Overcrowding we can prevent; the accumulation of filth in towns and houses we can prevent; the supply of light, air, and water, together with the several other appliances included in the all-comprehensive word Cleanliness, we can secure. To the extent to which it is in our power to do this, it is in our power to prevent epidemics.
The human family have now lived in communities more than six thousand years, yet they have not learnt to make their habitations clean. At last we are beginning to learn the lesson. When we shall have mastered it, we shall have conquered epidemics.
Among the upper and middle classes distrust in vaccination was general. How, indeed, could it be otherwise? All were vaccinated, yet whenever smallpox was epidemic, recipients of the rite enjoyed no immunity. In one of Miss Mitford’s letters we find an experience and a judgment which were far from uncommon. Writing, 1st February, 1850, she observed—
About two months ago, my man, a very steady and respectable servant, was seized with Smallpox after Vaccination. He was very, very ill, delirious nearly a fortnight, and not a nurse could be had for love or money. I have lost all faith in Vaccination, either as preventing or mitigating Smallpox. I know of thirty severe cases this winter, five of them fatal, in my own immediate neighbourhood, and in Reading it has been a pestilence.[281]
Vaccination among the poor was (as it is) detested. Coaxed or forced into its reception without consideration or preparation, like sheep or cattle, they realised its mischiefs and misery in full measure; and naturally, whenever pressure was relaxed, avoided its acquaintance.
How then did vaccination come to be imposed upon a community thus affected? The answer is the usual one, illustrated continually in English politics: an organised interest, possessed with a definite intention, can always prevail over the public—careless, uninstructed, and without positive conviction. Under such circumstances, it is a mere question of management what may be achieved in Parliament at variance with the common welfare. Those there get, who know how to take.
All trades and professions fulfil the law of their being in striving after advantage and extension. The clergy and the clerically-minded laity are persuaded that to multiply churches and provide stipends, is to prepare for the millennium, and nothing save hopelessness prevents demands upon the national exchequer for the purpose. The sacrifices the army and navy would exact on their own behalf for security from foreign aggression are only limited by the public incredulity. The commercial classes are free-traders in principle; but if a protective bounty could be had for any manufacture, it would be instantly grasped at by those concerned, and most ingenious reasons invented to justify that particular departure from the rule of justice. This tendency of interests to aggrandise themselves, per fas et nefas, at the public expense, is recognised by all statesmen, and is only kept in check by perpetual vigilance.
What is true of all, is true of the medical profession, crowded with competitors eager for employment. Vaccination as a branch of business, capable of development and endowment at the public cost, was certain of vigorous promotion whenever there was opportunity; but not until 1853 did the way open for the compulsory infliction of the Jennerian rite. The undertaking was hazardous. The opposition to which Canning and Peel had given expression, had to be circumspectly encountered. It was a job that might easily be wrecked; and therefore it was considered inexpedient that the medical corporations should appear too openly in the transaction. Instead, a committee was formed in 1850 under the title of “The Epidemiological Society for the Investigation of Epidemic Diseases,” with a number of suitable decoys, and ostensible occupation; but chiefly designed as an instrument wherewith to operate on Parliament for the better establishment and more liberal endowment of vaccination.
It was resolved to proceed tentatively—to secure if possible the affirmation of compulsion, allowing the shock of innovation to subside before going on to provide the effective means of espionage and persecution. As it turned out, the caution exercised was superfluous. Much more might have been demanded and conceded of the ignorance and indifference of the legislature. Lord Lyttelton was selected to introduce what was called the Vaccination Extension Bill, and in moving the second reading in the House of Lords on 12th April, he ingenuously disowned any qualification for the task, saying—
I have no scientific knowledge of the subject myself, and for my information I am indebted to some able and learned persons belonging to the Epidemiological Society—