Chapter 8

It appears to have been understood before Jenner's time that persons who had acquired cowpox by handling cattle, but especially by milking cows, were immune from smallpox. In the reign of Charles II. it is well known that the court beauties envied the dairy-maids because having had cowpox, they could not take smallpox which all women so dreaded. Dr. Corlett tells us that the Duchess of Cleveland, one of the King's mistresses, on being told that she might lose her place in the royal favor if she were disfigured by smallpox, replied that she had nothing to fear as she had had cowpox. In 1769 a German, Bose, wrote on the subject of cowpox protecting from smallpox. In the year 1774 a cattle dealer, Benjamin Jesty, at Yetminster, in Dorset, inoculated his wife and three children with cowpox. None of them ever took smallpox during the rest of their lives although frequently exposed to its infection. Jesty died in 1816, and it is recorded on his tombstone that he was the first person who inoculated cowpox to protect from smallpox. Cowpox, or vaccinia, though infectious for cows, is not transmissible among human beings, in other words, as a disease of man it is not infectious. Edward Jenner, the Englishman of Berkeley in Gloucestershire, was the first person to think scientifically on the fact that cowpox protected from smallpox. John Hunter had said to him, "Jenner, don't think, try." Luckily, however, he did both. Thinking alone avails little, experimentation alone avails not much, but the one along with the other has removed mountains. Just as Newton thought scientifically about that falling apple and reduced our conceptions of the universe to order, just as Watt thought scientifically about that kettle-lid lifted by the steam and so introduced the modern era of mechanical power brought under man's control, so Jenner thought about and experimented with cowpox until he had satisfied himself that he had discovered something which would rid the human race forever of the incubus of an intolerable pestilence.

It was in 1780 that Jenner set himself to study cowpox in a way that had never before been attempted, for he was convinced that in the having had an attack of the disease lay the secret of the conquest of that world-scourge. He confided in his fried Edward Gardner about "a most important matter . . . which I firmly believe will prove of essential benefit to the human race . . . should anything untoward turn up in my experiments, I should be made, particularly by my medical brethren, the subject of ridicule." Luckily he was quite prepared for both ridicule and opposition; for has not everything new been ridiculed and opposed? Galileo was opposed, Bruno was opposed, Copernicus was opposed, Harvey was opposed, George Stevenson was opposed, Pasteur was ridiculed and opposed, and so were Darwin, Simpson and even Lister. The physiological inertia even of the educated has too often blocked the path of advancement: but Jenner is in illustrious company, a prince amongst the hierarchy of the misunderstood.

The facts or surmises before Jenner at this date, then, were--(a) Cowpox produces an eruption extremely like that of mild smallpox, it is, therefore, probably a form of smallpox modified by transmission through the cow; (b) And an attack of cowpox protects from smallpox. To test these things experimentally some one must first be inoculated with cowpox, and, having recovered from the vaccinia, that same person must, secondly, be inoculated with the virus of smallpox or be exposed to the infection, and, thirdly, this person ought not to take the disease.

In 1788 Jenner had a careful drawing made of the hand of a milkmaid suffering from cowpox to demonstrate to Sir Everard Home how exceedingly similar were vaccinia and variola. Home agreed it was "interesting and curious," and the subject began to attract some attention in medical circles.

In November, 1789, Dr. Jenner inoculated his eldest child Edward, aged 18 months, with some swinepox virus, and as nothing untoward happened, he inoculated him again with swinepox on April 7, 1791. The child had a slight illness, very like vaccinia, from which he rapidly recovered. The moment for the crucial experiment was not yet; it came in due time, but Jenner had to wait five years for it, and five years are a long time to a man who is yearning to perform his crucial experiment. Happily for suffering humanity, in the early summer of 1796 the opportunity came; the hour and the man were there together.

Cowpox had broken out on a farm near Berkeley and a dairy maid called Sarah Neames contracted the disease. On May 14, 1796, Dr. Jenner took some fluid from a sore on this woman's hand and inoculated it by slight scratching into the arm of a healthy boy eight years old, by name James Phipps. The boy had the usual "reaction" or attack of vaccinia, a disorder indistinguishable from the mildest form of smallpox. After an interval of six weeks, on July 1, Jenner made the most momentous but justifiable experiment, for he inoculated James Phipps with smallpox by lymph taken from a sore on a case of genuine, well-marked, human smallpox, AND THE BOY DID NOT TAKE THE DISEASE AT ALL. Jenner waited till the nineteenth of the month, and finding that the boy had still not developed variola, he could hardly write for joy. "Listen," he wrote to Gardner, "to the most delightful part of my story. The boy has since been inoculated for the smallpox which, aS I VERNTURED TO PREDICT, produced no effect. I shall now pursue my experiments with redoubled ardor."

Here we are behind the scenes at a great discovery; "as I ventured to predict"; prediction is part of scientific theorizing; there is a place for legitimate prediction as there is for experimentation. All discoverers have made predictions; Harvey predicted the existence of the capillaries, Halley predicted the return of his comet, Adams predicted the place of the planet Neptune, the missing link in the evolutionary series of the fossil horses had been predicted long before it was actually found by Professor Marsh. Pasteur predicted that the sheep inoculated with the weak anthrax virus would be alive in the anthrax-infected field, while those not so protected would all be dead. A prediction verified is a conclusion corroborated, an investigator encouraged.

Early in 1797, through another outbreak of cowpox, Jenner was able to inoculate three persons with variola, only to find as before that they were immune from smallpox. He now felt himself justified in preparing a paper for the Royal Society, the highest scientific tribunal in England. The council, however, returned him his paper with the remark that in their opinion the amount of evidence was not strong enough to warrant its publication in the Transactions. Jenner was wise enough not to be discouraged, and so in June, 1798, he published the paper himself under the title, "Inquiry into the causes and effects of the Variolae-Vacciniae, a disease discovered in some of the western counties of England, particularly Gloucestershire, and known by the name of cowpox." This historic pamphlet, which ranks with the great classics of medicine, was dedicated to Dr. O. H. Parry, of Bath. Later on the Royal Society was sagacious enough to elect the very man whose paper it had previously refused.

While in London attending to the publication of his pamphlet, Dr. Jenner called on the great surgeon Mr. Cline, and left some cowpox virus with him for trial. Cline inoculated a young tubercular patient with vaccinia and later with smallpox in no less than three places. In due time this patient did not show a sign of smallpox. So impressed was Cline with this remarkable result that he wrote to Jenner thus: "I think the substitution of cowpox poison for smallpox one of the greatest improvements that has ever been made in medicine. The more I think on the subject, the more I am impressed with its importance."

The word "vaccination" was coined by the French, so remarkable for the aptness of their descriptive terms, and it has ever since remained with us as a convenient expression for the inoculation of vaccinia as protecting from variola.[4]

[4] It is certainly not necessary to point out that the principle of vaccination has been one of wide application in modern medicine. Our word "vaccine" testifies to this. A vaccine is a liquid, the result of bacterial growth, injected into a patient in order to render him immune from that particular disease which is caused by sufficient infection with the microorganisms in question, e. g., of typhoid fever or of plague.

Dr. Jenner's views were now becoming known, and the critics and the doubters had appeared: St. Thomas has always had a large following. The most formidable of the early objectors was Dr. Igenhouz, who had come to London to study inoculation for variola, and had already inoculated, among other notable persons, the Archduchess Theresa Elizabeth of Vienna. The careless vaccinations of Doctors Pearson and Woodville at the London Smallpox Hospital brought much apparent discredit on Jenner's work. In all his early work Jenner used lymph obtained directly from papules on the cow or calf, but Woodville in 1799 showed that excellent results could be got from arm-to-arm vaccination. As this latter method is a very convenient one, the technique was widely adopted. We have to remember that we are speaking of a period about sixty years before Lister gave to suffering humanity that other great gift, antisepsis: and so many arms "went wrong," not because of being vaccinated, but because the scratches were afterwards infected by the microorganisms of dirt. Jenner knew well the difference between the reaction of clean vaccination and that of an infected arm, but a great many medical men of his time did not, and so he was constantly plagued with reports of vaccinations "going wrong" when it was septic infection of uncleansed skin that had occurred. The explanation of these things by letter consumed a very great deal of his valuable time. By the end of 1799 a large number of persons had, however, been successfully vaccinated. As one Pearson proved troublesome by starting an institution for public vaccination on principles which Jenner knew to be wrong, and as Jenner found himself virtually supplanted and misrepresented, he came up to London in 1800 to vindicate his position. The King, the Queen and the Prince of Wales, to whom he was presented, materially helped on the cause by countenancing the practice of vaccination. Lord Berkeley, his Lord of the Manor, was in this as in all things a kind and wise patron. In the United States of America vaccination made rapid progress, having been introduced there under the good auspices of Dr. Waterhouse, professor of medicine at Cambridge, Mass. The discovery was announced with true American informality as "Something curious in the medical line," on March 12, 1799.

Things went even better on the continent of Europe; deCarro, of Vienna, inaugurated vaccination with such zeal and discrimination that it spread to Switzerland, France, Italy and Spain. From Spain it passed over to Latin America. In Sicily and Naples, "the blessed vaccine" was received by religious processions. Sacco, of Milan, commenced vaccinating in 1801, and in a few years had vaccinated 20,000. In Paris, a Vaccine Institute was established; and Napoleon ordered all his soldiers who had not had smallpox to be vaccinated. On Jenner's application, the Emperor liberated several English prisoners remarking--"What that man asks is not to be refused." Napoleon voted 100,000 francs for the propagation of vaccination. Lord Elgin introduced it into Turkey and Greece. The Empress of Russia, Catherine II., was one of the greatest supporters of Jennerian vaccination. She decreed that the first child vaccinated in Russia should be called "Vaccinoff," should be conveyed to Petrograd in an imperial coach, educated at the expense of the state and receive a pension for life. The Emperor of Austria and the King of Spain released English prisoners at Jenner's request. There were statues of Jenner erected abroad, at Boulogne and at Brunn, in Moravia, before any in England. Thus the European countries showed their gratitude to the Englishman whose patience, genius and absence of self-seeking had rid them of the detestable world-plague of smallpox. Vaccination was made compulsory by law in no less than five European countries before it was so in the United Kingdom in 1853. In eight countries vaccination is provided free at the expense of the government. The clergy of Geneva and of Holland from their pulpits recommended their people to be vaccinated. In Germany, Jenner's birthday (May 17) was celebrated as a holiday. Within six years, Jenner's gift to humanity had been accepted with that readiness with which the drowning clutch at straws. The most diverse climes, races, tongues and religions were united in blessing vaccination and its discoverer. The North American Indians forwarded to Dr. Jenner a quaintly worded address full of the deepest gratitude for what he had saved them from: "We shall not fail," said these simple people, "to teach our children to speak the name of Jenner, and to thank the Great Spirit for bestowing upon him so much wisdom and so much benevolence."

There are two allusions to smallpox in "Don Juan," which was published in 1819, showing to what an extent Jennerian teachings were in the air. The first is:

The doctor paid off an old pox By borrowing a new one from an ox. (Canto I., stanza 129.)

The second is:

I said the smallpox has gone out of late, Perhaps it may be followed by the great. (Stanza 130.)

Before 1812, Jenner had been made an honorary member of nearly every scientific society in Europe, and had received the freedom of the cities of London, Edinburgh, Dublin and Glasgow. The Medical Society of London presented him with a gold medal struck in his honor; in Berlin in 1812 there was a Jennerian festival on the anniversary of Phipps's vaccination. Addresses and diplomas were showered on him, and in 1813 the University of Oxford conferred on him the degree of M.D. honoris causa. As he refused point blank to pass the examination in Latin and Greek required by the Royal College of Physicians of London, Jenner never obtained admission into that learned body. When some one recommended him to revise his classics so that he might become an F.R.C.P. he replied, "I would not do it for a diadem"; and then, thinking of a far better reward, added: "I would not do it for John Hunter's museum."

But while the pure in heart were thus receiving the blessing offered them by the benovelent man of science, the pests of society, those discontented and jaundiced ones who are always to be found in the dark recesses of the cave of Adullam, were not idle. Many of his medical colleagues did indeed sneer, as some are always apt to do at any new thing however good. To all these Jenner replied, and a very great deal of his valuable time was consumed in arguing with them. But the sect of the anti-vaccinators had arisen, and was to some extent organized. Caricatures, lampoons, scurrilities, vulgarities and misrepresentations, the mean, were scattered on all sides. Nothing was too absurd to be stated or believed--that vaccinated persons had their faces grow like oxen, that they coughed like cows, bellowed like bulls and became hairy on the body. One omniscient objector declared that, "vaccination was the most degrading relapse of philosophy that had ever disgraced the civilized world." A Dr. Rowley, evidently imagining himself honored by a special participation in the Divine counsels, declared that "smallpox is a visitation from God, but cowpox is produced by presumptuous man. The former was what Heaven had ordained, the latter is a daring violation of our holy religion." It was rather hard to blame Dr. Jenner for the origin of cowpox. It took much forbearance to endure this sort of thing; but Jenner's was a first-class mind and he evidently dealt leniently even with fools. It was not for the first time in the world's history that a lover of mankind had been spurned with the words--"He hath a devil and is mad."

Besides enduring all these mental and physical worries, and the annoyance that the Royal Jennerian Society established in 1802 was so mismanaged that it collapsed in 1808, Jenner had spent a very large sum of private money on the introduction of vaccination. He had been, as he himself expressed it, "Vaccine clerk to the whole world." Parliament, it is true, in 1801, voted him a sum of 10,000 pounds which was not paid for three years afterwards and was diminished by 1,000 pounds deducted for fees, so that it barely recompensed him for his outlays. By 1806, the immensity of the benefit conferred upon his diseased fellow-creatures having been recognized more perfectly in every other country than his own, the British Parliament woke up, and voted him a sum of 20,000 pounds, only one member representing the anti-vaccinators opposing the grant. Parliament, which had previously received from the Colleges of Physicians of London, Edinburgh and Dublin the most favorable reports of the efficacy of vaccination, decided to reestablish the Royal Jennerian Institute. A subscription of 7,383 pounds from grateful India reached Jenner in 1812. In 1814 he was in London for the last time, when he was presented to the Emperor of Russia, Alexander I., who told him that he had very nearly subdued smallpox throughout that vast Empire. Jenner refused a Russian order on the ground that he was not a man of independent means.

The management of the Institute caused him much concern in his later years; he disapproved of the personnel and of many of the details of its working. One of the last worries of his life was an article in the November number for 1822 of the famous Edinburgh Review. Although it contained a good deal of praise, it was not favorable to Jenner, who said of it, "I put it down at 100,000 deaths at least." I have ascertained that this article was not written by the celebrated Francis Jeffrey, although he was editor of the Review until 1829.

Jenner's life, apart from his great discovery and his developing the practice of vaccination, has not much incident in it. He was born on May 17, 1749, the son of the Rev. Stephen Jenner, vicar of Berkeley, Gloucestershire, England, the same Berkeley in whose castle, Edward II., the vanquished at Banockburn, was murdered in 1327. Jenner's mother's name was Head. Edward went to school at Wotton-under-Edge and at Cirencester, and began to study medicine with a Mr. Ludlow, a surgeon at Sodbury near Bristol. In his twenty-first year, Jenner went to London as a pupil of the great John Hunter, in whose house, he lived two years, during which time he was entered as a medical student at St. George's Hospital. It is interesting to know that while still a student he was asked by Sir Joseph Banks to arrange and catalogue the zoological specimens brought home by the circumnavigator Captain Cook in his first voyage of 1771. Jenner devoted considerable attention to natural history, to geology and to the study of fossils, on which topics he kept up correspondence with Hunter long after he left London. In the year 1788 he married a Miss Kingscote, and settled down to practice in his native place. Mrs. Jenner died in 1815, after which date Jenner never left Berkeley again.

Curiously enough, it was not until 1792 that Jenner obtained the degree of M.D., and it was not from an English university at all, but from the University of St. Andrews in Scotland. This university, the smallest although the oldest of the Scottish universities, has therefore the honor of being the Alma Mater to the epoch-making Englishman. I have seen the entry of the name in the list of graduates for the year 1792; it has evidently been misspelled, for the name is corrected. The first foreign university to recognize Jenner's eminence was Gottingen. In 1794 Jenner had an attack of typhus fever. Jenner never cared for London or a city life, and although in 1808 he was persuaded to take a house in town, he soon gave it up and went back to his beautiful Gloucestershire. For many years he practiced during the season in the pleasant health-resort of Cheltenham. He loved the country, he studied lovingly the living things around him there: many are familiar with a piece of verse he wrote on "The signs of rain."

The year 1810 was a sad one for Jenner: his eldest son died, and that noticeably depressed his health. In 1823 he presented a paper to the Royal Society on the migration of birds, a subject not even yet fully cleared up. On January 26, in the same year, he was stricken with paralysis on the right side and died within twenty-four hours. His body was buried in the chancel of the parish church of Berkeley, where there is a memorial window placed by public subscription. In person, Edward Jenner was short and rather heavily built; his expression of face was pleasant with a touch of sadness. All reports agree that in dress he was conspicuously neat, looking more like a gentleman-farmer than a physician, with his blue coat, yellow buttons, red waistcoat, buff breeches and top-boots.[5]

[5] He was painted by Sir Thomas Lawrence, by Northcote and by Vigneron.

There is no disguising the fact that during his lifetime Dr. Jenner was much more appreciated in foreign countries than in England. The medico-social club of Alverton, near where he lived, would not listen to him when he addressed them on vaccination. The effort to collect enough money from the medical men of England in order to place a marble statue to Jenner in the nave of Gloucester Cathedral, was successful only after a long delay. An attempt to erect a statue in London died of apathy; but in 1858, 32 years after he died, a statue was erected in Trafalgar Square. In 1862 it was removed to a quiet corner of Kensington gardens; and perhaps its surroundings, the trees, the flowers and the birds he loved are more suitable than the effigies of those national heroes who served their country by taking, not by saving life. No, Nelson the hero is hardly the suitable companion for Jenner the hero.