Amidst the current search for vaccines to treat Covid-19, let us consider the history of vaccination as it pertains to the early modern period. Stefan Riedl explains in his short 2005 article ‘Edward Jenner and the history of smallpox and vaccination‘ that what we call vaccination is rightly associated with English surgeon Edward Jenner’s treatment for smallpox at the end of the 18th century, but had its precursors in early modern Europe as well as other parts of the world long before Jenner. It was vaccine there, but others had also done that.
Techniques for inoculation were developed as a result of the scourge of smallpox. The disease may have originated in African settlements as early as 10,000 BCE and spread to ancient India, Egypt, and China. It arrived around the 5th-7th centuries in Europe, though the Roman Empire may have been beset by a smallpox epidemic in the Antonine Plague of 165-180 CE. Arabs spread the disease throughout the Mediterranean, as did Crusader knights in Europe and western Asia. The Conquistadors brought it to the Americas, decimating both the Incas and Aztecs (as illustrated above in the 16th-century Florentine codex). Closer to home, Field Marshal Sir Jeffrey Amherst advocated the use of smallpox-ridden blankets in North America during the so-called ‘French and Indian War’ of 1754-63 to eliminate indigenous peoples hostile to the British. For the inhabitants of the Americas, this early and abhorrent form of germ imperialism and warfare was a-pox-alyptic.
The disease was called in Latin variola (referring to marks on the skin) and in English ‘small pockes’ (the latter meaning ‘sacs’) as distinct from ‘great pockes’ (syphilis). The Latin term is the origin of the treatment known as ‘variolation’, also referred to as ‘inoculation’ (meaning to graft). Variolation/inoculation referred to the technique of extracting a small sample of a smallpox pustule and then inserting it in the arms or legs of another person as a form of immunisation. Riedl notes that variolation was practiced in Africa, India, and China before its introduction to Europe. Variolation was also used to inoculate women from the Caucasus region headed for the harem of the Ottoman Sultan. This would explain why there is chickenpox but not Turkeypox, given such a poul-treatment.
European travellers to Istanbul observed the practice and communicated it to their countrymen in the 17th and 18th centuries. The medical establishment was generally resistant to the practice, but Lady Mary Wortley Montague–an English aristocrat who suffered disfigurement from a bout of smallpox in 1714, and whose brother died of the disease–travelled to Istanbul with her husband, who was appointed English ambassador there, and learned of variolation. She directed Charles Maitland, the embassy surgeon, to inoculate her infant son and daughter in 1718. Hearing of this success, Maitland was invited by the royal family to perform the procedure on inmates at Newgate Prison, observed by Court physicians, members of the Royal Society, and the College of Physicians: the inmates survived and were immune to smallpox. After another successful trial on orphans, Maitland inoculated the daughters of the Princess of Wales in 1722. Thus this technique came to be adopted throughout Europe: researchers in Early Modern Times’ Department of Musical Immunology have uncovered evidence that the composer J.S. Bach also dabbled in the treatment to inoculate the family of harpsichordist Johann Gottlieb Goldberg. The resulting experiment is known as the Goldberg Variolations.
Variolation was also practiced by English surgeon Edward Jenner (1749-1823), who later developed the treatment of vaccination. As a 13 year-old apprentice to a country surgeon, he reportedly heard a dairymaid remark, ‘I shall never
have smallpox for I have had cowpox. I shall never have an ugly pockmarked face’–a widespread notion at the time. Cowpox is a similar disease to smallpox, transmittable from the pustules on cows’ udders. By 1796, Jenner thought that cowpox could not only treat smallpox but even be transmitted between persons as a form of immunisation. That year, he extracted matter from the cowpox lesions of a dairymaid to inoculate an 8 year-old boy. The boy experienced mild illness, but soon recovered, and a subsequent application of a smallpox lesion showed that he was immune. Jenner called the technique ‘vaccination’ after the Latin words vacca (cow) and vaccinia (cowpox). Although Jenner was udderly blown away by the results, the medical establishment was not: in their disbelief, it was vaccine but not herd. But after a few years of further trials and promotion of vaccination, the technique came to replace variolation by the early 19th century: Jenner’s treatment caught on and was contagious.
Now, Jenner did not discover vaccination, as it had been practiced by various country doctors in the 18th century. Although he received honours, his financial situation tended to suffer due to his single-minded devotion to developing the treatment. Consequently, he received substantial sums of money from Parliament for his vaccination program–what we might call ‘immuneration’. Nevertheless, many of his contemporaries were sceptical and scornful of the treatment. Indeed, to this day there are many zealous ‘anti-vaxxers’ who question the effectiveness and safety of vaccination–leading to outbreaks of measles and other epidemics–which just goes to show that the popularity of this treatment continues to vax and wane.
Till next time,
Director, Early Modern Vaccinationalism Studies Program