[CHAPTER XXXIII.]
THE NORWICH EPIDEMIC—1819.
I have repeatedly cautioned my readers against the common assumption that the London smallpox of last century was the measure of English smallpox. It was not so. Smallpox was endemic in London, whereas it occurred as an occasional epidemic in other English towns, and was almost unknown in many rural districts. Moreover, the disease was not allowed to die out, but was diligently cultivated and diffused by variolation. As vaccination was introduced, the practice of variolation correspondently ceased, and with its cessation there was an abatement of smallpox, which abatement was unwarrantably ascribed to vaccination. How much of the smallpox of last century was due to variolation it is impossible to determine; nor would it be safe to accept the assertions of the early advocates of vaccination on the point. I apprehend that if smallpox were something desirable which everyone was intent on catching, it would be discovered that it could not be universally caught, and that its propagation had definite limits; and it is not improbable that among Londoners the limit of propagation was closely approached, so that nearly all who were susceptible contracted the disease. What, however, I wish to enforce is, that the decline in the prevalence of smallpox in some places coincidently with the introduction of vaccination was largely due to the discontinuance of smallpox culture, and that the suppression of that culture would have given the same result. Nor let it be forgotten that an almost world-wide fall in smallpox had set in toward the close of last century, which the vaccinators attributed to their prophylaxy in the nineteenth. Miraculous effects are frequently asserted where miraculous causes would be disowned.
The vital statistics of last century are, to a great extent, the products of inference and conjecture, and more or less affected by the purpose and bias of their collectors; but if even we had the correct mortalities of smallpox in the chief centres of population,—such as York, Hull, Norwich, Chester, Coventry, Bath, Bristol, Exeter, and Plymouth—we should still be puzzled to separate what was due to insanitary conditions of life from what was due to the artificial induction of the disease by variolation. It has been said that the 18th Century did not terminate in England until 1830; and accepting that liberal allowance, we may resort to an interesting record of a virulent epidemic in Norwich in 1819 for some light on the character and incidence of urban smallpox prior to the rise of such great communities as Liverpool, Manchester, Leeds, Sheffield, and Birmingham. The account of the epidemic was written by John Cross, a surgeon practising in Norwich.[268]
In those days Norwich contained a population of about 40,000. The city was accounted salubrious, and smallpox was little known. Cross writes that “in 1805, after being for a time almost extinct, smallpox prevailed so much in Norwich as to excite some attention.” The attention excited led to an attempt to introduce vaccination. A meeting was held in the Guildhall, 16th July, 1805, “to concert measures for the extermination of the disease,” and resolutions were passed to discourage inoculation with smallpox, and “to substitute immediate and universal vaccination of the inhabitants of the city and its hamlets.” This outbreak of smallpox and vaccination appears to have subsided together, for Cross continues—
After being absent for a year or two, Smallpox was again introduced to Norwich by an individual from London, and spread so extensively among those whose obstinacy or whose prejudices made them resist Vaccination, that 203 deaths from Smallpox were recorded in the Bills of Mortality between 1807 and the end of 1809. Smallpox again appeared in 1813, in which year 65 deaths took place; the mortality being confined to so small a number by the early and extensive adoption of Vaccination before the danger was actually at hand. From the year of 1813, it may be said, there was no Smallpox in Norwich until the rise of the epidemic which I propose to describe. Not a death from the disease was noticed for four years. Indeed, the only case that came to my knowledge, during the time specified, was the servant of a celebrated public character, who, being seized with Smallpox, was detained in Norwich, but from whom, so far as I could learn, the contagion did not extend.
I shall presently refer to the number of vaccinations effected in Norwich, and to their influence in arresting smallpox. What I would now draw attention to is, the comparative rarity of smallpox in Norwich in those times. Years two, three, and four elapsed without a single death from the disease! How does such a fact accord with the common-place of vaccinators, that before the advent of Jenner the people of England were decimated with smallpox, and that 40,000 perished annually? When we press for evidence for these extraordinary statements, we either get no answer, or we discover that the mortality of a bad year of London smallpox has been multiplied by the population of the United Kingdom, thus yielding the astounding total of 40,000 victims. Our reply is, that there is no warrant whatever for this conversion of London mortality into national mortality; that London was unique in its circumstances; and that, setting the immense rural majority aside, even in the largest cities, such as Norwich, years passed without any deaths from smallpox.
Vaccination had the prestige of fashion, and the leading citizens of Norwich were philanthropic and scientific after the newest lights, and whatever was accounted “proper,” they were intent to effect. To have the vulgar vaccinated was, however, no easy matter. Many declined because they had no fear of smallpox. What, indeed, had they to be alarmed about? Moreover, as experience advanced, the futility and danger of the new inoculation became more and more apparent. It began to be known that it not only failed to avert smallpox, but it frequently induced serious illness, permanent injury, and sometimes death. It is to be remembered that the symptoms of vaccination were watched at the outset of the practice with keen attention, and that the general verdict, especially of mothers, was distinctly adverse to its harmlessness. That such was the common judgment was manifest from the rapid decline of the early furore in its favour, and its contemptuous neglect by the mass of the people until revived and enforced by legislation. As the citizens of Norwich would not be vaccinated, it was determined to try the effect of bribery, and surgeon Rigby in 1812 induced the court of guardians to offer a reward of 2s. 6d. to every person “who should bring a certificate from a surgeon of having gone satisfactorily through the cowpox.” The results of this bribery are set forth as follows by Cross—
| 511 | received the award in 1813 | 49 | received the award in 1817 | |
| 47 | ” ” 1814 | 64 | ” ” 1818 | |
| 11 | ” ” 1815 | 1402 | ” ” 1819 | |
| 348 | ” ” 1816 |