At the close of last century, variolation had become the custom of the upper and middle classes of England. The trouble and the peril were disliked, but were accepted in the name of duty. The variolation of their children was an anxiety that weighed like lead on the hearts of affectionate parents; and glad and grateful they were when the operation was accomplished without serious mishap. Patients designed for variolation were dieted, purged, and bled; and smallpox from sufferers of sound constitution was diligently inquired for. Mild smallpox was in great demand and was propagated from arm to arm. When Dr. Dimsdale operated on the Empress Catharine he did not venture to convey smallpox direct to the imperial person. He looked out a case of “benign smallpox” with which he inoculated a strong young man, and from the young man the Empress. Unless we realise the inconveniences, the uncertainties, the disasters and the horrors of the practice of variolation, albeit minimised, excused and denied by its professors, we can never understand the enthusiasm with which vaccination was received as its substitute. The promise conveyed in vaccination was a relief inexpressible, bearing with it a show of reason that was well nigh irresistible. The argument ran thus: No one can have smallpox twice, and the mildest attack is as protective from subsequent attack as the severest. Therefore it is that in inoculation with smallpox we find security. But inoculation with smallpox is an uncertain operation with dangerous issues. Here, however, in cowpox is discovered a mild variety of smallpox, which may be inoculated with perfect ease, and with no possibility of harm. And inasmuch as the mildest smallpox is as preventive of future smallpox as the severest, it follows that this gentle cowpox must serve as a full equivalent for smallpox itself.
It was in this plausible shape that vaccination had an immediate triumph. The way was made straight for it and every difficulty removed by the existing practice of variolation. Dr. W. B. Carpenter says that vaccination was more strenuously resisted at the beginning of the century than it is at this day. He is completely mistaken. Vaccination came upon a generation prepared for it--which saw in it a prescription in full accord with common-sense. The entire medical profession, with a few exceptions, the King, Queen and court, were converted straight off, and parliament and society followed suit. It was, I confess, a natural development of opinion; and we need have little doubt that had we lived in those days we should have found ourselves shouting with the genteel mob. The limited resistance offered to vaccination was not based on physiological or sanitary science: such science did not then exist. It was the resistance of variolators who were satisfied with the established practice and resented its disturbance; professing at the same time immeasurable horror at the profanation to humanity by infection with bovine disease. Whilst we have no reason to identify ourselves with that resistance, we have to recognise the service rendered by the variolators in observing the results of vaccination--the persistency with which they traced and exposed its failure to prevent smallpox and the injuries and deaths it caused. So far as the maintenance of variolous inoculation was concerned, they fought a losing battle; but they drove the vaccinators from post to post (cursed while they did so as malignant false witnesses possessed of the devil) and at last compelled the admission that their infallible preventive could not be guaranteed to prevent, but only to make smallpox milder--a safe assertion because unverifiable, as disputable as indisputable in particular instances.