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the loss of one. For it is singular that in those days all inoculations performed by private gentlemen, monks, and old women, were uniformly successful; and empirics afterwards were equally fortunate: none lost patients from inoculation except the regular members of the faculty. The American reports were so encouraging, that about the year 1740, the practice was revived by a few surgeons in Portsmouth, Chichester, Guilford, Petersfield, and Winchester; and gradually extended in the southern counties.'
Mead, too, took up his eloquent pen in the cause; and Mr. Moore tells us that his attributing the beauty of the Circassian women to the custom of inoculation which had obtained amongst them, had very considerable weight with the British ladies. The practice now very sensibly advanced among the higher circles, and for the accommodation of those in the lower walks of life, the Smallpox Hospital was erected in the year 1746. In 1754 the London College of Physicians gave their powerful sanction to the practice, by publishing a tract in its favour, and the press now groaned with works on inoculation, and with various plans of treatment.' These complicated modes of management, medicinal and otherwise, served, however, to bring the practice into discredit, which did not therefore become very generally diffused until its simplification and consequent improvement by a very conspicuous character in the Annals of Medicine.
'Daniel Sutton, (says Mr. Moore,) with his secret nostrums, propagated inoculation more in half a dozen years, than both the faculties of medicine and surgery, with the aid of the church, and the example of the court had been able to do in half a century. This man was the son of Robert Sutton, a surgeon at Debenham in Suffolk, and he and his brother assisted their father in his business. But after a time both sons left their father's house, and Daniel was content to serve as an assistant to a surgeon at Oxford. In the year 1763, he rejoined his father, and proposed to make some alterations in his plan of inoculation. These were condemned by the father as highly dangerous, yet Daniel was so confident as to make the experiment, and he found it successful. On this the father and son quarrelled, and the latter set off for Ingatestone, in Essex, where he set up as an empirical inoculator. He pretended to have discovered an infallible secret, and brought himself into public notice by the old and still successful trick of puffing hand-bills and boasting advertisements. Yet, in truth, his pretensions, though extravagant, were not without foundation; and in a short time such multitudes crowded to Ingatestone to be inoculated, that the town and neighbouring villages were filled with patients. It is much to be regretted, (adds our author,) that Sutton should have stooped to employ such unworthy devices; for his plan of treatment was greatly superior to that of any former practitioner; and had he followed the correct rules of open professional conduct, his name would have been recorded with honourable distinction. It appears, however, by the
analyses of his medicine and his own confession in his old age, that Daniel Sutton, in strictness, invented nothing, but judiciously combined remedies which had been found out independently by others. Sydenham had discovered the utility of exposing small-pox patients to the cool air, and of allowing them to drink cold water, but he did not venture to deviate so much from ordinary rules as to prescribe purgatives. Subsequent physicians had ascertained that great benefit arose from opening medicines, and particularly from mercurial purges; but in conformity to old theories, they at the same time confined their patients to bed, covered them warmly, and promoted perspiration. But Sutton had the sagacity to extract what was beneficial in both these plans, and to reject what was injurious. Almost every modern essay now recommended purgatives, and our reformer only made choice of the prescription which was most in vogue.'
We have introduced these remarks on Sutton's plans of treatment, merely in conformity with our wish to give as satisfactory an explanation as possible of the eventual success of inoculation; which now spread rapidly through almost the whole of Europe, with the exception of Spain. That country, as our author states, in the present case, profited by its sluggish indisposition to adopt the improvement of neighbouring nations; for after some partial and feeble attempts to introduce the practice, the endeavour was relinquished; and it is a notorious fact, and highly worthy of remark, that Spain has suffered incomparably less from small-pox than any other European state: the reason is sufficiently obvious; and the fact furnishes an equally obvious objection, as above hinted, against the practice of artificially disseminating a distemper so infectious, and so fatal. It is indeed beyond dispute that even the mortality from small-pox increased with the progress of inoculation, from the impossibility of prevailing upon the whole population to adopt medical counsel; and of two estimates by two accredited physicians made of deaths from small-pox during the last thirty years of the preceding century, and laid before a committee of the House of Commons, 'the one stated the average numbers at 34,260, adding that he believed those deaths to be under the truth: the other physician made them amount to 36,000.'
'But this immense and increasing consumption of human lives, was not the sole evil produced by this distemper; for a considerable portion of the survivors were pitted and disfigured; some lost one of their eyes, a few became totally blind, and others had their constitution impaired, and predisposed to a variety of complaints, which were productive of future distress, and sometimes of death.'
In this state, then, did things stand in reference to small-pox, natural and acquired, when the newly suggested substitute presented its claims to the consideration of mankind; and the momentous business now devolves on us of investigating the legitimacy of
these claims, or of ascertaining the grounds upon which such high pretensions are preferred.
Dr. Jenner (whose name requires no formal introduction) was originally employed in general practice in a district in Gloucestershire. It was in the year 1768 that he first heard the report of those sores which infested the teats of cows, and which infected the chapped hands of the milkers, being sometimes a preventive of small-pox; and, in connexion with this report, it struck him as a remarkable fact, which came under his own cognizance, that many of the peasants whom he endeavoured to inoculate resisted the infection. Although these circumstances made at the time some impression on his mind, he did not systematically prosecute the investigation to which they ultimately led until after his return from London to establish himself at Berkeley. Then it was that he commenced the inquiry in earnest; and in the relation which he has given of the progress of his labours in this very extraordinary pursuit, he informs us,
That the disease (the cow-pox) had been known in the dairies from time immemorial, and a vague opinion prevailed that it was a preventive of small-pox. This opinion I found was comparatively new; for all the old farmers declared they had no such ideas in their early days, a circumstance which seemed easily accounted for, from my knowing the common people were very rarely inoculated for the small-pox, till that practice was become general, by the improved method introduced by the Suttons; so that working people in the dairies were very seldom put to the test of the preventive power of the cow-pox.'
As Dr. Jenner proceeded with his inquiries, he found that several persons contracted the small-pox after they had been subjected to the disease from the cow; and moreover that the medical practitioners in the neighbourhood all agreed in declaring, from experience, that the cow-pox was only an occasional, and a very uncertain preventive of small-pox.' These discoveries were certainly of a disheartening nature; but, although they might damp the ardour of hope, they did not cause the abandonment of the pursuit. On further investigation he ascertained that the cow had occasionally several varieties of eruptions on her teat, all of which were indiscriminately named cow-pox when productive of sores on the hands of the milkers; and it occurred to him as very probable that only one species of these eruptions possessed the preventive power; and that this was the true explanation of the observed irregularity in point of effect. One obstacle thus appeared to be done away; but lo! another now presented itself, which by most persons would have been considered insuperable; to his great mortification, Jenner found several examples of milkers who were seized with the small-pox, after having contracted sores on their hands from
the genuine cow-pox.' In spite even of this, our indefatigable investigator pursued his researches; and as it seemed to him inconsistent with the general uniformity of the laws of nature that this difference of susceptibility should so widely obtain, it occurred to him that the specific influence of the poison might not improbably vary with the progressive changes it underwent, after having been first secreted from the ulcerated surfaces of the cow's teat; and,
after much investigation, he at length ascertained, that the milkers, who acquired the cow-pox from vesicles on the teats of the cows, while advancing to maturity, were secured from the small-pox; while those contaminated by cows, in an advanced period of the disease, remained susceptible of the small-pox. In fine, from a multitude of cases he was enabled to draw these conclusions, that the property of preventing the small-pox appertained only to one of those diseases which were vulgarly denominated the cow-pox; and that this power principally resided in the liquid secreted during the early stages of that disease.'*
With these exceptions then of a spurious matter in the one case, and of a matter taken at a wrong time in the other, Jenner conceived that he had made out the fact of cow-pox being a preventive of small-pox for life; for he exposed in various ways individuals, who had been the subjects of the former, to the latter infection, (after the lapse of fifteen, twenty-seven, and even fifty years,) and found that they resisted its influence.
Thus a clear way was opened for the important application of this singular discovery. May not this preventive be propagated from man to man, and thus supersede the small-pox virus? was the idea that suggested itself to the mind of the discoverer, a suggestion, which it is needless to say has been extensively acted on, and which has given rise to one of the most important problems ever proposed, viz. Is vaccination an actual, a permanent, a safe, and unobjectionable security against small-pox infection?
For a moment we will suppose its preventive efficacy to be admitted, in order to advert to a separate charge which has been adduced against its employment,-for the vaccine virus has been said to be a means of engendering foul humours, to lay the foundation
* Not with a desire to prejudice the case, but merely for the purpose of pointing out that analogy subsisting between the variolous and vaccine secretions, which is contended for by some writers, we subjoin the following extract from Mr. Moore, as a continuation of and comment upon the above quotation:
'Jenner,' says Mr. Moore, perceived that these opinions corresponded with remarks that had been made on the small-pox, as the liquid most active for variolous inoculation is that which is first secreted; but the thick matter of pustules which have crusted, though it may excite local inflammation and suppuration, yet frequently fails of producing the real small-pox.'
of several chronic diseases, and to be therefore in the highest degree objectionable. This charge can only be substantiated by an appeal to facts; what then do these testify? Have chronic cutaneous eruptions (the disorders alleged to be the consequences of vaccination) recently been on the increase? All medical records and reports, presented to the world for the last twenty years, agree in the diminution rather than the augmentation, both of the number and severity of the complaints in question; and what may be considered as decisively to the point, is the following statement from a respectable surgeon to the Infirmary at Gloucester:
A more healthy description,' says this gentleman, of human beings does not exist, nor one more free from chronic cutaneous impurities, than that which suffers most from cow-pox, by reason of their being employed in dairies; and the Gloucester Infirmary, one of the largest provincial hospitals, is situated in a county in which accidental cow-pox has been prevalent from time immemorial; many hundreds among the labouring people have had the cow-pox since the establishment of that institution, and that more severely than is generally the case in artificial vaccination, and yet not a single patient has applied to the Infirmary in half a century for the relief of any disease, local or constitutional, which he or she imputed, or pretended to trace to the cow-pox and let it be repeated and remembered, that the artificial in no respect differs from the natural, except in being generally less virulent.'
This document, backed by the concurrent testimony of impartial and unprejudiced records from medical observers, that scrophulous and cutaneous affections are (as we have said) upon the decline, will, it is presumed, serve as a sufficient refutation of those partial and garbled statements which in the early stages of the controversy were made for the purpose of confirming the apprehensions of the timid, and giving strength to ungrounded prejudices. The question therefore of vaccine efficacy remains unincumbered by minor considerations, and it is now for us finally to observe upon the evidence by which the following proposition has been maintained, viz. that the vaccinated and the inoculated child stand upon precisely the same footing in respect of security against small-pox.
In spite of our professions of impartiality, we suspect that our readers have by this time set us down as determined defenders of the vaccine cause. We shall probably, therefore, excite some surprise by expressing it as our opinion, that the absolute truth of the above proposition does not appear to us to have been hitherto fairly established. It does, we confess, seem probable that there may be a shade of difference in the preventive efficacy of the vaccine and variolous virus; even this, however,