Chapter VI: Jenner’s Further Observations.111

This pamphlet appears to have been produced with many pains and extraordinary apprehensions. Jenner wrote to Gardner, 7th March, 1799--

Every sentence must be again revised and weighed in the nicest
balance that human intellect can invent. The eyes of the
philosophic and medical critic, prejudiced most bitterly against
the hypothesis, will penetrate its inmost recesses, and discover
the minutest flaw were it suffered to be present. Language I put
out of the question: it is the matter I refer to.[112]

These words betray excitement for which there was no warrant; and when we turn to the treatise that was to be weighed sentence by sentence in the nicest of balances, it is clearly seen that its author was a weak-minded creature. It is little more than a gossip about Cowpox without advance upon the statements of the _Inquiry_. Indeed, he sets out with the admission--

Although it has not been in my power to extend the Inquiry into
the causes and effects of the Variolæ Vaccinæ much beyond its
original limits, yet, perceiving that it is beginning to excite
a general spirit of investigation, I think it is of importance,
without delay, to communicate such facts as have since occurred,
and to point out the fallacious sources from whence a disease
resembling the true Variolæ Vaccinæ might arise, with the view
of preventing those who may inoculate from producing a spurious
disease; and further, to enforce the precaution suggested in
the former Treatise on the subject, of subduing the inoculated
pustule as soon as it has sufficiently produced its influence on
the constitution. (P. 69.)

Sometimes when it is objected that the evidence adduced in the _Inquiry_ was hastily collected, meagre and inconclusive, it is replied, “Yes, but recollect, it was merely a selection, if a poor one, from the author’s stores”--a reply which Jenner thus renders nugatory in recording--

My late publication contains a relation of _most of the facts
which had come under my own inspection at the time it was
written_, interspersed with some conjectural observations--(P.
70)--

Which is exactly what any perspicacious reader would infer from the cases adduced in the _Inquiry_. They were Jenner’s best and his all. Meanwhile, as observed, he had been able to do little in extension of the Inquiry; but if idle and helpless, Dr. Pearson had been active--

Since then Dr. George Pearson has established an inquiry into the
validity of my principal assertion, the result of which cannot
but be highly flattering to my feelings. It contains [Pearson’s
_Inquiry_] not a single case which I think can be called an
exception to the fact I was so firmly impressed with--that the
Cowpox protects the human body from the Smallpox. (P. 70.)

Here we have a distinct mis-statement. It was not Jenner’s “fact” that Cowpox protected the human body from Smallpox--that was a widespread superstition. His contribution to the question was a definition of the Cowpox effective against Smallpox, namely Horsegrease Cowpox, other Cowpox being adjudged spurious. Pearson so far from confirming Jenner’s position, deliberately set it aside. He not only accepted the rural faith in Cowpox (which Jenner knew to be unwarrantable), but, when he proceeded to practice, made use of Cowpox which owed nothing to Horsegrease. If therefore Pearson’s procedure was “highly flattering” to Jenner’s feelings, he was either easily pleased, or an adept in dissimulation.

The truth is, the publication of _Further Observations_ was designed by Jenner to loosen himself from what was definite in the _Inquiry_, so that he might be able to appropriate whatever might result from the investigations and experiments then going on. He had defined prophylactic Cowpox as Horsegrease Cowpox, but Horsegrease did not meet with favour, nor appear likely to answer; and it might be expedient to drop it; and thus he described the ground of his attachment to that form of specific--

Firstly.--I conceived that Horsegrease was the source of Cowpox
from observing that where the Cowpox had appeared among the
dairies here [Berkeley] (unless it could be traced to the
introduction of an infected cow or servant) it had been preceded
at the farm by a Horse diseased in the manner described, which
Horse had been attended by some of the milkers.

Secondly.--From its being a popular opinion throughout this great
dairy country, and from its being insisted on by those who here
attend sick cattle.

Thirdly.--From the total absence of the disease in those
countries where the men servants are not employed in the dairies.

Fourthly.--From having observed that morbid matter generated by
the Horse frequently communicates, in a casual way, a disease to
the human subject so like the Cowpox, that in many cases it would
be difficult to make the distinction between one and the other.

Fifthly.--From being induced to suppose from experiments, that
some of those who had been thus affected from the Horse resisted
the Smallpox.

Sixthly.--From the progress and general appearance of the pustule
on the arm of the boy whom I inoculated with matter taken from
the hand of a man infected by a Horse; and from the similarity to
the Cowpox of the general constitutional symptoms which followed.
(P. 91.)

The boy inoculated with secondary Horsegrease was Baker, Case xviii. of the _Inquiry_. He died of fever in the parish workhouse before he could be subjected to the variolous test.

Jenner’s drift in the foregoing propositions was obviously to lighten his responsibility for the advocacy of Horsegrease as the origin of Cowpox; but in doing so he deprived himself of any vestige of claim as a discoverer. Cowpox and Horsegrease as preventives of Smallpox were in common repute; but their combination as Horsegrease Cowpox was supposed by some to be Jenner’s peculiar specific. “Not so,” he said. “It is the popular opinion throughout the country that Cowpox is begotten of Horsegrease;” and proceeded to justify his prescription by the popular authority. He produced a letter from Parson Moore of Chalford Hill to prove how in November, 1797, his Horse had the Grease, with which his boy-servant infected the Cow, which in turn infected the lad with Cowpox, although eighteen months before he had been inoculated, and severely too, with Smallpox; the parson adding--

I am firmly of opinion that the disease in the heels of the
Horse, which was a virulent Grease, was the origin of the
Servant’s and the Cow’s malady. (P. 94.)

To the objection that attempts to raise Cowpox from Horsegrease had, so far, proved failures, Jenner replied--

The experiments published by Mr. Simmons of Manchester and others
on the subject, with the view of refuting the origin of Cowpox
in Horsegrease, appear to have but little weight, as even the
Cowpock Virus itself, when repeatedly introduced into the sound
nipples of Cows by means of a lancet, was found to produce no
effect. (P. 93.)

Having reached this point, I would beg the reader to pause and ask, What was Jenner’s discovery? It was not Cowpox; it was not Horsegrease; it was not Horsegrease Cowpox; all of which by his own admission were recognised by those familiar with them as preventives of Smallpox. What was it then?

Nothing is more conspicuous in the _Further Observations_ than the condition of ignorance and imbecility they reveal. As we have seen, critics of the order of Mr. John Simon represent Jenner’s _Inquiry_ as a Masterpiece of Medical Induction, the fruit of thirty years of incessant thought, observation and experiment; whilst the patience, the caution, and the modesty of the author are commended for imitation. Those who have been subjected to Mr. Simon’s homily cannot but suffer disenchantment when they come face to face with the facts. Not after his thirty years of asserted research could Jenner answer the simple question, What is Cowpox? Incredible as it may appear, the following was his deliverance in presence of the doubts excited by the discussion of his original communication--

To what length pustulous diseases of the udder and nipples of the
Cow may extend, it is not in my power to determine; but certain
it is, that these parts of the animal are subject to some variety
of maladies of this nature; and as many of these eruptions
(probably all of them) are capable of giving a disease to the
human body, would it not be discreet for those engaged in this
investigation to suspend controversy and cavil until they can
ascertain with precision what _is_ and what _is not_ the genuine
Cowpox? Until experience has determined which is the _true_
Cowpock, and which is _spurious_, we view our object through a
mist. (P. 73.)

Consider this declaration after thirty years of incessant thought, observation and experiment! The Masterpiece of Medical Induction with the essential fact undetermined! The discovery undiscovered! And the reputed discoverer sitting ready to appropriate any praise or profit from the execution by others of his proper business! Was there ever such an exhibition of self-satisfied futility?

Among the gossip adduced to show that the country folk called eruptions Cowpox that were not Cowpox, we learn that the affection induced by Horsegrease was thus designated--

From the similarity of symptoms, both constitutional and
local, between the Cowpox and the disease received from the
morbid matter generated by a Horse, the common people in this
neighbourhood, by a strange perversion of terms, frequently call
it the Cowpox. (P. 95.)

Wherefore, he argued, many thus affected may fancy themselves secure from Smallpox, supposing they have suffered Cowpox, when they have undergone nothing but Horsegrease; and in the event of incurring Smallpox, would bring discredit on the virtue of true Cowpox. How easy it was to confound the two diseases, he illustrated from the case of William Morris, a servant, aged 32, who applied to him on 2nd April, 1798--

His symptoms and the sores on his hands were so exactly like the
Cowpox, that I pronounced he had taken the distemper from milking
Cows. He assured me he had not milked a Cow for more than half
a year, and that his master’s Cows had nothing the matter with
them. I then asked him if his master had a Greasy Horse, which
he answered in the affirmative; and further said, that he had
constantly dressed him twice a day for the last three weeks or
more, and remarked that the smell of his hands was much like that
of the Horse’s heels. (P. 97.)

Thus Horsegrease sores so simulated those of Cowpox, or of Horsegrease Cowpox, as to be indistinguishable from them. At this time it was Jenner’s opinion that Horsegrease, _per se_, afforded no protection from Smallpox: it had to pass through the Cow to acquire its sovereign efficacy. The opinion is noteworthy in view of its absolute surrender at a later period, when the virus from the Horse’s heel came to be described by him as “the true and genuine life preserving fluid,” and was used by him for inoculation without any reference to the Cow.

One of the aims of _Further Observations_ was “to enforce the precaution of subduing the inoculated pustule as soon as it had sufficiently produced its effect on the constitution.” True Cowpox, according to Jenner, was a serious affection. “The sores ate into the flesh.” (P. 77.) They were capable of producing violent effects. They were attended with erysipelas. “They closely resembled Smallpox of the confluent sort.” (P. 111.) To prolong such suffering he considered useless, for the virus conferred its protective influence on the constitution as soon as received--

The symptoms which (as in the accidental Cowpox) affect the
patient with severity, are entirely secondary, excited by the
irritating processes of inflammation and ulceration; and it
appears to me this singular virus possesses an irritating quality
of a peculiar kind; but as a single Cowpox pustule is all that is
necessary to render the variolous virus ineffectual, and as we
possess the means of allaying the irritation, should any arise,
it becomes of little or no consequence. (P. 110.)

The means for allaying the irritation were mercurial ointment, acetate of lead, caustic potash, or any suitable escharotic--

After the pustule has duly exerted its influence, I should prefer
the destroying it quickly and effectually to any other mode.
The term caustic to a tender ear (and I conceive none will feel
more interested in this Inquiry than the anxious guardians of a
nursery) may sound harsh and unpleasing, but every solicitude
that may arise on this account will no longer exist when it is
understood that the pustule in a state fit to be acted upon is
then quite superficial, and that it does not occupy the space of
a silver penny. (P. 104.)

I would not, however, recommend any application to subdue the
action of the pustule until convincing proofs had appeared of
the patient having felt its effects for at least twelve hours.
No harm indeed could ensue were a longer period to elapse before
the application was made use of. In short, the pustule should be
suffered to have as full an effect as it could, consistently with
the state of the arm. (P. 109.)

Horsegrease annoyed Pearson--it was like to damn the whole thing; and this treatment of the Cowpox pustule was scarcely less objectionable to him and to Woodville.[113] It gave the public, they thought, a sense of the virulence of Cowpox that was wholly unwarrantable; and they did not stay to consider whether what Jenner called Cowpox in Gloucestershire and what they called Cowpox in London were the same virus. Jenner’s virus was Horsegrease Cowpox; Pearson and Woodville’s was Cowpox; and such being the case, the diversity of symptoms might have been accounted for. Anyhow, the difference between Jenner and Pearson and Woodville, as to a detail so elementary, shows in what an unfinished condition the Cowpox prescription was shot upon the world, and affords a curious commentary on the Masterpiece of Medical Induction, the fruit of thirty years of incessant thought, observation and experiment. At the same time we have to do Jenner the justice of allowing that at this date, 1799, he made no pretence to a finished Masterpiece, but ingenuously ascribed the prevalent uncertainty to “the present early stage of the Cowpox Inquiry; for early,” he wrote, “it must be deemed.” (P. 115.) Early it was: not a point firmly determined: the reverse of what might have been expected after thirty years of incessant thought, observation and experiment.

FOOTNOTES:

[111] _Further Observations on the Variolæ Vaccinæ._ By Edward Jenner, M.D., F.R.S. London, 1799. 4to pp. 73. Reprinted with the third edition of the _Inquiry_ in 1801, to which edition my references apply.

[112] Baron’s _Life of Jenner_, vol. i. p. 322.

[113] Baron’s _Life of Jenner_, vol. i. p. 315.