an infectious disease which so greatly reduced human happiness. In their concern for Vaccination, the House should not forget the mischief that was still wrought by inoculation with smallpox. Zealous as he was for the new practice, he had no wish to meddle with what others might imagine (however absurdly) tended to their own preservation and that of their families, but no one had a right to endanger the lives of others. It was proved beyond dispute that those who were inoculated with smallpox diffused the fatal contagion by going abroad, or being carried abroad. He thought, therefore, it was not only the right, but the duty of the State to oblige those who were infected with smallpox to keep within doors until complete recovery. He would not move an amendment to the resolution, but would have no hesitation in acceding to a larger sum.
General TARLETON could not withhold his tribute of praise from the author of this blessing to mankind. To his knowledge, it had saved the lives of many in his Majesty’s service. Soldiers could march and perform every military duty when under the process of vaccination. It had been said that gentlemen in the army had no respect for anything save success in war, but he thought that many officers knew how to admire Jenner, the preserver of millions, and to allow that in future ages his glory would exceed the renown of the greatest warriors.
Mr. STURGES BOURNE denounced the practice of inoculating out-patients at the Smallpox Hospital whereby the disease was systematically perpetuated and diffused throughout the community. He thought the legislature would be as much justified in taking measures to prevent this evil by restraint, as a man would be in snatching a firebrand out of the hands of a maniac just as he was going to set fire to a city.
Mr. HAWKINS BROWNE confessed with shame that he had voted for £10,000 instead of £20,000 in 1802; but at that time he little knew the extent of Jenner’s service to the human race.
Mr. EDWARD MORRIS did not think that even what had been said sufficiently set forth their debt of gratitude to Jenner. His discovery afforded a reasonable expectation of the extermination of smallpox, and the merit of the transcendent discovery was all his own. Inoculation in the old mode mitigated the disease in a few, and spread it in full fury over many. It was therefore a curse to mankind instead of a blessing. The Smallpox Hospital in its practice of inoculation, was a source of pestilence and a multiplier of victims to this deplorable distemper. The pre-eminent distinction of Vaccination was that it preserved its subject and injured no one. This unspeakable blessing they owed to Jenner, nor had the least improvement been effected upon his original and carefully matured prescription. They were bound to consider how he had abandoned the lucrative pursuit of his profession, and surrendered many years of his life for the good of his country and mankind. He would therefore submit an amendment to the resolution before the Committee, that the grant be £20,000 instead of £10,000, to mark their sense of Jenner’s merits and to place him in a state of independence.
The amendment was warmly supported by Mr. Wilberforce, Mr. Windham, Sir John Sebright, and Mr. Herbert.
Mr. PERCEVAL, as Chancellor of the Exchequer, stood to his resolution, but with indifferent arguments. It was without precedent that a vote recommended by Government should be thus increased. He admitted that Jenner was entitled to much more than they could afford, but it was also without precedent that so great a sum as £30,000 (inclusive of the former vote) should be bestowed on any discoverer.
Mr. WILLIAM SMITH would not submit to these objections. He recited the triumphs of Vaccination in Asia and America, and said it was true as of old that a prophet had no honour in his own country. [An observation singularly inapplicable to Jenner.] He urged the Committee to vote for the larger sum, and said that whilst the Chancellor of the Exchequer might in his public capacity protest, yet in his secret heart he would not be displeased if overborne by the sentiment of the House, of the country, and of the world.
Mr. WHITBREAD begged the Committee to bear in mind that Jenner had scorned to monopolise Vaccination, and had thereby sacrificed a great fortune. He called on the House to vote for the larger sum. Vaccination furnished the means for lessening the poor rate. Reduced smallpox signified fewer deaths, fewer orphans, fewer widows. Vaccination meant better health for the poor and more money in the pockets of the rich. They would excuse this appeal of his to the cupidity of the landed interest inasmuch as he had been anticipated in the exhibition of loftier considerations. He also wished to relieve the House from a renewal of this question. Let them reward Jenner once for all, and liberally: and remember that what was called economy in this connection, if practised by the House, would be, in the eye of the world, their disgrace.
Others spoke in a similar strain, and when the House divided, 60 voted for Mr. Morris’s amendment, and 47 against it, £20,000 being carried by a majority of 13. Including the £10,000 voted in 1802, Jenner was thus awarded £30,000 of public money, in times, too, of war and scarcity.
The debate, it will be observed, was conducted in a House of 107 members at a late period of the session, and the variations among the speakers consisted in degrees of extravagance and credulity. The fabulous matter as to Jenner personally affords curious evidence of the manner in which legends originate in the presence of contemporaries, and how they come to be repeated with the fervour of good faith by men whose competence and honesty might be taken for unimpeachable. Jenner’s party had whipped up their adherents, and the issue was sedulously arranged for; but because they had their way it need not be assumed that it was necessary to circumvent any active adversaries. Apathy was their chief difficulty. There was little to be got out of cowpox by the ordinary politician; and then, as now, the average M.P. rarely committed himself to any project that did not obviously make for his popularity. As for the enthusiasm for Vaccination displayed by the speakers in the House, we have to recollect that they were not converts to the practice per se. No really new discovery was ever received with such an instant chorus of approbation by the mob, educated or uneducated. They were one and all bred under the severe and dangerous practice of Variolous Inoculation, whereof Vaccination was no more than a modification with a seductive promise of equal or greater security from smallpox, and exemption from its perils and annoyances. Unless this prepossession be allowed for, the conduct of Parliament toward Jenner cannot be rightly understood. There was not a word uttered against Vaccination from the ground which physiologists at this day occupy, for that ground, in a scientific sense, was as yet unknown. Smallpox was a mysterious visitation to be mysteriously dealt with--dodged, if possible, by medical artifice; and not, as we are persuaded, a crisis of impurity in the blood induced by foul conditions of life, which cannot be better disposed of than in the course of nature by eruptive fever. If we could suppress smallpox (in any other way than by the removal of its causes) we should merely alter its manifestation and have to accept it in some other and aggravated form of disease.
XVII. VACCINATION ESTABLISHED AND ENDOWED
Jenner provided for, his adherents had yet another end to achieve, namely, their own release from the burden of the Royal Jennerian Society, paralysed by the secession of Dr. Walker and the Friends and the establishment of the London Vaccine Institution. At first they had endeavoured to discredit the new Institution, even to the extent of distributing hand-bills like the following in the streets--
A CAUTION.
To persons desirous of obtaining INOCULATION for the Cowpox Gratis under the sanction of
THE ROYAL JENNERIAN SOCIETY.
Whereas, Doctor JOHN WALKER has, under various pretences, obstructed persons going to the Central House of this Society, the Public are hereby warned to be upon their guard against any insidious representations, the connection between Dr. WALKER and the Society having ceased, and Dr. KNOWLES having been appointed the Resident Inoculator at the Society’s House, No. 14 Salisbury Square.
By Order of the Directors and Medical Council, 9th October, 1806.
It was all in vain. Walker was preferred to Sheridan Knowles backed by Jenner, whose friends had no liking for the support of the Society out of their own pockets. It was therefore planned to resort to Parliament for an annual subsidy so as dispense with the necessity of subscriptions. The managers of the London Vaccine Institution, learning what was on foot, naturally argued that if Government was to be thus propitious, it was they who had the better claim to assistance, and therefore prepared a petition setting forth their exertions in spreading Vaccine Inoculation. This interference with their scheme filled the Jennerians with fury, and Mr. JOHN FULLER undertook to speak their mind in the House of Commons. When, therefore, on 2nd June, 1808, Sir THOMAS TURTON presented the petition, FULLER sprang to his feet and denounced it, saying a grosser forgery had never been submitted to the House.
The SPEAKER interposed. The petition had not been read. When it was, the House would be enabled to judge of its contents. Mr. FULLER resumed his seat amid general laughter. The petition having been read--
Mr. FULLER apologised for his abruptness. The petition was a gross cheat, a wicked trick to swindle the public; or, if it was not absolute swindling, it went very near the wind. When they came to solicit his subscription, he thought they represented some respectable corporation, but what did they turn out to be? A parcel of Quakers, or Presbyterians, or whatever else they were called. They had got five guineas from him, but the moment he detected them, he threatened them with a Bow Street officer and a charge of swindling, which soon frightened them into a re-delivery of his money. What a shame it was to see the cause of such fellows espoused by any man in that House! He did not suppose the Honourable Baronet shared in their gains, and he might laugh as he pleased, and spout like a lawyer, but it was a poor way to show himself off for the sake of a little notoriety among such despicable sectaries. He hoped the House would not lend any countenance to the imposture.
Sir THOMAS TURTON good humouredly replied, that the Jennerian Society, in whose interest the preceding speaker exhibited so much untempered zeal, was not instituted till 1803. The original Vaccine Pock Institution was established by Dr. Pearson in 1799. The Institution to which the petition referred was established in 1806, chiefly by members of the Society of Friends, a sect to whose virtuous principles and behaviour it was his privilege to bear testimony. Since 1806 the Institution had communicated the vaccine matter to 81,000 persons in every situation of life. The petitioners only desired to have the facts they adduced inquired into, and hoped for public aid only in the event of being entitled to it on public grounds.
This application for assistance by Walker’s Institution rendered its concession to the Jennerian Society impossible: it was not for the Government to get into hot water by showing favour to either; and as both could not be subsidised, it was determined to vary the application, and to ask the House of Commons to provide means for the maintenance of a new and independent institution from which “the Genuine Vaccine Virus could be distributed without expense throughout the British dominions.” Mr. GEORGE ROSE, Treasurer to the Navy, took charge of the measure, which he introduced to the House on 9th June, 1808. After dealing with a notorious failure of Vaccination at Ringwood, he proceeded to observe, that whilst it could no longer be said that Vaccination was a certain security against Smallpox in all cases, yet the evidence showed that the failures were not one in 300. He would therefore move that the House having the testimony of the Colleges of Physicians and Surgeons of London, Edinburgh, and Dublin, that Vaccination was salutary and generally effective, it is desirable that a Central Institution be formed for the provision and distribution of Real Vaccine Matter, and that its administration be committed to the Royal Colleges of Physicians and Surgeons in London. The expense would not be more than £2500 or £3000 per annum.
Mr. DAVIES GIDDY said he should not oppose the resolution, but it would have been much better to have refrained from interference. The people would neglect inoculation, and then smallpox would break out with tenfold severity.
Mr. FULLER observed that Smallpox had been annihilated in Calcutta by systematic and enforced Vaccination, and he believed the same result was attainable in this country. He thought that even those who hesitated to resort to general compulsion, would not object to the Vaccination of all children in workhouses.
Sir T. TURTON would have preferred a committee of investigation. There were already three Institutions in London for the express purpose of propagating cowpox, and the object Mr. Rose had in view was more likely to be attained by private subscriptions and by assistance from Government than by a special Institution formed and endowed by the State.
Lord HENRY PETTY contended that as the evidence was now confessedly incomplete as to the infallible efficacy of Vaccination, it was highly proper that investigation should be persevered in under the eye of the public instead of by a number of small institutions which were not perhaps altogether exempt from the imputation of being guided by mercenary motives.
Sir FRANCIS BURDETT said Vaccination appeared before them with a complexion widely differing from that originally assumed. A short time ago they were assured it was an infallible preventive of Smallpox, and that its practice was so simple that any old woman was equal to it. Now they were told that it was a very nice operation requiring great judgment and skill, the want of which was held to account for the many failures which had occurred. Thus there was neither that simplicity nor security which was originally asserted. Considering these manifest discrepancies between promise and practice, it was, he thought, most unwise for the House to intervene in order to help what appeared to be a failing experiment. They ought to be cautious--they ought not to prop up what might prove to be pernicious error. Government in this free country cannot compel people to submit to the prescriptions of physicians, or the operations of surgeons, or anything except the laws; and it was doubtful whether science itself would be benefitted if placed under Government direction. They were referred to the reports of the Medical Colleges, but as he read these reports he detected much hesitation and evasion, and anything but the assurance displayed on behalf of Vaccination by several members of the House. Many instances of failure were admitted, and such instances might safely be doubled. As for Spurious Cowpox he wished to know what it was. It was used to account for all mishaps, and it was, he suspected, a mere shift, shuffle, and get-off. [Sir Francis need not have spoken thus dubiously, for the Report of the Physicians admitted what he suspected.] He would much prefer a committee of investigation, and hoped the resolution would not be pressed.
Mr. WILBERFORCE brought up the foreign argument. There might be failures at home, but these could be satisfactorily accounted for. It was for them to consider the magnificent successes of Vaccination in other lands [Omne ignotum pro magnifico est], concerning which there was no room for doubt. He saw no surer method of inspiring the public with confidence in Vaccination than by the establishment of the proposed Institution.
Mr. ROSE explained that he merely wished to bring the House to a resolution, leaving it to his Majesty [that was to say, himself for the Government] to give it effect.
Mr. GEORGE CANNING, Secretary of State for Foreign Affairs, declared that though he considered the discovery of Vaccination to be of the greatest importance, yet he could not imagine any circumstances whatever that would induce him to follow up the most favourable report of its infallibility with any measure for its compulsory infliction.
This declaration of Canning is well worth attention and commemoration. It serves to mark the reverence for personal liberty, which was the fine distinction of the former order of English statesmen, and separated, when little else did, the English from the Continental Tory. The noble tradition of this liberty meets with scant favour in these times, and Canning’s avowal in the new House of Commons would be heard as an anachronism. Nearly every adventurer who has a prescription for the moral and physical welfare of his fellow creatures hopes to have it enforced by legislation; and since, under penalty of fine and imprisonment, our babes are cut and poisoned to save them from smallpox, there is no infraction of personal liberty, however outrageous, that can now be pronounced impossible.
When the House divided there were 60 for the motion and 5 against it--again a small House for so critical a matter.
With the permission to spend £3000 a year, the National Vaccine Establishment was constituted, Jenner being consulted in its organisation. A Board was formed, consisting of the President and four Censors of the Royal College of Physicians, and the Master and two senior Wardens of the College of Surgeons. The Board met on 8th December, 1808, and proceeded to business. Jenner, as was his fatality on important occasions, was absent, being detained at Berkeley by family affliction. He wrote to Moore--
I should be unworthy of the name of father were I to stir from my children. Indeed, nothing would make me, not even a royal mandate, unless accompanied by a troop of horse.
Jenner was elected Director, but not a member of the Board, and immediately began to protest that he was disregarded and subjected to indignity. “The Board,” he said, “appointed me Director, but they soon contrived to let me feel that I was to be a Director directed.” The arrangement he had made with Mr. Rose and Sir Lucas Pepys, the President of the College of Physicians, was, he held, altogether different--
It was stipulated between Mr. Rose, Sir Lucas, and myself, that no person should take any part in the Vaccinating Department who was not either nominated by me or submitted to my approbation. On my reminding Sir Lucas of this, he replied, “You, Sir, are to be whole and sole Director. We [meaning the Board] are to be considered as nothing. What do we know of Vaccination.”[139]
Sir Lucas of course was jeering, but Jenner’s head was so turned with vanity and flattery that he could not distinguish mockery from sincerity. He had constructed for himself a fool’s paradise, out of which the Board pitched him unceremoniously. He recommended his bludgeon bearer, John Ring, for Chief Vaccinator and Inspector of Stations, but the Board declined to have anything to do with him, and added insult to contempt; for in Jenner’s words, written in the third person--
They appointed a gentleman in his place who was taken from an Institution which had been personally hostile to Dr. Jenner on all occasions.
Subsequently he sent in a list of seven names for Sub-Vaccinators, of which the Board rejected five, which brought matters to a crisis, and he resigned. In the memorandum, from which I have quoted, he wrote--
By the whole of these circumstances, Dr. Jenner felt himself under the necessity of withdrawing from the establishment. He could take upon himself no responsibility where he had no power, not even a vote. He did not wish to control the establishment; nothing was further from his thoughts. But he expected that the practical part of its concerns would have been under his direction, as the title of his office implied; and he expected that those gentlemen whom, from a consciousness of their pre-eminent ability, he had so strongly recommended to conduct this practical part, would have been appointed. But as his recommendations have been disregarded--as arrangements and appointments have been made which are contrary to his judgment, and as he is informed by the Board that it was intended for them to use their own discretion, and that they alone are responsible for the conduct of the establishment, Dr. Jenner declined accepting the station of Director, to which they had nominated him, since he found that he was to have nothing to do in the establishment, and that his office was only a name.[140]
To those who did not know Jenner, or who accepted him at his own estimate, the treatment to which he was subjected might appear reprehensible; but the Board understood their man, and only cared to have the benefit of his name, for little else was worth having. What could be made of a character indolent and untrustworthy; who disliked London and was off to Gloucestershire on any pretext; whose sickly family had from him the supreme consideration of an affectionate mother! He wrote to Moore--
I agree with you that my not being a member of the British Vaccine Establishment will astonish the world; and no one in it can be more astonished than myself.
He was mistaken. The world, so far as it thought at all, considered he was handsomely rewarded with his £30,000, and with so much public money in his pocket might have looked for a better disposition on his part. When his nominations were disregarded, he declined even to come to London, and thus excused his sulking at Berkeley--
I was quite in earnest at the time I informed you of my intention to come to town, but while I was getting things in order there came a piece of information from a Right Hon. Gentleman which determined me to remain in my retirement. It was as follows--
That the Institution was formed for the purpose of a full and satisfactory investigation of the benefits or dangers of the Vaccine Practice, and that this was the reason why Dr. Jenner could not be admitted as one of the conductors of it, as the public would not have the same confidence in their proceedings as if the Board were left to their own judgment in doubtful cases.
This is the sum and substance of the communication--
What do we know of Vaccination?
We know nothing of Vaccination!
Alas! poor Vaccinia, how art thou degraded!
You intimated something of this sort to me some time since, and now I get it from the fountain head. An institution founded on the principle of inquiry seven or eight years ago, would have been worthy of the British nation; but now, after the whole world bears testimony to the safety and efficacy of the Vaccine Practice, I do think it a most extraordinary proceeding. It is one that must necessarily degrade me, and cannot exalt the framers of it in the eyes of common-sense. I shall now stick closely to my own Institution, which I have the pride and vanity to think is paramount to all others, as its extent and benefits are boundless. Of this I am the real and not the nominal Director. I have conducted the whole concern for no inconsiderable number of years, single-handed, and have spread Vaccination round the globe. This convinces me that simplicity in this, as in all effective machinery, is best.[141]
In the discussion in the House of Commons it was stated by his friend, Lord Henry Petty, that one of the objects of the Establishment would be investigation, and it was absurd for Jenner to pretend that the fact came upon him as a revelation; and, unless completely blinded by conceit, he must have recognised that the general faith in Vaccination exhibited in 1801 had been much shaken by the experience of the succeeding seven years. But it is idle to argue the matter. When Jenner could say that he single-handed had conducted the whole concern for years and spread Vaccination round the globe, he could assert anything. The letter is interesting chiefly as an exhibition of character.
We shall return to the National Vaccine Establishment and its management--a curious story. Suffice it for the present to observe, that its immediate effects were adverse to Vaccination. The annual endowment was consumed in salaries, and many ceased to subscribe to the Cowpox Societies since Vaccination was so well provided for. The essential mischief consisted in the recognition of the evil practice by the State, whereby it has been perpetuated to the common injury to our own day.
THE ORIGINAL VACCINE POCK INSTITUTION.
The national endowment of Vaccination afforded a convenient pretext for closing this Institution, founded by Dr. Pearson and his friends in 1799; but some said the true reason was involved in the following resolutions--
VACCINE POCK INSTITUTION, Broad Street, Golden Square.
GENERAL QUARTERLY COURT, Nov. 5, 1805.
Resolved--That according to the experience of the medical establishment of this Institution, it appears that the Inoculation for the Cowpock affords security against the Smallpox equally with Variolous Inoculation, and that the new practice possesses all the advantages already stated to the public.
Resolved--That, in order to give a further proof to the public, and to afford an inducement for information adverse to the new practice, the following proposal be made public, viz.:--That, in future, every patient who shall be vaccinated at this Institution, on discharge, shall receive a Certificate, stating that such patient has gone through the Cowpock, and engaging that if hereafter the said patient shall take the Smallpox, he or she shall be entitled to the sum of Five Guineas, to be paid from the funds of this Institution at the first General Court, after the proofs have been given, according to the rules of the medical establishment.
WILLIAM SANCHO, Secretary.
The offer attested the sincerity of the conductors of the Institution, but so many patients, it is said, laid claim to Five Guineas that it was not without satisfaction that a reasonable cause was afforded for shutting up.
Dr. Pearson held that it was impossible to be re-vaccinated. He argued that since no one could have Smallpox twice, no one could have the equivalent of Smallpox, namely Cowpox, twice. It was a logical contention; but facts did not correspond to the logic. Pearson also objected to the Variolous Test, or inoculation with Smallpox after inoculation with Cowpox to prove that the constitution was fortified against attack. He preferred Cowpox to Smallpox for the purpose, as milder and less liable to dangerous results. He found that after Cowpox it was impossible to have Cowpox--at least immediately. Hence he was confirmed in his opinion that Cowpox after Cowpox was impossible; just as others argued on the same grounds that Smallpox after Cowpox was impossible. Yet at this day none doubt that Pearson was in error; for all believe in the possibility of re-Vaccination, or Cowpox after Cowpox; likewise of Smallpox after Cowpox.
FOOTNOTES:
[139] Letter to JAMES MOORE, 16th January, 1809.
[140] Baron’s Life of Jenner, vol. ii. p. 124.
[141] Letter to JAMES MOORE, 4th April, 1809. Baron’s Life of Jenner, vol. ii. p. 126.