An Irishman's Diary

THE MIGRATION from these shores to the Cotswolds every March is all too frequently described as a “pilgrimage”. Indeed, Cheltenham racecourse has certain resemblances to a shrine, particularly its statues of Arkle, Dawn Run, and other four-legged saints reputed to have performed miracles there. But if there is place in Gloucestershire truly worthy of pilgrims, its location is elsewhere, 24 miles to the south-west, in a little-known town called Berkeley.

Here lies the home, now a museum, of Edward Jenner, whose work has arguably saved more human lives than that of any other scientist. His main achievement was to rid the world of smallpox, long one of mankind’s deadliest scourges. But in so doing, he gave us a word and concept now central to all our lives – vaccination. A word that, incidentally, hints at the involvement of another four-legged hero: one not much celebrated in Cheltenham.

Her name was Blossom and she was, to put it bluntly, a cow. More specifically, she was the cow that gave cowpox to a dairy-maid, Sarah Nelmes, who in May 1796, consulted Jenner about a rash on her hand. Cowpox was a much milder cousin of smallpox and it was common folk wisdom even then that although milkmaids were prone to the former, they never seemed to catch the latter.

This suggested to Jenner that cowpox might offer protection against the more serious disease. And here, in the milkmaid’s blisters, was a chance to prove it. But he needed a guinea pig. And this is where James Phipps, the eight-year-old son of Jenner’s gardener, made medical history 214 years ago today, on May 14th, 1796.

First Jenner made scratches on the boy's arm and then he infected him with the dairymaid's affliction. An outbreak of cowpox inevitable followed, but the boy recovered fully, as calculated. Whereupon Jenner inoculated him – "variolated" was the contemporary term – with smallpox. And as Jenner also calculated, nothing happened. Thus were born the terms "vaccine" and "vaccination", from the Latin vacca, meaning cow.

There may have been ethical shortcuts in the experiment, by modern standards. But it was not as callous as it might seem to our delicate sensibilities. Variolation was by then a well-established practice among Britain’s better-off, to whom it had been introduced from Turkey some 80 years earlier by one Lady Mary Wortley Montagu.

During her travels as a diplomat’s wife, Lady Montagu (whose portrait hangs in the National Gallery of Ireland) was so impressed by the success of the Turkish practice of deliberately infecting the healthy for later protection against smallpox that she used it on her own son. Many other parents followed the example, including Jenner’s. But variolation was risky, as Jenner’s own health problems attested. Using cowpox to fight smallpox proved far safer.

Smallpox was so-named, incidentally, to differentiate it from the “great pox”: syphilis. But there was nothing small about smallpox fatality rates. In Jenner’s lifetime, Europe’s annual death-toll from the disease was 400,000, including one in every 10 children. When it didn’t kill, it could cause blindness. Many’s the Irish harper, including Carolan, who was blind because of it, as was Raftery the poet.

If you survived with mere disfigurement, another smallpox signature, you were getting off lightly. George Washington was so marked. Chief Sitting Bull too. And so was Joseph Stalin, whose childhood brush with the disease did nothing worse – perhaps unfortunately – than leave facial scars, giving him another reason later in life for air-brushing photographs.

Jenner’s breakthrough put an end to all that, but of course not immediately. There are vaccination sceptics even today, so we can imagine the opposition Jenner’s idea met in its time.

One opponent was a Dr Mosely, who feared the consequences of introducing a “bestial humour” into the

bodies of children: “Who knows but that the human character may undergo strange mutations from quadrupedan sympathy?” Sure enough, another medic subsequently reported the case of a child who, post-vaccination, “ran upon all fours, bellowing like a cow, and butting with its head like a bull.”

The same Mosely lamented that, by the early 1800s, God had chosen to punish mankind with the triumvirate of “evil, [Napoleon] Buonaparte and vaccination”. But he urged his fellow Christians to resist all three as best they could.

Happily, others were more welcoming of the advance. Among the organisations inspired by Jenner’s work was Dublin’s Cow Pock Institution, which by 1859 was advertising its services in the newly published Irish Times. Through that and many other agencies around the world, smallpox gradually declined as a threat to the point where, by the 1970s, mass vaccination was no longer necessary.

Jenner has been well honoured for his achievements. Blossom, by contrast, has been somewhat overlooked. Shamefully, given Gloucestershire’s record of immortalising four-legged heroes, no sculptor has yet commemorated the famous cow. Her putative hide is preserved in a medical school in London, and there are also several horns attributed to her, a maximum two of which can be genuine (DNA tests continue even as I write).

But still no statue. Perhaps moves to redress the injustice might be considered this weekend when the Jenner Museum celebrates three separate milestones: the 214th anniversary of Jenner’s first vaccination; his 261st birthday (on May 17th); and the passing of 30 years since the World Health Organisation declared smallpox the first – and still only – human infectious disease to have been eradicated.