Newmarket and smallpox

Smallpox (which has now been eradicated) was a virus transmitted from person to person through coughing or sneezing etc., like many others. This obviously produced small air droplets, which were then inhaled by the next victim (less commonly it was spread by infected skin or even clothing/bedding contact). After about 12 days incubation the new smallpox sufferer would develop a sudden high fever, headache and generalised muscle aches etc., then a few days later a rash would develop that particularly affected the face and extremities. The rash then formed pustules that healed over the course of about a month, but leaving disfiguring scars. Even worse, various complications caused death in about a third of cases!

Interestingly, because of the way smallpox spread, to exist it required a certain density of population, and the density determined the pattern of spread too. It couldn’t exist in very sparse populations, dying out through lack of new victims to infect after everyone in the group had either died or become immune. In very dense populations it gained a permanent presence, pretty much everyone being exposed in childhood, and either dying from the disease or progressing into adulthood immune. In populations with a density somewhere in between these two extremes the disease tended to occur in epidemics, i.e. intermittent sudden outbreaks in a largely non-immune population causing mass deaths followed by a time when the population was free again from the disease. This was the pattern observed in Newmarket before inoculation in the 18th century, followed by vaccination in the 19th century, led eventually to the complete eradication of smallpox from the face of the earth in the 20th century. The last naturally occurring case occurred in 1977, in Somalia.

The origins of inoculation (as opposed to vaccination – see the next paragraph) are obscure and seemingly quite ancient. It involved taking pus from a smallpox pustule on someone with an active infection, then scratching it into the skin of the person being inoculated. The practice was introduced to Europe in the early 18th century, becoming increasingly popular after its efficacy became clear, with a big but: about 3% of those inoculated died from smallpox! However, that must be set against the approximate 30% death rate from catching smallpox, so especially when the disease was prevalent inoculation became a popular option. Also, the later development of just pricking the skin rather than making deeper cuts reduced the risks.

Edward Jenner's lancets, which could be used to apply vaccines and for blood-letting (see below or click image for source and acknowledgements etc., ref. Image 1).

Edward Jenner’s lancets, which could be used to apply vaccines and for blood-letting (see below or click image for source and acknowledgements etc., ref. Image 1).

Vaccination was the next big breakthrough, developed by the Gloucestershire medic Edward Jenner (who interestingly seems to have had a similar early career to that of Newmarket’s Thomas Searancke 3, in that he was about the same age, initially served an apprenticeship to a surgeon-apothecary, and then went on to higher studies – but sadly Thomas Searancke 3’s life was cut short). On the other hand Edward Jenner, in his late 40s, started promoting the practice of inoculating people with material from cowpox pustules instead of smallpox pustules, since it had been observed in his country practice that milk maids naturally exposed to cowpox were generally immune to smallpox. Cowpox is a disease of cattle closely related to smallpox that could be caught by humans, causing a mild illness. He called this technique vaccination after the Latin word for cowpox (vaccina) from cow (vacca).

His ideas were published in 1798 (privately, since the establishment rejected a paper he submitted in 1797!). Eventually though his ideas became accepted, such that by 1840 a law banning smallpox inoculation and encouraging vaccination was introduced. Then in 1853 another law made vaccination of all infants in the UK compulsory. Initially the material for vaccination ‘lymph’ was obtained largely from so called ‘arm to arm’ vaccination, i.e. the vaccine was obtained from a pustule on a patient vaccinated the week before! This practice largely ceased with another law in 1898, from which point calf lymph became the norm. A concerted effort by the World Health Organisation in 1967 led to the total eradication of smallpox by 1977 as mentioned above.

It’s interesting, refreshing and instructive that Jenner presented this gift to the world without attempting to cash in via patents, royalties or the like. It’s even more interesting that parliament unilaterally decided to recognise his free contribution to society by later graciously awarding him several thousand pounds (a lot in those days).

The earliest known smallpox outbreak in Newmarket took place in the autumn of 1634, causing the cancellation of a royal visit (Charles I and his court). The Newmarket All Saints’ parish records from that time look rather incomplete, and the St Mary’s register doesn’t go back that far, but the St Mary’s bishop’s transcripts have survived (technically archdeacon’s transcripts in this case – duplicates sent to the archdeacon of Sudbury each year). They show 28 burials in 1634 compared with only 11 in 1635, so consistent with the reported outbreak that prevented the royal visit.

It’s interesting to consider which medics would have been in Newmarket at that time and what they might have done. Robert Greene would still have been around, likely with Francis Greene as his apprentice. Nicholas Searle was possibly the only other medic in town as far as we know. This early they certainly would not have been using prophylactic inoculation. They would probably have employed methods similar to those advocated by a New England medic called Thomas Palmer, who’s 1696 notebook suggested blood-letting and a multitude of other remedies including a medicine made up from figs, raisins, fennel seed, saffron and gum tragacanth. Also recommended was the bathing of sores with an infusion of the flowers from roses, mallows and figs, together with opening up of the pustules with a needle. However, he warned ‘Take heed of scratching the pox if you would avoid scarrs’ (just like we would advise against today with chickenpox!), and he makes the realistic comment, ‘If nature work kindly it is better to leave the whole cure to nature’.

Burials in Newmarket St Mary's parish register 1762, showing smallpox deaths marked with a '+' as indicated by the note at the bottom of the image (see below or click image for source and acknowledgements etc., ref. Image 2).

Burials in Newmarket St Mary’s parish register 1762, showing smallpox deaths marked with a ‘+’ as indicated by the note at the bottom of the image (see below or click image for source and acknowledgements etc., ref. Image 2).

In 1738 the Newmarket St Mary’s parish register includes a note to say that baptisms for the parish might be found in the All Saints’ register, since St Mary’s parish was ‘sorely afflicted’ with smallpox for a great part of that year. The burials record contains a large number of names marked with a ‘+’, which seems to denote the smallpox victims. Interestingly they include Jane the wife of William Sandiver the Carpenter, mother of William Sandiver the cleric (see The Sandivers). Also of interest from a Newmarket medical history point of view is that Elizabeth the daughter of Simon Clements the apothecary was baptised at All Saints’ church in June of that year, although the family were noted to be from St Mary’s parish; presumably she was one of those referred to in the St Mary’s parish register note.

After the smallpox outbreak of 1738 there was another outbreak in 1762. Again a large number of deaths are marked with a ‘+’ in the register, and this time it’s confirmed that the symbol indicates smallpox deaths, since on the 1762 burials page (see image on the left) is an entry that reads ‘N.B: The Small-Pox raged in Town this year, Of which Distemper all with this mark (+) died.’ The last death so marked was on 9th July 1762. Then, presumably after waiting to make sure all was clear, on 9th August 1762 William Sandiver 1, Thomas Searancke 2 and Elijah Robinson were all involved with declaring the town free from smallpox – see the image below (William Sandiver 2 and John Edwards made a similar statement in 1788 – but the burial registers for that year do not show excessive deaths or ‘+’ marks and their statement reads more like the rebuttal of a rumour – see an image on the page about John Edwards).

Newspaper notice declaring Newmarket free from smallpox in August 1762 (see below or click image for source and acknowledgements etc., ref. Image 3).

Newspaper notice declaring Newmarket free from smallpox in August 1762 (see below or click image for source and acknowledgements etc., ref. Image 3).

After this we start to see evidence of Newmarket medics getting involved with inoculation. In 1763 Thomas Searancke 2 set up an inoculation house within 5 miles of Newmarket and by 1764 he appears to have set up several such establishments. The adverts (see a transcription in the references below, and an image on the page about Thomas Searancke 2) seem to imply that patients could stay for a while in these houses to convalesce. There was some concern that recently inoculated patients might become infectious and set off a local epidemic so perhaps that’s why these houses were out of town and patients remained for a while, although it appears that Thomas Searancke 2’s own house was used as well. William Sandiver 1’s inoculation houses were also out of town, although he appears to have relocated to Mildenhall by that stage, with his inoculation house being in between Newmarket and Mildenhall, at the smaller Tuddenham (see the page on William Sandiver 1 for an image and more about his relocation, and another digitally enhanced yet still rather difficult to read but interesting image below – see a transcription in the references below if it’s too difficult to read). Also, his adverts imply that his patients just came and went?

A 1767 notice from William Sandiver 1, now 'of Mildenhall', setting up an inoculation house 'between Newmarket and Mildenhall' (see below or click image for source and acknowledgements etc., ref. Image 4).

A 1767 notice from William Sandiver 1, now ‘of Mildenhall’, setting up an inoculation house ‘between Newmarket and Mildenhall’ (see below or click image for source and acknowledgements etc., ref. Image 4).

It’s interesting to read the terms of these inoculations, including the varying facilities and associated costs, which ranged from 2 – 6 guineas (a guinea was 21 shillings, equivalent to £1.05, over a hundred pounds in today’s money). So it seems that an inoculation would have cost in today’s money somewhere between about £250 to £800 depending on the facilities chosen (which might have included staying in a house for some time afterwards). See the page on William Sandiver 1 for more on the interesting contents of his adverts/notices.

The 19th century saw vaccination come to Newmarket. The earliest mention found to date comes from the Newmarket Union minutes of 1838, when it was decreed that, ‘the present inmates and every adult and Child upon entering the workhouse who have not already been inoculated or vaccinated be forthwith vaccinated’ by the surgeon to the workhouse, who was Richard Faircloth at that time (he’d been elected surgeon to the Union House in 1837). Within a few weeks he’d done this and been paid £14-3-6 for the work ‘charged to the respective parishes to which the paupers vaccinated are chargeable’. In 1839 a smallpox outbreak in Cheveley and Borrough Green resulted in the Newmarket Union ordering the medical officer responsible for those villages (again Richard Faircloth) to ‘vaccinate the paupers therein’. Other similar initiatives are recorded in the minutes.

The vaccination act of 1840 features significantly in the Newmarket Union minutes for that year, culminating in a long contract document written out in full recorded in the 17th November minutes. This includes interesting detailed hand drawn forms and certificates that the medical officers contracting to do the work had to fill in.

Nevertheless the outbreaks continued. Despite that fact, and the serious nature of the disease, it’s fascinating that the first case of vaccination refusal in Newmarket is recorded in 1843. This prompted questions regarding what to do in such circumstances. Vaccination itself could not be enforced at that stage, but was encouraged, for example by public notices in 1848. However, a significant outbreak in 1845 led to measures being introduced to prevent the spreading smallpox by mixing, and enforcement of this.

Then came the 1853 Act making vaccination itself compulsory. This also featured in the Newmarket Union minutes, with subsequent plans for its implementation. However, in 1860 smallpox was noted to be prevalent in Newmarket due to poor vaccination rates, so there was a new drive with public notices and enforcement again. There are examples of prosecutions later in the minutes (see 1870/1 in the references below). In 1862 further detailed measures were introduced regarding where and when vaccination would take place, together with a strict system to register successful vaccinations, and the interesting detail of weekly attendance by the vaccinators at appointed stations ‘for the purpose of increasing the percentage of arm to arm vaccination’, presumably designed to keep the costs of vaccine supply down (and which as mentioned above was standard practice back then). In 1883 a child not turning up from the week before caused problems with lymph supply, and in 1889 someone was even prosecuted for refusing to allow the vaccinator to take the lymph from their child’s arm (but vaccination rates that same year were hugely better than in the 1860s). The August 1870 minutes contain a particularly detailed and interesting chart regarding where and when vaccinations were carried out, including medics’ houses, various village school rooms, vestry rooms and even someone’s house in Cheveley. There were two main seasons for vaccination, and medics with a large district like Richard Faircloth would have been quite busy travelling between villages several days per week to perform and inspect cases during these autumn and spring initiatives (see details in the August 1870 reference below).

Despite all of these measures outbreaks continued, but tended to be more easily contained, such as in 1867 when some tramps brought smallpox into town, but the outbreak was controlled. In 1874 there was a more troublesome outbreak, with various measures taken, including re-vaccination, the Board of Guardians moving their meetings out of the workhouse, and a temporary smallpox hospital being set up on Newmarket Heath in the July stand (see details in the 1875 reference below). A similar temporary smallpox hospital was set up in 1881 when the guardians were advised to buy ‘an ambulance for the conveyance of infectious cases to the temporary Small Pox Hospital and a Hand Hearse for removing dead bodies to be buried’!

It’s of interest that the effective end of arm to arm vaccination in 1898 appears to have prompted the local public vaccinators to write to the Newmarket Union requesting ‘a satisfactory supply of calf lymph be provided free’ as part of a new vaccination fees agreement.

Anti-vaccination groups continued to be an issue, such that in 1909 the Newmarket Union minuted a letter they’d received from the Anti Vaccination League, regarding the vaccination of children born in the workhouse (in 1872 they’d minuted that no child be discharged from the workhouse without having been vaccinated – a policy that was likely still in place and perhaps what they were objecting too?). In 1925 conscientious objection to vaccination (which by that stage was permitted) was becoming so prevalent that the vaccination officer’s pay structure had to be adjusted to compensate for the decreased income!

Smallpox outbreaks and measures to prevent them continued to feature right up to the end of the Newmarket Union. In 1928 the potential for ‘casuals’ introducing smallpox into the town was still an issue, there actually being an outbreak amongst casuals in neighbouring Ely at that time. Beyond the end of the Newmarket Union minutes in 1930 no further references to Newmarket and smallpox have yet been found, so it’s not known when the last Newmarket case occurred.

 

Image sources and acknowledgements:-

Image 1: From the Science Museum, London (cropped); image used under CC BY 4.0, reproduced with kind permission of the Science Museum and Wellcome Collection. [Note: click here for the source.]

Image 2: The 1762 Newmarket St Mary’s parish register (1717-1780 volume), reference FL610/4/3 (cropped); image ©, reproduced with kind permission of the Suffolk Record Office, Bury St Edmunds and Newmarket St Mary’s parish.

Image 3: The Ipswich Journal. Saturday Aug 14 1762: 3 (cropped); image © The British Library Board, all rights reserved, reproduced with kind permission of The British Newspaper Archive, www.britishnewspaperarchive.co.uk. [Note: clicking here leads to the specific page on their website, but requires logging in to it.]

Image 4: The Ipswich Journal. Saturday Sept 26 1767: 4 (cropped); image © The British Library Board, all rights reserved, reproduced with kind permission of The British Newspaper Archive, www.britishnewspaperarchive.co.uk. [Note: clicking here leads to the specific page on their website, but requires logging in to it.]

Note: see comments regarding images and copyright © etc. on the Usage &c. page as well. 

Relevant references in chronological order

1634: 28 burials recorded in Newmarket St Mary’s parish. Reference: J502/20, microfilm of archdeacon’s transcripts, (Suffolk County Record Office, Bury St Edmunds).

1635: 11 burials recorded in Newmarket St Mary’s parish. Reference: J502/20, microfilm of archdeacon’s transcripts, (Suffolk County Record Office, Bury St Edmunds).

1738: ‘N.B. What Xtenings are not mentioned here may be met with in ye Registr Book kept for ye Parish of All Saints this parish of St Marys being sorely afflicted with ye Small Pox great part of this year’. Reference: J552/9, microfilm of Newmarket St Mary’s parish register, (Suffolk County Record Office, Bury St Edmunds). [Note: this is on the March 1738 – March 1739 page – see New Year change.]

1738, 9th June: Elizabeth daughter of Simon and Elizabeth Clements of St Mary’s baptised, All Saints’ church, Newmarket. Reference: Microfiche of Newmarket All Saints’ parish register (fiche 2), (Suffolk County Record Office, Bury St Edmunds).

1738, 15th July: Jane the wife of William Sandiver buried, St Mary’s church, Newmarket. Reference: J552/9, microfilm of Newmarket St Mary’s parish register, (Suffolk County Record Office, Bury St Edmunds). [Note: marked as one of the smallpox deaths by the symbol +.], [Note also, see the page on the Sandivers for more details regarding which Sandivers these were.]

1762: ‘N.B: The Small-Pox raged in Town this year, Of which Distemper all with this mark (+) died.’ Reference: FL610/4/3, Newmarket St Mary’s parish register (1717-1780 volume), (Suffolk County Record Office, Bury St Edmunds). [Note: see image above.]

1762, 9th August:Tho. Searancke’ alongside ‘E. Robinson and Wm. Sandriver [sic]’, ‘Surgeons’, and the curate, churchwardens, overseers and other inhabitants listed (including ‘Marcon Braham’ son of Wotton Braham interestingly), ‘We the Minister, Churchwardens, Overseers of the poor, and others, principal Inhabitants of the Town of NEW-MARKET, whose Names are underwritten, having this Day made the strict-est Enquiry relative to the SMALL-POX, do hereby certify, that the said Town is now entirely free from that Distemper.’ Reference: The Ipswich Journal. Saturday Aug 14 1762: 3. [Note: see image above.]

1763, 30th April: ‘We are assured from Newmarket, that Mr. Searancke, Surgeon and Apothecary, has taken a commodious house within five miles of the said place, for inoculating the Small Pox: and that he will be ready to receive patients by the middle of May next.’ Reference: The Cambridge Chronicle. Saturday Apr 30 1763: 3.

1764: ‘INOCULATING the SMALL-POX. THOMAS SEARANCKE, of NEWMARKET. SURGEON and APOTHECARY. HAVING been encouraged by his Friends, and the Success he has met with, to fit up separate Houses, at proper Distances, for inoculating, nursing, and airing his Patients, which he discontinued during the hot Months, will begin to take in Patients again on the 14th of September; and as his Houses are large and commodious, for the Reception of Persons of different Ranks, he has fixed the several Prices of Four, Five, and Six Guineas for the whole Expense. Such as are desirous to be prepared at Mr. Searanke’s own House, or to have Friends with them, shall meet with genteel Treatment, on moderate Terms.’ Reference: The Ipswich Journal. Saturday Aug 11 1764: 1., Saturday Aug 18 1764: 1., Saturday Aug 25 1764: 1., Saturday Sept 1 1764: 4., Saturday Sept 8 1764: 1., Saturday Sept 15 1764: 1. [Note: the same advert appeared in these five consecutive weekly editions – see an image of the 25th August edition on the page about Thomas Searancke 2.]

1767, 26th September:WM. SANDIVER, Surgeon, of MILDENHALL in the County of Suffolk, being desired by many of his Friends to reassume [sic] the Practice of INOCULATION, (having inoculated Hundreds with the greatest Success) is now fitting up a House that will be ready to receive Patients at the latter End of October next, in a most delightful, clean, and pleasant Situation, and for the Excellency of Air, is scarcely to be equalled in England, being situated between the two great Roads of Norwich and Bury, and also between Newmarket and Mildenhall [note: this is a good description of Tuddenham – see 1768 advert below]. As I shall make no boisterous Encomiums on the Ease and Safety of my Practice, as I can have Hundreds to certify for it, if occasioned, these Patients who do me the Pleasure to put themselves under my Care may depend on the greatest Neatness, Decency, and Regularity, the tenderest Care and Attendance, and to be received on the following Terms: To pay Five Guineas, Four Guineas, and Three Guineas, and to be paid at the Time of Inoculation, to find themselves with Tea, Wine, and Washing. / I shall be ready to prepare, attend and inoculate any private Family or Families, and also any Town, on the most reasonable Terms.’ Reference: The Ipswich Journal. Saturday Sept 26 1767: 4. [Note: see image above.]

1768, 13th February: ‘INOCULATION / WILLIAM SANDIVER, Surgeon, of MILDENHALL in the County of Suffolk, begs Leave to acquaint the Public, that he has fitted up a House at TUDDENHAM, in a very pleasant Situation, for the Reception of Patients, having inoculated Hundreds with the greatest success, and at the following Expence [sic]; Five Guineas, Four Guineas, and Three Guineas. The Money to be paid at the Time of Inoculation, and every necessary Article to be found, except Washing, Tea, Sugar, and Wine.’ Reference: The Ipswich Journal. Saturday Feb 13 1768: 3.

1768, 18th June: ‘To be SOLD / ALL that Freehold CAPITAL MESSUAGE, or Tenement, with a good Yard, and all convenient Outhouses and Appurtenances to the same belonging, situate and being in MILDENHALL in the County of Suffolk, and now in the Occupation of William Sandiver, Surgeon. / For further Particulars enquire of William Isaacson, Attorney, at Mildenhall aforesaid. / N.B. The said Mr. SANDIVER intends wholly to remove from thence to TUDDENHAM, a village in the Neighbourhood, about 4 Miles distant from Mildenhall, for the Benefit of Inoculation; where he has fitted up a very good House for the Reception of Patients, and has already inoculated many with greatest Success, on the following Terms, viz. Three Guineas Parlour Patients & Two Guineas Kitchen Patients; they finding their own Washing, Tea and Wine: And will at the same time be ready on all Occasions to give his Attendance in Physick and Surgery upon the earliest Notice.’ Reference: The Ipswich Journal. Saturday Jun 18 1768: 4. [Note: see the page on William Sandiver 1 for an image of this.]

1788, 9th June: John Edwards listed as the surgeon heading up All Saints’ parish alongside William Sandiver as the surgeon heading up St Mary’s parish declaring with others listed underneath, ‘Whereas a Report has been propagated, that the SMALL-POX is in Newmarket: We, the Churchwardens, Overseers, and other principle Inhabitants of St. Mary’s and All Saints parishes, in Newmarket aforesaid, do certify, that no persons have got the Small-Pox in either of the said parishes.’ Reference: The Ipswich Journal. Saturday Jun 14 1788: 3. [Note: see the page on John Edwards for an image of this.]

1837, 5th December: Richard Faircloth elected surgeon to the Union House. Reference: 611/12, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1838, 8th May: ‘Ordered that the present Inmates and every Adult and Child upon entering the workhouse who have not already been inoculated or vaccinated be forthwith vaccinated’. Reference: 611/12, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1838, 25th June: ‘A check upon the treasurer for £14..3..6 was drawn in favour of R Faircloth for vaccination in the workhouse and ordered to be charged to the respective parishes to which the paupers vaccinated are chargeable’. Reference: 611/12, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1839, 2nd April: ‘The medical officers of the district in which the parishes of Cheveley and BoroGreen are situate were ordered to vaccinate the paupers therein at 1/6 per head the smallpox having broken out’. Reference: 611/12, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: again Richard Faircloth covered these villages – see the page on the Newmarket Union.]

1840, 1st September: A letter from the Poor Law Commissioners regarding the Vaccination Act was referred to the Medical Committee. Reference: 611/13, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1840, 22nd September: Various resolutions made with regards to vaccination on the recommendation of the Medical Committee. Reference: 611/13, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1840, 17th November: Vaccination contract documents and forms. Reference: 611/13, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: this was to cover ‘all persons resident in the Union’ so presumably not just the paupers, which would explain the term ‘Public Vaccinator’ – see below and references to the various medics on pages relating to specific individuals elsewhere on this website.]

1843, 21st November: ‘The workhouse committee reported that… [x and y]… inmates of the house had refused to allow their children to be vaccinated when the clerk was desired to request the advice of the poor law commissioners on the subject’. Reference: 611/15, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1845, 21st January: ‘In consequence of the prevalence of the small pox throughout the union the clerke [sic] was instructed to order to be printed forms of notices of the liability to penalties for disseminating the disease’. Reference: 611/16, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1845, 4th February: ‘The subject of the great increase in the number of cases of small pox throughout the union, and of the necessity of taking measures to check its further progress was brought before the board, when it was considered that one great cause of the spread of the disease was the unrestricted intercourse that took place amongst the poor while it prevailed and the clerk was directed to issue a circular to the overseers and churchwardens of every parish in the union urging upon them the adoption of such measures as might appear to them availing for the purpose of impressing upon the minds of the poor of their respective parishes the importance of avoiding as far as possible all intercourse between the infected and the healthy, and the legal obligation they are under to do so, as stated in the printed notices circulated throughout the union and of enforcing observance of such restrictions’. Reference: 611/16, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1845, 18th February: ‘Charles Clarke, Relieving Officer was directed to lay an information against… [x]… of the parish of Newmarket All Saints for wilfully disseminating the small pox’. Reference: 611/16, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1848, 9th May: ‘A circular Letter from the Poor Law Board dated 1st inst. on the subject of vaccination, and recommending the circulation throughout the Union of a form of notice accompanying the same, with a view to encourage the practice of vaccination, was laid before the Board, and the Clerk was instructed to adapt the form to the different Districts, and have 200 copies printed for circulation’. Reference: 611/18, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1853, 23rd September: ‘The clerk laid before the board the Vaccination Extension Act 1853 with the letter from the Poor Law Board thereon of the 6th inst when it was ordered that the division of the union into districts with the places for the performance of vaccination and the days and hours for the requisite attendances of the medical officers be with their assistance arranged by the clerk and submitted to the board for their approval. Also that the clerk procure the proper notices and handbills to be printed and distributed and all other forms required by the act The guardians do not however consider it necessary to advertise the notices in the local newspapers’. Reference: 611/20, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1860, 21st December: ‘A letter from the Lords of the Privy Council upon the prevalence of small pox in the Newmarket district and the requisite remedial plans to be taken was read when it was resolved that in consequence of the great neglect of parents in having their children vaccinated the clerk of the union be authorised upon the report of either of the public vaccinators of any future cases of refusal or neglect to prosecute the parties offending for the penalty thereby incurred the costs of such prosecution not recovered from the offenders to be paid out of the common fund and that the public notice recommended by the Privy Council be placarded throughout the parishes of the union. The clerk was directed to forward a copy of this minute for the sanction of the Poor Law Board. A copy of the above minute and notice to be sent to each of the registrars of births and deaths and to the public vaccinators with a request that they will forthwith make the arrangements for vaccination in their respective districts.’ Reference: 611/22, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1862, 12th September: Detailed initiatives regarding vaccination, including, ‘Vaccinator to attend the Stations at the times appointed by the Guardians and if circumstances require it, to continue such attendance from week to week for the purpose of increasing the percentage of arm to arm vaccination’. Reference: 611/23, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1867, February/March: ‘NEWMARKET. SMALL POX.- This disease was brought into the town a week or two ago by some tramps, who have been in a bad state, but under the treatment of Messrs. Fyson and Gamble they are recovering; and by the care and discretion of the occupiers of the Lamb public-house, where they were lodging, and the inhabitants of that part of town, the further spread of the disease has been, we hope, prevented.’ Reference: The Bury Free Press. Saturday Mar 2 1867: 5.

1870, 30th August: ‘The following times and places having in pursuance of the recommendation of Dr. Stevens Vaccination Inspector been appointed for Vaccination and Inspection respectively…’ followed by three pages of charts divided up by Medical Officer and his District and sub divided into parishes/villages. For Robert Fyson’s District 1 vaccination took place every Monday in April and November with inspection the following week at Robert Fyson’s residence (for both Newmarket parishes). In contrast, Richard Faircloth’s District 2 had six vaccination stations, the school rooms of Borough Green, Brinkley and Dullingham, and the Vestry rooms of Snailwell, Stetchworth and Westley. He vaccinated on the first three Mondays, Wednesdays and Thursdays of May and November, again with inspections the following week, with Brinkley, Borough Green, and Westley being done on Mondays (at 12 noon, 2pm and 3pm respectively), Stetchworth and Dullingham on Wednesdays (at 12pm and 2pm respectively) and Snailwell on Thursdays at 12 noon. Similarly, George Borwick Mead’s District 3 had five stations, at school rooms in Ashley, Kennett, Moulton and Woodditton, and ‘at the house now occupied by Mrs. Wright near the Church’ at Cheveley, with similar times and schedules. Reference: 611/27, Newmarket Union Minutes, (Suffolk County Record Office, Bury St Edmunds).

1870, 27th December: ‘Messrs.. Anderson, Malden, and Millington Vaccination Officers laid on the table a list of defaulters at the present time under the Vaccination Acts extracted from the returns of the Registrars of Births and Deaths when a peremptory notice was ordered to be delivered to each person in default requiring compliance with the Act on or before the 1st.. [sic] day of February next’. Reference: 611/27, Newmarket Union Minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: on 7th February a list of those who ‘refused to comply with the provisions of the Act were ordered to be prosecuted forthwith’ (only one name was from Newmarket, the others being from Fordham (3), Isleham (1) and Soham (3), so it appears there were very few defaulters, which makes sense given that the alternative was prosecution, or even worse smallpox! – see also August 1889 below)], [Note also, the Vaccination Officers were not medics but those responsible for monitoring the system, in this case they were also Relieving Officers who’d been appointed to the Vaccination Officer role earlier in the year – Reference 25th October minutes (611/27); (see also the page on the Newmarket Union regarding the wider role of Relieving Officers). At the end of 1871 these three were replaced by the Clerk of the Union Mr Thomas Ennion, ‘to see the execution of the Vaccination Acts within the whole Union’ –  Reference 21st November (611/27).]

1872, 27th August: ‘It was unanimously resolved that in future no child one month of age or upwards and not having had small pox shall be discharged from the workhouse without having been vaccinated unless the state of health of any child renders it unfit for vaccination when and in every such case the medical officer shall give a certificate in writing to that effect setting forth the nature of the sickness or other sufficient reason for his not having performed the operation’. Reference: 611/28, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1874, 7th July: ‘A letter from the Local Government Board was read in respect of the outbreak of Small Pox at Newmarket and enclosing memoranda on the steps specially requisite to be taken by Boards of Guardians in places where Small Pox is epidemic and on the subject of re-vaccination. / The Clerk reported that he had taken all necessary steps of the kind referred to in these memoranda for the enforcement of vaccination and the promotion of re-vaccination and generally for preventing the spread of the disease’. Reference: 611/29, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1874, 6th October: ‘The clerk reported that Mr. Hubert Isaacson who recently placed the large Room at Rothsay House Newmarket at the disposal of the Guardians for their weekly meetings during the prevalence of Small Pox at the workhouse intended to charge no rent’. Reference: 611/29, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1875, 20th April: Some money ‘rendered by the Newmarket Local Board of Health for care and maintenance of Small Pox patients in the temporary Hospital provided by that authority in the summer of 1874’ mentioned in the Newmarket Union minutes. Reference: 611/29, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: a newspaper report from September 1874 refers in passing to ‘the Heath Hospital’, which Clement Gray was in charge of, and also referred to as ‘on the Heath’. Reference: The Bury and Norwich Post. Tuesday Sept 8 1874: 6. – this was part of a report regarding an investigation by the Newmarket Union into alleged problems with the way in which Dr Mead had vaccinated some patients and some other issues.], [Note also, the September 1874 edition of the Newmarket St Mary’s parish magazine carried an article entitled ‘THE SMALL POX’ dated 4th August, which mentioned ‘the July Stand Hospital. However well adapted the building may be to racing purposes, certainly it makes an admirable Hospital, with those health-giving breezes playing around it. It is fitted up with beds in the lower room for men, and in the upper room for women… the Weighing Room has been turned into an excellent Kitchen. The Establishment is under the medical charge of Dr. Gray, and Mr. C. F. Gray…’. It also mentioned that some patients were in ‘the Union Infirmary. Some of the severest cases were admitted there before the July Stand was ready’.], [Note also, it was even reported nationally in the medical press, with some interesting measures mentioned: ‘SMALL-POX has, through the praiseworthy exertions of the local au-thorities and the kindness of the Jockey Club in giving up the Grand Stand as a hospital, been entirely stamped out in Newmarket. It is now nearly a fortnight since the last case, a mild one, was removed; and all the afflicted, both from the town and union, are in the hospital. Active measures have been taken… to purify the infected quarters; the houses of the sick have been whitewashed; the papering of the rooms has been removed; bedding and clothing have been destroyed or disinfected. The union workhouse is quite free from the disease, and has been ren-dered pure by disinfectants. At the hospital, the cases are fast ap-proaching convalescence, only three of four patients being confined to their beds. The majority are seen outside the hospital, waiting for the doctor’s certificate for them to return home…’ Reference: British Medical Journal 1874;2(714):309. – interestingly, some similar methods were used following smallpox at the workhouse in 1844, when the 3rd December minutes record that the master was ‘to avoid the use of the wards lately occupied by the small pox patients, to air, lime wash, and sprinkle the floor with chloride of lime’. Reference: 611/16, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1881, 7th June: ‘The Guardians upon the application of the Rural Sanitary Committee advised the purchase of an ambulance for the conveyance of infectious cases to the temporary Small Pox Hospital and a Hand Hearse for removing dead bodies to be buried.’ Reference: 611/31, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1883, October: On 2nd October it was minuted ‘that Mr. John R. Wright, Public Vaccinator in the second District had not attended the Vaccination station at Brinkley at the times entered in his contract with the Guardians during the month of September’ and on 9th October ‘the Clerk read a letter from him explaining that the child to whom he trusted for lymph in the first instance had failed and upon the second occasion he was prevented from attending by urgent private business.’ Reference: 611/30, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: this appears to have contributed to the contract going to Walter Hutchinson instead in 1884.]

1889, 23rd April: A vaccination case was reported in the press, in which someone was prosecuted by the Newmarket Union Board of Guardians because Walter Hutchinson had vaccinated a child on 21st March ‘and on the 28th the child was brought up for inspection by the defendant’s mother-in-law, who refused to allow him to take lymph from the child’s arm to vaccinate children brought up for that purpose.’ The case was brought because they ‘wanted the public to understand that the surgeon had a right to take lymph from the arm of the child when brought to a public vaccinator.’ Reference: The Bury and Norwich Post. Tuesday Apr 23 1889: 6. [Note: given October 1883 above, it’s perhaps not surprising that Walter Hutchinson reported this to the Board.]

1889, 6th August: The return of the Vaccination Officer respecting the vaccination of children whose births were registered between 1st July and 31st December inclusive was laid before the Board from which it appeared that the number of such births was 444. Successfully vaccinated 389 / Dead unvaccinated 35 / Postponements by medical certificate 15 / Removals to Districts the vaccination officer of which has been apprised 2 / Removals to places unknown 3’. Reference: 611/33, Newmarket Union Minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: this shows very high compliance with vaccination, but also incidentally an infant mortality rate of just under 8% in the first year alone. A similar minute from 18th August 1891 shows just under 7% (611/34). It’s of note that this minute passes without further comment, showing that this was an expected state of affairs, whereas an infant mortality rate that high today would be a source of great alarm and debate as to the cause and what could be done about it!]

1898, 27th December: ‘The Clerk read a letter under the hands of each of the Public Vaccinators of the Union with reference to the scale of fees which it was proposed to adopt under the provisions of the Vaccination Order 1898…. These terms will be accepted, provided that a satisfactory supply of calf lymph be provided free’ with signatures including Clement Gray and Walter Hutchinson of Newmarket and six others. Reference: 611/37, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1909, 12th October: ‘A letter was read from the Anti Vaccination League with reference to the vaccination of children born in the workhouse when it was resolved that the letter lie on the table’. Reference: 611/41, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: it was not mentioned again in the minutes.]

1925, 19th May: ‘The committee considered the application of the vac-cination officer for an increase in his remuneration in consequence of the very considerable reduction in his fees consequent on the increase in the number of cert-ificates of conscientious objection when it was recommended that subject to the approval of the Minister of Health the fees be increased…’ Reference: 611/46, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1928, 24th January: ‘The Board considered the question of the danger of an outbreak of smallpox in this district when after discus-sion it was resolved that in view of the prevalence of Small Pox amongst casuals the Board requests the Medical Officer to examine all those coming into this Institution and offer to vaccinate all who have not been vaccinated recently’. Reference: DC1/4/1, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: this measure ended on 30th September but still the person ‘supervising the bathing of casuals should at once report to the medical officer any casual found to be suffering from any skin eruption or other evidence of infection’ – Reference: 2nd October minutes (DC1/4/1).]

1928, 21st February: ‘A letter was read from the Ely Union stating that in view of the closing of their Institution owing to an outbreak of Small Pox in the Casual Wards they desired to ask whether this Board will agree to admit to this Institution any sick or urgent cases in their Union’. Reference: DC1/4/1, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: this was agreed to, and when the measure ended with the re-opening of Ely (minuted on 17th April in Newmarket) the minutes reveal that only two patients required transfer.]

Some other sources consulted include:-

Dudgeon JA. Development of smallpox vaccine in England in the eighteenth and nineteenth centuries. The British Medical Journal 1963;1(5343):1367-1372.

Hore JP. The History of Newmarket and Annals of the Turf. Vol II. London: AH Baily and Co.; 1886. [Note: mentions cancellation of the royal visit to Newmarket as a consequence of smallpox there in 1634 – pg 25.]

Kiple KF. The Cambridge historical dictionary of disease. Cambridge: Cambridge University Press; 2003.

Microfilm transcripts of St Mary’s and All Saints’ parish records, Newmarket. Reference: J562/69, (Suffolk County Record Office, Bury St Edmunds).

Newmarket All Saints’ parish register for 1620s and 1630s. Reference: Microfiche of Newmarket All Saints’ parish register (fiche 1), (Suffolk County Record Office, Bury St Edmunds).

Palmer T. The Admirable Secrets of Physick and Chyrurgery; 1696. (Edited by Thomas Rogers Forbes). New Haven and London: Yale University Press; 1984.

Riedel S. Edward Jenner and the history of smallpox and vaccination. Proc (Bayl Univ Med Cent) 2005;18(1):21-25.

UK historical money equivalents calculator using old inflation data. http://www.whatsthecost.com/cpi.aspx (accessed 17th October 2015).

Note: For published material referenced on this website see the ‘Acknowledgements for resources of published material’ section on the ‘Usage &c.’ page. The sources used for original unpublished documents are noted after each individual reference. Any census records are referenced directly to The National Archives, since images of these are so ubiquitous on microfilm and as digital images that they almost function like published works. Census records are covered by the ‘Open Government Licence’ as should be other such public records (see the ‘Copyright and related issues’ section on the ‘Usage &c.’ page for which references constitute public records, and any other copyright issues more generally such as fair dealing/use etc.).