As to the immunity of the vaccinated, it was disproved in every smallpox epidemic, and in every smallpox hospital, and by the precautions and terrors of those accounted secure. To sustain the proposition that smallpox had decreased in consequence of the introduction of vaccination, a variety of statistical tables were adduced, English and Continental; but had the Lords or Commons subjected them to scrutiny they would have discovered that the details were either irrelevant or adverse to the conclusion asserted. Many of the statistics, especially of last century, were not certainties, but conjectures and estimates, vitiated, too, with the bias of their compilers. When it is said that smallpox decreased in consequence of the introduction of vaccination, the answer is that smallpox was decreasing prior to its introduction in almost every country of Europe; and that the decrease continued irrespective of its influence, save in so far as it might have discouraged the culture of smallpox by inoculation. To illustrate this contention it may suffice to take the table of London Smallpox set forth by Dr. Seaton, in which the average of deaths from Smallpox in every 1000 deaths from all causes was contrasted in decennial periods for fifty years, prior and subsequent to the introduction of vaccination.
| Prior to Vaccination. | Subsequent to Vaccination. | |||
| Ten Years ending— | Deaths from Smallpox. | Ten Years ending— | Deaths from Smallpox | |
| 1760 | 100 | 1810 | 64 | |
| 1770 | 108 | 1820 | 42 | |
| 1780 | 98 | 1830 | 32 | |
| 1790 | 87 | 1840 | 23 | |
| 1800 | 88 | 1850 | 16 | |
The figures are far from trustworthy, but taking them as they stand, and admitting the decline, where was the proof that it was due to vaccination? The introduction of that practice was one thing: its application quite another. There was no reason to believe that more Londoners were vaccinated in 1820 than in 1810, or in 1840 than in 1830; indeed, the available evidence went to the contrary, vaccination having fallen in repute after the furore of 1801-5, and the demonstration of its impotence and its injuriousness. Probably not ten per cent. of the births in London up to 1840 were accounted for as vaccinated; and notwithstanding the provision of vaccination at the cost of the poor-rate by the Act of 1840, not fifty per cent. in 1850. Yet to a cause so utterly inadequate, the steady decline in London Smallpox was ascribed! The same fallacy pervaded the statistics of other countries and cities, yet so strong was the prepossession in favour of the conclusion determined upon, that it was apparently neither seen nor suspected, obvious though it was.
Nor was it surprising that with a disposition so fixed and obtuse, no enlarged or philosophic views should have been entertained. “Smallpox,” said Dr. Seaton, “had decreased compared with mortality from other causes.” True; but what if mortality from other causes had compensated for the decrease of smallpox? and if such compensation had taken place, as, for example, in Glasgow, in what consisted the advantage? Again, no reference was made to illness and death resulting from vaccination, as if the rite were harmless as baptism. Allowing that the practice did in some occult fashion tend to the abatement of smallpox, it was still open to question whether the infliction of an acute specific disease on all sorts and conditions of infancy was not likely to be far more injurious to life than the smallpox it was supposed to avert. Such considerations, however, were foreign to Dr. Seaton and his Epidemiological Society with whom vaccination stood for little else than an extension of medical business at the public cost.
It is not to be forgotten that the Act of 1853 brought to fruition what was long hankered after by the trade spirit of the medical profession. The Act of 1840 endowed vaccination out of the poor-rate; but to make the rite compulsory and to ensure good pay for its performance was the consummation desired. The terms and conditions that ensued on the Act of 1840 are thus described by Dr. Seaton—
The fee paid in England and Wales varies from 1s. to 2s. 6d., never falling below or rising above those sums. In 1842 and 1843, the Commissioners estimated the average fee at 1s. 9d. From our inquiries, it appears that in the large manufacturing towns the fee varies from 1s. to 1s. 6d.; the larger sums of 2s. and 2s. 6d. being paid for the most part in country towns. In London, the more ordinary fee is 1s. 6d.; in several parishes 2s. 6d. is paid; and in one, 1s. In some few unions a bad principle obtains of paying a larger sum for a certain number of cases, as 50, and a smaller sum for all above. The average payment per case for the whole of England and Wales from 1841 to 1851 inclusive, was 1s. 5½d.
In Ireland, the payment appears to be very low. The more general sum is 1s., often 6d.; in three or four instances, 3d. and 4d. The vicious principle just noticed, of paying a higher fee for a limited number of cases, seems to be almost universal. Thus, where 1s. is the fee, this is paid for the first 200 cases, and 6d. for all above. In one case, Nenagh, 1s. is paid up to 200, and 1d. for all above. In other cases, 3d. and 4d. are paid for all above a certain number. Whilst this pitiful remuneration exists, it is not surprising to find that in many districts the medical practitioners decline the appointment, leaving the people unvaccinated.
According to the information we have received, it is found, as might be anticipated, that on the whole Vaccination is more efficiently carried out in the districts where the higher fee of 2s. 6d. is paid; or where, as in large towns, the number and proximity of children compensate the vaccinator in some degree for lower payment.
The better pay, the better vaccination! The object of the Epidemiological Society, as the stalking-horse of the medical trades-unions, lay in those fees. Vaccination was a pretext for a universal poll-tax, set at as high a figure as practicable, to be succeeded when possible by compulsory revaccination, with a correspondent tariff annexed. Recalling the early days of vaccination when the operation was described as simplicity itself, and when women, parsons, and busybodies inoculated and propagated “the benign fluid” under Jenner’s authority, it was remarkable to have the rite thus formalised and converted into the peculium of a priesthood. Nor can it be objected that when vaccination was thus practised, it was ineffective against smallpox; for whenever its virtue is brought into dispute, we are referred to those primitive times and that primitive practice for the most successful and unquestionable exhibitions of its power.