Oh, and I do hope you are all well...
This is most of an essay I wrote for my History Coursework, slightly altered and some things changed, it focuses on Edward Jenner (A man I must confess I am a fan of) who discovered (you could say) the smallpox vaccine. This man pioneered an invention that has saved so many lives, therefore he became the focus of my coursework, and receives what I can only describe as earned worship here...
In my essay..
Which took DAYS.
no.... WEEKS.
NO. MONTHS.
okay no, There I am just being dramatic.
In
1796 Edward Jenner pioneered the use of cowpox to vaccinate people against
smallpox, a lethal disease which caused ⅕ deaths in London that same year, and
described as the ‘the most terrible of all the
ministers of death’ by
Donald Hopkins. He was hailed a ‘hero’ for his discovery, and held
significance at this point in history, as he began preventing one of the most
prominent diseases in the 18th century. However his significance within public
health is debatable. He discovered and began
distributing the vaccine, which opened up a whole new avenue of medicine to be
investigated - the avenue of vaccinations. When the vaccine was in its early
stages of development he vaccinated the poor people of Berkeley (his town of
residence) without charge, saving lives from the beginning of its discovery to
1980 when it was declared eradicated. On the other hand, during the same time
period of Jenner’s advancements, many inroads were
made to modern medicine, and the government was also making serious
improvements to public health through legislation. Furthermore, Edward Jenner
is credited solely, despite the fact that evidence shows farmer Benjamin Jesty
had vaccinated his family in 1774 after realising that those who had been
infected with cowpox could not be infected with smallpox. Inoculation had also
been present in Britain from earlier in the 17th century, courtesy of Lady Mary
Wortley Montagu, who brought the procedure from Turkey, inoculation was also
the seed which Edward Jenner developed, using the theory of inoculation to
create the vaccination. Furthermore, the industrial revolution started around
the 1760’s, which could have had a huge impact
on public health, due to the higher earning rates, as could have the
national borders becoming effective in
quarantining after the Public Health Act of 1721, which was implemented to help
reduce the spread of diseases. Dr John Snow also had a prominent effect to
public health at the time, contributing to medicine when investigating cholera
and identifying it as a waterborne disease. In 1795 Alexander Gordon suggested
that fevers were infectious processes, this, along with Ignaz Semmelweis and
Thomas Watson resulted in hygiene being adopted in hospitals by the late 1800’s. Additionally, it is plausible to
argue that Edward Jenner was simply a result of the ‘enlightenment’ which
took over Europe in the 17th and 18th century, the ‘enlightenment’ focussed
on individualistic approaches instead of traditional approaches - this was a
very positive development, as the traditional approaches were what put people
at risk due to medieval practises and beliefs.
Smallpox
has plagued mankind from 430 BC where in Athens, it supposedly wiped out a
quarter of the Athenian army, along with Pericles and all his legitimate
children. These theories of smallpox existing so far in the past are not only
supported by examination of Egyptian mummies, but are sustained by numerous historical
accounts, documented by Thucydides or Diodorus, and Chinese and Indian medical
texts. Smallpox continued to deplete populations and disfigure survivors until
the 1700’s, where significant progress was
made. Inoculation had been carried out in China originally, where
they took matter from a smallpox scab and inserted it into a cut in the skin,
the person would then develop smallpox, but it would normally be a slightly
less severe case. This technique spread from China and reached Constantinople,
Turkey, where Lady Mary Wortley Montagu was living, due to her husband being
the Turkish Ambassador, as a smallpox survivor. She observed the procedure and
wrote to England telling those she knew about it, and brought it back to
England when she returned. The procedure of inoculation did reduce the
mortality rates - it was estimated by doctors at the time that the survival
rate of those who had been inoculated was 2%[[1]]. 'Facing the virtual certainty of catching severe, natural
smallpox, many risked inoculations and successful inoculations became rich' [[2]], e.g. Thomas Dimsdale in 1768 visited Russia and inoculated
Catherine the Great and was awarded £10,000, an annuity of £500 and was given
the title of Baron Dimsdale. The difficulty was that the smallpox inoculation
could still kill sometimes - George III's son Octavius died from an inoculating
in 1783. A safe alternative was needed. Edward Jenner, a doctor trained by John
Hunter, noticed a belief in Gloucestershire, that once interacting cowpox you
could not be infected with smallpox. He spent 5 years researching this theory,
discovering that there were at least three diseases under the name 'cowpox',
deciphering which disease provided immunity to smallpox. In 1796 he
'inoculated' James Phipps, an eight year old boy, with cowpox matter from Sarah
Nelmes, a milk maid. Six weeks later when exposed to smallpox Phipps did not
become infected with smallpox. After confirming his suspicions, he carried out
the same procedure on 23 other people to form a solid conclusion. The report
Jenner wrote to the Royal Society of London for Improving Natural Knowledge, of
which he had been elected a Fellow in 1788, with a report on what he had found.
It was rejected by the Royal Society, who ‘actually
saved his reputation’[3] due to the state that the
manuscript was in, it was ‘weak evidence and [had] unsupported ideas’[4] so would not have been
taken seriously by doctors or scholars at the time. In 1796 1/5 of deaths
in London were due to smallpox, it killed 1 in 3 city children and 20% or more
in highly populated areas. In the 18th century Berlin recorded a 2%
survival rate for children who contracted smallpox[5]. He waited and improved
his work, which lead to him publishing his findings in An
Inquiry Into the Causes and Effects of the Variolae Vaccinae, or Cowpox in 1798
at his own expense. William Woodville, physician to the Hospital
for Smallpox and Inoculation read Jenners’ report and set up his own version of
the study, using George Pearson to assist. ‘From the beginning it was a
disaster’[6] which meant that the
reputation of vaccination began to be tarnished before it had properly formed.
Jenner’s associates began a petition in 1802 for Jenner to be re-compensated
£10,000 for his expenses in developing the vaccine.
The compensation that
Jenner received was the first step the Government made towards improving public
health (in light of vaccines), the second was allowing the establishment of the
Vaccine Pock Institute. However the establishment of the Institute was led by
George Pearson, whose relationship with Jenner had soured due to Jenner
claiming, through the petition process, that he was the man who discovered the
benefits of cowpox. Pearson, appears to have been outraged, as he invited Jesty
down to London and commissioned a portrait that was hung in the Vaccine
Establishment to act as a constant reminder that Jenners’ reputation was
inflated. Pearson appears to have been one of the few people who attempted to
limit the credit Jenner received, as he was adamant in refuting the claim
Jenner had made and achieving credit for Jesty, where he believed it was
deserved. Parliament commissioned in total £30,000 pounds to open a vaccination
clinic, this was the beginning of the elimination of smallpox. In 1802 the
Jennerian Society was established, it performed vaccinations for free,
vaccinating 12,000 people in just two years.
Jenners procedure was
quickly travelled, and by 1803 Doctors in America were vaccinating the rich and
the poor alike, this is due to Thomas Jefferson, President of the USA at the
time, who received a letter from Jenner himself, explaining what he had
discovered. After reading the evidence, Thomas Jefferson ‘took an early part in
recommending it to [his] countrymen’[7] and stated to Jenner that
‘You have erased from the calendar of human afflictions one of its greatest’[8]. Thanks from the President
of the United States helps to demonstrate how pronounced Jenners achievement
was, and how it would make an indelible mark in history. King of Italy and
Emperor of the French Napoleon insisted that all his military who had not
previously suffered from smallpox be vaccinated in 1805, giving Jenner a medal
for his discovery. Universally Jenner was slowly gaining credit as the vaccine
was proved to be successful over and over again. In 1807 the Grand Duchy of
Hesse passed a law, making the vaccination obligatory, as did Bavaria, Denmark
passed a similar act in 1810[9]. Jenner gained worldwide recognition
for his discovery, receiving honours from Cities and Universities. A ring from
the Empress of Russia (Catherine the Great) after she herself was vaccinated,
and statues erected in his honour in many cities, including London and Tokyo. In
1852 Parliament in England passed an act deeming the smallpox vaccine
obligatory, this was one of the most important decisions made by Parliament for
the health of those who inhabited the United Kingdom, as it allowed the long
process of elimination to begin. The discrepancy of dates – Denmark in 1810 and
the UK in 1852 is worrying, as it makes Parliament look sceptical of Jenner,
but the credit he receives still demonstrates how much of an impact his
discovery was on the entire world. ‘Initially vaccines were considered a matter
of national pride and prestige. They quickly became integral to utilitarian and
public health notions of societal security, productivity, and protection[10]’.
Jenner receives a lot
more credit than is necessarily due, Lady Mary Wortley Montagu was the one who
introduced inoculation into Europe. She had suffered from smallpox herself, and
was disfigured as a result of this. After observing inoculation in Turkey she
had her son inoculation in 1718. At this point in time to be inoculation was
still regarded with uncertainty, so this was a bold move. Mr Maitland the
family doctor was asked to inoculate her daughter, who was four years old at
the time, in 1721. This was an outrageous act, as her husband was not even
aware of the procedure taking place until Lady Montagu wrote to him a week
after it had taken place. After writing to England Princess Caroline became
interested, but was not willing to risk inoculating her two daughters, an
alternative of convicted prisoners was suggested. Those who volunteered would
be pardoned of their crimes if they survived; six were chosen and all survived.
She then used six children from an orphanage charity program, all of which
survived. Only then would Princess Caroline agree to have her children
inoculated, which, when successful led to Lady Montagu and Princess Caroline
trying to raise awareness and increase the use of inoculation. Many people
found ways to oppose it, due to the 2% death rate that came hand in hand with providing
lifelong immunity to a threatening disease.
When inoculation
reached America Cotton Mather, a practising doctor at the time, began
inoculating. It was received almost violently, his house was bombed, he was
targeted but he continued. It could be argued that Cotton Mather deserves
credit, as he risked his life to attempt to remove the threat of a serious
disease. He inoculated 286 people, then smallpox returned to Boston and more
than half the entire population of Boston fell ill, increasing the mortality
rate to 15%. Of the 286 he inoculated 6 died, this falls in line with the
expected 2%, so in 1792 when smallpox re-emerged more than 8,000 people
volunteered to be inoculated. This shows how desperate people were to avoid
falling ill with smallpox, as it was a force to be reckoned with, those who
survived were likely to be disfigured, with large scars and even possibly
blind. Another example of the severe effect it could have is the 6,000 people
who died in Rome from smallpox epidemics between 1746 and 1754.
Inoculation became a
business of its own, many franchisers developed, but only one has really made
an indent on history. Richard Sutton and his son Daniel managed to become the
most sought for inoculator. They inoculated over 14,000 people in 1764 making a
fortune, additionally making serious progress within the actual procedure. They
challenged the current procedure, and changed it; only a shallow scratch was
made, and the smallpox pus was taken from someone who was suffering from a mild
case. This change helped to gain inoculation a more positive reputation.
Realistically, Edward
Jenners discovery was a product of all of the progress made, that began at the
Enlightenment. The Enlightenment was ‘A European intellectual movement of the
late 17th and 18th centuries emphasizing reason and individualism rather than
tradition’[11].
The reason and individualism that resulted caused people such as Edward Jenner
to come to the conclusion that he did.
Public health in
Britain in the 18th century was beyond appalling, public health care
was non-existent, the National Health Service had yet to be established and the
was no hygiene. Poverty came hand in hand with illness and disease, the shanty
houses of London being disgusting environments seething with disease. Disease
was everywhere, and there was little understanding of its source or cause. ‘In London, perhaps one in
five children died before their second birthday’[12] causing the birth rates
to be high, as survival was not guaranteed, this caused the population pyramids
from the 18th century to have wide bases – demonstrating the high
infant mortality rate. ‘In certain districts the infant mortality rate reached
75% of all births whenever epidemics struck’[13] indicating that children
were the most susceptible to illness, and therefore the ones who required the
most protection from epidemics if they struck, but there was no solution.
Evidence indicates that something changed, as from 1700-1739 the population
grew at an average annual rate of 0.3 percent, but from 1800-1839 it was
growing at an average annual rate of 1.45 percent. This shows a definite
change, but the causation is hard to distinguish.
There were frequent
Cholera outbreaks through Europe, especially between 1829 and 1851. John Snow
held a huge role in reducing the spreading of Cholera. In Lambeth, London,
between 1848 and 1849 there was a serious outbreak of Cholera, claiming over 1,618
waterfront residents[14]. Snow was the man who
discovered that Cholera was a water-borne disease, reaching this conclusion
after making the link between those who were inflicted with cholera and where
they sourced their water – those who were infected retrieved their water
directly from the Thames. In 1854 when another outbreak of Cholera occurred he
plotted the death on a map and formed a conclusion that the disease was coming
from the water pump on Broad Street[15]. He reported his findings
to the local council and the handle to the pump was removed and the death rate
declined steeply, but this could have been due to the fact that by this time
over three quarters of the population had fled the area due to the 616 people
who had died by this point around Broad Street. Snow revolutionised the
approach to the spread of Cholera, despite the Public Health Act passed in 1848
by Parliament promising ‘clean drinking water’ – which therefore should have
prevented the 1854 cholera outbreak, but didn’t.
In the 18th
century water was unclean, the source unknown and teaming with diseases. People
needed alternatives, so turned to Gin – it was pure and distilled hygienically
and most importantly cheap. The ‘Gin Craze’ began in the 1720’s and was so
cheap because corn prices were so low. By 1730 around 6000 of the houses in
London were selling gin openly to the public, in 1740 gin consumption had
reached an average of 6 gallons per person, and by 1750 over half the annual
corn harvest would go directly to gin production.[16] Many believed that the
dependence on gin would lead to a social crisis, so Parliament passed a number
of acts in the 1740’s and 1750’s to control and limit the selling of and
production spirits. The legislation installed by the parliament was a primitive
action that was the beginning of parliament noticing the lower classes and the
help they needed.
The legislation
demanding vaccination that was imposed in 1852, despite the fact it was needed,
was not taken seriously. Between 1852 and 1867 over 34,303 people died from
small pox. Then in 1872 Britain experienced the worst smallpox epidemic it had
ever seen, over 44,840 people died[17]. This was the reminder
the government needed to implement the obligatory vaccination, which had
already saved millions of lives, thanks to Edward Jenner.
According to data the population went from 6,045,008 in 1700
(estimate) to 35,026,108 in 1881. This dramatic change can be credited to a
number of things, but Roderick Floud and Donald McCloskey credit it to ‘medical
advances, especially the spread of the smallpox vaccine’[18] among
other reasons. The fact that the smallpox vaccination is specifically mentioned
simply demonstrates how impactual it was, yet realistically the effect is immeasurable
due to the number of other factors that were in play at the time. Despite this
evidence Edward Jenner is still credited for his discovery, gaining places in
books with people who risked their lives for science. Edward Jenner was a
product of the enlightenment, which produced free thinking, individual
scientists, many which had an impact on the 18th and 19th
century and even the modern day. Yet only Edward Jenner was given fame and
fortune (literally – he received £30,000 in total from Parliament). Overall,
the credit Jenner received was not over inflated for what he discovered, but
was exaggerated for the time period he lived in, because it overshadowed many
others that deserved appreciation for their discoveries.
[1]
Derrick Baxby - The End of Smallpox (History Today)
[2]
Derrick Baxby - The End of Smallpox (History Today)
[18] The Economic History of Britain since 1700 RODERICK FLOUD and
DONALD MCCLOSKEY - Cambridge University Press
If you have no desire to read then don't bother, I can ensure you that despite the fact it does contain some really thrilling stories, it also is not written in my usual way (so is a tad dry)
If you have in fact simply scrolled straight to the bottom and avoided all 3,300 words that is this essay then I hurrah you, as you clearly have better things to do...
Any way my chums, Au Revoir for now, see you soon!!
(I hope)
