I. S. Bailey

EDWARD JENNER 17 May 1749-26 January 1823 I. S. BAILEY, M.D., F.R.C.P. Chairman, Jenner Educational Trust.

Based on the talk given to a joint meeting of the Western Branch of the Institute of Biology and the History of Biology Group at the Jenner Museum and Conference Centre, Berkeley, Gloucestershire, on 24 April 1993.

THOSE of us who come to Berkeley and to the Jenner Museum and Conference Centre do so to honour Edward Jenner, country practitioner, naturalist, scientist and benefactor to mankind. Jenner was born in the old vicarage house, Berkeley, the eight child of the Reverend Stephen Jenner. He was orphaned in early childhood. After school in Wotton-under-Edge and Cirencester: he was apprenticed aged 13 to Daniel Ludlow, a surgeon in Chipping Sodbury.

In childhood he had been inoculated against the smallpox, a procedure introduced from the east in the early part of the eighteenth century. He had the usual several weeks of preparation with purging, starving and bleeding. The risk of severe smallpox and of spread to others was recognised, and Jenner was isolated in the "smallpox stables" and suffered a moderate attack. Around 1768, when in Chipping Sodbury, he learnt that there was a report rife in the dairies of a distemper named the cowpox which affected the teats of milking cows, infected the hands of milkmaids and was sometimes a preventive of smallpox. After seven years as an apprentice, he became house pupil to John Hunter (1728-1795) the noted surgeon, experimentalist and teacher, and studied with him in his home and at St. George’s Hospital. When Joseph Banks returned in 1771 from Cook’s Pacific explorations, he asked Hunter who might best help in classifying the material. Jenner was recommended and did so well that, according to Lettsom, he was offered the post of Botanist to a new expedition on the Resolution. He refused, however, partly because of an attachment to the rural scenes and habits of his early youth, and returned to Berkeley in 1772.

Jenner had been interested in natural history in childhood and spent time searching for fossils in cliffs around the Severn and collecting the nests of field mice. Back in Berkeley as country practitioner, he corresponded with Hunter and together they studied the breeding of toads, the cuckoo, the hibernation of the hedgehog and the migration of birds. Hunter wrote; "Have you caves where Batts go to at night?", "Are there no batts in the castle at Berkeley?" "If you have I will put you upon a set of experiments concerning the heat of them at difft seasons". "Have you got the bones yet of a large porpass?", "Is ever salmon spawn seen, if it is I wish you could get some", "Send me all the fossils you can find", "I shall employ you with hedgehogs", and asked whether they lost weight in hibernation, what was their body temperature in winter, and if meat put in the stomach in cold weather digested. "This may be difficult, but make them lively in a warm room, feed them and put them immediately in the cold", "Collect air from the gut to see if a candle will burn in it as long as in common air". Finally, and the best known quotation from Hunter's letters, of 2 August 1775: "I thank you for your expt on the hedgehog; 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 trie the experiment". At a dinner party in Bath, there was discussion as to which was the hottest part of a candle flame. Jenner put his finger in the bottom of the flame for a short time and then at the top, but was obliged to snatch it away immediately. "This, gentleman, is a sufficient test". In 1784, a year after the pioneering flights of Montgolfier in Lyons and Charles in Paris, Jenner made the first balloon flight in Britain. In a letter to Dr. Caleb Hillier Parry of Bath he was thanked for the offer of tubes, half a yard of silk and directions for their use. Jenner oiled the silk, filled the balloon with hydrogen, released it in the hall of Berkeley Castle and then outside and followed on horseback until it came down in the grounds of Kingscote. Jenner’s first paper "Observations on the emetic tartar" was published privately and described an improved method of preparation. Hunter wrote: "I am puffing off your tartar as the tartar of all tartar", "Do you mean to take out a patint?", "I approve of it much but I would advise you to give it a new name expressive either of the composition or of its virtues in the body". For some years, Jenner had been observing the nesting habits of the cuckoo. In a paper read to the Royal Society on 13 March 1788, he described how the young cuckoo ejected the eggs of the host hedge sparrow by means of a declivity on its back, and that this disappeared by the twelfth day of its life. Jenner, interested in the migration of birds, had noticed that the cuckoo was in England for only eleven weeks, that fifteen

weeks were needed for independence of its young, and suggested that it was for this reason that the cuckoo laid its eggs in the nest of another bird. For this work Jenner was elected a Fellow of the Royal Society on 26 February 1789. Earlier, between 1780 and 1782, he had at the request of Joseph Banks, then and for many years President of the Royal Society, studied the value of blood as manure. Serum helped grass to grow but, prevented, unless diluted with two parts of water, the sprouting of seeds. Blood harmed Polyanthusand currant bushes. There may have been a connection between these experiments, reported in 1787, and Banks’s interest in the gardens of the King’s newly acquired house at Kew. In March 1788 Edward Jenner married Catherine Kingscote and they moved into the Chantry, now the Jenner Museum. Their first child, Edward, was born in January 1789. Hunter wrote, "I wish you joy. I hope Mrs Jenner is well and that you begin the look grave now that you are a father". In 1785 Jenner founded the Medico Convivial Society which met at the Fleece Inn, Rodborough. It was a successor to the older Convivio-Medical Society which had met at Alveston. Dr Caleb Parry came from Bath, Dr Hicks from Bristol, Dr Matthews from Hereford, Dr Paytherus from Ross-on-Wye and Dr Ludlow from Sodbury. Jenner described mitral stenosis. He observed ossification of the coronary arteries. "When making a section of the heart, the knife struck against something so hard and gritty that I well remember looking up at the ceiling conceiving that some plaster had fallen down, but on further scrutiny the real cause appeared. The coronary arteries had become bony canals". Jenner was one of the first doctors to relate angina to coronary artery disease. He recognised that Hunter suffered angina. Home reported that the post mortem in 1795 had shown ossified coronary arteries. Jenner had not forgotten the milkmaids of Sodbury. He studied those who had escaped smallpox after cowpox and challenged some with smallpox and found that this failed to take. Benjamin Jesty, a Dorset farmer (1737-1816) had inoculated his wife and two sons with cowpox in 1774. But it was Jenner who performed the crucial experiment on 14 May 1796. He inoculated James Phipps with material taken from a cowpox sore on the hand of a milkmaid Sarah Nelmes. Two months later he challenged James Phipps with smallpox. "But now listen to the most delightful part of my story. The boy has since been inoculated for the smallpox which as I ventured to predict produced no effect. I shall now pursue my experiments with redoubled ardour".

Two years later, in 1798, Jenner published ‘The inquiry into the causes and the effect of variolae vaccinae, known as smallpox’. It sold well. A copy bound in red velvet was presented to King George III. Vaccination spread rapidly. But it had its critics. Gillray drew people with cows’ heads sprouting from their bodies. Some were vaccinated with contaminated material and developed smallpox. Moseley foretold of a new race of minotaurs - ‘Semi Bovemque Virum, Semi Virumque Bovem’. In 1801 Jenner published "The origin of the Vaccine Inoculation" and predicted that vaccination would end smallpox. "It now becomes too manifest to admit of controversy that the annihilation of the smallpox, the most dreadful scourge of the human species, must be the final result of this practice". Smallpox was indeed a scourge. Macaulay had called it "the most terrible of the ministers of death". Between 200,000 and 600,000 people died in Europe each year. A third of childhood deaths were from smallpox. Those who recovered were disfigured by pock marks. It had led to the end of the reign of the House of Stuart. It destroyed the Aztecs and Incas. It disrupted the Franco-Spanish Armada of 1779, and later influenced the outcome of the Franco-Prussian War in 1870. Smallpox was eliminated as a result of the ten year eradication programme of the World Health Organization. The last natural case of smallpox was in Somalia in October 1977. On 8 May 1980 the thirty-third World Health Assembly adopted a resolution declaring that smallpox had been eradicated globally. Smallpox is the first and only infectious disease to be eradicated. There is no animal reservoir. Isolation and vaccination of contacts is possible in the twelve day incubation period, before they become infectious. There is cross immunity between orthopox viruses and protections lasts several years. Equine pox is now extinct. Dracunculiasis may be the next disease to be eliminated and poliomyelitis may soon disappear from the northern hemisphere. Helicobacter pylori, which has only a human host, may be eliminated from the stomach by a suitable vaccine with consequent reduction or prevention of peptic ulceration, gastric carcinoma and gastric lymphoma. Jenner was lucky. Though he referred to ‘virus’ he used the word in its ancient sense of a noxious agent. Bacteria were described first well into the seventeenth century. The organisms which we know as viruses were discovered at the end of the last century. He knew nothing of immunity and was fortunate that cowpox protects against another orthopox virus, smallpox. Cowpox is, and probably was, rare and there are other commoner diseases of the udder and Jenner recognised that these did not induce immunity to smallpox and called them spurious cowpox. We now

know these are parapox viruses and bovine herpes mammillitis, both diseases of cows, whereas cowpox is an incidental in the cow, cat and in man, with rodents as the natural reservoir host. There are still puzzles. The material used for vaccination was shown in 1939 to be vaccinia and not cowpox. We do not know from where it came but it is possible that it arose from the now extinct equine pox. Recombinant vaccinia can be used to protect against other infectious diseases. A vaccinia based rabies vaccine is being used in spiked pellets to reduce and to push eastward rabies in foxes. A recombinant avipox virus, for example canary pox, may be better since these viruses - though producing immunity - do not replicate in man. How do we honour Jenner, and how will be celebrate the bicentenary of the first vaccination, 14 May 1796? The late Malcolm Campbell, neurologist, with Bruce Perry, Professor of Medicine and other West Country physicians and interested people formed the Jenner Trust in 1966. A small museum was opened in Phipps’ Cottage, Berkeley, on 17 May 1966. In 1983, the Diocese of Gloucester wished to sell the Chantry, which had been the home of the vicars of Berkeley from 1885, and to build a new vicarage. A Jenner Appeal was launched and raised some money. A generous gift from Mr Ryoichi Sasakawa, in gratitude for the elimination of smallpox, allowed us to buy the Chantry, to refurbish the house and stables and to establish a larger museum in the Chantry and the Sasakawa Conference Centre in the stables. The museum opened to the public on 1 May 1985 and since then has attracted up to 10,000 visitors a year. A number of conferences for up to sixty people are held each year in the Sasakawa Centre and the Institute of Biology was welcomed there on 24 April 1993. The centenary in 1896 was celebrated in Britain, Europe, and in a number of other countries. There were papers in several journals. Gloucester, where there was at that time a strong anti-vaccination movement, suffered one of its worst epidemics of smallpox. Recently Gloucestershire has honoured Jenner with a plaque in County Hall and described him as pre-eminent among its six famous sons: Whittington, Tyndale, Holst, Raikes and W.G. Grace. In 1996 we hope that there may be a Jenner stamp, that there will be celebrations in America, Europe, in London, Bristol and Berkeley. The medical Royal Colleges, the Royal Society, the Royal College of Veterinary Surgeon’s, St George’s Hospital, the Department of Health, the World Health Organization, the British Paediatric Association and The Institute of Biology have all expressed an interest. We hope that many people and other groups will wish to join in the celebrations, looking back to Jenner but forward from Jenner to the

many developments in virology, infectious disease and immunity which continue at an ever increasing rate. The British Society for Immunology will meet in Bristol in April 1996 and there will be events in the University and in the Department of Child Health. We shall mount an appeal nearer 1996 for the better endowment of the Museum, for a new exhibition to show developments in immunology, to endow student prizes, to fund medical student intercalation in science subjects and perhaps research fellowships. We have this year started in a small way with a prize for Gloucestershire primary schools, the Jenner Environmental Challenge, and we are presenting prizes to two schools for studies of plants growing in the school grounds. They will, we think, appreciate Jenner’s studies just as he would have valued their observations and experiments.