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Put Edward Jenner’s statue back in Trafalgar Square

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c1582 (Published 25 March 2010) Cite this as: BMJ 2010;340:c1582

This article has corrections. Please see:

  1. Gareth Williams, professor of medicine
  1. 1Faculty of Medicine and Dentistry, University of Bristol, Learning and Research Building, Southmead Hospital, Bristol BS10 5NB
  1. gareth.williams{at}bristol.ac.uk

    Hero who defeated an enemy of all humankind

    London’s Trafalgar Square is famous for pigeons and statues of British military heroes. At its centre, Nelson presides from his column, celebrating the victory at Trafalgar that cost him his life but also set back Napoleon’s ambitions to rule the world. At the corners of the square are four plinths, three of which carry statues.

    A strikingly empty plinth awaits a final decision about what to put on it. Although recent occupants have included randomly selected people (with or without agendas, inhibitions, or clothes) the plinth began its career with pomp and circumstance, supporting an imposing statue unveiled in 1858 by Prince Albert and funded largely by public subscription.1 The subject was an unconventional warrior who inspired loathing as well as adulation. His enemies were powerful—and four years later, his statue was quietly carted away and parked in obscurity in Kensington Gardens, where it remains today.

    The statue is of Edward Jenner, widely known for developing a vaccine against smallpox. His “Inquiry,” self published in 1798, contains the first documented cases of protection from smallpox after a previous infection with cowpox. Cowpox, caused by a poxvirus related to variolavirus, the smallpox virus, was a known occupational hazard in milkmaids. Jenner not only observed this remarkable lesson of nature but also translated it into practical treatment: he infected healthy subjects with cowpox and tested some by scratching smallpox pus into their skin—so called “variolation”—an established but intrinsically risky procedure that protected against the natural disease. None of his variolated subjects developed signs of smallpox and Jenner concluded that cowpox inoculation conferred immunity against smallpox.2

    The importance of Jenner’s discovery was quickly realised. Vaccination was available in North America by 1800 and India by 1802, and literally travelled around the world by 1806, thanks to the Royal Philanthropic Expedition which carried the new technology to Spain’s colonies.1 Accolades for Jenner flooded in from across the globe, including a hand written letter and a diamond ring from “Marie” (Empress of Russia), reverential titles from North American Indian tribes, and cash from impoverished cities in India. And three years before Trafalgar, while locked in hostilities with England, Napoleon granted Jenner’s request to free two English prisoners of war, saying “I can refuse this man nothing.”3

    Back in England, however, Jenner faced strong opposition. Wealthy “variolators,” who fleeced patients by cloaking the procedure in lucrative mystery, fought to defend their income. Leading doctors, jealous or dismissive of the provincial surgeon, set out to undermine vaccination; some claimed that children developed cow-like features after vaccination.4 Churchmen, appalled by people being infected with “bestial” pus, bent Biblical texts to prove that vaccination was the devil’s invention. Posthumously, Jenner became the focus of anger stirred up by legislation making the vaccination of infants compulsory. The anti-vaccinationists were merciless in their criticism of Jenner—“His unscientific, foolish, unsupported assertions show that it was time that he should die”5—but had little to offer as an alternative. One “cure,” published in 1884, recommended bleeding with leeches, which were applied to the anus in cases where a confluent rash left no normal skin.6

    Jenner was not perfect. His scientific approach was more Brownian than Newtonian. An easily distracted procrastinator, he took more than 20 years from first discussing vaccination to trying it out. The “Inquiry” was full of holes.7 He did not even state how many experimental subjects he studied and initially covered up the reason that one of his “guinea pigs” was unavailable for follow-up (the boy, inoculated with pus from blisters on a horse’s heel rather than cowpox, died of a fever). Jenner was not the first to make the connection between an attack of cowpox and subsequent protection against smallpox. Moreover, others had already inoculated healthy subjects with cowpox as long as 20 years before his first experiments, notably Benjamin Jesty in Dorset and—uncomfortably close to home—Jenner’s friend and colleague, John Fewster.8 However, Jenner was the first to publish and disseminate his results, thus dragging vaccination into mainstream medical practice. Ultimately, vaccination was the decisive weapon that eradicated smallpox in 1978, nearly 180 years after Jenner voiced his aspiration that his invention would achieve that aim. Meanwhile, smallpox has also been eradicated from the world’s consciousness. We have forgotten that this disease was one of the most brutal killers and mutilators in our history. Before vaccination, smallpox attacked one person in three and killed one in 12; even in the 20th century it killed 300 million people. Many survivors were left severely scarred or blinded.

    Much has moved on since the Battle of Trafalgar. Our enemies then are our friends today (mostly), but the statues of long dead military men remind us that the freedoms we now take for granted were not won easily. On that basis, Jenner’s statue deserves reinstatement alongside the other Trafalgar Square heroes. Napoleon’s reign of terror lasted 20 years, while smallpox stalked the planet for centuries. In defeating smallpox, Jenner opened the door for immunisation against many other infections, and vaccination has proved to be one of medicine’s most transferable technologies. To date, smallpox is the only infection that we have eradicated, but polio and other major killers will undoubtedly follow. A century from now, Jenner’s legacy will be even stronger, whereas Nelson’s may well have shrunk further into history.

    The year 2010 is the 30th anniversary of the World Health Organization’s formal declaration of the greatest public health coup of all time, the eradication of smallpox. This is a fitting time to recognise Jenner for his role in defeating an enemy of all humankind, not just of England, that killed more people than all human wars combined. A petition to persuade the government to restore Jenner’s statue to its original and rightful place alongside the other heroes of Trafalgar Square can be accessed at http://petitions.number10.gov.uk/Jenner2010/.

    Notes

    Cite this as: BMJ 2010;340:c1582

    Footnotes

    • Competing interests: The author has completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declares: (1) No financial support for the submitted work from anyone other than his employer; (2) No financial relationships with commercial entities that might have an interest in the submitted work; (3) No spouse, partner, or children with relationships with commercial entities that might have an interest in the submitted work; (4) No non-financial interests that may be relevant to the submitted work. Sales of his book, Angel of Death: the Story of Smallpox, could benefit from publication of this article but all royalties will be donated to the Edward Jenner Museum, Berkeley (www.jennermuseum.com).

    • Provenance and peer review: Commissioned; not externally peer reviewed.

    References

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