The change from Variolation to Vaccination at the Newcastle Dispensary was immediate. Dr. Monteith says—
It is creditable to the good sense and enlightenment of the Dispensary authorities that they at once abolished Inoculation of Smallpox, and substituted Vaccination in its stead. In 1801, the first year, 215 children were vaccinated. The annual number rapidly rose until it reached its maximum in 1813, when 1,874 were vaccinated, after which the numbers as rapidly declined.
For this decline various reasons were assigned, such as the increase of the private practice of vaccination, and the disposition to undervalue every benefit, however great, that is purely eleemosynary. It is forgotten that Vaccination fell off as its illusory character became more and more manifest, and as the promises made on its behalf were, one and all, indisputably belied. When Jenner died in 1823, he passed away amid indifference, if not contempt. His bubble had burst. The furore for vaccination witnessed in the present generation is by no means a continuation of the original furore. That passed away. Our furore is a revival, dating from the popularity of sanitary reform, to the back of which a new generation of medical men contrived to attach vaccination!
In the hundred years, 1777 to 1877, the Dispensary had to deal with 2,616 cases of smallpox, of which 428 terminated fatally, which as to years and mortality may be thus classified—
| Years. | Cases. | Deaths. | Mortality per 100. |
| 1777 to 1802 | 365 | 90 | 24·6 |
| 1808 ” 1827 | 273 | 57 | 20·8 |
| 1828 ” 1852 | 925 | 152 | 16·4 |
| 1853 ” 1877 | 1,053 | 129 | 12·25 |
| —— | —– | —— | |
| 2,616 | 428 | 16·3 |
The progressive reduction in mortality is, of course, ascribed to vaccination having made the disease milder; though the report informs us that “the mortality from smallpox reached its highest point—33·3 per cent. in the five years from 1802 to 1807,” the very time when enthusiasm in favour of the Jennerian rite was at its acme. We, on the other hand, would attribute the lower mortality, as did Dr. Andrew Combe, to better modes of treatment, even neglect being preferable to much of the old-fashioned regimen for smallpox. Considering the figures, Dr. Monteith observes—
Of Smallpox I desire to speak with circumspection, for in Newcastle Anti-Vaccinators are somewhat rampant. Figures, however, are stubborn things, and their import is not easily explained away. Like the vast majority of medical men, I have always firmly believed in the good results of Vaccination. Without admitting that my faith has been shaken by considering these statistics, I must confess that I have been a good deal disappointed with them. I had expected to find this terrible disease regularly decimating the population every year until the epoch of Jenner’s discovery, and afterwards diminishing, rapidly and steadily, almost to nothing. These figures do not warrant us in taking so sanguine a view of the matter.
Whilst, therefore, we observe considerable improvement in the figures, I am of opinion that they leave us in this dilemma—either that there now exists a grossly exaggerated impression of the prevalence and fatality of Smallpox in former times, or else that they had begun to decrease long before the discovery of Vaccination, the beneficial effects of which must, therefore, have been at least assisted by other causes.
Here we have an honourable confession from out the bonds of professional prejudice, and a reluctant exposure of the legend of a world decimated by smallpox, and ceasing to be decimated after the advent of Jenner. There is nothing singular in the Newcastle evidence that has awakened distrust in the mind of Dr. Monteith. Similar evidence is found wherever facts are available. The legend to the contrary has become established, like many other legends, by dint of repetition, until those who venture to question it are regarded with suspicion and dislike.