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May 16, 1863.]
ONCE A WEEK.
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phenomenon which roused curiosity as to how it could have happened, we now read of sixty or seventy deaths per week in London alone. The Smallpox Hospital seemed, some few years since, to be going out of use; and some people began to covet it for other purposes, and reckon how soon they might propose for it; and now its directors have been advertising, day by day, that it can receive no more patients. It has been gradually filling for a considerable period; at present it is overfull: and it is continually sending away patients whose troubled friends do not know what on earth to do next for their sufferers. After being mischievously careless and thoughtless, many of the citizens are becoming mischievously alarmed; and the most rational part of the public has undeniable reason for anxiety. If the sufferers remain where they sicken, they endanger the persons about them to an unknown extent: and if they are removed, they may leave the infection in the vehicles which carry them, and wherever they go. One’s London acquaintance complain of having met men and women in the street full of the eruption, and of children sickening with it lounging on doorsteps, or, just recovering, playing in the squares.

We, in the country, hear worse things in proportion to our numbers than Londoners. The smallpox is in the village school. A. B. cannot be married next week because he is down in smallpox, and his betrothed cannot go near him because she has never been vaccinated. C. D., who was so pleased at having got an excellent place in Manchester, little supposed she was leaving our valley for ever: but her mistress writes that the doctor can give no hope, for a worse case of smallpox he never saw. The poor girl was never vaccinated. If it is shocking to hear of seven in one house all down at once, or in quick succession, it is afflicting to go from cottage to cottage in a village, and to see children in arms, fine lads and lasses, or the head of the household in the loathsome condition which our parents hoped we should escape the sight of altogether. It will be very painful, for a generation to come, to observe the effects left by the disease. Our children will see the blind led about, or groping their way; the seamed faces showing how they lost their sight. We shall hear, month after month, the consumptive cough, under which so many smallpox patients waste away sooner or later after another name is given to their ailments. Many a handsome and well-grown boy, and many a pretty and healthy girl will never look like themselves again. Henceforward they will be frail, lame, or weak-eyed, short of breath, and unfit for work, disfigured, and suffering from the change in their skin, as dogs suffer from heat, because they do not perspire. Some who never knew before what headache was will henceforth be seldom without it: and many who could not remember what it was to be feverish, will suffer that misery with every slight ailment. What a thought it is that in London, sixty or seventy people are dying week after week of this disease; and that for every one that dies there are many lying sick of it! We are told on authority that where the disease occurs “naturally” (as we call it) one in four dies. In the Smallpox Hospital the deaths have been stated to be 30 per cent. Among the vaccinated not one in 450 dies.

Here, then, is reason enough for humiliation under this scourge. We have not been vaccinated at all, or we have been vaccinated badly; multitudes have never been watched, to see whether the experiment succeeded; and the class whose business it was to see that the vaccine matter was of the proper quality have been lax about this great duty,—receiving and using any lymph which was said to have come from the cow, without ascertaining whether the cow’s case was that of the true pock; or taking lymph from the human subject from one course of years to another, without trying whether it had lost its efficacy by long transmission.

There is another reason for shame and grief which, being admitted in a general way, is not enough thought of in connection with smallpox. We all understand the mischiefs of the old method of nursing in this disease, when fresh air was excluded, and heat and crowding, and noise and confusion increased the patient’s fever: but as far as I know, it never occurred to any of us that smallpox comes of itself, like ordinary fever, when the air is vitiated in a certain manner, to a certain extent. I know of nobody who ever publicly and confidently said this before Miss Nightingale. She tells us, in her “Notes on Nursing,” that she was brought up to suppose that smallpox was a special disease which had been communicated from one person to another, from the first that had it,—(however that person may have come by it:) whereas Miss Nightingale has herself seen smallpox created by bad management. She has, moreover, seen one of these special diseases pass into another, according to the circumstances which surrounded the patient. She has seen smallpox begin where it could not possibly have been “caught:” and she has seen fever which began among people living crowded together pass into typhoid fever, if the crowding increased; and into typhus, after more crowding still.

These considerations are beyond measure important to us at this juncture, for more reasons than one.

If it is indeed the truth that the diseases which we have always considered as special, and natural to man, are actually generated by our own mismanagement, the prospects of posterity are very different from what has been supposed, and our own duty must appear to us in a very different light. We are vexed at the ignorance of our cottagers and servants who resist precautions against smallpox, because they suppose that everybody has the disease in him, and is appointed to undergo the illness; and that all endeavours to evade it will only make him suffer more in another way. Yet we are not much wiser than this if we believe that the disease must be “caught,” and that therefore we need fear nothing whatever from it if it is kept down by vaccination. We have always believed this; and now we find ourselves in the midst of such an amount of it as we never imagined would be seen again in England. We must not overlook the very significant facts that, along with smallpox, there is an alarming prevalence of typhus fever: and that this fearful spread of typhus is attributed