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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 1797the 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
Smallpox.

I. The natural Smallpox is a loathsome, infectious, painful, and fatal disease. It is confined to no climate, but rages in every quarter of the world, and destroys a tenth part of mankind.

II. Those who survive the ravages of that dreadful distemper, often survive only to be the victims of other maladies, or to drag out a miserable existence worse than death.

III. This cruel and lamentable disorder leaves behind it pits, scars, and other blemishes and bodily deformities which embitter life.

The Inoculated
Smallpox.

I. The inoculated
Smallpox also is loath-
some, infectious, pain-
ful, and sometimes
fatal; and, when par-
tially adopted, spreads
the contagion, and in-
creases the mortality
of the disease.

II. It sometimes occasions the same maladies as the natural Smallpox.

III. It frequently leaves behind it the same blemishes and deformities as the natural Smallpox, which are the more deplorable as they are brought on by a voluntary act.

The Inoculated
Cowpock.

I. The inoculated Cowpock scarcely deserves the name of a disease. It is not infectious; and, in the opinion of the most experienced practitioners has never proved fatal.

II. It occasions no other disease. On the contrary, it has often been known to improve health, and to remedy those diseases under which the patient before laboured.

III. It leaves behind no blemish, but a Blessing--one of the greatest ever bestowed on man-a perfect security against the future infection of the Smallрох.

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 deathrate 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 factitiousfrom 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

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