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“MAY I NOT with perfect confidence congratulate my county and society at large
on their beholding … an antidote that is capable of extirpating from the
earth a disease which is every hour devouring its victims; a disease that has ever
been considered as the several scourge of the human race”.
With these mild, modest phrases did Edward Jenner, in the year 1800, close his third
publication, A Continuation of Facts and Observations Relative to the Varialoe Vaccinae,
or Cowpox? The statement was typical of this home loving English country doctor
of Berkeley, whole keen sense of observation and persistence in experimentation
had give to Medicine and to the world an entirely new principle with which to combat
disease: vaccination..
Smallpox had been a scourge upon humanity for untold centuries. Described accurately
by the Persian, Rhazes (865-925), smallpox evidently had been known to China and
in India long before; and for centuries Orientals had sought to protect themselves
against the disease by inoculation: by snuffing dried crusts of smallpox pustules
into the nose; inserting pustule material from an infected person into a vein of
a healthy person; or by binding a bit of such material over a scratch in the skin.
By one of these methods, practitioners sought to confer immunity to smallpox upon
healthy persons, particularly children, by producing in them a mild form of smallpox.
If the procedure was successful, the patient was unlikely to be affected during
subsequent inevitable epidemics of smallpox in his community; and hazards of severe
scarring and of crippling from infection were lessened. If unsuccessful –
well, the patient probably would have succumbed to smallpox later on, anyway. The
risk was considered worthwhile, even though the procedure carried the further risk
that inoculated persons might convey active infection to others in the community.
Inoculation, though long practiced in the Far East, in Greece, and in the Ottoman
Empire, did not find acceptance in Europe until 1717, after the idea was advocated
by Lady Mary Wortley Montagu, wife of the British Ambassador to Turkey. Lady Mary’s
efforts were at first violently denounced; but went, through her influence. King
George I permitted his two granddaughters to be inoculated, the practice was accepted.
Concurrently, the Reverend Cotton Mather, in Boston, was pressing the cause for
inoculation in the American colonies, with the cooperation of Dr. Zabdiel Boylson.
On June 26, 1721, Noylston inoculated his six-year-old son and two Negro slaves.
His experiment was successful – but his acts and Mather’s publications
touched off near-riotous reactions.
Such was the status of the medical profession’s and of the public’s
attitudes toward smallpox when Edward Jenner came into the world. As prevalent as
measles, but far more deadly, smallpox during the latter half of the eighteenth
century accounted for 10 per cent of all deaths. Often smallpox disfigured faces
of those whom it did not kill, and caused much of the blindness of that time.
The impact of Jenner’s work was not limited to his victory over smallpox :
extension of his principle, of vaccination as a means of prevention of disease,
in the next 160 years was to enable the medical profession to score almost total
victory over several other infectious diseases.
Edward Jenner was born May 17, 1749, the son of the Reverend Stephen Jenner, vicar
of Berkeley, in Gloucestershire, England. When he was five, his father died, and
he was looked after by his elder clergy – man brother. Early in life he exhibited
an extraordinary interest in nature. At age thirteen he was apprenticed to Daniel
Ludlow, surgeon and apothecary of Sodhury. In 1770 Jenner became a student at St.
George’s Hospital, in London, and a house pupil of the famous London surgeon
and naturalist, John Hunter. From this relationship developed a lifelong friendship,
a strong interest in comparative anatomy, and collaboration in research and observation
of natural phenomena. Young Jenner’s abilities as a naturalist earned him
the job of classifying and soft arranging zoological specimens brought back by Joseph
Banks from Captain Cook’s first voyage to the Pacific, in 1771, and an offer
to accompany Cook’s next expedition. Jenner turned down this and other lucrative
offer, for he preferred to return to his native Berkeley to engage in the practice
of medicine.
Dr. Jenner is described as a rather handsome man of stocky build who liked to dress
well. He was generally beloved for his congenital and kindly personality and for
his readiness to go to the sick through storm or mud. He did not disdain to look
at a farmer’s sick cow, after having cared for his family. Not only was he
a competent physician; he also was interested in music and in poetry – even
to composing bits of verse from time to time. At Berkeley, where he lived in Chantry
Cottage near the church, he continued his studies of natural history, goaded frequently
by letters from John Hunter demanding this investigation or that specimen. From
Hunter he received a famous bit of advice: “Why think? Why not try the experiment?”
Jenner’s work on habits of the cuckoo and on migration of birds brought him
fame and controversy long before he wrote on vaccination; from time to time he also
addressed papers on various medical subjects to local medical societies.
Jenner was quite familiar with inoculation as a means of preventing smallpox; he
carried a vivid memory of the severity of his own experience following inoculation
when he was but a boy.
Early in his career, Jenner was impressed by the insistence of dairy-maids, suffering
from sores and from mild reactions to cowpox, that they now would be safe from smallpox.
Medical men believed this to be but an old country fold saying; but the idea intrigued
Jenner. He then collected examples of persons who had had cowpox and afterward had
escaped smallpox; or who, having had cowpox, did not react successfully to smallpox
inoculation. Of this methodical work, Underwood says: “Even at this early
stage he seems to have been obsessed by the feeling that cowpox ought to give complete
and permanent immunity to smallpox. This is indeed strange, since every practitioner
knew that smallpox did not always give complete and . permanent protection against
itself….Jenner set out to show that cowpox protected against smallpox, and
also that cowpox could be transmitted from one human being to another just as smallpox
could…that cowpox, naturally acquired, could be transmitted artificially
from person to person so that there would result an increasing reservoir of persons
who had been given the opportunity of becoming… immune…to smallpox…
That was the cardinal factor in Jenner’s doctrine, and it was an idea which
had probably not occurred seriously to anyone before; at least, no one had attempted
to put it into practice.”
Jenner’s progress was slow. His observations extended over a quarter of a
century. It was in 1796 that Jenner made his crucial experiment. He found that Sarah
Nelmes, a dairymaid, had a typical cowpox lesion on her hand. On May 14, he inoculated
a young friend, eight-year-old Janes Phipps. Jenner reported: “The matter
was taken from a sore on the hand of a dairymaid, who was infected by her master’s
cows, and it was inserted… into the arm of the boy by means of two superficial
incisions, barely penetrating the cutis, each about half an inch long.
“on the seventh day he complained of uneasiness in the maxilla, and on the
ninth he became a little chilly, lost his appetite, and had a slight headache. During
the whole of this day he was perceptibly indisposed, and spent the night with some
degree of restlessness, but on the day following he was perfectly well.”
But Jenner wanted to be sure. Therefore, he wrote: “In order to ascertain
whether the boy, after feeling so slight an affection of the system from the cowpox
virus, was secure from the contagion of the smallpox, he was inoculated on the Ist
of July following which raviolis matter, immediately taken from a pustule. Several
slight punctures were made on both his arms, and the matter was carefully inserted,
but no disease followed…Several months afterward he was again inoculated
with raviolis matter, but no sensible effect was produced on the constitution.”
By spring, 1798, Jenner had collected further evidence to substantiate his claims,
and privately published his famous booklet: An Inquiry into the Causes and Effects
of the Variolae Vaccinae, a disease discovered in some of the Western countries
of England. Particularly Glouceslershire, and known by the name of the cowpox.
Jenner’s great discovery at first evoked resistance, not acceptance. Tjree
months in London in 1798 failed to arouse interest either among physicians or among
patients. His first break came when Henry Cline, a surgeon, used a quill of dried
cowpox serum, which Jenner had left with him, as a counter-irritant in treating
another disease, and found later that his patient had become immune to smallpox
inoculation. From interest created by Cline’s report of this incident the
practice of vaccination began to spread.
As vaccination became popular, there was no lack of detractors, nor of persons seeking
spurious credit for its discovery. Jenner’s work, however, was based upon
sound experimental data; his results were so positive and so convincing and the
need for this surer, safer, and less torturous prophylaxis was so great, that he
received official recognition earlier in life than did most medical innovators.
In 1800, Jenner was invited officially to London to vaccinated the 85th regiment,
which assignment he took personally. In the United States, Professor Benjamin Waterhouse
performed the first vaccination in July, 1800, with material received from London.
After lengthy investigation of Jenner’s claims, Parliament in 1802 voted him
a sum of £10,000; and again, in 1806, a grant of £20,000.
Despite swirling currents of fame and of defamation, Jenner continued to make his
home in Berkeley and to practice medicine. He published two additional pamphlets
on vaccination: Further Observations on the Variolae Vaccinae or Cowpox, in 1799;
and A Continuation, previously mentioned, in 1800. His correspondence grew in volume
apace with his fame, taking up more and more of his time. In the midst of such circumstances,
the life of the great benefactor of mankind ended, at Chantry Cottage, in his seventy-fourth
year. A cerebral hemorrhage was fatal to Jenner on January 26, 1823.
Jenner’s dedication to his cause and to singleness of purpose is well defined
in his own words.
“While the vaccine discovery was progressive, the joy I felt at the prospect
before me of being the instrument destined to take away from the w one of its great
calamities, blended with the fond hope of enjoying independence and domestic peace
and happiness, was often so excessive that, in pursuing my favorite subject among
the meadows, I have sometimes found myself in a kind of reverie. It is pleasant
for me to recollect that these reflections always ended in devout acknowledgements
to that Being from whom this and all other mercies flow.”
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