Tuesday, May 14, 2013

This Day in History: May 14, 1796: Edward Jenner administers the first smallpox vaccination

 

Edward Anthony Jenner, FRS (17 May 1749 – 26 January 1823) was an English physician and scientist from Berkeley, Gloucestershire, who was the pioneer of smallpox vaccine.[1] He is often called "the father of immunology", and his work is said to have "saved more lives than the work of any other man".[2][3][4]

 

Edward Jenner was born on 17 May 1749[5] (6 May Old Style) in Berkeley, as the eighth of nine children. His father, the Reverend Stephen Jenner, was the vicar of Berkeley, so Jenner received a strong basic education.[6]


Edward Jenner went to school in Wotton-under-Edge and Cirencester.[7] During this time he was inoculated for smallpox, which had a lifelong effect upon his general health.[7] At the age of 14 he was apprenticed for seven years to Mr Daniel Ludlow, a surgeon of Chipping Sodbury, South Gloucestershire, where he gained most of the experience needed to become a surgeon himself.[7]


In 1770, Edward Jenner became apprenticed in surgery and anatomy under surgeon John Hunter and others at St George's Hospital.[8] William Osler records that Hunter gave Jenner William Harvey's advice, very famous in medical circles (and characteristic of the Age of Enlightenment), "Don't think; try."[9] 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, practicing on dedicated premises at Berkeley.

Jenner and others formed the Fleece Medical Society or Gloucestershire Medical Society, so called because it met in the parlor of the Fleece Inn, Rodborough, in Rodborough, Gloucestershire, meeting to dine 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 that met in Alveston, near Bristol.[10]



 Jenner was elected Fellow of the Royal Society in 1788, following his publication of a careful study of the previously misunderstood life of the nested cuckoo that combined observation, experiment, and dissection.


His description of the newly hatched cuckoo, pushing its host's eggs and fledgling chicks out of the nest (contrary to existing belief that the adult cuckoo did it) was only confirmed in the 20th century,[11] when photography became available. Having observed this behaviour, Jenner demonstrated an anatomical adaptation for it—the baby cuckoo has a depression in its back, not present after 12 days of life, that enables it to cup eggs and other chicks. The adult does not remain long enough in the area to perform this task. Jenner's findings were published in Philosophical Transactions of the Royal Society in 1788.[12][13]
"The singularity of its shape is well adapted to these purposes; for, different from other newly hatched birds, its back from the scapula downwards is very broad, with a considerable depression in the middle. This depression seems formed by nature for the design of giving a more secure lodgement to the egg of the Hedge-sparrow, or its young one, when the young Cuckoo is employed in removing either of them from the nest. When it is about twelve days old, this cavity is quite filled up, and then the back assumes the shape of nestling birds in general." (Letter to Hunter at the Royal Society, as above)
Jenner's nephew assisted in the study.
 
 Jenner married Catherine Kingscote (died 1815 from tuberculosis) in March 1788 after meeting 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.
Jenner earned his MD from the University of St Andrews in 1792.
 
Jenner is also credited with advancing understanding of angina pectoris.[14] In his correspondence with Heberden, he wrote, "How much the heart must suffer from the coronary arteries not being able to perform their functions."
 

Inoculation was already a standard practice, but involved serious risks. In 1721, Lady Mary Wortley Montagu had imported variolation to Britain after having observed it in Istanbul, where her husband was the British ambassador. Voltaire, writing of this, estimates that at this time 60% of the population caught smallpox and 20% of the population died of it.[15] Voltaire also states that the Circassians used the inoculation from times immemorial, and the custom may have been borrowed by the Turks from the Circassians.[16]
In 1765, Dr John Fewster published a paper in the London Medical Society entitled "Cow pox and its ability to prevent smallpox", but he did not pursue the subject further.[17]
 

In the years following 1770, at least five investigators in England and Germany (Sevel, Jensen, Jesty 1774, Rendell, Plett 1791) successfully tested a cowpox vaccine in humans against smallpox.[18] For example, Dorset farmer Benjamin Jesty[19] successfully vaccinated and presumably induced immunity with cowpox in his wife and two children during a smallpox epidemic in 1774, but it was not until Jenner's work some 20 years later that the procedure became widely understood. Indeed, Jenner may have been aware of Jesty's procedures and success.[20]


Noting the common observation that milkmaids were generally immune to smallpox, Jenner postulated that the pus in the blisters that milkmaids received from cowpox (a disease similar to smallpox, but much less virulent) protected them from smallpox. He may already have heard of Benjamin Jesty's success.
On 14 May 1796, Jenner tested his hypothesis by inoculating James Phipps, an eight-year-old boy who was the son of Jenner's gardener. He scraped pus from cowpox blisters on the hands of Sarah Nelmes, a milkmaid who had caught cowpox from a cow called Blossom,[21] whose hide now hangs on the wall of the St George's medical school library (now in Tooting). Phipps was the 17th case described in Jenner's first paper[22] on vaccination. Jenner inoculated Phipps in both arms that day, subsequently producing in Phipps a fever and some uneasiness, but no full-blown infection. Later, he injected Phipps with variolous material, the routine method of immunization at that time. No disease followed. The boy was later challenged with variolous material and again showed no sign of infection.



Donald Hopkins has written, "Jenner's unique contribution was not that he inoculated a few persons with cowpox, but that he then proved [by subsequent challenges] that they were immune to smallpox. Moreover, he demonstrated that the protective cowpox pus could be effectively inoculated from person to person, not just directly from cattle.[23] Jenner successfully tested his hypothesis on 23 additional subjects.

Jenner continued his research and reported it to the Royal Society, which did not publish the initial paper. After revisions and further investigations, he published his findings on the 23 cases. Some of his conclusions were correct, some erroneous; modern microbiological and microscopic methods would make his studies easier to reproduce. The medical establishment, cautious then as now, deliberated at length over his findings before accepting them. Eventually, vaccination was accepted, and in 1840, the British government banned variolation – the use of smallpox – and provided vaccination – using cowpox – free of charge. (See Vaccination acts). The success of his discovery soon spread around Europe and, for example, was used en masse in the Spanish Balmis Expedition,[24] a three-year-long mission to the Americas, the Philippines, Macao, China, and Saint Helena Island led by Dr. Francisco Javier de Balmis with the aim of giving thousands the smallpox vaccine. The expedition was successful, and Jenner wrote, "I don’t imagine the annals of history furnish an example of philanthropy so noble, so extensive as this."

Jenner's continuing work on vaccination prevented him continuing his ordinary medical practice. He was supported by his colleagues and the King in petitioning Parliament, and was granted £10,000 for his work on vaccination. In 1806, he was granted another £20,000 for his continuing work in microbiology.
In 1803 in London, he became involved with the Jennerian Institution, a society concerned with promoting vaccination to eradicate smallpox. In 1808, with government aid, this society became the National Vaccine Establishment. Jenner became a member of the Medical and Chirurgical Society on its founding in 1805 and presented a number of papers there. The society is now the Royal Society of Medicine. In 1806, Jenner was elected a foreign member of the Royal Swedish Academy of Sciences.
 

Returning to London in 1811, Jenner observed a significant number of cases of smallpox after vaccination. He found that in these cases the severity of the illness was notably diminished by previous vaccination. In 1821, he was appointed Physician Extraordinary to King George IV, a great national honour, and was also made Mayor of Berkeley and Justice of the Peace. He continued to investigate natural history, and in 1823, the last year of his life, he presented his "Observations on the Migration of Birds" to the Royal Society.
Jenner was found in a state of apoplexy on 25 January 1823, with his right side paralysed. He never fully recovered and eventually died of an apparent stroke, his second, on 26 January 1823, aged 73. He was survived by one son and one daughter, his elder son having died of tuberculosis at the age of 21.

 Legacy

In 1979, the World Health Organization declared smallpox an eradicated disease.[25] This was the result of coordinated public health efforts by many people, but vaccination was an essential component. And although the disease was declared eradicated, some pus samples still remain in laboratories in Centers for Disease Control and Prevention in Atlanta, Georgia, in the United States and State Research Center of Virology and Biotechnology VECTOR in Koltsovo, Novosibirsk Oblast, Russia. Jenner's vaccine also laid the foundation for contemporary discoveries in immunology, and the field he began may someday lead to cures for arthritis, AIDS, and many other diseases.[26]


An illustrated history of smallpox eradication, Smallpox Zero,[27] was published with the support of Sanofi Pasteur and distributed on May 17, 2010, in Geneva during an event sponsored by the World Health Organization.[28][29] Smallpox Zero includes President Thomas Jefferson's letter of congratulations to Edward Jenner.

In 2002, Jenner was named in the BBC's list of the 100 Greatest Britons following a UK-wide vote.[30]

References


  1. ^ Stefan Riedel, MD, PhD (2005 January). Edward Jenner and the history of smallpox and vaccination 18 (1). Baylor University Medical Center. pp. 21–25. PMC 1200696. PMID 16200144.
  2. ^ "Edward Jenner - (1749–1823)". Sundaytimes.lk. 1 June 2008. Retrieved 28 July 2009.
  3. ^ "History - Edward Jenner (1749 - 1823)". BBC. 1 November 2006. Retrieved 28 July 2009.
  4. ^ "Edward Jenner - Smallpox and the Discovery of Vaccination". Retrieved 28 July 2009.
  5. ^ The Jenner Institute
  6. ^ "About Edward Jenner". The Jenner Institute. Retrieved February 25, 2012.
  7. ^ a b c "About Edward Jenner". The Jenner Institute. Retrieved January 12, 2013.
  8. ^ "Young Edward Jenner, Born in Berkeley". Edward Jenner Museum. Retrieved 4 September 2012.
  9. ^ Loncarek K (April 2009). "Revolution or reformation". Croatian Medical Journal 50 (2): 195–7. doi:10.3325/cmj.2009.50.195. PMC 2681061. PMID 19399955.
  10. ^ Papers at the Royal College of Physicians summarised at http://www.aim25.ac.uk/cgi-bin/search2?coll_id=7135&inst_id=8
  11. ^ http://www.jennermuseum.com/ej/cuckoo.shtml[dead link]
  12. ^ Observations on the Natural History of the Cuckoo. By Mr. Edward Jenner. In a Letter to John Hunter, Esq. F. R. S Jenner, E Philosophical Transactions of the Royal Society of London (1776-1886). 1788-01-01. 78:219–237 (Text at http://www.archive.org/details/philtrans06624558 )
  13. ^ Cuckoo chicks evicting their nest mates: coincidental observations by Edward Jenner in England and Antoine Joseph Lottinger in France Spencer G. Sealy and Mélanie F. Guigueno Department of Biological Sciences, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada (e-mail: sgsealy@cc.umanitoba.ca). Citation Information. Archives of natural history. Volume 38, Page 220-228 DOI 10.3366/anh.2011.0030, ISSN 0260-9541, Available Online October 2011
  14. ^ J R Coll Physicians Edinb 2011; 41:361–5doi:10.4997/JRCPE.2011.416
  15. ^ François Marie Arouet de Voltaire (1778). "Letters on the English or Lettres Philosophiques".
  16. ^ "Voltaire on Circassian Medicine: Inoculation". Circassian World. from Voltaire (1733). The Works of Voltaire. Vol. XIX (Philosophical Letters).
  17. ^ Hopkins, Donald R. (2002). The greatest killer: smallpox in history, with a new introduction. University Of Chicago Press. ISBN 978-0-226-35168-1.
  18. ^ Plett PC (2006). "Peter Plett and other discoverers of cowpox vaccination before Edward Jenner" [Peter Plett and other discoverers of cowpox vaccination before Edward Jenner]. Sudhoffs Archiv (in German) 90 (2): 219–32. PMID 17338405.
  19. ^ Hammarsten J. F. et al. (1979). "Who discovered smallpox vaccination? Edward Jenner or Benjamin Jesty?". Transactions of the American Clinical and Climatological Association 90: 44–55. PMC 2279376. PMID 390826.
  20. ^ Grant, John (2007). Corrupted Science: Fraud, Ideology and Politics in Science. London: Facts, Figures & Fun. p. 24. ISBN 978-1-904332-73-2.
  21. ^ "Edward Jenner & Smallpox". The Edward Jenner Museum. Retrieved 13 July 2009.[dead link]
  22. ^ An Inquiry into the Causes and Effects of the Variolae Vaccinae, Edward Jenner retrieved 17 November 2012
  23. ^ Hopkins, Donald R. (2002). The greatest killer: smallpox in history, with a new introduction. Chicago: University of Chicago Press. p. 80. ISBN 978-0-226-35168-1. OCLC 49305765.
  24. ^ Carlos Franco-Paredes, Lorena Lammoglia, and José Ignacio Santos-Preciado (2005). The Spanish Royal Philanthropic Expedition to Bring Smallpox Vaccination to the New World and Asia in the 19th Century 41 (9). Clinical Infectious Diseases. pp. 1285–1289. doi:10.1086/496930.
  25. ^ World Health Organization (2001). "Smallpox".
  26. ^ "Dr. Edward Jenner and the small pox vaccination". Essortment.com. Retrieved 28 July 2009.
  27. ^ "Smallpox Zero". African Comic Production House, Johannesburg, South Africa. ISBN 978-0-620-43765-3.
  28. ^ "Smallpox".
  29. ^ Jonathan Roy (November 2010). Smallpox Zero: An Illustrated History of Smallpox and Its Eradication 16 (11). Centers for Disease Control and Prevention. doi:10.3201/eid1611.101145.
  30. ^ "100 great Britons - A complete list". Daily Mail. 21 August 2002. Retrieved 2 August 2012.

 Taken from:  http://en.wikipedia.org/wiki/Edward_Jenner [14.05.2013]
Posted by at

No comments:

Post a Comment

Subscribe to: Post Comments (Atom)