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Smallpox Treatment
Smallpox has threatened our world for the past twelve thousand years. Treatments were desperately searched for until a cure called variolation was discovered. Variolation is the use of the virus placed into a being to which they will receive the illness to a lesser degree and overcome the illness forming an immunization to it. This process was started in China and went worldwide after Lady Montagu took the process from Turkey and informed the British about it. From here the process set fire and spread across Europe, curing many, but also killing them too. This new discovery opened a channel of research for many doctors, until in 1774 a farmer named Benjamin Jesty discovered that the lesser illness of cowpox could vaccinate one from smallpox. Jesty’s discovery plagued the world and set another opening for research, into which doctors searched for the best way to vaccinate citizens with. Vaccination helped a plethora of people until 1980 when the disease was finally eradicated. However, smallpox’s ugly face reared itself just recently with the new threat of bioterrorism. Yet this will most likely not affect our society due to the huge amount of preparatory work that would need to be placed into a new smallpox outbreak.
For the past twelve thousand years, Smallpox has obliterated societies with ease. Many civilizations found ways to inoculate their citizens with the least amount of symptoms through processes known as variolation and vaccination. Development of the treatment for smallpox mostly began in the end of the eighteenth century and continued through 1970s, until smallpox was eradicated in 1980.
Smallpox is thought to have first started in Africa and then moved to India and onto China. With the increasing risk of this fatal disease, citizens of the threatened societies began desperately searching for ways to protect themselves. Using a method called variolation, societies could force immunization upon their population. The Chinese found that by inserting powdered smallpox scabs into their nostrils that they would slowly obtain the disease and hopefully become immune. In Turkey, citizens would use the puss from smallpox pustules as a rub on their skin (Baxby 21). The disease was also found in Africa, Egypt, and India as early as 1350 BC (Brannon 1). Unfortunately this method was likely to be lethal, but through successful trials, the word spread across Europe by the 1700s. Different forms of variolation came up across the country, some of which were successful and are still recognized.
The first variolation was recorded in 1717 in Constantinople by a British woman named Lady Mary Wortley Montagu, the wife of the British Ambassador to Turkey, lived in Turkey and visited England frequently where her family lived. Bringing her knowledge of the Turkish variolation, she introduced the method to England, opening up a new channel for researchers. Soon after arriving back to England she had her sons variolated, starting a new revolution in medicine. In 1721, Lady Montagu had her four-year-old
daughter variolated. Following this, there was a large breakout of smallpox in England, which all of the variolated Montagus survived. Once doctors saw the success of variolation in their own country, this practice erupted into full-fledged research (Baxby 22).
Anxious to see if variolating really was successful, a team of six inmates from Newgate Prison was used as test subjects with the promise that they would be let out of jail if they cooperated. Run by Charles Maitland, a surgeon to the Embassy in Constantinople, the inmates were variolated. The outcome was that five of the six inmates came down with smallpox; the last one did not receive the illness due to having it prior to jail. These results boosted the practice for immunology of smallpox (Baxby 22-23).
From this date on, the inoculation of smallpox became tradition for the more well to do, due to the expense of the preparatory and post period of variolation. Unfortunately, with this new tradition, following a few steps behind was death. In 1723, two children of Caroline of Ansbach, the Princess of Whales, and six children of Lord Bathurst were all successfully variolated. However, along the way there was a footman who was killed by the variolation of smallpox. His death triggered fear in all citizens, ceasing development. Closer to the 1750s, variolation became increasingly more popular due to the risk of smallpox as well as the safer plans of variolation. Instead of rubbing the smallpox onto the skin, doctors developed a method of making a superficial cut into the top layer of skin and inserting the virus under the skin (Baxby 22-32).
The next step for smallpox was vaccination. Vaccination and variolation are different in three ways: 1.) It was much safer, with a noticeable decrease in fatalities, 2.) once a person was vaccinated there was no communicability between the infected being and the healthy, and 3.) there were no usual lesions or pustules. When current day physicians later reviewed variolation, notes were taken that in variolation there was an increased risk of deaths over vaccination, lesions would show, and did spread it to other people. This shows how closely the two really were related. In variolation, deaths were about one in seventy (Baxby 24), whereto vaccination death rates were about one in eighteen hundred (Krasner 2). Throughout the eighteenth century, doctors were constantly trying to improve their variolation techniques. In the end, the shallower the cut, the worse of an infection was discovered. By the 1840s, variolation was outlawed due to its fatality rate (Baxby 25).
First off, we need to understand the differences between cowpox and smallpox in order to understand the next step of the smallpox vaccine revolution as well as the reason why many famous
vaccinators used it to immunize themselves and fellow citizens. Since both smallpox and cowpox are of the same strain of virus, when a person falls ill with cowpox, they are therefore immune to smallpox and vice versa. Studies have shown that the effects of cowpox are much less extreme and the fatality levels are much lower than that of smallpox, where cowpox fatality levels are one in a million and for smallpox one to three percent of the infected risk death (Ogden 6). When one receives cowpox, the lesions appear, but are in much less intense of a form, and are in a more concentrated area of the body. For smallpox, the lesions are actually pustules, meaning they produce some form of pus and appear all over the body as well in one concentrated stage of the viral infection (Baxby 5). As it is human, we tend to choose the less painful way, so when doctors found out that cowpox could vaccinate oneself from smallpox, they jumped at this opportunity.
The first authentic smallpox vaccination was practiced in 1774 by a farmer Benjamin Jesty. Having three children, two sons and one daughter with a pregnant wife, he felt his family’s lives were in danger with the oncoming threat of the deathly smallpox. As a child, Benjamin fell ill with cowpox, therefore immunizing himself from the other members of the pox family, he also had two milkmaids who had also received cowpox sometime in their lives. Using this to his advantage, Jesty tried to immunize his family. Some time later the cows in a nearby farm came down with cowpox and Jesty led his family to the pasture. Here he took a needle and infected it with the bacteria from the pus of a diseased udder and scratched his wife just above the elbow, inoculating her with cowpox. Next he did the same with his two sons, but not his daughter since she was too young for her immune system to be able to fight off the disease. Ironically, this is the origin of the word vaccination, since in Latin ‘vacca’ means cow. The next few days the disease contaminated their bodies, making them fall ill. Fortunately the two sons were healthy again soon after inoculation. However, the mother did not come out as well as her sons. Scared for his wife’s safety as well as his unborn child, Benjamin called the local doctor to come cure her illness, this let out Jesty’s secret. It is also known that Benjamin vaccinated some of his friends and neighbors, yet this was the start of the vaccination of smallpox (The Dorset Page 1).
In the late 1790s, Jenner, a well-known scientist at this point, began a study revolving around what Benjamin Jesty had discovered. Prior to this research topic, Jenner had studied the behavior of the Cuckoo bird, studied different insect species that Captain Cook had brought back from his first journey, and had
invented Emetic Tartar, which helped acute depression, eczema, fevers, and bronchitis. However, in Jenner’s Cuckoo studies, he became bored of his topic and published findings about the bird without being able to back it up with research, it is said that he never even did the research rather made an educated hypothesis. Unfortunately, this gave Jenner a very bad reputation for being lazy, so when Jenner produced research about the vaccination of smallpox, it was not thought to have been fully, or even properly, researched. Therefore it took many other doctors’ trusted word for the citizens to believe this life-saving discovery. In Jenner’s finding, he took the discovery of Benjamin Jesty, and published it, but with more scientific background. In the end, Jenner pretty much copied the exact studies that Jesty discovered (Baxby 51-69). However, the problem with Jenner’s practicing of vaccination was that he never knew if he exactly had cowpox or smallpox. Jenner ended up mixing both the diseases and coming out with a less intense form of smallpox, which he would use to vaccinate his patients and have a less severe outcome. Jenner’s first vaccination was on May 14, 1796 on James Phipps with actual cowpox. A follow up infection was tested on James on July 1st of the same year and Phipps resisted the infection. This was the first and only successful vaccination until the spring of 1798. In those midyears, the vaccination was tainted with smallpox, which gave a bad outcome when he vaccinated people, giving them pustules and extreme illnesses. There is not much information about exactly what happened, all we know is that the vaccination became tainted and this affected his patients and made them scared of vaccinations because they did not want to fall ill.
Other than Jenner there were other physicians trying to perfect the vaccination, some were Woodville, Redfearn, Ceely, Pearson, Creaser, Sacco, and Razzell. With all the help from these doctors a perfected method was discovered and replicated time after time. Also, with no logical way to describe the pustules or lesions on certain people but not on others, doctors stated that this may have been due to ‘delicate stomachs or skins’ (Baxby 126). Contamination often occurred, which could breakout to full city infections. Through the rest of the eighteenth and into the nineteenth century, discoveries were made about smallpox. A very peculiar discovery was that smallpox could only be transmitted to monkeys, but with much difficulty it could also be passed to others. Yet it did naturally infect monkeys where with artificial infection, it could live in other animals.
Up until just recently, smallpox was not a threat to our world anymore since its eradication in 1980. Bioterrorism has placed fear into our eyes with the revived threat of smallpox again. With the recent events in Iraq, problems as smallpox being used for terrorism are becoming more realistic. The only way that our society may protect ourselves is to revive the vaccination for American citizens, making it a demand for everyone to have it. Word has it that cults that plan bioterrorism have gone to Zaire to collect Ebola virus, made Anthrax, and have ample supply of smallpox available. Thankfully, the possibility of smallpox used as bioterrorism is highly unlikely due to the lack of supplies for the smallpox virus. Until then, our society lives in fear of the possible infection of the lethal disease.
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