Edward Jenner

The Vaccination Visionary

Rob Boddice

• Publisher: The History Press
• Year: 2015
• Print ISBN: 9780750961080
• eBook ISBN: 9780750966856
• Topic: Technology & Engineering
• Subtopic: Science & Technology Biographies
• Index: Technology & Engineering

Edward Jenner is a giant of modern medicine. Throughout history, smallpox had plagued humanity with disfigurement, blindness and death. It was an incurable blight, the suffering of which Jenner helped to end.

Surmising from the immunity of milkmaids that cowpox might be some defence against the ravages of smallpox, in 1793 he took some of the matter from a human case of cowpox and inserted it into the arm of a young boy. To test this, the first human-to-human vaccination, he subsequently inoculated the boy with smallpox itself, and found him to be immune from the disease. In 1979 smallpox was declared extinct.

In this concise biography, Rob Boddice tells the story of Jenner's life, his medical vision and his profound legacy. It is a story that encompasses revolutions in medical experimentation, public health provision and the prevention of other diseases, from anthrax to measles, but above all it highlights the profound impact that Jenner's vision has had upon humanity's battle against disease.

1

Going Cuckoo

But why think, why not try?

John Hunter, 17755

The popularity of natural historical observation in England reached a peak with the publication of Gilbert White’s The Natural History of Selborne in 1789. Jenner tapped into the popular mood, and assured himself a place of honour among scientific minds, by going cuckoo in 1788. In that year he finally published his ‘Observations on the Natural History of the Cuckoo’ in the Philosophical Transactions of the Royal Society, after more than a decade of thinking about it. The article capped years of ad hoc research in which Jenner observed, shot, collected, dissected and prepared. It is easy, perhaps, for the contemporary reader to see in Jenner’s rambling and scrambling among the hedgerows, looking for birds’ nests, a mark of amiable eccentricity. Yet Jenner was of a piece with many of his peers, who sought to explain the natural history of the phenomena around them by collecting, and often by killing, what they saw. Not only was his treatise accurate scientifically – it was the first to fully explain what happened to the ‘siblings’ of cuckoo chicks and why – it also tapped a rich vein of general interest.6 Jenner was a man of the moment.

The cuckoo research did not come out of nowhere. Jenner was Hunter’s country collector, doing experiments at his bidding and sending all manner of materials to London. Hunter wanted salmon, eels and cuckoos, and had an insatiable appetite for hedgehogs. Hunter once wrote to explain an experiment involving living bats, ‘if you catch any’.7 The ‘if’ was, undoubtedly, an imperative. Between them, they materially accelerated the disappearance of the bustard from England, its rareness even in the 1780s making Hunter all the more desirous of having one killed and sent. Jenner’s roaming of the countryside on his way to the homes of patients provided the ideal opportunity to fill his bags. His spoils went by the new mail coach service, which started in 1784 between Bristol and London, via Bath (and which must have exercised a high degree of tolerance with Jenner’s parcels). Mostly, Jenner’s preparations were already dead, but sometimes they were sent to Hunter alive. As early as 1773, Hunter commissioned Jenner to provide him observations on cuckoos and on the breeding of toads, congratulating him at the same time for his success with parsnips. Within days, Jenner sent him a cuckoo’s stomach by mail. Hunter demanded more, telling Jenner to start meddling with cuckoo eggs, placing them in different nests and keeping an account of his observations.

The research was anything but disciplined. Jenner, on his rounds, would stop to observe, shoot and collect. In his mid-twenties, Jenner was much more concerned with hedgehogs than with cuckoos, trying to find out (again at Hunter’s behest) what happened to their temperature at different times of year. Jenner’s work room at home must have been a forbidding place, as he beheaded and dissected one hedgehog after another; then cuckoos, rooks, swifts, martins, and later dogs, and the organs of cows, pigs, and, occasionally, people. Jenner was particularly interested in the sexual habits of various animals, and he carefully measured the size of the testes of many birds at different points in the season. Hunter set him about sexing eels.

Such enthusiasm for experimentation was not untypical for a young man of science, filled with Enlightenment principles. There were no ethical quandaries; only the pursuit of knowledge. This drive would come to be essential to the development of the vaccine, which employed children as Jenner’s experimental subjects. Jenner’s attitude towards the natural world was directed, shaped and commanded by Hunter. Any tendency to intellectual speculation was soon eliminated in favour of more practical methods. In a letter of 1775, Hunter made this perfectly clear:

I thank you for your Exp.t on the Hedge Hog; but why do you ask me a question, by the way of solving it. I think your solution is just; but why think, why not try the Exp.t Repeat all the Exp.t upon the Hedge Hog as soon as you receive this, and they will give you the solution.8

Jenner’s cuckoo research gives an indication of how his experimental instinct was developing; in particular, his determination to gather certain proof. Most of his observations were of cuckoos in the nests of hedge sparrows, but he also documented cuckoos being fed by other species. On one occasion he had the opportunity of seeing a cuckoo chick being fed by titlarks (pipits), which was a somewhat rare occurrence: ‘I saw the old birds feed it repeatedly, and, to satisfy myself that they were really Titlarks, shot them both, and found them to be so.’9

There ended the vagaries of speculation, and also lives of the titlarks, and probably that of the cuckoo as well. We might now recoil from such matter-of-fact killing, but Jenner’s time was not ours. Nature was then thought to be at the disposal of man, who had been nominated ‘Lord of the Creation’ by God. Creatures were placed on earth for the amusement and education of men, and to kill an animal for the sake of widening the scope of human knowledge was not a moral concern, but a scientific obligation. This outlook could take a local naturalist to extraordinary lengths. Perhaps the peak of Jenner’s willingness to do Hunter’s bidding concerned the acquisition of a porpoise. Hunter wanted one ‘for either Love or Money’. In early 1777, Jenner was alerted to a female porpoise – actually it was a bottle-nosed dolphin – swimming up the Severn with a calf. He shot both, and must have recruited many people to haul the carcases out of the river. Jenner’s account of this event, which he still recalled over forty years later, has a sensory quality and is filled with a kind of awe, but no sense of remorse or disgust. We might judge this harshly, but modern Western ethics and the sentiments that underlie them were not part of the emotional repertoire of the eighteenth century.

Hunter wanted the mammal ‘coarsely stripp’d & the bones put into a casket and sent’, which evidently happened, since it now resides in the Hunterian Museum at the Royal College of Surgeons in London. The calf was to be preserved whole if not too large. Almost giddy with excitement, Hunter was eager for Jenner to taste the porpoise’s milk, telling him exactly where to find the nipples. Hunter later asked him if the milk was sweet, imploring him to preserve some if he could. Even in 1819 Jenner could recall that the ‘milk was like that of the Alderney Cow’. Hunter wanted the breasts, the kidneys, the stomach and a piece of the intestines sent intact. All this Jenner did, bloodied to the elbows and relishing the chance to examine and dissect what he described as ‘very wonderful animals – they seem to be the human beings of the Ocean & wherever nature could humanize them compatibly with progressive motion & their apparatus for taking their food, she does it’.10 Notwithstanding the high place in nature accorded this class of animals, Jenner and Hunter were perfectly in accord with their era’s Enlightenment ideals of mastery over nature. To skeletonise a ‘whale’ was a major achievement.

Throughout the dolphin episode Hunter continually pressed Jenner to get on with the cuckoo work, but Jenner was about to experience a bump in the road that would slow his progress. For several months in 1778 the correspondence between the two men dried up, specifically after Hunter wrote to Jenner in July that he had heard about Jenner’s marriage to ‘a young Lady with a considerable fortune’.11 Hunter had hoped it was true, but alas Jenner was experiencing heartbreak. We do not know the details of the object of Jenner’s affections or the reasons for his love remaining unrequited, but at the end of September Jenner finally told Hunter of his disappointment. Hunter’s response is perhaps the best example of the nature of their relationship, which was at once tender and distant, friendly but clearly stratified. The mentor wrote to his disciple:

I own I was at a loss to account for your silence, and I am sorry at the cause. I can easily conceive how you must feel, for you have two passions to cope with viz that of being disappointed in love and that of being deserted, but both will wear out, perhaps the first soonest. I own I was glad, when I heard that you was married to a woman of fortune; ‘but let her go never mind her’. I shall employ you with Hedge Hogs.12

According to Baron, being occupied with hedgehogs was not an effective tonic, and Jenner suffered for some years over his loss. He wrote to his oldest local friend, Edward Gardner, some five years later, complaining of ‘constant fatigue’, not only of body, but also of mind. ‘Still the same dead weight hangs upon my heart’, he complained, describing a ‘stream of unhappiness’ that seemed ‘inexhaustible’.13 If Jenner was inconsolable, Hunter was insatiable, demanding eels, hedgehogs and, relentlessly, cuckoos.

In the process of working out the peculiar life course of the cuckoo, Jenner had cause to kill a great number of them. Hunter in particular pressed his protégé to mail them to London, in various states. Through such work, Jenner refined his skills in making anatomical displays, many of which were of cuckoos. Some of his avian preparations are to be found among the prized possessions of the Hunterian Museum. Hunter thanked Jenner for sending him a cuckoo’s stomach. He also wanted cuckoos’ eggs and nests – a nest with an egg, a nest with a young cuckoo, and a nest with an old cuckoo (as well as crows’ nests and magpies’ nests). Killing females at various points in the season, Jenner was able to dissect them and display them so as to demonstrate the cuckoo’s prodigious egg-laying capacities:

That the Cuckoo actually lays a great number of eggs, dissection seems to prove very decisively. Upon a comparison I had an opportunity of making between the ovarium, or racemus vitellorum, of a female Cuckoo, killed just as she had begun to lay, and of a pullet killed in the same state, no essential difference appeared … The appearance of one killed on the third of July was very different. In this I could distinctly trace a great number of the membranes which had discharged yokes into the oviduct; and one of them appeared as if it had parted with a yolk the preceding day.14

This morbid anatomy was part of Jenner’s proof. The cuckoo did not stay in England for long enough to rear its own young. By laying its eggs in other birds’ nests, it gained the capacity for the continuous production of eggs, just as with domesticated chickens whose eggs are collected daily. In Jenner’s estimation, nature had found a way for the cuckoo, briefly passing through English shores, to produce a great progeny.

Jenner killed and dissected the fauna about him yet also revered nature as an expression of God’s creation. There is no contradiction in this, even though it might be difficult for us to comprehend. Jenner was Romantic as were the times (though his poetry, of which much survives, leaves something to be desired). Death was part of nature. Jenner saw the object of his study, the young cuckoo, set about killing the other birds in the nest, designed by nature to eliminate all competition. In his paper for the Royal Society, Jenner commented on the balance in the natural order of things:

nature permits the young Cuckoo to make this great waste, yet the animals thus destroyed are not thrown away or rendered useless. At the season when this happens, great numbers of tender quadrupeds and reptiles are seeking provision; and if they find the callow nestlings which have fallen victims to the young Cuckoo, they are furnished with food well adapted to their peculiar state.15

In short, nature put everything in its place, for divine reasons. It was man’s place to seek to understand nature, the better to revere it. To kill and contrive with nature went hand in hand with curing ailments and mastering the art of survival.

Hunter’s sponsorship of Jenner’s cuckoo work cannot be underrated. Without Hunter’s repeated requests and guidance, Jenner probably would not have set about his systematic research. The final paper was sufficient to gain Jenner his entry into the Royal Society, becoming a fellow in early 1789. The letters FRS after a name carried a great weight of prestige and respectability, elevating the reputation of the bearer to a special rank of the medical and scientific elite. Nevertheless, Jenner would always remain on the fringes of the medical and surgical establishments. He did become a founder member, with Alexander Marcet and others, of the Medical and Chirurgical Society of London (1805), which would gradually evolve into the Royal Society of Medicine.16 At the time, however, it was a breakaway group from the Medical Society of London, and was not significant until later. Here we find a peculiar conflict in Jenner’s character: he was clearly possessed of a significant ambition and a need for recognition, but this need was balanced by a clear preference for the hedgerows of Gloucestershire, wherein lay his objects of study. Jenner felt the pull of London life and resisted. If he were to have fame, it would be chiefly by correspondence; if he were to have fortune, it would be ...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Introduction: The Jenner Legend
• 1 Going Cuckoo
• 2 A Brief History of Smallpox
• 3 Inspiration
• 4 Hero?
• 5 Villain?
• 6 Tragedy
• 7 Legacy
• Timeline
• Abbreviations
• Notes
• Further Reading
• Web Links
• Acknowledgements
• About the Author