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Edward Jenner (1749 – 1823)

Life:

Edward Jenner was an English doctor and a pioneer of small pox vaccine. Jenner was also known as the father of immunology and his work is said to have "saved more lives than the work of any other human"

Edward Jenner was born in Berkeley, Gloucestershire on 17th May, 1749 to Rev. Stephen Jenner, rector of Rockhampton and vicar of Berkeley, and Sarah, daughter of the Rev. Henry Head, a former vicar of Berkeley.   Rev. Jenner owned land and was considered to be minor country gentry.  Edward was the eighth of nine children and the fourth son.  Only five of Edward’s siblings survived childhood.  In 1754, when Edward was just five years old, both his parents died within a few weeks of each other and he came under the guardianship of his elder brother, Stephen Jenner, who had succeeded their father as rector of Rockhampton.

In March 1788 Edward married Catherine Kingscote of Kingscote near Berkeley. They had three children – two sons and a daughter.  They had a happy married life although Catherine suffered from tuberculosis and consequent ill health.  Ill health plagued many members of the Jenner family.  In 1810, his oldest son, Edward, died of tuberculosis.  His sister, Mary, died the same year and his sister, Anne, two years later.  In 1815, his wife, Catherine, also died of tuberculosis.

On 23 January 1823, he visited his last patient, a dying friend. The next morning Jenner failed to appear for breakfast and was found in his study suffering from a massive stroke from which he never recovered.  Edward Jenner died during the early hours of 26th January 1823.  He was laid to rest with his parents, his wife, and his son near the altar of the church at Berkeley.

Education & Work:

Jenner received his first schooling from the Rev. Mr. Clissold at the nearby village of Wotton-under-Edge.  Later, he was sent to a grammar school at Cirencester.   Jenner was inoculated for smallpox at school.  This had a lifelong effect on his health.  Edward developed a strong interest in science and nature that continued throughout his life.

In 1763, Jenner was apprenticed to Daniel Ludlow, a country apothecary in Sodbury, near Bristol.  In 1764, he began his apprenticeship with George Harwicke, a local surgeon. During these years, he acquired a sound knowledge of surgical and medical practice.  In 1770, Jenner moved to St George’s Hospital, London to complete his medical training under the legendary surgeon, John Hunter.  In 1772 Jenner returned to Berkeley to become a medical practitioner. He was offered a partnership by Hunter, but did not take up this opportunity.

In 1792, with twenty years' experience of general practice and surgery, Jenner obtained an MD degree from St Andrews University.  To get this qualification he only required recommendations from two reputable doctors and his colleagues Caleb Parry and John Hickes acted for him.  Now able to style himself physician and surgeon, Jenner left most general practice matters to his nephew and assistant, Henry Jenner, and took on the role of consultant.  From 1795 he established a second home in Cheltenham where well-to-do patients of his London colleagues could consult him when they visited the fashionable spa.

He belonged to two local medical societies ostensibly for the promotion of medical knowledge - the ‘medico-convivial’ society that he co-founded in 1788 and the ‘convivio-medical’ society that met at The Ship Inn, Alveston.  Jenner was interested in a variety of issues - he studied geology and carried out experiments on human blood.   In 1793, Joseph Montgolfier held public demonstrations of the hot air and hydrogen balloons in France.  In 1794, Jenner built and twice launched his own hydrogen balloon that flew for 12 miles.

Jenner and Hunter maintained a lively correspondence, until Hunter's death in 1793.  Jenner was encouraged to undertake a variety of anatomical and physiological experiments.   It was at Hunter's suggestion that Jenner conducted a study of the cuckoo. It was commonly believed 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 behaviour.  In 1788 Jenner published his research paper concluding that it was the newly hatched cuckoo that ejected the foster parents' eggs and nestlings from the nest.  Many naturalists in England dismissed his work as pure nonsense.  For more than a century many who were against vaccinations used the supposed defect of the cuckoo study to cast doubt on Jenner’s other work. Jenner was finally vindicated in 1921 when photography confirmed his observation.

After a decade of being honoured and reviled in more or less equal measure, Jenner gradually withdrew from public life and returned to the practice of country medicine in Berkeley.  Apart from his studies in London, Jenner remained in Berkeley virtually all his life, living in ‘Chauntry Cottage’ that he bought in 1785.  Jenner built a one-room hut in the garden of his cottage that he called the “Temple of Vaccinia” where he vaccinated the poor for free.

Jenner and Smallpox Vaccination:

Like any other doctor of the time, Edward Jenner carried out variolation to protect his patients from smallpox.  This and his own experience of variolation as a boy (and the risks that accompanied it) led him to undertake the most important research of his life.

Cowpox is a mild viral infection of cows.  It causes a few weeping spots (pocks) on their udders, but little discomfort.  It was observed that milkmaids occasionally caught cowpox from the cows.  Although they felt rather off-colour for a few days and developed a small number of pocks, usually on the hand, the disease did not trouble them.   Edward Jenner had been intrigued by country-lore that people who caught cowpox from their cows would not get smallpox.   He had observed that there were different types of pocks, but exposure to only one of them prevented the smallpox infection.  Jenner called this  type“true cowpox.”  He subsequently found that even true cowpox conferred immunity against smallpox only when matter was taken from the cowpox pustules whilst they were fresh.  Jenner thought mistakenly that true cowpox was identical to the horse foot disease known as “grease” and that the pox was carried from horses to cattle on the hands of milkmen who also cared for horses.  He also believed 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.

In 1796, Jenner carried out his now famous experiment on 8 year old James Phipps. Jenner inserted pus, taken from a cowpox pustule, into an incision on the boy's arm. He was testing his theory that milkmaids who suffered the mild disease of cowpox never contracted smallpox, one of the greatest killers of the period, particularly among children. Jenner subsequently proved that having been inoculated with cowpox Phipps was immune to smallpox.

In 1797, Jenner sent a short communication to the Royal Society describing his experiment and observations. However, the paper was rejected. Then in 1798, having added a few more cases to his initial experiment including his eleven-month old son, Jenner privately published a small booklet entitled ‘An Inquiry into the Causes and Effects of the Variolae Vaccinae, a Disease Discovered in Some of the Western Counties of England, particularly Gloucestershire and Known by the Name of Cow Pox’. The Latin word for cow is vacca, and cowpox is vaccinia.  Jenner therefore decided to call this new procedure vaccination.

The 1798 publication had three parts. In the first part Jenner presented his view regarding the origin of cowpox as a disease of horses transmitted to cows. The theory however was discredited during Jenner's lifetime. He then presented the hypothesis that being infected with cowpox prevents subsequent infection with smallpox. The second part contained the critical observations relevant to testing the hypothesis. The third part was a lengthy discussion, in part polemical, of the findings and a variety of issues related to smallpox. The publication of the Inquiry was met with a mixed reaction in the medical community.

Jenner conducted a nationwide survey in search of proof of resistance to smallpox or to variolation among persons who had cowpox. The results of this survey confirmed his theory.  Jenner went to London in search of volunteers for vaccination. However, after 3 months he had found none.  People were initially fearful of the possible consequences of receiving material originating from cows and opposed vaccination on religious grounds.  It was considered as bestiality to be treated with substances originating from God's lowlier creatures. Variolation was also forbidden by an Act of Parliament.

Vaccination slowly gained popularity through the activities of others like surgeon Henry Cline, Dr.George Pearson and Dr. William Woodville who started vaccinating their patients.  The extraordinary value of vaccination was publicly acknowledged in England when in 1802, the British Parliament granted Edward Jenner the sum of £10,000.  Five years later, Parliament awarded him a further £20,000.  Jenner not only received honours but also found himself subjected to attacks and ridicule.  Despite all this, he continued to be a passionate advocate of the vaccination programme.

Although he received worldwide recognition and many honors, Jenner made no attempt to enrich himself through his discovery.  Edward Jenner spent much of the rest of his life supplying cowpox material to others around the world and discussing related scientific matters.  He was so involved in corresponding about smallpox that he called himself 'the Vaccine Clerk to the World'.  He actually devoted so much time to the cause of vaccination that his private practice and his personal affairs suffered severely.

Honours and Recognition

Ø  In Jenner’s honour, the technique of introducing material under the skin to produce protection against disease became universally known as vaccination.

Ø  Jenner was elected to the Royal Society in 1788.

Ø  Jenner received the freedom of many cities - London, Glasgow, Edinburgh and Dublin.

Ø  Honorary degrees and memberships were conferred on him from around the world.

Ø  He received recognition in France from Napoleon whose entire army was vaccinated.

Ø  He received gifts from famous people.  Napoleon honoured him by minting a special medal in 1804.  The Empress of Russia gifted him a ring.  North American Indian Chiefs gifted a belt of Wamum beads and a certificate of gratitude.

Ø  There are many statues of Jenner across the world. The most well-known statue by Robert William Sievier, was erected in Gloucester Cathedral.  Another statue was erected in Trafalgar Square in London but later moved to Kensington Gardens.  St George’s Medical School in London has a bust of Jenner in the Jenner Pavillion.  The most famous statue of Jenner is at the Modern Art Gallery in Genoa Nervi.  It is a marble statue by Monteverde depicting Jenner vaccinating his son.  Bronze copies of this are also displayed at the Wellcome Institute in London and the Modern Art Gallery in Rome.  In 1865, a statue of Jenner was erected in his honour in Boulogne sur Mer in France.  The National Society of Hygiene of Japan erected a statue of Jenner in the gardens of the National Museum in Tokyo.

Ø  Gloucestershire Royal Hospital and Northwick Park Hospital in London have wards named after Jenner.

Ø  Jenner's house in the village of Berkeley, Gloucestershire, is now a small museum, housing, among other things, the horns of the cow, Blossom.  Near the Gloucestershire village of Uley, Downham Hill is locally known as "Smallpox Hill" for its possible role in Jenner's studies of the disease.

Ø  Early 19th century English settlers in the USA gave Jenner’s name to many townships.

Inoculation (Variolation), Vaccination and Immunisation

Inoculation is the method of purposefully infecting a person with an organism in a controlled manner in order to minimise the severity of the infection and also to induce immunity against further infection.

Vaccination is the process of administering weakened or dead pathogens to a healthy person, with the intent of conferring immunity against a targeted form of a related disease agent.  Late in the 19th century, it was realized that vaccination did not confer lifelong immunity and that subsequent revaccination was necessary.

Immunization is a general term for the process by which an individual is exposed to an agent that is designed to fortify his or her immune system against that agent.  Immunization is the same as inoculation and vaccination in that they both use a viable infecting agent.  The process of administering the organism makes the difference between inoculation and vaccination.

Development of Vaccination

Before the introduction of a vaccine, the mortality from the severe form of smallpox was about 35% in some outbreaks.  Historical records show that a method of inducing immunity was already known.  It is said that inoculation, also known as insufflation or variolation was practiced in India as early as 1000 BC. However this is disputed by many as the ancient Sanskrit medical texts of India do not describe these techniques.  The first clear reference to smallpox inoculation was made by the Chinese author Wan Quan (1499–1582) in his ‘Douzhen xinfa’ published in 1549.  In China, powdered smallpox scabs were blown up the noses of the healthy.  The patients would then develop a mild case of the disease and from then on were immune to it. The technique did have a 0.5 - 2.0% mortality rate.  Variolation was also practiced throughout the latter half of the 17th century by physicians in Turkey, Persia, and Africa. In 1714 and 1716, two reports of the Ottoman Empire’s Turkish method of inoculation were made to the Royal Society in England, by Emmanuel Timoni, a doctor affiliated with the British Embassy in Constantinople and Giacomo Pylarini.

Lady Mary Wortley Montagu, wife of the British ambassador to Ottoman Constantinople, is widely credited with introducing the process to Great Britain in 1721.  She discovered the local practice of inoculation against smallpox called variolation and had her son variolated with no ill effects.  She returned to London and had her daughter variolated during a smallpox epidemic. This encouraged the British Royal Family to take an interest and a trial of variolation was carried out on prisoners in Newgate Prison. This was successful and in 1722 two of the daughters of Caroline of Anspach, Princess of Wales, were inoculated. The success of these variolations assured the British people that the procedure was safe.

The Eradication of Smallpox:

Although the mortality from smallpox had declined, epidemics until 1950 showed that the disease was still not under control.  In the 1950’s a number of control measures were implemented, and smallpox was eradicated in many areas of Europe and North America. The process of worldwide eradication of smallpox was set in motion when the World Health Assembly received a report in 1958 of the catastrophic consequences of smallpox in 63 countries.

In 1967 the World Health Organization (WHO) launched its campaign to eradicate smallpox worldwide. They estimated, at that time, that there were still up to 15 million cases of smallpox each year. The biggest problem areas were South America, Africa and the Indian subcontinent.  Their approach was to vaccinate every person in the areas at risk.  Teams of vaccinators from all over the world journeyed to the remotest of communities.  After a period of checking for new cases, in 1980, the WHO formally declared: "Smallpox is Dead! The world and all its people have won freedom from smallpox, which was the most devastating disease sweeping in epidemic form through many countries since earliest times, leaving death, blindness and disfigurement in its wake”.

The most feared disease of all time had been eradicated, fulfilling a prediction that Edward Jenner had made in 1801. It has been estimated that the task he started has led to the saving of more human lives than the work of any other person.  The last remaining specimens of the smallpox virus are now held in just two laboratories, in Siberia and the USA. The samples, used for research, are afforded higher security than a nuclear bomb. One day they too will be destroyed. Smallpox will have become the first major infectious disease to be wiped from the face of the Earth.


Divya Bala - (Member-in-charge of People and Places)

Chan Badrinath (Sub-Editor)

Sources

http://www.jenner.ac.uk/edwardjenner

http://www.oxforddnb.com

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/

http://www.bbc.co.uk/history/historic_figures/jenner_edward.shtml

http://www.jennermuseum.com/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1295916/pdf/jrsocmed00051-0040.pdf

Stefan Riedel, MD, PhD (January 2005). Edward Jenner and the history of smallpox and vaccination.

Baxby, Derrick. "Jenner, Edward (1749–1823)". Oxford Dictionary of National Biography.

 "About Edward Jenner". The Jenner Institute.