A 10-year-old girl died when her doctor refused to treat her due to his antiscientific beliefs. Not only did he get away with it, he was honoured by politicians and celebrities and had a foundation named after him.
There’s a brief biography of Dr Walter Hadwen on the website of Animal Free Research UK (AFRUK), which was formerly The Dr Hadwen Trust.
It details how he moved to London aged 18, became a vegetarian and worked in a pharmacy while studying at college, then on to Reading and Somerset, then finally to Gloucester where he worked as a General Practitioner for 36 years. During this time he became a speaker for, then the President of, the British Union for the Abolition of Vivisection (now Cruelty Free International).
AFRUK describes Dr Hadwen in glowing terms: “As a physician Dr Hadwen was naturally very skilled, and few people could have been more conscientious and caring. He was not only a good physician but was always aware of the human needs of his patients and their families.”
But there is one fairly significant detail missing from that biography: he once stood trial for the manslaughter of a little girl in his care due to medical malpractice.
In 1924, diphtheria was a common but manageable disease. The diphtheria bacterium was first identified in the 1880s and, in the 1890s, the diphtheria antitoxin was developed in Germany to treat the disease. It quickly became a mainstream medicine that won the 1901 Nobel Prize, and it remains on the World Health Organisation’s list of essential medicines.
The antitoxin is prepared using horse blood. The animals are injected with the diphtheria toxin, which is largely harmless to them at the dosage given, and they naturally produce antibodies that neutralise the toxins produced by Corynebacterium diphtheriae. The blood plasma of the infected horse was thus used in the 1920s to create an antitoxin that reduced the death rate from diphtheria in human patients from over 30% to no more than 5% if administered within the first two days of illness.
Children are twice as likely as adults to die from diphtheria and, unfortunately for 10-year-old Nellie Burnham, she not only fell ill with diphtheria on 30 July 1924 but also came under the care of Dr Hadwen. Dr Hadwen did not simply oppose animal research and animal-derived medicines on principle but also believed them to be ineffective for humans due to species differences, having done his own research into the topic.
Hadwen chose not to test for diphtheria or to use the diphtheria antitoxin when he attended Nellie on four separate occasions, directing instead that she should gargle with warm water and vinegar. On 9 August, Hadwen declared that there was “scarcely anything the matter” with the child, despite the fact she could no longer gargle. By that evening, Nellie’s increasingly concerned parents sought a second opinion from one Dr Ellis, who found her very severely ill with no hope of recovery. She died an hour past midnight, most likely from suffocation and/or heart failure.
Nellie’s parents consented to a post-mortem and an inquest, in which 9 of 12 jurors concurred that the cause of death was “diphtheria and pneumonia caused or contributed to by the failure of Dr Hadwen to use competent skill and sufficient attention”. Dr Ellis, who had attended to Nellie too late, said that he would have ordered a swab for lab testing, and taken Nellie’s temperature and pulse, none of which had occurred to the “skilled… conscientious and caring” Dr Hadwen.
Having been found responsible for Nellie’s death by the inquest, Dr Hadwen was committed by the coroner to stand trial for manslaughter.
It is important to remember that Dr Hadwen was a significant public figure. He sat as a magistrate in the court that he now stood before as the accused. He was persuasive, decisive and well-connected - a lay preacher for the Plymouth Brethren, a Christian “Creationist sect”, who had honed his oratory skills delivering ‘fire and brimstone’ sermons. He was also an anti-vaxxer, before the term had been coined, who thought Pasteur was a fraud. He declared that the discovery of insulin using dogs would lead to the deaths of more Type 1 diabetics. He said a lot of silly things like that, but he said them with conviction. He had a feel for narratives that people find appealing.
The same elements appear over and again in his firebrand speeches: the suggestion of conspiracy among scientists, science journalists and the political establishment, dark references to the influence of money, and flattery of the audience. In a speech in Newcastle, Hadwen asserted “I maintain that the ordinary man in the street knows quite as much of this subject as the ordinary medical man”. You will never go broke telling people that they are right and clever.
At the same time, Hadwen declared most medical men to be dim and supine, unquestioningly accepting that animal experiments had led to great insights. He “othered” people who were later recognised as pioneers of medicine, as if they were monsters. He particularly disliked anyone who had a licence from the Home Office to use an animal which, throughout the 1920s, included Alexander Fleming who discovered penicillin and tested its safety on mice and rabbits.
So Hadwen’s trial didn’t happen in a bubble. He’d been up in front of the court bench several times before – nine times in Somerset alone for refusing to vaccinate his children against smallpox. Following a spate of anti-vaxxers being jailed in the Weston-Super-Mare region, Hadwen had been invited to speak at rallies during what would be the heyday of the Anti-Vaccination League. It was said that “there was no hall in Gloucester large enough to accommodate those opposing Jennerism” (Edward Jenner having developed the world’s first vaccine).
Hadwen had engaged in many public spats with many prominent doctors and scientists, some of whom had gloomily lamented his membership of “some sort of anti-scientific cult”. This allowed Hadwen’s lawyers to argue that the medical testimony against him was personally motivated and biased.
To anyone familiar with the patterns and tactics of contemporary anti-science discourse, Hadwen’s rhetoric in defence of his position will seem familiar. If you dismiss inconvenient facts as “fake news” ahead of time, anybody who is motivated to disregard those facts has a reason to do so. If you tell your followers that you are in a fight against the “deep state”, how does it look when you are arrested? For the true believers, any attack on Hadwen simply confirmed his hypothesis.
Hadwen’s trial ultimately came down to this:
Whether a jury believed that Nellie had died:
-
of diphtheria, which had been found in the post mortem
or, as Dr Hadwen contested,
-
as a result of Nellie going to get a glass of water while not wearing any shoes.
The jury sided with Dr Hadwen.
Hadwen showed no remorse at all following the death of Nellie. Even at the coroner’s inquest he declared germ theory, and the existence of the diphtheria bacterium, to be “all bosh” and he was similarly bullish at his manslaughter trial, dismissing the diphtheria antitoxin as “poisoned horse blood” that was “unscientific” and unnatural.
It was hoped by some that the trial would provide an opportunity to educate the public. The Journal of the American Medical Association declared that Hadwen was a “deluded fanatic”, writing: "It is unfortunate that it should have required the needless death of an innocent child before the government could take any activity to curb his influence on his equally ignorant followers. It is hoped that the trial for manslaughter will give opportunity for further education of the public, so that means will be no longer forthcoming for supporting Hadwen in his endeavours.”
Their hope was little more than wishful thinking.
Hadwen’s supporters noisily celebrated his acquittal. As one eyewitness recalled: “I can, all these years afterwards, remember the electric atmosphere in Gloucester. Feelings ran high because of Hadwen’s popularity. The case became one of the great trials of the century. Afterwards, I remember his congregation outside Albion Hall in Gloucester, where he was well known as their preacher, raising him shoulder high and singing the hymn ‘Standing by a purpose true, heeding God’s Command! Everyone in the crowd was moved to tears. Later Dr. Hadwen attended a thanksgiving meeting in the Shire Hall, which was packed with over 2,000 and many left outside. His fame had spread across the country and a meeting as a tribute to him was held in the Queen's Hall in London, at which letters of congratulations were read from (authors) G. K. Chesterton, (George) Bernard Shaw, John Galsworthy, Margaret Bondfield (trade unionist, suffragette and the first female Cabinet minister) and others.”
The world may have changed in the 100 years following Dr Hadwen’s trial, but people are much the same. We too often forget the names of the victim. Nellie Burnham’s name has been forgotten while Walter Hadwen’s has lived on, whitewashed, in medical practices, a trust fund and more. Today’s celebrities have venerated him just as much as yesterday’s, despite what he did.
We still respond to the same irrational narrative tropes and so will always be vulnerable to the charlatans, the science deniers, the daft celebrities and the misguided social reformers or opportunist politicians who tell us what we want to hear, and they profit by telling us.
In his summing up, the judge in Hadwen’s trial, Montague Lush, said “I don't pass judgment on Dr Hadwen, but I say that a doctor may get his mind into such a state of prejudice and his judgment so blinded that he would rather sacrifice his patients than his prejudice. If such a doctor was so prejudiced that he is unwilling to avail himself of the discoveries of the profession, I can understand a jury saying that he is guilty of wilful neglect.”
The terrible, avoidable death of Nellie Burnham should be all the evidence anyone needs that this was the case. Perhaps we could use 10 August each year to remember her name and stop venerating the man who sacrificed her to his baseless beliefs.
Image: Pseudomembrane, characteristic of diphtheria , User:Dileepunnikri, CC BY-SA 3.0
Last edited: 14 August 2024 11:42
