An Inquiry into the Causes and Effects of the Variolae Vaccinae
(Few papers have had a greater impact on the health of the...)
Few papers have had a greater impact on the health of the human species than the simple, yet elegant, observations and clinical trials of Edward Jenner with what was at the time called the Cow Pox.
Edward Jenner was an English physician and scientist. He was the pioneer of the smallpox vaccine, the world's first vaccine.
Background
Edward Anthony Jenner was born on 17 May 1749 (6 May Old Style) in Berkeley, Gloucestershire, England, United Kingdom. Edward Jenner was the sixth and youngest child of the Reverend Stephen Jenner, rector of Rockhampton and vicar of Berkeley, a small market town in the Severn Valley. His mother was the daughter of the Reverend Henry Head, a former vicar of Berkeley. In addition to his church offices, Jenner’s father owned a considerable amount of land in the vicinity of Berkeley.
In 1754, when Edward was five years old, both parents died within a few weeks of each other and he came under the guardianship of his elder brother, the Reverend Stephen Jenner, who had succeeded their father as rector of Rockhampton.
Education
Jenner’s first schooling was received from the Reverend Mr. Clissold at the nearby village of Wotton-under-Edge at Katherine Lady Berkeley's School. Later he was sent to a grammar school at Cirencester. One of his favorite boyhood activities was searching for fossils among the oolite rocks of the countryside.
In 1761 Jenner was apprenticed to Daniel Ludlow, a surgeon of Sodbury, with whom he worked until 1770 when he went to London to study anatomy and surgery under John Hunter. Hunter had just taken over the large house of his brother William in Jermyn Street, and Jenner was one of Hunter’s first boarding pupils. Jenner also served as Hunter’s arranged the zoological specimens brought back by Joseph Banks from the first voyage of H. M. S. Endeavour. He studied at St George’s Hospital under surgeon John Hunter and was influenced by his philosophy of seeking new discoveries - “Don’t think, try.”
In 1773, Jenner returned to his native Berkeley to become a general practitioner. In his spare time, he pursued his study of native wildlife and also followed any new developments in medical science.
In 1792 he earned his Doctor of Medicine degree from the University of St. Andrews, Scotland.
Jenner’s medical practice at Berkeley left him enough leisure time for activity in local medical societies, making observations in natural history, playing the flute, and now and then writing verse. His poetry has sometimes a simple beauty, his best poems being "Address to a Robin" and "The Signs of Rain."
John Hunter continually encouraged Jenner’s studies in natural history, for instance, by asking him to obtain particular specimens and to investigate temperatures of hibernating animals. Hunter incorporated many of Jenner’s observations in his own papers, published in the Philosophical Transactions of the Royal Society and in his book Observations on ... the Animal Oeconomy (London, 1786).
In 1786 Jenner wrote a paper on the breeding habits of the cuckoo and Hunter submitted it to the Royal Society. Jenner had shown that when a cuckoo’s egg, laid in the nest of another bird such as the hedge sparrow, was hatched, the eggs or nestlings of the foster parent were thrown out of the nest, apparently by their own parents. Jenner had no explanation for this seemingly unnatural behavior. The paper was read before the society on March 29, 1787, and was accepted for publication in the Philosophical Transaction. Then, on June 18, 1787, Jenner discovered that it was the newly hatched cuckoo that ejected from the nest of its “foster parent” the hedge sparrow’s own unhatched eggs and nestlings. Accordingly, Jenner withdrew his original paper before publication and revised it. On December 27, 1787, he sent the revised report to Hunter, and it was read before the Royal Society on 13 March 1788.
When Jenner began medical practice at Berkeley, he was frequently asked to inoculate persons against smallpox. Smallpox inoculation had been introduced into England early in the eighteenth century. A person in good health was inoculated with matter from smallpox pustules and was thus given what was usually a mild case of the disease in order to confer immunity against further smallpox infection. The practice was dangerous, however, since smallpox thus induced could be severe or fatal, and it tended to spread smallpox among the population.
Such inoculation was evidently not a common practice in the English countryside until about 1768, when it was improved by Robert Sutton of Debenham, Suffolk. Sutton required the patient to rest and maintain a strict diet for two weeks before inoculation. He inoculated by taking, on the point of a lancet, a very small quantity of fluid from an unripe smallpox pustule and introducing it between the outer and inner layers of the skin of the upper arm without drawing blood. He used no bandage to cover the incision.
Jenner began to inoculate against smallpox using Sutton’s method, but he soon found some patients to be completely resistant to the disease. On inquiry, he found that these patients had previously had cowpox, the disease which produced a characteristic eruption on the teats of milk cows and was frequently transmitted to people who milked the cows. Jenner also found that among milkmen and milkmaids it was generally believed that contraction of cowpox prevented subsequent susceptibility to smallpox, although there had apparently been instances where this had not been the case. His fellow medical practitioners in the countryside did not agree that cowpox prevented smallpox with certainty.
As early as 1780 Jenner learned that the eruptions on the teats of infected cows differed. All were called cowpox and all could be communicated to the hands of the milkers, but only one kind created resistance to smallpox. He called this type “true cowpox.” Jenner subsequently found that even true cowpox conferred immunity against smallpox only when the matter was taken from the cowpox pustules before they were too old (as had been the case with Sutten’s smallpox fluid). Jenner thought (mistakenly) that true cowpox was identical with a disease of the feet of horses known as “grease,” and that the pox was carried from horses to cattle on the hands of milkmen who also cared for horse. He also believed at that time that the cowpox could be transmitted from person to person, serving to protect them from smallpox. But he was not able to confirm his opinions for another sixteen years.
On May 14, 1796, Jenner inoculated James Phipps, an eight-year-old boy, with matter taken from a pustule on the arm of Sarah Nelmes, a milkmaid suffering from cowpox. The boy contracted cowpox and recovered within a few days. On July 1, 1796, Jenner inoculated him with smallpox, but the inoculation produced no effect. In June 1798 Jenner published at his own expense a slender volume of seventy-five pages, An Inquiry Into the Cause and Effects of the Variolae Vaccine. In this work, he described twenty-three cases in which cowpox had conferred a lasting immunity to smallpox. Jenner described “grease,” the disease on the heels of horses, and suggested that it could cause cowpox in cows. He showed that cowpox was transmitted to the milkmaids, giving rise to pustules on their hands and arms but not to systemic disease. They recovered after a few days of mild illness and were thereafter immune to smallpox.
To describe the matter producing cowpox Jenner introduced the term “virus,” contending that the cowpox virus had to be acquired from the cow and that it gave permanent protection from smallpox. In Case IV of the Inquiry Jenner also describes a kind of reaction now known as anaphylaxis. In 1791 one Mary Barge, who had had cowpox many years before, was inoculated with smallpox. A pale red inflammation appeared around the inoculation site and spread extensively, but it disappeared within a few days. Jenners noted how remarkable it was that the smallpox virus should produce such inflammation more rapidly than it could produce smallpox itself. He also observed that although cowpox gave immunity to smallpox, it did not confer similar immunity to the cowpox, itself.
Following the publication of Jenner’s book, the practice of vaccination was adopted and spread with astonishing speed. It was taken up not only by medical practitioners but also by country gentlemen. clergymen, and schoolmasters. Jenner found that lymph taken from smallpox pustules might be dried in a glass tube or quill and kept for as long as three months without losing its effectiveness. The dried vaccine could thus be sent long distances. Jean de Carro, a swiss physician living in Vienna, introduced vaccination on the continent of Europe and was instrumental in sending vaccine virus into Italy, Germany, Poland, and Turkey. In 1801 Lord Elgin, British ambassador at Constantinople sent vaccine virus received from de Carro overland to Bussora (Basra) on the Persian Gulf, and thence to Bombay. The marquis of Wellesley, governor-general of India, actively promoted the distribution of the vaccine and many thousands of people were vaccinated in India during the next few years. In Massachusetts, Benjamin Waterhouse introduced vaccination to America with vaccine received from Jenner. Jenner also sent a vaccine to President Jefferson, who vaccinated his family and his neighbors at Monticello.
After 1798 Jenner’s life was taken up almost entirely by the question of vaccination. He had to provide vaccines to those who requested it, explain the details of the procedure, and defend the practice against ill-informed criticism. He had to answer first the somewhat casual criticisms of Ingen-Housz and in 1799 the more serious attack of William Woodville, head of the London smallpox Hospital. Woodville had inadvertently inoculated his patients with smallpox when he attempted to vaccinate them, a misfortune which produced serious cases of smallpox and at least one death. Jenner wrote a number of pamphlets in defense of vaccination. He was obliged to spend extended periods of time in London and to carry on a vast correspondence. In 1802 the British Parliament voted him a grant of £10,000 in recognition of his discovery and in 1806 an additional grant of £20,000. In 1803 the Royal Jennerian Society was founded in London to promote vaccination and Jenner took a large part in its affairs; it was superseded in 1808 by a national vaccination program.
Although Great Britain and France were at war, in 1804 Napoleon had a medal struck in honor of Jenner’s discovery, and in 1805 he made vaccination compulsory in the French army. At Jenner’s request, he also released certain Englishmen who had been interned in France.
After his wife’s death in 1815, Jenner rarely left Berkeley and never visited London. He resumed his studies in natural history and completed a paper on the migration of birds, published after his death, in which he showed that birds appeared to migrate into England in summer for the purpose of reproduction and that the ovaries of the female and testes of the male were enlarged at that time. Jenner also served as a justice of the peace at Berkeley.
The day before his death he walked to a neighboring village, where he ordered that fuel be provided for certain poor families. In 1820 he had suffered a mild stroke, and on January 25, 1823, a severe one. He died early the next morning.
Edward Jenner is remembered across the world for his finding of a vaccine for the dreaded smallpox epidemic.
Jenner’s discovery of vaccination made possible the immediate control of smallpox and the saving of untold lives. It also made possible, as Jenner realized, the ultimate eradication of smallpox as a disease, an end which is only in 1972 within sight for the whole world. Jenner must be considered the founder of immunology; in vaccination, he made the first use of an attenuated virus for immunization. For his coining of the term “virus,” his effort to describe the natural history of the cowpox virus, and his description of anaphylaxis, he must be considered the first pioneer of the modern science of virology.
In 1805 he was presented with the “Freedom of the City” for the discovery of the vaccination from the Lord Mayor and Corporation of London.
In 1813 the University of Oxford awarded Jenner an honorary Doctor of Medicine degree.
In 1821, he was appointed Physician Extraordinary to King George IV.
Jenner was named in the BBC's list of the 100 Greatest Britons in 2002.
Neither fanatic nor lax, Jenner was a Christian who in his personal correspondence showed himself quite spiritual. He treasured the Bible.
Views
Edward Jenner was fascinated with wildlife and birds, and in the last year of his life, presented a paper on the “Observations on the Migration of Birds” to the Royal Society.
Quotations:
"I am not surprised that men are not grateful to me, but I wonder that they are not grateful to God for the good which he has made me the instrument of conveying to my fellow creatures."
“The deviation of man from the state in which he was originally placed by nature seems to have proved to him a prolific source of diseases.”
“I hope that someday the practice of producing cowpox in human beings will spread over the world - when that day comes, there will be no more smallpox.”
“I shall endeavor still further to prosecute this inquiry, an inquiry I trust not merely speculative, but of sufficient moment to inspire the pleasing hope of its becoming essentially beneficial to mankind.”
Membership
American Academy of Arts and Sciences
,
United States
1802
Royal Swedish Academy of Sciences
,
Sweden
1806
Fellow of the Royal Society
The Royal Society
,
United Kingdom
1788
Fellow of the Royal College of Physicians of Edinburgh
Royal College of Physicians of Edinburgh
,
United Kingdom
Linnean Society of London
,
United Kingdom
Worshipful Master
Royal Berkeley Lodge of Faith and Friendship
,
United Kingdom
1812 - 1813
Personality
Physical Characteristics:
When Jenner was small he was injected for smallpox and that put an effect on his health for the whole life.
Interests
flute, poetry
Connections
On March 6, 1788, Jenner married Katherine Kingscote and moved to Chantry Cottage, a comfortable Georgian country house at Berkeley, where he resided, except for intervals at London and Cheltenham, for the rest of his life. His wife died on September 13, 1815. During their relatively short life together they had three children, Edward (1789-1810), Catherine (1794-1833), and Robert Fitzharding (1797-1854).
