CONTROVERSIALISTS

Charles Creighton (1847-1927):

eminent medical historian but vehement anti-Jennerian

G C Cook
London, UK

Keywords: Charles Creighton; vaccination; variolation; Edward Jenner; medical historian; epidemics; anti-vaccination campaign

Little doubt exists that Charles Creighton was one

of the foremost (if not the leading) medical
historians of his era 1-5; he was also one of
Britain's outstanding medical scholarsv'. Today,
however, he is equally, if not more widely,
remembered for his anti-Jennerian stance-", and
is closely associated with a movement in opposi-
tion to vaccination which had a great deal of
public support in the latter years of the nine-
teenth, and early part of the twentieth, century.
These"anti-establishment" views led to his virtual
ostracization by the medical profession for the last
40 years of his life2.4.5.
Charles Creighton (Figure 1) was born on 21 or
22 November 1847, the son of Alexander
Creighton, a sawmiller and timber merchant of
Peterhead, and Agnes (nee Brandjt>, He was
educated at the Gymnasium in Old Aberdeen
and, having passed its "bursary competition",
entered the University of Aberdeen, from which
he graduated MA in 1867; after studying medicine
at Aberdeen (which he left temporarily following
friction with some of the professors'') and
Edinburgh, he obtained the MB and MD degrees of
the University of Aberdeen in 1871 and 1878,
respectively. After qualification in medicine he
studied at Berlin (in Virchow's Institute) and
Vienna (with Skoda and Rokitanskirl-'.
After returning to England, he became a medical
registrar at Charing Cross Hospital, and surgical Figure 1. Charles Crt'ighton 0847-1927): photograph taken when he
registrar at St Thomas' Hospital'>, London. After wasaged aborlt 60 yt'Qrs l ,J.4" .
four years' engagement on "anatomical problems"
and cancer research with Sir John Burdon- some other library. Attempts to set up in practice in
Sanderson FRS (1828-1905) at the recently opened Savile Rowand New Cavendish Street both failed;
Brown Institution in Wandsworth Road, he was he was not apparently suited to clinical work. For
appointed (in 1877) demonstrator in anatomy over 30 years he lived in "bachelor chambers" in
under Sir George Murray Humphry FRS (1820- Great Ormond StreetJ.4 and in 1918 moved to a
1896), at the University of Cambridge'-': he subse- small "tumble-down cottage" ("The Yews") at
quently (in 1880) obtained an MA (Cantab). Upper Boddington, Northamptonshire, where he
In 1881 he returned to London, spending the next lived for eight years; he died there on 18 July 1927,
37 years (until 1917) in either the British Museum in his eightieth year.
(where he amassed a wealth of material for his After the vaccination controversy (which
book on the history of epidemics - see below) or reached a peak in 1904 - see below), Creighton is
said to have come "to the front for a short
Correspondence to: G C Cook MD DSc FRcr FRAcr A.5, The time ... with some views on plague", which he
Wellcome Institute for the History of Medicine, 183 Euston Road, studied in India I; however, he considered, some-
London NW1 2BE, UK what unorthodoxly, that that disease was caused

Journal of Mt'dical Biography 2000; 8: 83-88

84 Journal of Medical Biography Volume 8 May 2000

by "an abstract [substance] inherent in the soil", Creighton's "monetary reward for his labours was
and not by "Bacillus [Yersinia] pestis"! In later years [apparently] negligible:".
he was described by one biographer as "a poor,
lonely bachelor, leading a most frugal and physio-
logical life'". In his declining years he received a Creighton's controversial views on
civil pension (amounting to £14()3) from Lord
Oxford and Asquith FRS (the former Prime vaccination
Minister, H H Asquith, 1852-1928) - who appar-
ently recognized that he possessed "all the Creighton published two books related to (cowpox)
elements of a great scholar"]. vaccination: The Natural History of Cow-Pox and
Creighton spoke and read "nearly all the Vaccinal Syphilis (1887)9 (Figure 3), and Jenner and
European languages'P: he also had "an extraor- Vaccination: A Strange Chapter of Medical History
dinary knowledge not only of medicine but of the (1889)10 (Figure 4). Dr Benjamin Moseley (1742-1819)
classics and the Bible"]. had, long before Creighton, contested Jenner's
"discovery" - in 1808; among other opposing
views, he wrote: "The mere operative practice
Creighton, the eminent historian of of vaccination has been chiefly carried on by
epidemiology lady-doctors, wrong-headed clergymen, needy
and dependent medicasters, and disorderly men-
Creighton's greatest medical work was undoubt- midwives'U'', It was a theologian and Arabic scholar,
edly his two-volume text A History of Epidemics in Robertson Smith (editor of the ninth edition of the
Britain, which was published in 1891 and 1894 Encyclopaedia Britannica), who apparently persuaded
(Figure 2)2,7. The first volume addressed the period Creighton to write articles in that publication on:
from AD 664 until the extinction of plague (1666), malaria, medicine, Morgagni, pathology, pellagra,
and the second spanned from that date up to the and, most importantly as it transpired, vaccination;
late nineteenth century (1893). A second edition of the last contribution (published in volume 24 in
this important work was published (posthu- 1888), in the opinion of one of his biographers,
mously) in 19658 . Although the first edition
rapidly became the recognized text on the subject,

A HISTORY
THE
0"

EPIDEMICS IN BRITAIN

from A.D. 884 to the ExtInotlon fA PlICue

CHARLES CREIGHTON, M.D.

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CHARLES CREIGHTON, M.A., M.D.• i.
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Figure 2. Title page of the first volume of Creighton's two-volume Figure 3. Title page of The Natural History of Cow-Pox and
magnum opus, published in 1891 and 1894. Vaccinal Syphilis, published in 1887 9 •

. -
'JE~NER AND VACCINATION:
BY.
'CHARLES CRE'IGHTON, M.D.
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Figure 4. Till!' pag!' of Jenner and Vaccination: A Strange Chapter
of Medical History, published in 188910,
"literally sealed [his] fate"! and, furthermore, con-
stituted the "real tragedy of Creighton's life".
Jenner (an FRS from a wealthy and prestigious
family, who had shown considerable indolence in
carrying out his work on the cuckoo and hedgehog
hibernation) was, Creighton claimed, certainly not
the first practitioner to suggest that cowpox
prevented subsequent smallpox (this attribution
should, if a single person is to be named, go to
Benjamin Jesty). In fact, Jenner, in his first draft of
An Inquiry into the Causes and Effects of the Variolae
Vaccinae, a Disease Discovered in some of the Western
Counties of England, Particularly Gloucestershire, and
known by the Name of The Cow Pox, had carried out
only one experiment and his paper was rightly
rejected by Sir Joseph Banks PRS (1743-1820) and Sir
Everard Home FRS (175Cr1832) for the Philosophical
Transactions of the Royal Society. In a letter
addressed to Dr Jan Ingen-housz FRS11, a very
experienced inoculator residing in England when
Jenner's Inquiry was published in 1798, Jenner had
written: "Truth, believe me, sir, in this and every
other physiological investigation which has
Cook. Charles Creighton 85
occupied my attention, has ever been the object
which I have endeavoured to hold in view"lO; this,
. to Creighton, was sheer cant! Creighton firmly
believed that Jenner's claims that "natural cow-pox
is Variolae Vaccinae [literally smallpox of the cow]
and also that it is protective [against smallpoxl'<'
were both scientifically unsubstantiated. In his
writings he discussed at length the nature of
Jenner's logical "error" in naming the disease
Variolae Vaccinae; was it "a catachresis, hypocor-
isma, metalepsis or synedoche'P? Historically,
"smallpox" (or lesser pox) had been used nosolo-
gically to differentiate this affliction from the
"greatpox" (syphilis - probably in its secondary
stage), which had been introduced to Britain about
1494 12; Creighton maintained, rightly, that cowpox
has nothing in common with either of these entities.
He wrote that Jenner believed that "vaccine
inoculation prevents [my italics] smallpox, ... is
itself not contagious ... is unattended by a general
eruption like that of smallpox, and that it is free
from risk"!",
Jenner was, he also claimed, exceedingly elusive
in his definitions of "genuine" and "spurious"
cowpox! There was absolutely no scientific justifi-
cation (Creighton claimed) for Jenner's belief
(opposed by Woodville - see below - and later
abandoned by Jenner) that "genuine" cowpox
was related to equine grease (which affected
horses' hooves); an experiment conducted (on 16
March 1798) by Jenner in which serum from a man
infected with horse grease was injected into a five-
year-old boy (who subsequently died) was in
Creighton's view totally unjust and unethicall''!
Furthermore, Jenner's conclusion in the Inquiry
("What renders the Cow Pox so extremely singular
is, that the person who has been thus affected is for
ever after secure of the infection of the Small Pox")
that vaccination gave lifelong protection against
smallpox was also manifestly untrue. Many "took
the smallpox" (Creighton claimed) after cowpox-
ing lll! In the 1817-18 epidemic, for example,
numerous deaths from smallpox had occurred in
vaccinated individuals. Challenge with smallpox
matter (after vaccination) and the "variolous test"
had been, in Creighton's opinion, grossly under-
used.
Creighton also alleged (erroneously in this case)
that vaccinal syphilis was in effect "a reversion of
vaccinal type with disastrous consequences in the
ordinary course of vaccination practice"!". William
Woodville (1752-1805)13 was, Creighton wrote'P;
one of the few men in the profession who knew almost as much
of the secret history of Jenner's discovery as we know now [but
he] was a man of quiet disposition, far more inclined to efface
himself than to enter into a controversy with such a man as
Jenner.
M'Vail has summarized Creighton's conclusions
under five headingss: the folklore surrounding
cowpox vaccination; widespread views against
the anti variolous power of cowpox; objections to
86 Journal of Medical Biography Volume 8 May 2000

the Latin name Variolae Vaccinae; relative disre-
gard of the variolous test; and the relationship
between cowpox and syphilis", In summarizing
Creighton's anti-Iennerian approach, Bulloch con-
sidered': "By the anti-vaccinators he was hailed as
the greatest recruit to their ranks and by the
medical profession as a renegade, to be treated
with disdain and obloquy".
Creighton also felt that the £30,000 granted by
Parliament to Jenner (£10,000 in 1802 followed by a
further £20,000 in 1807) was a totally unacceptable
reward for this (scientific) "discovery".
Public opinion against vaccination
It should be recognized that at this time a
significant undercurrent of public opinion whole-
heartedly opposed vaccination (Figures 5 and 6).
Parliament had ruled (in 1840) that "inoculation for
the smallpox" was illegal, and in an Act of 1853
compulsory vaccination became (temporarily) law;
·THE ,NEW SCHOOL-BOARD:
OR VACCINATION ALPHABET.
•
A ia the Aaes that let it be dODe ;
. B ia the BealiDg that eomes from the bealIt ;
'0 ia CompulaiOD, or denl'l-GWD IUD;
o ia the Doetor, or medicine prietlt;
E ia the E?il ODe eggiDg him on ;
F ia the F8I that ia De'fer forgot;
G ia the Go'fernment craftily won;
H ia the Hone that ia dying 01 rllt ;
by 1880 there had, however, been so much
opposition to this latter move!' that the penal
clauses were relaxed.
Therefore, although Creighton's books contained
a great deal of accurate and fully justified criticism
of Jenner's work, he was forever afterwards
considered to be an active member of the de-
/enner-ation I5 camp! The method used by the
establishment (by no means for the first or last
time) in dealing with Creighton was! "to drop
[him] into oblivion, and if he was ever referred to at
all [following his two major publications on this
subject] it was only as 'Creighton the Anti-
vaccinator' ".
Other writings
Creighton was, by any standard, a prolific author':
Underwood has summarized his major medical
contributions! (Table I), Bulloch his epidemiologi-
cal works'', and Ovenall has composed a
bibliography of relevant works published during
or after Creighton's time (i.e. since 1894)16. Many of
Creighton's papers were devoted to anatomical
and pathological topics. Contemporary admirers of
Creighton's literary contributions considered that
his translation of Hirsch's Handbuch der historisch-
geographischen Pathologie (Handbook of Historical and
Geographical Pathology) for the New Sydenham
:!
:
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I ia the Ignol'&llC8 O'fer the land ; 0

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K ia old Knanl)', cliflni!ed, bland; .l:!
0
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'l ia the lAw and its eolllCieDeeleea tooll ; f

;M ia the Kuder 01maDI a child
,:N is the Nobody ha'fiDg a care ; .
Q
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·0 ia the Oddity how thei" beguiled l!

,Pwith Pwc lymph, that absurdity rllre; i
it
:.:',Q is the Qu8I'J: how long will it hold 7 ...
~
: ,Ii is the RaiD and wreek that il made
's bI the Sorcery,-pn.ctiaed 01 old ; i=
:T is the Tomb where the eorpeea are lu:J. ~
U ia the Use 01the doetol'l at all ?
· V is the VapboDdl ougbt to be atril,t, !
W hipped witha seourge made01lanC8t.a, and I)'mph
X ceeainly rotteD all O'fer them dript; .l!
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Y et DO I-it is best the profeuioD Le led .

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u a nine, till the word 01ill judgment ill Z.

& the demODll in troops from it.a C8J'l:llI8 are fled.
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~ THE VACCINE UPAS TREE. "
, .JOBR TBOKSON, 1110.. Blunt GLASGOW, ..... un8.
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Figure 5. A vaccination "alphabet" (priced at onepenny), dated 1873,

which was circulated by opponents of compulsory vaccination - a Figure 6. Cartoon dated 1885 indicating some 40 diseases which had,
move which had been passed by Parliament in 1853. at that time, beeJl attributed to vaccination.

Table 1. Underwood's summary' of Creighton's majormedical and literary contributions
Category
(a) Early pathological work
(b) Infectious disease and historical epidemiology
(c) Unconscious Memory in Disease, 1886
(d) The vaccination question
(e) The Encyclopaedia Britannica (ninth edition)
(f) Historical epidemiology
(g) History of public health
(h) Late pathological work
(i) Plague
Gl Tuberculosis
(k) Cancer
Society secured "him ... immortality", Later in life
he became an authority on Shakespeare; he wrote
Shakespeare's Story of His Life (1905) and
Shakespearian Allegories (1912), which was based
on Othello and Lear',
Creighton apparently held the idea that diseases
(tuberculosis and cancer included) were "due to
some dyscrasia in the workings of the body"l; he
might be more "at home" today - with greater
understanding and recognition of the relevance of
host (immunological) factors in the pathogenesis of
most disease entities. As one contemporary obser-
ver proclaimed: "He simply could not acclimatise
himself to modem theories of disease ... he lived in
a world of miasmas and effluvia rather than
particulate contagion in the form of bacteria'". He
also believed in "'epidemic constitutions' and
nebulous 'dyscrasiae' "3; Creighton might still be
proved correct!
Creighton - the man
Despite his insurmountable problems with the
establishment (see above), one of his biographers
considered that he was "contented and cheerful
and an admirable companion". He was a "tall,
handsome, well-preserved man". The same biog-
rapher wrote: "By his death Aberdeen University
has lost one of her most distinguished medical
graduates and Britain the most leamed medical
scholar and historian of his time"3. Elsewhere he
wrote: "I was his only intimate friend for years
before he died, for he was a most lonely forsaken
Cook. Charles Creighton 87
Works
(i) Early papers: Privy Council, &c
(ii) Contributions to the Physiology and Pathology of the Breast, 1878
(iii) Other writings on the breast, cancer and bovine tuberculosis
(i) On the Autonomous Life of the Specific Infections, 1883
(ii) Translation of Hirsch's Handbuch der historisch-geographischen Pathologic,
3 vols, 188~
(i) Cow-Pox and Vaccinal Syphilis, 1887
(ii) Encyclopedia Britannica. Article on vaccination, 1888
(iii) Jenner and Vaccination, 1889
Articles on malaria, medicine, Morgagni, pathology, pellagra (vaccination, see
(d»
History of Epidemics, 1891-4
In Traill's Social England, 1894
(i) Formative Property of Glycogen, 1896-9
(ii) Cancer and Other Tumours of the Breast, 1902
Plague in India, 1906
Contributions to the Physiological Theory of Tuberculosis, 1908
Some Conclusions on Cancer, 1920
man. To the end he was a scholar and philoso-
pher'". In summary, he concluded that Creighton
was "the most learned man [he had] ever met"3.
However, he "seemed possessed of some cacodae-
mon, which was entirely inimical to worldly
success, for which [he] cared not a jot". "He was
like a lonely rock in the great flowing tide of
human progress"}, He was very fond of classical
music (being for many years an habitual attender at
St Paul's Cathedral") and was a great walker". He
was also described as being"an admirable debater
[but] could never have worked in a team with
others":',
Epilogue
Major Greenwood's obituary notice in the British
Medical Journal succinctly summed up the medical
profession's attitude to Creighton-, His death:
should excite emotions of ... pride in his scholarly achievements,
shame that his colleagues never paid him the tribute of respect
willingly conceded to far smaller men [and], sorrow that what
[Samuel] Johnson [1709-1784] would have called the anfractu-
osities of his character, if they did not excuse, partly explained
the cold hostility with which he was almost universally
treated.... It was rather hard to explain to Continental scholars
[he concluded] that the practical British mind could not take an
antivaccinator seriously.
References and notes
1 Bulloch W. The late Dr Charles Creighton. Lancet 1927;ii:
250-1
88 Journal of Medical Biography Volume 8 May 2000
2 Greenwood M. Charles Creighton, MD. BMJ 1927;ii:24G-1
3 Bulloch W. Charles Creighton, M.A., MD.. Aberdeen Univ Rev
1928;15:112-18
4 Underwood EA. Charles Creighton M.A., MD. (1847-1927):
scholar, historian and epidemiologist. Proc R Soc Med
1948;41:869-76
5 Underwood EA. Charles Creighton, the man and his work.
In: A Historyof Epidemics in Britain (2nd edn). London: Frank
Cass & Co. Ltd, 1965: vol. 1, pp. 41-135
6 M'Vail [C, Dr Creighton on vaccination: a review. Edinburgh
Med J 1889-90;35:142-9, 249-56, 347-55, 656-67, 95~
7 Creighton e. A History of Epidemics in Britain. Cambridge:
Cambridge University Press, 1891, 1894: 706, 883
8 Creighton C (with additional material by Eversley DEC,
Underwood EA, Ovenall L). A History of Epidemics in
Britain (2nd edn). London: Frank Cass and Co. Ltd, 1965:
706, 883
9 Creighton e. The Natural History of Cow-Pox and Vaccinal
Syphilis. London: Cassell & Co. Ltd, 1887:160
10 Creighton e. Jenner and Vaccination: A Strange Chapter of
Medical History. London: Swan Sonnenschein & Co.,
1889:360
11 Dr Jan Ingen-housz FRS (173G-1799) was born at Breda, The
Netherlands, and studied medicine at Leuven University
(1746-52) - see Furukawa A. Medical History Through
Postage Stamps. Tokyo: Ishiyaku EuroAmerican Inc., 1994:
150. He also studied medicine and botany at Leiden, Paris,
and Edinburgh. Having learned the technique of variolation
under Thomas Dimsdale (1712-1800), he performed it
successfully on three surviving children of the Empress
Maria Theresia in Vienna in 1760; after this he was
appointed court physician, and during 1768-72 travelled
to Italy, Switzerland, The Netherlands, France, Hungary,
and Bohemia, teaching variolation. Further details are given
by Jenkins JS. The English inoculator: Jan Ingen-Housz. J R
Soc Med 1999;92:534-7
12 Arrizabalaga J, Henderson J, French R. The Great Pox: The
French Disease in Renaissance Europe. London: Yale
University Press, 1997:352
13 Cook Ge. Dr William Woodville (1752-1805) and the St
Pancras Smallpox Hospital. J Med Biog 1996;4:71-8
14 Swales JD. The Leicester anti-vaccination movement. Lancet
1992;340:1019-21
15 Cook Ge. From the Greenwich Hulks to Old St Pancras: A
History of Tropical Disease in London. London: Athlone Press,
1992:6-8
16 Ovenall 1. A select bibliography of epidemiological
literature since 1894. In: Creighton e. A History of
Epidemics in Britain (2nd edn). London: Frank Cass & Co.
Ltd, 1965: vol. 1, pp. 137~6