The First Vaccine — The Art of Chinese Viriolation

Smallpox was one of the worst diseases to ever afflict mankind, claiming hundreds of millions, if not billions of lives throughout all of history.  Thus, it is no wonder that the first vaccines were developed to guard against smallpox.  The first proto-vaccines were practiced in China in the 15th century, perhaps as early as the 10th century.  The Chinese method was nothing like modern vaccination methods, but was an early form of viriolation (inoculation against smallpox), a method first coined by the English physician Edward Jenner.  The early Chinese method of viriolation was to take the dried out scabs of smallpox victims.  The scabs would then be ground into a powder, then blown through a pipe into the nostrils of the patient. There was a bit of ceremony behind the act; typically viriolation was done with a decorative silver pipe, and boys were viriolated through the right nostril while girls were viriolated through the left nostril.

While the Chinese at the time had no knowledge of germ theory and little knowledge of immunology, the purpose of this was to infect the patient with a mild form of smallpox.  Indeed, the dried out scabs would contain weakened or dead smallpox virus, which the human immune system could easily fight off or at least obtain an immunological memory from its antigens.  Viriolation became popular in China, especially among nobles and the upper class.  One doctor named Zhang Yan boasted that he had successfully viriolated up to 9,000 people.  In the 18th century a Japanese physician reported that around 80%-90% of China’s upper class families had their children viriolated.

The practice of Chinese viriolation was not without risks, as the virus could mutate and the patient become infected with full blown smallpox.  However, the benefits far outweighed the risks in an age when smallpox decimated entire societies.  Over time the Chinese would perfect their technique, finding easier and safer ways to infect patients.  Their methods would spread across the Silk Road, being adopted in India, the Middles, and by the 18th century in Europe.  It was then that Dr. Edward Jenner would experiment with various viriolation methods.  It was in 1796 that he would develop the first modern vaccine by inoculating patients with cowpox, a disease similar to cowpox but much less deadly, and thus make them immune to smallpox.  Today, the use of vaccines are a staple of modern society.  The last case of smallpox occurred in 1977. 

It’s been said that English physician Edward Jenner (May 17,1749-Jan. 26,1823) saved more lives than any other human. Jenner developed the smallpox vaccine – the first successful vaccine – in 1798. In the late 18th century, smallpox cases were increasing and had a mortality rate of 40%. Through interviews and experiments with local farmers, Jenner observed that milkmaids who had been infected by cowpox – a milder form of the often deadly smallpox disease – during milking were immune to smallpox. The resemblance of the ulcer shape between the cowpox and smallpox viruses led to the discovery. Culled from our collections, here we have an original copy of Jenner’s “An Enquiry into the Causes and Effects of Variolae Vaccinae, known by the name of Cow Pox” (1798).


Top: Edward Jenner performing his initial inoculation experiments in 1796
Bottom: Typical presentation of vaccination site when successfully inoculated.

You know those shots and nasal sprays you get for vaccinations these days? Well, it wasn’t always like that. Though the practice of intentionally infecting people with Variola minor (much less fatal) to avoid Variola major goes back all the way to ancient China, Edward Jenner performed the most well-documented trials of using inoculation with Vaccinia virus (cowpox), in order to avoid later infection from smallpox.

Jenner, and many other physicians of the period, noticed that milkmaids and other farm-hands who had close contact with cows almost never became infected with smallpox during outbreaks, and hypothesized that the reason was due to the fact that they’d previously been infected by cowpox. To prove this fact, Jenner actually used his own children as guinea pigs, and inoculated them with the fluid from a cowpox sore on a milkmaid. To do this, he had to puncture the dermis with the infectious agent, and the child would contract a generally mild cowpox infection several days later.

As you can see on the lower image, the effects on the skin were not pretty, and the virus often caused substantial scarring, which can still be seen on most people who received the vaccines - just ask any relative growing up before the 1950s, and they probably still have that scar!

The method of Vaccinia virus inoculation to prevent serious smallpox infection was also much more dangerous than vaccination methods we have today. Approximately 1 in 1000 people would die from the initial methods , and approximately 1 in 75,000 people would die from the last methods used before we discontinued routine vaccination. This is because the virus was not attenuated (weakened) at first, and even when it was, you still had to have the body react as if it were infected in order to receive any immunity. It was a lot worse than the acute soreness some of today’s vaccinations give us, but it still saved thousands of lives - Variola major had a 35% mortality rate in unvaccinated people.

Top: “The Vaccination (1796)” by Gaston-Theodore Melingue, 1879.
Bottom: Pediatrics: The Hygienic and Medical Treatment of Children. Thomas Morgan Retch, 1906.

Did you know that the first successful vaccine was for smallpox?

As a young doctor, Edward Jenner was obsessed with finding a way to prevent horrific and deadly smallpox infections. He noticed that milkmaids who contracted cowpox were later immune to smallpox and used this discovery to develop the first smallpox vaccine in 1796. Jenner’s process was used all over the world, saving millions of lives.

Want to learn more about vaccination?  Read the Academy’s report to get your questions answered: http://bit.ly/FAQAdultVaccines


A page from a first edition copy of Edward Jenner’s “An Inquiry Into the Causes and effects of the Variolae Vaccinae” with a hand colored sanguine engraving of cow pox.  With the publication of this volume Dr. Jenner outlined using Cowpox to cure Smallpox thus saving more lives than any other man in history. They don’t call him the Father of Immunology for nothing! 

In Gloucester Cathedral, there’s a statue of Edward Jenner. He’s the bloke who worked out that milkmaids didn’t generally get smallpox because the pus in the blisters which milkmaids received from the less virulent cowpox protected them. Early vaccination theory. Seems that he was not the first to work that one out. But he got the statue.


Thomas Jefferson's Medical Experiments on Slaves

“In the best patrician tradition of his times, Thomas Jefferson was not only a country squire and leading politician but also a scientist. Eager to make his mark, Jefferson embarked on enthusiastic adventures in vaccination by gambling with the lives of his slaves. He wished to establish that Edward Jenner’s new technique of vaccination was superior to the technique of inoculation (or, as it came to be called a century later, variolation). Inoculation consisted of inserting or injecting infected material from a sick person directly into a well one to induce immunity. Vaccination in this era, referred to the process of injecting cowpox to provide immunity to smallpox, as Jenner first described in 1796. Jefferson obtained some cowpox vaccine indirectly from Dr. Benjamin Waterhouse of Boston, but it was known to be of dubious potency: The vaccine had failed to protect the subjects of an earlier trial. Jefferson spent that summer vaccinating two hundred of his family’s and his neighbor’s slaves. Only after they escaped illness did Jefferson inject his white family at Monticello.

The vaccinated persons remained well and the unvaccinated ones fell ill, but this did not convince Jefferson’s scientific peers, so Jefferson had a vaccinated slave injected with live smallpox material. When this slave remained well, Jefferson wrote his daughter Martha to proceed in order to ‘place our families and neighbors in perfect security.’

As a seasoned politician, Jefferson knew that his experiments on slaves would be criticized and that they seemed at variance with his sympathetic statements about blacks, so he slyly used language to deflect possible criticism, referring to conducting experiments ‘on some of my own family,’ without clarifying that the ‘family’ in question consisted of slaves owned by himself and his son.” -From, “Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to The Present” By: Harriet A. Washington

[SIDEBAR: This book is a MUST read! Please go out and get it. It has superb information in it! It should be required reading in all educational institutions.]

Jesus fuck.

Female Inventors of the British Industrial Revolution Part 2: Lady Mary Wortley Montagu

(You can read about the other female inventors here)

Lady Mary Wortley Montagu (1689-1762) is the second of the female innovators in my inventors database, and possibly one of the most important medical pioneers of the 18th Century, responsible for introducing and promoting the practice of smallpox inoculation in Britain and Western Europe.

Inoculation, or variolation (from the Latin for smallpox: variola) involves collecting the pustules from a smallpox victim and inserting the live virus via a scratch to a patient in order to prompt an immune reaction. While the practice substantially reduces the risk of death, scarring and blindness by giving a milder version of the virus, it still involves the risk of death. It’s not quite the same as vaccination, discovered by Edward Jenner, which involves using cowpox (variolae vaccinae) at no risk of death.*

Lady Mary took note of the process while stationed in Adrianople, Belgrade and Constantinople (Istanbul) with her husband, who was very briefly ambassador to the Ottoman court. She observed that the practice was common in Turkish folk medicine, and with the aid of the embassy surgeon Charles Maitland arranged to have her 5-year old son inoculated.

It’s worth underscoring the dangers of smallpox, and Lady Mary’s bravery as a medical pioneer. Of those who became infected, 30-35% could expect to die, with much higher mortality among children. It left around 65-85% of its survivors permanently scarred, in some cases causing blindness. Indeed, it was responsible for perhaps a third of all cases of blindness. It killed 300-500 million people in the 20th Century alone, even though it was finally eradicated mid-Century in 1979. For most of human history, it was the world’s greatest killer. 

Lady Mary had herself survived smallpox during her early years at Court, although she was not lucky enough to avoid the scarring. As such, she would have been fully conscious of the risks to her son, yet even more aware of the greater risks of his succumbing to a later epidemic. Upon her return to England, a smallpox epidemic broke out, and she made the difficult decision to inoculate her daughter. This was the first inoculation in Western Europe. She became a passionate and untiring advocate of the technique, enduring condemnation from doctors, the media, and even some clergymen. The propaganda battle intensified to the point that she would be derided in the street as an ‘unnatural mother’ for risking the lives of her own children.

However, inoculation experienced a major PR coup when the Prince and Princess of Wales sponsored an experiment at Newgate Gaol. Six prisoners facing the death penalty were offered the chance for a pardon if they underwent the procedure (You can read about them here). The success of the experiment was a resounding blow in favour of spreading the practice throughout Europe, laying the essential groundwork for Jenner’s discovery of vaccination in 1796. 

I mentioned in Part 1 that one of the reasons there are only two female inventors in my sample of 677 may be due to women at the time being deprived of the same educational opportunities as men. Lady Mary was the daughter of an ambitious gentleman, Evelyn Pierrepont, who became the 5th Earl of Kingston, then the Marquess of Dorchester and finally the 1st Duke of Kingston in 1715. Despite her aristocratic upbringing, however, she was forced to “steal” an education by secretly studying Latin in her father’s libraries while pretending to read romances.

Lady Mary is thus a prime example of the obstacles women had to overcome, subverting gender education stereotypes that were also reinforced by her hated governess. However, credit should be given to the apparently more enlightened Bishops Thomas Tenison and Gilbert Burnet, who corresponded with her and encouraged her self-improvement and study during her early teenage years. 

Like Eleanor Coade from Part 1, Mary Wortley Montagu was extremely self-assured. The stolen education is one example of this, as was her decision to elope with Edward Wortley Montagu, disobeying her father’s pressure to marry the heir to an Irish peerage. Furthermore, she was a prolific and outspoken opponent of society’s treatment of women over the course of her literary career.

As an accomplished poet, playwright and satirist, she fitted easily into the London literati at Court, befriending Alexander Pope and others, and becoming the first female writer for The Spectator. Nevertheless, despite her literary fame, she still on occasion had to write pseudonymously on subjects like economics and politics. Pope soon turned vehemently against her (see an artist’s rendition of her self-assured rejection of his amorous advances, below).

Later in life, Lady Mary left England to pursue an affair with the Venetian scholar Francesco Algarotti. Although they probably never consummated the affair, she became an integral part of literary society in the courts of Italy. From 1746 she became the tenant of the aristocratic bandit Count Ugolino Palazzi in Brescia, but upon being met with repeated excuses, realised in 1754 that she had de facto become his prisoner. Her self-assuredness was very much in action again when she finally made her escape two years later.

But Lady Mary Wortley Montagu’s numerous adventures and her contributions to literature and gender equality pale in comparison with her medical achievement. Her discovery, coupled with that of Jenner, is responsible for saving more lives than perhaps any other innovation in human history.

*The two words are now used interchangeably and vaccination has become a term applied to immunising against a whole host of other diseases. This was largely because when Louis Pasteur applied similar methods to immunise against anthrax and rabies, he named it in honour of Jenner’s discovery. It is thus a peculiar quirk of the history of medicine that vaccines for many other diseases find their etymological root in the Latin for ‘cow’.



This is a memorial statue of Edward Jenner. Edward Jenner was a scientist and a physician. He is famous for developing a vaccine for smallpox. Smallpox was widespread in the UK during the 18th century.  So his medical studies saved many lives.

İlk aşıyı kim olmuştur? Aşı ismi nereden gelmektedir?


Aşı olmak bizi korkutsa da pek çok hastalıktan korunmak için bu gereklidir. Peki ilk aşıyı kim olmuştur?

1700'lerin sonlarına doğru, virüslerin yol açtığı en tehlikeli hastalıklardan biri çiçekti. Edward Jenner adlı İngiliz, 13 yaşında, bir cerrahın yanında çırak olarak çalışmaya başlamıştı. Sonra Londra'da St. Georg Hastanesi'nde tıp eğitimi aldı. 

Jenner, inek çiçeği denilen tehlikesiz bir hastalığa yakalananların, çiçek hastalığına yakalanmadıklarını keşfetti. 

1796'da sağlıklı bir çocuğun derisini çizerek ona inek çiçeği hastalığı bulaştırdı. İki ay sonra da aynı yolla çiçek hastalığı bulaştırdı. Deney tam bir başarıyla sonuçlandı.

Latince'de inek anlamına gelen “vacca” kelimesinden gelen “vaccinatio” (aşılama) adı verildi.


Check out this funny video that explains how vaccinations work. Also…get your kids vaccinated!