19th Century Medical Revolution: Vaccination
Description
This article is from the Health Articles series.
19th Century Medical Revolution: Vaccination
Smallpox was the most virulent of the infectious diseases, with a mortality rate well over 50% in previously unexposed populations. Attempts at prevention were made in the early eighteenth century by inoculation with pus from active cases of smallpox. This process, variolation, was often effective, but was lethal in a significant proportion of patients.
Edward Jenner (1749-1823), a Gloucestershire physician, observed that local country people believed that those who had had cow-pox would not contract small-pox. Jenner vaccinated a boy James Phipps with material taken from a cow-pox vesicle on the hands of a dairy maid and then showed that the boy was immune to small-pox.
In this dairy country a great number of cows are kept, and the office of milking is performed indiscriminately by men and maid servants. One of the former having been appointed to apply dressings to the heels of a horse affected with the grease, and not paying due attention to cleanliness, incautiously bears his part in milking the cows, with some particles of the infectious matter adhering to his fingers. When this is the case, it commonly happens that a disease is communicated to the cows, and from the cows to dairy maids, which spreads through the farm until most of the cattle and domestics feel its unpleasant consequences. This disease has obtained the name of cow-pox. It appears on the nipples of the cows in the form of irregular pustules.
Case I. Joseph Merret, now an under gardener to the Earl of Berkeley, lived as a servant with a farmer near this place in the year 1770, and occasionally assisted in milking his master's cows. Several horses belonging to the farm began to have sore heels, which Merret frequently attended. The cows soon became affected with the cow-pox, and soon after several sores appeared on his hands. Swellings and stiffness in each axilla followed, and he was so much indisposed for several days as to be incapable of pursuing his ordinary employment. Previously to the appearance of the distemper among the cows there was no fresh cow brought into the farm, nor any servant employed who was affected with the cow-pox. In April, 1795, a general inoculation taking place here, Merret was inoculated with his family; so that a period of twenty-five years had elapsed from his having the cow-pox to this time. However, though the variolous matter was repeatedly inserted into his arm, I found it impracticable to infect him with it; an efflorescence only, taking on an erysipelatous look about the centre, appearing on the skin near the punctured parts. During the whole time that his family had the smallpox, one of whom had it very full, he remained in the house with them, but received no injury from exposure to the contagion.
Case II. Sarah Portlock of this place, was infected with the cow-pox when a servant at a farmer's in the neighborhood, twenty-seven years ago.
In the year 1792, conceiving herself, from this circumstance, secure from the infection of the smallpox, she nursed one of her own children who had accidentally caught the disease, but no indisposition ensued. During the time she remained in the infected room, variolous matter was inserted into both her arms, but without any further effect than in the preceding case.
Case XVII. The more accurately to observe the progress of the infection I selected a healthy boy, about eight years old, for the purpose of inoculating for the cow-pox. The matter was taken from a sore on the hand of a dairymaid, who was infected by her master's cows, and it was inserted on the 14th day of May, 1796, into the arm of the boy by means of two superficial incisions, barely penetrating the cutis, each about an inch long.
On the seventh day he complained of uneasiness in the axilla and on the ninth he became a little chilly, lost his appetite, and had a slight headache. During the whole of this day he was perceptibly indisposed, and spent the night with some degree of restlessness, but on the day following he was perfectly well.
In order to ascertain whether the boy, after feeling so slight an affection of the system from the cow-pox virus, was secure from the contagion of the smallpox, he was inoculated the 1st of July following with variolous matter, immediately taken from a pustule. Several slight punctures and incisions were made on both his arms, and the matter was carefully inserted, but no disease followed.
The practice spread within two years and by the time of Jenner's death in 1823 was being used in many countries around the world.
by Dr. Ian Carr, Professor Emeritus, Faculty of Medicine, University of Manitoba
Continue to:
My Books
