mind with King George in that respect; and Jefferson not only approved of the practice in common with Queen Charlotte, but, as soon as he could obtain virus, set to work with his sons-in-law, and vaccinated their families and neighbours to the number of two hundred. There is a letter from Jefferson to Jenner in 1806, which is remarkable as an absolute confession of faith at a date when much had occurred to shake faith. The President wrote

MONTICELLO, VIRGINIA, 14th May, 1806. SIR, I have received the copy of the evidence at large respecting the discovery of the Vaccine Inoculation, which you have been pleased to send me, and for which I return you my thanks. Having been among the early converts in this part of the globe to its efficacy, I took an early part in recommending it to my countrymen. I avail myself of this occasion to render to you my portion of the tribute of gratitude due to you from the whole human family. Medicine has never before produced any single improvement of such utility. Harvey's discovery of the circulation of the blood was a beautiful addition to our knowledge of the animal economy; but on a review of the practice of medicine before and since that epoch, I do not see any great amelioration which has been derived from that discovery. You have erased from the calendar of human afflictions one of its greatest. Yours is the comfortable reflection that mankind can never forget that you have lived. Future nations will know by history only that the loathsome Smallpox has existed, and by you has been extirpated. Accept the most fervent wishes for your health and happiness, and assurances of the greatest respect and consideration.

TH. JEFFERSON.

That smallpox should be erased from the calendar of human afflictions, and be known only in history as extirpated by Jenner, were vain expectations; but to recognise their vanity did not lie within Jefferson's possibilities. He had been bred in the belief that inoculation with smallpox prevented smallpox, and it came forth as a corollary, that as cowpox was an equivalent for smallpox, if all were cowpoxed, the disease must be extirpated. His expectations, therefore, were not without plausibility. Nor was it possible for Jefferson in the light of his time to see that smallpox was no specific entity that could be got rid of per se whilst all else remained unaffected. We

know that if even vaccination made an end of smallpox, and did no harm of itself, we should reduce neither illness nor mortality (supposing no other change in the conditions of existence were effected), but should have our due allotment of disease in other forms. To attack smallpox as smallpox, and suppose that if suppressed we should be in anywise advantaged, is mere illusion. Zymotic diseases, to be dealt with effectually, must be dealt with as forms of a common malady; to get rid of one, we must get rid of all; and with a graver sense of the difficulties to be encountered we, too, believe with Jefferson, that smallpox may be extirpated, but in company with much else, and by practice that has no affinity with the creation of disease implied in vaccination.

Of all people the English are most abandoned to medical quackery, said Lady Mary Wortley Montagu; and the English characteristic was reproduced and exaggerated in New England. The first resistance to vaccination being overcome, there was a run upon the practice

The zeal of American medical men [says Baron] was excited to an unparalleled degree; but, unfortunately, their discretion did not keep pace with it. They disregarded the cautions of Dr. Waterhouse, and paid no attention either to the state of the matter with which they inoculated, or to the progress of the pustule. It appears, likewise, that the cupidity of persons not of the medical profession was stimulated, and the manner in which they carried on their traffic was alike indicative of their avarice and their ignorance. The followers of this trade obtained the shirt-sleeves of patients which had been stiffened by the purulent discharge from an ulcer consequent on Vaccination. These they cut into strips, and sold about the country as impregnated with the true Vaccine Virus. Several hundred persons were actually inoculated with the poison, which, in several cases, produced great disturbance in the constitution. A vessel arrived from London at Marblehead with a sailor on board, who was supposed to have Cowpox: matter was taken from him, and was used extensively. It was soon discovered that Smallpox matter had been employed, and that disease spread rapidly through the neighbourhood. These blunders, it is to be feared, were not confined to vagrant quacks, inasmuch as medical men were not quite blameless.*

* Baron's Life of Jenner, vol. i. p. 387.

Whilst such doings discredited vaccination in one way, they served it in another: they made it easy to conceal its failures and injuries by ascribing them to the use of spurious virus. Everything is to be gained for truth in the question of vaccination by taking it in what its believers allow to be its unexceptionable form, so as to leave no room for evasion. Smallpox in America as in England soon showed itself indifferent to the art of the vaccinator, and then it was settled that at least it made the disease milder; and under cover of the convenient fiction, it continued to be practised where fees were to be had for the performance.

The attitude of the medical mind to epidemics, and the ignorance of what we now regard as the first elements of sanitary science, are illustrated with touching sincerity in a letter addressed by Dr. Waterhouse, in 1817, to the surgeons of the United States army. Said the Jenner of the New World

You need not waste your time, or distract your attention by guessing at the remote causes of dysenteries or epidemic fevers. We learn from the highest authority, that the pestilence "walketh in darkness." The enemy approaches unseen. We are pretty well convinced that epidemic fevers depend not on any of those changes in the air that are pointed out by the thermometer, barometer, or hygrometer. These wide-spreading maladies, as well as endemics, or local disorders, seem as if they arose from some secret movements, or alterations in the earth, or on its surface-that is, on some new combinations in the soil, or some effluvium from a deeper situation, affecting not only the air we breathe, but the water which we use for everything. Epidemics seem to accompany or follow a blighted state of vegetation. They seem also to accompany an abundant harvest; but whether in the series of cause and effect is not fully known. As to myself, I'm weary of conjecture.

Well might he be weary! He does not say so, but neither does he make any reserve in favour of vaccination; and, after seventeen years' trial of it, the old physician must have included it in his cry of Vanitas Vanitatum!

CHAPTER XXIX.

INTRODUCTION OF VACCINATION TO INDIA AND THE EAST.

THE enthusiasm for cowpox in England was reproduced with fury among the English in India. It is always so. What is the fashion at home is an intenser fashion abroad.

When we say India, we speak as of a country when we are dealing with a continent-of not one but many peoples, of races numerous and tongues various: wherefore, in naming India, I would be understood as limiting my remarks to the portion designated, and to the population affected by English influence. In several parts of India smallpox is endemic-begotten in permanently unwholesome conditions of life, and cultivated and propagated by inoculation. When, therefore, it was heard that cowpox might be substituted for smallpox, and that the mild served every purpose of the severe disease, there arose a demand among the English for the virus, alike for their own and for native use. Dr. Underwood, writing to Jenner from Madras, 28th Feb., 1801, observed—

I have read with very great pleasure your publications on Cowpox, and feel particularly anxious to introduce and extend it in this country, under the greatest confidence that it would save many lives. I have hitherto embraced every opportunity of inoculating with variolous matter, but the loss of a beautiful little patient has humbled me, and I confess I never now take up a lancet but with fear and trembling.*

It was easier to ask than to obtain. There was no cowpox to be heard of in India, and the long voyage round the Cape, and the tropical heat were fatal to its transmission. Repeated attempts were made, but all ended in failure. Jenner proposed to place a number of picked men on board an East Indiaman, and to have them successively vaccinated in the course of the voyage, so as to land with fresh virus in Bombay or Calcutta ;

* Baron's Life of Jenner, vol. i. p. 410.

but the East India Company declined the proposal. An attempt was then made to raise a subscription for the purpose, Jenner putting his name down for 1,000 guineas; though it was difficult to imagine where the 1,000 guineas were to come from, unless out of the pockets of some of his admirers.*

These efforts were, however, superseded by the energy and ingenuity of Dr. De Carro, of Vienna. Lord Elgin, British ambassador to the Porte, had made acquaintance with De Carro, and had received virus from him with which his infant son and others were vaccinated at Constantinople. The news spreading abroad, Lord Elgin was entreated to meet the Indian demand, sending the vaccine overland to Bombay by way of Bagdad and Bussora. He made several futile attempts, and thereon determined. to place the matter in the hands of De Carro; and for that purpose addressed himself to the Hon. Arthur Paget, British ambassador at Vienna, saying—

I have so many applications for Vaccine Virus from Bussora, the East Indies, and Ceylon, that I beg you will immediately apply to Dr. De Carro, and request him to send some by every courier. †

De Carro accepted the commission with alacrity. He had already had an application from Bagdad, and, dismissing the vehicles which had been tried and failed, such as lancets of steel, silver, gold, and ivory, and threads enclosed in quills, he saturated lint with virus, and, placing it between glasses, in one of which was a cavity for its reception, tied them together, sealed the edges, and, taking them to a wax chandler, had them dipped until enclosed in a ball of wax, which was packed in a box stuffed with shreds of paper. In this manner virus was conveyed through Constantinople, across the deserts to Bagdad, where it was received on 31st March, 1802, still liquid, and was used "with complete success." The like success was reported from Bussora, Muscat, and Bushire. From Bussora virus was conveyed to Bombay, arriving,

*Baron's Life of Jenner, vol. i. p. 409. +Ibid. vol. i. p. 419.