6th August 2022
I find vaccines quite fascinating. To be more accurate, I find the thinking and emotion around vaccines endlessly fascinating… and often quite disturbing. They have become, what we in the UK call ‘national treasures.’
A national treasure is someone, such as Dame Judi Dench, or Sir David Attenborough. We laugh at their little jokes, we forgive them any possible weakness, we treat their statements as carrying a great and solemn weight. They have moved to a sainted realm.
If, for example, someone was to say about David Attenborough. ‘God, what a terrible bore. Time he was put into a nursing home, and stopped moaning on about Climate Change…’ This statement would not, I can guarantee, be met with Universal approval.’ Moving on …
Mithridatism. Most people have never heard of it.
‘Mithridatism is the practice of protecting oneself against a poison by gradually self-administering non-lethal amounts. The word is derived from Mithridates VI, the King of Pontus, who so feared being poisoned that he regularly ingested small doses, aiming to develop immunity.’ From my favourite website of all time – Wikipedia. Hey, before you start, it’s good for non-contentious subjects.
From mithridatism came the substance Theriac Mithridatium. Also called Galene, or Venetian treacle. These were the universal panaceas, designed to cure all ailments suffered by mankind … and, of course, womankind. They were complex to prepare:
‘The preparation of Galene was simple in that its ingredients were free of fractional measures. Four vipers cut down small were placed in a solution of sal ammoniac, about one gallon, to which were added nine specified herbs and Attic wine, together with five fresh squills also cut down small. The pot was covered with clay and set upon a fire. When the vapour came out of the four small holes left in the clay seal, dark and turgid, the heat had reached the vipers and they were cooked. The pot was left to cool for a night and day. The roasted matter was taken out and pounded until all was reduced to powder. After 10 days the powder was ready for the next stage of manufacture.
At the final stage the prescribed quantities of 55 herbs previously prepared by various processes, along with the prescribed quantity of squill and viper flesh powder (48 drachms), were added to hedychium, long pepper and poppy juice (all at 24 drachms); eight herbs including cinnamon and opobalsam (all at 12 drachms); 18 herbs including myrrh, black and white pepper and turpentine resin (at 6 drachms); 22 others and then Lemnian earth and roasted copper (at 4 drachms each); bitumen and castoreum (the secretion of beaver); 150 drachms of honey and 80 drachms of vetch meal.
The concoction took some 40 days to prepare, after which the process of maturation began. Twelve years was considered by Galen the proper period to keep it before use. Galen records that the Emperor Marcus Aurelius consumed the preparation within 2 months of its being compounded without ill effect.
Mithridatium was similar but contained fewer ingredients and no viper but did contain lizard! The other differences were that the opium content of Andromachus’ theriac was higher than that of Mithridatium, which also differed in containing no Lemnian earth, copper or bitumen and 14 fewer herbal ingredients…’ 1
Simple to prepare … I think I would prefer to make a bacon sandwich, thanks very much.
Various formulations of mithridatium were painstakingly put together, in public, to ensure that no-one was cutting corners, by substituting newt for lizard – or some other such underhand substitutions. Yes, it was vitally important that mithridatium was made of pure unadulterated nonsense. No cut-price, corner-cutting nonsense here, thank you very much. It was then sold for a fortune. And people flocked to buy it.
The manufacture of mithridatium, and its variants, went on from the second century BC to the end of the eighteenth century. Or, to frame this another way. The idea of creating a substance that contained small portions of various poisons, in order to allow the body to build up immunity, and fight off all illnesses and infections, has an extremely long history.
All doctors in the mid to late eighteenth century would have been acutely aware of mithridatium, and its variants, and the thinking behind it.
William Heberden, a famous UK physician, is the man we can most credit with attacking the idea of ‘Mithridatium and Theriaca’. His pamphlet on the matter was written in 1745. He argued that it was all complete, unscientific, twaddle. Following this, and other attacks, the sales of Theriac mithridatium suffered a rapid decline.
By the end of the eighteenth century Mithridatium had pretty much disappeared from the world. To the point whereby nowadays ninety-nine per cent of people – or more – have no idea that such a substance ever existed. Or how hugely significant it was.
Let us move on a few years to 1796. A moment in time when an eight-year-old boy, James Phipps, was inoculated with ‘matter’ from Sarah Nelms, a dairy-maid, who had cowpox. Three months later, the same boy was ‘inoculated’ with fresh ‘matter’ from a smallpox lesion – and no disease developed. Lucky boy. Not sure you would get that past the ethics committee today. ‘I am fairly confident that he will not die of smallpox ... probably.’
Yes, as mithridatism departed from this world, vaccination moved in to take up the available space – a different substance to protect against future illness. In truth, the idea of inoculating people with small amounts of smallpox ‘matter’ to help the body fight off a more serious infection had been around for some time before this.
It was carried out in China, Africa, and the Ottoman empire perhaps for, hundreds of years. Although the idea that it is possible to have a ‘small’ inoculation with a deadly virus is interesting …. Do not try this at home.
To me, the important point I am trying to make here, is that the underlying idea behind vaccination had been around for millennia. Vaccination was, in effect, a variation on the theme of mithridatism.
However, the idea that a cowpox infection could protect against future smallpox was new, and it was Jenner’s idea. At least he made the most noise about it. Others claim it was Benjamin Jesty. Who knows? Success has a thousand authors, failure but one.
I think I shall credit the milk maids instead. They had known for many years that if you got infected with cowpox, you were protected against smallpox. An observation that Jenner picked up on, then ran with. Good for him …
‘… The record shows that it was there that Jenner heard a dairymaid say, “I shall never have smallpox for I have had cowpox. I shall never have an ugly pockmarked face.” In fact, it was a common belief that dairymaids were in some way protected from smallpox.’ 2
But, of course, at the time all this this was complete speculation and guesswork. When vaccination began no-one knew that there such things as bacteria, or viruses. No-one knew there was an immune system. No-one had the faintest idea about T-cells and B-cells and suchlike. Which leads to the question. What did Jenner actually think he was doing? How did he believe vaccination could possibly work?
After all, he was experimenting with vaccination decades before germ theory had emerged. This happened in the late(r) nineteenth century. A time when Pasteur, John Snow and the like, finally managed to convince the medical profession that infectious diseases were not spread by Miasma – essentially nasty smelly stuff that floated about in the atmosphere. Instead, disease was spread by very small ‘germs.’
If Jenner did not know that germs existed, what did he think was causing smallpox? If it was via miasma, how would vaccination work? A part of me thinks that he must have believed that a physical agent, or some sort, was causing ‘pox’. Otherwise, why would he scrape away at cowpox blisters to get ‘stuff’ off. He couldn’t have believed he was transferring miasma from one person to another.
Maybe he thought the miasma theory was complete nonsense but didn’t dare point this out. Semmelweis certainly found out, to his cost, that trying to suggest infection could be passed on by physical contact was not well received.
A Hungarian physician, he did some thinking, and research, on how infections were passed on. He recommended that it might be a good idea if doctors might just, possibly might, consider washing their hands after doing a post-mortem … then helping women to deliver their babies.
For which heresy, he ended up being flung into a lunatic asylum. He was later beaten to death by a warden. This was some forty years after Jenner began his experiments on vaccination. Yes, Semmelweis is now a very famous figure in the history of medicine, the ‘saviour of mothers’ but it didn’t do him much good at the time.
As you can probably tell, I find the development of medical thinking – indeed all scientific thinking – to be fascinating. Where do the ideas come from? At times I believe it is all complete luck. Good ideas, bonkers ideas, they all appear to be taken up with equal enthusiasm. All you need is a good tale and a charismatic promoter, then off you go.
‘It was not noisy prejudice that caused the work of Mendel to lie dead for thirty years, but the sheer inability of contemporary opinion to distinguish between a new idea and nonsense.’ Wilfred Trotter
With vaccination though, there was no major new idea. There were two thousand years of Mithridatism to build on. Namely, use a small amount of a substance to create future immunity. A general concept that was, and remains, highly seductive to the human mind. With vaccination it just happened to be right.
However, it could just as easily have been wrong. For example, the thinking behind mithridatism also underpins homeopathy. A concept that first came to Samuel Hahnemann. A doctor who obtained his medical degree in 1779. Yes, he was kicking around at very much the same time as Jenner.
‘Hahnemann believed that if a patient had an illness, it could be cured by giving a medicine which, if given to a healthy person, would produce similar symptoms of that same illness but to a slighter degree. Thus, if a patient was suffering from severe nausea, he was given a medicine which in a healthy person would provoke mild nausea. By a process he called ‘proving’, Hahnemann claimed to be able to compile a selection of appropriate remedies. This led to his famous aphorism, ‘like cures like’, which is often called the ‘principle of similars’; and he cited Jenner’s use of cowpox vaccination to prevent smallpox as an example.’ 3
It is said that the idea of homeopathy first popped into Hahnemann’s head because he noted that quinine, in small doses, created similarly symptoms to malaria, although in a much milder form. So, he tried to use quinine to protect against malaria. Then he expanded the concept, to infinity and beyond.
Mind you, the use of quinine to protect against malaria led to the creation of tonic water, to protect the British in India. This, in turn, led to the creation of gin and tonic. So, Hahnemann must be celebrated for this wonderous legacy, at least. Yes, for this, I can forgive him just about everything.
And, of course, quinine does protect against malaria. If not that well. Oh, the delicious irony.
Mithridatism: Ingestion of small doses of poisons to create immunity
Homeopathy: Use of very small doses of a substance to create immunity/cure
Vaccination: Deliberate infection, using small doses of an agent, to create immunity
- Mithridatism is gone
- Homeopathy is mocked
- Vaccination is venerated
Imagine if, on the other hand, Jenner had decided to keep on using smallpox scrapings to try and prevent a later, more deadly smallpox infection. Maybe vaccination would never have happened, at all.
Just to give one example of the problems with smallpox inoculation. In 1783, Prince Octavius, the youngest son of King George II was inoculated with the smallpox virus. He died soon after – of smallpox. Had King George then taken violently against ‘vaccination’ at this point, the entire idea may have died right then and there. At least in the UK.
Instead, with Jenner came the crossroads. The point where mithridatism, homeopathy, and vaccination parted company. One works, the other two don’t.
This is because there is no such thing as a vanishingly small dose of an infection. You get infected, or you do not. The dose is pretty much irrelevant. Of course, what happens after infection can vary enormously. Some people get no symptoms, at all, others may die.
The key point of difference with vaccination is that you are notgiving a small dose of the infective agent – however vanishingly small. The point, the critical difference, is that you have to give ‘something else’ instead. Something other than the actual infective agent. This stimulates the immune system and leads to the creation of memory cells that will recognise a ‘similar’ agent in the future, and then kill it off. Hopefully.
However, there is no way on earth that Jenner, or anyone else at the time, would have had the slightest idea why this would be the case. They thought it might work. So, they did it, and it worked. And lo, vaccination was born.
It amuses to me look at articles describing the history of vaccination, and Edward Jenner, and compare them with – for example – articles on Hahnemann:
‘While it can scarcely compare in antiquity with Chinese or Indian medicine, homeopathy is the longest established CAM (complementary medicine) to have arisen in Europe. It was founded by Samuel Hahnemann (1755-1843), who grew up in Meissen in Germany, received his medical degree in Erlangen in 1779, and died a millionaire in Paris in 1843. During his first fifteen years as a physician Hahnemann struggled desperately to make a living.’ 4
If we turn to Jenner …
In addition to his training and experience in biology, Jenner made great progress in clinical surgery while studying with John Hunter in London … In 1773, at the end of two years with John Hunter, Jenner returned to Berkeley to practice medicine. There he enjoyed substantial success, for he was capable, skillful, and popular. In addition to the practice of medicine, he joined two local medical groups for the promotion of medical knowledge and continued to write occasional medical papers. He also played the violin in a musical club and wrote light verse and poetry. As a natural scientist, he continued to make many observations on birds and the hibernation of hedgehogs and collected many specimens for John Hunter in London.
So, it seems that, on one hand, Hahnemann was both a scoundrel, and a failure as a doctor. Only when he turned to the dark side, did he become that worst of all things. A greedy millionaire, selling snake oil.
On the other hand, Jenner was virtually a saint. A man both skilful and popular, and successful. He even wrote poetry (unlikely to be a good thing in my opinion) and he played the violin (almost certainly not a good thing). My goodness, this is a man you would want your daughter to marry. An intelligent man, a man of the most delicate and thoughtful sensibilities, was he not …
‘Although he received worldwide recognition and many honors, Jenner made no attempt to enrich himself through his discovery. He actually devoted so much time to the cause of vaccination that his private practice and his personal affairs suffered severely.’
Maybe this wasn’t a man you would want your daughter to marry … after all, ‘It is a truth universally acknowledged, that a single man in possession of good fortune, must be in want of a wife.’ So, Hahnemann, in possession of a good fortune as he was, might have been a better choice.
Despite his lack of money, indeed because of it – Jenner has become a historical national treasure. A selfless searcher for the truth. A delicate man, a popular man, a sensitive man. A man with a soul above such grubby things as making money… and suchlike. One is reminded of the propaganda surrounding Kim Jong-Il. The first time he played golf, he had eleven holes in one …
‘That time Kim Jong-Il tried golf for the first time and finished with 11 holes-in-one to achieve a 38-under-par game on a championship 18-hole golf course.’5
I imagine Jenner would have had twelve holes in one. Playing blindfolded, whilst entertaining an enraptured crowd with an impromptu violin and poetry recital. All for free, of course.
Yes, Jenner is a now national treasure; vaccination has also become a national treasure. Both exist in a realm above all criticism. This is never a good thing. Particularly not in the world of science. But it has happened. Dare to critically examine either, at your great peril. Try suggesting that the whole concept of vaccination was pure luck, primarily based on a two-thousand-year-old idea, and you will be attacked. This, I guarantee.