TAKE YOUR BEST SHOT, Edward Jenner

I look at her face, and honestly, I just don't see whatever it was that captured his heart. They had the ultimate Age of Enlightenment cute-meet, but where he was a 38 year old endlessly curious bon vivant sociable genius, a doctor, a scientist and a poet, she had few friends and her only interest was religion. And at the age of 27, Catherine Kingscote must have thought, as her down turned mouth seems to indicate (above) that she had missed her chance to find a suitable husband.

And then on a fair September afternoon, his balloon landed in a meadow near her home, and two years later she married one of the greatest men – ever . He was to be the man responsible for saving hundreds of millions of lives by applying the scientific method to an obvious problem. Clearly Catherine must have had a secret appeal. And Edward Jenner was smart enough to recognize it.

Edward Jenner started life with a few advantages. He was born wealthy, but not so rich he didn't have to work for a living, just rich enough he never cared more about money than about people. He never patented his great discovery, because he didn't want to add his profit to the cost of saving lives. And maybe that was Catherine's influence. And maybe it was the humanity he'd always had. And maybe it was because when he was still a child, his own father had inoculated him against small pox.

The two most deadly diseases in the 18^th century were the Great Pox (syphilis) and the Small Pox (Variola – Latin for spotted). Reading the genetic code of Variola hints it evolved within the last 50,000 years from a virus that infected rats and mice, and then moved on to horses and cows and then finally to infecting people. 

It disfigured almost all of its human victims, leaving their features scared and pockmarked, even blinding some survivors. It killed half a million people every year – and 80% of the children who were afflicted. The chink in Variola's protein armor was that it had evolved into two strains, one which preferred temperatures of around 99 degrees Fahrenheit before it started dividing, and the second which preferred something closer to 103 degrees.

They called the lesser of these two evils the cow pox, and sometimes the udder pox, because that was where the blisters often showed up on infected milk cows. And it was the young women whose job it was to milk the cows who were the only humans who usually contracted the cow pox. 

They would suffer a fever, and feel weak and listless for a day or two, and, in sever cases have ulcers break out on their hands and arms. But recovery was usually rapid and complete, and there was an old wife's tale that having once contracted cow pox, the women would never suffer the greater evil of smallpox.  It was mucus from a cow pox ulcer which Richard's father had applied to his son's open flesh, in the belief it would somehow protect him from smallpox.

The working theory behind this idea was first enunciated by the second century B.C. Greek doctor, Hippocrates. Its most succinct version was “Like cures like.” Bitten by a rapid dog? Drink a tea made from the hair of the dog that bit you, or pack the fur into a poultice pressed against the wound. The fifteenth century C.E. Englishman, Samuel Pepys, was advised to follow this theory by drinking wine to cure a hangover. “I thought (it) strange,” he wrote in his diary, “but I think find it true.” 

In 1765 London Doctor John Fewster published a paper entitled “Cow pox and its ability to prevent smallpox.” But he was just repeating the old wife's tale, and offered no proof of his own. So the idea was out there. It only waited for someone smart enough to put the obvious to a scientific test.

In early May of 1796, Sarah Nelms, a regular patient of Doctor Edwards, and “a dairymaid at a farmer's near this place”, came in with several lesions on her hand and arm. She reported cutting her finger on a thorn a few weeks previous, just before milking her master's cow, Blossom.  Upon examining both Sarah and Blossom,  Edward diagnosed them both as suffering from the cow pox. 

And he now approached his gardener, Mr. Phipps, offering to inoculate ( from the Latin inoculare, meaning “to graft") his 8 year old son James, against small pox. The gardener agreed, and on 14 May 1796 Edward cut into the healthy boy's arm, and then inserted into that cut some pus taken directly from a sore on Sarah Nelms' arm.

Within a few days James suffered a slight fever. Nine days later he had a chill and lost his appetite, but he quickly recovered. Then, in July, 48 days after the first inoculation, Edward made new slices on both of James' arms. This time he inserted scrapings taken directly from the pustules of a smallpox victim. And this time what should have killed the boy did not even give the child a fever.  Nor did he infect his two older brothers, who shared his bed. 

Over the next 20 years James Phipps would have pus from a small pox victims inserted under his skin twenty separate times. And not once did he ever contract the disease. He married and had two children. And when Edward Jenner died, James was a mourner at his funeral. The original boy who lived did not pass away until 1853, at the age of 65.

Edward Jenner (above) coined the word vaccine for his discovery, from the Latin 'vacca' for cow, as a tribute to poor Blossom, whose horns and hide ended up hanging on the wall of London's St George's medical school library. And that was the whole story, but, of course it wasn't, because it wasn't that simple, because nothing is that simple - certainly not the immune response system developed on this planet over the last four billion years, nor the stupidity of simple human beings.

Edward duplicated his procedure with nine more patients, including his own 11 year old son, and then wrote it all up for the Royal Society of London for Improving Natural Knowledge. And those geniuses rejected it. They refused to publish it because they thought his idea was too revolutionary, and still lacked proof. So Edward, convinced he was on the right track, redoubled his efforts. When he had 23 cases and the Society still refused to publicize his work, Edward self published, in a 1798 pamphlet entitled “An Inquiry Into the Causes and Effects of the Variolæ Vaccinæ, Or Cow-Pox”

By 1800, Edward Jenner's work had been translated and published world-wide. And a few problems were revealed. There was a small percentage of patients who had an allergic reaction at the vaccination sites, and eventually it would be decided not to inoculate very young children, as their immune systems were not yet strong enough to resist even the cow pox.

And without a fuller understanding of how the human immune system functioned, it was still impossible to know “to a medical certainty” (to use legal jargon) how the vaccine would affect specific patients. Still, the over all reaction was so positive that Edward was surprised by the reaction of the people he called the “anti-vaks”.

Opposition became centered on the Medical Observer, a supplemental publication by the daily newspaper, The Guardian.  After 1807, an under editor Lewis Doxat, it condemned Jenner's introduction of a “bestial humor into the human frame”. 

In 1808 its readers were assured they should presume “When the mischievous consequences of his vaccinating project shall have descended to posterity...Jenner shall be despised.” Edward was even accused of spreading Small Pox, for various evil reasons. 

The argument presented from the pulpit was that disease was the way God punished sin, and any interference by vaccination was “diabolical”.  

Under this barrage of fantasy and conspiracy the percentage of vaccinated children and adults in England still climbed up to around 76%.   But without 100% protection Variola found enough victims and survived. 

In January of 1902 there was yet another smallpox outbreak in England that killed more than 2,000 people.  But after that disaster, the doubters were finally silenced, at least in England, and vaccinations were required for all children.

About 500 million human beings world wide have died from Smallpox after Edward Jenner introduced his vaccine. But the last victim on earth was Rahima Banu, a 2 year old girl in Bangladesh, in 1975. At 18 she married a farmer named Begum, and they gave birth to four children (her again, below). And each of her children is living proof that while religion may save souls, science saves lives.  Science, not snake oil.

The scientists working for the World Health Organization issued a report on 9 December, 1979, which announced, “...the world and its people have won freedom from Smallpox.” Variola was finally extinct, wiped out to the last living cell, by the dedication of scientists and doctors and nurses working under their guidance. 

It was, as Jenner himself wrote after the first successful eradication of Smallpox on Caribbean islands, “I don’t imagine the annals of history furnish an example of philanthropy so noble, so extensive as this.” It is hard to believe there are still idiots today who question the value of vaccinations.   

Jenner's dear Catherine died of tuberculosis in 1815, and Edward followed her in January of 1823. And for his life – and her's – we all owe a great debt. He was like the bird in his poem “Address to a Robin”: “And when rude winter comes and shows, His icicles and shivering snows, Hop o'er my cheering hearth and be, One of my peaceful family: Then Soothe me with thy plaintive song, Thou sweetest of the feather'd throng!”

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