Edward Jenner
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Symptoms of the Disease
Smallpox is caused by the virus variola and according to historians can be traced as far back as 1157BC – indeed it is believed that the death of Pharaoh Rameses V was caused by the disease, and certainly it was described in Roman times. Other notable members of society contracted the illness include Queen Anne’s heir, Prince William who died at the age of 11, Elizabeth 1, Mozart, George Washington and Abraham Lincoln as well as the 60,000,000 lives who perished from the scourge in 18th Century Europe. |
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Smallpox enters the body through the lungs and is carried in the blood to the internal organs which
become infected. A perfectly fit person would suddenly become very sick; develop a high fever together
with backache, vomiting and delirium. Three or four days later a rash would appear, beginning as
small pink spots which grow bigger and are slightly raised. In a few days these spots become
hard blisters filled with pus. Most of these lesions appeared on the face, eyes, forearms, legs and feet.
If the patient survived (bearing in mind that 20 to 40 percent did not) scabs would form where the blisters
had once been, dry up and eventually drop off. The patient would then be left badly disfigured or blinded.
During the seventeenth and eighteenth centuries one-third of the population in London bore the scars of
smallpox and two-thirds of blind people lost their sight because of the illness.
In the eighteenth century, smallpox was a killer disease, as widespread as cancer or heart disease is today, but the majority of its victims were infants and young children. Thanks to Jenner and his introduction of vaccination - which took him twenty years to perfect – the World Health Organization (WHO) officially declared "the world and its peoples" free from endemic smallpox. It is the only illness to have been wiped out as a human disease; the last natural victim was in 1977 in Somalia. |
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Attempted Cures Over the years physicians had sought a cure. Healers in Ancient China and India believed that one attack of smallpox would create lifelong immunity, but this was not necessarily the case. The Chinese were the first to introduce protective measures. They ground a smallpox scab into dust and blew the powder into one of the nostrils (left for a man, right for a woman) through a silver tube. In some cases the person would develop a mild case of smallpox and an English trader, Joseph Lister, encouraged a Fellow of the Royal Society to promote the technique in England, but the suggestion was not accepted. The Arabs developed a different method; they made small cuts in a healthy person’s arm and rubbed pus from the smallpox blister into the incision. The Turkish physician, Dr. Emmanuel Timoni, wrote a book in English describing the procedure, but initially the book was not well received in England. Variolation Variolation or variolization was introduced in England in 1717 when Lady Mary Wortley Montagu, the wife of an English Ambassador in Constantinople, had seen it practised among the Turks. Lady Montagu was considered to be quite a beauty, but after she contracted smallpox, although she survived, was severely disfigured for the rest of her life. That same year, she gave birth to a daughter and her English physician, Dr. Maitland, invited Dr.Timoni (see above) to assist in the delivery. Dr. Timoni, recognising her smallpox scars, persuaded her to allow him to immunise her firstborn child, a son, and then when the two English families returned to England, Dr. Maitland immunised the little girl. Although Variolation did in some way provide a defence against smallpox; it was also risky and sometimes caused a serious infection. However by 1735, eight hundred and fifty people in Britain had received Variolation. The reason why so few people had undergone this treatment was due to the preparatory period which some surgeons had introduced. For six weeks before variolation the patients were bled, placed on a low-calorie diet and purged continuously. Needless to say, at the end of the six weeks, the patients were thin and weak and it was thirty years before this procedure was abandoned. Present-day estimates suggest that about twelve percent of those treated died, but this was still preferable to the 20-40 percent who died untreated during an epidemic. |
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Edward Jenner Edward Jenner was born in Berkeley, Gloucestershire, near Bristol on May 17th 1749. His father, Stephen, was a clergyman of the Church of England and his mother, Sarah, was the daughter of a clergyman. They had nine children, two of whom did not survive. Edward was their eighth child, but his mother died giving birth to the ninth baby when she was forty-six and his father died two months later at the age of fifty-two. At the age of five, Edward an orphan was raised by his three sisters Mary, Sarah and Ann and his brother Stephen. When Edward was eight he was sent to a free boarding school and the events which occurred changed his life and decided his future. The school had a smallpox epidemic and all the children, including Edward, who had not received variolation, had to endure the procedure. The experience affected Edward very badly and he developed severe anxiety, insomnia and auditory hallucinations. The family, realising that their brother was in distress, moved him to a small private school, where he made many friends, including Caleb Parry who later helped him in some of his medical experiments. Jenner’s weakness in certain academic areas prevented him from following the family tradition by going to Oxford and becoming a clergyman. It was decided that he should have a career in medicine and, as he was not qualified to be accepted at the best medical schools, he was apprenticed at thirteen to a country surgeon, John Ludlow, where he trained for six years. During his time with John Ludlow, Jenner was fascinated by the stories the locals told. One day a young girl came to the surgery and during a discussion about smallpox, the girl made a comment which impressed Jenner, she said "I cannot take that disease for I have had cowpox." It was a fact that the milkmaids who caught cowpox on their hands never caught smallpox later. Cowpox is a harmless disease of the teats and udders which only affects cows in Britain and Western Europe. At 21, Edward left Bristol and John Ludlow and went as a student to St. George’s Hospital in London, where he came under the tutelage of the celebrated surgeon John Hunter. They became great friends and from Hunter Edward learned not to speculate but to prove or disprove a hypothesis by performing experiments. After two years in London, Jenner wanted to return to the country and be near to his brother Stephen. He became a country doctor in Berkeley. Despite the efforts of Hunter to encourage him to return to London as his assistant, and the various offers of posts offering huge salaries, he declined and refused to leave Berkeley Jenner’s scientific interests were many and varied, but he is remembered for his work as the pioneer of smallpox vaccination and father of immunology, but he was also a keen researcher in other areas of medicine and surgery, including heart disease. |
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Discovery of the Smallpox Vaccination Despite his many hobbies, Jenner still remained fascinated by the possibility that there was a link between cowpox, horse pox and human smallpox. He met a Mr. Frewster at a medical conference and was interested to hear that Frewster had in fact presented a paper to the London Medical Society on cowpox and its ability to prevent smallpox. Although this paper had never been published, the two men found they had a great deal in common and bombarded the medical meetings with their views on the various poxes. In 1765 Jenner did not know that smallpox, cowpox, and the various other animal poxes which are capable of infecting humans can also immunise a person against infection with all the other members. However, in December 1789 this fact became abundantly clear to him when an incident occurred in his own household. A nurse, who had been looking after Jenner’s son Edward Junior, developed swinepox. Jenner took samples from the swinepox lesions and inoculated his son and two other women who had been in contact with the nurse with this material. After nine days all three became ill and developed red lesions where the incisions on their arms had been made. Several weeks later he variolated the three with smallpox and none of them developed a rash. Thus Jenner demonstrated that they were protected against smallpox. |
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Seven months later there was an outbreak of swinepox locally and, although Jenner presented a paper on his recent experiment, there was little reaction from the medical society. In December 1790, Jenner again variolated his son, who had a slight reaction, proving that swinepox only gives temporary immunity. However, in December 1791, young Edward was again variolated and this time he had no reaction, thus proving that smallpox protected against smallpox for a longer period than swinepox. |
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It would appear that for some years following this achievement Jenner did no more experiments.
He contracted typhoid fever in 1795 and while convalescing came up with the idea of inoculating a
healthy person who had never had smallpox with cowpox. Once they had recovered, he would then
variolate the person with smallpox and if this did not take, then it meant that cowpox had given
the subject immunity against smallpox. This was basically the same as the experiment he had conducted
on Edward Junior and the two women.
Because cowpox tended to disappear for a while and then reappear, Jenner realised that his plan could only succeed in large numbers if he could transmit cowpox from human to human. To avoid a possible public outcry if the experiment went wrong, he had to be careful whom he chose as his subject. This was an eight- year old boy called James Phipps whose father, a homeless labourer, worked for Jenner. The donor was Sarah Nelmes, the daughter of a local farmer; she had scratched her hand on a thorn which became infected when she milked the cow Blossom who had cowpox. The experiment took place on 14th May 1796. Two cuts, each one-half inch long, were made in James’s left arm and the fluid from Sarah’s pustules was inserted into the two incisions. Eight days later James developed pustules similar to those on Sarah’s hand and for the next two days he had a slight fever. Six weeks later on 1st July, Jenner variolated James which should have given him an attack of smallpox, but he did not develop the disease. For the first time in history, Edward Jenner proved that giving healthy person cowpox protected them against smallpox. Jenner repeated his experiment on others. He obtained fluid from James’s pustule and inoculated a second group of patients with it; when these patients developed cowpox, he took fluid from them and inoculated another group of patients and so on. In this way he inoculated eight children, including his own son Robert. It took two centuries before smallpox was finally eradicated from the world. |
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Struggle for Recognition |
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Discovery of the Smallpox Vaccination After his successful experiments Jenner then spent the next two months preparing a paper for publication. However, he was advised by the Royal Society not to publish until he was able to inoculate more subjects to prove his theory. It was felt that he might endanger his reputation by continuing with his work. Despite that fact that cowpox virtually disappeared for the next two years, Jenner continued with his experiments and undeterred prepared further copies of his paper asking five of his friends to make suggestions on any necessary modifications. They recommended that he should publish privately, which he did, paying for the printing himself. His study was published in 1798, entitled An Inquiry into the Causes and Effects of the Variolae Vaccinae. | |
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Although, as expected, there was a certain amount of opposition to the procedure, shortly after the publication of the original paper, physicians and surgeons began vaccinating people, originally in London and Gloucestershire, followed by the rest of the British Empire, Europe and the United States. The King of England was so impressed by Jenner’s work that he granted him permission to dedicate the second edition of the book 'To the King'. |
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However, certain members of the medical profession were vehement in their objections. Cowpox did not occur everywhere and doctors who wanted to test the procedure had to obtain the cowpox material from Jenner himself. There were incidents when the samples became contaminated. Even the political cartoonists added their opposition by publishing engravings showing people growing cow’s heads on their bodies. During this period Jenner spent much of his time in London, neglecting his wife and children and also his medical practice. His financial state became serious and he owed more than £12,000. He had always maintained that he did not require payment for his work, but thanks to the efforts of his supporters, a petition was submitted to Parliament asking its members to reward Jenner for the work and expense he had incurred while working on vaccination. The petition was accepted and after interrogation and examination of witnesses, they awarded him £10,000. At the age of fifty-four, still in debt, Jenner returned to his home and practice and remained there for the next two years, building a clinic adjacent to his cottage and giving free vaccinations. There was still opposition to vaccination and more people were variolated than vaccinated, resulting in more than eight thousand people dying of smallpox in London. Constantly fighting for recognition, Jenner’s financial predicament became worse and became known in other parts of the world. In India, the citizens aware of his plight raised £4,000, Bombay sent £2,000 and the Presidency of Madras sent him £1,383. Eventually in 1807 the British Parliament granted him a further £20,000. Despite his considerable standing all over the world, the attacks on his work continued. Investigation into reports of failed vaccinations kept him occupied, but in 1809 he decided to 'retire', although he continued with his medical practice until 1822. |
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Certificate forthe Eradication of Smallpox Jenner, is acknowledged as the ‘Father of Immunology’ and thanks to his work, the scourge of smallpox no longer exists. Compulsory vaccination was introduced in Britain in 1853 and ended in 1971. Edward Jenner’s original technique of arm-to-arm transfer was used until 1858. |
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In 1967, the World Health Organisation launched its campaign to eradicate smallpox by vaccinating every person in areas at risk – teams of vaccinators from all over the world travelled to remote communities using a special vaccination gun that fired a jet of vaccine. However this required too much maintenance and a disposable 'bifurcated needle' was used instead. This had a narrow flattened forked end which drew up just enough vaccine by capillary action and was jabbed into the skin giving a painless vaccination. In 1980 it was declared 'Smallpox is Dead', fulfilling the predication made Edward Jenner in 1801 |
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Bibliography
Medicine’s Ten Greatest Medical Discoveries Meyer Friedman; Gerald Friedland History of Medicine Roberto Margotto Edward Jenner - An Inquiry into the Causes and Effects of the Variolae Vaccinae. Web links Jenner Museum |
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