Smallpox in Ewell
Edward Jenner Vaccinating 8 year old James Phipps on 14 May 1796
The first Sunday of August, 1766, saw an unusual gathering at St. Mary's church in Ewell. A crowd of 156 people - young and old, women and children - attended to give thanks for their health after being inoculated with smallpox in the previous month. Prayers were led by James Hallifax the vicar, who had organised the inoculation, bringing in the surgeon Robert Sutton to provide the medical skills needed. When the service was over, he retired to the vicarage and wrote it all up in a letter to the Gentleman's Magazine.
The population of the village was a little over 1,000 at this time, so that, allowing for strangers and relatives who had arrived to share in protection from the disease, one in ten of Hallifax's parishioners were inoculated. He adds that a further 94 then asked for the treatment on seeing that their friends and neighbours had gone through with it and survived. Most people were inoculated with pus from the sores of a woman and her daughter who lived in the neighbourhood, and who had contracted smallpox in the usual way. Smallpox itself was not invariably fatal, but about 1 in 6 of those who got the disease died, enough to give it a fearsome reputation as a killer. Inoculation was by no means a safe process, either, and up to 1 in 50 might die out of those who were treated in this way. So there was good reason for Ewell people to give thanks at St. Mary's that all of them had survived. But even with its high rate of risk, inoculation formed the best safeguard against contact with people carrying the highly infections virus of smallpox, and a village like Ewell which was in continual contact with London could hardly escape this, as the example of the infected woman and her daughter showed. A generation earlier, in 1721-3, the burial register for St. Mary's had recorded the victims of a local smallpox epidemic.
Sutton took every precaution to minimise the risks that inoculation entailed. He took his infected matter from patients in an early stage of the disease, when it was less virulent, and introduced it through a light incision and not a deep cut. As an alternative, patients could have a thread which had been steeped in the pus drawn through their skin, but this method, though less alarming than the surgeon's lancet, turned out not to work for the Ewell volunteers, and they had to be incised like everyone else. Inoculation was no picnic. Within a week, all the patients 'began to complain of great lassitude, of fluctuating pains... a dimness in the eyes, and now and then a giddiness, and cold shiverings'. Shortly afterwards the typical pustules of the disease would appear, and were extremely painful until they broke. But after a week in isolation, strengthened by various proprietary medicines marketed by the enterprising Sutton, the crisis was over and people could return to their employments.
In 1766 the only preventative treatment for smallpox consisted of inoculation using pus from the disease itself, with all the risk that this entailed. A generation later, Edward Jenner's discovery of vaccination, where the patient only had to take the less life-threatening disease of cowpox, had become common knowledge. But whichever method was used, it was the clergy and the principal gentlemen of the parish who would hire the smallpox doctor and sort out the logistics of putting over a hundred people in a fortnight's quarantine. At Ewell, the scheme was backed by Anthony Dickins JP, with much of the practical administration probably falling into the hands of William Jubb from the paper mills, who was churchwarden for that year, and the Overseers of the Poor, John Bunny and Henry Kitchen. They all appear as co-signatories of the Gentleman's Magazine letter.
1802 caricature of Jenner vaccinating patients who feared it would
make them sprout cowlike appendages.
There was an element of self-interest in this, of course - Hallifax in his plan for inoculation included 'six persons in my own family', by which he probably meant servants rather than relatives. In this way he lessened the risk that infection would be introduced into his own household. But many of the gentry class clearly thought that they should run schemes for the prevention of smallpox as part of their duties to those below them. At Carshalton, inoculation was introduced by Edward and John Wallace from 1807 onwards; at Woodmansterne it was another clergyman, the rector Gilbert Buchanan, who brought in a surgeon from the Royal Jennerian Society in 1804. Another Surrey rector, who was also a magistrate, 'had not thought it any disparagement of his rank, to inoculate his poor neighbours with his own hands'. Some of the elite obviously enjoyed the role of doctor, and William Cobbett (who, typically, was against inoculation of any type) thought this was a new pastime for the gentlemen and ladies. 'If a cottagers child ever seen by them on a common, were not pretty quick in taking to its heels' it would be infected with some type of serum before it could get away.
Vaccination was introduced at Leatherhead when the disease broke out there in 1833, but this was one of the last occasions in which it was left to local initiative. The establishment of Poor Law Unions in 1834 put health policy on a more bureaucratic footing, and the last mention of smallpox in Epsom and Ewell comes thirty years later, when the Clerk to the Guardians of Epsom Workhouse
issued a notice for compulsory vaccination by medical practitioners, as authorised under Act of Parliament. The days when well-meaning gentry might run voluntary vaccination programmes of their own were past, but the results of their labours lived on the developing model of a public health service.
This article was written by Jeremy Harte, Curator Bourne Hall Museum (Opens in a new window)
- Letters from Joseph Richardson of Ashtead: SHC 203/28/14
- Burial register of St. Mary's Church, Ewell: SHC 2374/1/1
- Epsom Poor Law union papers: SHC 2395/8/2
- Ian and Jenifer Glynn, The Life and Death of Smallpox (Profile, 2004).
- James Hallifax, 'An authentic account of the state of inoculation at Ewell, in Surry'. Gentleman's Magazine 1766, pp413-4.
- Francis Leeson, 'Vaccination 150 years ago', Local History Records of the Bourne Society 5 (1966) pp12-15.
- Stanley Williamson, The Vaccination Controversy: The Rise, Reign and Fall of Compulsory Vaccination for Smallpox (Liverpool UP, 2007).