III.—Have you any reason to believe or suspect that lymph, from a true Jennerian vesicle, has ever been a vehicle of syphilitic, scrofulous, or other constitutional infection to the vaccinated person; or that unintentional inoculation with some other disease, instead of the proposed Vaccination, has occurred in the hands of a duly educated medical practitioner?
IV.—Do you (assuming due provisions to exist for a skilful performance of the operation) recommend that, except for special reasons in individual cases, Vaccination should be universally performed at early periods of life?
Whilst these questions were framed to draw the answers required, yet, however modified, the tenor of the returns would have been much the same. We might confidently predict uniform replies, if a circular were addressed to 500 clergymen soliciting their judgment as to the disendowment of the Church, to 500 Nonconformist divines as to the benefit of hearing sermons, to 500 military men as to the expediency of an imminent war, to 500 naval officers as to an enlargement of the navy, or to 500 publicans as to the justice of local option. Nor is there sense in attributing value to testimony to be had on demand by the yard. It is brought forth as of course, and to expect otherwise is to expect what is contrary to nature.
It will be said, “Do you really mean that medical men defend vaccination because it pays?” In no other sense, I reply, than as clergymen or publicans defend their vested interests. Medical men among themselves make no secret of their pecuniary interest in vaccination, as any one may see who reads their journals; and Simon’s advocacy culminated in a demand for more liberal pay, as the only guarantee for “properly-performed vaccination.”
We may view the matter in another light. Suppose a circular had been addressed to 500 medical men fifty years ago, as to the utility of bleeding, or blistering, or salivation, would not the tenor of the answers have been equally uniform with Simon’s in favour of vaccination? Where are these practices now? But suppose any one of them had obtained legislative sanction and endowment, can we doubt that it would have survived to this day, certified as salutary and harmless by the gross of the medical profession? Let us clear our minds of cant. The assumption that men’s convictions (I except the moral aristocracy) are not controlled by their selfish interests (often enough the reverse of their true ones) is cant.
Among those interrogated was Dr. Joseph Hamernik of Prague, whose developed answers form a paper which, by reason of the independence, acumen and philosophy displayed, constitutes the distinction of Simon’s collection of documents.
First, Hamernik inquired whether cowpox and smallpox had any relation to each other, deciding that they were diverse and independent diseases. Vaccinated persons may be attacked with smallpox during the development of the cowpox vesicle, or a few days after the drying-up of the same. When inoculation is made with a mixture of cowpox and smallpox, there ensue a vaccine vesicle on the site of the puncture and a variolous eruption over the body. In fact, it is not uncommon to find cowpox and smallpox flourishing simultaneously on the same individual. Under some conditions, the one disease appears to stifle the other. Thus a powerful epidemic of smallpox will prevent the development of cowpox, illustrating the Hippocratic aphorism, Duobus doloribus simul obortis—vehementior obscurat alterum, exactly as happens when other diseases simultaneously invade the human organism. Again, in well-marked epidemics, cowpox does not protect from smallpox, even after repeated vaccinations. Under stress of such experience, the confidence in such vaccination was much shaken in England during the epidemics of 1825 and 1838. Vaccination was likewise found useless in the epidemics of Paris in 1825 and Marseilles in 1828. “Nor can revaccination achieve what vaccination cannot,” said Dr. Brown of Musselburgh. The revaccinated die of smallpox like other people, as is proved by the official returns of the armies of Wurtemburg and Prussia—
Revaccinations among civilians in Bohemia are extremely rare, and hence I am unable to cite many cases. I only saw two persons who had been revaccinated die at the Prague Hospital—a Russian officer in the guards, and a physician from Bremen.
There is no validity in the statement that epidemics of Smallpox are arrested and made milder by rapid Vaccination and Revaccination; unless medical men could test the accuracy of their verdict, as lawyers do, by a new trial. Until they can do so, we must admit that there are cases and epidemics of Smallpox light and severe. It was so before Vaccination was heard of, and is likely so to continue longer than Vaccination will endure.
Second, turning to the examination of the characters of smallpox before and after vaccination, he observed—