Poxes great and small: The stories behind their names.

The word "pox" indicated, during the late 15th century, a disease characterized by eruptive sores. When an outbreak of syphilis began in Europe during that time, it was called by many names, including the French term "la grosse verole" ("the great pox"), to distinguish it from smallpox, which was termed "la petite verole" ("the small pox"). Chickenpox was initially confused with smallpox until 1767, when the English physician William Heberden (1710-1801) provided a detailed description of chickenpox, differentiating it from smallpox. The cowpox virus was used by Edward Jenner (1749-1823) to develop a successful vaccine against smallpox. He devised the term "variolae vaccinae" ("smallpox of the cow") to denote cowpox. Jenner's pioneering work on a smallpox vaccine has led to the eradication of this disease and opened the way to preventing other infectious diseases, such as monkeypox, a poxvirus that is closely related to smallpox and that is currently infecting persons around the world. This contribution tells the stories behind the names of the various "poxes" that have infected humans: the great pox (syphilis), smallpox, chickenpox, cowpox, and monkeypox. These infectious diseases not only share a common "pox" nomenclature, but are also closely interconnected in medical history.

Dr. James Smith's Dream of Eradicating Smallpox and the National Vaccine Institution.

This article re-examines from a new perspective the efforts of James Smith (1771-1841), a Maryland doctor, to eradicate smallpox in the United States. As one of the few successful cowpox inoculators at the turn of the nineteenth century, Smith recognized the necessity for a public vaccine institution that could ensure the safe production and continuous preservation and circulation of vaccine matter. Thus, he devoted himself to creating statewide and national vaccine institutions funded by the state and federal governments. He established the National Vaccine Institution (NVI), but despite his efforts, the NVI existed only a short time from 1813 to 1822. Previous studies on Smith have focused on the 1813 Vaccination Act (An Act to Encourage Vaccination) and the NVI, and have evaluated them as failed projects or historically missed opportunities. However, this kind of approach does not justly place the act and institutions within Smith's larger plan and do not fully discuss the role of the NVI in his system of promoting vaccination in the United States. This article analyzes how he responded to the problems hindering cowpox vaccination, including spurious vaccine, failed vaccination, and low public acceptance of cowpox vaccine. In doing so, this study shows that Smith attempted to establish a universal and systematic vaccination system connecting citizens, government, and medical personnel through the NVI, as well as ensuring a safe and regular supply of vaccine.

Antibiotics: From the Beginning to the Future: Part 1.

The first written record of intervention against what later came to be known as an infectious disease was in the early seventeenth century by a Buddhist nun. She dried 3 to 4 wk old scabs from patients with mild smallpox and asked well people to inhale the powder. More than a century later in 1796, Edward Jenner described vaccination against smallpox by using cowpox that later was found to be caused by cowpox virus which is non-pathogenic for humans. Another century later in 1890, Robert Koch published the Koch's Postulates allowing the study of pathogenic bacteria and subsequently the study of agents to fight them. The first chemical cure for disease was reported by Paul Erhlich in 1909 in the form of an arsenic compound to treat syphilis. One hundred and ten years since then a lot has happened in the area of preventing and treating infectious diseases with significant contribution to increase in human lifespan. This is the only area of medicine in which treatment (antimicrobial agent) is used to eradicate a replicating biological agent inside the human host. The potential of this second biological agent to mutate under the selection pressure of antibiotics making them resistant was recognized in the 1940s. But the indiscriminate use of antibiotics for over 70 y has led to the present crisis of resistance in major pathogens with increased morbidity and mortality. In this review, we have incorporated all the possible avenues that might be useful in the future. However, none is more important than relearning the judicious use of antibiotics based on microbiology, pharmacology, and genetics.

The Cowpox Controversy: Memory and the Politics of Public Health in Cuba.

Vaccination played an important role in the formation of a national consciousness in Cuba, and vaccination's earliest promoters dominate nationalist narratives of medical achievement on the island. This article investigates the intense hostility exhibited by the creole medical elite toward a pivotal figure in the history of smallpox vaccination in Cuba, Spanish physician Dr. Vicente Ferrer (1823-83), the first in the Americas to mass produce smallpox vaccine using calf vaccinifiers. I argue that anger and mistrust of both Ferrer and his innovatory vaccine production technology originated in the relationship between medical politics and cultural identity in late nineteenth-century Cuba. By the late nineteenth century, smallpox vaccination was linked to glorified memories of a Cuban creole-led vaccination program and a disinterested medical profession. Both Ferrer and his private institution for the mass production of "cowpox" became associated with destructive changes in public health, challenging cultural narratives and regional power structures.

An examination of John Fewster's role in the discovery of smallpox vaccination.

Edward Jenner is recognised today as the father of vaccination but, as this paper explores, he was not the only Gloucestershire doctor to be linked to this discovery. John Fewster, a local surgeon and apothecary, is also said to have experimented with vaccination, many years before Jenner. This claim is made in a letter addressed to John Coakley Lettsom, written by John Player, a Quaker farmer. Player describes in detail Fewster's realisation that cowpox could be used to protect against smallpox. This letter is frequently cited but has not previously been subjected to critical analysis. We have identified several inconsistencies, including conflicting dates and a possible ulterior motive in that Player's son was to marry Fewster's daughter. We think it unlikely that Player, a devout Quaker, would have consciously fabricated evidence, but argue that the discrepancies in his account undermine the assumption that Fewster carried out vaccination experiments prior to Jenner. We also explore the assertion that Fewster presented a paper in 1765 on the subject of cowpox and its protective effect over smallpox. We conclude that, although there is no doubt that Fewster did pre-empt Jenner's discovery of vaccination, he did not realise the significance or importance of this momentous medical advance.

El ensayo inédito sobre la vacuna de Ignacio María Ruiz de Luzuriaga (1763-1822) / The unpublished essay on vaccines by Ignacio María Ruiz de Luzuriaga (1763-1822)

El contenido del conjunto documental conocido como «Papeles sobre la vacuna» archivado en la Real Academia Nacional de Medicina y generado por Ignacio María Ruiz de Luzuriaga (1763-1822) no ha sido estudiado hasta la fecha de forma exhaustiva. Como parte de una amplia investigación sobre estos manuscritos se describe el hallazgo de un texto inédito producido en 1801 por Ruiz de Luzuriaga que, con forma de ensayo, pretendía recopilar los conocimientos sobre el método vacunal sugerido por Edward Jenner durante los inicios de su introducción en España. Su objetivo era establecer un corpus científico y académico sobre la vacuna que facilitara su comprensión, asimilación y buena práctica entre los vacunadores españoles. El texto, contenido en el volumen 3 de los «Papeles», fue consecutivo a otros dos inmediatamente anteriores, la «Carta a D. Luis» y el «Informe imparcial sobre la vacuna». Este estudio analiza el origen y destinatarios de los tres textos, revelando la identidad de «D. Luis» y describiendo los contenidos del «Ensayo», documento hasta ahora desconocido y en el que destaca por su valor historiográfico la primera traducción al español del «Inquiry» de Jenner, realizada por Ruiz de Luzuriaga (AU)

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[Johann Gottfried Bremser (1767-1827) as a protagonist of the cowpox vaccine]. / Johann Gottfried Bremser (1767-1827) und die Kuhpockenimpfung.

Vienna was the first city on the European continent where the cowpox vaccination was applied in 1799, shortly after Jenner's (1798) publication of his encouraging results in England. Nevertheless, substantial denial and distrust was evident among doctors and patients in Europe as well, particularly in Austria. The medical doctor Johann Gottfried Bremser remains well known even today among parasitologists as a pioneer of helminthological research in Austria. He founded, in Vienna, one of the richest parasitic worm collections worldwide and published perceptive papers about helminthology. But his role as a protagonist of the cowpox vaccine has been buried in oblivion. In the late 18th and early 19th centuries, Bremser worked as a medical doctor in Vienna and was influenced by the major proponents of the vaccine in Austria, Pascal Joseph Ferro, Jean de Carro, Johann Peter Frank and others. Beyond his practical contribution as vaccinator, he excelled as a propagandist, mainly through his publications on cow pox vaccination. Bremser used his expert knowledge and sophisticated argumentation to prompt people to accept the prophylactic treatment, especially for their children. He argued for an obligatory cowpox vaccination for all. On one hand, his argumentation summarizes the contrarian opinions of that time, on the other hand the discussion shows striking analogies with the controversies of today. In a way, Bremser's commitment was a forerunner for future health policies that led to vaccination laws and ultimately to the eradication of smallpox worldwide in the second half of the 20th century.

Introduction: simultaneously global and local: reassessing smallpox vaccination and its spread, 1789-1900.

SUMMARY: The last two decades have seen a reawakening of scholarly interest in the history of smallpox prevention. Accounts of vaccination and others efforts at controlling smallpox have moved away from heroic narratives toward more nuanced and contextualized understandings. It is now accepted that several viruses traveled under the vaccine label from the outset, and it has been demonstrated that a variety of techniques were used to perform vaccination operations. The character of nineteenth century sea voyages that took the vaccine to distant territories has also been re-examined; sometimes the spread of the vaccine was caused by private networks and ad hoc decisions, while at other times it was the result of enterprises with close resemblances to contemporary centralized vaccination campaigns. Looking beyond Europe and North America we encounter a variety of state attitudes toward vaccination, ranging from concentrated efforts to spread the technique to efforts more uncertain and diluted. Although the reluctance to accept vaccination has been amply documented, recent studies emphasize this should not be attributed to simplistic dichotomies of modernity versus tradition or science versus culture; instead, instances of resistance are best studied as specific contextualized interactions. Indeed, factors like favorable geography, strong bureaucratic structures, and the absence of variolation seem to have helped the relatively smooth transfer of vaccination technologies. Perhaps most important, recent research encourages us to continue to study smallpox vaccination as a phenomenon that was simultaneously global and local.

Catching cowpox: the early spread of smallpox vaccination, 1798-1810.

SUMMARY: The introduction of smallpox vaccination after the publication of Edward Jenner's An Inquiry into the Causes and Effects of Variolae Vaccinae depended on the spread of cowpox, a relatively rare disease. How Europeans and their colonial allies transported and maintained cowpox in new environments is a social and technological story involving a broad range of individuals from physicians and surgeons to philanthropists, ministers, and colonial administrators. Putting cowpox in new places also meant developing new techniques and organizations. This essay focuses on the actual practices of vaccination and their environmental contexts in order to illuminate the dynamic exchanges of materials, images, and ideas that made the spread of vaccination possible.

Smallpox and cowpox under the Southern Cross: the smallpox epidemic of 1789 and the advent of vaccination in colonial Australia.

SUMMARY: In histories of smallpox and vaccination, little attention has been paid to their progress in the southern latitudes. In this paper, I focus on the appearance of smallpox around Sydney Cove in 1789 and the introduction of cowpox (vaccine) to New South Wales in 1804. I demonstrate the connections, historical and virological, between the two events and examine the role of variolation in the spread of smallpox and in anticipating vaccination. I argue that imported "variolous matter," perhaps obtained in Cape Town, may have been the source of infection in the catastrophic epidemic among the Aborigines in 1789. I likewise examine the means by which vaccine was brought to Australia in relation to comparable initiatives around the Indian Ocean. I assess the significance of the early history of vaccination in Australia in relation to subsequent developments and as a remarkable demonstration of the global reach of the new prophylactic.

[Documents and figures about the vaccine in Bologna at the beginning of the nineteenth century]. / Documenti ed immagini sull' innesto del vaiuolo vaccino in Bologna al principio del XIX secolo.

An interesting documentation, related with the campaign for the diffusion of the vaccine in Italy at the beginning of the nineteenth century, is available at the Museum Luigi Cattaneo of Anatomical Waxes of the University of Bologna. In this collection there are two wax models reproducing a cow-udder with pocks and two girl arms with the pocks of a "true" and "false" vaccine rash. The waxes were moulded under the direction of the leading physician Pietro Moscati, and overlap with the engravings of the chief treatise about the cow-pox and vaccine published by Luigi Sacco in 1809. The presence of the same models also in the Museums of the University of Pavia, and the available documentation about these waxes, demonstrate the educational purpose of the preparations. According to Sacco, they would be an effective tool directed to physicians and midwiwes for the learning and the knowledge of the outcomes of vaccination.