Edward Jenner and the cowpox - third part of the series about the smallpox

The man who discovered the connection between smallpox and cowpox and how this connection can be used for a safe vaccine

For the first part - the disease that brought down three empires

For the second part - Mary Montague and her war with smallpox

The man who discovered the vaccine with the help of which the disease of smallpox was eradicated was a modest and shy doctor, whose great virtue was in the experiments he did and the good teacher who stood by him. Edward Jenner was born in 1749 near Bristol in England. His father, the Reverend Stephen Jenner, died when young Edward was 5, and his mother followed soon after. Edward was raised by his older brother who took good care of him, but shortly after the death of his parents the smallpox epidemic was revealed to young Edward in all its force. The plague struck Gloucestershire, killing many people and forcing others to vaccinate against it. In his autobiography, Jenner says that as a preliminary preparation for the vaccine, he underwent blood transfusions until his blood was thin enough and was forced to fast until he was as thin as a skeleton. During the fast, he was imprisoned in a closed stable, and after the vaccination - in which he almost died - he was kept at the farm for several weeks until he recovered. This was the immunization procedure in some places, and it is easy to understand why the mortality rate from inoculation was higher there than usual.

After Jenner managed to survive the inoculation, he began to study the medical profession which he practiced for the rest of his life. At the age of 13 he became the apprentice of a rural surgeon named Daniel Ludlow. While learning how to treat the sick, Jenner became enamored with the farming community in the area. In the same period of time, he heard a milkmaid bragging to her friend that, "I'll never get the smallpox, because I got the cowpox. I will never have an ugly, scarred face." Jenner realized the importance of that diagnosis, and brought the matter to Ludlow's attention, but the teacher ignored the information and advised Jenner to drop the matter, saying that it was a common superstition in the countryside. Jenner was disappointed by Ludlow's attitude to the mystery, but he remembered the milkmaid's words well. When he finished his apprenticeship with Ludlow, he moved on to study with Dr. John Hunter, who was one of the scientific giants of the 18th century. Besides being one of the most renowned surgeons in England, he was also a biologist, skilled experimenter and anatomical researcher. Some of Hunter's diagnoses about the body accompany us to this day, and you can find a hospital named after John Hunter in Australia, and the Hunterian Museum in London.

Despite their sharp differences, Jenner and Hunter bonded immediately and continued to maintain a warm relationship until Hunter's death in 1793. Jenner was more withdrawn and inclined to thoughts and reflections. Hunter, even though he was 20 years his senior, preferred to act than to wonder in vain. When Jenner told him about the milkmaid's words, and wondered aloud whether there might be a connection between cowpox and smallpox, Hunter answered him with three famous words, which have since entered history as an important scientific mantra:
"Don't think. try out."

Despite Hunter's advice, Jenner did not immediately move to investigate cowpox. He completed his studies at Hunter, and in the following years practiced medicine in the city of Berkeley, side by side with various studies in medicine, biology and engineering. He knew how to play the violin and the flute, composed poetry and prose, and even experimented with aeronautics: he designed and launched balloons filled with hydrogen, which managed to fly 18 kilometers in the wind. At the same time, he also conducted an in-depth study of the cuckoo, which, as we know, has a criminal habit of laying its eggs in the nests of other birds. The chick that hatches from the egg wins the love of the 'adoptive' mother, without her realizing that it is an impostor. Naturalists believed that a mother cuckoo pushes the adoptive mother's eggs and chicks out of the nest, leaving only her own egg inside the nest. In this way, she makes sure that the adoptive mother devotes all possible efforts to caring for the only remaining chick - which is actually the cuckoo chick. Jenner followed the cuckoos and their chicks, and discovered that the mother cuckoo was not to blame for the eggs falling from the nest. As soon as the cuckoo chick is born, it pushes the eggs and the other chicks out of the nest by itself, with the help of a special socket on its back that is just right to exert force on the other eggs in the nest. This depression disappeared about 12 days after the chick hatched, and that was the reason why they didn't notice its existence until then. For this extraordinary discovery, Jenner was elected a member of the Royal Society of Science.

All the while, Jenner continued to ponder and wonder about the connection between cowpox and smallpox. Since he himself almost died from the inoculation he went through, he was not satisfied with the process and preferred not to inoculate people. He asked his medical colleagues in the West of England to test the possibility that cowpox protects against the deadly virus, but the answer was one and only: this is complete nonsense, and nothing more than a folk tale.

Jenner did not give up. Among his many occupations as a doctor, inventor and biologist, he also found the time to research cowpox. He examined many cattle and learned to distinguish between genuine cases of cowpox and similar diseases caused by other infections. In 1788, he returned to London with an illustration showing the hand of a farm worker infected with cowpox, and presented it to Hunter, along with his ideas about how infection with cowpox protects against smallpox. Hunter's answer was as before. "There is still a long way to go until proof. You must conduct experiments, instead of hypothesizing."

Jenner returned home with renewed strength, determined to prove the connection between the two diseases. A year later, luck came his way, when the nanny who took care of his 10-month-old son contracted cowpox. Jenner drained the fluid from the smallpox, and used it to vaccinate his young son. The baby contracted cowpox, but recovered quickly. A year later, Jenner tried to inoculate the nanny and his son. In other words, he infected them both with the weakened smallpox virus. According to all the expectations he had developed, they should not have shown the signs of the disease. They had to be completely immune to the vaccine.

And so it was. Neither the nanny nor the baby showed any signs of having been intentionally infected with smallpox. Their immune system, from the moment it became aware of the cowpox virus, could have easily fought off the smallpox.

But Jenner was still not completely convinced of the effectiveness of the new vaccine. He knew that in certain cases of infection with cowpox, the patients do not acquire protection from smallpox. From this he realized that there are different types of cowpox, and that not all of them are able to give the body immunity from smallpox. It took him several years to determine how to choose the right disease, and which blisters should take the liquid. In the end he decided to use the fluids drained from blisters developed by people infected with the correct strain of cowpox. In this way, the vaccinated could infect each other, even without the presence of a cow to mediate between them.

In 1796, Jenner vaccinated James Phipps, an 8-year-old boy from Berkeley, after receiving his parents' permission. James was vaccinated with fluid taken from the blisters created by a milkmaid named Sarah Nelms, who contracted the disease from the cow Blossom. Two months after the vaccination, Jenner infected the boy with smallpox with the help of inoculation, proving that young James was completely immune to the disease. James Phipps made a good return, despite the fact that he was infected with smallpox at least 20 more times, in order to prove his resistance to the disease. As a thank you, Jenner built a house for him in Berkeley, and even planted the roses in the garden with his own hands.

A year later, Jenner tried to publish the results in an article for the Royal Society, but the article was rejected outright on the grounds that it did not have enough actual results. Jenner did not give up, and continued to conduct vaccination experiments using cowpox. In 1798, he emptied all his savings and published a 64-page pamphlet explaining the principles of vaccination with cowpox. It's hard not to admire his determination and commitment to finding a cure for the disease, especially when considering Jenner's financial and family situation in those days. His wife was bedridden and needed expensive medical care for the rest of her life, and Jenner was never a wealthy man. He put his money and the fate of his family on the line, and vowed to spread the vaccine he invented and bring an end to the epidemic that has been killing humanity for more than 10,000 years. One man, against a virus that has survived the ravages of time and wiped out entire civilizations in the blink of an eye.

And despite those unequal power relations, man won. Jenner conducted enough experiments to be confident in his predictions and observations, and to sort out the chaff from the chaff. Hunter's student learned the lesson - he thought only after conducting enough experiments, he found the right virus and demonstrated its effectiveness in the vaccine. Three different editions of the book came out in the three years after he published it, and the third edition was translated into many languages ​​besides English. Jenner decided to call the vaccine variolae vaccinae, which means 'cattle pox' in Latin, but the name was shortened and became vaccination. This is the vaccine we know today for smallpox, and the name became so popular that the word in English today for vaccine is Vaccine.

Why does infection with the cowpox virus immunize against the smallpox virus?

Today we have the tools to understand the body's immune system, and the way it reacts to different viruses. The cowpox virus has certain proteins that are similar to the proteins found in its cousin - the smallpox virus. When the body is infected with cowpox, the immune system acquires the ability to act effectively and quickly against those proteins. The body becomes immune to these proteins. When the smallpox virus enters the body after the cowpox vaccination, the system can already recognize the familiar proteins it carries on its shell, and kill it quickly.

The spread of vaccination in Europe

Although the book gained popularity among some of the population in England, it was met with an equal amount of insults and ridicule (see a cartoon depicting people who undergo vasectomy and start growing cow organs). Most importantly, the doctors themselves were not convinced by him. Jenner himself went to London a few days after the publication of the book, equipped with a suitcase full of vaccines and tried to convince the local doctors to use them, but to no avail. The hand of chance turned in his favor when he visited Dr. Henry Klein. The doctor did not agree to vaccinate his patients, but after the discussion, Jenner forgot on the table a quill - a pointed feather - which he used to demonstrate the idea of ​​vaccination. The tip of that quill was dipped in the storage liquid produced from the cowpox. After Jenner left the room, Klein received a patient with an inflamed thigh, from which he wanted to drain pus. When he was looking for a sharp tool with which to drain the pus, his hand fell on that sharpened quill and he used it to pierce the swollen thigh. When the same patient was subsequently inoculated, Dr. Klein discovered to his astonishment that he was already vaccinated against the disease (because the substance on the tip of the quill was sufficient to immunize the patient). This case was published in the medical community and contributed to the spread of vaccination in England.

We would expect that after Jenner's great contribution to medical science, he would become a saint in the eyes of doctors in England, but he is not. When it became beyond doubt that his discovery could protect against smallpox, many doctors took the method and tried to spread it with their own variations, as if they had invented it themselves. Others claimed that the method was already known, and was first tried by Benjamin Justy - a simple English farmer, who vaccinated his wife and two children with cowpox in 1774. Although Benjamin Justy is indeed considered the first user of vaccination, he did not try to spread it in the public and thereby lost the right of the first to the invention and the reputation that goes with it. Despite this, Jenner was slandered in every possible media as a thief, a charlatan and a hypocrite, by those who were, as he said, "snarling people, and so ignorant that they know no more about the disease they write about than the animals that produce it."

The hurt Jenner tried to stay out of the public eye in England. He invested the best of his money in publishing the discovery, and now, when he was almost impoverished, he tried to return to the family life he loved so much. He tended the bed of his sick wife, raised his children and continued to care for his permanent community of patients. The only reminder that he agreed to receive lucination in those years, was in the cabin he built in the yard of his house. He called it the 'Temple of Vaccination' and it was a focal point of pilgrimage for anyone who wanted to be vaccinated against smallpox. In the 25 years until his death, Jenner vaccinated thousands of people in that cabin, without demanding a return or payment from them.

Indeed, there is no prophet in his city, but outside England the spirits were stormy and agitated. The vaccine reached all of Europe, and proved to be a great success. Emperors, kings and heads of state immunized themselves against the smallpox, and all the masses of the people flocked after them. Compared to inoculation, the vaccine was safer to use, because it did not infect the vaccinee with smallpox, but with its cousin - cowpox. According to statistics, only one vaccinated in a million dies as a result of the vaccine. In addition, the people who underwent the vaccination did not have to worry about infecting their relatives with the epidemic, and did not have to be imprisoned in 'stables' during the first month of vaccination. When Napoleon heard about the simple vaccine in 1805, he inoculated the entire French army with the "Generian vaccine," as he called it. A year later, he ordered the vaccination of all French residents. Vaccination became compulsory in Bavaria in 1807 and in Denmark three years later.

The vaccine came to America in an unusual way. The cowpox virus could not survive the arduous journey across the sea, and in order to transport it all the way, an extraordinary test tube was needed to contain it: the human body itself. A delegation that went to America included a group of children who were not vaccinated against smallpox. At the beginning of the journey, one of them was vaccinated, which caused blisters to grow on his skin. Those blisters contained the cowpox virus, and they could be drained and the fluid produced could be used to infect another child. This is how the virus was passed from child to child, as it regenerated and maintained its power of endurance in each passage, until the ship arrived at the port of Lisbon. From there the vaccine spread to all of America, and President Jefferson himself vaccinated his entire family, some of his neighbors and the last Mohican.

Jenner's fame skyrocketed all over the world, and England could no longer ignore him. In 1802, the British Parliament decided to award him 10,000 pounds as a reward for his invention (according to today's exchange rate, this is a little more than half a million dollars). Five years later, the parliament added another 20,000 pounds. Many universities and associations awarded him honorary degrees. After Jenner intervened to mediate between France and England, Napoleon agreed to release the English prisoners in his hands. After he learned who was seeking to release them, Napoleon declared, “Ah, this is Jenner! I can never say no to Jenner!" The Emperor of Austria and the King of Spain also released English prisoners after Jenner's intervention.

The good doctor received many letters of thanks and appreciation from the entire western world, from all different strata of the population. President Jefferson himself sent a congratulatory letter to Jenner, thanking him for "erasing from the calendar of human disasters, one of the most terrible disasters". Even the chiefs of the five Indian nations in North America sent him a belt decorated with shells, along with a letter:

"Our brother: our father sent us the book you sent, which instructs us how to use the discovery that the great spirit showed you, and thus to keep the smallpox, the deadly enemy of our tribes, off the face of the earth. We are sending with this letter a belt and a string of shells, as a token of our acceptance of your precious gift."

Jenner died in 1823, showered with awards from all nations of the world, but still the object of ridicule, slander and envy in his own homeland. In the writings of the shy doctor, who cured all humanity of the smallpox, we find that he understood the consequences of his work. Already in 1802 he wrote that, "...it can now be seen that the final result of the practice of vaccination will be the elimination of smallpox, the most terrible killer of the human race." [F] President Jefferson, in his letter to Jenner, prophesied that, "future generations will know only from history that the terrible disease of small-pox ever existed, and that you transferred it from the world." [G]

Indeed, Jenner and Jefferson's predictions came true. Less than two hundred years have passed since the vaccination of James Phipps and the announcement by the World Health Organization that the smallpox epidemic has been wiped off the face of the earth. This announcement was broadcast in 1980, and was preceded by a 13-year worldwide operation during which delegations of doctors, scientists and explorers set out to vaccinate the entire population on Earth against the virus. They crossed jungles, deserts and war zones to bring the redeeming angel to people they had never seen before. The fruit of their labor is the world we know today, where the smallpox epidemic, the red death, the most terrible disease of all the ministers of death, no longer exists.

We will tell about the operation for the global eradication of smallpox in one of the following articles in the series. In the next article we will return to the controversy about spontaneous formation, and we will see how the controversy was settled once and for all by Louis Pasteur.