Compulsory Vaccination is a letter written by Arthur Conan Doyle first published in The Evening Mail (Portsmouth) on 15 july 1887.





Compulsory Vaccination

Sir, — From time to time some champion of the party which is opposed to vaccination comes forward to air his views in the public Press, but these periodical sallies seldom lead to any discussion, as the inherent weakness of their position renders a reply superfluous. When, however, a gentleman of Colonel Wintle's position makes an attack upon what is commonly considered by those most competent to judge to be one of the greatest victories ever won by science over disease, it is high time that some voice should be raised upon the other side. Hobbies and fads are harmless things as a rule, but when a hobby takes the form of encouraging ignorant people to neglect sanitary precautions and to live in a fool's paradise until bitter experience teaches them their mistake, it becomes a positive danger to the community at large. The interests at stake are so vital that an enormous responsibility rests with the men whose notion of progress is to revert to the condition of things which existed in the dark ages before the dawn of medical science.

Colonel Wintle bases his objection to vaccination upon two points: its immorality and its inefficiency or positive harmfulness. Let us consider it under each of these heads, giving the moral question the precedence which is its due. Is it immoral for a Government to adopt a method of procedure which experience has Proved and science has testified to conduce to the health and increased longevity of the population? Is it immoral to inflict a Passing inconvenience upon a child in order to preserve it from a deadly disease? Does the end never justify the means? Would it be immoral to give Colonel Wintle a push in order to save him from being run over by a locomotive? If all these are really immoral, I trust and pray that we may never attain morality. The colonel's reasoning reminds me of nothing so much as that adduced by some divines of the Scottish Church, who protested against the induction of chloroform. "Pain was sent us by Providence," said the worthy ministers, "and it is therefore sinful to abolish it." Colonel Wintle's line of argument is that smallpox has been also sent by Providence and that it becomes immoral to take any steps to neutralise its mischief. When once it has been concisely stated, it needs no further agitation.

In the second place is the mode of treatment a success? It has been before the public for nearly a hundred years, during which time it has been thrashed out periodically in learned societies, argued over in medical journals, examined by statisticians, sifted and tested in every conceivable method, and the result of it all is that among those who are brought in practical contact with disease, there is a unanimity upon the point which is more complete than upon any other medical subject. Homoeopath and allopath, foreigner and Englishman, find here a common ground for agreement. I fear that the testimony of the Southsea ladies which Col. Wintle quotes, or that of the district visitors which he invokes, will hardly counter-balance this consensus of scientific opinion.

The ravages made by smallpox in the days of our ancestors can hardly be realised by the present sanitary and well-vaccinated generation. Macaulay remarks that in the advertisements of the early Georgian era there is hardly ever a missing relative who is not described as "having pock marks upon his face." It was universal, in town and in country, in the cottage and in the palace. Mary, the wife of William the Third, sickened and died of it. Whole tracts of country were decimated. Now-a-days there is many a general practitioner who lives and dies without having ever seen a case. What is the cause of this amazing difference? There is no doubt what the cause appeared to be in the eyes of the men who having had experience of the old system saw the Jennerian practice of inoculation come into vogue. When in 1802 Jenner was awarded £30,000 by a grateful country the gift came from men who could see by force of contrast the value of his discovery.

I am aware that Anti-Vaccinationists endeavour to account for the wonderful decrease of smallpox by supposing that there has been some change in the type of the disease. This is pure assumption, and the facts seem to point in the other direction. Other zymotic diseases have not, as far as we know, modified their characteristics, and smallpox still asserts itself with its ancient virulence whenever sanitary defects, or the prevalence of thinkers of the Colonel Wintle type, favour its development. I have no doubt that our recent small outbreak in Portsmouth would have assumed formidable proportions had it found a congenial uninoculated population upon which to fasten. In the London smallpox hospital nurses, doctors and dressers have been in contact with the sick for more than fifty years, and during that time there is no case on record of nurse, doctor, or dresser catching the disease. They are, of course, periodically vaccinated. How long, I wonder, would the committee of the Anti-Vaccination Society remain in the wards before a case broke out among them?

As to the serious results of vaccination, which Colonel Wintle describes as indescribable, they are to a very large extent imaginary. Of course there are some unhealthy children, the offspring of unhealthy parents, who will fester and go wrong if they are pricked with a pin. It is possible that the district visitors appealed to may find out some such case. They are certainly rare, for in a tolerably large experience (five years in a large hospital, three in a busy practice in Birmingham, and nearly six down here) I have only seen one case, and it soon got well. Some parents have an amusing habit of ascribing anything which happens to their children, from the whooping-cough to a broken leg, to the effects of their vaccination. It is from this class that the anti-vaccinationist party is largely recruited.

In conclusion I would say that the subject is of such importance, ancestors call and our present immunity from small pox so striking, that it would take a very strong case to justify a change. As long as that case is so weak as to need the argument of morality to enforce it I think that the Vaccination Acts are in no great danger of being repealed.

It was Yours faithfully,

A. CONAN DOYLE, M.D., C.M.

Bush Villa, July 14th, 1887



