SMALL-POX

Its Fearful Ravages during the Eighteenth Century—John Williamson’s Mode of Inoculation— Its Wonderful Success—Small-Pox in Present Century—Vaccination.

AS being next in importance, let us now consider what, for convenience of classification, may be termed epidemics. These are almost all of the exanthematous class. First in importance amongst them stands small-pox, that awful scourge of mankind, fortunately long since divested of its sting by the genius of Jenner. The history of this disease in Shetland I have not been able to trace back further than the year 1700, when Brand visited the country. The worthy old missionary says—“It hath been observed often by the inhabitants that; when in Holy Providence any sickness cometh upon or breaketh up in the country, it useth to go through them like a plague, so that, since we came off, the small-pox hath seized upon many, both old and young; and was so universal that, upon one Lord’s-day, there were ninety prayed for in the Church of Lerwick, all sick of the same disease; whereas, when we were there a few weeks before, there was not one we knew .sick thereof. They say, a gentleman's son, in the country, who had lately gone from the south, and was under it when he came home, brought it with him, which very quickly spread among the people—the old as well as the young—and so sad have been the desolating effects thereof, that one told me, who had arrived here lately from the place, that he verily judgeth that the third part of the people in many of the Isles are dead thereof.” The disease must have been very prevalent when ninety persons were prayed for in one day; for Lerwick, in 1700, only contained a population of about 1000. During the eighteenth century, small-pox continued to work awful havoc in these islands. For the greater part of that period it visited them regularly every twenty years—viz., as already mentioned, in 1700, and again in 1720, 1740, and 1760. In 1720, the disease was so fatal as to be distinguished by the name of mortal pox. On this occasion, tradition tells us, in the remote Island of Foula, probably inhabited then by about two hundred people, it only left four or six (I forget which) to bury the dead. In 1760, small-pox was also very fatal. During this epidemic, inoculation was introduced; but, owing to the high fee (two or three guineas) of the operator, only ten or twelve persons availed themselves of it. The malady again appearing in 1769, inoculation was more generally had recourse to, and, practised according to the usual method, appears to have been followed by the usual results— viz., those of diminishing the mortality, but spreading the disease. The mortality still continuing very great, a common, uneducated, but very able peasant, named John Williamson, invented an improved method of inoculation, which, had it not been superseded by the more valuable discovery of vaccination, I venture to say, would have proved one of the most valuable discoveries in modem medicine. Williamson's method is thus described in 1792, by his contemporary, the Rev. Mr Dishington:—“He is careful in providing the best matter, and keeps it a long time before he puts it to use—sometimes seven or eight .years; and, in order to lessen its virulence, he first dries it in peat smoke, and then puts it underground, covered with camphor. Though many physicians recommended fresh matter, this self-taught practitioner finds, from experience, that it always proves milder to the patient when it has lost a considerable degree of its strength. He uses no lancet in performing the operation; but, by a small knife made by his own hands, he gently raises a very little of the outer skin of the arm, so that no blood flows; then puts in a very small quantity of matter, which he immediately covers with the skin that had been thus raised. The ohly plaster that he uses for healing the wound ia a bit of cabbage leaf. It is particularly remarkable, that there is not a single instance in his practice where the infection has not taken place, and made its appearance at the usual time. He administers no medicine during the progress oi the disease, nor does he use any previous preparation.” Mr Dishington also informs us that “several thousands have been inoculated by him ' (Williamson), and he has not lost a single patient.”

It may here be proper to state that there can be no doubt of the nature and results of Williamson's practice as above described; for Dr Edmondston, writing in 1808, only sixteen years after Mr Dishington had published his account of it, says: “ Since 1770 inoculation has been performed by a great number of native doctors, one of whom (i.e., Williamson) met with such unexampled success in his practice, that were I not able to bear testimony to its truth, I should myself be disposed to be sceptical on the subject.”

Mr Dishington informs us that Williamson, from his “various attainments and superior talents,” was called Johnny Notions among his neighbours. Under this cognomen he is spoken of by his countrymen to this day. To his “ attainments ” in medicine and surgery he added the arts of the shoemaker, the tailor, the carpenter, the cutler, the farmer, and the fisherman. In short, he appears to have been a bona fide “ ack-of-all-trades,” and probably master of a good many of them. As to his medical practice, one remarkable circumstance is the statement of Mr Dishington that “he administers no medicine daring the progress of the disease.” Is it not strange that, at the very time when the most learned and able physicians in Europe treated most inflammatory diseases by excessive salivation, bleeding, purging, and blistering, this poor unlettered empiric in the Shetland Islands refrained from the use of medicine altogether. This is the more remarkable as the people among whom he practised believed then, as their descendants do now, that a medical disease can only be successfully treated by incessantly pouring down immense doses of drugs. The advanced surgical practice of “Johnny Notions” is no less wonderful. He applied to his lancet wound simply a “piece of cabbage blade,” while his contemporary, Mr Bromfield, “Surgeon to Her Majesty and to St George’s Hospital,” London, dressed his larger wounds with thirteen layers of applications placed on them at the same time.

After this long, but I trust pardonable, digression, it will now be necessary to conclude this imperfect sketch of the history of small-pox in these islands. The disease again broke out in 1791, but on this occasion it seems to have assumed a very mild form, no doubt owing in & great measure to the efforts of “ Johnny Notions” who, whenever human suffering demanded, was found itinerating the country, and saving thousands of lives by his great discovery. In 1804 vaccination was introduced, and at first was taken advantage of by many of the people. Very soon, however, vaccination, like inoculation, got into the hands of ignorant men, who could not distinguish true lymph from matter resembling it. The matter thus introduced into the system proving itself spurious on the appearance of small-pox, the confidence of the people in vaccination was almost destroyed, and it fell into comparative disuse till 1830. In this year a pretty severe epidemic of variola brought them to their senses. Since then vaccination has been pretty generally practised, considering the paucity of medical practitioners, the insular and detached nature of the country, and at the same time the absence of any severe or wide-spread epidemic of small-pox. When the malady did reach the islands it was chiefly through the seaport of Lerwick; and the accommodation afforded by the little hospital in that town has no doubt done much to prevent its extension. Notwithstanding all they have suffered from small-pox, the people of some of the remote islands were at first very refractory against the working of the “ Compulsory Vaccination Act,” as I found wheu sent there to perform the operation. The fearful mortality from small-pox during the first half of last century was, undoubtedly, very much to be ascribed to the murderous “ hot method ” of treatment, which, then universally prevailed. The antiphlogistic method is said to have been first adopted in Shetland by the late Principal Jack, of King's College, Aberdeen, who was a native of the country, and whose original profession was that of a Doctor of Medicine.