The larger numbers in 1813, ’16, and ’19 were due to panic and pressure; but the figures maybe taken for a graphic representation of the distrust with which vaccination was regarded after ample experience. Of course many were vaccinated who did not claim the parish half-crown; and at the end of 1819 it was calculated that 10,000 in Norwich had submitted to the Jennerian rite from the date of its introduction at the beginning of the century. Thus considerably less than a fourth of the inhabitants were what is called “protected.”
We now come to the narrative of that great outbreak of smallpox, which, says Cross, destroyed more lives in less time in Norwich than any epidemic since the Plague. It is almost superfluous to state that the disease did not originate in Norwich: it never appears to originate anywhere: it was imported. A girl travelling with her parents from York caught the infection in transit at a market-town, and as soon as she arrived in Norwich was laid up with the disease.
This happened [says Cross] in the latter end of June, 1818; and the earliest cases of Smallpox that were seen by any medical man were traced to this origin. I have been able to ascertain the different families by which the disease was kept up during the remainder of that year, but it extended to very few, and proved fatal in only two instances. A druggist inoculated three children in January, 1819, thus helping in a small degree to spread the contagion, which the season of the year was calculated to keep within narrow bounds. Still no alarm was excited; a single medical man only was acquainted with the disease; and the cases of Smallpox were so few until the latter end of February as to be scarcely noticed. At this time, however, the disease extended from one of our greatest charity schools to all quarters of the city.... Comparatively dormant during the winter, as the season became milder it burst upon us suddenly and unexpectedly, continuing its work of devastation for three or four months with undiminishing fury. The following list of burials taken from the Bills of Mortality will give a sufficiently accurate idea of the advance and decline of the disease—
| 1819. | Deaths from Smallpox. | Deaths from other diseases. | Total of deaths. |
| January, | 3 | 61 | 64 |
| February, | 0 | 71 | 71 |
| March, | 2 | 68 | 70 |
| April, | 15 | 61 | 76 |
| May, | 73 | 63 | 136 |
| June, | 156 | 70 | 226 |
| July, | 142 | 61 | 203 |
| August, | 84 | 63 | 147 |
| September, | 42 | 96 | 138 |
| October, | 10 | 63 | 73 |
| November, | 2 | 62 | 64 |
| December, | 1 | 83 | 84 |
| —– | —– | —— | |
| 530 | 822 | 1352 |
The greatest mortality occurred in June when 43 were buried from Smallpox in one week. The rapid declension of the disease from that period is obvious from the above table; and it was so nearly extinct at the end of the year, that I could not find a variolous patient from whom ichor could be procured for an important experiment. As probably one in six of all who were affected by the epidemic died of it, I am convinced it is not far from the truth to assert that considerably over 3000 individuals, or a thirteenth part of the whole population of Norwich, had Smallpox in the year 1819.
It is always sound policy to take what is considered the case against us at its worst; and as this dreadful Norwich epidemic is cited as evidence of what is possible in the absence of vaccination, and as something that opponents of vaccination should regard as conclusive against them, there is cause to give it special attention; and the more so as the leading facts are well ascertained. First, however, I would remark that I have no desire to minimise the horrors of smallpox: it is a loathsome, and, because preventible, a discreditable disease: but neither let us maximise its horrors, but try, at least, to recognise facts in their true dimensions.
Five hundred and thirty died in Norwich of smallpox in 1819 of 3000 supposed to have had the disease, the deaths being, as commonly estimated, one in five or one in six of those affected. The deaths from all diseases in Norwich in 1819 were 1352—a mortality of 30 per 1000; a high rate, but by no means uncommon in urban populations free from smallpox. I have next to observe that if 3000 had smallpox, there were 37,000 who escaped, and to ask, How did they escape? By what means were they protected? It may be replied that a fourth of them were vaccinated; but how does that account for the immunity of 30,000 unvaccinated? The 10,000 vaccinations reputed to have been effected in Norwich from the beginning of the century were the work of nearly twenty years, and the major part of them in 1819 must have been represented by adults practically out of the range of infection, protected not by vaccination, but by their years.
“Protected by their years! What do you mean?” exclaims a reader.
Precisely what I say—that in the Norwich epidemic, as in variolous epidemics generally, adults are comparatively secure, and the young, and especially infants, are the victims. In Norwich, in 1819, scarcely a bread-winner, or a father or mother was laid in the grave slain by smallpox.