Chapter III: Jenner in 1798

Jenner, with his wife and daughter, left Berkeley for London on 24th April, 1798, in order to see the _Inquiry_ through the press. He remained in London until 14th July, and failed, if he tried, to induce any inoculator to substitute cowpox for smallpox. In the Jenner legend, it is usual to find some touching remarks on this trip to town: genius unrecognised: truth turned from every door: the great soul abiding in patience and courage invincible. Dates, however, are again merciless. The _Inquiry_ was not in the booksellers’ hands until the end of June, and, within a fortnight after publication, Jenner was on his way to Berkeley. There was no occasion for the virtues specified.

Among Jenner’s acquaintance was Henry Cline, teacher of surgery in St. Thomas’s Hospital; and with Cline he left some virus in a quill that he had taken from the arm of Hannah Excell, at Berkeley on 5th April. Cline had a patient, a child named Richard Weller, with an affection of the hip-joint, and intending to create an issue by way of counter-irritation, he inoculated the hip with Excell’s virus, and thus described the experiment in a letter to Jenner--

LINCOLN’S INN FIELDS, _2nd August, 1798_.

The Cowpox experiment has succeeded admirably. The child sickened
on the seventh day; and the fever, which was moderate, subsided
on the eleventh day. The inflammation extended to about four
inches diameter, and then gradually subsided without having been
attended with pain or other inconvenience. The ulcer was not
large enough to contain a pea; therefore, I have not converted
it into an issue as I intended. I have since inoculated him with
smallpox in three places, which were slightly inflamed on the
third day, and then subsided.

Dr. Lister, who was formerly physician to the Smallpox Hospital,
attended the child with me, and he is convinced that it is not
possible to give him the smallpox.

I think the substituting of cowpox poison for the smallpox
promises to be one of the greatest improvements that has ever
been made in medicine; for it is not only so safe in itself, but
also does not endanger others by contagion, in which way the
smallpox has done infinite mischief. The more I think on the
subject, the more I am impressed with its importance.

Cline then attempted to vaccinate with virus taken from Weller’s hip, but failed. He wrote to Jenner--

LINCOLN’S INN FIELDS, _18th August, 1798_.

Seven days since I inoculated three children with cowpox matter,
and I have the mortification of finding that the infection has
not taken, and I fear I shall be entirely disappointed unless you
can contrive to send me some fresh matter. I think it might come
in a quill in a letter, or enclosed in a bit of tin-foil.

Jenner was unable to comply with Cline’s request: he had no cowpox to transmit: and readers of the _Inquiry_ who addressed to him similar requests had to submit to similar disappointments, out of which some suspicion was naturally developed. The recommendation of a remedy whereof there was no available supply was not a passport to confidence.

Baron relates, that “Mr. Cline perceiving _at once_ from the success of his first trial, what incalculable blessings were connected with the diffusion of the new practice, immediately advised Jenner to quit the country, and to take a house in Grosvenor Square, and promised him £10,000 per annum as the result of his practice; in which opinion Mr. Cline was supported by Sir W. Farquhar; but that all these splendid prospects of wealth and distinction could not move Jenner.”[101]

The story is either an invention, or it does little credit to Cline’s judgment. Jenner had neither the means for a house in Grosvenor Square, nor was there any likelihood of his earning £10,000 a year by cowpox. Nevertheless it would appear that at this juncture some one was advising him to try London (one’s vanity is never without a prompter), and that Jenner replied--

CHELTENHAM, _29th September_.

My perplexity really amounts to agitation. On the one hand,
unwilling to come to town myself for the sake of practice, and,
on the other, fearful that the practice I have recommended may
fall into the hands of those who are incapable of conducting it,
I am thrown into a state that was not at first perceptible as
likely to happen to me; for, believe me, I am not callous to all
the feelings of those wounds which, from misrepresentation, might
fall on my reputation; on the contrary, no nerves could feel more
acutely; and they now are actually in a tremor from anticipation.

How very few are capable of conducting physiological experiments!
I am fearful that before we thoroughly understand what is cowpox
matter, and what is not, some confusion may arise, for which I
shall, unjustly, be made answerable.[102]

If his correspondent had been a man of sense, he might have replied--

Why so much ado about nothing! You recommend that horsegrease
cowpox be substituted for smallpox in cases of inoculation. It is
a simple prescription, easily determined altogether apart from
you, and there is no reason why you should work yourself into
such a flutter.

But Jenner was not the unimpassioned man of science, who can leave truth to take care of itself, and submit when truth contradicts his prepossessions. Dr. Ingenhousz, an Anglicised Dutchman (born at Breda, 1730), with reputation as electrician and chemist, read the _Inquiry_ with considerable amazement. He was himself an inoculator of mark, having been selected by the Empress Maria Teresa to operate upon the imperial family of Austria; and by her had been rewarded (after the pattern of Catharine of Russia and Dimsdale) with a pension of £600 a year, and the titles of Aulic Councillor and Imperial Physician. Naturally, therefore, Ingenhousz had a lively interest in Jenner’s project, and being on a visit to the Marquis of Lansdowne at his seat in Wiltshire, addressed him as follows--

BOWOOD PARK, _12th October, 1798_.

As soon as I arrived at Bowood, I thought it my duty to inquire
concerning the extraordinary doctrines contained in your
publication, as I knew the cowpox was well known in this county.

The first gentleman to whom I addressed myself was Mr. Alsop,
an eminent practitioner at Calne, who made me acquainted with
Mr. Henry Stiles, a respectable farmer at Whitley, who, thirty
years ago, bought a cow at a fair, which he found to be infected
with what he called the cowpox. This cow soon infected the whole
dairy; and he himself, by milking the infected cow, caught the
disease which you describe, and that in a very severe way,
accompanied with pain, stiffness, and swelling of the axillary
glands. Having recovered from the disease, and all the sores
dried, he was inoculated with smallpox by Mr. Alsop. The disease
took place, a great many pox came out, and he communicated the
infection to his father who died of it.

This being an incontrovertible fact, cannot fail to make some
impression on your mind, and excite you to inquire further on
the subject before you venture finally to decide in favour of a
doctrine, which may do great mischief should it prove erroneous.

The impression made on Jenner’s mind was simply one of annoyance. He fell back on the assertion that all was not cowpox that was supposed to be cowpox, and that Farmer Stiles could not have had the genuine distemper, or he would not have received smallpox by inoculation. It did not even occur to him that it was necessary to investigate and account for the evidence adduced by Ingenhousz, which was every whit as valid as much of his own. He was content to protest--

In the course of my inquiry, not a single instance occurred of
any one having the disease, either casually or from inoculation,
who on subsequent exposure to variolous contagion received
the infection of smallpox.... Should it appear in the present
instance that I have been led into error, fond as I may appear
of the offspring of my labours, I had rather strangle it at once
than suffer it to exist, and do a public injury. At present, I
have not the most distant doubt that any person, who has once
felt the influence of perfect cowpox matter, would ever be
susceptible of that of the smallpox.

Could universal conclusion be deduced from more questionable premisses? and this, too, by one who had just exclaimed, “How very few are capable of conducting physiological experiments!” Always, as we shall see; ungenerous toward those who questioned his assertions, Jenner wrote to his friend, Gardner--

This man, Ingenhousz, knows no more of the real nature of
the cowpox than Master Selwyn does of Greek: yet he is among
philosophers what Johnson was among the literati, and, by the
way, not unlike him in figure--

When, in fact, what provoked him was that Ingenhousz knew too much about cowpox, and had laid his finger on the point of error at the outset. Inquiry on the part of Ingenhousz brought to light several other instances of smallpox after cowpox; and Dr. Pulteney of Blandford reported that Dorsetshire inoculators were familiar with the one sort of pox after the other sort. Jenner’s constant answer to such objections was, “Yes; but it could not have been true cowpox to start with”--a style of argument maintained with parrot-like persistency when smallpox followed vaccination. “Ah!” it was said, “there must have been some mistake about the vaccination; for no one can be thoroughly vaccinated and have smallpox.”

Looking back on the final years of last century, it is much to be regretted that more pains were not taken to hold Jenner fast to his position that smallpox never followed cowpox, and to demonstrate beyond contention that it was not true. It certainly was not true; the evidence to that fact was indisputable; but few were disposed to follow Ingenhousz into the West of England and search for the requisite proof; and Ingenhousz was cut out of the controversy by his death at Bowood on 7th September, 1799. Presently Jenner managed to have the contention shifted from the experience of the dairies to vaccination from arm to arm and the illusory variolous test, and the advantage of a decision at the springs of fallacy was lost. In the general confusion which ensued Jenner came to be taken for a discoverer, and he posed diligently in the character, when he was nothing more than the advertiser of the vulgar opinion of his neighbourhood, with the modification that not Cowpox but Horsegrease Cowpox was the true and infallible specific. The fact is so clear, that he was a mere advertiser, that it would not be worth repetition, were it not so systematically treated as unseen. How distinctly it was at first recognised appears in a letter of thanks for a copy of the _Inquiry_ addressed to Jenner by Francis Knight, a London surgeon, wherein he observed--

CLIFFORD STREET, _10th September, 1798_.

I have read your publication with much satisfaction; and, from
a long residence in the dairy part of Wiltshire, as well as in
Gloucestershire, I know the facts to be well supported; at least,
it was a general opinion among the dairymen, that those who
had received the cowpox were not susceptible of the variolous
disease. The cowpox pustule is very familiar to my eye, and I am
quite charmed with the delineation of it in your plates. You have
opened to the world a very curious field of investigation, and it
is too interesting a subject to die with the day.[103]

In these remarks of Knight, we have Jenner’s position accurately defined. He made himself responsible for “the general opinion among the dairymen”; and had some one at that time shown in perspicuous and emphatic fashion that the dairymen were wrong, Jenner would have been summarily disposed of. Vain, however, are such regrets; and we may find comfort in the reflection that there is an order in the universe which converts misfortune into means for greater and rarer good.

Another letter to Jenner from Dr. Hicks contains these remarks--

BRISTOL, _3rd October, 1798_.

I wish you had been able to have communicated the cowpox to the
cow by means of inoculation from a greasy horse’s heel, for your
work would then have been more complete and satisfactory.

I do not see that you need hesitate to accept the invitation
given you to inoculate with the cowpox, convinced as you are that
it will secure the persons so inoculated from ever being infected
with the smallpox.

Everlasting security from smallpox! Such was the unqualified promise, and with how little warrant! In presence of a Socratic inquirer with his persistent, how do you know? Jenner must have stood confounded.

A letter to Jenner from Dr. Percival, also contains some remarks worth notice. He wrote--

MANCHESTER, _20th November, 1798_.

The facts you have adduced incontestably prove the existence of
the cowpox, and its ready communication to the human species.
But a larger induction is yet necessary to evince that the virus
of the Variolæ Vaccina renders the person who has been affected
with it secure during the whole of life from the infection of the
smallpox.

Mr. Simmons, an ingenious surgeon of this town, has inoculated
a human subject with the ichor issuing from what is termed
the grease in horses; but the fluid introduced, though eight
punctures were made, neither occasioned inflammation nor
eruption; yet the same child was soon afterwards inoculated with
success for the smallpox. Mr. Simmons has now engaged a herd of
cows, and is busily employed in making such experiments as your
publication has suggested.

It is very remarkable, that the cowpox has been hitherto
unnoticed in Cheshire, which is not less a dairy county than
Gloucestershire, and where the office of milking is performed
also by men and maid servants indiscriminately.

The frequent statement that Jenner’s _Inquiry_ was at first received with indifference is entirely untrue: on the contrary, it was read with interest from the outset, and the only check he met was due to his inability to supply the demands of correspondents for samples of the precious virus. Cowpox was absent for awhile from the dairies, and great was his relief and delight when toward the end of 1798 some matter was obtained from a farm at Stonehouse wherewith on the 27th November he vaccinated the children of his friend, Henry Hicks of Eastington; “the first gentleman,” says Baron, “who had the merit of submitting his own children to the new practice.”

Ere 1798 had passed away, Jenner had secured an energetic ally in Dr. George Pearson, F.R.S., Physician to St. George’s Hospital, London.[104] Pearson entered into the cowpox question with his whole heart, and constituted himself a sort of partner in Jenner’s project. He wrote to him--

LEICESTER SQUARE, _8th November, 1798_.

Your name will live in the memory of mankind, as long as men
possess gratitude for services and respect for benefactors; and
if I can but get matter, I am much mistaken if _I do make you
live for ever_.

And in a more decided strain on 13th November--

I wish you could secure me matter for inoculation, because,
depend upon it, a thousand inacurate but imposing cases will be
published against the specific nature of the disease by persons
who want to send their names abroad about anything, and who will
think _you and me_ fair game.

In the same letter he told Jenner what some were saying about the suggested practice--

You cannot imagine how fastidious the people are with regard to
this business of the cowpox. One says that it is very filthy and
nasty to derive it from the sore heels of horses. Another, that
we shall introduce the diseases of animals among us, and that we
have already too many of our own. A third sapient set say, it is
a strange odd kind of business, and they know not what to think
of it. All this I hear very quietly, and recollect that a still
more unfavourable reception was given to inoculation for the
smallpox.

Such observations were natural and to be expected. Jenner wrote to Gardner that “brick-bats and hostile weapons of every sort were flying thick around him,” but they were chiefly imaginary. His revelation was communicated to a ready world. It was no revolutionary project, but a seductive modification of existing practice. Inoculation with smallpox was the order of the day among all respectable people. The operation was troublesome and uncertain, perilous to patients and to those in contact with them; and, when all was done, it afforded no unquestionable security against the disease it was designed to avert. To a community thus harassed and anxious, came Jenner with his prescription and his promise--Substitute cowpox for smallpox and you will escape from this distress, danger, doubt. You will have a harmless fever without pustules and without risk of infection, and the security from smallpox will be absolute and perpetual. What wonder that in such circumstances Jenner’s message was heard gladly and accepted with grateful enthusiasm. That he should have encountered some resistance was inevitable, for what change is ever effected without opposition and ominous prediction? But the change Jenner proposed was the slightest of changes with the largest prospects of advantage. Unless these conditions are borne in mind, we shall never rightly understand the reception accorded by our forefathers to inoculation with cowpox.

FOOTNOTES:

[101] Baron’s _Life of Jenner_, vol. i. p. 154.

[102] _Ibid._ p. 155.

[103] Baron’s _Life of Jenner_, vol. i. p. 159.

[104] Born at Rotherham, 1751. Graduated M.D., Edinburgh, and practised at Doncaster until 1784, when he removed to London. Died at his house in Hanover Square from a fall down stairs, 9th November, 1828.