SIR THOMAS J. PETTIGREW
In the advance of medical science no more famous discovery has been made than that of vaccination, that is, inoculation with the modified virus of a disease, thereby causing a mild form of it, in order to prevent a virulent attack. This treatment has in recent years been applied by the use of various serums and antitoxins against different diseases; but, originally and specifically, vaccination, as now understood, is inoculation with cowpox for the prevention of smallpox.
Jenner's work in connection with the modern introduction of this practice is fully described in the following pages. In a more primitive manner inoculation against smallpox was practised many centuries ago in India, China, and other lands. The first modern accounts of it are said to have been given by a Turkish physician in 1714. In England it was first actually employed through the efforts of Lady Mary Wortley Montagu, who (1716-1718) had observed it in Constantinople, and there seen her son inoculated. The practice soon spread through Western Europe and to North America.
Jenner's discoveries and demonstrations as to the specific value of the vaccine virus of cowpox, which led to the modern methods of vaccination for prevention of smallpox, proved of such efficacy and importance that the whole credit for this service to medical science has been popularly given to him. But among the intelligent it detracts nothing from his just fame to make due acknowledgment of previous work along similar lines.
There have always been some, since Jenner's time, and are still considerable numbers of people in different countries, strongly opposed to vaccination for smallpox, on the ground of what they deem its unscientific and dangerous nature. But the vast majority of medical practitioners, and of the world at large, are convinced of its vital benefits, and in several countries vaccination is made compulsory by the State.
Edward Jenner was born on May 17, 1749. He was a native of Berkeley in Gloucestershire, England. His father was the vicar of this place, and his mother was descended from an ancient family in Berkshire. In early life Jenner was deprived of his father, and the direction of his education devolved upon an elder brother, the Rev. Stephen Jenner. He attained a respectable proficiency in the classics, and his taste for natural history manifested an early development; for, at the age of nine, he had made a collection of the nests of the dormouse, and he employed the hours usually devoted by boys to play, in searching for fossils in the neighborhood. "No childish play to him was pleasing."
Intended for the medical profession, Jenner was apprenticed to Daniel Ludlow, of Sodbury, near Bristol, to acquire a knowledge of surgery and pharmacy; and, after the period of his apprenticeship had expired in 1770, he went to London to complete his professional studies, and was a student at St. George's Hospital, and a resident, for two years, in the family of the celebrated John Hunter. The similarity of their tastes and spirit of research will render it a matter of no surprise that he should become a most favorite pupil. That this was the case in an eminent degree the correspondence which was maintained between the two great physiologists sufficiently proves. "There was in both a directness and plainness of conduct, an unquestionable desire of knowledge, and a congenial love of truth."
Jenner was remarkable for the neatness and precision with which he made preparations of anatomy and natural history. His dissection of tender and delicate organs, his success in minute injections, and the taste he displayed in their arrangement are said to have been almost unrivalled. Hunter recommended him to Sir Joseph Banks, to prepare and arrange the various specimens brought home by the celebrated circumnavigator, Captain Cook, in his first voyage of discovery in 1771, and he was solicited to become the naturalist of the succeeding expedition in the year following; but Jenner's partiality to his native soil, and his desire of settling in the place of his birth, were too strong to admit of his being allured into such an appointment. He preferred the seclusion of a country village; and to this selection do we owe one of the greatest blessings ever bestowed upon mankind. It is not unreasonable to suppose that the subject by which he should afterward be known to the whole world, dwelt upon his mind with considerable force even at this early period, for the prophylactic powers of the cowpox were known, or rather rumored of, in a few districts, and the subject had been mentioned by Jenner to Hunter and others, though he had not been successful in directing their attention sufficiently to the importance of it. Indeed, he pressed this subject so much upon his professional brethren, that, at a medical club at Redborough to which he belonged, he was threatened to be expelled if he persisted in harassing them with a proposition which they then conceived had no foundation but in popular and idle rumor, and which had become so entirely distasteful to them. It remained, therefore, to Jenner to pursue the inquiry and to place the whole matter upon a proper physiological basis, by which it might be rendered permanently beneficial. This inquiry was perfected amid the labors and anxious toils attendant on the life of "a country surgeon," with few books to consult, and little leisure to devote to their perusal. Observation necessarily supplied the place of literary research; the book of nature was open to his view, and it was one he was well calculated to comprehend; it surpassed all others, and its contemplation amply repaid the student.
Of all classes of men with whom it has been the fortune of the writer of this sketch to associate, there is none, in his opinion, so generally and so truly amiable as the naturalists. The contemplation of nature seldom fails to produce an elevation of character; it also begets a sweetness of disposition flowing from a sense of what is beautiful in creation; and the evidences of beneficence, everywhere so abundant, soften the feelings and impart to the individual a sincere benevolence of heart. This disposition was strikingly manifested in Jenner, to whose affection, kindness, meekness, good-will, and benevolence so many have borne the most ample testimony. It was no uncommon thing for Jenner to be accompanied in his daily professional tour of many miles by friends, who have eagerly listened to the outpourings of his mind called forth by the beauties which in the vale of Gloucester surrounded him.
His observations on the structure and economy of the various objects of natural history were delivered with the most captivating simplicity and ingenuity. Full of information himself, he delighted to impart it, and was equally solicitous of obtaining a return from others. He was an enthusiast in his devotion to nature, and he anxiously desired that all should participate in the gratification which such a study never failed to afford. He united in an especial manner a talent for the most profound observations to a disposition most lively and ardent distinguished by mirth, playfulness, and wit. With these powers, it is not surprising that his society should have been much courted; and, fully engaged as he was by the duties of an extensive practice, he yet found time to cultivate an acquaintance with polite literature. Many little productions of his muse have appeared in print; they were addressed to some of his more favored correspondents, or occasionally read at convivial meetings, and display the turn of his mind, the benevolence of his disposition, and the liveliness of his imagination. His best poetical productions find their subjects in natural history. The Signs of Rain unites the accuracy of the naturalist with the fancy of the poet.
Jenner had nearly passed half a century before he made known to the world his experiments and investigations relative to the vaccine disease. His first successful vaccination was made May 14, 1769. His ardor from an early period had been noticed, and it took its rise from the following accidental circumstance. While a pupil with Mr. Ludlow, a young countrywoman applied for advice. The subject of smallpox was mentioned, upon which she observed, "I cannot take that disease, for I have had the cowpox." This was sufficient to excite the attention of Jenner, and the incident never escaped his recollection. It is easier to conceive than to express the emotions which would naturally spring from reflection on such a subject; his benevolent feelings were at once aroused to full activity; he pictured to himself all the horrors of that pestilential and most loathsome disease, disfiguring Nature's greatest work, slaying thousands upon thousands, and he was yet sufficiently young to recollect the severity of discipline to which he had himself submitted in the process preparatory to the practice of inoculation, which, to use his own words, in that day was no less than that of "bleeding till the blood was thin; purging till the body was wasted to a skeleton; and starving on vegetable diet to keep it so."
The patience manifested by Jenner in the prosecution of his inquiry into the cowpox, the scrutiny to which he subjected every appearance that presented itself, and the fortitude with which he withstood every untoward circumstance entitle him to all praise and show forth his great capabilities for conducting a philosophical investigation. He divested the subject of all its difficulties and obscurities, and gave to "vague, inapplicable and useless rumor the certainty and precision of scientific knowledge." The extent of his anticipations upon this truly momentous subject do not appear to have been fully stated until 1780, ten years subsequent to his mention of it to John Hunter. He then confidentially disclosed to his intimate friend, Edward Gardner—who gave evidence upon the subject before the committee of the House of Commons—the opinions he entertained upon the natural history of the cowpox; dated its origin from the diseased heel of a horse; alluded to the different diseases with which the hands of the milkers became affected from handling the infected cows; distinguished that which was calculated to afford security against the smallpox; and divulged the hope he entertained of being able finally to eradicate that disease from the face of the globe. Doctor Baron has recorded the remarkable words with which this important communication was made:
"I have intrusted a most important matter to you, which I firmly believe will prove of essential benefit to the human race. I know you, and should not wish what I have stated to be brought into conversation; for should anything untoward turn up in my experiments I should be made, particularly by my medical brethren, the subject of ridicule—for I am the mark they all shoot at."
Jenner's reasons for concealment did not arise from any selfish or unworthy motive. The publicity he had always given to the subject and the efforts he had made among his professional associates to pursue the inquiry exclude the possibility of entertaining such a suspicion. It arose from a dread of disappointment and the fear of failure should the matter be brought forward in a state other than that of a maturity sufficient to carry conviction immediately upon its promulgation. In the course of his researches he was led to conclude that swinepox, as well as cowpox, was only a variety of smallpox. He inoculated his eldest son with the matter of swinepox and produced a disease similar to a very mild smallpox. After this, the inoculation of variolous matter would produce no effect.
He ascertained that cowpox, as it was commonly termed by the milkers, would frequently fail in effecting a security against the smallpox. This led him to inquire more particularly into the variety of spontaneous eruptions to which the teats of the cow were liable, and to discriminate the different kinds of sores produced by them on the hands of the milkers, and to establish the character of those which possessed a specific power over the constitution, and those which had no such efficacy. He found that instances occurred in which the true cowpox failed in preventing smallpox; but nothing daunted by this apparently fatal discovery he set about ascertaining the causes of this deviation. He found the specific virtues of the virus to have been lost or deteriorated so that it was rendered capable only of producing a local affection and had no influence whatever upon the constitution; and by the greatest ingenuity and patience of observation of the analogies drawn from the virus of smallpox, aided by his knowledge of the laws of the animal economy, he discovered that it was only in a certain state of the vesicle that the virus was capable of affording its protecting agency, and that when taken under other conditions, or at other periods, it could produce a local disease, yet that it was not able to manifest any constitutional effect, or afford immunity from the invasions of the smallpox.
On May 14, 1796, Jenner inserted lymph taken from the hand of Sarah Nelmes who was infected with cowpox, into the arm of James Phipps, a healthy boy about eight years of age. This is the first instance of regular inoculation of the vaccine disease by Jenner. The boy went through the disorder, and on July 1st following he had the matter of smallpox introduced into his arm, but no effect followed. Jenner had not before seen the cowpox but as presented on the hands of the milkers, nor had it been transmitted from one human being to another. He was struck with its great resemblance to the smallpox pustule. The success of this case must necessarily have operated powerfully upon him, and have urged him to continue the research with increased energy.
His anticipations thus realized, his intentions accomplished, what must have been the feelings of such a man as Jenner? They were suited to the magnitude of the occasion, and mark the character of the philosopher, distinguished as it ever was by great simplicity, benevolence, and humility. "While," says he, "the vaccine discovery was progressive, the joy I felt at the prospect before me of being the instrument destined to take away from the world one of its greatest 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 to me to recollect that these reflections always ended in devout acknowledgments to that Being from whom this and all other mercies flow." Lord Bacon said that "it is Heaven upon earth to have a man's mind move in charity, rest in Providence, and turn upon the poles of truth." Jenner was a striking illustration of the truth of that remark.
The modesty of Jenner was evidenced in his original intention of submitting his observations on the cowpox in a paper addressed to the Royal Society. Doctor Baron tells us that "when the subject was laid before the president (the late Sir Joseph Banks), Jenner was given to understand that he should be cautious and prudent; that he had already gained some credit by his communications to the Royal Society and ought not to risk his reputation by presenting to the learned body anything which appeared so much at variance with established knowledge, and withal so incredible." It came forth most unostentatiously, about the end of June, 1798, dedicated to his friend Doctor Parry of Bath. Doctor Jenner visited London in the month of April of that year, and remained until July 14th. His object in this visit was to demonstrate the disease to his professional friends, but such was the distrust, or apathy, felt on the occasion, that Jenner returned to the country, without having been able to prevail on a single individual to submit to the inoculation of the virus.
The virus Jenner brought to London was consigned to the care of the late Mr. Cline, of St. Thomas's Hospital. This celebrated surgeon inserted some of it, by two punctures, into the hip of a young patient with a disease of that part of the body. This calescent mode of proceeding was adopted with the idea of exciting a counter-irritation in the diseased part. The intention was to convert the vesicles into an issue, after the progress of the cowpox had been observed. This idea was, however, abandoned. Smallpox matter was afterward inserted into this child in three places. It produced a slight inflammation on the third day, and then subsided. The child was effectually protected against the disease. Mr. Cline now became very sanguine as to the result and inoculated three other children with lymph taken from the vesicles of the child, but no evil effect ensued. The subject began to excite the attention of the profession, and all were eager to put the matter to the test of experiment. Mr. Cline urged Doctor Jenner to settle in London. He promised him ten thousand pounds a year as the result of his practice. What was his reply?
"Shall I, who even in the morning of my days, sought the lowly and sequestered paths of life, the valley, and not the mountain; shall I, now my evening is fast approaching, hold myself up as an object for fortune and for fame? Admitting it as a certainty that I obtain both, what stock should I add to my little fund of happiness? My fortune, with what flows in from my profession, is sufficient to gratify my wishes; indeed, so limited is my ambition, and that of my nearest connections, that even were I precluded from future practice I should be enabled to satisfy all my wants. As for fame, what is it? A gilded butt, forever pierced with the arrows of malignancy."
That a discovery of such importance to mankind, once divulged, should bring forth many claimants, and that its author should be subjected to virulent attacks, is easy to be conceived. Jenner, however, never thought it necessary to reply to unfounded and harsh aspersions, satisfied in the strength of his own case, and feeling the justice and truth of his own claims and position. The practice being now established, it is unnecessary even to refer to the names of the opponents of vaccination. Many mistakes, and some of a serious nature, occurred to interrupt the progress of the discovery; these had been for the most part foreseen by Jenner, and were satisfactorily explained. In a letter to a friend, Jenner says, "I will just drop a hint. The vaccine disease, in my opinion, is not a preventive of the smallpox, but the smallpox itself; that is to say, the horrible form under which the disease appears in its contagious state is, as I conceive, a malignant variety." Again: "What I have said on this vaccine subject is true. If properly conducted, it secures the constitution as much as variolous inoculation possibly can. It is the smallpox in a purer form than that which has been current among us for twelve centuries past." And, in a letter to Mr. Pruen, "I have ever considered the variola and the vaccine radically and essentially the same. As the inoculation of the former has been known to fail, in instances so numerous, it would be very extraordinary if the latter should always be exempt from failure. It would tend to invalidate my early doctrine on this point."
It is not necessary here to dwell upon the fatality of the smallpox when taken in the natural way, or to show that the mortality has been increased by the practice of inoculation, which creates an atmosphere for the constant propagation of the disease; these have been satisfactorily demonstrated in evidence before the House of Commons, and anyone may readily obtain this information. It is, however, interesting to record the names of those who, abandoning all prejudice and solicitous to promote a general good, submitted to the practice at its earliest period. Mr. Henry Hicks was the first to submit his own children to the vaccination. Lady Frances Morton (Lady Ducie) was the first personage of rank who had her child, and her only child, vaccinated. The Countess of Berkeley was instrumental in forwarding it; and the children of King William IV were vaccinated by Mr. Knight.
Jenner's discovery entailed upon him a most extensive correspondence, and obliged him frequently to travel in London. His professional engagements were not only interrupted, but almost annihilated, and his private fortune encroached upon by such circumstances. His friends urged an application to Parliament. A petition to Parliament was presented on March 17, 1802, and Mr. Addington—later, Lord Sidmouth—informed the House that he had taken the King's pleasure on the contents of the petition and that His Majesty recommended it strongly to the consideration of Parliament. A committee was appointed, of which Admiral Berkeley was the chairman. A great mass of evidence was brought forward, and many professional and other persons examined. The Duke of Clarence gave his testimony, and manifested strongly his conviction of the prophylactic powers of the vaccine disease. Much opposition was offered to the claims of Jenner. He felt this deeply, and in a letter to his friend Mr. Hicks, dated April 28, 1802, he writes: "I sometimes wish this business had never been brought forward. It makes me feel indignant to reflect that one who has, through a most painful and laborious investigation, brought to light a subject that will add to the happiness of every human being in the world, should appear among his countrymen as a supplicant for the means of obtaining a few comforts for himself and family."
The committee reported, and the House voted ten thousand pounds to Doctor Jenner. An amendment, proposing twenty thousand pounds, was lost by a majority of three! Sir Gilbert Blane, Doctor Lettsom, and others, feeling the utter inadequacy of this reward to the merits of the case, proposed to raise a fund by public subscription; but it was not carried into effect.
The Royal Jennerian Society was established in 1803, and had the King for the patron, the Queen for the patroness, and various members of the royal family and nobility for its supporters. The design of the institution was to vaccinate the poor gratuitously, and supply virus to all parts of the world. It effected great good, and reduced the number of deaths by smallpox in a very remarkable degree. But dissensions sprang up, chiefly through the conduct of the resident inoculator recommending practices contrary to the printed regulations of the society, and it was virtually dissolved in 1806.
Lord Henry Petty—later, Marquis of Lansdowne—was the chancellor of the exchequer in 1806, and on July 2d brought the subject of vaccination again before the House of Parliament. Upon this, the College of Physicians was directed to make inquiry into its state and condition, and a report was made on April 19, 1807. The report was highly satisfactory as to the advantages of the practice. On July 29th the Right Honorable Spencer Perceval,[47] being then chancellor of exchequer, called the attention of the House to it, and moved an additional grant of ten thousand pounds, when an amendment to double the sum was proposed by Mr. Edward Morris, M.P. for Newport, in Cornwall, and carried by a majority of thirteen. In 1808 the "National Vaccine Establishment" was formed, where the practice of vaccination and the supply of lymph has ever since been continued.
Foreign academies and societies enrolled Doctor Jenner in the lists of their associates, and the medical societies of his own country were not less anxious to adorn their roster with his name. In 1808 he was elected a corresponding member of the National Institute, and in 1811 was chosen an associate, in place of Doctor Mackelyne, deceased. The Empress Dowager of Russia sent him a diamond ring, accompanied by a letter in testimony of her admiration of vaccination. She had the first child vaccinated in Russia named "Vaccinoff," and fixed a pension upon it for life. The Medical Society of London presented him with a gold medal; the Physical Society of Guy's Hospital instituted a new order of members, under the title of "Honorary Associates," and named Jenner for the first; the nobility and gentry of Gloucestershire presented him with a handsome gold cup; and various other marks of consideration were bestowed upon him as testimonies to the benefits he had conferred upon mankind. He was chosen mayor of his native town; received the freedom of the corporation of Dublin; the freedom of the city of Edinburgh; and elected an honorary fellow of the Royal College of Physicians of that city. In 1813 the University of Oxford granted him a degree of Doctor in Physic, by a decree of the convocation. The diploma was presented him by Sir C. Pegge and Doctor Kidd, the professors of anatomy and chemistry. On this occasion—and a similar honor had not been conferred by the university on any man for nearly seventy years before—Doctor Jenner observed, "It is remarkable that I should have been the only one of a long line of ancestors and relations who was not educated at Oxford. They were determined to turn me into the meadows, instead of allowing me to flourish in the groves of Academus. It is better, perhaps, as it is, especially as I have arrived at your highest honors without complying with your ordinary rules of discipline." The conduct of the London College of Physicians, it is painful to remark, was not characterized by such liberality. The majority of the fellows refused to admit him without the usual examination. Many of the fellows were anxious upon the subject, but their wishes did not prevail.
The commander-in-chief of the army, upon the recommendation of the Army Medical Board and the Lords of the Admiralty, recommended the adoption of vaccination in the army and navy, and the naval physicians and surgeons presented a gold medal to Jenner for his discovery. The practice extended itself through France, Germany, Italy, Spain, Russia, and the United States. In the East, it overcame even the scruples of the Hindu and the Chinese. The writer of this memoir, by the kindness of Sir George Staunton, is in possession of a treatise on vaccination drawn up by Mr. Pearson and translated by Sir George into the Chinese language. It was of great use in encouraging the natives to the adoption of the salutary practice. The King of Prussia submitted his own children to vaccination. He was the first monarch to do so.
On September 13, 1815, Doctor Jenner lost his wife. He retired to Berkeley, and thereafter lived in retirement. He died January 26, 1823, in the seventy-fourth year of his age, and was buried on February 3d in the chancel of the parish church of Berkeley.