|Epidemic City Fathers|
| Epidemic City Fathers in circum-1900 England
Famously, the first-ever vaccinal preventive was against the extremely infectious disease of smallpox (officially 1796). Yet only during the 1970s was an eradication-strategy fully implemented: isolation of sufferers; isolation-plus-vaccination of contacts. What occurred during the 180 years between these two developments was, in England-Wales, a classic of how not to build public support for official medicine, particularly among those who, into the circum-1900 decades, were widely considered unworthy of inclusion within the 'public'.
On their side, anti-vaccinationists of all classes preferred to blame environment, notably insanitation. This underlines our question: what sort of environment did local 'anti' Councillors or Poor-law Guardians help create?
Most prominently then and now, those in the Midland city of Leicester picked-and-mixed intelligently among the policies which Whitehall tried to force on them: non-enforcement of vaccination for as many years as they dared, but widely-supported insistence on isolation in a separate hospital or, well-enforced, in sufferers' homes. Meanwhile, each successive Medical Officer whom they appointed vaccinated as many as he could persuade, not least among those who were coming to be defined under that new word, "contact". In effect, the two sides muddled through together towards something of a forerunner of the 1970s.
Even here, though, luck played a major role. And few other 'anti' local authorities exactly distinguished themselves. Though proud of their locally low vaccination-rates, all too many left hospital-provision till too late. Some even wasted precious time in doctrinal disputation. One example of all these aspects is the Yorkshire industrial town of Dewsbury where also, during late 1904, Councillors tried imposing a news blackout to, of all things, stem panic. The alternative policy (home-isolation or a sort of mini-quarantine) presupposed an increase in the number of local officials to deal with poor people's culture of mutuality in sickness. Quarantine was not so often (as most historians used to say) mothballed as moth-eaten.
Quarantining of whole cities had long been associated, at least by rhetorically able opponents (plus historians in tow), with absolutism. Yet Australia, self-consciously the most (albino-) democratic country ever, had long relied on oceanic isolation and on quarantining: irrespective of laws, vaccinal practice remained more for emergencies. This logic, though, might also impel the quarantining of large groups of fellow-Australians who, on their side, might be less than enthusiastic. During 1903, Tasmania's government quarantined the island's second city of Launceston. The inhabitants, from the mayor down, celebrated defiance.
True, "well-vaccinated" towns were not necessarily immune, partly because Whitehall medics had admitted the need for re-vaccination later than most of their continental equivalents. Sheffield's epidemic of 1887-8 showed insufficient provision of hospitals, themselves helping as also in other cities to spread infection in their localities, a possibility which Whitehall had admitted even more belatedly.
Everywhere, smallpox seemed a virus with a rosy future. Ironic that its doom was first sounded in one of the world's most embattled, and also no more than relatively well-provided, 'anti' cities.
Logie Barrow (Bremen University)