The Milkmaid and the Cure

On 14 May 1796, in the village of Berkeley in Gloucestershire, a doctor sat down with an eight-year-old boy.

He held a small, clean lancet. Very gently, he made two shallow scratches on the boy's arm. Into them, he rubbed a tiny amount of fluid that he had taken from a sore on the hand of a young dairymaid.

The boy was James Phipps, the son of the doctor's gardener. The doctor was Edward Jenner. And what he was testing was an old piece of country wisdom that might, if it were true, defeat one of the deadliest diseases in human history.

The speckled monster

Smallpox had haunted the world for thousands of years. It began with fever and aches, and then a rash of painful blisters spread across the body. In Jenner's time, it killed many of the people who caught it, very often children. Many who survived were left deeply scarred, and some were left blind.

There was one way to protect people, called variolation. A doctor took a little material from a smallpox sore and scratched it into the skin of a healthy person. Usually this caused a milder illness, after which the person was protected for life. But it was risky. Some people died from it, and they could pass smallpox on to others while they were ill.

Jenner himself had been variolated as a boy, and he remembered it as a miserable experience.

What the milkmaids knew

Edward Jenner was born on 17 May 1749 in Berkeley, the son of the local vicar. He trained as a surgeon, studied in London under the famous surgeon John Hunter, and then came home to be a country doctor. He was endlessly curious about nature. He studied birds, and he was one of the first to describe how a young cuckoo pushes other eggs and chicks out of the nest.

In the countryside, he kept hearing the same thing. Dairymaids and farmhands often caught a mild disease from cows called cowpox, which gave them a few sores on their hands. And people said that those who had had cowpox never caught smallpox.

Jenner was not the first to notice this. A few farmers had even tried it, including a Dorset farmer named Benjamin Jesty, who had deliberately given cowpox to his wife and sons in 1774. But no one had tested the idea carefully and written it up for the world.

For years, Jenner collected cases. He wanted proof.

The experiment

In May 1796, a young dairymaid called Sarah Nelmes came to him with cowpox sores on her hand. She had caught it, she said, from a cow named Blossom.

This was Jenner's chance. He took fluid from Sarah's sores and placed it in the scratches on James Phipps's arm. Over the next week or so, James felt a little unwell. He had a slight fever and lost his appetite for a day. Then he recovered.

Now came the frightening part. On 1 July, Jenner variolated James with material from a real smallpox sore. If the country wisdom was wrong, James might fall ill.

Nothing happened. James did not develop smallpox at all. The cowpox had protected him.

We must be honest that, by today's standards, this experiment would never be allowed. James was a child, and there was a real risk. Modern medicine has strict rules to protect people in trials, rules that did not exist in Jenner's time.

Laughed at, then listened to

Jenner wanted to be sure, so he tested more people. Then he sent a report to the Royal Society, Britain's leading scientific body. It was not accepted.

So in 1798 he published the work himself, in a short book with a long title, describing his cases. He called cowpox variolae vaccinae, from vacca, the Latin word for cow. From that came the words vaccine and vaccination.

Some doctors scoffed. A famous cartoon showed people sprouting little cows from their bodies after being vaccinated. Some religious leaders objected to putting material from an animal into a human.

But other doctors tried it, and it worked. Within a few years, vaccination had spread across Europe and to America, India and beyond. Jenner sent cowpox material to anyone who asked, and spent so much time on the work that his own practice suffered. He vaccinated poor people in his village for free, in a little thatched hut in his garden. Parliament later gave him money to recognise his work.

The end of smallpox

Jenner died in Berkeley in 1823. He had hoped that vaccination might one day wipe smallpox off the face of the earth.

It took more than a century and a half. In 1967, the World Health Organization began a worldwide campaign, with health workers travelling to remote villages across Asia, Africa and South America. The last natural case of smallpox was found in Somalia in 1977. In 1980, the World Health Organization declared that smallpox had been eradicated, the first human disease ever to be completely defeated.

Today, vaccines protect us against many diseases, from polio to measles. They all trace their story back to a country doctor, a curious idea, and a milkmaid's hand.

Jenner's house in Berkeley is now a museum. The hide of Blossom the cow hangs in the library of St George's, a medical school in London.

Want to read more?

Jenner's own Inquiry, published in 1798, is short and still readable. Richard B. Fisher's Edward Jenner is a full biography, and the World Health Organization's Smallpox and Its Eradication tells the story of how the disease was finally defeated.