[back] Smallpox vaccination lies

[extracted from] 1884 book:  SIR LYON PLAYFAIR  taken to Pieces and Disposed of:  LIKEWISE  SIR CHARLES W. DILKE, BART by William White

7.—The Grand 3,000 per Million Statistic.

" In examining the state of Vaccination, we compare the Mortality from Smallpox with that of last century. This, Dr. Farr tells us, was 3,000 per million of the population annually for the whole country."

Let us pay special attention to this statistic because of the importance assigned to it, and because it affords an excellent test of Sir Lyon Playfair's veracity.

First, we ask, Where does Dr. Farr tell us "that the Mortality from Smallpox was 3,000 per million for the whole country last century ? " It would not be safe to meet the statement with a direct negative, for Dr. Farr may somewhere have been betrayed into a thoughtless repetition of the fiction; but it is unlikely, and therefore we ask, Where ?

At a session of the Vaccination Committee on 7th March, 1871, Dr. Lyon Playfair being present, the 3,000 per million statistic was under consideration, and Dr. C. T. Pearce stated—

"I put the question to Dr. Farr at Somerset House whether the estimate of 3,000 per million was to be relied upon, and whether there were any statistics that would enable such a conclusion to be arrived at; and Dr. Farr said emphatically, ' No, it is a mere estimate; no statistics of the last century, or of the previous one, are to be relied upon.'"

Dr. Farr's answer to Dr. Pearce was matter of course. There are no trustworthy statistics for last century or for the first third of the present. The 3000 per million Smallpox Mortality was never more than a conjectural estimate; and it is easy to show that as a conjectural estimate it is preposterous.

It originated thus. Dr. Lettsom in his Observations on the Cowpox, published in 1801, during the early Vaccination furore, wrote—

" In London and its environs there are about one million of inhabitants, of whom about 3,000 die annually by the natural Smallpox, or about 36,000 in Great Britain and Ireland."

Dr. Lettsom's estimate was raised by Sir Gilbert Blare to 45,000, and, fancy being free, other estimates were put forth, and continue to be put forth; Dr. Playfair himself saying at St. Mary's Hospital in 1870, that "80,000 lives were saved annually by Vaccination."

But did 3000 die annually of Smallpox in London last century ? Fortunately we can refer to Dr. Farr for an answer. In M'Culloch's Statistical Account of the British Empire he wrote—

"Smallpox attained its maximum mortality after Inoculation was introduced. The annual deaths from Smallpox averaged 2,323 from 1760 to 1779; in the next twenty years they declined to 1,740; this disease, therefore, began to grow less fatal before Vaccination was discovered ; indicating, together with the diminution of Fever, the general improvement in health-then taking place."

Thus the average annual London Smallpox mortality toward the close of last century was not 3,000: it was 1,740.

But whatever the metropolitan death-rate, where was the warrant for converting it into the death-rate of England, Wales, Scotland and Ireland ? London overcrowded and pestiferous, was no standard for the general population, urban or rural; and the assumption was monstrous that Smallpox, a notoriously sporadic disease, was constant and equally diffused over the land. We are without statistics for the time in question, but arguing from London of to-day in constant communication with the provinces, to London of the 18th century in comparative isolation, what do we find? Why, Smallpox prevalent in London with little or no Smallpox in the country ! In the early part of 1878 there were 1,134 fatal cases registered within fifteen miles of Charing Cross, while but 8 occurred in nineteen English towns with an aggregate population equal to that of London. Indeed, forgetful of its destruction of his own case, Sir Lyon Playfair brings out the irregularity between London and country Small­pox in forcible terms.    Thus he says—

" The epidemic of 1871 struck the civil population of England and Wales strongly and was exceptionally severe in the metropolis. With the exception of local outbursts in Birmingham, Liverpool, and Salford, Smallpox since 1873 has been very small in all our large towns, except London, where it has lingered, and came as a renewed outburst in 1877 and 1881. Most of the arguments of the Anti-Vaccinators are derived from Metropolitan Smallpox. Thus, in 1880 the total deaths in England and Wales from Smallpox were 648, out of which London alone was responsible for 471. The epidemic of 1871-72 was general and severe, but the recent epidemics of 1877 and 1881 have been mainly Metropolitan. . . . While, therefore, other parts of the country seem to have recovered from the great epidemic influence of 1871, London has not yet gained control over the disease. It had practical immunity in 1873, 74, 75, but outbursts came in 1877 and 1881—in the latter year to about one-third of the extent of 1871, but still amounting to 640 per million. That, large as it is, represents about one-fifth of the average mortality of the last century. The other parts of England and Wales during the same year had only a mortality of 100 per million"

The sporadic character of Smallpox is illustrated where-ever we get at the figures. In 1874 there were in London 735 deaths from Smallpox but not one in Birmingham; 386 in Liverpool, but not one in Plymouth; 347 in Salford, but not one in Nottingham; 190 in Manchester, and but 1 in Sheffield; 24 in Bristol and 4 in Leeds; and so on. What reason is there to believe that what is true of Smallpox within our own experience was otherwise than true in the experience of our forefathers ?

With these facts before us, we see how baseless was Lettsom's original estimate, and how unwarrantable was the extension of the London rate to the population of the United Kingdom, and the assumption of the equal diffusion of the disease over the country. Yet the imaginary statistic is used by Sir Lyon Playfair as if its accuracy were indisputable—eking it out occasionally with an exaggeration of his own ; thus—

" The average death-rate from Smallpox in London " before Vaccination was 4,000 per million, and in the " great epidemic year 1871, it was 2,420 per million. So " that even in this exceptionally severe epidemic the " death-rate was only about one-half of that of average " years in last century."

Dr. Lettsom said  the London  Smallpox death-rate was 3000 per million; Dr. Farr said it had fallen to 1740 before Vaccination was introduced; whilst Sir Lyon Playfair says it was 4000. Well, statistics at discretion cost nothing, and are worth—what they cost.