11/23/2015 Princesses, Slaves, and Explosives: The Scandalous Origin of Vaccines — gizmodo.com https://www.readability.com/articles/ehuu43kd 1/10 gizmodo.com Princesses, Slaves, and Explosives: The Scandalous Origin of Vaccines 11 min read • original The history of inoculation may sound a little dry, but it’s really an epic tale of human trafficking, semi-illicit experimentation, and high explosives. It’s a globe-hopping story that stars harem girls, noblewomen, prisoners, princesses, slaves, and even a witch hunter. In the Shadow of Smallpox Smallpox has troubled humanity for thousands of years. Wherever we’ve settled in the world, the smallpox virus has eventually followed. A dangerously high fever comes first, accompanied by headaches, back pain, and vomiting. Painful sores open in your mouth and nose, and a rash spreads all over your body. Blisters form and fill with pus; these pustules eventually scab over and dry up. About 30% of people who catch smallpox will die; the rest will live with scars left behind by the pustules. People eventually noticed one very important thing about smallpox: those who had survived didn’t catch the disease again, or if they did, they didn’t get very sick the second time around. History doesn’t record who first got the idea to expose healthy people to pus from infected
Transcript
11/23/2015 Princesses, Slaves, and Explosives: The Scandalous Origin of Vaccines — gizmodo.com
Princesses, Slaves, and Explosives:The Scandalous Origin of Vaccines
11 min read • original
The history of inoculation may sound a little dry, but it’s really an epic tale of humantrafficking, semi-illicit experimentation, and high explosives. It’s a globe-hopping story thatstars harem girls, noblewomen, prisoners, princesses, slaves, and even a witch hunter.
In the Shadow of SmallpoxSmallpox has troubled humanity for thousands of years. Wherever we’ve settled in the world,the smallpox virus has eventually followed.
A dangerously high fever comes first, accompanied by headaches, back pain, and vomiting.Painful sores open in your mouth and nose, and a rash spreads all over your body. Blisters formand fill with pus; these pustules eventually scab over and dry up. About 30% of people who catchsmallpox will die; the rest will live with scars left behind by the pustules.
People eventually noticed one very important thing about smallpox: those who had surviveddidn’t catch the disease again, or if they did, they didn’t get very sick the second time around.
History doesn’t record who first got the idea to expose healthy people to pus from infected
History doesn’t record who first got the idea to expose healthy people to pus from infectedpatients’ pustules - or how they talked anyone into letting them try it. But the practice seems tohave sprung up independently in several places: India, China, West Africa, and elsewhere. Theidea was already an old one in 570 AD when people in Europe started calling it “variolation,”from the Latin name for smallpox, Variola. (Later generations used “variolation” and“inoculation” interchangeably; today “inoculation” also includes vaccination.)
Variolation usually meant rubbing pus from a smallpox pustule - a good ripe one, the runnier,the better - into a cut or scratch on a healthy person’s arm, but in China, people just soaked acotton ball in infected pus and stuck it up their noses. (Ah, the good old days, right?)
Most modern experts would consider this “stick it up your nose” strategy as the exact oppositeof what you’re supposed to do with a deadly pathogen. But it was the best option available at thetime, and it worked remarkably well. Only about two percent of people who were exposed tosmallpox through inoculation died of the disease, and only two to three percent spread theinfection to others. Today, that wouldn’t be an acceptable safety record for a vaccine, but in the17th and 18th centuries, it beat the daylights out of a 15-30% chance of dying if you caughtsmallpox on your own.
Herd Immunity and the Harem
Circassia in 1700. Image: Adamsa123 via Wikimedia Commons
In the northern Caucasus Mountains, women of the Circassian ethnic group traditionallyinoculated their children at about six months, and many Circassian women carried theirknowledge with them when they were trafficked to Turkey as slaves - a common fate for manyCircassians up until the early 20th century.
The French philosopher Voltaire described the situation in 1778:
“The Circassians are poor, and their daughters are beautiful, and indeed, it is in them they
“The Circassians are poor, and their daughters are beautiful, and indeed, it is in them theychiefly trade. They furnish with beauties the seraglios of the Turkish Sultan, of the PersianSophy, and of all those who are wealthy enough to purchase and maintain such preciousmerchandise.”
The unfortunate Circassian women who ended up in the Ottoman Sultan’s harem left theirmark on Turkish culture, one that would eventually spread across Europe and into NorthAmerica. According to Voltaire,
“The Turks, who are people of good sense, soon adopted this custom, insomuch that at this timethere is not a bassa in Constantinople but communicates the small-pox to his children of bothsexes immediately upon their being weaned.”
According to some sources, inoculation first caught on in Turkey in the late 1600s, thanks to theSultan’s trafficked Circassian women. Fifty years later, another woman carried the techniqueto England and eventually helped spread it throughout Europe.
A Woman on a Mission
Lady Mary Wortley Montagu in Turkish attire, painted 1756. Image: Wikimedia Commons
In December of 1715, Lady Mary Wortley Montagu was on top of the world, or at least her ratherluxurious corner of it. She was the daughter of an English Duke and the wife of a member ofParliament (with whom she’d eloped a couple of years earlier to avoid marrying theunfortunately named Clotworthy Skeffington). Her wit and beauty made her the toast of KingGeorge I’s court.
Then she caught smallpox.
She recovered, but with the characteristic pockmarked scars. Early in 1716, she left Londonbehind to accompany her husband to Turkey, where he was the King’s new ambassador to theOttoman court. In early 1718, she wrote to a friend,
“The small-pox, so fatal, and so general amongst us, is here entirely harmless, by the invention
“The small-pox, so fatal, and so general amongst us, is here entirely harmless, by the inventionof ingrafting, which is the term they give it. There is a set of old women, who make it theirbusiness to perform the operation, every autumn, in the month of September, when the greatheat is abated. People send to one another to know if any of their family has a mind to have thesmall-pox: they make parties for this purpose, and when they are met (commonly fifteen orsixteen together) the old woman comes with a nutshell full of the matter of the best sort ofsmall-pox, and asks what vein you please to have opened. She immediately rips open that youoffer to her, with a large needle, (which gives you no more pain than a common scratch) andputs into the vein as much matter as can ly upon the head of her needle, and after that, binds upthe little wound with a hollow bit of shell; and in this manner opens four or five veins.”
Soon after, she convinced embassy surgeon Charles Maitland to variolate her five-year-old son,Edward. The procedure went well, and Mary Wortley Montagu was now a woman on a mission:
“I am patriot enough to take pains to bring this useful invention into fashion in England; and Ishould not fail to write to some of our doctors very particularly about it, if I knew any one ofthem that I thought had virtue enough to destroy such a considerable branch of their revenue,for the good of mankind. But that distemper is too beneficial to them, not to expose to all theirresentment the hardy wight that should undertake to put an end to it. Perhaps, if I live toreturn, I may, however, have courage to war with them.”
Cotton Mather and the Anti-Vaxxers
The first slaves arriving in Boston in 1683. Image: Library of Congress.
While Lady Montagu learned about inoculation, the practice was also beginning to spread toNorth America. In Massachusetts, an aging Puritan minister named Cotton Mather (now bestknown as the architect of the Salem Witch Trials, which killed 24 people in 1692, mostly
women), had a chat about smallpox with an African man named Onesimus, a slave in his Boston
11/23/2015 Princesses, Slaves, and Explosives: The Scandalous Origin of Vaccines — gizmodo.com
women), had a chat about smallpox with an African man named Onesimus, a slave in his Bostonhousehold.
“He told me that he had undergone the operation which had given something of the smallpoxand would forever preserve him from it,” Mather wrote in a July 1716 letter to physician JohnWoodward. Onesimus described the inoculation process and showed off the small scar it hadleft on his arm.
“How does it come to pass, that no more is done to bring this operation, into experiment andfashion in England?” Mather asked Woodward. He was fascinated by the lifesaving potential ofinoculation - but he didn’t appreciate the knowledge quite enough to free the man who shared itwith him. (Mather did free Onesimus a few months later, but only after making him promise topay five pounds and to do chores for the family whenever they asked. Nobody ever said CottonMather was a nice guy.)
But when a ship from the West Indies sailed into Boston with infected sailors on board in Aprilof 1721, Mather remembered what Onesimus had shared. As a well-known minister in 18thcentury Massachusetts, Mather had both celebrity and political clout, and he used both toadvocate for inoculation. He addressed Boston’s physicians on June 6, 1721, making an earnestcase for inoculation as the best way to stop the disease from spreading.
That address stirred up an immediate controversy among Boston doctors and even in Mather’sown congregation. People worried that inoculation would be too dangerous and that it wouldonly spread the disease more quickly. Others argued that it was a “heathen practice” and indefiance of the Puritan view of disease as part of God’s plan for whoever might fall ill.
He managed to convince only one man: a doctor named Zabdiel Boylston (fact: names were atleast 48% cooler in the 1700s, with some very obvious exceptions). Boylston launched avariolation campaign, and he sought input on variolation from African slaves around Bostonwho had experience with the process, though their contributions, like Onesimus’, went mostlyunrewarded and remain anonymous to this day.
Throughout the summer of 1721, Mather published tracts and treatises, gave addresses andsermons, and wrote letters arguing that inoculation was safe, moral, and urgently necessary.But Boston was having none of it. Although people had embraced Mather’s every word when hewas calling for the hanging of women in Salem for putting curses on their neighbors, theyrecoiled at the idea of inoculation. It was a weird time.
In July, he wrote in his diary:
“The Destroyer, being enraged at the proposal of any Thing, that may rescue the lives of ourpoor People from him, has taken a strange Possession of the People on this Occasion. Theyrave, they rail, they blaspheme; they talk not only like Ideots but also like Franticks, And notonly the Physician who began the Experiment, but I also am an Object of their Fury; theirfurious Obloquies and Invectives.”
All the while, the infection raged. At its peak, some sources estimate that half of Boston wassick. Boylston inoculated as many people as he could convince, but that wasn’t nearly enough ofthe population to have any real chance of stopping the spread of the infection. As the epidemicworsened, people blamed Mather and Boylston for its swift, unstoppable spread.
“Towards three a clock in the night, as it grew towards Morning of this Day, some unknownHands, threw a fired Granado into the Chamber where my kinsman lay, which uses to be myLodging-Room,” he wrote in his diary on November 14 after a rather eventful night. A relativehad traveled to Boston for inoculation and was staying with Mather while he recovered. Healmost didn’t make it home.
But Mather and his family were lucky. The firebomb - a heavy iron ball, split into two halvesfilled with gunpowder and turpentine, according to Mather - hit part of the window casementon the way in and bounced to the floor in a way that just happened to put out the fuse in the
process. Because the bomb failed, Mather got to read the message, tied to the fuse with string:
“COTTON MATHER, You Dog, Dam you; I’ll inoculate you with this, with a Pox to you.”
To make his case for variolation, Mather published data on the fatality rate for inoculation -about 2% - and for actual smallpox infection - about 14% in the Boston outbreak. It was the firstdocumented use of comparative data in medicine, and it eventually helped persuade people toaccept inoculation.
Meanwhile, Back in England
Lady Mary Wortley Montagu.
That same year, Lady Montagu insisted that Charles Maitland inoculate her four-year-olddaughter in a demonstration for the royal physicians. It worked, and in August, the King gaveMaitland permission to conduct a trial of the technique on prisoners in London’s NewgatePrison. Six men volunteered on the promise of the King’s pardon for the survivors.
When all six prisoners survived and later proved to be immune to smallpox, Maitland moved onto testing his inoculation on orphaned children, who were slightly less expendable thanconvicted criminals. But only slightly.
The plucky orphans also survived, so Maitland moved on to inoculating princesses (skippingseveral rungs on the expendability ladder). In April of 1722, he inoculated the daughters of thePrincess of Wales. After that, inoculation started to catch on in England, though it took anotherfew decades to become widely accepted in the rest of Europe. According to Voltaire in 1774,
“It is inadvertently affirmed in the Christian countries of Europe that the English are fools andmadmen. Fools, because they give their children the small-pox to prevent their catching it; andmadmen, because they wantonly communicate a certain and dreadful distemper to theirchildren, merely to prevent an uncertain evil. The English, on the other side, call the rest of theEuropeans cowardly and unnatural. Cowardly, because they are afraid of putting their childrento a little pain; unnatural, because they expose them to die one time or other of the small-pox.”
Variolation had actually been banned in France for five years, from 1762 to 1767, after it caughtthe blame for an outbreak. But in 1774, when King Louis XV died of the disease after two weeks
11/23/2015 Princesses, Slaves, and Explosives: The Scandalous Origin of Vaccines — gizmodo.com
the blame for an outbreak. But in 1774, when King Louis XV died of the disease after two weeksof illness, along with 10 other members of his court, his son - the newly crowned King Louis XVI— boldly decided to have himself and his two younger brothers variolated (the guillotine, ratherthan smallpox, finished off Louis XVI).
And eventually, inoculation did catch on in Europe, partly thanks to the data published byMather and others, and partly thanks to Lady Montagu’s trendsetting advocacy in England. Itwas the best defense against smallpox until 1840, when England banned variolation in favor of anew preventative: vaccination.
How Vaccination Went Viral
A milkmaid and cows, sometime between 1790 and 1843. Image: Dordrechts Museum via Wikimedia Commons.
Thirty-five years later, in 1757, a young boy named Edward Jenner received an inoculationagainst smallpox. Eventually, he also received most of the credit for developing the firstsmallpox vaccination: a way to give people immunity smallpox without exposing them to thelive smallpox virus.
Cows’ udders sometimes become infected with a virus that causes small pustules, similar tosmallpox but less severe. The two viruses are closely related - so closely that the humanimmune system has trouble telling them apart. So exposure to one will help you developimmunity against the other. In the 1700s, most people in Gloucestershire and the surroundingcounties knew, or at least suspected, that exposure to cowpox kept milkmaids from catching itsdeadlier cousin, smallpox - just as people all around the world knew that variolation worked foryears before Montagu, Maitland, Mather, and Boylston. That’s how Jenner heard about theconnection between cowpox and immunity to smallpox; he spent the early days of his medicalcareer in a dairy community.
In May of 1796, he tested cowpox inoculation on the nearest available child - as one does,presumably. Eight-year-old James Phipps suffered from a mild fever and aches for about nine
presumably. Eight-year-old James Phipps suffered from a mild fever and aches for about ninedays, and then felt better.
So of course Jenner inoculated him with smallpox a couple of months later. Phipps didn’t getsick. The cowpox had given him immunity to smallpox.
Jenner self-published his results in 1798, after rejection by the Royal Society. He called the newtechnique “vaccination,” from the Latin word vaccinia for cowpox. By inoculating people withcowpox, it was possible to protect them from smallpox, without actually exposing them to thedeadly
Today, the word “vaccine” is a generic term for any substance that causes the body to developimmunity to a disease. Usually, vaccines are made from dead or weakened forms of the virusbeing vaccinated against. Modern vaccines use viruses, or antigens from viruses, grown incultures in a laboratory - not an actual gob of someone else’s infected pus. We’ve come a longway.
Whose Discovery Was It?
Benjamin Jesty in 1805. Source: Jesty.org via Wikimedia Commons
Today Edward Jenner is known as the father of vaccination - but he wasn’t the first to inoculatewith cowpox. In fact, the first person to vaccinate with cowpox wasn’t even a doctor.
In 1791, a German teacher named Peter Plett inoculated three children with cowpox; likeJenner, he had learned about the connection from milkmaids (who probably deserve most ofthe credit in the long run). When he reported his results to professors of medicine at the nearbyUniversity of Kiel, they basically ignored him, so Plett resumed his teaching career. He got alittle recognition in the early 1800s, but barely a footnote compared to the accolades Jennereventually received.
But even Plett wasn’t the first. A Dorset cattle farmer named Benjamin Jesty inoculated hiswife and two sons with cowpox (and one of his wife’s knitting needles) in 1794 to protect them
wife and two sons with cowpox (and one of his wife’s knitting needles) in 1794 to protect themfrom a nearby smallpox outbreak. That claim is carved in stone - literally. The epitaph onJesty’s tombstone calls him “an upright honest Man; particularly noted for having been the firstPerson (known) that introduced the Cow Pox by Inoculation, and who from his great strength ofmind made the Experiment from the (Cow) on his Wife and two Sons in the Year 1774.”
Ultimately, of course, it’s probably the milkmaids and dairy farmers of rural Europe whodeserve the credit for discovering the smallpox vaccine.
So why does Jenner get all the credit? Although the link between cowpox and smallpoximmunity was pretty well known in dairy farming areas, it was still a new idea outside thoseareas. Jenner might not have been the first person to figure out the connection, or even to applythat knowledge to inoculation, but he did bring it to the attention of the scientific communityand convince them to accept it.
In the words of Victorian statistician and scientist Francis Galton, “In science, credit goes tothe man convinces the world, not the man to whom the idea first occurs.”
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