DOUGLAS SHEPHERD on how 18th Century Scottish medics faced 'the wrath of God' in their battle against small pox
Recent surveys have suggested that one in six Scots were unlikely to agree to being vaccinated against Covid 19,with many of them influenced by strident posts on social media and a flood of misleading and false information to be found on countless web sites.
It has been difficult for politicians, Government scientists and medical staff to persuade these doubters that the benefits of the vaccines far outweigh the risks and disadvantages.
But the battle to win hearts and minds in 2021 is nothing compared to the widespread hostility and abuse faced by the inoculators who were attempting to turn back an eighteenth century tide of small pox which was claiming the lives of millions across the continent of Europe.
By the year 1760 small pox was so common that in some locations up to 96,000 people in every 100,000 had been exposed to the disease. One in every three or four children who suffered the terrible affliction did not survive. More than a third of the deaths of Scottish boys and girls under the age of 10 was down to the dreaded pox.
In such circumstances surely the arrival of a medical procedure offering a much better chance of survival would be welcomed by parents desperately hoping and praying their children would survive and recover.
A paper written by Alexander Monro, surgeon and anatomist and Foundation Professor at the University of Edinburgh described how the first place in Scotland where the practice of inoculation became frequent was Dumfries, a town where "the natural small pox were generally of a remarkably bad malignant kind" The pioneering attempts at protection began there in 1733.
Inoculation involved making a small incision on a patient’s limbs and then introducing material from the pus of the pock of another patient with a minor form of the disease to the open incision. This allowed the patient to become infected with a minor and more controlled form of small pox and thereby develop immunity from the disease for life.
But just like Covid injections there could be complications and side effects for a small minority of recipients, and on occasion the patient would die as a result of inoculation.
In 1764 Monro was appointed to inquire into the advantages and drawbacks of small pox inoculation by the Dean and delegates of the Faculty of Medicine at Paris. His very detailed report, An Account of the Inoculation of Smallpox in Scotland, became a prime reference source for future generations of doctors and historians.
The professor told the French faculty: "The first and most general prejudice against inoculation, was its being deemed a tempting of God's providence, and therefore a heinous crime; for it was creating a disease by which children's lives might be in danger. The greater number of the gentry, and most of the medical gentlemen, see the latter scruple, or neglecting what they think proper means, in the strongest light, and have their children inoculated; but the former one, the tempting of Providence, weighs more among many of the populace, who will not allow the small pox to be artificially implanted."
Monro argued that if it was true a much greater number lost their lives by the natural than by the artificial infection, it was better to introduce the small pox artificially than to allow the disease to "destroy multitudes".
On a comparison of those who had died of inoculated small pox with those who had fallen victim to the disease in the natural way, it was evident there was a much greater proportion of the latter than of the former. In other words, an 18th Century parallel of today's pros and cons surrounding Covid vaccination.
Research carried out by Monro proved that of 5,554 people inoculated with small pox 72 died. A table of statistics shows that in Dumfries 560 residents were inoculated and nine died as a result of the intervention. The returns from Monro's correspondents also revealed the following numbers: Edinburgh & Leith 703 inoculations (10 deaths); Glasgow 970 (seven) and the Scottish Borders burghs 130 (one death in Kelso).
The strength of feeling against inoculation among the God-fearing Scottish masses is graphically illustrated in a PhD thesis for the Open University, written in 1977 by Alfred Derek Farr and entitled Medical Developments and Religious Belief with Special Reference to Europe in the 18th and 19th Centuries.
Mr Farr, who trawled through hundreds of church records for his material wrote: "In Scotland, with its Calvinist traditions of the supreme sovereignty of God and the supreme authority of the scriptures, resistance might have been expected to the introduction of inoculation and, in contrast to England, there is indeed clear evidence of widespread opposition to inoculation surviving at least until the end of the 18th century."
He found evidence that apparently none of the Church of Scotland ministers in more than 800 parishes were opposed to inoculation even though, in some cases, the vast majority of their parishioners were steadfastly against the practice.
The Farr thesis includes the following passage: "The reasons for not accepting inoculation were twofold: Most objections were made on religious grounds. These were well expressed by the minister of. Dron (Perthshire) as 'A superstitious dread of acting contrary to the will of heaven, by introducing disease' into the human frame, not inflicted by the immediate hand of Providence'.
"The minister of Auldearn (Nairnshire) was even more blunt and specific, noting that "the people are in general averse to inoculation, from the general gloominess of their faith, which teaches them, that all diseases which afflict the human frame are instances of the Divine interposition, for the punishment of sin; any interference, therefore, on their part, they deem an usurpation of the prerogative of the Almighty. Such views were, of course, in conformity with the Calvinist teaching of the sovereignty of God. In Tough (Aberdeenshire) 'so violent were the prejudices of the people, that, it is said, some of them declared, if the inoculated children had died, they would have considered it as a just dispensation of Providence'".
Farr discovered from Kirk documents that other considerations than religion also applied, for it was noted that inoculation, was not practised as widely as it might be from reasons of expense.
So far as the cost of inoculation was concerned, at this time, in Aberdeen, a labourer earned only 10d a day, while a skilled carpenter or mason earned ls. 6d.a day and a female servant's wages for a half-year were £1.10s.
As Farr observed: "With beef at 4d. per lb and cheese at 5s. a stone, few ordinary people would have had even a crown (5s. = 25p. ) available to pay the surgeon. For this reason, as well as that of the relatively few medical practitioners available in many country areas, many ministers practised inoculation themselves gratis, and one clergyman even suggested that divinity students should be instructed 'in the art' of inoculation as part of their training.
There were initiatives in some areas aimed at circumventing the costs associated with inoculation.
"At Towie (Aberdeenshire) 'the minister recommended from the pulpit a general inoculation throughout the parish, and as an encouragement to the poorer sort, added that no fees to the surgeon would be expected from them who could not afford the expense. In consequence of which, all the children, and young people, some of them 20 years of age and upwards, who had not formerly had the small-pox, were inoculated at once"
The 1977 thesis by Farr also cites the clan system of 18th century Scotland as a factor for the presence of so many inoculation deniers in society.
He concluded: "A further reason may well lie in the Scottish character and traditions. The ancient clan system bred a feeling of loyalty to the clan and its chief which far outstripped that offered to central government. Together with the traditional independence of the Scottish character this led to a situation in which any central authority had difficulty in imposing its will in Scotland.
"It is very possible that these factors had much to do both with the ready acceptance of the Calvinist reformation in religion and the general opposition to inoculation in Scotland: both shows of independence against a remote central authority - the church of Rome in the one case and the corporate attitude of the British medical profession in the other."
But Farr notes that the clan system was 'broken' with the failure of the 1745 rising and it is possibly significant that it was after that time strict Scottish Calvinism drifted towards 'moderatism', and Scottish opposition to inoculation melted away, as the country came under the sway of central authorities which were, for the first time, free of' the constraining influence of the independent clan chiefs.
So almost 300 years ago with not a derogatory Facebook post or a negative Tweet in sight to hinder them the brave physicians who ventured out into the community to inoculate their patients with pox pus faced a much more powerful adversary than social media...the contemporary fear of the wrath of God.
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