Review of the history of the Church of France The clergy and the diffusion of vaccination Monsieur Yves-Marie Bercé Citer ce document / Cite this document : Bercé Yves-Marie. The clergy and the diffusion of vaccination. In: Revue d'histoire de l'Église de France, tome 69, n°182, 1983. pp. 87-106; doi : https://doi.org/10.3406/rhef.1983.3298 https://www.persee.fr/doc/rhef_0300-9505_1983_num_69_182_3298 pdf file generated on 13/04/2018 THE CLERGY' AND THE DIFFUSION OF VACCINATION In June 1798, Edward Jenner published the results of his experiments attesting to the anti-smallpox immunity conferred by the inoculation of a minor veterinary disease, cowpox. In October 1798, a popular science magazine published in Geneva, the British Library, gave European distribution to the process. On April 29, 1799, thanks to threads soaked in this mysterious mood, a Genevan doctor established in Vienna, Jean De Carro succeeded in repeating the experiment on the continent*. The process, called vaccination, was implemented in Paris in May 1800. In October 1800, Dr. Luigi Sacco, from Milan, carried out vaccinations in his turn, but with an original indigenous strain, taken from cows" in Lombardy. The propagation, in spite of the European war, was therefore very fast. It benefited from the threat of a deadly smallpox epidemic that in 1799-1801 took the lives of hundreds of children and prompted parents to search for medical help. Above all, it was addressed to generations convinced of the potential of a hygienic, preventive and political medicine, certainly capable, it was believed, of removing, sooner or later, from mankind the great plagues that had plagued its past. Without this scientific hope, we cannot understand the extraordinary enthusiasm that welcomed the announcement of the process, "the vaccine frenzy", "the commotion of the discovery", to use expressions of contemporaries stunned or admiring the magnitude of the movement. Because the obvious hold of the clergy on popular opinion 1. Many of the facts and quotations given below concern the Italian departments of the Empire, which will be the focus of the book I am preparing on the origins of vaccination. Mr. Pierre Darmon is preparing a doctoral thesis on the history of smallpox in France. He has published "L'odyssée pionnière des premières vaccinations françaises au xixe s.", in Histoire, économie et société, éd. Sedes, 1982. The controversies about vaccinia in France are the subject of a thesis by Marie-Françoise Lafosse at the E.H.E.S.S. On the part of inoculation in England, then the value of Jenner's discovery, see the discussions of P. Razzell and especially the clarification of the biologist D. Baxby, London, 1981. 2. The word "frenzy" is due to Dr. Moseley, author of Medical Tracts from January 1799, who was very critical of Jenner. The term "concussion" was used by Dr. Arnal, of Montpellier, in 1803. IUH.É.F., t. LXIX, 1983. 88 Y.-M. BERCÉ The attitude of the clergy towards this medical innovation was immediately the subject of public debate and accusations of intent. One could imagine that the clergy, in unison with the universal utopian expectation, would easily adhere to the vaccine propaganda, or, on the contrary, that they would see in it an additional manifestation of the impiety of the new times, an imprudent and dangerous attack on the most ancient traditions. These preconceived ideas about enlightened benevolence or the obstinacy of obscurantism are still the first ones that come to mind when one considers the encounters between religious and medical behavior. The vaccine had, in the space of a few years, been transmitted throughout the world, without distinction of borders or regimes, by land and by sea, according to the communication routes. It is the story of this reception that must first be presented, by examining the more or less pressing recommendations of the clergy, more or less repeated over the years. Some were the result of spontaneous initiatives of the clergy, others, much more numerous, were in response to political directives. At first they took the form of simple exhortations; later they became real moral demands. The arguments used in these texts were based on religious foundations, scriptural references, reasoning deduced from theology or from elementary common sense. Finally, the action of particular personalities, either in favor of the procedure, or more rarely in terms of defiance, will complete the picture of the weight of religion in the fortune of this medical procedure. The diffusion of the vaccine in Catholic countries . The diffusion followed the same stages, the same circumstances in the Protestant countries, as in the nations of deep Catholic tradition, as in consular France then declared enemy of the pontifical power. Italy had the first experiences even before Paris, since vaccinations were successful in Genoa in April 1800. In Spain, the process was carried through France and arrived in Catalonia in the spring of 1801; it was multiplied in all the provinces within a few months and even sent to the American colonies at the beginning of 1803. In the Mediterranean, the English fleet, on its way to Egypt, naturalized the vaccine in Gibraltar, Minorca, then in Malta in October 1800, only one month after the capitulation of the French garrison. The propagator on board the ships, Dr. Joseph Marshall, was a personal friend of Jenner. On March 14, 1801, he organized an inoculation session in Palermo, with the pro- THE CLERGY AND VACCINATION * 89 tection of the king of Naples. Marshall stayed in Sicily until the onset of winter and spread the vaccine throughout the island. During the first trials in March, relatives had seized vials of the vaccine and, surrounded by a large crowd of people, carried them to the altar of the cathedral in Palermo. ." "It was not unusual," Marshall reports, "to see during the mornings of public vaccinations at the hospital processions of men, women and children led through the streets by a priest carrying a cross at arm's length to lead them to the session.... The same people claimed to be certain that they saw a blessing sent by Heaven, even if it had been discovered by a heretic and practiced by another heretic" *. In Milan, Sacco had witnessed a similar religious enthusiasm among the people; the parish priests had summoned the children and families, announced the sessions at the Sunday sermon, rang the bells and led the faithful to the maternity hospital for foundlings, where the free inoculations were carried out *. If Rome had not been the scene of the same enthusiasm and massive debates, vaccination had been early. Marshall, after having established a vaccine strain in Naples, took advantage of the armis*. tice effective since February 1801 to return to England by land. Throughout his journey, he gave demonstrations in Rome (end of November 1801), Livorno, Genoa and Turin (end of December). The conviction or the zeal of the Roman doctors was not however assured, since in 1802 the vaccine strain had dried up. The Secretary of State for the Ecclesiastical State, Cardinal Consalvi, was aware of the health problems, either because of the military concern for quarantines in the ports, or because of his recent trip to Paris during the negotiations for the Concordat. In 1802, he obtained from Jean De Carra the sending from Vienna of lancets loaded with vaccine5. The pontifical archiatrist Alessandro Flajani was convinced; his publication of popularization, the Giornale medico-chirurgico, whose first number appeared in January 1808, provided with V imprimatur, devoted notes to the smallpox preservation. The received idea of the Roman obscurantism was however sufficiently rooted that a French prefect, after the annexation of the ecclesiastical state to the Empire in 1809, asserted an alleged prohibition of the vaccine. This accusation came from the young Roederer, prefect of Trasimeno, in Perugia, who assured that "the ancient prejudices of this country and the superstition which reigns there have always delayed the progress of useful discoveries... Inoculation is among the discoveries that were never authorized under the Pope's government, because it was believed that it was contrary to the principle 3. John Baron, The Life of E. Jenner, London, 1827; cf. 1. 1, p. 400. John Ring, An answer to Dr. Moseley, London, 1805. 4. British Library, vol. 20, pp. 399, 404. J. Baron, op. cit. t. I, p. 529. 6 Bibl. nat. 8°, T" 69. 90 Y.-M. BERCÉ of the Gospel. This prejudice spread in the countryside will be the strongest opposition to the introduction of vaccinia". The Count of Tournon, prefect of Rome, a practicing Catholic, did not have the same prejudices; he says only: "In Rome, vaccination has not yet obtained the general confidence and in the department this operation is almost not known. The repugnance of the people of this country for any novelty and the ignorance of several doctors and surgeons, who tried to describe this practice, bring many obstacles to it" 7. The vaccination campaigns implemented by the French administration in 1810 came up against inertia rather than a declared unwillingness. Neither Tournon in Lazio, nor Roederer in Umbria could produce the triumphant statistics of the other prefects, where the number of vaccinations victoriously exceeded that of the births". With the restoration of the pontifical regime, the black legend that vaccination had been forbidden is again found. This assertion, lacking in textual proof, is still repeated today. It is probably based on the edict of May 13, 1814, by which Cardinal Rivarola, extraordinary commissioner of Pius VII, charged with replacing the Neapolitan officers appointed by Murat, had provisionally and globally revoked all the Napoleonic codes. In fact, the vaccinations of the foundlings continued at the hospital of the Holy Spirit and the maintenance of the immunity to the vaccine was well demonstrated since Rome, although close to 150,000 inhabitants, a place of pilgrimage and seasonal migrants from the Sabine mountains, did not experience a particular outbreak of smallpox in those years. Even in November 1821, when most Italian states were renewing and clarifying their vaccination regulations, the ecclesiastical state adopted particularly restrictive measures signed by Consalvi. The preamble of the edict expressed "the full adhesion of the pontiff to the vaccine system". It attributed the hesitations of parents to the shameful ignorance of the poorest and qualified as impiety the possible refusals of educated people* "Ministers of evangelical charity," the edict called out, "the law requires you to instruct the people on this gift of the Most High; make known to them the will, the wishes, the wise measures taken by the visible head of the Church, the true interpreter of the divine commandment. The directives of the bishops. Everywhere in Christendom, pastoral letters had, from the first years of the discovery, drawn the attention of priests to the duty of enlightening their flock and to their responsibility as pastors 7. National Archives, F8 126, Perugia, Sept. 1810; F8 122, Rome, May 1810. 8. Biblioteca vaccinica, 1822, pp. 78-80. THE CLERGY AND VACCINATION 91 capable of sparing a terrible death to so many little children in their parishes. The very first example of ecclesiastical collaboration, an example very often invoked later in propaganda literature, had been encountered by De Carro in the vicinity of Vienna in January 1801. . I had inoculated," he wrote, "four children of a prominent person living in Brunn am Gebirge, a village a league and a half from Vienna; the parish priest, an educated, intelligent and charitable man, was so struck by the gentleness and regularity of the vaccination of these children that he wished to read the German translations of the principal works on vaccination. This discovery seemed to him to have such a degree of authenticity that he no longer doubted the truth. The following Sunday, he spoke from the pulpit to his parishioners about the discovery of vaccinia, explaining the advantages of this method in a simple and accessible way, after having painted the ravages of smallpox in a natural way. He also relieved their conscience by making them feel that it was not acting against the views of Providence to preserve oneself from a disease in any way. Finally, he told them that those who wanted to show him their confidence and prove their tenderness for their children had only to meet at such and such a day and time... This speech had such a good effect on these peasants that I found 35 children to inoculate from the first visit I made to Brunn...". This anecdote was published in the British Library and had a great edifying success. Henceforth, doctors writing pamphlets for the popularization of vaccines or composing speeches intended to win the support of local authorities, never omitted the model of the parish priest of Brunn'. The printed addresses multiplied, composed for country practitioners, enlightened parents, municipal magistrates and also for the parish priests. Sacco in March 1802 addressed to the priests of the Cisalpine Republic: "I hope from your pastoral zeal, from your eagerness to respond to the paternal measures of the government, from your solicitude for the good of your parishioners, that you will not tire of inviting them in the most suitable way to take advantage of such an interesting discovery". In Paris, the Central Committee of Vaccination, sitting at the School of Medicine, had sent to all the bishops a copy of an order of the Minister of the Interior of April 4, 1804, . It read, "in order that this wish of several wise men, who desire that the same men who advise humanity in the afflictions of the soul be called to soften the sufferings and to heal the infirmities, be realized. Thus was renewed by this modern practice the ancient and august alliance of the priesthood and medicine" u. On October 13, 1804, another circular to the bishops asked them to keep a copy of the minutes of the Vaccine Committee and the minister 9. Circular to the parish priests of the department of Mella (ch.-L. Brescia), May 1802. 11. General meeting of the Central Society of vaccinia (24 frimaire an XIII; 15 déc. 1804). 92 Y.-M. BERCÉ l of the Interior informed them that they had to inform their priests. For greater security, pastoral publications were, moreover, obligatorily submitted, in April 1805, to an authorization from the prefect. Very punctually, most of the bishops complied, often contenting themselves with reproducing word for word elements of the texts of the Vaccine Committee 12. "Let us persevere with vaccination," wrote the sub-prefect of an Italian department (Locard, sub-prefect of Borgo San Donnino, in the Taro, corresponding to the States of Parma), "and, in a few years, the people of my district will regard vaccination as another sacrament, which must be administered to children between baptism and confirmation. It will perhaps only be a matter of tonsuring doctors and surgeons and prescribing celibacy for them. All joking aside, once well introduced, the vaccine will surely be & perpetually in use in our countryside... Happy is the man who is a friend of humanity and whom chance calls to lead good, simple and ignorant men. New pastoral letters were periodically requested by the Ministry of the Interior, on which depended the office of the Hospices and Relief in charge of organizing the vaccination campaigns. Each time, at the origin, there was the denunciation by a local notable of the negligence or the alleged hostility of certain ecclesiastics*. The affair went up to the prefect, then to the minister of the Interior who alerted his colleague of the Cults, who decided to sow the bishops of the concerned region. Thus complaints concerning the Aosta Valley (department of the Dora) in October 1808 led to a circular to the bishops of Piedmont at the beginning of 1810. A denunciation from Livorno in February 1811 led to a letter to the bishops of Tuscany on the following March 6: "Dear Bishop. Pastoral letters have been published in the various dioceses of the Empire in favor of vaccinia. Everywhere the ministers of religion have usefully assisted the beneficial views of the government by recommending this preservative as a means of preserving life consecrated by experience. I invite you to give instructions to those of your diocese so that they also make the faithful entrusted to their care feel the advantages of this precious discovery. Nothing that interests humanity can be foreign to the solicitude of the ministers of religion". Indeed, throughout the years 1811 and 1812, the pas-* toral letters were repeated throughout the dioceses of the Empire. In Milan, one employed to the drafting of these letters an ecclesiastic, discredited for having rallied to the Jacobin regime of Lucca in 1796, the abbot Ferloni. His writings were transmitted "to the bishops least capable of composing them and most devoted to the wills of the government. They sent them back with their signatures and this is how they obtained 12. Arch. F*" 1083 and 5596. 13. Locard to Husson, Borgo San Donnino, 19 Nov. 1806, Acad. Médecine, Paris. 14. Bigot de Préameneu to the bishops, March 6, 1811 (Arch, nat., F19 1083). THE CLERGY AND VACCINATION 93 ■ - , those of these acts which astonished the French clergy by the force and boldness of the expressions " u. The misfortunes of the war from 1813 to 1815, the political upheavals, and the typhus epidemic that ravaged all of Europe, caused the vaccine averages to fall, but the changes of regime did not alter the regulations. In November 1814, the General Administrator of Cults, under the first Restoration, required the collaboration of the clergy in imperative terms: "Remember that in all that is temporal, you owe obedience to the Head of State..., so be docile to the voice of our beloved monarch, by supporting with all your efforts his beneficent and paternal views". , The tone used by the royal circulars towards the bishops was not less authoritarian than that of the imperial ministers. The losses of war and the political reversal inspired new arguments to the vicars general of Strasbourg. The hecatombes made vaccinia even more necessary, and these subjects, saved by medicine, would serve, not for warlike enterprises, but for the growth of a peaceful state. "Vaccination is a blessing that Providence seems to have reserved for a time when civil discord and the fury of war were to make such a horrible consumption of the human race... If a tyrant saw in men only the instruments of his ambition and in the male child who was born only a victim destined to perish in his time to support his fury, a king, more a father than a master of his people, only wants to see him grow and rise in order to preserve him for the State and for religion. ~ In all the States of Europe, ecclesiastics had been aggregated to the local sanitary committees, invited to the solemn sessions of vaccination, associated to the administration of the hospices. The authoritarian example of the French Empire did not differ from other sovereignties; it was considered everywhere that it was not possible to conduct a health police, a political hygiene, without the active participation of the clergy. The theological disputes on the vaccine. Apart from political, population and humanitarian motives, apart from the strictly medical instructions, there were special arguments. Father Ferloni would have been the author of an ecclesiastical history that remained in manuscript and was accidentally destroyed. A renowned preacher, he loudly rallied to the revolutionary regime installed by the French in Lucca in 1796. Condemned during the restoration of 1800, he later joined the administration of the Kingdom of Italy in Milan. He died, miserable and despised, in October 1813. According to Ch. Lafoue, Histoire de l'administration du royaume d'Italie (1823), cf. p. 207.' 16. Circular letter of Mgr de Faudoas, bishop of Meaux, 30 Dec. 1814, printed, kindly communicated by M. l'abbé Espinasse. Circular letter of the vicars general of Strasbourg, 6 Feb. 1814, ed. by Mgr. Médard Barth. 94 Y.-M. BERCÉ The arguments that were specifically religious recurred in the texts of the vaccine propaganda. These arguments had often already been developed in the preceding decades concerning the voluntary variola inoculation of < small children, used as a preservative against a more serious accidental smallpox. The controversy, very lively in the 1760s, had been all the more bitter because scholarly opinion was very divided, and because to the immunity guaranteed to a few, one could oppose the risk - of an increased dissemination of the virus. At least, theologians had pronounced themselves on the moral right to contract a certain but benign evil, in order to avoid a very serious but uncertain evil. Isaac Maddox, Anglican bishop of Worcester, had justified the enterprise in a famous sermon delivered in March 1752 to the governors of the Small Pox Hospital in London. Roman doctors had pronounced themselves in the same sense in 1754, and especially the illustrious Gianlorenzo Berti, professor of ecclesiastical history at the University of Pisa, had published in 1763 a theological-moral consultation favorable to inoculation. In the 1800s, the same arguments could be repeated - with even more confidence, since vaccinia was supported by all medical authorities, recognized as perfectly effective, benign and free of contagiousness. The religious impregnation of the minds is first of all manifest. The lay propagandists, doctors and sub-prefects, almost all used Christian vocabulary and metaphors. Smallpox is called "massacre of the innocents". Jenner's procedure is "a miraculous discovery", a "divine branch of medicine", a "help from Heaven", a "grace from Providence". It is necessary "to bless the happy day of vaccination", to grant it faith and belief", "to disabuse the ignorant and the superstitious" 17. The operation itself is likened to baptism. In this connection, there was certainly a reason .-% of convenience. By combining the two gestures, the baptismal anointing and the vaccination insertion, the doctors would have been certain to reach all the newborns. There was also an analogy in effect. Just as the sacrament of baptism washes away the original sin from the soul, the vaccine rids the child of a variola peril, which popular opinion believed to be innate. The vaccine thus became "an animal baptism that washes the body of the original variolous vice. The strongest and most enduring objection to the Church's participation in vaccine propaganda was the limits of its role 17. Expressions extracted from circulars of the sub-prefects of the Stura (ch.-l. Mondovi). 18. Some addresses of Italian doctors to the priests of their neighborhood, among many others: - Gaetano Palloni, Memoria sopra l'inoculazione delia vaccina in Toscana, Florence, 1801 (Wellcome Institute, London) - B. Spiaggta, Committee of vaccinia of Savona, ch.-l. of Montenotte, Ai signori parrocchi..., June 1809 (Acad. Médecine, Paris) - Fr. Bruni, secretary of the Vaccination Committee of Arno, "To the parish priests of the department...", July 1810 (Acad. Médecine), etc. THE CLERGY AND VACCINATION 95 pastoral. Should the spiritual pastor be concerned with the care of the body? Many episcopal texts felt the difficulty and began their exposition with a concessive proposition. "Although our main task is to teach the faithful the duties that concern another life..." "Although the pastoral ministry has as its primary goal the sanctification of souls and eternal happiness..." "Perhaps, with good reason, someone might object that it is not the task of the sacred pastors of souls, but of doctors to persuade people of the efficacy of a new remedy. * The answers to this objection were nourished by examples from the Scriptures: "The laws of the sacred legislator Moses were not less directed to improving the physical state of men than their moral state. - Did not Jesus, our model and teacher, fulfill during his mortal life the double task of instructing the poor and healing the sick?" He consented to heal the daughter of the Canaanite woman tormented by a demon, or, at Capernaum, the dying son of a royal officer (Math., 15:21; John, 4:46). Further back in history, the annals of the Church "prove that the ministers of religion have always propagated, introduced and maintained the arts and sciences... An infinite number of bishops, priests and deacons joined the medicine of the body to that of the souls, Saints Eusebius, Zenon, Biaise, Zenobia and Theodotus, physicians and bishops, up to Saint Fulbert, bishop of Chartres, and Saint Lanfranc, archbishop of Canterbury...". Bishops have been pontifical archiatrists, missionaries have inoculated and cured the savages of the banks of the Rio Negro and the Amazons. Finally, the fight against the plague mobilized the energies" of St. Charles Borromeo in Milan, of Alexander VII in Rome and of Henri de Belsunoe in Marseilles; these last examples are never forgotten in the circulars of the Minister of Cults w. Can one hinder the designs of Providence? "Christian morality teaches us to receive quietly from the hand of God the infirmities with which we are beset." "Is this not a manifest usurpation of the prerogatives of the Lord? By using this means, are we not sinning against the Providence which has fixed its term for each of the mortals?" - We must answer that Providence does not forbid us to take precautions against infirmities by means of appropriate remedies and the secrets of art" (Turin, 1805) *- "Nothing that has as its goal the relief of humanity is foreign to religion" (Meaux, 1814). God loves life, said the prophet David (Psalms, 30, 6). God takes no pleasure in the death of the living (Wisdom, 1:13), so do not seek death by your errors (ibid., 1:12). In contrast to Christian activism, resignation and submission to a system of strict predestination are represented as 19. Cf. G. Babzellotti, Polizia di sanità..., Siena, 1806. 96 . Y.-M. BERCÉ , characteristics of the Muslims or of the religion of the Chinese, rebellious - it is believed - to any invention. Finally, any religious justification of medical intervention takes up, of course, this passage from Ecclesiastes (chapter 38), which is devoted to the role of the physician, and where it is said that the medicines of the earth were created by God, and for the intention of men ao. It is only in the spiritual order, when it is a question of offending God, that it is not permitted to do any harm. On the contrary, very often, in the course of our ordinary life, we choose small inconveniences to avoid the great ones we are threatened with, to prevent an apoplexy by a bloodletting, an illness by a purgative, etc.". Finally, it is not only a question of a possibility offered to the ecclesiastics to exercise their charity, but of a true duty of state. < The ministers of the altar have too much influence over the people not to use it on this occasion." "Indecision itself is an error against love of neighbor." Priests are the "ministers of a God of truth"; therefore, it is their duty to dispel popular ignorance and errors. Among these errors, the fear of a bovine disease figures prominently. Doesn't the human race have enough diseases without taking them from horned animals? And don't we risk in time "contracting the temperament and instinct of the bovine species"? The archbishop of Turin took the trouble in 1808 to refute this myth, quoting De Carro's words on the subject s. c Poor cows are not tigresses; we hardly have better friends than these interesting animals... Moreover, is the vaccine the only use we make of the cow? Do we not drink its milk? Do we not feed on its flesh? I would say that those who have such fears should also tremble when they eat beef a la mode" tt. There is even an ultimate benefit to the cause of religion in associating oneself with a work that relieves mankind... c The husband, the father, the mother, the son spared by that specific of which their pastor has persuaded them of its efficacy, will be even more willing to listen with fruit' to the truths of the Gospel from the very mouth from which they have learned the means of prolonging their existence." - It is remarkable that Christian culture and familiarity with theological discourse were widespread enough among everyone that doctors and administrators could easily find religious arguments and that their texts and those of the prelates proved interchangeable. The most astonishing case is that of a homily given in 1801 by a German bishop on the Gospel of the 13th Sunday 20. ha practice of vaccinia ordered and consecrated by religion. Sermon given by Geoffroy-Jacques Schaller, pastor in Pfaf-Tenhofen, Strasbourg, 1808. 21. Pastoral letter of G. Delia Torre, Turin, July 26, 1808. THE CLERGY AND THE VACCINATION * 97 after Pentecost. It is a commentary on the parable of the ten lepers healed by Jesus on the road to Jerusalem, of whom only one returned to give thanks, and also on chapter 38 of Ecclesiastes to the glory of the physician. We must not, says the homily, tempt the goodness of God, and make ourselves unworthy of healing. God has given nature, plants and animals, to man so that he may draw from it. If it is legitimate to heal oneself, it is even more necessary to heal one's children. "These poor children who cannot yet use reason, why do you want to leave them exposed to the danger of losing them? Do not abandon yourselves to a blind destiny, which is contrary to the Catholic religion and repugnant to common sense... Believe in your pastor who so willingly welcomes the opportunity to console you with such a joyful announcement. Imitate with gratitude the one of the lepers, healed in today's Gospel, who recognized the gift of God. This text was given as delivered by the Bishop of Goldstat, and translated from German. The first edition seems to have come out of the departmental presses of Brescia in 1802. There were later reprints in Bologna in 1804, Parma and Pistoia in 1805, Florence 1808, etc. M It is given in French and Italian; it is very often quoted by doctors looking for an ecclesiastical guarantee. However, there is no city, nor bishopric of Goldstat; this name of city of gold seems to refer to a kingdom of utopia. The first edition coincides with a stay of Sacco in Brescia, where he succeeds in stopping an epidemic, vaccinating in two summer months 14,000 subjects. It seems that the apocryphal homily was composed by Sacco himself. He always professed, in fact, the necessity of the adhesion of the clergy to obtain this massive extension of the vaccination, which alone is able to stifle a variolous return. He would have flattered himself with the counterfeit at the end of his life, and, as early as 1851, friendly biographers established the tradition of a pious deception M. It is significant that no one noticed it, that no clergyman protested, that no one thought of being indignant about it, and this very silence translates well the very wide assent of all the elites of the time. Some figures of ecclesiastical propagandists. -In this apparently easy unanimity, there is however room for nuances between militant adhesion and simple benevolence. 22. Cf. F. Manzï, Vaiolio, vaolizzazione e vaccinazione a Bologna, Bologna, 1968. The 1805 edition in Parma, printed by the imperial press, was commissioned by the administrator of the States of Parma, Moreau de Saint-Méry (copy in the Wellcome Institute, London). The edition of 1808 in Florence, is due to Luigi Biagini,102). F8 professor of obstetrics at the university of Pisa (copy in the Arch, nat., . 23. F. Freschi, Storia delia medicina..., Milan, 1851, vol. 8, pp. 1017 ff; quoted by L. Belloni, Per la storia delia medicina, Sala Bolognese, 1980, cf. pp. 79-86. 98 : Y.-M. BERCÉ . The personalities of the most active propagandists are not indifferent and we can try to identify some of these prelates who put their eloquence and their pastoral prestige at the service of a very recent medical technique. In France, the name of Claude Le Coz (1740-1815) stands out. He was archbishop of Besançon in 1802, and in the summer of 1803 he wrote a pastoral on vaccinia. He is said to have convinced some 800 parish priests of his diocese to propagate the vaccine themselves in the remote Jura villages, far from any doctor or health officer. The Vaccine Committee honored him with a medal in 1806. Le Coz would even have proclaimed "that the number of men that the war has seized from us is not the tenth of those that the vaccine has kept for us". He had been in 1780 principal of the college of Quimper, constitutional bishop of Ille-et-Vilaine from 1791 to 1801, with the interruption of an imprisonment during the Terror. H is well known thanks to the preservation of his correspondence with Grégoire, Fouché and a number of former sworn-in priests. Active, charitable, cultivated, he was at the same time entirely linked to the government. Confusing in the same reprobation "the enemies of the government and of religion", that is to say the emigrants, the anti-concordant priests and the refractory conscripts, he was certainly one of the prelates the most complacent towards the power **. In Cahors, in July 1812, Bishop Guillaume Cousin de Grain-' ville (1745-1828) addressed to his priests an instruction that stood out from the common pastoral letters by its medical certainty, its precise distinction between inoculation and vaccinia. He had refused to swear but also to emigrate. He had condemned the refractory from the pulpit and it was said that he had the ability to apply flattering texts from the Scriptures to the emperor. In medical matters, his competence came from the fact that, under Louis XVI, he had been vicar and chancellor of the University of Montpellier. The diffusion of the vaccine among the population was favored by the privileged collaboration of the archbishop of Dublin. John Thomas Troy (1739-1823), Dominican, bishop of Ossary, then archbishop of Dublin since 1786, had granted in 1804 to the vaccinators an efficient patronage among his parish priests. Indeed, the great epidemics of 1837 and 1839-40, which were deadly in Scotland, were limited to a few dozen cases in Ireland. Better still, the miserable Irish living in the slums and the hospices of Glasgow were 24. P. Huard, R. Laplace, Hist, illustrée de la puériculture, 1979, cf. p. 129. 25. A. Roussel, Un évêque assermenté, Lecoz évêque d' Ille-et-Vilaine, Paris, 1902. - Id. edition of the Correspondence of Le Coz, Paris, 2 vols. 1903 (Soc. d'hist. contemp.), t. 22 and 32). - Correspondence of Lecoz and Grégoire (1801-1815), ed. L. Pingaud, Besançon, 1906. 26. Pastoral letter, Cahors, July 5, 1812 (Arch, nat., F1* 1083). THE CLERGY AND VACCINATION 99 spared from smallpox. Archbishop Troy was also a prudent politician, having condemned the revolt of 1798, approved the legislative union with the United Kingdom in 1801, and generally accepted all measures of government control over his clergy.m In the Italian dioceses, the prelates who were prolific in pastoral letters were often the French ecclesiastics imposed by Napoleon. Thus Jean-Chrysostome Villaret (1739-1824). He had been vicar general of Rodez, deputy to the States General. He had been neither sworn in nor emigrated and these qualities had earned him the seat of Amiens in 1802. In 1803, Bonaparte had entrusted him with the application of the Italian concordat, with the title of extraordinary commissioner for ecclesiastical affairs in Piedmont with residence in Turin. He was then bishop of Casale from 1804 to 1814, where he obtained remarkable results in vaccination 28. To the see of Florence, vacant in 1810, Napoleon had sent Bishop d'Osmond, concordat bishop of Nancy, baron of empire, devoted to the regime. His installation in the archiepiscopal palace in January 1811 was against the metropolitan chapter, against most of his clergy and suffragan bishops. To the circulars of Portalis inviting him to promote vaccinia, he answered that it was already very well accepted in France; "By a singularity whose reason I do not explain to myself, it is not on it that the prejudices carry in this country". In any case, he added, to claim to recommend her in his name would be enough to harm the process: . "I must not disguise to you that I am far from having established confidence and that I cannot flatter myself to ever reach this goal" **. In Turin, Archbishop Buronzo del Signore, a tired septuagenarian, had been in charge since 1786. He had shown his attachment to the house of Savoy during the retreat of the French in 1799 and their victorious return in June 1800 had forced him to flee. After the return of peace in 1802, he had opposed in vain the suppressions of nine Piedmontese dioceses and was held in disgrace. In January 1805, to the first circulars on vaccinia, he answered that "his ministry obliged him to preach the Gospel and that to the happy discoveries of the doctors, he could only applaud. The letter he sent to the parish priests repeated this division of roles and amounted to a refusal. He was forced to resign in June 1980. In his place was installed Giacinto Delia Torre, an Augustinian priest, a scholar 27. Samuel B. Labatt, An Address to the Medical Practitioners of Ireland..., Dublin, 1840. 28. National Archives, Flf 1083, Casale, 16 Sept. 1809. 29. Antoine E. d'Osmond to the Minister of Cults, Florence, 6 March 1811 (Arch, nat., F1' 1083); cf. Eugène Martin, Mgr d'Osmond, archbishop appointed of Florence, 1909. 30. Carlo Luigi Buronzo del Signore (1731-1806); cf. notice in Dix. biografico degli Italiani. . 100 * Y.-M. BERCÉ ; theologian formerly archbishop of Sassari, then of Acqui. He gave the desired example of skillful and argued pastoral letters and applied himself to promote vaccination. Here he was, at the beginning of September 1812, traveling the steep mountain roads for a confirmation tour: "I shuddered," he said, "at the sight of the disgusting physical degradation caused by the variola contagion of the faithful who came to me to obtain the holy confirmation. In every parish he preached on the subject and urged parents "not to betray their offspring". Not content with preaching, he organized free vaccination sessions in the village presbyteries or in the communal hotels, which he presided over amidst the influx of mountain people who came down from the surrounding hamlets to attend his visit to the valley. The zeal of Le Coz in Besançon or Delia Torre in Turin was reflected in the local clergy, where one could count tens or hundreds of parish priests going to vaccinate children with their own hands. More than the prestigious and distant encouragement of the prelate, the permanent presence of the priest of the village, his authoritative or affectionate influence on the families constituted the surest guarantee of the success of the mass vaccinations in campaigns, only the ministers of the cult can inculcate this beautiful and great truth in the most vulgar heads. The testimonies report, in order to congratulate or complain about it, the strength of the opinions of the priests on the popular opinion, often mentioning their role of omnipresent adviser, listened to for the quarrels of parents or the problems of health. "These pastors, burdened with tasks and yet miserable, far from all ambition and satisfaction, deprived of the honors and pleasures of society, strong only in the feeling of their duty, edify and console the most useful part of society, the inhabitants of the countryside. They lack brilliant knowledge, but have common sense to spare, they do not have the veneer of virtue but have the substance and candor of it. With them Socrates would not disdain to talk and Solon would willingly sit at their table. Observe how they speak in their rustic temples, how eagerly the people listen to them, how much they are consulted in the most scabrous affairs, how their decisions are followed with respect "**. Especially in the remote countryside, in the bocage countries or in the mountain valleys, the parish priest had to know a little bit about practical medicine, to compose herbal teas, plasters, and even to act as an empiric. The medicalization of the countryside and the defense of the 31. Pastoral letter, Turin, 14 Oct. 1812 (Acad. Médecine, Paris). 32. M. Buniva, Discours historique sur l'utilité de la vaccination, Turin, 1804, cf. p. 57-67. 33. Reflections of Melchiorre Gioja, agronomist and statistician, in his economic essay Sul dipartimento del Lario, Milan, 1804. THE CLERGY AND VACCINATION 101 medical titles were still too little advanced for denunciations of errors, dangers, and prosecutions for usurpation or chart latanism to be numerous. On the contrary, the Lutheran Directory of Strasbourg in 1808 encouraged its pastors to meddle in popular medicine: "In many families, especially in the lower classes of society, certain preservatives and remedies, ointments, and elixirs circulate in secret and are passed from father to son, and even more so from mother to daughter, as a precious part of the estate. Such a practice used among the people could lead the man of art to important results and the great discovery of vaccination is a very memorable proof. Indeed, the villages of Alsace offer several examples of Catholic priests and Lutheran pastors vaccinating themselves or having a surgeon come at their own expense to vaccinate their community. It is well known that the scattered settlement structure offers parish priests opportunities for major cultural influence. The most common participation of the parish priests consisted in offering their rectory as a vaccination room and in welcoming for one or two days the noisy and invading crowd of mothers and their infants, who had come from the outskirts of the parish or from more remote communes to wait for the passage of the itinerant vaccinator. One Burgundian parish priest had the school closed and the children dressed up to turn the vaccination appointment into a children's party. Buniva, professor at the Faculty of Medicine of Turin, tells that in the isolation of the Alpine valleys, where he ventured in the beautiful season, the mountain priests waited for his car along the road: . -j. ' "Could we," they said, "be careless spectators of the terrible effects of this disease which plunges into desolation and mourning every family of our beloved flock?" M. The most educated priests subscribed to medical sheets, or corresponded with the vaccine committee of the sub-prefecture, asking it for instructions. Others put their hand to the pen themselves, like Vallecchi, parish priest of Dicomano, an isolated parish in the Tuscan highlands. His book La vaccine triomphante de tous ses ennemis, recommandée aux nations par la nature, par la religion, par la politique et les lois civiles, had the good fortune to be recommended both by the French authorities and by the local clergy 87. . 34. See the works of Jacques Léonard, especially La médecine entre le" pouvoirs et les savoirs, Paris, 1981. 35. Address of the Directory of the Augsburg Confession to the pastors of its jurisdiction..., by Silbermann, Secretary General, Strasbourg, August 1808. Cf. Médard Barth, op. cit. p. 261-269. - National Archives, F19 5596. 36. Vallée de la Doire Ripaire, Sept. 1808, Acad. Médecine, dossier Pô. 37. Arch. nat. F8 102; F" 1083. , 102 Y.-M. BERCÉ i Finally, some priests discovered a vocation and devoted all their time to vaccination. For example, M. Meunier, a former Carthusian monk, who became the parish priest of Marolles, near Bar-sur-Seine, operated on hundreds of children and did not even stop his operations during the year 1814, when the doctors no longer dared to venture out on the roads. Thus, above all, M. Cochin, parish priest of Mottereau^ canton of Brou, in Eure-et-Loir. "As early as 1803, hearing about the benefits of vaccination for humanity, seeing that no one was concerned with it in my canton, and filled with a strong feeling of sorrow for the terrible ravages of smallpox, I formed the project of stopping this scourge by imposing the vaccine. I had no difficulty in determining all my inhabitants to have the children inoculated. I did not repeat this operation many years on the newborns without the beneficial effects being known, in that the limits of this commune became insurmountable barriers to this epidemic. From 1803 to 1834, the date of his report, he boasted of having inoculated nearly 20,000 subjects in eighteen communes in the Chartres region *-. These easily multiplied anecdotes could make one imagine a regular propagation and a very wide and effective protection. In fact, the vaccinia "enthusiasm" was sometimes without success and even the zeal of too improvised vaccinators was transformed into deadly blunders. Several of the Jura parish priests hired by Bishop Le Coz had only transmitted bastard vaccinations, or had not known how to check the regular course of the vaccine, so that a few years later, an epidemic return came to take away adolescents who had been believed to be duly vaccinated and protected.48 < Clerical anti-vaccinism or medical anti-clericalism . Finally, it remains to consider the circumstances of inertia, routine or ill will that could reinforce the image so well anchored of an ignorant clergy and enemy of the slightest change. As for theological argumentation, the models had been fixed, at the time of the inoculation. The archetype goes back to Voltaire and to letter XI of the Lettres philosophiques (1734), which he had devoted to the praise of Lady Montagu, whom he had made the sole propagator of inoculation brought from Constantinople to London in her luggage as an ambassador curious about exoticism... c She thought, says Voltaire, of giving without scruple the smallpox to a child of which she had given birth in this country. Her chaplain told her that this experience was not Christian and could not succeed 38. Marolles-lès-Bailly (cant, de Bar-sur-Seine), Àcad. Medicine, Aube file. 39. Journal de vaccine, 1834, pp. 137-166; 1838, pp. 354-368. 40. Complaints from Drs. Barrey, of Besançon, and Faivre, of Salins, cited in the Report of the Central Committee of Vaccination for the year 1810. THE CLERGY AND VACCINATION 103 that among the infidels, the son of Mrs. Wortley Montague found himself at sea* on the eve... A parish priest preached against it: he said that Job had been inoculated by the devil; this preacher was made to be a Capuchin, he was hardly worthy of being born in England. Prejudice was the first to rise to the pulpit and reason only later: this is the ordinary course of the human mind"... The way was then traced and the doctors were not the least readers of Voltaire. They were ready to recognize in any obstacle to the progress of vaccination the mark of superstition and clerical fanaticism. The Gazette de Santé in 1834 noted an almost inevitable opposition between the two intellectuals of the village. "The priest and the doctor, when they meet in the same commune, are often the only two men who, in different capacities, exercise the most positive moral influence on their compatriots... Well! such has been the misfortune of the temples and perhaps also the effect of the political calamities which have afflicted the country for forty years, that one would count today few communes where the doctor and the priest have not planted their banner in opposite camps" tt. The conviction of many physicians that they would encounter only silliness and hostility on the part of the clergy was even more sensitive when religious antagonism was added. William Batt, an English physician, settled in Cènes, where he played a great role in the accreditation of the vaccine, did not hide his fears and his contempt for "the ignorant part of the clergy, the plague of society": Louis Odier, a Calvinist physician from Geneva, who was also a pioneer of vaccination, attacked the parish priests of Savoy and Valais, whom he blamed, in 1805, for the slowness of the diffusion of vaccinia at the very gates of Geneva **. The Journal des Débats (2 germinal year X; 23 March 1802) published a plea for vaccinia in the form of a mocking apologue by doctors named Joslé and Canolle. The purpose was clearly anticlerical. Let us judge it : in some part of an imaginary India, a country would have been cut by a deep river infested with crocodiles ; in crossing it, many inhabitants found death or infirmity. Somebody imagined crossing the river in pods, "but the great lama found this practice condemnable". A man of genius then built a bridge, in spite of the clamors of the boatmen deprived of a profit and of the lamas vexed in their magistracy. In the long run, common sense triumphed, all the castes allowed themselves to be enlightened. "The images are clear; the dangerous river is smallpox: the pods are the inoculations and 41. Gazette de santé A l'usage des gens du monde, des curés et des bienfaiteurs des pauvres, Journal de médecine domestique, t. 2, 1834, p. 250. ■ 42. William Batt, Distinzione necessaria fra la vaccina " gli errori..*, Genoa, August 1802 (Copy in Arch, nat., F8 110). - Denunciation of Louis Odier, Jan. 14, 1805, Acad. Médecine, dossier Léman. 104 Y.-M. BERCÉ their nauthors are the inoculators; the slaves and the lama, i.e. the priests and the pope, are represented as unreasonable enemies of progress. The apologue was successful and was often copied or quoted *8 . In two specific regions of the Empire, denunciations of clerical hostility led to investigations and the identification of real areas of refusal; these are certain Belgian countryside and certain Italian valleys. The Flemish countries remained an important source of smallpox; the number of vaccinations was low and smallpox sometimes took hundreds of children in Antwerp. The prefect of the Deux-Nèthes incriminated the clergy, but also the political opposition to the French regime, which was very strong in all the Belgian departments.* - - - "An unfortunate opinion leads the public to avoid everything that has to do with the actions of the administration. The always blind and ungrateful public will be disillusioned only by the experiment; the results of this one always too long to develop will still give time to the small pox to harvest a number of victims" (Antwerp, March 29, 1808). He had solicited in vain the collaboration of the archbishop of Malines. He was an old French prelate, Jean Armand de Roquelaure (17211818), who had been bishop of Sentis, chaplain to Louis XV, Conseil er d'Etat and academician. He had neither sworn nor emigrated and had resumed his functions in Sentis more or less clandestinely at the end of the Terror. Bonaparte had imposed him to the seat of Matines where he knew he was ignored by a great part of his followers. He confessed to the prefect his powerlessness: "Everything that does not emanate from this people is rejected mercilessly and the voice of the first pastor would only increase the aversion for what displeases, by the only reason that it is new" (Malines, May 23, 1807). In 1808, the unfortunate archbishop learned of his resignation through the newspapers and his replacement by the bishop of Poitiers, Dominique de Pradt, who, to tell the truth, obtained even less of an audience than he did ** . A similar refusal was encountered in the Val d'Aoste, forming the department of the Dora, capital of Ivrea. In 1807, there had been fewer vaccinations (828) than cases of smallpox (979); 173 children had died. About ten priests were quoted as preaching defiance towards vaccination, in spite of the clearly favorable pastoral letters of the bishop of Ivrea, - , r " 43. Text reproduced in B.-P. Despeaux, Instruction sur la vaccine, A l'usage des ecclésiastiques, des Sœurs de la Charité, des propriétaires et des habitants des campagnes du département de l'Oise. Suivie de quelques observations sur la clavelée . des moutons, Paris, 1808. ■ 44. Letter from Desmousseaux, prefect of the Ourthe (ch.-l. Liege) to the bishop of Liege, n.d., before May 1806. - Letter of the archbishop of Mechelen to the prefect of the Two Nethers (ch.-l. Antwerp), Mechelen, 23 May 1807. - Letter from the prefect Cochon to the Minister of the Interior, Antwerp, 29 March 1808 (Arch, nat., F8 118). ^ THE CLERGY AND VACCINATION 105 "A priest who puts himself forward to support us," wrote the prefect in October 1808, "is a Jacobin in the eyes of all the others. They even pretend to declare that all orders imply mental restrictions, by means of which they believe they are authorized to regard the orders of their superiors as nothing more than vain formalities which the latter cannot dispense with.46 . In Flanders, as in the Valle d'Aosta, the opposition was directed less at vaccination in particular than at everything imposed by the French occupier. The vaccination is confused in a detestable conglomerate that includes the conscription, the united rights and the persecutions of religious. The animosity is not the result of the medical innovation itself, but of the identity of its advocates, the mayors appointed by the French, the gendarmes chasing the refractory, and the Freemason doctors who support a hated regime. Similarly, in Muslim countries, a few decades later, in Egypt and in Algeria, entire villages would hide their children or flee when the vaccination doctors approached. They were believed to be in charge of taking a census of children to send them to the army or to establish a new tax. In Russia, vaccination met with resistance as early as 1811 from certain sects of the Old Believers, who refused to use any medicine or to consult a doctor 47. In each of these circumstances, the authorities renounced the use of force and left it to time to remove the prejudices. In spite of the accusations made here and there by health officers or doctors, cases of blatant resistance provoked by the clergy turned out to be very rare. The greatest enemy of the vaccinators was not prejudice and superstition, as they liked to declare in a persistent stereotype, but, quite simply, the inertia and indolence that, apart from the epidemic returns, made parents forget the threats of the smallpox peril. For the enthusiastic generation of the early years of the nineteenth century, vaccination was a marvelous challenge. There was, here and now, the possibility, thanks to the lights of science, to erase from the world a plague whose terrible effects could be seen in every family. Dissatisfaction and irritation were exasperated when, in spite of efforts and hopes, the popular adhesion, which one had believed obvious, was made wait. One was tempted to incriminate an oppo45. Letter B from the prefect of the Doire (ch.-l. Ivrée) to the bishop of Ivrée, 9 Sept. 1808; to the minister of the Interior, 9 Oct. 1808. - Letter from the minister to the prefect, Paris, 30 Nov. 1809 (Arch, nat., F1 106; F" 5596). 46 "Notes sur la vaccination en Egypte...", by Chadefau, chief surgeon of the military training hospital, Cairo, Oct. 2, 1843 (Acad. Med.). - Y. Turin, Changements culturels dans l'Algérie coloniale, 1830-1880, Paris, 1971, cf. p. 337-374. 47. J. Baron, op. cit. in vol. 2, pp. 183-187. - 106 Y.-M. BERCÉ , It was necessary to invent an enemy for ourselves. It was necessary to invent an enemy; the clergy and religion could have been the most convenient scapegoats. Instead, the doctors found only silence and negligence, resignation and indifference. In order to overcome these seemingly insurmountable obstacles, the clergy offered the best cultural vector in the state of society of that time. This was understood by the most far-sighted politicians and hygienists. From the top to the bottom of its hierarchy, the clergy manifested the same beliefs and attitudes towards innovation as the global society. It simply reflected the illusions or hopes of the time in which it lived. Yves-Marie Bercé. University of Reims.