Smallpox vs Edward Jenner: How One Doctor Invented Vaccination and Cured the World

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The deadly disease smallpox had been feared by man for thousands of years by the 1800s, and rightly so. It was highly contagious, incurable, and killed a third of those unlucky enough to catch it.

Those who survived it were rarely left unscathed. Aside from the inevitable permanent scarring, it could leave victims blind and doomed to spend the rest of their days battling lung or joint problems. The disease also did not discriminate between the rich or poor.

Several royals and world leaders contracted it. Queen Elizabeth I, George Washington and Joseph Stalin all had pock-marked faces which they took great pains to disguise. The 18th century fashion for wearing patches stemmed from the desire to hide the damage smallpox had done to aristocratic skin. Smallpox killed both King Louis XV of France and Queen Mary II of England, monarchs who could well afford the best physicians to try to save them, so the merest threat of it was enough to send the population into a panic.

Of course, it didn’t help matters that medical scientists had no idea how the disease was spread and had no way of treating it. The concept of bacteria and viruses would not begin to enter into medicine until 1861, so physicians were clueless. Theories abounded over time, blaming God, the alignment of the planets, and eventually evil miasmas (bad air) as the root cause of an epidemic. Treatments were equally as primitive. Prayer, smelling sweet nosegays, and bonfires were the only weapons the Western World had for centuries. As a result, outbreaks could kill thousands in a very short space of time with terrifying speed, especially children or the old. The only thing they did know, was once you had caught it, you couldn’t catch it again.

In the East where medicine was traditionally more advanced and largely unencumbered by religious interference, physicians expanded upon this idea. Using the healing scabs of a recovering smallpox victim, which they scratched into the skin of healthy people, they protected them. Although they did not realise it at the time, what they were doing was building up the body’s antibodies using a weakened dose of smallpox and thereby rendering the body resistant to any stronger. It’s still a common practice nowadays with certain diseases. Polio is a classic example. Variolation (or inoculation as we now know it) was brought to Britain in 1715 by Lady Wortley Montague, an ambassador’s wife who had suffered smallpox as a child and lost a brother to it.

Whilst inoculation did work in a great majority of cases, it was not without serious risk. By exposing people directly to smallpox, albeit a significantly weaker version of the disease, at least ten percent of those inoculated contracted full-blown smallpox in the process, often with fatal consequences. King George III lost his son Prince Frederick after he had the boy inoculated. When even the king could not guarantee its safety, a great many preferred not to take the risk. Inoculation was also very expensive, which put even more off it, so smallpox remained a devastating killer throughout the eighteenth century.

In 1784, after extensive study of smallpox victims during an epidemic in his hometown of Chester, Dr John Haygarth became convinced smallpox was transferred by human contact. He recommended quarantining anyone with smallpox and gave sound advice as to how anyone coming into contact with a victim should stop the infection spreading:

“During and after the distemper, no person, clothes, food, furniture, cat, dog, money, medicines or any other thing that is known or suspected to be bedaubed with matter, spittle, or other infectious discharges of the patient should go out of the house until they have been washed…When a patient dies of smallpox, particular care should be taken that nothing infectious be taken out of the house so as to do mischief.”

Haygarth’s methods were soon widely adopted. Wherever possible, smallpox victims were isolated away from the rest of the community. Every item of clothing and bedding used was burned to avoid contaminating others. Sometimes, this occurred using quarantine ships. These were hardly floating hospitals as there was little doctors could do other than let the disease run its course, however, moving sufferers offshore was fairly successful in containing the disease if they caught it quickly enough.

cowpoxThe big breakthrough came thanks to a country doctor called Edward Jenner. He decided to test the validity of an old wives’ tale which claimed all those who worked with cows were immune to smallpox. Over the course of many years, he discovered that those new to working with cattle–such as milk maids–often caught a relatively harmless disease from them. Cowpox caused a mild fever and an irritating skin rash in humans which quickly cleared up of its own accord. Jenner began to suspect cowpox was the key to the immunity from smallpox. However, to test his theory he would need to infect a human with cowpox who had never come into any contact with cows before.

In 1796 he paid the parents of James Phipps, and then injected the pus from a cowpox pustule into the boy. A few weeks later, he exposed the boy to smallpox and when nothing happened declared it a resounding success. He called his new treatment vaccination as the word vacca is Latin for cow and was convinced it was the only thing capable of defeating the ‘speckled monster’. However, the Royal Society did not welcome his research with open arms. They declared it too revolutionary and asked for more proof. It took until 1798, and several more experiments with cowpox including one on his own baby son, before they published his findings.

Although conclusive, the people were less enthusiastic to this new miracle prevention. There was an enormous backlash against Jenner’s vaccination accompanied by an extensive propaganda campaign. Aside from the fact the new prevention was more expensive than the old-fashioned inoculation, the widespread resistance came because of two things:

Firstly, and perhaps most importantly, vaccination was seen as ungodly. The very religious masses listened to the anti-vaccination sermons preached from pulpits the length and breadth of the British Isles. After all, in Corinthians is stated quite clearly: “All flesh is not the same flesh: but there is one kind of flesh of men, another flesh of beasts”. Mixing the two things was grossly unacceptable according to the scriptures.

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James Gillray, The Cow Pock. An anti-vaccination cartoon from 1802.

Secondly, although Jenner was able to prove vaccination did work with none of the risks caused by inoculation, he had no earthly idea why. Even the educated struggled to justify agreeing to vaccination without knowing the science behind it. Perhaps it was possible they would begin to sprout horns and udders in the future? Nobody could say for certain this wouldn’t happen.

Others were less resistant. Napoleon honoured Jenner with a medal after the Frenchman vaccinated his troops. Before that, more of his army were killed by smallpox than by battle. Another fan was President Thomas Jefferson who, in 1806, wrote a gushing letter of thanks to Edward Jenner:

“I avail myself of this occasion of rendering you a portion of the tribute of gratitude due to you from the whole human family. Medicine has never before produced any single improvement of such utility… Future nations will know by history only that the loathsome small-pox has existed and by you has been extirpated.”

While history proved Jefferson’s prediction correct, such accolades from Britain’s then enemies did not really do Edward Jenner any favours at home. Vaccination remained hugely unpopular with the masses and some dyed-in-the-wool physicians despite overwhelming evidence of its success and continued to be during Edward’s lifetime and beyond. He died in 1823 with his vaccination still as controversial then as it had been in 1796.

Things came to a bit of a head in the UK when the government stepped in. In 1840 they declared the old inoculation illegal, thus eliminating the choice. Then, the 1853 Vaccination Act made it compulsory in law for all babies to be vaccinated before they were three months old. Failure to do so resulted in a one pound fine and potentially the risk of prison. People argued they were now denied the right to decide what they could put into their own bodies and many took to the streets to protest. Compulsory vaccination was so unpopular, the government had to back down and stopped prosecuting those who refused.

It was only once the brilliant French scientist Louis Pasteur began to do more experiments on vaccination in the late 19th century, and was finally able to explain why it worked, that public objection lessened. Smallpox vaccination became widespread and the catastrophic and destructive epidemics died out. The last known recorded case of smallpox was in Somalia in 1977 and in 1980 the World Health Organization declared the disease eradicated save the few samples kept secure in laboratories. And all thanks an old wives’ tale and a tenacious, mild-mannered country doctor from Gloucestershire who never wanted to be famous.
virginia heath cover
Virginia Heath writes witty Regency romantic comedies for Harlequin Mills & Boon. The first book in her ‘Wild Warriners’ series, A Warriner to Protect Her, will be released in April 2017.

“A Second St Domingo”: Sickness during the Walcheren Expedition of 1809

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Terrain of the Walcheren campaign, from France Militaire: histoire des Armees Francaises de terre de mer de 1792 a 1833…by A. Hugo, 1837.

In 1809, the British government sent an amphibious force of 40,000 men and 600 naval vessels to the Scheldt to destroy the French fleet and dockyards at Antwerp and Flushing. It was Britain’s biggest expeditionary undertaking since the beginning of the wars with France in 1793, part of the War of the Fifth Coalition and a diversion to assist the Austrians against Napoleon in central Europe.

The expedition, under the military command of John Pitt, 2nd Earl of Chatham, was a complete failure. The Austrian allies were defeated before the expedition left; although the British captured the island of Walcheren, they advanced too slowly across the neighbouring island of South Beveland, allowing the French to reinforce Antwerp. The expedition was finally withdrawn after a catastrophic outbreak of ‘Walcheren fever’, a combination of several diseases, including malaria.

The impact of this sickness can best be gauged through dry statistics. Of the 39,219 rank and file sent to Walcheren, 11,296 of them were on the sick lists by February 1810. By this time 3,960 were dead. A further 106 had died in battle, but those numbers were swallowed up in the sheer scale of the tragedy.

‘Walcheren fever’ struck the troops suddenly and savagely. One source, the anonymous Letters from Flushing, recorded fatalities from sickness as early as 12 August 1809, but on 8 August the British Chief of Staff reported ‘We have as yet no sick,’ and on 11 August the commander-in-chief Lord Chatham thought ‘the Troops upon ye whole continue healthy.’[1]

By 20 August, however, things had changed. The official Proceedings of the Army recorded on 22 August: ‘Sickness began to show itself among the Troops in South Beveland. On the 20th the number of Sick was 1564, and within the two following days it increased very considerably.’ The next day, the 23rd, the Proceedings recorded ‘Sickness increased very much within the last 24 hours.’ By the 24th the sickness had spread to Walcheren.[2]

At first the officers were not too worried. One of the aides-de-camp to Sir Eyre Coote (Chatham’s second-in-command) recorded in his diary on 24 August: ‘5000 French Troops are said to have fallen a victim to the climate last year, but I consider this as a very exaggerated statement, and at any rate, the constitutions of our men & their habits of life, are much better adapted to this moist atmosphere.’[3]

But by the 27th there were 3467 sick. The following day the officer compiling the official returns could not restrain his concern: ‘The sickness increased to an alarming Proportion, some of the General, and many other Officers were seized with fever, and the Number of Men on the Sick List was nearly 4000.’[4]

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The evacuation of South Beveland, August 1809

The sickness was described by Lieutenant William Keep of the 81st:

The disease comes on with a cold shivering, so great that the patient feels no benefit from the clothes piled upon him in bed, but continues to shiver still, as if enclosed in ice, the teeth chattering and cheeks blanched. This lasts some time and is followed by the opposite extremes of heat, so that the pulse rises to 100 in a small space. The face is then flushed and eyes dilated, but with little thirst. It subsides and then is succeeded by another paroxysm, and so on until the patient’s strength is quite reduced and he sinks into the arms of death.[5]

The British army had been sent to Walcheren with medical supplies for only 30,000 men. It was caught completely off-guard by the scale of the sickness. Things were not helped by the fact that the British had bombarded one of Walcheren’s largest merchant towns, Vlissingen (Flushing), in mid-August, which restricted the accommodation available to the British troops. By 30 August there were nearly 900 sick in Flushing alone, ‘all of them laying [sic] on the bare boards without Paillasses & many without Blankets.’ Two days later Coote’s aide concluded in despair: ‘This island is a mere Hospital and an Inspector of Hospitals will shortly be a more useful officer than the General Commanding.’[6]

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Flushing Harbour. Photograph by Jacqueline Reiter

All these circumstances contributed to an atmosphere of near-panic. Nobody knew who would be next, and no rank was exempt. ‘A considerable degree of apprehension of Climate and Disease has prevail’d too generally, and there has been much anxiety shewn to get away from this Island as if it had been a second St Domingo,’ the Chief of Staff reported disapprovingly, but by this time several generals (including General Mackenzie-Fraser, who later died) were dropping like flies.[7] By mid-September the Adjutant-General of the army was sending in daily (rather than weekly) sick reports, and Chatham decided to start sending the sick home ahead of official orders from the War Office.

According to one account, one doctor ‘and his assistant [had] nearly five hundred patients prostrate at the same moment … the whole concern was completely floored’. [8] By 23 September the army had almost completely run out of bark (now quinine, used to treat malaria) and the medical corps were of course also losing staff to sickness. Sir Eyre Coote (who took over from Chatham, who was recalled) reported to the Secretary of State for War: ‘I can assure Your Lordship, without any Fear of Exaggeration … that the Situation of the Troops in this Island is deplorable … The Sick are so crowded, as to lay Two in one Bed in several Places, and have no Circulation of Air.’ In Flushing, by contrast, many of these places had rather too much air circulation, owing to ‘the damaged State of the Roofs, never repaired since the Siege.’[9]

Totally overburdened, the medical corps became desperate in their attempts to stem the disease. They had no idea what was causing it: they knew it wasn’t contagious, but thought it was due to ‘local or endemic Causes, viz. the Miasmata or Exhalations from the Soil.’ They did, however, notice that the sailors on board the British ships remained healthy, with the exception of the ones who had gone ashore to help with the siege of Flushing (naturally, as mosquitoes do not breed around salt water). One proposed treatment therefore was to pack the British sick into ships and sail them around the islands, in the hope that the sea air and a change of scene would restore them to health. Unsurprisingly, this did not work.[10]

The impact of Walcheren fever on the British army was significant and long-lasting. The soldiers who had served on the campaign continued to relapse periodically for years after. In March 1812 Lord Wellington, in the midst of fighting in the Spanish Peninsula, lamented the fact that his troops had been ‘so much shaken by Walcheren.’ [11] The careers of the commander-in-chief of the Army, Lord Chatham, and the naval commander, Sir Richard Strachan, were destroyed by the disaster.

The British government that had planned the expedition under the Duke of Portland fell, and its successor nearly foundered during the ensuing parliamentary inquiry into the debacle. Two government ministers, Lord Castlereagh and George Canning, ended up fighting a duel. None of this, of course, was especially comforting to the four thousand men who had died from ‘Walcheren fever’.

References
[1] Letters from Flushing … by an Officer of the Eighty-First Regiment (London, 1809), p. 120; Sir Robert Brownrigg to Colonel Gordon, 8 August 1809, BL Add MSS 49505, f. 9; Chatham to Castlereagh, 11 August 1809, PRONI D3030/3220; John Webb to the Surgeon General, 27 August 1809, A Collection of Papers relating to the Expedition to the Scheldt (London, 1809), pp. 588-90.
[2] The National Archives WO 190, 22-4 August 1809.
[3] University of Michigan Coote MSS, Box 29/3, Diary of the Walcheren Expedition, 24 August 1809.
[4] The National Archives WO 190, 27-8 August 1809.
[5] Quoted by Martin Howard, Walcheren 1809, Barnsley, 2011, p. 161.
[6] University of Michigan Coote MSS, Box 29/3, Diary of the Walcheren Expedition, 30 August, 1 September 1809.
[7] Sir Robert Brownrigg to Colonel Gordon, 8 September 1809, BL Add MSS 49505 f. 69.
[8] Rifleman Harris, quoted by Howard, Walcheren 1809, p. 172.
[9] Sir Eyre Coote to Castlereagh, 17 September 1809, A Collection of Papers, pp. 137-40.
[10] Memorandum dated 25 September 1809, A Collection of Papers, pp. 623-5; Sir Eyre Coote to Lord Liverpool, 23 October 1809, A Collection of Papers, pp.177-8.
[11] Howard, Walcheren 1809. p. 215.

Further reading
Gordon Bond, The Grand Expedition (Athens, GA, 1971)
Martin R. Howard, Walcheren 1809 (Barnsley, 2011)
John Lynch, ‘The Lessons of Walcheren Fever, 1809’, Military Medicine 174(3) 2009, pp. 315-19
T.H. McGuffie, ‘The Walcheren Expedition and the Walcheren Fever’, English Historical Review jacquelinereiter_bookcover62(243) 1947, pp. 191-202

Jacqueline Reiter has a PhD in late 18th century political history from the University of Cambridge. A professional librarian, she lives in Cambridge with her husband and two children. She blogs at www.thelatelord.com and you can follow her on Facebook or Twitter. Her first book, The Late Lord: the life of John Pitt, 2nd Earl of Chatham, was published by Pen & Sword Books in January 2017.

Five Horrible Ways to Die in Restoration London

 

In my book Tyburn, the heroine, Sally, is convinced that Death is following her, and the more you read about life in Restoration London, the more you realize that she is probably right.

Seventeenth-century London was an incredibly dangerous place, and causes of death were mostly mysterious. In his Natural and Political Observations Made Upon the Bills of Mortality, John Graunt offers some of the following explanations: traffic, sciatica, swine-pox, wen, lethargy, fear, sadness, itch, and rather worryingly, “mother.”

If the people living in Restoration London were lucky enough to survive childhood, they could be killed by several afflictions that no longer trouble us today. Apart from the most serious culprits like Tuberculosis and plague, people could die from as little as falling down in the uneven, filthy streets. Do you think you could survive Restoration London? Here’s what you’re up against:

95524-pestarztPlague: Which one? Both the pneumonic and the bubonic plagues claimed lives throughout the period. Infection would begin with a flea bite, and from there either spread to the lungs (pneumonic) or the lymph nodes (bubonic). The pneumonic plague resulted in death within three days. The bubonic plague could had a survival rate of about 30%, but still managed to kill an estimated 100,000 people in London alone between 1665-66.

Falling into a Plague Pit: In Journal of a Plague Year, Defoe describes an occurrence of a cart, driver, and horses crash into a plague pit where it was completely swallowed by the corpses and never recovered. There were so many of these pits and they were so large that this happened frequently. There’s a massive plague pit underneath Hyde Park that has affected the path of the Underground, and other pits are still being discovered.

84a31-dc3bcrersyphilis1496Syphilis (The Great Pox, the French Pox): Syphilis was probably brought to Europe by Columbus and had reached Naples by 1494 (thanks, jerk). It was seen as primarily a male problem, and was often passed to unsuspecting spouses (and any children conceived) during periods of remission. The first stage was a chancre on or near the genitals, followed by rashes and open sores. Syphilis was treated at this stage with mercury in every form from enemas, ointments, and pill to steam baths or “sweats” in mercury vapor. This treatment was someone successful, although it was known even at the time to cause madness. At this point, the soft tissues of the nose and palate could begin to rot, and the teeth and hair would loosen and fall out. If this stage was survived, the disease could lie dormant for up to 30 years, but could still be easily transmitted. If you were lucky enough to make it until the third and final stage of syphilis, you could look forward to madness and paralysis.

Jail Fever (Epidemic Typhus): Spread through body lice, common in dirty, overcrowded conditions, it broke out mainly in jails like Newgate. It causes fever, headache, weakness, and rash, and can lead to swelling of the heart or encephalitis.

The King’s Evil (Scrofula): Tuberculosis of the lymph nodes of the neck. It was believed to be curable by the touch of royalty as far back as Edward the Confessor. The disease often went into remission on its own, so the Royal Touch appeared to work. Charles II touched more than 90,000 people afflicted between 1660 and 1682.

Good thing Sally fancies a physician, huh?

Originally posted on Kimber Vale’s blog here. Stop by and say hi!

The King’s Evil: Touch Me, Your Majesty

Here’s the King, curing some Evil.

Disease was very common during the Restoration. In spite of the medical advances of the seventeenth century, there was much about the human body and disease in particular that remained mysterious. Magic was still believed to cure any number of ailments, and people often relied on superstition to treat illnesses. Executioners made most of their money by selling off pieces of dead convicts: their clothes, the noose, and even body parts were sold to Quacks for the making of charms thought to cure everything from headaches to bad luck. 

One of the most mysterious of these illnesses was the King’s Evil. I know how it sounds, but it’s not chlamydia. The King’s Evil, or scrofula, is tuberculosis of the lymph nodes of the neck. It was called the King’s Evil because it was believed that only the touch of a King could cure it. 

The disease often went into remission on its own, so the Royal Touch appeared to work. Kings had been touching people afflicted with scrofula as far back as Edward the Confessor. Robert Herrick even wrote a poem about it:

O! lay that hand on me,
Adored Caesar! and my faith is such,
I shall be heal’d, if that my KING but touch.
The Evill is not yours: my sorrow sings,
Mine is the Evill, but the cure, the KINGS.

-Robert Herrick, “To the King, the cure the Evil.”


While he waited in exile, touching those afflicted with the King’s Evil was one of the few royal duties Charles II could perform. As soon as he was back on the throne, people flocked to him to cure it, and he touched 1,700 of them within his first two months back.

Charles took his duty very seriously. Before long, a system was worked out whereby the afflicted would visit the King’s chirurgeon on Bridges Street in Covent Garden for what we would think of as a referral, and the King would see the afflicted personally on Wednesdays and Fridays, often in the Banqueting Hall. Once the system was up and working, he began to see up to 4,000 people per year, seeing more than 90,000 total between 1660 and 1682. 

Louis XIV touched those afflicted with the King’s Evil in France, but there were those who believed that he lacked the divine gift so generously demonstrated by Charles II:

All lawful monarchs, God’s viceregents are
And by his Princely Patent govern here; 
But all have not an equal grant from Heaven. 
The Cure o’ th’ Evil to Britain’s Monarch’s given! 
Whose royal touch hath healed our leprous land, 
‘Tis therefore TREASON not t’obey’s command.

-John Gadbury’s Almanac, 1666.

There you have it. If you are unlucky enough to be afflicted with scrofula, you’d better make sure the monarch touching you is British. 


In other news, Virtue’s Lady is out today. If wondering what happened to Mark and Jane has been driving you crazy, now you can find out! The buy links are below. 

My blog tour is well and truly under way, and today you can find me talking about different aspects of the book all over the place. I’ll be stopping by Nicole Hurley-Moore’s blog with a post about the plot and why I wrote it the way I did, and I’ll be visiting Susan Hughes with a post about seventeenth century marriage. I also made it to Tara Quan’s blog with a writing tip, and The lovely Christa Maurice has a fun excerpt for us today as well, so be sure to stop by and tell us all what you think. 

Without further ado, I’m going to go throw some confetti around and find something bubbly to drink. It’s Release Day! Woohoo!