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Smallpox: A Great and Terrible Scourge banner
Smallpox: A Great and Terrible Scourge written in white lettering with a black border Public Health Service Historian History of Medicine Division National Library of Medicine National Institutes of Health The Threat written in red letters. Variolation written in red letters. Vaccination written in red letters. Resistance to Vaccination written in red letters. The 20th Century Threat written in red letters. Campaign to Eradicate written in red letters. Obstacles and Struggle written in red letters. Success written in red letters.


Upper arm of Sarah Nelmes, with five pustules on the eighth day.

The arm of Sarah Nelmes, a dairy maid, who had contracted cowpox. Jenner used material from her arm to vaccinate an eight year old boy, James Phipps. Edward Jenner, An inquiry into the causes and effects of the variolae vaccinae, a disease discovered in some of the western counties of England, particularly Gloucestershire, and known by the name of the cow pox (1798).

Edward Jenner, an English physician, used folk knowledge to find an alternative to variolation. Recognizing that dairymaids infected with cowpox were immune to small-pox, Jenner deliberately infected James Phipps, an eight year old boy, with cowpox in 1796. He then exposed Phipps to smallpox–which Phipps failed to contract. After repeating the experiment on other children, including his own son, Jenner concluded that vaccination provided immunity to smallpox without the risks of variolation. Jenner’s findings were published in 1798.

A color etching of a crowded room where a physician (Jenner) prepares to vaccinate a young woman sitting in a chair; the scene about them is mayhem as several former patients demonstrate the effects of the vaccine with cows sprouting from various parts of their bodies.

A color etching of a a physician vaccinates a young woman sitting in a chair with a fearful look in her face.

Vaccination was not without its critics. In this cartoon from 1802, the British satirist James Gillray implied that vaccination caused people to become part cow.

Vaccination provided immunity for up to ten years. Because war always spread smallpox, governments encouraged recruits to be vaccinated. In 1807, the Bavarians became the first to require recruits to be vaccinated and the practice of vaccination spread with the practice of war.

Three-quarter length, left pose, full face of Edward Jenner leaning against a tree; holding top hat; pastoral scene in background.

Although he was a country physician, Edward Jenner had studied with and maintained contact with the leading physicians of his day. His cowpox experiment was performed at the urging of John Hunter, a prominent London anatomist and Jenner’s former teacher.

Title page from Onderzoek naar de oorzaaken en uitwerkselen der variolae vaccinae, eene ziekte, in de westklijke gedeelten van Engeland ontdekt, voornaamlijk in het graafschap Gloucester, en aldaar bekend onder den naam van koepokken. In het Nederduitschvertaald en met een bijvoegsel verm. door L. Davids by Edward Jenner and L. Davids.

Title page from Indagaçao sobre as causas e effeitos das bexigas de vacca, molestia descoberta em alguns dos condados occidentaes da inglaterra, particularmente na comarca de Gloucester, e conhecida pelo nome de vaccina by Edward Jenner.

Title page from Recherches sur les causes et les effets de la variolae vaccinae, maladie découverte dans plusieurs comtés de l’ouest de l’Angleterre, notamment dans le comté de Gloucester, et connue aujourd’hui sous le nom de vérole de vache by Edward Jenner and Jacques Joseph La Roque.

Within twenty years of its publication, Jenner’s text had been translated into a variety of languages including Portugese, French, Dutch, Italian and Japanese.