Pox (43 page)

Still, even their detractors had to admit that the antivaccinationists constituted a genuine movement, complete with its own polemicists, its own journals (notably the Terre Haute–based
Vaccination
, 1898–1906, and
The Liberator
, 1898–1907); its own international literature of pamphlets and books; and its own lawyers (including C. Oscar Beasley of Philadelphia, who specialized in vaccine injury suits, and Harry Weinberger of New York, for whom antivaccination was part of a distinguished career in defense of civil liberties). The societies sent delegates to international congresses in Paris, Cologne, and Berlin. Every well-read American antivaccinationist knew that Leo Tolstoy sympathized with the cause, as he did “with every struggle for liberty in any sphere of life”; that George Bernard Shaw called vaccination “a peculiarly filthy piece of witchcraft”; and that the British naturalist Alfred Russel Wallace had predicted, in 1898, that the practice “will, before many years have passed, be universally held to be one of the foulest blots on the civilization of the nineteenth century.” As American antivaccinationists saw the international “Vaccination Question,” theirs was the enlightened view of the matter. The apologists for state medicine were the true cranks. The antivaccinationists were determined to wipe the blot of compulsion from the statute books of the United States.
²¹

Who were the antivaccinationists?

In England, antivaccinationism fostered a cross-class alliance of factory workers, artisans, clerks, and shopkeepers. English vaccination measures explicitly targeted working-class families, and antivaccinationism gained strongholds in workers' neighborhoods, especially those with robust labor movements. For a half century after the passage of England's first compulsion statute in 1853, hundreds of thousands of parents joined the movement to resist government-mandated vaccination of their children. Many were fined or jailed. Government distraint sales—public auctions of property seized from resisters who failed to pay their fines—spawned riots. An estimated 80,000 to 100,000 people participated in the Leicester Demonstration of 1885, a grand urban spectacle that featured the hanging of Edward Jenner in effigy. Parliament established the Royal Commission on Vaccination in 1889. After studying the subject for seven years, the commission endorsed vaccination as scientifically sound but advised Parliament to create an exemption for “conscientious objectors”: people who sincerely believed the procedure threatened their own or their children's health. Parliament introduced that exemption by law in 1898. Within ten years, conscience exemptions reached one quarter of all births in England.
²²

In the United States, organized antivaccinationism never enjoyed such a broad, politicized working-class base. Most activists instead came from the country's broad, educated middle class. A typical league counted among its members businessmen and lawyers, shopkeepers and artisans, schoolteachers and housewives. To an outsider, the most striking fact about antivaccination activists—particularly those who wrote tracts and made public speeches—was how many of them were doctors. Or how many
called themselves doctors
, a regular physician would have said.

The controversy over the vaccination question was closely tied to the contemporary battle over state medical licensing and the increasing dominance of “regular,” allopathic medicine. So intertwined were the two issues in some states (including New York and Massachusetts) that at times the political fight over compulsory vaccination could seem little more than a proxy war for the professional struggle over licensure. But it was much more than that.
²³

The ranks of the antivaccination movement teemed with practitioners of the stunningly diverse systems of alternative medicine to be found in turn-of-the-century America. For many so-called irregular practitioners, the rise of state medicine in the late nineteenth century—with its boards of health, medical licensing bodies, and compulsory vaccination orders—was an insidious development. State medicine posed a direct challenge to their livelihoods and to their ways of understanding the body, nature, and the world. For many alternative practitioners, the fights against compulsory vaccination and medical licensure were two fronts in the same war. By discrediting vaccination, the Indiana “Physio-Medical” practitioner Dr. R. Swinburne Clymer declared, “we are striking at the very root and foundation of so-called scientific or ‘regular' medicine.”
²⁴

It was a long-running war. In the early republic, state licensing laws had granted a professional monopoly to mainstream physicians of the allopathic school. It had been their idea to call themselves “regular” physicians and their upstart competitors in homeopathy and Thomsonianism “irregulars.” During the 1830s and 1840s, those laws were wiped off the books by state lawmakers, part of the broad Jacksonian-era assault on intellectual elitism and government-granted special privileges of all sorts. As the Massachusetts Sanitary Commission lamented in 1850, henceforward “any one, male or female, learned or ignorant, an honest man or a knave, can assume the name of physician, and ‘practice' upon any one, to cure or to kill, as either may happen, without accountability. ‘It's a free country!'” Free to healers and also free to patients, who could choose among practitioners, all of whom were equally entitled to hold themselves out as “doctor.”
²⁵

By 1900, the United States had an estimated 110,000 orthodox physicians and roughly 20,000 practitioners of alternative medicine. The bestestablished irregulars were America's 9,000 homeopaths (who treated disease by administering minute doses of remedies known to produce symptoms in a healthy person that were similar to those of the disease) and the eclectics (who favored botanical remedies). Relative newcomers to the medical culture included practitioners of osteopathy, chiropractic, and naturopathy—all forms of drugless healing. Although adherents of each of the unorthodox schools viewed their own system as superior, they shared a general belief in the therapeutic and preventive power of nature—emphasizing the virtues of sound diet, a daily regimen to maintain the integrity of the body, and the administration, in times of illness, of gentle remedies such as herbs. The irregulars rejected the mercurial drugs, bleedings, and other strenuous measures of mainstream practice. They prided themselves on their holistic, empirical, “common sense” approaches to disease. For much of the nineteenth century—the age of heroic surgeries and toxic mercurials—the irregulars' gentler medicine seemed to many patients the safer approach.
²⁶

For years, the unbridled contempt of the mainstream medical societies had only enlarged the irregulars' self-esteem, and, not incidentally, their market share. From its inception in 1847, the American Medical Association had strived to drive the irregulars (particularly the homeopaths) from the temple of medicine. The association imposed on its members a “consultation clause,” which forbade them to consult with doctors who lacked “proper” (regular) medical credentials. Even in the absence of exclusive state licensure laws, this clause effectively barred homeopaths from practicing in many publicly funded hospitals. Regulars who consulted with unorthodox practitioners faced expulsion from their medical societies. The consultation clause was increasingly perceived by the public as petty and dangerous. (The AMA would eventually do away with the mandatory provision in 1903.) And as Dr. Oliver Wendell Holmes acknowledged as early as the mid-nineteenth century, every insulting comment from a regular physician was “a gratuitous advertisement” for his irregular rival. The irregulars, Holmes observed, “understand the hydrostatic paradox of controversy: that it raises the meanest disputant to a seeming level with his antagonist.” This was a truism of public debate that the antivaccinationists understood as well.
²⁷

The final decades of the nineteenth century brought a new campaign for state medical licensing laws, precipitating a struggle between the regulars and irregulars that remained heated well into the early twentieth century. The advent of the germ theory of disease enabled extraordinary advances in medicine, particularly in the field of surgery, an area that alternative practitioners had generally conceded to mainstream physicians. Rising standards of medical education and the general culture of middle-class professionalization in late nineteenth-century America helped win the support of state lawmakers. Nearly every state enacted some form of medical licensing statute. Though homeopaths and eclectics were by that time too well established to legally exclude from the practice of medicine, many still resented the government imprimatur that the new laws conferred upon the regular-dominated state medical societies. In most states newcomers in fields such as chiropractic and naturopathy found themselves subject to prosecution for practicing medicine without a license.
²⁸

During its long struggle for authority, the regular medical profession established uneasy but increasingly close ties with American state and local governments. As the AMA and the state medical societies pushed for laws to eliminate their irregular competitors, the AMA helped establish the authority of orthodox practitioners through its pursuit of laws criminalizing abortion and the distribution of information about contraception, and by establishing alliances with boards of health in the control of contagious and infectious diseases. The AMA strongly endorsed compulsory vaccination at its annual meeting in 1899, lamenting that “well-meaning but fanatical persons have, for some time past, been endeavoring to excite a prejudice against vaccination.”
²⁹

Those “persons” included a great many irregulars, who perceived that every medical society endorsement of compulsory vaccination carried a rebuke to alternative medicine. Homeopaths (who many regulars grudgingly recognized as well educated and intentioned) were in fact divided on the vaccination question. Some regarded vaccination as clear proof of the homeopathic maxim
simila similibus curentur
(“Let like be cured by like”), while a vocal minority, including J. W. Hodge, regarded “the state-supported vaccination rite” as an exercise in blood poisoning. The 1901 meeting of the New England Eclectic Medical Association adopted a resolution proclaiming “the right to resist the vaccinator in his disseminating of disease.” Botanical physicians of the Physio-Medical School contributed several leaders to the cause, such as Dr. Clymer, vice-president of the Terre Haute–based Anti-Vaccination Society of America and author of the intermittently brilliant 1904 tract
Vaccination Brought Home to You
. (Clymer figured out that the best sources of damaging material on vaccination were the regulars' own medical journals, where doctors let down their public guards and shared personal experiences of vaccinations gone wrong.) The vaccination procedure may have garnered the greatest scorn from devotees of the least legitimate (in regulars' eyes) schools of drugless healing—including hydropaths and chiropractors. For Dr. T. V. Gifford of Indiana, a “pioneer in Hygeio-Therapy,” antivaccination was simply another part of a sound health regimen, like taking cold baths and avoiding salt, meat, and sex.
³⁰

Although beset and beleaguered, alternative medicine survived the return of medical licensing laws. Homeopaths and eclectics won their own licensing acts in some states. And even practitioners of the new or more marginal schools held out the hope that their system would eventually triumph over medical orthodoxy. “The day of powder and pill and knife is nearing its end,” declared one osteopathic text in 1903.
³¹

Another source of support for the antivaccinationists came from the growing communities of faith healers in turn-of-the-century America. The cause had long enjoyed support from spiritualists, a movement of alternative religion that flourished in the nineteenth century. Known for séances and “table-rappings,” spiritualists emphasized the fundamental unity of matter and spirit; their anti-institutionalism and strong belief in the sovereignty of the individual tied them to various radical causes, including women's rights, antislavery, and antivaccination. Vaccinators were persona non grata at John Alexander Dowie's Zion City, a settlement established outside Chicago in 1899 that banned alcohol, smoking, dance halls, and medical doctors.
³²

Mary Baker Eddy's Church of Christ, Scientist, established in Boston in 1879 and reaching forty thousand members by 1906, shared the natural healers' concerns about vaccination. Adherents of Christian Science believed in the power of the mind to cure disease through prayer. During the 1890s, Christian Scientists had denounced compulsory vaccination as a violation of the laws of God and their religious freedom. In Beloit, Wisconsin, a Christian Scientist won a major legal victory in 1897, securing the right for his unvaccinated children to attend the public schools. When the city council of Americus, Georgia, where smallpox was epidemic in 1899, passed an ordinance compelling vaccination, local Christian Scientists rebelled, insisting their faith would protect them against the disease. City authorities arrested the resisters, assessing fines from $3 to $30 and imposing jail terms from ten to thirty days. Some Christian Scientists joined antivaccinationist societies, while others, such as Putnam J. Ramsdell of Cambridge, Massachusetts, took an individual stand, refusing to comply with local vaccination orders.
³³

In 1900, with the vaccination controversy heating up across the United States, church leaders adopted a new conciliatory stance toward the government. By that time, the young church had gained extensive experience with the American legal system. Christian Science parents had faced prosecution for failing to provide medical treatment for sick children. In some states, authorities arrested Christian Scientists for practicing medicine without a license. (In their defense, the faith healers argued that they were “practicing religion, not medicine,” an argument for religious liberty that American courts increasingly accepted.) In 1900, Eddy issued a terse statement on compulsory vaccination. She advised her followers that “if the law demand an individual to submit to this process, he obey the law; and then appeal to the gospel to save him from any bad results.” Two years later, Eddy advised Christian Scientists to cooperate with health boards by reporting contagious diseases, including smallpox. Both actions were taken in a time when the church and its faithful were struggling for recognition and religious liberty in the states. Eddy cited Matthew 22:21: “Render unto Caesar the things that are Caesar's.” But reports from local communities showed that some Christian Scientists continued to dodge vaccination and to insist upon healing smallpox-infected family members by prayer alone.
³⁴