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Smallpox Vaccine
Smallpox and the first Vaccine
A historic global disease conquered by science.
Early perceptions and treatments
The journey to a smallpox vaccine began long before western medicine even existed. Smallpox was a feared disease throughout much of human history, known for its terrifying efficacy in causing high mortality and severe disfigurement among survivors. Historical accounts trace smallpox back to ancient civilizations, with descriptions suggesting its presence in Egyptian, Indian, and Chinese cultures thousands of years ago. The disease had a profound impact on societies, shaping medical practices and public health responses.
The first concerted efforts to control smallpox involved the practice of variolation, which originated independently in several parts of Asia. In India and China, written records describe the process of introducing material from smallpox sores into the skin of healthy individuals. This method was based on the observation that survivors of smallpox appeared to acquire immunity against the disease.
![The ravages of smallpox](https://i0.wp.com/halfcockedtales.com/wp-content/uploads/2024/05/kidwithsmallpox.jpg?resize=150%2C250&ssl=1)
![A smallpox vaccination](https://i0.wp.com/halfcockedtales.com/wp-content/uploads/2024/05/smallpox.jpg?resize=150%2C250&ssl=1)
Variolation, an early weapon
Variolation reached the Ottoman Empire, where it became a well-established practice by the 17th century. It was introduced to Western Europe in the early 18th century by Lady Mary Wortley Montagu, the wife of the British ambassador to Turkey. Montagu had witnessed the practice in Constantinople and, convinced of its efficacy, had her own children variolated. Her advocacy played a crucial role in the adoption of variolation in Britain, despite considerable resistance and skepticism from medical professionals and the public.
In England, the practice gained gradual acceptance as a means of controlling smallpox outbreaks, particularly among the upper classes. However, variolation was not without risks: it often resulted in severe disease and could even initiate outbreaks. This paradox made the search for a safer preventative method a significant concern for medical practitioners and the public alike.
![Portrait of Dr. Jenner](https://i0.wp.com/halfcockedtales.com/wp-content/uploads/2024/05/EdwardJenner.jpg?resize=195%2C276&ssl=1)
Dr. Jenner and the Cowpox Hypothesis
Born in 1749 in Berkeley, Gloucestershire, Edward Jenner was keenly aware of the devastation caused by smallpox from an early age. His medical training included an apprenticeship under John Hunter in London, where Jenner was exposed to both advanced surgical techniques and Hunter’s emphasis on empirical evidence and observation. Jenner’s rural upbringing and medical practice in a country setting exposed him to folklore and observations not commonly noted in urban medical practices, including the local lore that milkmaids who contracted cowpox did not catch smallpox.
In May 1796, Jenner found the ideal opportunity when one of his patients, Sarah Nelmes, a local milkmaid, reported having fresh cowpox lesions on her hands. These lesions were typical of those contracted from cows, specifically from a cow named Blossom, whose udders showed similar sores. Jenner identified this as a source of pure cowpox matter, uncontaminated by other diseases, which was crucial for a clear experiment.
Jenner also needed a human subject who had never been infected with either cowpox or smallpox to ensure an unambiguous interpretation of the experiment’s results. He chose James Phipps, the eight-year-old son of his gardener, who was healthy and had no previous history of either disease.
![Illustration of Dr. Jenner administering the first vaccination.](https://i0.wp.com/halfcockedtales.com/wp-content/uploads/2024/05/512px-Jenner_phipps_01_cropped-1.jpg?resize=512%2C338&ssl=1)
The Experiment: May 14, 1796
On May 14, 1796, Jenner carried out the procedure that would become a milestone in medical history. He collected pus from the cowpox sores on Sarah Nelmes’ hand using a clean lancet. With this material, Jenner inoculated James Phipps by making two small cuts on the boy’s arm and introducing the pus into them. After the procedure, the site was dressed and James was monitored closely.
The following days were crucial. James developed a mild fever and discomfort at the site of the incision, but these symptoms soon subsided. Crucially, he did not develop any severe illness during the following weeks, indicating that the infection had been mild and localized.
To confirm that the cowpox had indeed provided protection against smallpox, Jenner needed to expose James to smallpox matter and observe the outcome. About six weeks after the initial cowpox inoculation, Jenner variolated James Phipps using matter taken from a smallpox patient. This was a risky step, as variolation itself could be fatal. However, it was considered necessary to conclusively demonstrate cowpox’s protective effect.
Finally, a Smallpox Vaccine
James Phipps did not develop smallpox after the variolation, indicating that the cowpox infection had successfully immunized him against smallpox. This was a significant result, as it was the first documented case where a deliberate introduction of a disease (cowpox) had provided immunity against another (smallpox). The smallpox vaccine had officially arrived.
Buoyed by the success of his initial experiment, Jenner continued to test his cowpox sourced vaccine on other subjects, including his own son and several other children, replicating the results. Each successful vaccination added to the growing body of evidence supporting his hypothesis.
In 1798, Jenner published “An Inquiry into the Causes and Effects of the Variolae Vaccinae,” where he detailed his experiment and findings. Although his work met with initial skepticism, the undeniable success of the vaccine led to widespread acceptance and adoption within a few years, drastically altering the landscape of public health and medicine.