T. M. Greenhow

“ If then, the first promoters of Vaccination were led, from their ardour in a cause of such vital interest to the whole human race, and before time had been allowed to afford sufficient data whereon to found a more correct opinion, to conclude that Vaccination would, in every instance, prove an absolute and infallible preventive of future susceptibility of Small Pox infection, let us not, on that account, run into an error incalculably more dangerous in its tendency, and underrate or deny altogether the degree of security which it actually affords. ”

“ Could every child have been subjected to the process of inoculation, before any exposure to the infection of natural Small Pox had taken place, the case would have been widely different: but it can scarcely be considered either just or politic to render one individual secure at the risk of endangering many, or with a certainty of destroying some. It may fairly be concluded, then, that inoculation for Small Pox, as practised for the last fifty years of the eighteenth century, although certainly a great individual good, was, in reality, without a doubt, a most serious general evil. ”

“ And it can scarcely excite surprise, that something like this should have been the case with incomparably the most important discovery of modern times, for such we may truly esteem Vaccination, whether we consider it as a means of preserving life, or of obviating effects, perhaps, even more deplorable than the loss of life itself. ”

“ He will feel that his own personal exertions, in promoting the general use of Vaccination in his own family, amongst his dependents and all those whom he can in any the slightest degree influence, are essential to the accomplishment of the great philanthropic end proposed—the total extinction of Small Pox: a consummation that would prevent a larger portion of human misery, and preserve a larger number of human lives, than any other which it is in the power of imagination to conceive, or of reason to contemplate. ”

“ But it is demonstrable, that if at the first moment of this singular discovery, at any moment since, at the present or any future moment, mankind were sufficiently wise and decided to vaccinate the whole of the human species, who have not yet gone through the Small Pox, from that moment would this most loathsome and afflicting of all the scourges of humanity, be instantaneously and for ever banished from the earth. ”

“ Taken altogether, it is remarkable how nearly they resembled those which have been opposed to the introduction of Vaccination. Now, that distance of time has enabled us to view the facts of the case with coolness, and to reason upon them without prejudice, while we admit the individual security which arose from the practice of inoculation, we must in candour confess its tendency to encrease the general destruction of life from Small Pox, by forming so many new sources of infection. ”

“ But however remarkable and satisfactory this immense saving of human life, in the country where Vaccination originated, may appear, as an unanswerable evidence of its efficacy, the result has been still more decisive in many foreign countries, where it has been much more generally employed. In proof of this, I shall again quote the very valuable little work of Sir Gilbert Blane, (which, by the way, I should strongly recommend to the attention of the public, as containing much valuable matter and sound argument within a very small compass) . ”

“ Jurin expressed his opinion that this ought not be imputed to inoculation, as the numbers who had been inoculated did not exceed sixty. This was a very inadequate answer. A single person may bring the plague into a town or into a nation, and be the cause of the destruction of an innumerable multitude. The Small Pox is fully as infectious a disease as the plague; and sixty inoculations were more than sufficient to account for the augmented mortality, and were probably the cause of it. ”

“ Jenner put this fact to the test of repeated experiment, and finding it thus confirmed, proposed introducing the Cow Pox into the human constitution artificially, as a means of securing it against the dangers of Small Pox, and, in the end, of entirely exterminating the latter disease; for it must appear very evident, that if every individual could in any way be rendered incapable of being infected by Small Pox, the infection itself must necessarily become entirely extinct. ”

“ There are few of the rich, who have not the power of influencing some of the poor, nor do I believe there are any of the latter who may not be influenced by some one or other of the former. Whether this influence may be exerted through interest, through persuasion, or through the conviction of reason, is a matter of less moment than the attainment of the end in view—namely, to induce all, without exception, to have their children vaccinated during infancy—and were it employed in its fullest extent, this end might certainly be accomplished. ”

“ Moreover, we have the most undoubted proofs from experience, that where Vaccination has been performed perfectly, Small Pox, occurring after it, is almost universally a safe disease; and though ushered in by severe symptoms, has hardly ever failed to be cut short before it had reached that period at which it becomes dangerous to life. ”

“ That Vaccination is a process perfectly unattended with danger to the individual who passes through it, and incapable of communicating any noxious infection to those around him, are facts too well known and too generally admitted, to require more than a passing notice ”

“ INTRODUCTION. What reliance may safely be placed on Vaccination as a means of exemption from Small Pox?
It may be affirmed, without hazard of contradiction, that no question connected with the physical well being of mankind involves considerations of more serious interest, or consequences of more vital moment, than that which has just been proposed. During the last quarter of a century, it has engaged a degree of attention, both from medical practitioners and from society in general, proportionate to the great importance of the subject ”

“ How uncertain the data!”—It is, however, enough to know, that while the relative number is sufficiently great to prevent the rule, That no individual can be affected by Small Pox oftener than once,—from being considered absolute, it is yet too small reasonably to shake our confidence in the fact, that a very large proportion will escape a recurrence of that disease. ”

“ Instances, wherein the beauty of the human countenance has been materially injured by the occurrence of Small Pox in the early stages of life, are now happily much more rare than formerly, especially in the higher ranks of society, and I trust will, in the course of another age, become entirely unknown. ”

“ If he hesitate to confer on his children the advantages, which Vaccination has been proved to be capable of bestowing, let him remember, that it has already been the means of preserving nearly four hundred thousand of his countrymen, and that, perhaps, he owes his own existence at this day, to its salutary influence ”

“ It is, I think, from this sufficiently evident, that nothing but the preconceived opinions of the physicians consulted in these cases could have prevented their acknowledging the true nature of the disease; and there cannot, I conceive, be a doubt, that it was no other than Small Pox rendered milder in its character by the previous occurrence of it in these children. It is of importance too to remember that they afford examples of the recurrence of the disease after both natural and inoculated Small Pox. ”

“ When artificially produced by inoculation, the Small Pox is rendered materially milder in its character, so that one in two hundred only of those to whom the disease has been thus communicated, have been found to die in consequence. ”

“ The question involves consequences so closely connected with the well-being of individuals and of society in general, and the actual existence of so many thousands annually, that ignorance, or doubt, will scarcely form an admissible apology for the omission of what is alike essential for private and for public security. ”

“ It very generally happens, when a discovery is made which promises to exert any considerable influence over the happiness of man, that its capabilities cannot for some time be very accurately defined; and that the effects, which a few years’ experience shall prove it to possess the power of producing, will, at the commencement, be either undervalued or overrated. ”

“ The principal arguments, on which the employment of inoculation for Small Pox was supported, appear to have been the following:—
1. The infectious nature of the disease, which was so virulent as to permit few individuals to pass through life without being at one time or other affected by it.
2. Its fatality—destroying at least one in five or six of those attacked by it.
3. The generally received opinion that no individual could be affected by it oftener than once. ”

“ From what has been hitherto stated, I conceive, we are authorised in assuming the following as facts, which will furnish a satisfactory answer to the first of the questions proposed, What were the destructive consequences of Small Pox previous to the introduction of Vaccination?
1. Small Pox is a disease of so infectious a nature, that few individuals passed through life without suffering from an attack of it. ”

“ We may, therefore conclude, that while the number of deaths from Small Pox, within the bills of mortality, was increased in the proportion exhibited in the tables by means of inoculation, in the country the increased mortality from this cause was in a much greater ratio. ”

“ After having been once affected by Small Pox, a very considerable proportion of individuals resist entirely a second attack: but still in very many instances a recurrence of the disease is proved to have taken place.
5. Secondary Small Pox is, for the most part, very mild in its symptoms, and of shorter duration than a first attack, insomuch as to have frequently given rise to doubts respecting the real nature of the disease. ”

“ In this situation, there is much less intercourse of persons with each other than in towns, so that not only many individuals escaped, from their not being exposed to infection during their whole lives, but whole districts were known to have been exempt from it for a long series of years before it was universally diffused by inoculation. ”

“ Had the number of these cases, and the respectability of the individuals by whom they are related, been duly considered, they surely were more than sufficient to have satisfied the minds of the most incredulous, of the possibility, and even of the frequency of secondary Small Pox.” De Haen, however, was an opposer of inoculation, and the facts he adduced were not permitted to have the weight which they merited, in consequence of the arguments he deduced from them. ”

“ Thomson goes on to say, that “M. Gaulard, Physician in ordinary to the King, was called to see the son of Delatour on the third day of the eruption, which he declared to be a mild case of Small Pox, of the kind commonly called, he says, though improperly so, Chicken Pox, and the disease in the boy’s companions he considered of the same nature.”—Four physicians were called in to consult with Mons. ”

“ Cross, in his History of the Epidemic Small Pox, which at that time prevailed in the city of Norwich and the county of Norfolk. Mr. Cross mentions many instances of the disease being introduced into parishes, in which it did not before exist, by means of inoculation, the contagion afterwards spreading in all directions; and affirms (p. 272) , that “thirty-eight surgeons, who from various motives, practised it, lost among those to whom they had thus given the disease, twenty-one patients ”

“ This will naturally give rise to a second division of the history of Small Pox. Our first enquiries will therefore be directed to the time antecedent to the use of inoculation for Small Pox, when no artificial measures were adopted for protecting mankind from its fatal attacks. ”

“ Thomson’s experience of the epidemic at Edinburgh.
Mr. Cross relates that two deaths only took place after Vaccination, and justly observes, that “these can have no weight against the practice of Vaccination compared with 10,000 vaccinated individuals, living in the midst of a contaminated atmosphere; with 530 deaths among little more than 3000 who had neglected to be vaccinated; and with the occasional occurrence of regular Small Pox in those who formerly had the disease.” Of the 10,000 persons thus protected by Vaccination, the Reviewer of Mr. ”