Editing Edward Jenner (section)

==Invention of the vaccine==
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| heading1 = Jenner's Hypothesis:
| content1 = The initial source of infection was a disease of horses, called "the grease", which was transferred to cattle by farm workers, transformed, and then manifested as cowpox.
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[[Inoculation]] was already a standard practice in Asian and African medicine but involved serious risks, including the possibility that those inoculated would become contagious and spread the disease to others.<ref>{{Cite web|url=http://www.muslimheritage.com/article/lady-montagu-and-introduction-smallpox-inoculation-england|title=Lady Montagu and the Introduction of Smallpox Inoculation to England {{!}} Muslim Heritage|website=www.muslimheritage.com|date=16 February 2010 |language=en|access-date=3 March 2017}}</ref> In 1721, [[Lady Mary Wortley Montagu]] had imported [[variolation]] to Britain after having observed it in [[Istanbul|Constantinople]]. While [[Johnnie Notions]] had great success with his self-devised inoculation<ref name="Smith1998">{{Cite journal|last=Smith|first=Brian|date=July 1998|title=Camphor, Cabbage Leaves and Vaccination: the Career of Johnie 'Notions' Williamson of Hamnavoe, Eshaness, Shetland|url=https://www.rcpe.ac.uk/sites/default/files/vol28_3.1_10.pdf|journal=Proceedings of the Royal College of Physicians of Edinburgh|publisher=Royal College of Physicians of Edinburgh|volume=28|issue=3|page=402|pmid=11620446|access-date=12 October 2019}}</ref> (and was reputed not to have lost a single patient),<ref name="Dishington1999">{{Cite journal|last=Dishington|first=Andrew|date=1999|orig-year=1792|editor-last=Sinclair|editor-first=Sir John|title=United Parishes of Mid and South Yell|url=https://stataccscot.edina.ac.uk:443/link/osa-vol2-p569-parish-shetland-yellmid_and_south|journal=The Statistical Account of Scotland Drawn up from the Communications of the Ministers of the Different Parishes|location=University of Edinburgh, University of Glasgow|publisher=Edinburgh: William Creech|volume=2|issue=50|page=571|oclc=1045293275|access-date=10 October 2019|via=The Statistical Accounts of Scotland online service}}</ref> his method's practice was limited to the [[Shetland|Shetland Islands]]. [[Voltaire]] wrote that at this time 60% of the population caught smallpox and 20% of the population died from it.<ref>{{cite web |url=http://www.fordham.edu/halsall/mod/1778voltaire-lettres.asp#Letter%20XI |author=François Marie Arouet de Voltaire |title=Letters on the English or Lettres Philosophiques |year=1778 }}</ref> He also stated that the [[Circassia]]ns used the inoculation from times immemorial, and that the Turks may have borrowed the custom from them.<ref>{{Cite web | title=Voltaire on Circassian Medicine: ''Inoculation'' | url=http://www.circassianworld.com/new/history/miscelleneous/1202-circassian-medicine.html | publisher=Circassian World | access-date=26 May 2012 | archive-date=8 June 2012 | archive-url=https://web.archive.org/web/20120608053649/http://www.circassianworld.com/new/history/miscelleneous/1202-circassian-medicine.html | url-status=dead }} from {{cite book| author=Voltaire | title=The Works of Voltaire | volume=XIX (Philosophical Letters) | year=1733 }}</ref> In 1766, Daniel Bernoulli analysed smallpox morbidity and [[Mortality rate|mortality]] data to demonstrate the efficacy of inoculation.<ref>reprinted in {{cite journal|year=2004|pmid=15334536|url=http://www.semel.ucla.edu/biomedicalmodeling/pdf/Bernoulli&Blower.pdf|title=An attempt at a new analysis of the mortality caused by smallpox and of the advantages of inoculation to prevent it|last1=Blower|first1=S|last2=Bernoulli|first2=D|volume=14|issue=5|pages=275–288|doi=10.1002/rmv.443|journal=Reviews in Medical Virology|s2cid=8169180|url-status=dead|archive-url=https://web.archive.org/web/20070927032605/http://www.semel.ucla.edu/biomedicalmodeling/pdf/Bernoulli%26Blower.pdf|archive-date=27 September 2007}}</ref>

By 1768, English physician [[John Fewster]] had realised that prior infection with cowpox rendered a person immune to smallpox.<ref>{{Cite book |last=Pearson |first=George |url=https://books.google.com/books?id=osdEAAAAcAAJ&pg=PA102 |location=London |title=An Inquiry Concerning the History of the Cowpox, Principally with a View to Supersede and Extinguish the Smallpox |pages=102–104 |date=1798 |publisher=J. Johnson}}</ref><ref>{{cite journal|first1=L. |last1=Thurston |first2=G. |last2=Williams |year=2015 |url=https://www.rcpe.ac.uk/sites/default/files/thurston.pdf |archive-url=https://web.archive.org/web/20221014111232/https://www.rcpe.ac.uk/sites/default/files/thurston.pdf |archive-date=14 October 2022  |title=An examination of John Fewster's role in the discovery of smallpox vaccination |journal=[[Journal of the Royal College of Physicians of Edinburgh]] |volume=45 |issue=2 |pages=173–179|doi=10.4997/JRCPE.2015.217 |doi-broken-date=27 February 2025 |pmid=26181536 }}</ref> In the years following 1770, at least five investigators in England and Germany (Sevel, Jensen, Jesty 1774, Rendell, Plett 1791) successfully tested a cowpox vaccine against smallpox in humans.<ref name="PlettSudhoffs"/> For example, [[Dorset]] farmer [[Benjamin Jesty]]<ref>{{cite journal | pmc = 2279376| author= Hammarsten J. F. | pmid = 390826 | title = Who discovered smallpox vaccination? Edward Jenner or Benjamin Jesty? | journal = Transactions of the American Clinical and Climatological Association | volume=90 | year=1979 | pages=44–55 | last2 = Tattersall | first2 = W | last3 = Hammarsten | first3 = JE}}</ref> successfully vaccinated with cowpox and presumably [[artificial induction of immunity|induced immunity]] in his wife and two children during the 1774 smallpox epidemic, though it was not until Jenner's work that the procedure became widely understood. Jenner may have been aware of Jesty's procedures and success.<ref>{{cite book |last=Grant |first=John |title=Corrupted Science: Fraud, Ideology and Politics in Science |publisher=Facts, Figures & Fun |location=London |year=2007 |isbn=978-1-904332-73-2 |page=24 |url-access=registration |url=https://archive.org/details/corruptedscience0000gran/page/24}}</ref>  In 1780, [[Jacques Antoine Rabaut-Pommier]] made similar observations in France.<ref>{{cite journal | pmc= 1082587 | pmid=390274 | volume=23 | title=Rabaut-Pommier, a neglected precursor of Jenner | author=Théodoridès J | journal=Med Hist | pages=479–480 | doi=10.1017/s0025727300052121 | year=1979| issue=4 }}</ref>

Jenner postulated that the [[pus]] in blisters from sufferers of [[cowpox]] (a disease similar to smallpox but much less virulent) protected them from smallpox. On 14 May 1796, Jenner tested his hypothesis by inoculating [[James Phipps]], the eight-year-old son of Jenner's gardener. He scraped pus from cowpox blisters on the hands of Sarah Nelmes, a milkmaid who had caught cowpox from a cow called Blossom<ref name="JennerMuseum"/> (whose hide now hangs on the wall of the [[St George's, University of London|St. George's Medical School]] library, now in [[Tooting]], London). Phipps was the 17th case described in Jenner's first paper on [[vaccination]].<ref>[http://www.gutenberg.org/catalog/world/readfile?fk_files=1556742&pageno=13 An Inquiry into the Causes and Effects of the Variolae Vaccinae, Edward Jenner]. Retrieved 17 November 2012</ref>

Jenner inoculated Phipps in both arms that day; this led to a fever and some uneasiness but no full-blown infection. Later, Jenner injected Phipps with [[variolation|variolous material]], the routine method of immunization at that time and again no disease followed. The boy was later challenged with variolous material and again showed no sign of infection.  There were no unexpected side effects, and neither Phipps nor any other recipients underwent any future 'breakthrough' cases.

Jenner's biographer [[John Baron (physician)|John Baron]] later speculated that it was Jenner's observation of the unblemished complexion of milkmaids that led to his understanding that it was possible to be inoculated against smallpox by being exposed to cowpox, that is he did not build on the work of his predecessors. The milkmaid story is still widely repeated even though it appears to be a myth.<ref>{{Cite journal |last=Boylston |first=Arthur |date=2013 |title=The origins of vaccination: myths and reality |journal=Journal of the Royal Society of Medicine |volume=106 |issue=9 |pages=351–354 |doi=10.1177/0141076813499292 |pmid=23995824 |pmc=3758677 }}</ref><ref>{{Cite web |last=Jarry |first=Jonathan |date=9 June 2023 |title=The White Lie at the Heart of Vaccine History |url=https://www.mcgill.ca/oss/article/medical-critical-thinking-history/white-lie-heart-vaccine-history |access-date=12 June 2023 |website=Office for Science and Society}}</ref>

{{sidebar|navbar=off
| style  = text-align:left; float:right; clear:left; margin:0.5em 1.0em 0.5em 0
| heading1 = Known:
| content1 = Smallpox is more dangerous than variolation and cowpox less dangerous than variolation.
| heading2 = Hypothesis:
| content2 = If target is infected with cowpox, then target is immune to smallpox.
| heading3 = Test:
| content3 = If variolation after infection with cowpox fails to produce a smallpox infection, immunity to smallpox has been achieved.
| heading4 = Consequence:
| content4 = Immunity to smallpox can be induced much more safely than by variolation.
}}

US physician [[Donald Hopkins]] has written, "Jenner's unique contribution was not that he inoculated a few persons with cowpox, but that he then proved [by subsequent challenges] that they were immune to smallpox. Moreover, he demonstrated that the protective cowpox pus could be effectively inoculated from person to person, not just directly from cattle."<ref name="Hopkins"/> Jenner successfully tested his hypothesis on 23 additional subjects.

Jenner continued his research and reported it to the [[Royal Society]], though the initial paper was not published. After revisions and further investigations, he published his findings on the 23 cases, including his 11-month-old son Robert.<ref>{{cite book |last = Williams | first = Gareth |title = Angel of Death: The Story of Smallpox |publisher=Palgrave Macmillan |location=Basingstoke |date=2010 |isbn=978-0-230-27471-6 |page=198}}</ref> Some of his conclusions were correct, some erroneous; modern microbiological and microscopic methods would make his studies easier to reproduce. The medical establishment deliberated at length over his findings before accepting them. Eventually, vaccination was accepted, and in 1840, the British government banned variolation{{spaced ndash}}the use of smallpox to induce immunity{{spaced ndash}}and provided vaccination using cowpox free of charge (''see'' [[Vaccination Act]]).

The success of Jenner's discovery soon spread around Europe and was used ''en masse'' in the Spanish [[Balmis Expedition]] (1803–1806), a three-year-long mission to the Americas, the Philippines, Macao and China led by [[Francisco Javier de Balmis]] with the aim of giving the smallpox vaccine to thousands.<ref>{{cite journal |author1=Carlos Franco-Paredes |author2=Lorena Lammoglia |author3=José Ignacio Santos-Preciado |title=The Spanish Royal Philanthropic Expedition to Bring Smallpox Vaccination to the New World and Asia in the 19th Century |publisher=Oxford Journals |volume=41 |issue=9 |pages=1285–1289 |year=2005 |journal=Clinical Infectious Diseases |doi= 10.1086/496930 |pmid=16206103|doi-access=free }}</ref> The expedition was successful, and Jenner wrote: "I don't imagine the annals of history furnish an example of philanthropy so noble, so extensive as this".<ref>"Andean Studies: New Trends and Library Resources : Papers of the Forty-Fifth Annual Meeting of the [[Seminar on the Acquisition of Latin American Library Materials]]", University of California, Los Angeles ... 27–31 May 2000. p. 46</ref> [[Napoleon]], who at the time was [[Napoleonic Wars|at war with Britain]], had all his French troops vaccinated, awarded Jenner a medal, and at Jenner's request,  released two English prisoners of war, allowing them to their return home.<ref name="Napoleon"/><ref>{{cite journal |title=The Jenner Society and the Edward Jenner Museum: Tributes to a physician-scientist |first1=A.J. |last1=Morgan |first2=Gregory A. |last2=Poland |journal=[[Vaccine (journal)|Vaccine]] |volume=29 |issue=Supplement 4 |date=30 December 2011 |pages=D152–D154 |doi=10.1016/j.vaccine.2011.08.128 |pmid=22486976 |url=http://www.edwardjennersociety.org/wp-content/uploads/The-Jenner-Society-and.pdf}}</ref> Napoleon remarked he could not "refuse anything to one of the greatest benefactors of mankind".<ref name="Napoleon">{{cite journal |title=The relations between fellows of the Royal Society and French men of science when France and Britain were at war |last=De Beer |first=G. R. |journal=Notes and Records of the Royal Society of London |date=May 1952 |volume=9 |issue=2 |page=297 {{^|Whole article is pp. 244–299}} |doi=10.1098/rsnr.1952.0016|s2cid=202574537 }}</ref>

Jenner's continuing work on vaccination prevented him from continuing his ordinary medical practice. He was supported by his colleagues and King [[George III]] in petitioning [[UK Parliament|Parliament]],<ref>{{cite web|url=https://books.google.com/books?id=xpFIAQAAMAAJ&q=Dr+John+Griffiths%2C+surgeon+to++st+George%27s+Hospital&pg=PA176|title=Reports from Committees of the House of Commons which Have Been Printed by Order of the House: And are Not Inserted in the Journals [1715–1801]|first=Great Britain Parliament House of|last=Commons|date=18 July 2018|via=Google Books}}</ref> and in 1802 was granted £10,000 for his work on vaccination.<ref name="DNB1892" /> In 1807, he was granted another £20,000 after the Royal College of Physicians confirmed the widespread efficacy of vaccination.<ref name=Baxbydnb />

[[File:Edward Jenner- Smallpox.svg|center|300px|The steps taken by Edward Jenner to create vaccination, the first vaccine for smallpox. Jenner did this by inoculating James Phipps with cowpox, a virus similar to smallpox, to create immunity, unlike variolation, which used smallpox to create an immunity to itself.]]
<gallery widths="200" heights="200">
File:"Edward Jenner advising a farmer to vaccinate his family". O Wellcome V0018221.jpg|''Edward Jenner advising a farmer to vaccinate his family''. Oil painting by an English painter, {{Circa|1910}}
File:A cow's udder with vaccinia pustules and human arms exhibiti Wellcome V0016678.jpg|Jenner's discovery of the link between cowpox pus and smallpox in humans helped him to create the smallpox vaccine.
File:Jenner phipps 01 (cropped).jpg|Jenner performing his first vaccination on [[James Phipps]], a boy of age 8, on 14 May 1796
File:The cow pock.jpg|[[James Gillray]]'s 1802 caricature of Jenner vaccinating patients who feared it would make them sprout cowlike appendages.
File:Jenner and his two colleagues seeing off three anti-vaccinat Wellcome V0011075.jpg|1808 cartoon showing Jenner, [[Thomas Dimsdale]] and [[George Rose (politician)|George Rose]] seeing off anti-vaccination opponents
File:Edward_Jenner._Photograph_of_a_sculpture_by_Giulio_Monteverd_Wellcome_V0028722.jpg|1873 sculpture of ''Jenner Vaccinating His Own Son Against Smallpox'' by Italian sculptor Giulio Monteverde, [[Galleria Nazionale d'Arte Moderna]], Rome
</gallery>