Bodily Matters: The Anti-Vaccination Movement in England, 1853-1907 [NOOK Book]

Overview

Bodily Matters explores the anti-vaccination movement that emerged in England in the late nineteenth century and early twentieth in response to government-mandated smallpox vaccination. By requiring a painful and sometimes dangerous medical procedure for all infants, the Compulsory Vaccination Act set an important precedent for state regulation of bodies. From its inception in 1853 until its demise in 1907, the compulsory smallpox vaccine was fiercely resisted, largely by members of the working class who ...
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Bodily Matters: The Anti-Vaccination Movement in England, 1853-1907

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Overview

Bodily Matters explores the anti-vaccination movement that emerged in England in the late nineteenth century and early twentieth in response to government-mandated smallpox vaccination. By requiring a painful and sometimes dangerous medical procedure for all infants, the Compulsory Vaccination Act set an important precedent for state regulation of bodies. From its inception in 1853 until its demise in 1907, the compulsory smallpox vaccine was fiercely resisted, largely by members of the working class who interpreted it as an infringement of their rights as citizens and a violation of their children’s bodies. Nadja Durbach contends that the anti-vaccination movement is historically significant not only because it was arguably the largest medical resistance campaign ever mounted in Europe but also because it clearly articulated pervasive anxieties regarding the integrity of the body and the role of the modern state.

Analyzing historical documents on both sides of the vaccination debate, Durbach focuses on the key events and rhetorical strategies of the resistance campaign. She shows that those for and against the vaccine had very different ideas about how human bodies worked and how best to safeguard them from disease. Individuals opposed to mandatory vaccination saw their own and their children’s bodies not as potentially contagious and thus dangerous to society but rather as highly vulnerable to contamination and violation. Bodily Matters challenges the notion that resistance to vaccination can best be understood, and thus easily dismissed, as the ravings of an unscientific “lunatic fringe.” It locates the anti-vaccination movement at the very center of broad public debates in Victorian England over medical developments, the politics of class, the extent of government intervention into the private lives of its citizens, and the values of a liberal society.

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Editorial Reviews

From the Publisher
“All too often the large-scale resistance to compulsory vaccination in England has been treated as a quaint case study in ‘anti-modern’ or ‘irrational’ opposition to scientific progress. Nadja Durbach has made a key contribution to modern British history in particular and to the analysis of class culture more generally by rescuing this resistance to state medicine from what E. P. Thompson memorably termed ‘the enormous condescension of posterity.’”—George Behlmer, author of Friends of the Family: The English Home and Its Guardians, 1850–1940

“This fascinating book uses the anti-vaccination movement to illuminate our understanding of the major themes in nineteenth-century British history: the nature of liberalism, class tensions, and resistance to state intervention. Beautifully written, it brings the movement to life.”—Anna Clark, author of Scandal: The Sexual Politics of the British Constitution

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Product Details

  • ISBN-13: 9780822386506
  • Publisher: Duke University Press
  • Publication date: 12/9/2004
  • Series: Radical Perspectives
  • Sold by: Barnes & Noble
  • Format: eBook
  • Sales rank: 1,260,775
  • File size: 3 MB

Meet the Author

Nadja Durbach is Assistant Professor of History at the University of Utah, Salt Lake City.

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Read an Excerpt

Bodily Matters

THE ANTI-VACCINATION MOVEMENT IN ENGLAND, 1853-1907
By NADJA DURBACH

Duke University Press

Copyright © 2005 Duke University Press
All right reserved.

ISBN: 978-0-8223-3423-1


Chapter One

The Parliamentary Lancet

[W]ho could receive with cordiality and respect the Doctor of Physic who should burglariously thunder at the door, armed with scab and lancet, feloniously threatening to assault the inmates therewith, and, no matter how loudly he should protest that he was bent upon a mission of mercy, who could avoid suspecting that his real objects were power and gain?-John Gibbs, 1854

"Are we to be leeched, bled, blistered, burned, douched, frozen, pilled, potioned, lotioned, salivated ... by Act of Parliament?" demanded an outraged John Gibbs in 1854. This graphic image of a body medically tortured by government decree was a direct attack on the Compulsory Vaccination Act of 1853, which mandated the vaccination of all English infants against smallpox. That the state could impose medical procedures on the "free-born Briton" seemed to usher in a new and dangerous era in which the individual had no right to his or her own body. Are "the intelligent people of this free realm," Gibbs challenged, merely to become "abject slaves to the medical profession"?

For Gibbs, a hydropath, and his communityof heterodox practitioners, compulsory vaccination represented the epitome of an already pervasive system of medical despotism. Indeed, the 1850s were a critical moment for conflicts over medical access and authority as orthodox medicine emerged as a profession and as heterodox practitioners vigorously opposed their exclusion from the medical marketplace. The Compulsory Vaccination Act of 1853 played a particularly important role in these larger debates, for compulsory vaccination quickly became a flash point for contests over state authority, professional control, and the meanings of "medical liberty."

The Growth of Professional Medicine

Historians have consistently demonstrated that Georgian medicine favored and encouraged pluralism in the medical marketplace, permitting consumers to purchase the services of a variety of practitioners. In search of remedies, the sick often moved freely from one type of practitioner to another, employing, among others, surgeons, bonesetters, and patent-medicine vendors. This meant both that treatments were often negotiated between patient and practitioner and that the sick could be active in orchestrating their cure. In theory, a structured system of medical provision still existed within the larger marketplace, as orthodox practitioners were hierarchically divided into physicians, surgeons, and apothecaries. However, these boundaries remained fluid, as medical roles could not always be clearly demarcated. Methods for training varied widely even within each category, and degrees could be purchased freely and openly. Until the middle of the nineteenth century, there existed no uniform regulation of medicine, no single licensing body, and no nationally recognized and agreed on standards or criteria against which one could measure legitimacy and illegitimacy in medical practices. In fact, before 1858 nineteen different licensing bodies existed in Britain. The most prestigious, the Royal College of Physicians (RCP), was more an aristocratic club than a professional association, as it accepted only Oxbridge graduates. Admitting only 168 fellows between 1771 and 1833, the RCP had neither the base of support nor the clout to prevent nonmembers from practicing medicine. Divisions within medicine, therefore, were as much social markers as descriptors of actual practice.

By the end of the eighteenth century, these traditional divisions within medicine appeared increasingly outdated. Doctors-especially those practicing outside London-performed varied medical roles, being at one and the same time physician, surgeon, apothecary, and midwife. Throughout the nineteenth century, the tripartite system slowly disintegrated, leaving a dichotomy of general practitioner and consultant (a doctor with a hospital appointment) in its place. If the clientele of the orthodox physician in the eighteenth century was generally the social elite, in the nineteenth century regular medicine expanded its mandate and sought increasingly to provide treatment to many more people by way of the general practitioner. The general practitioner's reach extended into the working classes, for his practice was no longer highly specialized. In the early nineteenth century, medicine began to take on a much more significant social role. No longer merely a service rendered for profit, it gradually became an institution with exclusive rights to control medical knowledge and, by extension, the health and bodies of the entire population. This process of professionalization involved both a move toward scientizing medicine and an attempt to strengthen ties with an expanding and increasingly bureaucratic state.

The changing relationship between doctors and the state became evident in the 1830s. The 1832 Anatomy Act bolstered the relationship between medicine and the state at the expense of the destitute. It specified that the bodies of those who died in a workhouse or charity hospital and went "unclaimed" by their kin would be turned over to anatomists for dissection. Bodies for dissection were difficult to obtain before 1832, and grave robbers abounded as anatomy became an increasingly important component of medical education. The sensational true story of Burke and Hare, who murdered the poor in order to sell their bodies to anatomists, contributed to a climate of fear among the laboring population. The 1832 act did little to mitigate this anxiety. Opponents of the act claimed that it objectified the bodies of the poor, allowing them to be probed and penetrated for the use of middle-class doctors and medical students. While the bodies of criminals had been dissected for centuries, those of the innocent poor had not. Although paupers' graves were generally the first to be robbed, until 1832 the state treated this practice as immoral. It was not, however, illegal, as the dead body did not constitute property. The new act sanctioned the dissection of the poor; in doing so, critics insisted, the state confounded the "unclaimed" pauper with the criminal. In effect, the Anatomy Act made poverty a crime and the destitute dead body property of the state. Not surprisingly, this only provoked working-class anxieties about the relationship between medicine and the state.

According to Ruth Richardson, the Anatomy Act "was in reality an advance clause to the New Poor Law." The 1834 New Poor Law represented an important move away from humanitarian approaches to the problems of poverty and toward a regime that privileged utilitarian economics over charitable impulses. With its doctrine of "less eligibility" and its emphasis on institutionalization, the New Poor Law radically reformulated the philosophy of relief, attempting to force all recipients of Poor Law benefits into the workhouse. There administrators segregated the sexes, separated families, and outlawed personal belongings. These increased regulations made more severe the standard workhouse experience of grueling labor, poor food, and squalid living conditions. Rumors abounded regarding cruelty and cannibalism, tales that were passed along well into the late twentieth century, imprinting themselves on workhouse buildings long after they had ceased to serve the Poor Law. Ironically, many of the myths that circulated about the terrors of the workhouse were encouraged by the Poor Law commissioners themselves. Because the workhouses were intended to be the place of last resort, administrators rendered the workhouse regime undesirable and nurtured resistance to institutionalization to keep the number of those dependent on relief as low as possible. To the poor, these "bastiles" seemed little better than prisons, which, like the Anatomy Act, served to criminalize poverty.

While the New Poor Law denied outdoor relief to the able-bodied pauper, it kept a system of outdoor medical relief in place, presided over by Poor Law medical officers who treated the sick poor out of the rates. By 1847, medical services had become a standard component of poor relief; by 1871, the Poor Law itself had "developed into the State medical authority for the poor." However, some unions refused to provide this type of relief altogether, and many found the poor resistant to the pauperizing nature of Poor Law medicine. State medicine was born and nurtured, then, within a context already invested with contentious meanings. It was by definition pauperizing, and, its critics maintained, it shamed and punished precisely those whom it was intended to serve.

By the middle of the nineteenth century, the government was not only providing medical services, but also regulating those offered by private practitioners, for medical reform had become an ardent concern for many practitioners and parliamentarians. Although calls for improvement came from a number of directions, the most active agitators were general practitioners who felt unrepresented by any of the corporations. They opposed the power of the colleges and denounced the tripartite division as unrepresentative of medical practice. Despite internal conflicts, by the 1850s most medical practitioners could agree that change was necessary. Exactly what these reforms would look like was the subject of heated debate, but practitioners intent on making medicine more professional lobbied for a definition of a legally qualified practitioner as well as a centrally kept medical register. It would take a Select Committee in 1847, followed by fourteen medical-reform bills, before anything specific could be agreed on.

The 1858 Medical Act emerged out of this debate. It established a General Council of Medical Education and Registration that united representatives of medical corporations into a single body to oversee medical education and licensing. It published a general register of qualified practitioners, meaning those with licenses from any corporation, although it did not distinguish between different types of practice. The Medical Act also restricted unregistered practitioners from government employment and from using titles such as physician, surgeon, doctor, and apothecary, without the corresponding license. Its reforms were limited, however, as it did not establish a uniform system of education or examination, and it continued to allow each corporation to grant its own licenses. Perhaps most significantly, it did not prevent unregistered practitioners from plying their trade. The Medical Act was a compromise; it went only partway toward professionalizing medicine. But it was an important step in what was to be a long process of consolidating this authority, a process in which vaccination was to play a vital role. For vaccination, a technology of orthodox medicine, was the first medical intervention to be enforced by British law. The Compulsory Vaccination Act was thus crucial to the development of the field of state medicine, and thus to the rise of medical authority.

Compulsory Vaccination and the Medicalization of Public Health

Vaccination, as the first continuous public-health activity undertaken by the state, ushered in a new age in which the government began to provide health care to the general public. Significantly, the policy of universal compulsory vaccination also marked an important shift away from sanitary approaches to the persistence of dirt and disease and toward preventive medicine. Compulsory vaccination was therefore central to the new state emphasis on scientific medicine as the key to public health.

THE SANITARY IDEA The sanitary programs that Edwin Chadwick pioneered in the 1830s were essentially an institution of local government administered not by doctors but by bureaucrats. Their intent was to combat the urban problems of dirt and disease, but the solutions they offered were not primarily medical. Chadwick, former secretary to the Poor Law Commission, focused on reforming municipal and household technologies. Chadwick's "sanitary idea" became institutionalized in state-sponsored projects that culminated in the 1848 Public Health Act. This act established the General Board of Health, charged with administering local boards in the promotion of municipal sanitation. Since the establishment of local boards was entirely voluntary, few towns applied for a board, and fewer still could be encouraged to, as the General Board of Health seemed to be merely another "coercive central interference with local government." According to Christopher Hamlin, this approach to public health concealed the relationship between disease and poverty, substituting toilets and sewers for any larger efforts to deal with social conditions. Public health took shape in Britain largely within discourses around sanitation that engaged with neither medical responses to disease nor the larger issue of poverty. An emphasis on sewers and public works does not necessitate a denial of the importance of food, work, and disease. But a decision to pursue the former was in this case also a conscious choice not to pursue the latter. Chadwick, Hamlin argues, suggested that "sewers and water were to end famine fevers, Chartist threats, drink, despair, and discontent, and to produce disciplined industrial laborers and happy proletarian families."

Despite their emphasis on a seemingly apolitical plumbing infrastructure, the sanitary reforms of the early Victorian period deliberately exposed the bodies of the working classes to greater scrutiny and regulation. During the cholera and fever epidemics of the 1830s, '40s, and '50s, poor neighborhoods were labeled "fever dens." Sanitary bureaucrats perceived these areas as squalid and poorly ventilated and associated them with other sites of disease: prisons, charity hospitals, workshops, and workhouses. By implication, these administrators saw the bodies of the working classes themselves as contagious and, like prisoners, patients, and paupers, in need of surveillance and control. This manifested itself, among other ways, in the policing of poor neighborhoods by state-sanctioned medical officers of health, who quarantined cholera patients and destroyed their property. For all the disinterestedness of sanitary-engineering schemes, public health in this period also had a decidedly moral element, as it identified and tracked the "great unwashed."

Although highly influential, Chadwick's policies were not enough in and of themselves to combat the enduring problems of urbanization. While Chadwick and his sanitary technologies dominated the public-health movement of the 1830s and '40s, it was John Simon, medical officer of health for the City of London and then medical officer to the Privy Council, and his epidemiological coterie who were to be the public face of public health in the 1850s and '60s. During the 1850s, medical doctors and their institutions, such as the Association of Medical Officers and the British Medical Association, began to play more active roles in turning the public's health into a scientific, and decidedly medical, pursuit. Some practitioners even proposed that the safety of the public depended on medical men obtaining seats in Parliament. The Public Health Act of 1858, which abolished Chadwick's Board of Health and instead transferred Simon and certain health responsibilities to the Privy Council, was passed in the same year as the Medical Act. By the late 1850s, then, Parliament had helped to create a medical profession and endowed it with the authority to superintend the health of the nation. But it was the Compulsory Vaccination Act of 1853 that really initiated-and, indeed, continues to epitomize-the medicalization of public health.

(Continues...)



Excerpted from Bodily Matters by NADJA DURBACH Copyright © 2005 by Duke University Press. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Table of Contents


Contents
Acknowledgments
Introduction
1. The Parliamentary Lancet
2. Fighting the "Babies_ Battle"
3. Populism, Citizenship, and the Politics of Victorian Liberalism
4. The Body Politics of Class Formation
5. Vampires, Vivisectors and the Victorian Body
6. Germs, Dirt, and the Constitution
7. Class, Gender, and the Conscientious Objector
Conclusion
Notes
Bibliography
Index
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