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Edward Jenner: soloist or member of a trio? Part 2

In 1805 a Dorset farmer, Benjamin Jesty arrived in London on an invitation from the Original Vaccine Pock Institute to describe his cowpox vaccination procedure on his own family which included a real time inoculation of his son Robert with smallpox. This new institute was formed by the anti-Jenner physician George Pearson in an attempt to shift the credit for vaccination discovery away from Jenner. Despite the prevailing view amongst Jenner supporters, it was clear from the records at the time that Jesty had carried out his vaccine attempts some 22 years before Jenner’s experiments with Sarah Nelms and James Phipps, yet until 1805 had been essentially unrecognized. On the basis of this some writers have sought to ascribe the invention of vaccination to Jesty.

What is evident however is that while vaccinating his family with cowpox secretions, Jesty appears not to have immediately followed that up with variolation, a sine qua non for proof of any hypothesis on the cowpox protective effect. A further intriguing fact is that a third surgeon and older colleague of Jenner, John Fewster who lived in a village near to Berkeley, also appeared to have made the connection between cowpox exposure and smallpox immunity. It has been suggested he presented a paper to the London Medical Society in 1765 entitled “Cowpox and its ability to prevent smallpox” but no evidence of that exists (Jesty and Williams). Fewster had a lucrative business in variolation the financial success of which may have led him to downgrade the importance of the cowpox approach. On the other hand, as a colleague and young apprentice member of the same local medical society where Fewster discussed his observations that individuals exposed to cowpox were ‘uninfectable’ with smallpox, it would be surprising if Jenner had not taken on board the connection. So, in chronological order, Fewster, Jesty, Jenner. Equal members of a vaccination trio or professional soloist and amateur accompanists?

Edward Jenner Book CC-BY-2.0 via Wikimedia Commons
Edward Jenner Book. Public domain via Wikimedia Commons.

As Sir Francis Darwin observed, “In science credit always goes to the man who convinces the world, not the man to whom the idea first occurs”. (Darwin, 1914).

Is this principle supportable even if common today? In discussing the problem of attribution of credit (also quoting Francis Darwin), Sir William Osler, commenting on the discovery of anaesthesia attributed to William Morton in 1848 observed that, despite many who had practiced or had ideas on anaesthesia, from Diascordes to Hickman in 1844,

“Time out of mind patients had been rendered insensible by potion or vapours, or by other methods, without any one man forcing any one method into general acceptance, or influencing in any way surgical practice.” (Osler, 1917)

Therein perhaps lies the answer to the question that still lingers in the historical literature, with its scientific Whigs and Tories debating the creditworthiness of farmer Jesty’s amateur experiments over Jenner’s scientific method (Pead, 2014). The crucial question it seems to me is not who was first but, had Jesty been the only proponent of cowpox vaccination, would the method have had ‘general acceptance’ and further would it have ‘influenced medical practice’? Even with Jenner’s reputation the vehement objections to the cowpox procedure that included claims that patients receiving the vaccine “rendered them liable to particular diseases, frightful in their appearance and hitherto unknown” (The Jennerian Society, 1809) created serious questions about the efficacy and indeed the morality of the procedure. In assessing the validity of these objections, a report of the Medical Committee of the Jennerian Society on the subject of vaccination, contributed to by “21 Physicians and 29 surgeons of the first eminence in the Metropolis”, was published in the Belfast monthly Magazine in 1809. In addressing the alleged claims, 22 separate statements based on analysis of the information by the committee were made. The conclusion of the report states “that it is their full belief, that the sanguine expectations of advantage and security, which have been formed from the inoculation of the cow pox, will be ultimately and completely fulfilled.”

In the end, credit usually gets to the right place, and there would seem to be only one historically supportable conclusion. Jesty was certainly an intelligent amateur who was first to apply the secretions of cowpox as a protection against smallpox, and Fewster was perhaps closer to being in a position to turn the phenomenon into a generally accepted procedure, but chose to maintain his variolation business for whatever reasons. But it was the painstaking scientific methods and the driven ardour of Edward Jenner that overturned the engrained establishment skepticism and established vaccination as a widely adopted procedure. By 1800, Jenner had provided vaccines to a colleague in Bath, England who passed it to a Professor at Harvard, who then introduced vaccination into New England and with Thomas Jefferson’s mediation, into Virginia. As a result the US National Vaccine Institute was set up by Jefferson. By 1803 it was reported that 17,000 vaccinations had been performed in Germany alone, 8,000 individuals of which had been tested by variolation and found to be immune to smallpox. In France, Jenner was revered by Napoleon for his vaccination impact on the health of the Grande Armée, despite being at war with England. By 1810 or so cowpox vaccination had been adopted in most of Europe, the United States, South America, China, India, the Far East, and many other parts of the globe with outstanding success. All this as a result of Jenner’s almost fanatical belief in the importance of a correct procedure in preparing and administering the cowpox vaccine and critically, his ability to garner support from the highest scientific and medical influences.

Had there been a Nobel Prize committee in 1805, would Jenner and Jesty have shared the prize? We shall never know but it’s mighty intriguing to think about.

This is part two of a series about Edward Jenner and the discovery of the smallpox vaccine. Read part one, “Edward Jenner: soloist or member of a trio? Part 1“, which addresses Edward Jenner’s early education and medical career.

Featured image: The Cow Pock, James Gillray. Public domain via Wikimedia Commons.

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