E Doc Edward Jenner
E Doc Edward Jenner
E Doc Edward Jenner
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EDWARD JENNER
Jenner is often called "the father of immunology", and his work is said to have "saved more
lives than the work of any other human". In Jenner's time, smallpox killed around 10% of the
population, with the number as high as 20% in towns and cities where infection spread more
easily. In 1821, he was appointed physician extraordinary to King George IV, and was also
made mayor of Berkeley and justice of the peace. A member of the Royal Society, in the field
of zoology he was the first person to describe the brood parasitism of the cuckoo. In 2002,
Jenner was named in the BBC’s list of the 100 Greatest Britons.
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PERSONAL LIFE AND CAREER
Edward Jenner was born on 17 May 1749 in Berkeley, Gloucestershire, as the eighth
of nine children. His father, the Reverend Stephen Jenner, was the vicar of Berkeley, so
Jenner received a strong basic education.
In 1770, aged 21, Jenner became apprenticed in surgery and anatomy under
surgeon John Hunter and others at St George's Hospital, London. William Osler records that
Hunter gave Jenner William Harvey's advice, well known in medical circles (and
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characteristic of the Age of Enlightenment), "Don't think; try." Hunter remained in
correspondence with Jenner over natural history and proposed him for the Royal Society.
Returning to his native countryside by 1773, Jenner became a successful family doctor and
surgeon, practising on dedicated premises at Berkeley.
John Hunter
Jenner and others formed the Fleece Medical Society or Gloucestershire Medical
Society, so called because it met in the parlour of the Fleece Inn, Rodborough,
Gloucestershire. Members dined together and read papers on medical subjects. Jenner
contributed papers on angina pectoris, ophthalmia, and cardiac valvular disease and
commented on cowpox. He also belonged to a similar society which met in Alveston, near
Bristol.
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Jenner married Catherine Kingscote (died 1815 from tuberculosis) in March 1788. He
might have met her while he and other fellows were experimenting with balloons. Jenner's
trial balloon descended into Kingscote Park, Gloucestershire, owned by Anthony Kingscote,
one of whose daughters was Catherine.
University of St Andrews
Jenner was a Christian who in his personal correspondence showed himself quite
spiritual; he treasured the Bible. Some days before his death, he stated to a friend: "I am not
surprised that men are not grateful to me; but I wonder that they are not grateful to God for
the good which He has made me the instrument of conveying to my fellow
creatures". However, his contemporary Rabbi Israel Lipschitz in his classic commentary on
the Mishnah, the Tiferes Yisrael, wrote that Jenner was one of the "righteous of the nations",
deserving a lofty place in the World to Come, for having saved millions of people from
smallpox.
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HISTORY OF SMALLPOX AND VACCINATION
For many centuries, smallpox devastated mankind. In modern times we do not have to
worry about it thanks to the remarkable work of Edward Jenner and later developments from
his endeavours. With the rapid pace of vaccine development in recent decades, the historic
origins of immunization are often forgotten. Unfortunately, since the attack on the World
Trade Center on September 11, 2001, the threat of biological warfare and bioterrorism has re-
emerged. Smallpox has been identified as a possible agent of bioterrorism. It seems prudent
to review the history of a disease known to few people in the 21st century.
Edward Jenner is well known around the world for his innovative contribution to
immunization and the ultimate eradication of smallpox. Jenner's work is widely regarded as
the foundation of immunology—despite the fact that he was neither the first to suggest that
infection with cowpox conferred specific immunity to smallpox nor the first to attempt
cowpox inoculation for this purpose.
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Smallpox was introduced to Europe sometime between the fifth and seventh centuries
and was frequently epidemic during the Middle Ages. The disease greatly affected the
development of western civilization. The first stages of the decline of the Roman Empire
(AD 108) coincided with a large-scale epidemic: the plague of Antonine, which accounted
for the deaths of almost 7 million people. The Arab expansion, the Crusades, and the
discovery of the West Indies all contributed to the spread of the disease.
Unknown in the New World, smallpox was introduced by the Spanish and Portuguese
conquistadors. The disease decimated the local population and was instrumental in the fall of
the empires of the Aztecs and the Incas. Similarly, on the eastern coast of North America, the
disease was introduced by the early settlers and led to a decline in the native population. The
devastating effects of smallpox also gave rise to one of the first examples of biological
warfare (1, 7). During the French-Indian War (1754–1767), Sir Jeffrey Amherst, the
commander of the British forces in North America, suggested the deliberate use of smallpox
to diminish the American Indian population hostile to the British. Another factor contributing
to smallpox in the Americas was the slave trade because many slaves came from regions in
Africa where smallpox was endemic.
Smallpox affected all levels of society. In the 18th century in Europe, 400,000 people
died annually of smallpox, and one third of the survivors went blind. The symptoms of
smallpox, or the “speckled monster” as it was known in 18th-century England, appeared
suddenly and the sequelae were devastating. The case-fatality rate varied from 20% to 60%
and left most survivors with disfiguring scars. The case-fatality rate in infants was even
higher, approaching 80% in London and 98% in Berlin during the late 1800s.
The word variola was commonly used for smallpox and had been introduced by
Bishop Marius of Avenches (near Lausanne, Switzerland) in AD 570. It is derived from the
Latin word varius, meaning “stained,” or from varus, meaning “mark on the skin.” The
term small pockes (pocke meaning sac) was first used in England at the end of the 15th
century to distinguish the disease from syphilis, which was then known as the great pockes.
It was common knowledge that survivors of smallpox became immune to the disease.
As early as 430 BC, survivors of smallpox were called upon to nurse the afflicted. Man had
long been trying to find a cure for the “speckled monster.” During medieval times, many
herbal remedies, as well as cold treatment and special cloths, were used to either prevent or
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treat smallpox. Dr. Sydenham (1624–1689) treated his patients by allowing no fire in the
room, leaving the windows permanently open, drawing the bed clothes no higher than the
patient's waist, and administering “twelve bottles of small beer every twenty-four hours”.
However, the most successful way of combating smallpox before the discovery of
vaccination was inoculation. The word is derived from the Latin inoculare, meaning “to
graft.” Inoculation referred to the subcutaneous instillation of smallpox virus into nonimmune
individuals. The inoculator usually used a lancet wet with fresh matter taken from a ripe
pustule of some person who suffered from smallpox. The material was then subcutaneously
introduced on the arms or legs of the nonimmune person. The
terms inoculation and variolation were often used interchangeably. The practice of
inoculation seems to have arisen independently when people in several countries were faced
with the threat of an epidemic. However, inoculation was not without its attendant risks.
There were concerns that recipients might develop disseminated smallpox and spread it to
others. Transmission of other diseases, such as syphilis, via the bloodborne route was also of
concern.
Variolation came to Europe at the beginning of the 18th century with the arrival of
travelers from Istanbul. In 1714, the Royal Society of London received a letter from Emanuel
Timoni describing the technique of variolation, which he had witnessed in Istanbul. A similar
letter was sent by Giacomo Pilarino in 1716. These reports described the practice of
subcutaneous inoculation; however, they did not change the ways of the conservative English
physicians.
It was the continued advocacy of the English aristocrat Lady Mary Wortley
Montague that was responsible for the introduction of variolation in England. In 1715, Lady
Montague suffered from an episode of smallpox, which severely disfigured her beautiful face.
Her 20-year-old brother died of the illness 18 months later. In 1717, Lady Montague's
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husband, Edward Wortley Montague, was appointed ambassador to the Sublime Porte. A few
weeks after their arrival in Istanbul, Lady Montague wrote to her friend about the method of
variolation used at the Ottoman court. Lady Montague was so determined to prevent the
ravages of smallpox that she ordered the embassy surgeon, Charles Maitland, to inoculate her
5-year-old son. The inoculation procedure was performed in March 1718. Upon their return
to London in April 1721, Lady Montague had Charles Maitland inoculate her 4-year-old
daughter in the presence of physicians of the royal court.
After these first professional variolation procedures, word of the practice spread to
several members of the royal family. Charles Maitland was then granted the royal license to
perform a trial of variolation on six prisoners in Newgate on August 9, 1721. The prisoners
were granted the king's favour if they submitted to this experiment. Several court physicians,
members of the Royal Society, and members of the College of Physicians observed the trial.
All prisoners survived the experiment, and those exposed to smallpox later proved to be
immune. In the months following this very first trial, Maitland repeated the experiment on
orphaned children, again with success. Finally, on April 17, 1722, Maitland successfully
treated the two daughters of the Princess of Wales. Not surprisingly, the procedure gained
general acceptance after this last success.
Jenner's interest in the protective effects of cowpox began during his apprenticeship
with George Harwicke, it was 1796 before he made the first step in the long process whereby
smallpox, the scourge of mankind, would be totally eradicated. For many years, he had heard
the tales that dairymaids were protected from smallpox naturally after having suffered from
cowpox. Pondering this, Jenner concluded that cowpox not only protected against smallpox
but also could be transmitted from one person to another as a deliberate mechanism of
protection. In May 1796, Edward Jenner found a young dairymaid, Sarah Nelms, who had
fresh cowpox lesions on her hands and arms.
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Cowpox lessions in Sarah Nelms
On May 14, 1796, using matter from Nelms' lesions, he inoculated an 8-year-old boy,
James Phipps. Subsequently, the boy developed mild fever and discomfort in the axillae.
Nine days after the procedure he felt cold and had lost his appetite, but on the next day he
was much better. In July 1796, Jenner inoculated the boy again, this time with matter from a
fresh smallpox lesion. No disease developed, and Jenner concluded that protection was
complete.
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Jenner's discovery of the link between cowpox pus and 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, 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 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 was discredited during Jenner's lifetime. He then
presented the hypothesis that infection with cowpox protects against 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.
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resistance to smallpox or to variolation among persons who had cowpox. The results of this
survey confirmed his theory. Despite errors, many controversies, and chicanery, the use of
vaccination spread rapidly in England, and by the year 1800, it had also reached most
European countries.
DEATH
Jenner was found in a state of apoplexy on 25 January 1823, with his right side
paralysed. He did not recover and died the next day of an apparent stroke, his second, on 26
January 1823, aged 73. He was buried in the family vault at the Church of St Mary,
Berkeley. He was survived by his son Robert Fitzharding (1797–1854) and his daughter
Catherine (1794–1833), his elder son Edward (1789–1810) having died of tuberculosis at age
21.
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MONUMENTS AND BULIDINGS
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Dr Jenner’s house
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A ward at Northwick Park Hospital is called Jenner Ward.
Jenner Gardens at Cheltenham, Gloucestershire, opposite one of the scientist's
former offices, is a small garden and cemetery.
A statue of Jenner was erected at the Tokyo National Museum in 1896 to
commemorate the centenary of Jenner's discovery of vaccination.
A monument outside the walls of the upper town of Boulogne sur Mer, France.
A street in Stoke Newington, north London: Jenner Road, N16 51.55867°N
0.06761°W.
Built around 1970, The Jenner Health Centre, 201 Stanstead Road, Forest Hill,
London, SE23 1HU.
Edward Jenner's name is featured on the Frieze of the London School of Hygiene
& Tropical Medicine. Twenty-three names of public health and tropical medicine
pioneers were chosen to feature on the Keppel Street building when it was
constructed in 1926.[68]
Minor planet 5168 Jenner is named in his honour.
PUBLICATIONS
1798 An Inquiry into the Causes and Effects of the Variolae Vaccinae.
1799 Further Observations on the Variolae Vaccinae, or Cow-Pox.
1800 A Continuation of Facts and Observations relative to the Variolae
Vaccinae 40pgs.
1801 The Origin of the Vaccine Inoculation.
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CONCLUSION
Jenner's work represented the first scientific attempt to control an infectious disease by
the deliberate use of vaccination. During the past years, there has been a growing recognition
of Benjamin Jesty (1737–1816) as the first to vaccinate against smallpox. When smallpox
was present in Jesty's locality in 1774, he was determined to protect the life of his family.
Jesty used material from udders of cattle that he knew had cowpox and transferred the
material with a small lancet to the arms of his wife and two boys. The trio of vaccinees
remained free of smallpox, although they were exposed on numerous occasions in later life.
Benjamin Jesty was neither the first nor the last to experiment with vaccination. In fact, the
use of smallpox and cowpox was widely known among the country physicians in the dairy
counties of 18th-century England. However, the recognition of these facts should not
diminish our view of Jenner's accomplishments. It was his relentless promotion and devoted
research of vaccination that changed the way medicine was practiced. Late in the 19th
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century, it was realized that vaccination did not confer lifelong immunity and that subsequent
revaccination was necessary. The mortality from smallpox had declined, but the epidemics
showed that the disease was still not under control. In the 1950s a number of control
measures were implemented, and smallpox was eradicated in many areas in 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, a global campaign was begun under the guardianship of
the World Health Organization and finally succeeded in the eradication of smallpox in 1977.
On May 8, 1980, the World Health Assembly announced that the world was free of smallpox
and recommended that all countries cease vaccination: “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 Edward Jenner performed his first vaccination on James Phipps have proved him
to be more right than wrong. The germ theory of disease, the discovery and study of viruses,
and the understanding of modern immunology tended to support his main conclusions. The
discovery and promotion of vaccination enabled the eradication of smallpox: this is Edward
Jenner's ultimate vindication and memorial.
REFERENCES
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/
2. https://www.historyofvaccines.org/content/jenner
3. https://www.britannica.com/biography/Edward-Jenner
4. https://en.wikipedia.org/wiki/Edward_Jenner
5. https://www.vbivaccines.com/wire/edward-jenner-and-the-first-modern-vaccine/
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