An objection to the practice of Inoculation considered.
From the time that Inoculation was introduced into this country one may date the opposition to its practice; many learned and ingenious men soon entered the field against it, and were encountered by others of equal abilities in its defence. The questions were warmly agitated, and in a short time foreigners of great name became authors on both sides. But the strength of argument on the part of the defenders of Inoculation, supported by the good success of the practice, hath almost silenced opposition; and the concurrence of the courts of Petersburg, Vienna, and France, who have submitted to the operation, and by their illustrious examples encouraged its progress in their dominions, will probably close the dispute in its favour.
One objection alone seems not to have been satisfactorily removed, which, although it does not relate to the safety or health of the patient, is yet of great importance to the community, and well deserves the most attentive consideration.
You have, say the objectors, produced accurate and satisfactory accounts and calculations of the alarming proportion of deaths that happen from the natural Small Pox, and also proved, that the loss sustained under Inoculation is inconsiderable. But admitting what you have advanced to be true, whence comes it that the same Bills of Mortality to which you appeal, prove also a certain increase instead of a diminution of deaths from the Small Pox, and that for such a series of years as to leave no room to dispute the fact? does it not naturally follow, that though almost the whole number of the inoculated recover, the disease must have been spread by their means, and a greater proportion having taken the natural disease, a consequent greater loss has been sustained by the public? If the above is admitted, it will be difficult to exculpate Inoculation from having been hurtful to society[[2]].
[2]. Extract from the Bills of Mortality, and a continuation of the estimate from page 19.
| Total of Deaths. | Small Pox. | Under 2 Years. | ||||
|---|---|---|---|---|---|---|
| 1768 | 23639 | 3028 | 8229 | Total Deaths | 178807 | |
| 69 | 21847 | 1968 | 8016 | Under 2 Years | 63056 | |
| 70 | 22434 | 1986 | 7994 | ────── | ||
| 71 | 21780 | 1660 | 7617 | 18821) | 115751 | (6 |
| 72 | 26053 | 3992 | 9112 | 2825 | ||
| 73 | 21656 | 1039 | 6850 | |||
| 74 | 20884 | 2479 | 7742 | |||
| 75 | 20514 | 2669 | 7496 | |||
| 178807 | 18821 | 63056 | Totals. |
By the above table it will be found, that with respect to the proportion of infants to the total number of deaths, there is still a surprising agreement with both the former estimates; the number of those under two years of age remains to be somewhat more than one-third of the whole.
But if we pursue the same method as before by subtracting the infants,
| 178807 | |
| 63056 | |
| ────── | |
| the number will be | 115751 |
| ══════ |
which now amounts to somewhat more than one in six; whereas before it was about one in eight.
But if the eight years are divided, it will appear that the deaths from the Small Pox in the first four years are 8642; the medium for each of those years will be 2160.
For the last four years the numbers are 10179, the medium for each 2544; an increase that is truly alarming, and well deserving the attention of the public.—For the present I shall forbear any remarks.
Several attempts have been made to obviate this objection, many of which I have perused; but consistent with my intention of brevity, and avoiding all controversy, I shall decline entering into particulars, or inserting any quotations from authors. It will be sufficient to say, that although the arguments advanced have been ingenious, and in some respects just, they do not in my apprehension remove the objection that has been mentioned.
Let us see then whether the practice may not be fairly chargeable with some blame; and this will appear more evidently, if we take a view of the usual conduct of families on such occasions; which however pertinent to the question, seems hitherto to have been avoided, or not attended to, by the several writers on the subject.
In London it has been the general custom for those who intend to inoculate, to take into account all the circumstances that may be material for the conveniency of their families and friends, and these being settled to their minds, few precautions are thought necessary respecting the security of others: what passes previous to the eruptive fever, does not claim our consideration, since it is universally allowed that no infection can be communicated before that time; but it is after this period the danger begins, and the disease may be spread by the intercourse of visitants, trades people, washerwomen, servants, and others, and in a mild state of the disease, the frequent excursions of the sick by way of airings, and often in hired carriages of various kinds, contribute greatly towards spreading the infection. It would perhaps be deemed a designed omission, if the inoculators were not also supposed to be of the number of those that contribute to spread the disease.
When all these circumstances are duly considered, surely it will be allowed, that the Small Pox is frequently caught from the inoculated; and let it be remembered, that whoever takes the disease from an inoculated patient, has himself the natural Small Pox, with all the circumstances of danger in respect to his own life, and of spreading the contagion to others.
I know it has been said, and even publicly declared, that the Small Pox from Inoculation is so mild, as scarcely to be infectious to others; but if this was true, how comes it that matter, taken from inoculated patients, conveys the distemper with equal certainty, as if it was taken from the natural Small Pox? is it not morally certain, that the effluvia partake of the same infectious quality? No physician of any experience, I am sure, will ever countenance such an opinion. But lest it should prevail, and do mischief among the ignorant and credulous, I think it incumbent on me to contradict so dangerous and unwarrantable an assertion.
In fact, it is certain that the Small Pox is infectious, in proportion to the number and malignity of the pustules; so far there is usually less danger from the artificial disease, than from the natural. But let not this presumption make any one remit their care, or abate their concern for the community; for I can assert from my own knowledge, that[[3]] many fatal instances have happened from the disease having been spread by the inoculated.
[3]. Vide note page 9.
Having considered the subject as fully as I am able, it shall be left to the consideration of the public without any comment; only entreating every family that may inoculate, to be extremely careful, and use every possible precaution to prevent spreading the infection during the illness, and to be also particularly attentive, that all furniture and cloaths be well aired. The persons concerned in inoculating should, on their parts, take great care that they do not contribute to the mischief.
If strict attention is paid to these particulars, it may be reasonably hoped, that the only remaining objection to the practice of Inoculation in London among persons of condition, may be much weakened, if not entirely removed.