Dr Anthony Butler
Bute Medical School, Purdie Building, St Andrews KY16 9ST
SMJ 2006 51(3): 343-46
Lyon
Playfair was born in India but brought up by his uncle in St Andrews.
He studied medicine in Glasgow and Edinburgh but never practised as a
doctor. Instead he worked for the chemist Thomas Graham in London and then
studied for a PhD with Liebig in Germany.
While serving on a government commission he became very interested in
public health, particularly the control of infectious diseases.
In 1883, while a member of parliament, he made a passionate speech in
support of a government bill in favour of compulsory vaccination against
smallpox. He was violently attacked for his speech in a pamphlet by
William White, an adherent of the teachings of the Swedish mystic Emanuel
Swedenborg. Playfair died in 1898
and is buried in St Andrews.
In
1800 Dr James Playfair (1838-1819), minister of Meigle Parish in Perthshire, was
invited to become Principal of the United College of St Salvator and St Leonard
in the University of St Andrews, as well as minister of St Leonards church.
This move initiated a connection between the city of St Andrews and the
Playfair family that lasted several generations.
One of James Playfair’s sons, George, qualified as a doctor and worked
for most of his professional life in India, latterly as Inspector-General of
hospitals in Bengal. He married
Janet Ross and one of their sons, the subject of this article, was named Lyon
after his paternal grandfather. At
the age of two Lyon Playfair was transported from India to his uncle’s house
in St Andrews and it was there that he spent the rest of his formative years.
At the age of 14 he enrolled as a student at the University of St Andrews
but thought the courses he attended rather uninspiring.
On leaving university he first tried a commercial career in the office of
his uncle James in Glasgow but found it unbearably tedious.
In 1835 he enrolled as a medical student at the Andersonian College in
Glasgow, where one of his fellow students was David Livingstone.
While at the College he came under the influence of the lecturer in
chemistry, Thomas Graham, and spent more time studying chemistry than other
subjects in the medical curriculum. Graham
moved to University College London and Playfair left Glasgow to continue his
medical training in a more conventional way at the University of Edinburgh.
Unfortunately he had to discontinue his studies as the vapours of the
dissecting room and hospital caused severe eczema.
Playfair wanted to return to science but his father, still in India,
urged a commercial career and set him up in a trading company in Calcutta. He enjoyed the voyage out to India, remarking in his journal:
‘The voyage was pleasant, for at that time, numerous young
ladies
He
survived the journey but the work in Calcutta proved as tedious as that in
Glasgow and he quickly returned to London to work for Thomas Graham. Graham advised him that, to make a career in science, he
needed a German doctorate and so Playfair enrolled as a doctoral student in
Justus von Liebig’s laboratory in Giessen.
In 1840 he returned to Britain with the coveted doctorate, the goodwill
of Liebig and an excellent command of German.
His first task was the translation of Liebig’s influential work on
agricultural chemistry.2 His
first salaried appointment was as chemist at the then-famous Primrose calico
works in Clitheroe but changing public taste resulted in the rapid closure of
the works and Playfair was forced to take an unpaid job as lecturer at the
ill-fated Royal Institution in Manchester.
In 1842 Liebig was a visitor to Britain and Playfair was his guide and
companion, meeting many influential people in the political field.
Out of the blue came a letter from no lesser person than Michael Faraday at the Royal Institution in London asking if he would like the chair of chemistry at the University of Toronto. When news of this offer reached the government there was an immediate response. The prime minister, Robert Peel, met Playfair and urged him not to accept the post but to stay in Britain. He was flattered enough to fall into line and returned to his unpaid post in Manchester. Remunerative work soon came his way. The British Association for the Advancement of Science asked the German chemist Robert Bunsen, of bunsen burner fame, to examine the gases coming from blast furnaces. He, in turn, asked Playfair to join him and it was during this project that Playfair met his first wife Margaret Oakes, the daughter of a Lancashire ironmaster. They married in 1846. In a very significant development Peel asked Playfair to join the Royal Commission on the Health of Towns. He studied conditions in a number of Lancashire towns and was appalled at the overcrowding, filth and disease that characterised the lives of the working classes. This commission started his life long interest in what he called ‘sanitation’ and what we call public health. Later this concern was to dominate his life leading, in 1898, to the award of the Harben Gold Medal of the Royal Institute of Public Health.
To
further his career he needed to be in London and a post was found for him at the
Geological Survey. It was there he
made his most significant chemical discovery: a group of salts called the
nitroprussides.3 The
sodium salt is marketed under the name Nipride as a vasodilator, used in
vascular surgery and the management of myocardial infarction.
It is a good vasodilator but the presence of the cyano groups makes death
of the patient by cyanide poisoning an ever-present possibility.
He
continued to serve in government commissions, including a study of the potato
famine in Ireland and the lavatories in Buckingham Palace.
Apparently the latter were primitive even by Victorian standards.
The most important of his government posts came in 1850 when he was
invited to be a Special Commissioner for the Great Exhibition at Hyde Park
housed in an enormous greenhouse (the Crystal Palace).
In spite of an inauspicious start, the Exhibition was a great success and
led to a life long friendship between Playfair and the Prince Consort and,
unlike the Millennium Dome, made a very considerable profit used to purchase the
ground on which the Victoria and Albert Museum, the Albert Hall and Imperial
College London were built.
In
March 1852 he became secretary of the government’s newly established
Department of Science and Art and he used this post to promote his vision of a
network of science schools. He met
with little success and in 1858 he abandoned his government work and accepted
the chair of chemistry at the University of Edinburgh.
During his time in Edinburgh he did little scientific research, although
he did supply James Young Simpson with various materials to test as
anaesthetics. Instead of research
he played a large part in the administration of the university.
He reorganised the teaching of chemistry and provided encouragement for
his colleagues. He was president of
the Chemical Society, now the Royal Society of Chemistry, 1857-59 but, by the
late 1860s, chemistry played only a small part in his life and in 1868 he quit
the chair at Edinburgh to take up politics fulltime. After a vigorous campaign he was elected the member of
parliament for the Universities of St Andrews and Edinburgh and took the Liberal
whip. He spoke frequently in the
House on education and public health. For
a time he was Deputy Speaker but without great success owing to the disruptive
behaviour of some Irish members. He
was knighted in 1883. He
represented the constituency of Leeds South from 1885 to 1892 when he was raised
to the peerage and took his seat in the House of Lords as the first Baron
Playfair of St Andrews.
One
issue exercised him greatly as part of his concern for public health:
legislation enforcing compulsory vaccination against smallpox.
The consequences of contagious diseases upon the working classes were
brought home to him forcibly during a number of Royal Commissions and smallpox
was one of the most deadly of these diseases.
It had been around in most of the world since earliest times but it was
the growth of cities that made it a major problem of public health.
Unlike cholera the means of controlling smallpox was known in the 19th
century. The simple observation that few people contracted smallpox twice led to
the practice of inoculation, or variolation as it was called in the case of
smallpox. The healthy victim was
given an attack of smallpox and, if he recovered, he would be free from smallpox
for the rest of his life. It was a
hazardous business as the victim might die or be scarred for life.
The technique of variolation was perfected by the Chinese in the 18th
century4 and passed to Arab physicians.
Lady Mary Wortley Montagu witnessed variolation by Greek women in
Constantinople when her husband was ambassador there and brought the therapy
back to London, where it was called engrafting.
Lady Mary was very active in encouraging aristocratic mothers to have
their children treated in this way but it had very limited use as a public
health measure amongst the working classes.
Edward Jenner’s genius was to see a safer way of achieving the same
end. He noticed that milkmaids, who
nearly all suffered from a mild disease called cowpox, which they contracted
from cows, rarely suffered from smallpox. He
reasoned that whatever mechanism stopped people from getting a second attack of
smallpox could be equally well activated by an attack of cowpox.
The effect was confirmed by experiments with orphans and vaccination
against smallpox was born. The
practice was slow to be accepted but grew during the 19th century
and, with increasing concern for public health, was seen as a way of controlling
epidemics. This meant compulsory
vaccination and it was the compulsory aspect that caused so much opposition.
Societies arose to oppose compulsory vaccination as the government
proposed legislation to enforce it. Those
who resisted compulsory vaccination were known as ‘conscientious objectors’.
Playfair
was adamant that good public health demanded the control of smallpox by
compulsory vaccination but other public figures differed.
As part of the opposition, on 19 June 1883 the following motion was
introduced in the House of Commons by the member for Leicester:
‘That,
in the opinion of the House, it is inexpedient and unjust to enforce vaccination
upon those who regard it as inadvisable and dangerous.’
Playfair
made a fine speech5 against the motion in which he marshalled all the
scientific evidence for the benefits of vaccination. It cannot have been easy listening; even Playfair suggests,
‘I fear I have wearied the House by statistical results.’
But
this was a fine scientist speaking with authority and the amendment supporting
compulsory vaccination was carried by 286 votes to 16.
One would have thought that this was the end of the matter.
However, some months later a long pamphlet6 was issued
containing a virulent attack on Playfair, with the intriguing title ‘Sir Lyon
Playfair taken to pieces and disposed of’. It questioned his stature as a scientist and he was deeply
hurt by the attack. The author of
the pamphlet was an unknown writer, William White.
The
pamphlet does not make captivating reading.
It is verbose (168 pages long) and strident.
None of the evidence adduced by Playfair stands up to scrutiny by a
rational person, or so William White claims.
A short quotation will give the flavour of the complete work:
‘Always
curious and eager to hear what can be urged in justification of a practice which
is a survival from the pre-scientific age, we followed Sir Lyon Playfair
attentively, but anything more hopelessly commonplace than his discourse it
would be difficult to imagine. The
stalest fallacies of the vaccinators were recited as if they had never been
answered. The freshness consisted
in the business-like assurance and plausibility, after the Scots manner, with
which the speech was delivered. Not
a single novel point was made………………..We all love to have our
prejudices flattered, and never more than when we suspect them to be
questionable.’
White’s
diatribe might be dismissed as political knockabout were is not for the serious
consequences of a smallpox outbreak.
Throughout
the pamphlet White questions Playfair’s statistics.
The latter quoted many examples where the incidence of smallpox in two
groups, one vaccinated and the other not, was compared.
In all the cases he quotes, unsurprisingly, it is lower in the former.
However, by modern standards, the groups are not well matched and effects
other than vaccination could explain the effect.
White credits the differences to changes in hygiene and public sanitation
which had had such a beneficial effect in reducing the incidence of other
infectious diseases such as typhoid and cholera.
With modern knowledge of the causation and transmission of smallpox it is
clear that this cannot be the case but White could not know that. A few
distinguished scientists, including Alfred Russel Wallace, were also unconvinced
by the statistical evidence. Others,
including many clergymen, objected to compulsory vaccination on moral or
spiritual grounds. The Genesis
story of creation sets man apart from other animals and to introduce something
into a man from a diseased animal was to deny man’s status.
Secretly, some saw smallpox as a way of controlling the size of the
working class population. At the
same time, in working classes circles there was a curious suspicion of
vaccination. They rarely saw a
doctor and their most frequent contact with the medical profession was when
there was an epidemic. The
simplistic conclusion was that doctors brought disease and compulsory
vaccination was another part of the capacity of doctors to generate illness
rather than cure it.
Playfair,
in his House of Commons speech, attempted to deal with the question of personal
freedom and the control of smallpox epidemics.
His conclusion was that it should not be left to the conscience of the
individual:
‘A
man may burn down his house if he injures no-one but himself. If he affects his neighbours we punish him.
Likewise smallpox vaccination.’
In
reading White’s polemic against Playfair it is clear that White is not a
scientist and it seems likely that his fundamental objection was moral or
religious and he uses scientific data merely to substantiate his view. But why was he so bitterly opposed to compulsory vaccination?
White wrote a short and generally unrevealing biography.7 He was born in Glasgow of Quaker stock but rebelled against the tedium of Quaker meetings for worship and the evangelical zeal of the boarding school to which he was sent. His rebellion against organised religion was reversed when he read, quite by chance, a book by the Swedish scientist and mystic Emanuel Swedenborg. Swedenborg is, today, an almost forgotten figure but, in his time, was a person of some substance. Born in 1688 in Stockholm, the son of a Lutheran bishop, he studied at Uppsala, entering the university at the age of eleven. Later he travelled extensively in Europe to broaden his intellect but returned to Sweden in 1722.
In 1724 he was made secretary to the Swedish Board of Mines by Charles XII and later published a massive book on mineralogy Opera Philosophica et Mineralia which won for him praise from savants throughout Europe and allowed him to correspond with the leading scientists and philosophers of his day. Later he set about writing books describing the state of understanding of all branches of natural philosophy. The language he used was Latin. At the age of 55 he underwent a curious conversion that caused him to switch from science to theology. From then on until his death in London he was the author of many wordy books in Latin based, so he claimed, on conversations he had with angels on religious matters. He set out to describe the soul and the heavenly kingdom in the same detail he achieved for the earthly world and to reinterpret Scripture in the light of these conversations.
The
most complete statement of his insights is given in the twelve volumes of the
Arcana Caelestia, the first volume of which appeared in 1749.
The new doctrines have attracted the attention of some distinguished
people including William Blake, Ralph Waldo Emerson, August Strindberg, William
Butler Yates, Elizabeth Barrett Browning and, somewhat incongruously, John
Wesley. The best known modern
commentator is the poet and Blake scholar Kathleen Raine, one of whose poems
gave Gavin Maxwell the title of his trilogy ‘Ring of Bright Water’. To
summarise Swedenborg’s ideas briefly is impossible but, for present purposes,
it is sufficient to say that he blurred the distinction between the material and
the spiritual. He writes:
‘Man
was created as to be at the same time in the spiritual and in the material
world.’8
There
is no resurrection of the body in Swedenborg’s system; the life after death is
a continuation of what we have now. White
embraced Swedenborg’s teachings with enthusiasm and became manager of the
bookshop of the Swedenborg Society in London.
Unfortunately he was dismissed under a cloud and much material relating
to him was destroyed.
According
to the current secretary of the Swedenborg Society, there is nothing in the
teachings of Swedenborg to oppose vaccination and he feels that White’s
commitment to the teachings was not the origin of his opposition. However, the distinguished medical historian, Roy Porter,
takes a somewhat different view. He
writes:
‘Influenced by the teachings of the mystic, Emanuel Swedenborg, some groups went further, discarding medicine altogether and trusting to the healing power of Nature, aided by water, prayer, self-control and spiritual illumination.’9
The
end of that road was, of course, Christian Science, which denies the reality of
sickness. A further influence on
White may have been William Wilkinson, an officer at the Swedenborg Society at
the same time as White, whose brother, James John Garth Wilkinson, was a
well-known homeopathic doctor and bitter opponent of compulsory vaccination.
In
view of this and of Porter’s judgment on the influence of Swedenborg on
alternative medical therapies in Victorian times, it is not unreasonable to
conclude that White’s bitter opposition to compulsory vaccination, expressed
so forcefully in his reaction to Lyon Playfair’s speech was, in some measure,
due to his association with the Swedenborg Society but his intemperate language
is alien to the mild-mannered Swedenborgian movement.
Subsequent events have proved, of course, that Playfair was right and
White was wrong. The
anti-vaccination movement is now a pale reflection of its former self and in the
global eradication of smallpox, completed in 1975, Jennerian vaccination played
an essential part.
Swedenborg
died in London, as he predicted, in 1772 and is now largely forgotten. Playfair, greatly honoured by a grateful nation, died in 1898
and is buried in the Eastern Cemetery in St Andrews. His physical memorial is a water fountain near the Royal and
Ancient clubhouse but his contribution to public health is his true memorial.
This
article is based on a talk given to the Scottish Society of the History of
Medicine.
Memoirs
and correspondence of Lyon Playfair ed. TW Reid Jeminaville: PM Pollak,
1976, 76.
Liebig
J von. Die Chemie in ihrer Anwendung auf Agrikultur und Physiologie,
Leipzig, 1840.
Playfair,
L. Ueber die Nitroprussidverbindungen, ein neue Klasse von Salzen, Annalen
der Chemie 1850: 74, 317-340.
Needham
J. Science and Civilisation in China Vol. 6, Part VI, Cambridge: Cambridge
University Press, 2000, 114-169.
Hansard’s
Parliamentary Debates 1883: 280, 1014-1030.
White
W. Sir Lyon Playfair Taken to Pieces and Disposed of: Likewise Sir Charles W
Dilke, Bart. London: Edward W Allen,1884.
White
W. Other World Order: Suggestions and Conclusions Thereon, London: Edward W
Allen, 1876.
Swedenborg
E. The New Jerusalem and its Heavenly Doctrine, London: Swedenborg Society,
text paragraph 36.
Porter R. Cambridge Illustrated History of Medicine. Cambridge: Cambridge University Press, 1996,115.