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Edward Jenner's Cowpox Vaccine:
The History of a Medical Myth order this bookPeter Razzell Price £30.00  Bernard Dixon World Medicine"What did Jenner do?": "Edward Jenner is remembered as the pioneer of vaccination, the man who vanquished the terror of smallpox by immunizing people with material from a related disease, cowpox. The story has all the ingredients for a powerful portrait of the triumph of human ingenuity over natural adversity - meticulous experimentation over many years, initial hostility from a conservative profession, and an apparently dramatic decline in smallpox mortality after the adoption of vaccination. "... And yet, as anyone who has looked at all the circumstances of Jenner's work knows, the story is by no means as black and white as it is usually painted. "One of the best accounts of the evidence against a conventional interpretation of Jenners work was published a few years back by Dr. P. E. Razzell in the pages of Medical History . . . Razzell started from the neglected observation that variolation - the inoculation of crusts of dried variola pustules to produce smallpox immunity - was effective in gradually eliminating natural smallpox well before the advent of vaccination at the beginning of the nineteenth century... This happened in spite of an increase in the virulence of the disease. "Razzell reminds us that the only apparent advantage vaccination was that it seemed to cause fewer direct deaths. But he also points out that many of the fatalities attributed to inoculation were most likely due to the recipients having contracted smallpox before inoculation . . . and . . . inoculation created longer-lasting immunity than did vaccination - which was of considerable importance in a world in which smallpox posed a continual threat . . . It is . . . a convincing case and one with enormous practical consequences. "... The inoculators certainly knew that arm-to-arm transmission yielded a milder form of disease, and contemporary evidence shows that the virus could be attenuated to such a degree that only a single pustule arose at the inoculation site, none being produced elsewhere on the body. . Hence to the crux of the historical problem. Was the virus Jenner and his followers used for vaccination merely attenuated smallpox virus?" "On December 11th, 1799, Dr. Andre of Petworth in Sussex, wrote the following account of the cowpox vaccine which had been sent to him for his practice of vaccination: "'The matter sent from Brighton to Petworth produced a disease in every shape resembling smallpox: the time of sickening, the symptoms, the eruptions and their maturation were the same. The number inoculated was fourteen. Three of these were children at the breast; the number of eruptions in them was from three to twelve. The ages of the remaining eleven were from three to fourteen, and the numbers of eruptions from fifty to a thousand.' "An elderly woman visiting the house in which the children were isolated caught smallpox, infected her husband, and died soon afterwards of the disease. The vaccination of the children had been sponsored by Lord Egremont, one of the most influential early supporters of vaccination, and as a result of this incident, he became highly anxious about the reliability and safety of the new practice. Jenner, writing to meet these anxieties, explained the origin of the contamination of the vaccine, which in the first instance had been supplied by Dr. George Pearson: "'About a twelvemonth ago Dr. Woodville, physician to the Smallpox Hospital, procured some virus from a cow at one of the London milk farms, and inoculated with it several patients at the Smallpox Hospital. Fearful that the infection was not advancing properly in some of their arms he inoculated them (some on the third, others on the fifth day afterwards) with smallpox matter. Both inoculations took effect; and thus, in my opinion, a foundation was laid for much subsequent error and confusion . . . Dr. Pearson . . . was then, and had been, busily employed not only inoculating from this source, but in dispersing threads embued in the virus to various places in our own country, and to many parts of the Continent . . . In many places where the threads were sent a disease like mild smallpox frequently appeared; yet, curious to relate, the matter, after it had been used six or seven months, gave up the variolous character entirely and assumed the vaccine; the pustules declined more and more, and at length became extinct. I made a few experiments myself with this matter, and saw a few pustules on my first patients; but in my subsequent inoculations there were none.'" |