REASONS Why the Practice of
INOCULATION
Ought to be introduced into the Town of
BƲ RY
AT PRESENT.
BURY St. EDMUNDS:
Printed in the Year, M.DCC.XXXIII.
SOME REASONS,
&c.
1. THE Number of People who have not had the
Small Pox
is so great, that in the Way of accidental Propagation it will probably remain in the Town a very long Time still, to the vast Detriment of all Trade and Business, and perhaps the Loss of the Assizes, Sessions, Fair and other publick Meetings: Whereas if Inoculation was generally practised, it might be got through the Town in a very short Time. In the first Case we may have it two Years; in the Last, we need not have it six Months.
2 As the utmost Hazard of dying of the inoculated
Small Pox,
appears by the last authentic Accounts, to be no more than that of 1 in 50, and by the same Accounts that of dying of the Natural is shewn to be that of One in Six; it would be the Means of saving great Numbers of Lives. For Instance, let us suppose that there are Three-thousand Persons in
Bury
who have not had the
Small Pox:
The 50th Part of Three-thousand, or the Number of Persons which may be supposed to die of Inoculation, is Sixty; but the 6th Part of Three-thousand, or the Number of Persons that are to be supposed to die of the natural
Small-Pox,
is 500. Deduct Sixty from Five-hundred, and there will remain Four-hundred and Forty for the Number of Lives which may be clearly saved by Inoculation upon this Supposition.
UNDER this Article it is to be observed, that the inoculated
Small Pox
has been found to be as favourable to grown People, as to Children; but all the World knows the Contrary is True of the Natural in a high Degree. So that if we consider the Value of the Lives as well as the Number, we shall have still farther reason for the Practice: For I suppose every One thinks the Life of a grown Person (especially of the Head of a Family) to be of more Consequence than that of a Child.
IT is also probable that the Hazard of dying of the inoculated
Small Pox
is less than that of One in Fifty. An impartial Judge who reads the Accounts of those who died after Inoculation will see, that the Death of several cannot in Reason and Justice be imputed to
that,
and it is much to be questioned whether the Preparation before Inoculation, the Pustules from whence the Matter was taken, and the Management of the Patient during the Distemper have been in most Cases, such as they ought to have been, and such as they may be for the future. Dr.
Nettleton
out of a Hundred and Nineteen, which he inoculated, had only one that miscarried. He is a Physician in
Yorkshire,
whose Skill and Integrity no Man that knew him ever yet called in Question; and in a Letter to Me, dated
February
27, 1729-30. when the
Small Pox
was much at
Newark,
he says where due Care is taken of the Choice of the infectious Matter, Inoculation will very rarely fail of Success.
IT is also to be observed that all those, who have not had the
Small Pox,
and resolve to continue in the Town must almost certainly have it now; at least Children and those who go much about. So that to
these
under the present Circumstances of the Town, it is only necessary to determine whether they will have the Chance of 50, perhaps 60, 80, or 100, or even more for their Lives, or that of 6 to 1 for 'em. One they must have.
3. As this Distemper is infectious, and produces it self, so the several Sorts of it produce themselves: A favourable Sort produces a favourable One; a malignant Sort a malignant One. This is certain in Inoculation, and very highly probable in the natural Way. As it advances, therefore the Kind will grow worse and worse, for where the Infection is taken from different Persons (and as it advances this will be more and more the Case) the Good can't correct the Bad, but the Bad will prevail over the Good. And here Experience confirms our Reasoning, for it is observeable, that agreeably to that, the
Small Pox
is for the most Part favourable at its first coming into a Town, but as it spreads, grows more malignant. Now in the Case of Inoculation, not above 1 in 50 has a bad Sort, perhaps not above 1 in 60, 80, or 100 as was hinted before. Inoculation therefore would be a great means to preserve the sort good; so that even those who have it not by Inoculation will have a fairer Chance, but in the natural Way where at a Medium 1 in 6 die, at the Time of the Town's being most infected 1 in 5, 4, or 3 may die: Nay perhaps more among grown Persons. At
Uxbridge
near
London
51 died out of 140, which is something more than 1 in 3.
4. THE last Reason is the general Good of Mankind. Dr.
Jurin
has shewn that at least a 14th part of Mankind die of the natural
Small Pox,
and within the Bills of Mortality it destroys at a middle Reckoning considerably more than 2000 Persons Yearly as appears from them: But it is very probable that if Inoculation was generally practised, we should arrive at such Perfection in it, that few or none would die. We have then a most happy Opportunity of serving Mankind at the same Time that we serve our selves. Indeed it is much to be feared, that Inoculation will never prevail, but by being introduced in such Cases, as ours is at present, where People are almost under a necessity of having it, and are only to chuse whether they will have it in a more or less dangerous Way. If besides the Loss of so many Lives we consider the Fears and Uneasinesses of People for themselves, of Parents, Children, Relations and Friends for them, their own Uneasiness at not being able to visit their Friends under this Distemper, the Unfitness for Business which it lays many under,
&c.
one has still greater Reason to wish that this was the general Practice in Children, from the Age of 2 or 3, to that of 7 or thereabouts. And when we call to mind the Indignation and Gontempt which we have for the Opposers of Bark, Opium, and Mercury in Physic, Reformations in Religion, the wisest Laws in Government, or of any Thing else, which is Great and Good (and Opposition has generally been the Fate of every such Thing, either out of Interest and Dishonesty, or Ignorance, Folly, and Superstition) it should make us seriously reflect what Censures Posterity may justly pass upon us in the present Point.
THE Objections that are made to this Practice are generally these.
I. WE are not certain that Inoculation is a Security from having the Distemper again.
THIS Objection may be answered thus. 1. Several Persons who have been inoculated, have been made to converse with, to handle, nurse, lie in the same Bed with others sick of the natural
Small Pox,
and no one ever had it again, as far as they that have enquired can learn. 2. Several Stories, that have been invented to perswade the World of the Contrary have been detected, and shewn to be Forgeries. 3. As the inoculated
Small Pox
is in every minute Circumstance, exactly like the natural One, of the same Kind and Degree, it would be very extraordinary, and contrary to the whole Course of Nature's proceedings in such Things, if it should not be like in this. Whatever be the Reason why the natural
Small Pox
preserves us from future Infection, it is inconceiveable that the Inoculated should not do the same, for the same Reason. Indeed if the natural
Small Pox,
especially of a favourable Sort, be not an absolute Security, which is the Opinion of some, neither can the Inoculated be supposed to be: But this if True, yet is so rare as not to deserve Notice. I suppose no one would desire a bad Sort, rather than a good One, for that reason.
II. ANOTHER Objection to the Practice of Inoculation is, that the inoculated
Small Pox
often leaves bad Consequences, as Consumptions, Boils, and Blotches, weak Eyes,
&c.
THAT the natural
Small Pox
is apt to leave the same Sort of ill Consequences is known to every one; and yet there are Methods, which will for the most Part entirely prevent or remedy them, and always do it in some degree. The Objection therefore to have its proper Force must suppose, that Inoculation leaves more or worse Disorders, than the natural
Small Pox,
and in order to know whether this be so or no, it will not be improper to enquire first, what is the Reason of these Disorders at all. In the Declension of the
Small Pox,
a Quantity of corrupted Matter returns into the Body, and mixes with the Blood; as is evident from the falling of the Face, Hands, and Feet which were before much swelled and inflamed: And tho' such be the excellent Contrivance of a human Body, that it converts Things of most different Natures into Blood, proper for its Nourishment and Uses, as we daily see in the vast variety of Things which all make healthful Food for Mankind, yet it cannot entirely overcome this corrupted Matter returning into the Vessels, so as to make
that
in all Things fit for the purposes of Life and Health, but suffers from thence the secondary Fever first, then what Physicians call Obstructions and Acrimonies, in which last consist the Disorders abovementioned. One would haturally think therefore, that where the most corrupted Matter, and of the worst Kind returned into the Blood, there the Disorders succeeding the
Small Pox
should be most and worst, and so we generally find it; but then there are a great many Accidents happening in the Conclusion of the Distemper, which concurring with the different Age, Constitution, manner of living, different Methods used by different Physicians,
&c.
make sometimes a malignant
Small Pox,
leave sew ill consequences, and a favourable one leave many: And particularly I think it is true that many who have the distinct Kind and soon recover their usual Health to appearance, and often more than their usual Appetite, are so defective in the Rules of Abstirence, and proper Physic, as to fall into an ill Habit of Body some time after. Now that something like this has been the Case with several that have been inoculated, is not at all improbable, since it is remarkable that in
London
great pains have been taken to perswade People, that Inoculation neither wants Preparation before, the Attendance of a Physician during the Distemper, nor Care afterwards: but this affects not those who will take Care afterwards. As was said in the 3d Answer to the foregoing Objection, it is inconceivable how the inoculated
Small Pox
should be like the Natural in the whole Progress of the Distemper, and yet differ in this: And to be more particular, it is inconceivable how a Quantity of corrupted Matter falling into the Body should be the occasion of the Disorders succeeding the
Small Pox
(a thing which all Physicians allow) and yet the inoculated
Small Pox,
where there is less of that Matter, and that of a more kindly Nature, be attended with worse Consequences. Now when any Matter of Fact is said to contradict such plain Reasoning as this is, one may be allowed to examine strictly into the Evidence for that Fact. Let us examine then. And first it is altogether impracticable to make any Estimate of the ill Consequences that attend the natural
Small Pox,
and therefore in like manner impracticable to compare the Natural and Inoculated together in that Respect. Then if any happen to suffer after the Inoculated, it is immediately in every once Mouth and that with many Aggrav
tions. In the Natural we hear nothing of those who tho' they escape with Life are yet severely afflicted with the i
sequences of it. In the Inoculated e
cept the Patient go through the whole St
of the Distemper without any ill Symptom, and continue free from any afterwards, perhaps without due Care to make him so as was said, we are sure to have the most made of it against the Practice. Nay there have been Cases, where Stories to discredit it have been entirely invented. One would wonder that there should be any, who tho' they may have Baseness enough to affirm what they know is false, can yet be so stupid as to do it, when they are sure they may and must be detected and exposed. But I believe every ones own Experience will furnish some Instance of it. There are Men in the World who love to triumph, be it only for a Week or a Day, even when they cannot but be convinced, all will then end in their own Confusion; and it is notorious that Inoculation has met with some such Opposers, as may be seen in Dr.
Jurin
's Accounts of it.
THE Answer to this Objection then in short is this. It compares the ill Effects of the natural and moculated
Small Pox
together, affirming that those of the last, are worse than those of the first, but fails in the Estimate of both sides of the Comparison. The Estimate of the first can never be had, and that of the last is grosly mis-represented. This Evidence therefore will never support a Position so contrary to all common Sense as this,
viz.
that where the Quantity of corrupted Matter returning into the Blood is less, and also less corrupted; there the ill Effects of it should be more severe. I will here add what I had from Dr.
Jurin
last
April.
He collected the Accounts of all (in Number 724) that were inoculated in
Great Britain
for some Years, during which he was Secretary to the ROYAL SOCIETY: And it must be acknowledged he has done it with the utmost Impartiality. Upon my asking him what his real Opinion about the Practice was, and particularly whether the ill Consequences that attend the inoculated
Small Pox
were worse than those of the Natural; he answered, that as far as he knew they were not, and that his real Opinion of Inoculation might easily be known, because he had just inoculated one of his own Children.
III. A third Objection is that by Inoculation we may communicate other Distempers.
MOST chronical Distempers (that is such as are not Fevers) are chiefly owing to the irregular Make of the Vessels thro' which the Blood and Juices pass, and as Children often resemble their Parents in the Features of the Face, so they may resemble them in the make of these Vessels, and by that means may have many Distempers hereditarily. Now if this was the Case of all, it would be as just to affirm that Inoculation could communicate the Features of another Man's Face, as communicate other Distempers. But it must be acknowledged that there are several which may be communicated by methods, no ways consistent with this Account: It cannot therefore be universally True. For instance, a Child receives its whole Sustenance from the Milk which has circulated thro' the Body of a Nurse, afflicted with scrophelous Complaints, and has them from her. Nay some are of Opinion, that lying much in the same Bed with People of distempered Constitutions is of bad Consequence but no one is afraid of such Infection in the ordinary Intercourses of Life, and yet in them we continually receive by means of the Air which we breath, (perhaps by other means) such Particles as fly from the Bodies of those we converse with. This is the Method in which the
Small Pox
is Infectious, and he that will affirm that Inoculation gives other Distempers, will find it hard to prove that accidental Propagation will not do the same, for the same Reason; and that the common Intercourses of Life should not much rather do the same, since there we often receive into our own Bodies greater Quantities from those of others, than the Matter of Inoculation amounts to. There has been no Instance of this Kind produced that ever I heard of. The infectious Matter according to Experience, appears to communicate nothing but what it was intended to communicate, the
Small Pox.
It was never pretended to have left an hereditary Complaint, such as the Person from whence it was taken was afflicted with. And if all that has hitherto been advanced upon this Head should be set aside, yet there are enough of the laborious Part of Mankind where we have moral Certainty, that they have sound and healthy Constitutions. I am sure no Parent would put put a Child out to a Nurse but upon such a Supposition.
IV. I come now to another Objection which is foreign to me as a Physician, but belongs to us all as Men. In this Capacity I have a strict Obligation not to mistake my Duty, and therefore a sufficient Right to enquire: This then is my Apology for doing so here. The Objection is that the Practice is sinful: That is, that a Practice which would restore Trade and Business, and the Means of living to many, who now want it, which would save great numbers of Lives, and which might be of fingular Service to all Mankind, by either promoting or discouraging its farther Progress, is a thing forbidden us by infinite Goodness, who sent us here to imitate his own Perfections, and that most especially in doing good. At first sight this seems to be a very inconsistent and unamiable Representation of the Parent and Governor of the World, such a one as would be unworthy of an earthly Father, or a wise and beneficent Magistrate. At first sight it seems, that if all, or the principal Part of what is here offered be true, this Objection must fall to the Ground of Course. But perhaps in another View of things it may appear otherwise. The Objectors say then that it is sinful to endanger our Lives voluntarily. Be it so. Consider now 50 Persons in this Town who have not had the
Small Pox,
and let us suppose that 2 escape and 48 have it, or that 8 escape and 42 have it, or that 14 escape and 36 have it, or that 20 escape and 50 have it, or lastly that 26 escape and 24 have it.
IN the first Case according to the Hazard above given of the natural
Small Pox
(that of 1 in 6) 8 will die, in the 2d 7, in the 3d 6, in the 4th 5, and in the last 4; for the 6th Parts of the Numbers 48, 42, 36, 30, 24 are 8, 7, 6, 5, 4 respectively.
HE therefore who waits for the natural
Small Pox
runs the Hazard of 4 in 50, even supposing the Hopes that he has to escape to be more than an equal Chance, which can never be true. He that tries Inoculation has only the Hazard of 1 in 50. If therefore to incur the Danger of Life voluntarily be a Sin, it is a greater Sin to incur a greater Danger, a less Sin to do incur a less Danger, that is, it is a Sin to do the First, and our Doty to do the Last. But say they again, the natural and inoculated
Small Pox
are not equally voluntarily; God brings one upon us, the other is our own doing. What does God confine Men and their Families in the Town? No; but their Affairs and Fortunes do. Shall then a Man for that reason stand the Hazard of 4 in 50, and not take the less Hazard of 1 in 50, to avoid the greater of 4 in 50? And as Men endanger their Lives voluntarily in the present Situation of the Town by staying in it, so they do, and must and ought to do it, by the Voyages and Journeys they daily make, the Physic they sometimes take, and the many Handicraft Trades pernicious to Health which are practised.
IF it be said that we are to trust in Providence, the Answer is, that Providence has given us Heads and Hands to contrive and execute what is most for our Advantage: And to neglect to use them for that Purpose, is not to trust in Providence, but to be presumptuous and ungrateful. To trust in Providence is to do all we can for our selves, and then to believe we shall be taken care of. But to believe so, till we have first done that, is Presumption. It is affirming that all Business must stop, Mankind sit still and e
pect that Providence should build for 'em, cloath 'em, and rain down their daily Bread.
A tender Parent says, I shall never forgive my self, if my Child should die of the inoculated
Small Pox,
that I did not stand the Hazard of the Natural. But for the same Reason, supposing the Hazards equal, a tender Parent ought to say, I shall never forgive my self if my Child should die of the natural
Small Pox,
that I did not try Inoculation. And if the Hazards be unequal, what is a tender Parent to say then? If particularly the Hazard of the Natural be more than that of 1 in 6, that of the Inoculated less than that of 1 in 50, the Hopes of escaping the Distemper in Children not 1 in 100, and the ill Consequences of the Inoculated considerably milder than that of the Natural; all which Suppositions in my Opinion are very probable. What would a tender Parent give to have a Child alive again, to try the Chance of Inoculation?
IT is often said that many of the Clergy are against the Practice. If they are it is upon a Supposition that the Practice does not promote our Lives, Healths and Happiness: At least all the Gentlemen of that Order that I have had the Honour to converse with upon the Subject have put it upon that Issue. And it is the Business of this Paper to shew that at least in our present Situation it would; and whether it is made out to be probable that it would, is submitted to them, and the rest of the Gentlemen and Tradesmen of the Town and Country. I have no other View, that I know of, but to serve Mankind in general, the Place where I live in particular, and most particularly in the way of my Profession, and by doing this to make my self regarded.
January
12. 1732-33.
D. HARTLEY.
FINIS.