Rob Boddice - Edward Jenner: pocket GIANTS

Thanks to Tony Morris for the inspiration to write this book, to Stephanie Olsen, Michle Cohen, Greg Fisher, Michele Haapamki and Martin Lcke for bearing witness to the research, and to the following for making the research possible: The Royal College of Surgeons of England; The Royal College of Physicians of England; The Royal Society of Medicine; The British Library; The Wellcome Library, London; the Deutsche Forschungsgemeinschaft and the Center for the History of Emotions, Max Planck Institute for Human Development.

The instrument in the hands of a gracious Providence.

John Baron, 1838

Edward Jenner was the protg, at first directly and latterly by correspondence, of John Hunter, the famous surgeon, scientist and observer. John Hunters maxim for life, as for scientific inquiry, was Do, dont think. His favourite pupil, Edward Jenner, certainly did .

Not all the doing was great and good. Jenner is immortalised as the man who made it possible to rid the world of one of its greatest scourges: smallpox. But along the way there was a whole host of experimental gambits, intuitive flights and spontaneous decisions. The spirit of scientific and medical investigation by induction was alive and well with Edward Jenner. Animated by scientific curiosity, without much obvious personal ambition, and driven by the energetic counsel of his mentor Hunter, Jenner shot, poked, boiled and pricked his way through a life of rural experimentation. One such experiment would provide proof of the concept for human-to-human inoculation of cowpox, which in turn provided immunity from smallpox. Jenner named the cowpox virus Variolae vaccinae , or smallpox of the cow, from which he derived the word vaccine. But to get to this breakthrough, which came well into Jenners middle age, we must first follow the spirit of trying things out that defined his earlier life.

To tell the life story of Jenner in this way cuts against the grain of typical narratives of his heroic life. Jenner has been at least in the popular imagination remembered as the saviour of more lives than any other single medical doctor. We know him as having rid the world of a terrible plague through a genius of daring experimentation, controlled trials and an indefatigable hard-nosed activism. Without these things vaccination would not have gained traction within the medical community and the global population at large. Received wisdom is that Jenner was without pecuniary interest, working for the benefit of humanity at great personal cost. He is remembered for qualities that set him apart from many of his peers. Such a rare and noble nature is the stuff of heroes.

This line of thinking has come down to us from the first memorialisation of Jenners life, published by his friend and colleague John Baron in 1838, some fifteen years after Jenners death. Baron was an uncritical disciple; his work was more hagiography than biography. It is filled with an expansive history of smallpox itself, and extensively documents the failings of all of Jenners opponents. While important for some of the essential details of Jenners life that are unobtainable elsewhere, one finds little left in the bag after shaking it free of detritus. The letters it contains are useful, but they uniformly show Jenner in the best light. What are we to make of Barons assessment: Jenner stood in a position never before occupied by mortal man; having been the instrument in the hands of a gracious Providence, of influencing, in a most remarkable degree, the destinies of his species? Jenner, for Baron, was sent by God himself.

Medical historians have long been familiar with the messy and contested reality of Jenners innovations and greatness, but there is no recent academic biography of his life in its entirety, even though much of Jenners correspondence survives. The latest biography, by Richard Fisher, is long out of print. Articles appear here and there on various aspects of Jenners life and world, but their reception is confined to small academic audiences. Common knowledge on Jenners life does not seem to run too deep. Considering the magnitude of Jenners contribution to medicine, it is perhaps surprising that he continues to be known as a kind of two-dimensional saint: a saviour of humanity with a statue here and there. This reputation in not confined to Britain; it stretches from Europe to the Americas, and from the Indian subcontinent to the Far East.

How does such a hero emerge? How can such an exceptional figure rise above the clamour and change the course of history? The answer is not a mystery, but hidden in plain sight. As a country surgeon, Jenner was not so extraordinary. His was a life of parochial interest, touched and pushed in various ways by exceptional circumstances, energetic friends and sponsors, and a deep-seated awareness of the importance of public reputation. Far from being set apart from the late eighteenth-century world of medicine, gentility and Enlightenment, Jenner was immersed in it. Tucked away in rural Gloucestershire, seemingly detached from the nature-conquering endeavours of urbane men of letters, Jenner was actually steeped in Enlightenment values, borne on a wave of correspondence and personal connections in London and farther afield. Setting up a country practice to meet his material needs, Jenner was motivated to experiment by a commonly held desire to understand nature so as to master it. With this firmly in view, the smallpox vaccination experiments can be put into a broad context of medical, anatomical and physiological experiments that Jenner carried out at home, some of which were successful, most not. The overwhelming success of vaccination would come to define the second half of Jenners life, but he had not planned for this. He spent his energy, with considerable chagrin, on the defence of his reputation and ended his life filled with uncertainty about his personal, professional and medical legacy.

The status of Jenners reputation at his death and in the decades that immediately followed should make us all the more amazed that we have come to know Jenner as a hero at all. He was hounded by anti-vaccinationists in his lifetime; the anti-vaccine movement throughout the nineteenth century made serial concerted attacks on Jenners character, his medical insight and his morality. Vaccination against smallpox would lead to riots, protests and paranoia. Vaccination was, for many, a scourge in itself, blighting children with animal or pestilential matter, and trespassing on the liberty of parents to decide what was best for their children. Anti-vaccination societies sprang up, particularly in Britain. Many prominent voices decried Jenners work as quackery, thrust upon an ignorant and vulnerable population by government tyranny, risking the health of the poor. Jenners allies, during his own lifetime and afterwards, fiercely defended the medical breakthrough that Jenner had made. Public opinion was polarised into Jenner-haters and Jenner-lovers. Those people who celebrated Jenner usually prominent medical and scientific public figures were forced to do so in unequivocal, absolutist terms, in the face of a torrent of abuse. Almost coeval with the invention of vaccination itself, therefore, arose the legend of Jenner the saviour of humanity, and the frightened naysayers of vaccination.

Edward Jenner was born in May 1749 in the village where he would come to spend most of his life, Berkeley in Gloucestershire. The son of the local vicar, Jenner was given a classical grounding for his education, first at Wotton-under-Edge and then at Cirencester. He was raised by his sisters after both of his parents died in 1754, when Edward was only 5 years old. He was probably fairly typical for a boy of his social class, making sport of the collection of nests (dormice were his special proclivity) and searching for fossils. At the age of about 14, a somewhat hypochondriacal Jenner was packed off to Sodbury near Bristol, where he became apprentice to Mr Ludlow, a local surgeon. There is little record of Jenners time spent learning the ropes of surgery, but he clearly became competent enough to attract the attention of the London elite. In 1770, a keen 21-year-old, Jenner moved to London to work under John Hunter, residing with his family for two years and, according to Baron, becoming his favourite pupil. Hunter at that time was surgeon at St Georges Hospital in Tooting, while also running a menagerie at Brompton for the purposes of scientific experimentation and observation. Hunters combined interests would soon become Jenners. There was love between the two men, in the manner of eighteenth-century relationships that were based on fellow feeling and frank exchange. But Jenner could not get on with London he would come to have a deep resentment for it and returned to take up his practice in Gloucestershire, dividing his time between Berkeley, his ancestral home, and Cheltenham. While Hunter may have allowed his pupil to leave, he would not leave him alone.