Philip Doddridge is in danger of being forgotten by the current residents of Northampton, but in the 18th century he was at the forefront of innovations in health care that shaped what we do today. Doddridge was a prominent Congregationalist minister in the town from 1729-1751. The church which he pastored may have reverted its name to “Castle Hill”, dropping Doddridge’s name from the title but his legacy remains. Beyond his regular duties to church life and education, in 1744 he co-founded one of England’s earliest provincial general hospitals and later advocated inoculation (or variolation, as it is also known) as a defence against Smallpox in 1750.
At the time of writing (late 2020), the UK is in its second period of “lockdown” in an attempt to control the Covid-19 pandemic. Pandemics are of course nothing new but remarkably our strategies for dealing with them have not changed significantly in the last 250 years: isolation and vaccination. We see illustrations of both of these in Doddridge’s approach.
A family in isolation
We get an insight into the impact of Smallpox on the lives of the Doddridge family from Philip Doddridge’s letters to his wife. In August 1740, he notes “the smallpox rages in the town, and depopulates the market, but not the meeting”. The “meeting” here refers to the services at the Castle Hill chapel.
In the 1740 epidemic Mrs Doddridge had been sent to London whilst the children, who were extremely ill with smallpox, were nursed by a kindly neighbour Sarah Dunkley and the Collier family at Delapré. As the epidemic began to wane Doddridge warned his wife, “You must not, on any Terms, come nearer than Delapré, my Country Seat, as my friends kindly call it.” Although many families suffered greatly, the Doddridge children soon recovered sufficiently to be rattling around the house.1
The epidemic of 1740 was not a one-off event, as Smallpox returned at intervals, the next particularly acute year being 1747.
Northampton is fortunate in that from 1736 “Bills of Mortality” were compiled each year for the town. These documents were originally created to enable insurance companies to compile their annuity tables. To do this they needed accurate annual totals of births and deaths (burials) and a record of the total population. The compiler for many years in Northampton was particularly diligent in recording all the burials including those at the infirmary and the various nonconformist chapels. The 1747 Bill also includes an interesting note about Smallpox.
Whereas the Small-Pox has been in this town this year, and many Persons have died thereeof; and knowing that it would be expected that I should give some Account thereof: I have made a careful Enquiry thro’ the Town, and have found that in the parish of All Saints 485 Persons have had the said Distemper, whereof 76 have died; St Sepulchre’s 175, whereof 21 died; St Giles’s 131, whereof 23 died; St Peter’s 30, whereof 6 died; in all 821, whereof 126 have died. There have been buried in the parish of All Saints 58, St Sepulchre’s 20, St Giles’s 29, St Peter’s 14, in all 121.
I have the Pleasure to assure the Publick, that on the 18th of this instant December, when I finish’d my last Enquiry thro’ the Town (by order of Mr. Mayor) after The Number of Persons then afflicted with the Small-Pox, found only 3.
The numbers are worth noting here. A census had been conducted in 1746 at which time 5136 people were living in the town. The 821 infections represented 16% of the population and of these, the death rate was 15%.
A hospital for the town
Early in 1743 a young doctor arrived in the town, Dr (later Sir) James Stonhouse from Coventry. Stonhouse was not a Christian at the time and had even written an anti-Christian pamphlet. However, through his attendance at a funeral at Doodridge’s chapel he and Philip Doddridge soon became friends and together started a campaign and subscription list to establish a hospital in Northampton. By the end of that year they had raised enough to rent and equip a house in George Row, Northampton. In 1744 the house was leased for £30 a year “for the poor, sick and lame,..and no money, gift or reward is taken of them or their friends whatever.” The infirmary had 30 beds and opened on 29th March 1744. It was one of the first six voluntary hospitals established in England. The building still stands and is now occupied by the Northampton and County Club.
Soon there was a waiting list so money was raised in 1750 to increase the number of beds to 60 and the house next door was purchased. By 1790 it had become obvious that George Row was not a satisfactory location mainly because of the noise of the passing traffic, the church bells and the town gaol next door. Land was purchased in Northampton Fields and a new hospital was built. That building remains as the main block of the present day Northampton General Hospital.
James Stonhouse soon converted and was also friends with Rev. James Harvey of Weston Favell. Stonhouse himself was ordained in the Anglican Church in 1749, but continued to practise as a doctor, not taking on a formal clerical appointment until 1764.
Inoculation against Smallpox
It has been known for probably 1000 years that some diseases could be combated by the practice of inoculation (or variolation), that is using the disease against itself, usually by injecting a small amount of infected material into a patient or at the site of a small scratch. Later it was found that treated patients were immune to a major infection.
There was in the 1740s considerable opposition to inoculation and subsequently vaccination programmes. The story though goes back to 1725 when another Congregational minister, Rev David Some of Market Harborough wrote a small pamphlet putting “The Case of Receiving the Small-pox by Inoculation”. The young Philip Doddridge joined David Some at Market Harborough as his assistant in 1727 and was clearly greatly influenced by him.
When a further outbreak of Smallpox occurred in 1750, Philip Doddridge decided it was time to republish David Some’s work with the extended title “The Case of Receiving the Small-pox by Inoculation, Impartially Considered, and Especially in a Religious View: Written in the Year M.DCC.XXV. By the Late Revd. Mr. David Some, of Harborough: and Now Published from the Original Manuscript”.
It was Doddridge’s concern for his community that urged him to champion the inoculation cause. In 1750 he wrote:
The Small-pox is just broke out with a very unusual Violence in some neighbouring Villages, in which several of my Friends reside, I am told, that in one of them forty or fifty Persons, most of them young, fell within little more than a Week; and the Terror with which it fills these Parts of the Country is exceeding great.
The story did not end there, of course. Opposition to the practice of inoculation emerged, for example in 1751 “A dissuasive against inoculating for the small-pox: in a letter to a gentleman, &c. To which is added, A parallel between the scripture notion of divine resignation, and the modern practice of receiving the small-pox by inoculation”, published anonymously.
The inoculation idea was a later development by Edward Jenner in the 1790s. Jenner observed that people that had been infected by a milder but similar infection – Cowpox, showed immunity to Smallpox. Widespread smallpox vaccination began in the early 1800s, following Edward Jenner’s cowpox experiments. Jenner’s ideas were novel for his time, however, and they were met with immediate public criticism. The Vaccination Act of 1853 ordered mandatory vaccination for infants up to 3 months old, and the Act of 1867 extended this age requirement to 14 years. These events became the trigger for the establishment of The Anti-Vaccination League and the Anti-Compulsory Vaccination League. Over the years these views persisted but ultimately Smallpox was declared globally eradicated in 1979.
Smallpox and Covid-19: The lessons of history
The academic Dr Peter Razzell has researched and written extensively on population history and the impact of Smallpox. In a recent paper “Covid-19: Possible Lessons from the History of Variolation and Vaccination against Smallpox: A Brief Note”2 he concludes:
Variolation [inoculation] appears to have stimulated a permanent boost to the immune systems, whereas vaccination only provided a temporary measure. It is possible that the same principle applies to any vaccination developed against Covid-19, and only a form of vaccination that can create a sufficiently robust response is likely to be successful. Likewise, a mild and asymptomatic form of the disease may only create limited immunity against further attacks of the virus.
- Deacon, Malcolm. Philip Doddridge of Northampton, 1702-51. S.l.: Northamptonshire Libraries, 1980. p.70
- Razzell, Peter. ‘Covid-19: Possible Lessons from the History of Variolation and Vaccination against Smallpox: A Brief Note’. Accessed 18 November 2020. https://www.academia.edu/44405850/Covid_19_Possible_Lessons_from_the_History_of_Variolation_and_Vaccination_against_Smallpox_A_Brief_Note
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