Had it always been slight, gentle, safe, and useful, with all those alluring epithets bestowed on it; had none had above a hundred or two hundred pustules, and no one died of it in the space of several years; and had there been no instance of any one’s being ever again infected with smallpox who had any pustules at all, how few soever, raised by inoculation, nobody would sooner have subscribed to the practice than myself.[49]
The primal promise that the inoculated were thereafter proof against smallpox was speedily belied, but that difficulty was disposed of by the assertion that inoculation in such cases must have been imperfect, for it was impossible for any one to have smallpox twice. The admission of fatalities from inoculation was very tardily made; and they were generally referred to some cause perversely concealed from the inoculator, which, had he known, would have prevented his operation. Then, the manifest fatalities were naturally suspected to stand for a larger number sedulously kept out of sight. As Massey put it—
The ill success of inoculation is very partially and sparingly given to the world. The operator will not tell it, who lives by the practice; nor will the relations, to whose authority the mischief is owing, be fond of revealing that to the public, which is grief to them in private.[50]
Fortunately for the public, several of the mishaps occurred in “good society,” and were too conspicuous to be hushed up or denied. Miss Rigby died eight weeks after inoculation, “miserably disordered by the operation.” A son of the Duke of Bridgewater and a son of the Earl of Sunderland likewise perished; and a servant of Lord Bathurst died of confluent smallpox “consequent on engraftment.” Such incidents struck terror everywhere, and caused wise and timid alike to face the ills they knew rather than risk certain peril for uncertain advantage.
Maitland returned to Scotland, his native country, in 1726, and, going among his relations in Aberdeenshire, showed off his skill by inoculating six children. One of them, Adam, son of William Urquhart of Meldrum, aged 18 months, sickened on the seventh, and died on the eighth day. There was a great outcry, and Maitland tried to excuse himself by asserting that Adam was afflicted with hydrocephalus, which had been improperly concealed from him. Anyhow, the Aberdeenshire folk were satisfied with their experience, and recommended “Charlie Maitland to keep his new-fangled remedy for the English in future.” He was more fortunate in the west of Scotland, where he “inoculated four children of a noble family,” who escaped alive. The Scots, however, were deaf to his persuasions, and he made no headway among them. At a later date, 1733, inoculation began to be practised in and about Dumfries, and occasionally elsewhere.
In Ireland little more was effected than in Scotland. It was said that 25 inoculations took place between 1723 and 1728 with 3 fatalities. Dr. Bryan Robinson inoculated five children in Dublin in 1725, and was the death of two of them.[51]
Inoculation met with faint acceptance on the Continent. Maitland went over to Hanover in 1724 and inoculated Prince Frederick and eight children of Baron de Schulenberg. In France the practice had been discussed by Dr. Boyer so far back as 1717; and in 1723 the English experiments were recounted in Paris with much enthusiasm by Dr. de la Coste, evoking a declaration from the College of Physicians, “that for the benefit of the public, it was lawful to make trials of inoculation.” A commencement was about to be made in the hospitals under the Sanction of the Regent, the Duke of Orleans, when his death put a stop to the design. Soon after Dr. Hecquet published Raisons de Doute contre l’Inoculation, which, coupled with bad reports from England, made an end of the project.
If a London journalist had been called upon in 1728 to report upon Inoculation, he might have written as follows—
Seven years ago the practice was introduced to this country under powerful auspices. It was confidently averred that anyone might have his blood infected with the virus of smallpox, that a trifling ailment would ensue, and that thenceforward he would be secure from smallpox in the natural form. Experience rapidly belied these promises. The trifling ailment proved, in many cases, a serious ailment—so serious that physicians tried to anticipate and mitigate its severity by a preliminary regimen of bleeding, purging and vomiting. So exhausting and hazardous is the whole operation, that only sound and vigorous constitutions are considered fit for it; and the delicate and feeble, who require protection most, are advised to submit themselves as of old to the ordinary course of nature. Moreover, the induced smallpox is occasionally as severe as the spontaneous; the pustules are multitudinous, and sometimes confluent, with death for the issue. Fear may exaggerate the risks of inoculation, but more are believed to have perished than the inoculators are willing to confess. Again, many are not susceptible of inoculation, and though the infection fails to operate in their blood as desired, they do not always escape injury: they find their health disordered—are rendered sickly and uncomfortable. Worst of all, what none at first reckoned on, the artificial smallpox turns out to be infectious, and begets natural smallpox in those who are with the inoculated. Thus, the very means taken to limit the disease become a cause of its extension. Smallpox was more than usually prevalent in Hertford in 1721, and in London in 1724, and there was fair reason to conjecture that it was extensively disseminated by inoculation. Lastly, it is doubtful whether even successful inoculation protects from subsequent smallpox; for it is maintained that some of the inoculated have already fallen victims to the natural disorder. In short, the preventive appears to have so many drawbacks that it is questionable whether it is not worse than the malady; and it is probable that in a year or two it will pass into forgetfulness in common with many other remedies as highly extolled on early and imperfect acquaintance.
So much might have been stated and prognosticated in 1728: how the prognostic failed to be verified remains to be told.