[CHAPTER XXXII.]
NEWCASTLE SMALLPOX: A COMMON STORY.
To examine the statistics of the larger English towns in order to determine whether vaccination has had any influence on the abatement of smallpox, would involve us in discussion interminable. For our immediate purpose it may suffice to select three examples; 1st, Newcastle-on-Tyne, as an instance of a common story; 2nd, Norwich, as an instance of a smallpox epidemic; and 3rd, Glasgow, as an instance of smallpox displaced and replaced as a factor of mortality.
THE NEWCASTLE DISPENSARY.
We often hear of “the statistics of the Anti-Vaccinators;” to which the summary answer is that Anti-Vaccinators have no statistics. Their statistics are the statistics of the Vaccinators, in which they provide the material for their own condemnation; which is probably the reason why the so-called statistics of the Anti-Vaccinators are so intensely disliked, avoided, and unanswered.
The Newcastle Dispensary in 1877 completed its hundredth year, having been founded in 1777, and Dr. Monteith prepared a concise history of the institution, which was published in 1878 by order of the Committee.[267] The report is especially valuable as a record of the comparative incidence of disease in a large industrial population, where, if anywhere, smallpox might be expected to show itself in severe form. In 1781 the population of Newcastle was estimated at 23,000; in 1821 it had risen to 41,794; in 1851 to 87,784; and in 1871 to 128,443; and through all these years and changes, the Dispensary continued in active operation, the percentage of the patients to the population being maintained with remarkable uniformity. It is needless to add that the majority of the patients have been from the ranks of the poor, among whom smallpox has always its chief seat. As Dr. Monteith observes—
They are the class intermediate between the well-to-do working-man and the pauper. The state of distress in which these people continually live is known to few. The patient, when visited by the doctor, is usually found lying in “poverty, hunger, and dirt,” and the treatment of the cases is undertaken in circumstances very unpropitious to success. Medical advice and medicine are not the only things needed. Good food, warmth, and judicious nursing are imperatively required, and are seldom if ever attainable.
Before turning to the Dispensary’s record of a century of smallpox, it may be well to observe that Variolation was practised in Newcastle with great assiduity, and that the Dispensary took a lead in the business, the surgeons inoculating any one who applied. Dr. Monteith relates—
By the year 1777 the arguments in favour of Variolation had so far triumphed over the habits and prejudices of the profession that there is no instance mentioned in our reports of any medical man in Newcastle opposing it. It is always spoken of as one of the best established facts of medical science. With the general public the case was different. Their prejudices were as strong as ever, and they exhibited a horror of Variolation which would satisfy the most ardent Anti-Vaccinator. To combat these prejudices various means were tried—sermons from the pulpit, pathetic exhortations in the newspapers, etc. The last and most convincing argument consisted of a pecuniary reward to parents who should allow their children to undergo the operation. The sum offered was 5s. for one child, 7s. for two, 9s. for three, and 10s. for four, and upwards. The success of this expedient was remarkable. Parents came flocking in with their children in great numbers. Tempted by the rewards, they subjected their little ones to an operation which, unless their sentiments had greatly altered, they believed to be barbarous and hurtful in the extreme, and a clear temptation of Providence. Variolation on these terms commenced in the spring of 1786; and every year thereafter, until 1801, children were operated on at the Dispensary at the rate of over 200 per annum. In 1801 there had been in all 3,268 operated upon.
As soon as Vaccination came into vogue, Variolation was denounced as the chief cause of the existence of smallpox. It was said that what was done to avert the disease from the individual diffused it among the multitude. Vaccinators long maintained that they could easily exterminate smallpox, if only Variolators would refrain from keeping it alive. Variolation gradually ceased, and was formally prohibited in 1840, and by and by Vaccination was made compulsory. Nevertheless, the confident prophecy of the Vaccinators remains unfulfilled, for smallpox is not exterminated.