On 13 May 1820, Tom Grenville writes to the Marchioness of Buckingham, Anna Eliza Brydges, with some medical advice. The following extract sums up much wisdom on the medical practices of the day:

I am no great friend as you know to the many-coloured phials which grow out of the grim-gribbler of the learned professors of the black doses; but a sensible man who has passed a long life in watching all the infirmities that our frail frames are subject to is certainly very likely to have a good guess at what spring it is that wants oiling in the clockwork; & tho’ they cannot take their magnifying glass & look at the machinery, as Arnold would examine his Timekeeper, & tho’ they must therefore travel in the dark, yet they become long-sighted by the long habit & experience & when that is found united with good sense & judgement, very important help may be afforded them.

Tom Grenville adds a waspish footnote about the consort of King George IV, Caroline of Brunswick:

At White’s somebody was wondering at the passion for Lady C “with a leg as thick as a post” what then said Copley, tho’ it is a post remember it is “Poste Royale”

My tutor, my friend, my drinking companion and my debtor, Robert Holt died today. He had been ill for some while and was taking asses milk in hope of alleviation or a cure. Holt will be remembered in Finmere, where my father had placed him as rector. Regrettably he will go down in history as the Rector who died insolvent, having spent monies due to the parish chest. He deserves instead to be celebrated for his pioneering work on smallpox among local communities.

In the summer of 1799, John Abernethy, founder of St Bartholomew’s Medical School, introduced Holt to vaccination:

In conversing with Mr Holt ... on the subject of the cow-pox [vaccine], the favourable report which I made of its effects from my own small experience and observations, induced him, as he takes a kind of parental interest in the sufferings and welfare of his parishioners, to inoculate some of them.

At first, Holt was concerned villagers would be too frightened to take part in his experiment:

The novelty of the vaccination experiment made me apprehensive that my parishioners would not readily submit to an operation which they might consider dangerous in its consequences.

His reservations were misplaced:

My fears were soon removed as I found all impressed by the belief that the cowpox caught in the natural way was a certain preventive of the smallpox.

He began his experiment with Elizabeth Smith who was then twenty-five years old:

I inoculated [her] in both arms to ensure the probability of infection. On the sixth day she complained of headache and pain. She had no pustules, except where I made the incisions … She had no indisposition … and on the thirteenth day the pustules became dry and peeled off.

Within two months, Holt had inoculated 300 people. His supply of vaccine was limited and he increased it by taking matter from the arms of people already vaccinated. The villagers recognised the benefits of vaccination but it was not a pleasant experience:

My cases were all like each other, viz. pain in the axillae the seventh or eighth day, slight head-ach, sometimes attended with feverish shiverings, which inevitably yielded to a dose of salts the day after.

There were exceptions. A painful inflammation of the arm kept baker Thomas Sheen from work for three days. Holt judged that the heat in Sheen’s bakery had aggravated the swelling. Seven-year-old Thomas Williams had a small smallpox-like pustule, and William Neal (10 years) and Hannah Beal (6) each had more than one hundred small pustules. But they were no more ill than others vaccinated.

Holt was concerned that William and Hannah might have smallpox. To test this, he drew matter from their pustules and inoculated eight children from them. Fortunately, [the eight] “all had the complaint in its mildest form.” Parish records reveal that William Neal lived a long life, dying in 1870, aged 81 years.

Holt supplied fellow clergyman William Finch in St Helens with vaccine. Beginning on 17 November 1799 with David Scarborough, son of a clogger, Finch vaccinated more than 3,000 people during the following two years.

All this was just a year after Edward Jenner published his Inquiry into the Cause and Effects of the Variolæ Vaccinæ. Robert Holt, and William Finch, deserve to be remembered as the Clergymen Vaccinators.

Holt was buried at Finmere and I dedicated a memorial in the nave by the chancel arch to him. It reads:

What kindliness there was in him, according to the poor
What friendship there was in him according to friends
May you readily recognise, therefore, that this was placed in grief
and with affection by his companion
  Richard Temple

Richard Temple