How did ancient cultures make sense of plagues and pandemics?

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St. Louis Red Cross Motor Corps on duty during influenza epidemic, 1918. Photo from Library of Congress (Public Domain).

In 1796, British doctor Edward Jenner became famous for being the first doctor to use a form of bovine disease called cowpox to inoculate or against smallpox. It was a breakthrough in medical history. Cowpox served as the natural vaccine until the modern smallpox vaccine was developed and by 1977 smallpox became the only human disease to be eradicated. Yet despite their achievement there were also those who were skeptical. The idea of putting something foreign inside your body led to the fear of vaccines that still exists today. 

KCRW’s Jonathan Bastian talks with Michael Kinch, author of “Between Hope and Fear: A History of Vaccines and Human Immunity” about the long and complicated cultural history of vaccines. 

The following interview excerpts have been abbreviated and edited for clarity. 

KCRW: How did ancient cultures make sense of plagues and pandemics? 

Michael Kinch: “There was a mythology to it, a lot of people felt that it was the gods striking back. But at the same time, there was a surprising amount of sophistication, to the point that in some cases, like in the Athenian plague, they would throw bodies over the gate at the enemy forces besieging Athens, to try to infect the other army. So they were far more sophisticated in realizing that this could be transmitted from person to person.”

At what point do we begin to see very primitive versions of immunization, to try and get the body to develop these natural defenses? 

Kinch: “So the first vaccine actually was before vaccines, which makes no sense. The word vaccine is derived from the Latin word for cow “vacca” but the first vaccine was actually before vaccines; smallpox was a disease that we really don't appreciate today  because we've eradicated it. But smallpox would wipe out large percentages, half or more of a village when it came raging through. Early in ancient China, and then later in the Middle East, and ended up in Turkey, and then it jumped from Turkey first to the United Kingdom than the US. 

The idea was to infect a healthy child, because children were the only ones susceptible to smallpox, because most adults had presumably survived smallpox.  So you would purposely infect a child with the scabs or material from the scabs of a smallpox sore. In China, they were inhaled through the nose and in the Middle East, they developed a technique where you would poke it under the skin using a specialized needle which today we call a Lancet and it gives a very distinctive scar. This is a process known as variolation. 

What variolation does is that it causes the disease in the individual for a time. The disease though is less severe and the person hopefully doesn't die. Nonetheless, there were high percentages of people that were variolated who died, especially if you had a doctor that didn't do it very well. And a lot of time it wasn't even a doctor doing this, sometimes it was a sort of witch doctor, because this was a process that was passed on down through generations. So this was a very deadly process, but it was better than facing the real smallpox, when the next outbreak comes through your village. But that created this fear of interference, having someone put something foreign into your body. And that really led to an anti-vaccine movement, predating the first vaccine.”

Do we know how or why this process got started?

Kinch: “We don't know who first came up with variolation. It’s thought to be probably some ancient Chinese scholars. But in the terms of vaccination, we think we know who did this first but it's actually wrong. We attribute modern vaccination to the idea of taking cowpox, which is a smallpox that cows get and which is far less severe than smallpox and you would scrape the pus from the udder of a cow that was having a cow pox eruption and you would then intentionally put that under the skin. 

We attribute this process to a gentleman by the name of Edward Jenner in the United Kingdom in the late 1790s. But in reality, when I was doing my research for the book, it turns out that there was not one but actually probably at least three other individuals who did this before Jenner. Probably the person that can really get the credit is a gentleman by the name of Benjamin Jesty, who again lived in the late 1700s. He was a farmer and the key he discovered turns out to be milkmaids because milkmaids no matter where you were, what country you're in, a person who milked cows for living generally tended to have very nice skin. Actually their skin was so nice that they were, in some cases, put in front of crowds of people to just admire. And the reason their skin was nice was they weren't marked by the scars from smallpox. 

So Jesty after a conversation with his milkmaid, put together that milkmaids didn't get smallpox but they did get cowpox from touching the udders when they were milking cows and they would get this minor skin irritation on their hands and lower arms and  that would seem to protect them from smallpox. So Jesty put two and two together and realized, if he intentionally did this, then that might be a good thing and so he did that. 

He was rewarded by the fact that when smallpox came through his wife and children were protected but unfortunately, he used his wife's dirty knitting needles to do the procedure and he had been variolated himself, remembered the procedure and he tried to replicate it using cowpox, the material from the udder but he caused his wife arm to be infected. And when the wife went to the doctor because her arm was infected, the doctor asked her how this happened. She told him and the result was basically the Jestys were then run out of town, because people were fearful that the Jestys  and then other people that were vaccinated would turn into these Minotaur-like creatures and go ravaging through the village, killing their children.” 

I have a memory of my grandmother growing up in Iowa and she had had polio that altered the length of one of her legs. It's a reminder that these things were very present in our country not so long ago.

Kinch:”Absolutely. We live in a bubble of time, as compared to most of the species' history. My mother remembers the fears of polio, the paralysis that was due to just pure fear, not just the virus and that is what we've had to combat. Frankly we've lost a lot of that fear. When I teach about anti-Vax movements in my university courses, invariably I have graduate students from South America, Africa, other places that don't understand the anti-Vax movement, because they live with infectious diseases all year long, especially in these tropical areas. And so they embrace vaccines because they still live in that world that we've long since forgotten.”

Credits

Guest:

Producer:

Andrea Brody