Dr. Scott Tebb
[back] Vaccine critics Smallpox
[Son of Willam Tebb.]
A Century of Vaccination and What it Teaches. London: Swan Sonnenschein & Co, 1898 by W. Scott Tebb
CHAPTER 3. Some of the Causes of the Decline in the Small-pox Mortality
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"Dr. Charles Creighton, Alfred Russel Wallace, William White, Prof. Edgar Crookshank, William Tebb, Dr. Scott Tebb, Dr. William J. Collins and his father, of the same name, who had been a public vaccinator for 20 years and had renounced the practice, were all head-and-shoulders above their opponents, both in intellect and in integrity. They may therefore never be mentioned on the radio, nor may their history."---Lionel Dole
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Let me call attention to what has happened with the other diseases in the table. Since 1871-75, typhus (for which we have no State-enforced preventive inoculation) has declined 95 per cent, or a fall as great as there has been in small-pox over the whole period of registration ; and scarlet fever shows the important reduction of 81 per cent, since 1861-65.
To sum up the contents of the present chapter, it will appear that, although there has been a marked decline in small-pox since the last century, there has been an equal, if not a greater, reduction in typhus fever. It has also been shown that since the commencement of registration the vaccination of a gradually increasing proportion of the population previous to the great epidemic of 1871-72 had very little effect on the smallpox death - rate, although there was an appreciable diminution in fever. From this epidemic to the present time, with an increasing neglect of vaccination since 1881, an enormous decline in small-pox has taken place, and a corresponding diminution in typhus and scarlet fevers ; the reduction in all three diseases being due, no doubt, in large measure to the sanitary improvements introduced by the Public Health Act of 1875.
" In these mazes of alleys, courts or rents,'" Dr. Creighton says, "the people were, for the most part, closely packed. Overcrowding had been the rule since the Elizabethan proclamation of 1580, and it seems to have become worse under the Stuarts. On February 24, 1623, certain householders of Chancery Lane were indicted at the Middlesex Sessions for sub-letting, 'to the great danger of infectious disease, with plague and other diseases.' In May, 1637, one house was found to contain eleven married couples and fifteen single persons; another house harboured eighteen lodgers. In the most crowded parishes the houses had no sufficient curtilage, standing as they did in alleys and courts. When we begin to have some sanitary information long after, it appears that their vaults, or privies, were indoors, at the foot of the common stair. In 1710, Swift's lodging in Bury Street, St. James's, for which he paid eight shillings a week, had a 'thousand stinks in it,' so that he left it after three months. The House of Commons appears to have been ill-reputed for smells, which were specially remembered in connection with the hot summer of the great fever-year, 1685."
In the sixteenth and seventeenth centuries, the state of the public health in London was at a very low ebb. The town ditch was a receptacle for all kinds of rubbish and decomposing organic matter ; the streets were unpaved and saturated with slops and other filth. Instead of regular highways, the out-parishes were reached by a maze of narrow passages and alleys. The dwellings of the poor were as bad as they well could be ; the houses projected over the roadway, which was so narrow that they almost met at the top ; there was no attempt at ventilation, and up to and even beyond the time of Queen Elizabeth, the floors were strewn with rushes, and, if we may trust to an epistle from Erasmus to his friend Dr. Francis, physician to Cardinal Wolsey, it would appear that these were seldom thoroughly changed, and, the habits of the people being uncleanly, the smell soon became intolerable. He speaks of the lowest layer of rushes (the top only being renewed) as sometimes remaining unchanged for twenty years, a receptacle for beer, grease, fragments of victuals, excremental and other organic matter. To this filthiness, Erasmus (one of the most acute observers) ascribed the frequent pestilences with which the people were afflicted.
In this chapter, I have attempted to deal with some of the principal causes of the diminution of small-pox. Firstly, I have shown that a part of the decline, and especially that part which has taken place in children, is not necessarily a saving of life, but only a shifting of the mortality on to some other disease, such as measles or whooping-cough, which happens for the time being to be more predominant.
The residue of the diminution is a real gain, and is probably due partly to the displacement of small-pox inoculation by a non-infectious malady; and to this extent was vaccination an advantage as compared with the old variolous inoculation. Other causes have been due to the more abundant air supply in and around houses ; the greater cleanliness of the people in their persons, their houses, and their towns ; and last, but not least, the greater material prosperity and freedom from war, which has been the lot of those who have been fortunate enough to be born into the present century.