Edward Jenner

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Edward Jenner

Edward Jenner by James Northcote
Born 17 May 1749
Berkeley, Gloucestershire
Died 26 January 1823(1823-01-26) (aged 73)
Berkeley, Gloucestershire
Residence Berkeley, Gloucestershire
Nationality English
Fields Microbiology
Alma mater St George's, University of London
Doctoral advisor John Hunter
Known for Smallpox vaccine

Edward Anthony Jenner (17 May 1749 – 26 January 1823) was an English scientist who studied his natural surroundings in Berkeley, Gloucestershire. Jenner is widely credited as the pioneer of smallpox vaccine,[1] and is sometimes referred to as the "Father of Immunology"; his works have been said to have "saved more lives than the work of any other man".[2][3][4]

Contents

[edit] Early life

Edward Jenner was born on 17 May 1749[5] (6 May Old Style) in Berkeley, as the eighth of nine children. His father was the vicar of Berkeley and so Jenner received a strong basic education.[6] Jenner trained in Chipping Sodbury, South Gloucestershire as an apprentice to Daniel Ludlow, a surgeon, for eight years from the age of 13. In 1770 Jenner went up to surgery and anatomy under the surgeon John Hunter and others at St George's Hospital.

William Osler records that Jenner was a student to whom Hunter repeated William Harvey's advice, very famous in medical circles (and characteristically Enlightenment), "Don't think, try".[7] Hunter remained in correspondence with him over natural history and proposed him for the Royal Society. Returning to his native countryside by 1773 he became a successful general practitioner and surgeon, practicing in purpose-built premises at Berkeley.

Jenner and others formed the Fleece Medical Society or Gloucestershire Medical Society, so called as it met in the parlor of the Fleece Inn, Rodborough in Rodborough, Gloucestershire, meeting to read papers on medical subjects and dine together. Jenner contributed papers on angina pectoris, ophthalmia and valvular disease of the heart and commented on cowpox. He also belonged to a similar society which met in Alveston, near Bristol.[8]

[edit] Natural history, science and marriage

Jenner was elected Fellow of the Royal Society in 1788, following a careful study combining observation, experiment and dissection into a description of the previously misunderstood life of the cuckoo in the nest.

Common Cuckoo

His description of the newly-hatched cuckoo pushing its host's eggs and fledglings from the nest (contrary to the existing belief that the adult cuckoo did it) was only confirmed in the 20th century [1] when photography became feasible. Having observed the behaviour, he demonstrated an anatomical adaptation for it—the baby cuckoo has a depression in its back which is not present after 12 days of life, in which it cups eggs and other chicks to push them out of the nest. It had been assumed that the adult bird did this, but the adult does not remain in the area for sufficiently long. His findings were published in the Philosophical Transactions of the Royal Society in 1788.[9][10]

"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.)

His nephew assisted in his observations.

He married Catherine Kingscote (died 1815 from tuberculosis) in March 1788 having met her when balloons were hot science, and he and other Fellows were experimenting with them. His trial balloon descended into Kingscote Park, owned by Anthony Kingscote, Catherine being one of his three daughters.

In 1792, he obtained his MD from the University of St Andrews.

Jenner is also credited with advancing understanding of Angina [11]. In his correspondence with Heberden he wrote: ‘How much the heart must suffer from the coronary arteries not being able to perform their functions’.

[edit] Smallpox

 This section needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (May 2011)

Inoculation was a standard practice, but had considerable morbidity and mortality itself. In 1721 Lady Mary Wortley Montagu had imported variolation to Britain having observed it while in Istanbul, where her husband was the British ambassador. Voltaire, a few years later, recorded that 60% of people caught smallpox, with 20% of the population dying of it.[12]

In 1765 a Dr Fewster published a paper in the London Medical Society entitled "Cow pox and its ability to prevent smallpox" but did not pursue it further.[13]

In the years following 1770 there were at least six people in England and Germany (Sevel, Jensen, Jesty 1774, Rendell, Plett 1791) who had successfully tested the possibility of using the cowpox vaccine as an immunization for smallpox in humans.[14] For example, Dorset farmer Benjamin Jesty[15] had successfully vaccinated and presumably induced immunity in his wife and two children with cowpox during a smallpox epidemic in 1774, but it was not until Jenner's work some twenty years later that the procedure became widely understood. Indeed, Jenner may have been aware of Jesty's procedures and success.[16]

Jenner's Theory:
The initial source of infection was a disease of horses, called "the grease", and that this was transferred to cows by farm workers, transformed, and then manifested as cowpox.

Noting the common observation that milkmaids did not generally get smallpox, Jenner theorized that the pus in the blisters which milkmaids received from cowpox (a disease similar to smallpox, but much less virulent) protected the milkmaids from smallpox. He may have had the advantage of hearing stories of Benjamin Jesty and others who deliberately arranged cowpox infection of their families, and then noticed a reduced smallpox risk in those families.

On 14 May 1796, Jenner tested his hypothesis by inoculating James Phipps, a young boy of 8 years (the son of Jenner's gardener), with material from the cowpox blisters of the hand of Sarah Nelmes, a milkmaid who had caught cowpox from a cow called Blossom,[17] whose hide hangs on the wall of the library at St George's medical school (now in Tooting). Blossom's hide commemorates one of the school's most renowned alumni. Phipps was the 17th case described in Jenner's first paper on vaccination.

Jenner inoculated Phipps with cowpox pus in both arms on the same day. The inoculation was accomplished by scraping the pus from Nelmes' blisters onto a piece of wood then transferring this to Phipps' arms. This produced a fever and some uneasiness but no great illness. Later, he injected Phipps with variolous material, which would have been the routine attempt to produce immunity at that time. No disease had followed. Jenner reported that later the boy was again challenged with variolous material and again showed no sign of infection.

Known:
Smallpox is more dangerous than variolation and cowpox less dangerous than variolation.
Hypothesis:
Infection with cowpox gives immunity to smallpox.
Test:
If variolation after infection with cowpox fails to produce a smallpox infection, immunity to smallpox has been achieved.
Consequence:
Immunity to smallpox can be induced much more safely than by variolation.

Ronald Hopkins states: "Jenner's unique contribution was not that he inoculated a few persons with cowpox, but that he then proved they were immune to smallpox. Moreover, he demonstrated that the protective cowpox could be effectively inoculated from person to person, not just directly from cattle.[18] In addition he tested his theory on a series of 23 subjects. This aspect of his research method increased the validity of his evidence.

He continued his research and reported it to the Royal Society, who did not publish the initial report. After improvement and further work, he published a report of twenty-three cases. Some of his conclusions were correct, and some erroneous – modern microbiological and microscopic methods would make this easier to repeat. The medical establishment, as cautious then as now, considered his findings for some time before accepting them. Eventually vaccination was accepted, and in 1840 the British government banned variolation – the use of smallpox itself – and provided vaccination – using cowpox – free of charge. (See Vaccination acts). The success of his discovery soon began to spread around Europe and as an example was used en masse in the Spanish Balmis Expedition[19] a three year mission to the Americas, 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.”

1802 caricature of Jenner vaccinating patients who feared it would make them sprout cowlike appendages.

Jenner's continuing work on vaccination prevented his 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 foundation in 1805, and subsequently presented to them a number of papers. This is now the Royal Society of Medicine. In 1806, he was elected a foreign member of the Royal Swedish Academy of Sciences.

Returning to London in 1811 he observed a significant number of cases of smallpox after vaccination occurring. He found that in these cases the severity of the illness was notably diminished by the previous vaccination. In 1821 he was appointed Physician Extraordinary to King George IV, a considerable national honour, and was made Mayor of Berkeley and Justice of the Peace. He continued his interests in natural history. 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 (he had suffered a previous stroke) 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.

His original report is in the Royal College of Surgeons (London)

[edit] The Rev Dr John Clinch - The first community vaccinator

On December 1, 1796, Dr. John Clinch,[20] a medical missionary at Trinity, then the second largest settlement in Newfoundland, sent a letter to Jenner in Gloucestershire. Clinch asked for further information about using cowpox pustule matter as a vaccination against smallpox. Jenner had vaccinated his first subject only 6 months earlier. By June 1800, when Jenner published his famous pamphlet, An Inquiry into the Causes and Effects of the Variolae Vaccinae,[21] describing his vaccination experiments on 23 subjects, Clinch probably had been vaccinating people in Newfoundland for a year or more.

Jenner and Clinch, both born in 1749, had been classmates at Reverend Dr. Washbourn’s school in Cirencester, Gloucestershire, before they went to London together to be pupils of the distinguished surgeon John Hunter.[22] Jenner returned to his home area, but Clinch practised 3 years in Dorset near Poole, the main shipping port for Newfoundland. In 1775 Clinch moved to Newfoundland to practise in Bonavista. After 8 years he moved to Trinity, where he also preached the Anglican sermons on Sundays. Jenner’s nephew, George Jenner, aiming for a similar church–medicine career, very likely began his medical apprenticeship under Clinch at Trinity in 1789

On July 15, 1800, a second shipment of vaccine from Edward Jenner reached Clinch; one of these two vaccine shipments, most likely the first, came via George Jenner, by then the Anglican minister at Harbour Grace, on the intervening peninsula between Trinity and St. John’s. By the first week of October 1800 Clinch had vaccinated additional people in the adjacent settlements of St. John’s and Portugal Cove, and by the end of 1801 he had vaccinated 700 people.

William R. LeFanu’s definitive bibliography of Jenner credits Clinch with being the first vaccinator in North America, before Benjamin Waterhouse, who vaccinated his own sons in July 1800 and then popularized vaccination in Boston. Sadly, exact dates for Clinch’s first vaccinations are unavailable for conclusive proof of his priority. Clinch is honoured by a memorial plaque in Trinity.[23] (This section reproduced from John W.R. McIntyre, MB BS; C. Stuart Houston, MD 'Smallpox and its Control in Canada'. CMAJ 14th Dec 1999)

[edit] Legacy

In 1979, the World Health Organization declared smallpox an eradicated disease.[24] This was the result of coordinated public health efforts by many people, but vaccination was an essential component. And although it was declared eradicated, some samples still remain in laboratories in Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia in the United States, and State Research Center of Virology and Biotechnology VECTOR in Koltsovo, Novosibirsk Oblast, Russia.

The importance of his work does not stop there. His vaccine also laid the groundwork for modern-day discoveries in immunology, and the field he began may someday lead to cures for arthritis, AIDS, and many other diseases of the time.[25]

2010 marks the 30th anniversary of the eradication of smallpox, and an illustrated history of the eradication of smallpox, “Smallpox Zero”[26] was published with the support of sanofi pasteur and distributed during an event organized on May 17, 2010 in Geneva by the World Health Organization.[27][28] "Smallpox Zero" features, among other things, President Thomas Jefferson's letter to Edward Jenner on the inside of the front cover.

[edit] Monuments

Dr Jenner's House, The Chantry, Church Lane, Berkeley, Gloucestershire, England
Bronze in Kensington Gardens, London
  • Edward Jenner is buried in the Jenner family vault at the church of St. Mary's, Berkeley.[29]
  • Jenner's house is now a small museum housing among other things the horns of the cow, Blossom. It lies in the village of Berkeley, Gloucestershire.
  • A statue, by Robert William Sievier, was erected in the nave of Gloucester Cathedral.
  • A statue was erected in Trafalgar Square, later moved to Kensington Gardens.[30]
  • Near the small Gloucestershire village of Uley, Downham Hill is locally known as 'Smallpox Hill', with a possible connection to Jenner's local work with the disease.
  • St George's Hospital Medical School in London has a wing named after him as well as a bust of him.[31]
  • A small grouping of villages in Somerset County, Pennsylvania, United States, were named in honour of Jenner by early 19th century English settlers, including what are now the towns of Jenners, Jenner Township, Jenner Crossroads and Jennerstown, Pennsylvania.
  • There is a section at Gloucestershire Royal Hospital known as the Edward Jenner Ward where blood is taken specifically
  • Also a ward at Northwick Park Hospital is named after him, called Jenner Ward
  • Jenner Gardens in Cheltenham, Gloucestershire, is a small garden/cemetery named after Jenner, owing to its location opposite one of his former offices

[edit] Publications

  • 1798 An Inquiry Into the Causes and Effects of the Variolæ Vaccinæ [21]
  • 1799 Further Observations on the Variolæ Vaccinæ, or Cow-Pox. [32]
  • 1800 A Continuation of Facts and Observations relative to the Variolœ Vaccinœ 40pgs [33]
  • 1801 The Origin of the Vaccine Inoculation 12pgs

[edit] In popular culture

  • The Walking Dead television series' character, CDC doctor, Edwin Jenner is an homage to Edward Jenner.

[edit] See also

[edit] References

  1. ^ Stefan Riedel, MD, PhD (2005 January). Edward Jenner and the history of smallpox and vaccination. 18. Baylor University Medical Center. pp. 21–25. PMC 1200696. PMID 16200144. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1200696. 
  2. ^ "Edward Jenner - (1749–1823)". Sundaytimes.lk. 1 June 2008. http://sundaytimes.lk/080601/FunDay/famous.html. Retrieved 28 July 2009. 
  3. ^ "History - Edward Jenner (1749 - 1823)". BBC. 1 November 2006. http://www.bbc.co.uk/history/historic_figures/jenner_edward.shtml. Retrieved 28 July 2009. 
  4. ^ "Edward Jenner - Smallpox and the Discovery of Vaccination". http://www.dinweb.org/dinweb/DINMuseum/Edward%20Jenner.asp. Retrieved 28 July 2009. 
  5. ^ The Jenner Institute
  6. ^ http://www.jenner.ac.uk/edwardjenner.html
  7. ^ 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. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2681061. 
  8. ^ Papers at the Royal College of Physicians summarised at http://www.aim25.ac.uk/cgi-bin/search2?coll_id=7135&inst_id=8
  9. ^ 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 )
  10. ^ 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
  11. ^ J R Coll Physicians Edinb 2011; 41:361–5doi:10.4997/JRCPE.2011.416
  12. ^ François Marie Arouet de Voltaire (1778). "Letters on the English or Lettres Philosophiques". http://www.fordham.edu/halsall/mod/1778voltaire-lettres.asp#Letter%20XI. 
  13. ^ Hopkins, Donald R. (2002). The greatest killer: smallpox in history, with a new introduction. University Of Chicago Press. ISBN 978-0226351681. http://books.google.com/?id=z2zMKsc1Sn0C&lpg=PA80&pg=PA80&q=dr%20fewster#v=snippet&q=dr%20fewster&f=false. 
  14. ^ 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]" (in German). Sudhoffs Archiv 90 (2): 219–32. PMID 17338405. 
  15. ^ 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. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2279376. 
  16. ^ Grant J. Corrupted Science. Facts, Figures & Fun, 2007. p. 24. ISBN 9871904332732. 
  17. ^ "Edward Jenner & Smallpox". The Edward Jenner Museum. http://www.jennermuseum.com/sv/smallpox2.shtml. Retrieved 13 July 2009. [dead link]
  18. ^ 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. 
  19. ^ 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. Oxford Journals. pp. 1285–1289. doi:10.1086/496930. http://cid.oxfordjournals.org/content/41/9/1285.full. 
  20. ^ John W. Davies, M.B., B.Sc., M.Sc., D.P.H. (August 28, 1970). "A Historical Note on the Rev. John Clinch, First Canadian Vaccinator". The Fisherman's Advocate. http://ngb.chebucto.org/Articles/clinch2.shtml. 
  21. ^ a b Edward Jenner. (1909–14.). "An Inquiry Into the Causes and Effects of the Variolæ Vaccinæ, Or Cow-Pox. 1798". The Harvard Classics. http://www.bartleby.com/38/4/1.html. 
  22. ^ John W. Davies, M.B., B.Sc., M.Sc., D.P.H. (August 28, 1970). "A Historical Note on the Rev. John Clinch, First Canadian Vaccinator". The Fisherman's Advocate. http://ngb.chebucto.org/Articles/clinch2.shtml. 
  23. ^ "Chapter 4: Differing Views On Science, Religion, And Illness In Newfoundland And Labrador". http://www.myplaceintheworld.nelson.com/studresources_ch04.html. 
  24. ^ World Health Organization (2001). "Smallpox". http://www.who.int/mediacentre/factsheets/smallpox/en/index.html. 
  25. ^ "Dr. Edward Jenner and the small pox vaccination". Essortment.com. http://www.essortment.com/all/edwardjennersm_rmfk.htm. Retrieved 28 July 2009. 
  26. ^ "Smallpox Zero". African Comic Production House, Johannesburg, South Africa. ISBN 978-0-620-43765-3. http://www.avpi.org/statics/flipbooks/SmallpoxEN/sources/. 
  27. ^ "Smallpox". http://www.sanofipasteur.com/sanofi-pasteur2/front/index.jsp?codePage=PAG_29_1252430162114&codeRubrique=29&siteCode=SP_CORP. 
  28. ^ Jonathan Roy (November 2010). 16. doi:10.3201/eid1611.101145. http://wwwnc.cdc.gov/eid/article/16/11/10-1145_article.htm. 
  29. ^ "Edward Jenner - St Mary's Church, Berkeley, Gloucestershire". http://www.stmarys-berkeley.co.uk/history/60-edward-jenner. Retrieved 2010-12-15. 
  30. ^ Royal College of Physicians. "JENNER, Edward (1749-1750)". AIM25 Archives. http://www.aim25.ac.uk/cgi-bin/search2?coll_id=7135&inst_id=8. 
  31. ^ St George's, University of London. "Our History". http://www.stgeorges.nhs.uk/aboutourhistory.asp. 
  32. ^ Edward Jenner. (1909–14.). "Further Observations on the Variolæ Vaccinæ, or Cow-Pox. 1799". The Harvard Classics. http://www.bartleby.com/38/4/1.html. 
  33. ^ Edward Jenner. (1909–14.). "A Continuation of Facts and Observations Relative to the Variolæ Vaccinæ, or Cow-Pox. 1800". The Harvard Classics. http://www.bartleby.com/38/4/3.html. 

[edit] Further reading

[edit] External links

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