CHAP. I.

We shall best estimate the value of any means of removing an evil, by enquiring, in the first place, into the extent of the effects of the evil which it is our object to remove. And we shall also form the most correct estimate of the value of the means which have been employed for its removal entirely, or in part, by reverting to its extent previous to the employment of such means, and comparing the amount of its former ill consequences, with those which are still produced by it.

To satisfy ourselves on the subject of the present enquiry then, it will be useful to put the following queries:—1st. What were the destructive consequences of Small Pox previous to the introduction of Vaccination? And, 2ndly, What influence has Vaccination exerted over these consequences—1. by extensively superseding the cause—and 2. by essentially interfering with the effect?

To answer the former question satisfactorily, it will be necessary to enter, at some length into the history of Small Pox, before Vaccination was proposed as a means of prevention. But it will be remembered, that previous to that era, a means had been already long in use, for the purpose of diminishing, at least, the danger of this terrific disease; and that for half a century the Small Pox had been communicated to thousands annually by inoculation, with the view of accomplishing this very desirable end. 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.

Although from the vague accounts which earlier European writers have given of the diseases which came under their notice, it is not always easy to distinguish very accurately the precise extent to which Small Pox proved fatal among the nations of Europe, it is yet pretty certain that for a thousand[2]years before inoculation was introduced, it was one of the most destructive scourges of the human race, frequently destroying thousands and tens of thousands, in any district where it occurred. It was at this time frequently included under the general term plague or pestilence, which was applied to every destructive epidemic that took place. It is not necessary, however, for my present purpose to go back to these remote ages; for, independent of the impossibility of obtaining sufficiently authentic information whereon to found any accurate argument, it is not to be doubted that the fatality of Small Pox, in common with that of every other disease, would then be materially greater than in the present day, in consequence of the want of cleanliness and ventilation in our cities and houses, and of good medical treatment. It will not be difficult, however, to produce ample proof of the great mortality occasioned by this disease, at a period when these disadvantages were less felt, and when the nature of it was sufficiently certain. For this purpose I have drawn up tables from the bills of mortality of London, comprising a period of 120 years, viz. from 1703 to 1823, which will form the basis of my arguments.

2.According to Mr. Moore, (History of Small Pox, p. 66-7) the Small Pox was first introduced into Europe during the invasion of Spain by the Saracens, in the commencement of the eighth century: after which, the infection rapidly spread into France and other countries.

Mr. Moore, in his History of Small Pox, (p. 243) tells us that “Dr. Jurin took the lead in replying to the opponents of this practice (inoculation for Small Pox): and being a calm man, well skilled in calculation, his writings were composed with great good sense and good temper. He drew his arguments chiefly from an accurate examination of the London bills of mortality for forty-two years, and from accounts collected from a few large cities: and he compared the numbers who died of the Small Pox with the general mortality. From all which he concluded,

“That of all the children that are born there will, some time or other, die of the Small Pox,one in fourteen.” And “that of persons of all ages, taken ill of the natural Small Pox, there will die of that distemperone in five or six.”

In other countries this disease appears to have been yet more fatal than in England. I shall, however, revert to the documents which I have myself collected on the subject.

The tables, which I have constructed, embrace a period of 20 years before inoculation was at all employed in this country—the whole period during which it was in use—and the time which has elapsed since the introduction of Vaccination. We shall thus be enabled, at a single glance, to compare the mortality of Small Pox under each of these several circumstances. In the first column of the table (No. 1.) is shewn the total number of deaths which occurred within the bills of mortality during each successive year, and in the second column, the number occasioned by Small Pox alone.

The table (No. 2.) is divided into periods of five years each—it consists of four columns—the first of which exhibits the total number of deaths during each period of five years—the second the number of deaths from Small Pox—the third shows the proportion of the latter in each thousand of the former—and the fourth points out the relative proportion of deaths from Small Pox compared with the whole. I am aware that the two latter columns may be considered as a repetition of the same statement, but I think it may appear more striking when placed in this double form.

When we compare the calculation of Dr. Jurin, which has been quoted above, (published I believe about the year 1723,) with the first twenty years of these tables, we shall find, that, with the exception of the first five years, it is rather below than above the results which they exhibit; that, according to them, for the fifteen years from 1708 to 1723 inclusive, the deaths from Small Pox exceeded one in twelve of the whole,—that in 1710 it was about one in seven, and that in 1719, although the relative number was not quite so great, being in the proportion of one in eight only; yet that the actual number was greater than in 1710, amounting to no fewer than 3229, the total number of deaths being 28,347.

Such was the destructive nature of Small Pox before the introduction of inoculation. Its ill effects, however, were not confined to those whom it precipitated into the tomb. A very large proportion of the living, who were fortunate enough to escape its fatal effects, yet suffered essentially for the remainder of their lives from its injurious attacks, not only in the loss of that beauty of countenance which we all value both in ourselves and in our friends, but frequently in the serious injury or total destruction of one or both eyes,[3]or of the general health of the constitution, which was, in many cases, never afterwards entirely restored, although death was not the immediate result.

3.“It appears, by a report of the Hospital for the Indigent Blind, that two-thirds of those who apply for relief, have lost their sight by Small Pox,”—Sir G. Blane on Vaccination, p. 9.

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. There are few of us, however, who are not still acquainted with some, and who cannot recall many more: and we every now and then meet with cases of blindness, which had succeeded to this formidable disease. I have myself had opportunities of seeing several such instances; and it is but a few weeks since my opinion was asked respecting a child, who was recovering from the Small Pox in its worst form, with a countenance dreadfully disfigured, and one eye entirely destroyed.[4]

4.Since this was written, I have been consulted on account of a little girl, of seven years of age, who has just sustained the same very serious deprivation, in consequence of an attack of Small Pox.

That a disease so destructive of human life, and which frequently entailed on the living such indelible proofs of its severity, should have been anticipated with peculiar feelings of dread and apprehension we can well believe, and it was natural that any method, which afforded a probability of diminishing its danger, and of rendering its attacks of a milder character, should excite no ordinary degree of public attention.

How far these ends were accomplished by the artificial communication of Small Pox by inoculation, we shall now proceed to inquire.

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