The Book of the Dead

by John Mitchinson

  In 1771, when Joseph Banks returned from James Cook’s first voyage, Hunter recommended Jenner to catalog his botanical collection. Banks agreed, and was so impressed with Jenner’s work that he invited him to join Cook’s second voyage in 1772. After some hard thought, Jenner decided against it and went back home to set up his own general practice in Gloucestershire. He had also turned down John Hunter’s offer of a partnership, but the two men kept in close touch, with Hunter directing Jenner’s research into natural history by letter. After Jenner suffered a romantic setback, Hunter wrote to him, saying:

  Let her go, never mind her. I will employ you with hedge-hogs, for I do not know how far I may trust mine. I want you to get a hedge-hog in the beginning of winter and weigh him; put him in your garden, and let him have some leaves, hay or straw, to cover himself, which he will do; then weigh him in the Spring and see what he has lost.

  Jenner was fascinated by hibernation and skeptical of contemporary theories that birds (like bats) hibernated in winter. He dissected them and found seeds that came from other countries. He also noted that returning swallows were not, in fact, “dirty”—going against the prevailing wisdom that they spent the winter asleep in the mud at the bottom of ponds.

  His work on bird migration wasn’t published until the very end of his life, but it was an earlier piece of birdlife research that first made his name. In 1787, his “Observations on the Cuckoo” revealed that cuckoo chicks have hollows in their backs, allowing them to scoop up the other baby birds in the nest and tip them over the side. This unique feature is present for only the first twelve days of the cuckoo’s life. Until Jenner’s publication, it had been assumed that it was the foster birds that got rid of their own chicks. His theory wasn’t universally accepted until photography confirmed he was right in the twentieth century, but it was good enough to get him elected to the Royal Society in 1789.

  Close observation was Jenner’s forte and it led to another breakthrough: he was one of the first doctors to make a connection between arteriosclerosis of the coronary arteries and angina. In 1786, he noted that in one of his patients who had suffered from angina, the coronary arteries were “blocked” with a “white fleshy cartilaginous matter” that made a grating sound when he cut through them. “The heart, I believe,” he wrote, “in every subject that has died of the angina pectoris, has been found extremely loaded with fat.”

  Jenner thoroughly enjoyed life in Gloucestershire. He was a popular country-house guest, highly regarded as a witty raconteur, poet, and violinist. He was also a natty dresser. According to his friend Edward Gardner, he was usually to be seen in “a blue coat, and yellow buttons, buckskin, well polished jockey boots with silver spurs, and he carried a smart whip with a silver handle.” Like Ben Franklin and Epicurus, he loved like-minded company, and founded two clubs: the Convivio-Medical Society and the Medico-Convivial Society. They met in separate inns and had, as their names imply, similar interests but opposite priorities. Jenner was also a keen balloonist, a hobby that terrified the local farmers but was to lead him to his future wife, Catherine: His unmanned, varnished-silk balloon landed in the grounds of her father’s estate.

  Edward and Catherine were married in 1788 and had four children. The eldest, Edward, died of tuberculosis, aged twenty-one. Jenner was devastated but, ever the scientist, used the blood from his son’s frequent bleedings to enrich his manure to see if it had any effect on the growth of plants.

  He was forty-seven when he made the discovery that would make him famous. By the late eighteenth century, 60 percent of the population of Europe was infected with smallpox. A third of those who contracted the disease died and survivors were left horribly disfigured. Elsewhere in the world, the toll was even worse: An estimated 95 percent of the indigenous peoples in the Americas perished from the disease after the conquistadores brought it with them in the fifteenth century. When Jenner was a child, the only hope of staving it off was a process called variolation (variola was the scientific name for smallpox, from the Latin varius, “spotty”) where dried smallpox scabs were rubbed into a cut on the hand in the hope that the body would develop resistance to the full-blown disease. It was reasonably effective, but the side effects were unpleasant and the risk of contracting smallpox remained unacceptably high.

  Jenner had suffered the discomfort of variolation as a child—it also involved being starved and purged—and though he introduced it to his village practice as a standard procedure, he began experimenting to see if a safer alternative could be found. Among his patients, he noticed that milkmaids rarely caught smallpox but regularly needed treating for cowpox, a related but much less virulent infection contracted from milking cows. He wondered if country lore that cowpox protected you from smallpox might have some basis in truth.

  On May 14, 1796, he took some discharge from cowpox pustules on the hand of a milkmaid called Sarah Nelmes and inserted it into an incision in the arm of eight-year-old James Phipps, the son of his gardener. Other than a slight fever, Phipps was fine. Six weeks later, Jenner inoculated him with pus from a smallpox sufferer. Again, no reaction. This wasn’t the first time it had been tried—a Dorset farmer called Benjamin Jesty had deliberately infected his wife and children with cowpox during a local smallpox epidemic twenty years earlier—but it was the first time it had been done scientifically. Two years later, having performed the procedure, which he named vaccine inoculation, or vaccination for short (from the Latin vacca, “cow”), on more than twenty patients, Jenner published the paper that would change everything: Inquiry into the Causes and Effects of the Variolae Vaccinae… known by the name of the Cow-pox (1798).

  The conclusion that Jenner reached was that the cowpox vaccine was safer than variolation and provided indefinite protection against smallpox. It could also be inoculated person to person. News of the Inquiry spread all over the world, and within two years it had been translated into Latin, German, French, Italian, Dutch, and Spanish. Jenner’s life changed overnight. “I have decided,” he declared, “no matter what trials and tribulations lie before me, to dedicate the whole of my life to ridding the world of smallpox.” This modest country doctor became “the Vaccine Clerk to the World,” sending samples of his vaccine to everyone who needed it. In his own garden at Berkeley, he built a small hut, which he called the Temple of Vaccinia, where he vaccinated the poor for free. He was feted by London society; was presented to George III and Queen Charlotte; met the tsar of Russia and the king of Prussia; received the freedom of the cities of London, Dublin, Edinburgh, and Glasgow; and was awarded honorary degrees from Oxford and Cambridge.

  Messages of admiration flooded in from all over the world. Thomas Jefferson wrote offering “to render you my portion of the tribute of gratitude due to you from the whole human family. Medicine has never before produced any single improvement of such utility.” Native Americans sent him a wampum belt and taught their children his name, which they commended to the Great Spirit. The British MP William Wilberforce commented that there was “no man who is so much inquired after, by Foreigners when they arrive in this country.” Jenner even corresponded with Napoleon, securing the release of two English prisoners, one of them a relative. Napoleon had already issued instructions for the mass vaccination of the French people. “Ah Jenner,” he exclaimed, “I can refuse him nothing.”

  Not everyone was convinced: The variolators saw the vaccine as a serious threat to business, and other doctors questioned whether Jenner’s sampling and recording methods were rigorous enough. Some patients were wary, too—scared that they might sprout horns or udders if excretions derived from cows were injected into them. But both the army and navy promptly adopted vaccination as standard procedure and many of Britain’s most eminent physicians came out in Jenner’s support. Nevertheless, the medical authorities dragged their feet: It took until 1840 for the government to set up a national program of free vaccination.

  By then, Jenner had been dead for seventeen years. In 1815 his wife, like his eldest son, fell vi
ctim to tuberculosis, and Jenner himself, increasingly infirm and tired of the public attention, returned to his haven at Berkeley. He remained there until his own death eight years later. A year before he died, he was appointed Physician Extraordinary to George IV.

  In his last years, Jenner occasionally treated patients, but spent of most his time out among nature, his original inspiration, finishing his investigations into the migration of birds and importing and propagating exotic fruits. He also made arrangements to help James Phipps, the cowpox guinea pig, who had also fallen ill with tuberculosis. Poor Phipps had been variolated at least twenty times after Jenner’s original experiment by other doctors keen to test the results for themselves. As a mark of gratitude, Jenner designed and built Phipps a small cottage and personally supervised the laying out of the garden and vegetable patch that went with it. Of the other players in the cowpox drama, nothing more was heard of the milkmaid Sarah Nelmes, but the hide of her cow Blossom still hangs in St. George’s Hospital, Tooting. The cow’s horns—rather like bits of the True Cross—have multiplied since her death: At least six “authentic” pairs have been recorded.

  It’s hard to overstate Jenner’s legacy. He founded the discipline we now call immunology. The modern equivalent of his discovery would be if a cure for cancer were announced tomorrow. Smallpox, the speckled devil, “the most dreadful scourge of the human species” for millennia, was declared finally eradicated by the World Health Organization in 1980, just as Jenner had predicted it would be back in 1801.

  The joy I felt as the prospect before me of being the instrument destined to take away from the world one of its greatest calamities was so excessive that I found myself in a kind of reverie.

  What is truly admirable is Jenner’s attitude. He knew he was right; he never gave up; he didn’t try to profit from his discovery. He just took quiet pleasure in being the right man in the right place at the right time.

  There was nothing quiet about Mary Seacole (1805–81), although she, too, was an exceptional healer. The Jamaican-born heroine of the Crimean War, forgotten for almost a hundred years, has recently been rediscovered and restored to her rightful place as one of great characters of the nineteenth century.

  The daughter of a Scottish soldier and a Jamaican nurse, Mary Grant grew up in a boardinghouse for sick and disabled members of the armed forces, run by her mother in Kingston, Jamaica. As a teenager, she made her way to England on her own, paying her way with a suitcase full of exotic West Indian pickles. When she returned home to take over the running of the boardinghouse, she was able to combine her knowledge of traditional Caribbean healing with the latest Western medical ideas she had picked up in London. In 1836 she married Edwin Horatio Hamilton Seacole, an English merchant resident in the house, who was rumored to be the illegitimate son of Horatio Nelson and Lady Hamilton. But her happiness was tragically short-lived. In 1843 a fire wrecked the boardinghouse, and the following year Mary’s husband and mother both died. Grief-stricken and penniless, Mary left Jamaica for a second time to join her brother in Panama, where they jointly ran a hotel. It was there that she first got to practice her medical skills in earnest, nursing the victims of outbreaks of cholera and yellow fever—with remarkable results. Her method was based on careful observation of the symptoms of each individual patient: “Few constitutions permitted the use of exactly similar remedies, and… the course of treatment which saved one man, would, if persisted in, have very likely killed his brother.” Although some of her medications, like sugar of lead, probably did more harm than good, her attentiveness and general empathy with the suffering of those in her care offered a holistic approach to healing that was ahead of its time.

  Encouraged by her success, she applied to the British War Office to serve as a nurse in the Crimea. Never one to under-dramatize her life, Mary wrote that she wanted to experience “the pomp, pride and circumstance of glorious war.” Needless to say, a loud and rumbustious fifty-year-old woman of mixed race and brightly colored attire was not what either Florence Nightingale or the War Office was looking for. Though laden with letters of recommendation, each of her several applications was rejected.

  But Mary was undeterred. She had grown up surrounded by British soldiers and was convinced that her “sons,” as she called them, would need her special form of bedside care. So she borrowed some money, bought a one-way ticket, and printed some business cards:

  Happy-go-lucky

  BRITISH HOTEL

  MRS. MARY SEACOLE

  (Late of Kingston, Jamaica),

  Respectfully announces to her former kind friends, and to the Officers of the Army and Navy generally,

  That she has taken her passage in the screw-steamer Hollander, to start from London on the 25th of January, intending on her arrival at Balaclava to establish a mess table and comfortable quarters for sick and convalescent officers.

  It was an astounding declaration, but she was as good as her word. In Balaclava, she bumped into an old business colleague of her husband’s, Thomas Day, and they set up a partnership. Using local laborers and any materials they could salvage—packing cases, driftwood, scrap metal—they built a small hotel. It opened in March 1855, on the main supply route to Sevastopol, two miles from the front line.

  The British Hotel became a Crimean institution. The restaurant alone was legendary—Mary’s rice puddings and sponge cakes reminded the troops of home—but the hotel also served as a bar, a hospital, and a general store that stocked anything from “a needle to an anchor.” From there each day Mary would ride to the trenches surrounding Sevastopol, sometimes under fire, with two mules—one carrying medicine, the other food and wine—to nurse and feed the wounded. Known to all as “Mother Seacole,” she was a warm, reassuring presence amid the slaughter, dressed in startling combinations of yellow, blue, and red. She was on hand to care for the British after the ill-fated assault on the Redan outside Sevastopol in June 1855, in which a quarter of the men were killed or wounded. Two months later, after the battle at the Tchernaya River, she tended wounded Russians as well as French and Italians but was ready the next day to throw “a capital lunch on the ground” at a British regimental cricket match. In September, when Sevastopol finally fell to the allies, after a horrific yearlong siege in which a hundred thousand Russians died, Mary Seacole was the first woman to enter the burning city.

  In 1856, the war over, Mary set off for England, penniless for the third time, ill, alone, and pursued by creditors. This would have been an unthinkable disaster for most women of her age, but she was unbowed: “I do not think I have ever known what it is to despair, or even to despond,” she wrote later. She took to wearing medals to remind people of her outstanding service to the military cause (although there is no record she was ever awarded any) and within a few months had mobilized her friends in the upper echelons of the army and the popular press to set up the Seacole Fund to save her from bankruptcy. It did that and more. In July 1857 the fund staged a four-day festival featuring more than a thousand performers, including eleven military bands. It was a kind of SeacoleAid, attended by a crowd of forty thousand people.

  A month earlier, Mary had published her autobiography, the Wonderful Adventures of Mrs. Seacole in Many Lands. It was bound in bright yellow boards, with scarlet lettering and a portrait of Mary on the front in military garb, wearing a Creole kerchief and an extravagantly feathered hat. If that didn’t pull in the Victorian reader, the opening paragraph was a real lapel grasper:

  All my life long I have followed the impulse which led me to be up and doing, and so far from resting idle anywhere, I have never wanted inclination to rove, nor will powerful enough to find a way to carry out my wishes.

  With its vivid and moving account of the war, it became an immediate bestseller and cemented Mary’s celebrity status.

  The last twenty-five years of Mary’s life were (by her somewhat frenzied standards) restrained and comfortable, and she died at her house in Paddington in 1881, aged seventy-six. Both the Times and the Ma
nchester Guardian ran glowing obituaries. Her subsequent disappearance from the public record is usually blamed on the preeminence of Florence Nightingale, who, as we all know, invented modern nursing at her Crimean hospital in Scutari. This is unfair to both women. Mary Seacole was a doer, a force of nature. She restored people’s souls as well as their bodies. It’s appropriate that she has become a role model for the medical profession only now, after a century of more mechanistic medicine. But she invented no system, left no legacy. And she ran hotels, not hospitals—as Florence Nightingale was keen to point out. In 1870 the Lady with the Lamp wrote a rather vinegary letter to her brother-in-law complaining about Mary’s “bad character” and summing up her contribution to the war effort. “She was very kind to the men &, what is more, to the Officers—& did some good—& made many drunk.”

  Florence Nightingale’s disdain raises another issue: Mary’s color. Was she the victim of prejudice? She certainly thought so. Reflecting on her rejection by the War Office, she wrote: “Did they shrink from accepting my aid because it flowed from a somewhat duskier skin than theirs?” In the 1970s, this became a rallying cry for disgruntled black nurses in the British National Health Service, marking the beginning of a process of rehabilitation for Mary Seacole that ended in her being voted the greatest Black Briton of all time and becoming a settled fixture in the national curriculum.

  Ironically, Mary didn’t consider herself “black” at all. She came from Jamaica, where the subtleties of skin coloring mattered intensely. She called herself a Creole “with good Scotch blood coursing in my veins.” Her father was white and her mother probably mixed race. In Jamaica this meant she was a Free Colored, less constrained and more socially acceptable than the black former slaves, but still definitely not white. As she wrote in her memoir: “I am only a little brown—a few shades duskier than the brunettes whom you all admire so much.” And she was fiercely proud of being British. One of the things that make her autobiography so compelling is the firsthand account of nineteenth-century racism and her sense of disappointment that skin color should matter at all. There is one powerful exchange from her time in Panama where a “sallow-looking” American toasts her for all she has done to stem disease in the colony, adding: “If we could bleach her by any means we would—and thus make her as acceptable in any company as she deserves to be.” Mary’s response is magnificent: