Jenner, in returning thanks to Dr. Fleming, of Calcutta, for the first remittance of cash in 1806, took occasion to communicate some English news, which is not without interest at this day. He wrote—
To say the truth, this country has been dreadfully supine in the matter of Vaccination hitherto. Some pamphlets, full of the grossest misrepresentations and forgeries, have been spread; and the common people became so terrified, particularly when told that their children, if vaccinated, would take the similitudes of bulls and cows, that a great dislike to the practice has arisen among them; and these accounts have been circulated through the country with peculiar industry. The consequence has been the re-introduction of Variolous Inoculation, which has produced an epidemic Smallpox through the metropolis and the whole island, except in those parts where Vaccination had previously been so generally adopted as to forbid its approach. This, now too late, has opened their eyes, and they see the powers of the Cowpox. The folly of the oppositionists has gone so far as to exhibit prints of children undergoing transformation from the human being into that of the brute.[244]
These prints were, many of them, intended for fun, and could have no serious influence. The decline of faith in vaccination was due to the general discovery that it did not prevent smallpox, and that it did excite other ailments. “It made smallpox milder” was the apology even then coming into vogue. As for the epidemic of smallpox raised in London and the whole island by the neglect of vaccination and a return to variolation, it was a creation of Jenner’s fancy. There was less smallpox in London in 1806 than in 1805; but if there was not more, the bold Jennerian would answer, there ought to have been, and it could only be through the mercy of Providence that there was not.
Throughout the century, the English in India have spared no pains to diffuse and enforce vaccination among the inhabitants, numerous medical men finding place and pay in the futile occupation. Smallpox can only be overcome by systematic sanitation, which is laborious and difficult; and among peoples whose conditions and habits of life freely generate zymotic disease, vaccination is as likely to be effective as any other sort of incantation. Sir Richard Temple states the position at this day in these words—
Smallpox is universally prevalent in India, carrying off tens of thousands of victims, children especially, in almost every province year by year, and impairing or disfiguring others for life. The Government has for many years made persistent efforts to arrest the disease by means of Vaccination, with remarkable success in some districts, like that of Kumaon in the Himalayas, but generally with indifferent success, and often without any perceptible result. The practice of Vaccination not being in vogue, Inoculation used to be largely adopted by the natives in many districts, but has now been prohibited, though not always prevented actually. The State everywhere undertakes or encourages Vaccination. Hundreds of native vaccinators are employed, and returns are rendered of large numbers of persons said to be successfully vaccinated. Nevertheless Smallpox appears again and again with terrible manifestations before the people, and causes them to disbelieve the efficacy of Vaccination.[245]
We now come to Ceylon, in which vaccination was held to have had a perfect triumph. “To Sweden and to Ceylon,” says Baron, “Dr. Jenner was in the habit of pointing when he wished to prove what his discovery might accomplish; or when he lamented that fatal obstinacy of his fellow-creatures which, with such examples before them, could induce them to reject blessings within their reach.”[246] Sweden we shall discuss in another chapter, and of Ceylon I may observe that a portion of the island was taken by the British from the Dutch in 1795, and that in several parts it was extremely unhealthy. Smallpox was a frequent and deadly epidemic, but to what extent there is no evidence save hearsay and estimates from hearsay. The Dutch did not concern themselves with the health of the natives, but when the English took over their settlements in 1800 in the midst of a severe epidemic, they opened hospitals for smallpox and for inoculation with smallpox under the supervision of Dr. Christie.[247] He, hearing the glad tidings of vaccination, resolved to introduce the practice, and having in 1802 received virus from Dr. Scott, of Bombay, he set to work with systematic energy and perseverance. Supported by the authority of successive Governors, he closed the hospitals, forbade variolation, organised a staff of vaccinators, and kept them employed, until the greater part of the population under English influence was vaccinated. In the words of Moore, writing in 1816—
At length the priesthood submitted to Vaccination, the last to adopt this innovation upon their ancient customs; and the remains of the Smallpox were happily extinguished in all that part of the island which belonged to Great Britain.[248]
That smallpox had been exterminated by vaccination in Ceylon was set forth by vaccinators as something indisputable; but there were two observations to make—first, that smallpox was often suppressed in the sense that for a time there was no smallpox in a certain population, and especially subsequent to a severe epidemic; and second, that variolation was suppressed. Granted that smallpox ceased in Ceylon coincidently with the introduction of vaccination, it may be fairly held that the exhaustion induced by the preceding epidemic, and the cessation of variolation, were sufficient to account for the phenomenon. What remains to be said of Ceylon, I shall leave Dr. George Gregory, physician of the London Smallpox and Vaccination Hospital, to say for me. He wrote—
Ceylon was the British colony where the Government earliest interfered and most vigorously encouraged the practice of Vaccination. Salaried vaccinators were scattered over the whole island. So successful were their labours, that up to the beginning of 1819, it had often been said that the experiment of exterminating Smallpox had been made and successfully carried out in Ceylon. In July, 1819, however, a severe epidemic Smallpox broke out there. In 1830 a second epidemic overspread the island—in 1833 a third, and in 1836 a fourth. In these four epidemics, 12,557 persons were attacked, of whom 4,090 died, being at the rate of 33 per cent., or one out of every three.
In each of these epidemics a certain number of vaccinated persons took Smallpox. The proportion of the vaccinated to the unprotected varied. In the third epidemic, out of a total of 460 attacked, 341 represented themselves as vaccinated.[249]