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instance. They exhibit, on the one side, all the characteristics of cosmic gems; on the other, those of manufactured crystals. They assure us that in the bowels of the earth, in the electric furnace, and on the unknown bodies disintegrated into meteoric dust, similar conditions have prevailed, or do prevail. Everywhere alike, carbon crystallised out from an intensely hot ferric solution under great pressure. The recipe for diamond-making is the same in the Sirian as in the Solar system. The Universe is one, chemically and physically. No minutest particle of matter can deviate from the laws of order imposed upon it; each acts 'according to its kind;' and the kinds' of matter are identical here and at the furthest verge of the Milky Way, and will continue to be identical until the cons of creation come to their appointed end.
ART. III.-1. The Final Report of the Royal Commission on Vaccination. Appendix VI. Dr. Sidney Coupland's Report on the Leicester Epidemic, 1892-3.' Appendix VII.: Dr. Sidney Coupland's 'Report on Gloucester Epidemic, 1895-6.'
2. The Milroy Lectures (1898) on Vaccination: its Natural History and Pathology. By Dr. S. MONCKTON COPEMAN. London: 1899.
3. A Review of the Statement of the Dissentients to the Report of the Royal Commission on Vaccination. By JOHN C. MCVAIL, M.D. London: 1897.
4. Vaccination Vindicated. By JOHN C. McVAIL, M.D. London: 1887.
5. The Story of the Gloucester Epidemic. By FRANCIS T. BOND, M.D. Lond. London: 1897.
6. The Vaccination Act, 1898.
THE Controversy that has been carried on for the last half
century or more, as to the value of vaccination and of vaccination legislation, throws a curious light upon the importance of the study of history. It is one of the functions of history, worthy of its name, to hand down the experience of the past to those living under the altered conditions of a later age. We have to know how people lived and died before our own days if we are to rightly understand the problems of the present. It is impossible, in the case before us, to form a sound judgement about vaccination upon the data supplied by our own experience. The subject must be illuminated by a study of the past, or it will remain dark. It is easy to realise how, to the toiling artisan or factory hand of a northern town, acquainted only with things that have come under his own immediate observation, special legislation with regard to one disease only— and that probably one which he has never seen-may appear superfluous, or even unjustifiable. He has to be taught a certain amount of social history before he can understand the basis on which vaccination legislation rests.
What, then, is the record of history as to the necessity for such legislation? It is unnecessary for our purpose to enter upon this subject from an antiquarian standpoint. It will suffice to recall a few of the undisputed facts from the records of the two centuries immediately preceding the
vaccination era, with possibly an occasional glance at the subject as known in still earlier times.
Till within a year or two of the end of the last century four great plagues were the terror of parents-measles, smallpox, whooping cough, and scarlet fever. Of the four, the last was the least deadly, the least common, and the least infectious. Smallpox was the most common and the most dreaded. It attacked almost every one exposed to the infection; it killed at least one in seven of those attacked, in many epidemics as many as one in three. It was often an illness of the gravest suffering-when it did not kill it left many of its victims blinded, and the large majority of them terribly disfigured. It was rightly described as the 'worst of human maladies.' One thing only can be said to lighten the picture, and that is, that the disease was in a large measure self-protective. The children who struggled through it did not, as a rule, have it again. They were protected by their early sufferings, so that where smallpox returned again and again in a community, the adult population was, to a great extent, immune, most of them having had it in childhood. No doubt there were isolated country districts and out-of-the-way corners where a large proportion of adults had escaped meeting the infection either in childhood or later life. Infection then, as now, depended upon the co-existence of two factors-the contagious poison and the presence in contact with it of unprotected people. Adults who had not gained immunity by going through the disease in childhood were almost sure, if they moved about the world at all, to meet the contagion and to take it in after life. The immense social effect of the adults being in great part immune to a second attack of the disease is seen if we compare the smallpox epidemics in England in the seventeenth and eighteenth centuries with those which have occurred when the disease was taken to new places, where no one had had it previously, and where, therefore, none were immune. Prescott, in his History of Mexico,' describes the ravages of the disease in 1520. He says:
'Maxixca, the old Lord of Tlascala, had fallen a victim to that terrible epidemic, the smallpox, which was now sweeping over the land like fire over the prairies, smiting down prince and peasant, and adding another to the long train of woes that followed the march of the white man. . . . It was imported into the country, it is said, by a negro slave in the fleet of Narvaez. . . . From Cempoalla it spread rapidly over the neighbouring country, and reached the Aztec capital, where Montezuma's successor, Cuitlahuac, fell one of its first victims.
Thence it swept down towards the borders of the Pacific, leaving its path strewn with the dead bodies of the natives, who, in the strong language of a contemporary, perished in heaps, like cattle stricken with the murrain.' Vol. ii. pp. 368-9.
Catlin, in his History of the North American Indians, mentions that, of a population of 12,000,000, 6,000,000 fell victims to smallpox. In another place he says 'each tribe has had this exotic disease in turn, and in a few 'months has lost one-half or more of its numbers.' Such statements as these need not be taken quite literally, the estimates being probably founded upon very imperfect data. That the mortality was frightfully large cannot, however, be doubted. The Icelandic epidemic in 1707 is said, from records furnished by the Government of Denmark, to have killed 18,000 out of 50,000 of the inhabitants-i.e. 36 per cent. In Greenland, in 1734, there was a great epidemic. Sir John Simon says that from 6,000 to 7,000-i.e. nearly two-thirds of the population-were destroyed. In Mexico and in Greenland there is no history of any earlier epidemic; in Iceland there had been none for a number of years, probably not since the epidemic of 1616. There would practically be, therefore, in all three cases, no section of the population protected by a previous attack. How severe a scourge smallpox was towards the end of the seventeenth century is plainly seen in the pages of Evelyn and Pepys. From 1684 to 1695, Evelyn's Diary abounds in references to the disease and to its terrible results:
'December 1684: The small pox very prevalent and mortal. March 7, 1685: My daughter Mary was taken with small pox, and there soon was found no hope of her recovery. A great affliction to me.'
A few days later there is mention of her death:
'Oh dear, sweet child, how shall I part with all this goodness and virtue without the bitterness of sorrow and reluctancy of a tender parent? . . . Never can I say enough, oh dear, my dear Child, whose memory is so precious to me! Thus lived and died . . . the joy of my life.'
She was nineteen years old. Three months later it is noted that
'Mr. Hussey, who made love to my late dear child, died now of the same cruel disease.' On August 27, 1685: 'My daughter Elizabeth died of the small pox soon after her marriage.' April 15, 1686: The Archbishop of York now died of small pox.' December 1694: The small pox increased exceedingly, and was very mortal. The Queen
died of it on the 28th.' January 13, 1695: The deaths by small pox increased to 500 more than in the preceding week.'
This was for London only. Pepys's Diary tells in his less striking way the same sad story.
The history of the deaths caused by smallpox among the royal families of Europe is a further confirmation of its great prevalence and severity. Mention has already been made of the death of Queen Mary, the wife of William III., in her thirty-third year. The King also lost from the same disease both his parents, his uncle the Duke of Gloucester, and two cousins. He had it himself very severely, and recovered with a constitution damaged for life. In Austria it killed Joseph I., and in the eighteenth century two empresses, six other members of the imperial family, an Elector of Saxony, and the last Elector of Bavaria. Also, a Dauphin (1711) and a King (1774) of France; a Queen (1741) of Sweden, and an Emperor (1727) of Russia.
Ben Jonson's epigram is another piece of evidence pointing the same way :
Envious and foule disease, can there not be
One Beautie in an age and free from thee?'
If, leaving these general statements, we try to get a notion of the real amount of mortality in England which was caused by smallpox in the seventeenth and eighteenth centuries, we are met by the fact that no register of births was kept till the present century, and that the only record of deaths up till the year 1838 were the bills of mortality or lists of burials kept for all the parochial burying-grounds. In these the causes of death are given mostly on the authority of the ancient females' or 'searchers,' whose duty it was to convey the information as to the cause of death to the custodian of the ground.
The London bills of mortality were first compiled by order of Thomas Cromwell about 1538, and the systematic keeping of them was begun by the Company of Parish Clerks in 1593. The charter of the Clerks' Company in 1611 directs that each parish clerk shall bring to the 'Clerks' Hall weekly a note of all christenings and burials.' Obviously any estimate of the population arrived at by such methods cannot be at all exact, but Sir John Simon's conclusion in the elaborate and valuable report he wrote in 1857, and presented to the Commission again in 1889, was that from 1660 to 1679 smallpox in London killed 4,170 per million of inhabitants, and that from 1746 to 1755 the rate was about 3,000 per million, To estimate