‘Dr Jenner is sorry it is not in his power to send today any vaccine’ — Edward Jenner, 1801

‘Dr Jenner is sorry it is not in his power to send today any vaccine’ — Edward Jenner, 1801

Three remarkably pertinent medical documents offered online from 14 to 28 April ‘remind us that the global battle against Covid-19 is being fought on the shoulders of giants’ 

Edward Jenner invents the vaccine

In 1801, the English physician Edward Jenner penned an apology for the delay in shipping life-saving supplies of his new smallpox vaccine to a ‘Mr. Long’ (mostly likely William Long, a doctor at St Bartholomew’s Hospital in London).

‘Dr Jenner presents his compliments to Mr. Long and is sorry it is not in his power to send him today any vaccine virus he can depend upon,’ he wrote, ‘but Mr. Long may be assured of its being sent as soon as possible.’

Jenner had established the effectiveness of the vaccine five years earlier, after noticing that milkmaids who had contracted cowpox, a virus that caused blistering on cows’ udders, were immune to the far deadlier smallpox.

On 14 May 1796, the doctor tested his hypothesis on his gardener’s son by scratching fluid from a cowpox blister on a milkmaid’s hand into the young boy’s arm. Over the next few days the boy developed a slight fever, but easily recovered. Then on 1 July, Jenner injected him with the smallpox virus, and waited with trepidation.

Happily, no disease developed.

An engraved portrait of Jenner, on a sheet measuring 217 x 185 mm, with biographical information added in a 19th-century hand, included with the present lot

An engraved portrait of Jenner, on a sheet measuring 217 x 185 mm, with biographical information added in a 19th-century hand, included with the present lot

Edward Jenner (1749-1823), Autograph letter to a ‘Mr. Long’, ‘Bond Street’, 26 June [1801]. One page, 185 x 119 mm. Estimate £4,000-6,000. Offered in Books, Manuscripts, Photographs From the Middle Ages to the Moon, 14-28 April 2021, Online

Edward Jenner (1749-1823), Autograph letter to a ‘Mr. Long’, ‘Bond Street’, 26 June [1801]. One page, 185 x 119 mm. Estimate: £4,000-6,000. Offered in Books, Manuscripts, Photographs: From the Middle Ages to the Moon, 14-28 April 2021, Online

Jenner’s breakthrough was published two years later in a paper outlining the successful results of another 22 trials, including one on his own 11-month-old son. In the text he referred to cowpox as variolae vaccinae, an amalgamation of the Latin for smallpox (variola major) and cow (vacca) that gave rise to the modern word ‘vaccine’.

Within a decade Jenner’s vaccine had been rolled out across Europe, the Americas and Asia. Napoleon, who was at war with Britain, vaccinated his entire army, offering the release of two English prisoners of war as a sign of his gratitude. He referred to Jenner as ‘one of the greatest benefactors of mankind’.

Ignaz Semmelweis realises the importance of handwashing

Half a century later, a young Hungarian doctor made another quantum leap in our understanding of infections.

As a young house officer of the First Obstetrical Clinic of the Vienna General Hospital’s teaching unit, Ignaz Semmelweis noted a remarkable discrepancy: while one of the hospital’s maternity units had a maternal and neonatal mortality rate of 13 per cent, the rate in the other unit was just 2 per cent. Yet the only discernible difference between the two was that the former was used to teach medical students, while the latter taught midwives.

Ignaz Philipp Semmelweis. Photo GL Archive  Alamy Stock Photo
Ignaz Philipp Semmelweis. Photo: GL Archive / Alamy Stock Photo

Semmelweis reasoned that students who came directly from the autopsy dissecting rooms to the maternity ward could be transmitting deadly infections from cadavers to healthy mothers. Using chlorinated limewater, he decided to implement strict handwashing controls on the ward.

The mortality rate duly plummeted and, in 1849, Semmelweis delivered his results in a famous lecture at the Medical Society of Vienna titled ‘The Origin of Puerperal Fever’.

Ignaz Philipp Semmelweis (1818-1865) [Ferdinand von Hebra (1816-1880)], Obervations of the highest importance on the etiology of the puerperal fever epidemic in maternity institutions. Estimate £12,000-18,000. Offered in Books, Manuscripts, Photographs From the Middle Ages to the Moon, 14-28 April 2021, Online

Ignaz Philipp Semmelweis (1818-1865) [Ferdinand von Hebra (1816-1880)], Obervations of the highest importance on the etiology of the puerperal fever epidemic in maternity institutions. Estimate: £12,000-18,000. Offered in Books, Manuscripts, Photographs: From the Middle Ages to the Moon, 14-28 April 2021, Online

The following year Semmelweis’s colleague Ferdinand von Hebra published the findings in the journal of the Society of Viennese Doctors, urging members of the medical community to institute their own handwashing procedures and see the results for themselves.

Thanks to Semmelweis’s work it is now known that handwashing is the most effective and inexpensive way to prevent some of the world’s most common infections. In fact, good hand hygiene saves more lives than any other medical intervention, including vaccines.

Alexander Fleming discovers penicillin

In 1928 the Scottish physician Alexander Fleming returned to his laboratory at St Mary’s Hospital in London after a two-week holiday, and discovered that a green fungus had developed on a petri dish containing staphylococcus bacteria. What astonished him, however, was the fact that the bacteria surrounding the fungus had been destroyed.

Alexander Fleming in his laboratory, 1943. Photo Popperfoto via Getty Images
Alexander Fleming in his laboratory, 1943. Photo: Popperfoto via Getty Images

Fleming isolated the mould — what we now know as penicillin — and experimented with its impact on other bacteria. He soon learnt it was also effective in destroying scarlet fever, pneumonia, meningitis and diphtheria infections. In 1929 he published his findings in a paper titled On the Antibacterial Action of Cultures of a Penicillium, with Special Reference to Their Use in the Isolation of B. Influenzae.

‘One sometimes finds what one is not looking for,’ he would famously recall. ‘When I woke up on the dawn of September 28, 1928, I certainly didn’t plan to revolutionise all medicine by discovering the world’s first antibiotic, or a bacteria killer. But I guess that was exactly what I did.’

Alexander Fleming (1881-1955), On the Antibacterial Action of Cultures of a Penicillium, with Special Reference to Their Use in the Isolation of B. Influenzae. Reprinted from The British Journal of Experimental Pathology, vol. 10, 1929, pp. 226-38 (here paginated 1-12). [London, 1944]. Octavo, 247 x 185 mm. Estimate £2,500-3,500. Offered in Books, Manuscripts, Photographs From the Middle

Alexander Fleming (1881-1955), On the Antibacterial Action of Cultures of a Penicillium, with Special Reference to Their Use in the Isolation of B. Influenzae. Reprinted from The British Journal of Experimental Pathology, vol. 10, 1929, pp. 226-38 (here paginated 1-12). [London, 1944]. Octavo, 247 x 185 mm. Estimate: £2,500-3,500. Offered in Books, Manuscripts, Photographs: From the Middle Ages to the Moon, 14-28 April 2021, Online

Unfortunately the scientific community was slow to respond, and by 1931 a despondent Fleming had turned his attention elsewhere.

In 1938, however, two researchers at the University of Oxford, Howard Florey and Ernst Chain, unearthed Fleming’s research while thumbing through old papers. Realising its importance, the pair managed, in the space of three years, to turn his findings into an injectable medicine.

The discovery couldn’t have come at a better time. As the world descended into conflict, the antibiotic was used to treat millions of soldiers with injuries that were vulnerable to infection. By 1945, American pharmaceutical companies were producing 650 billion doses of penicillin a month.

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In 1945, Fleming, Florey and Chain were awarded the Nobel Prize, and today, penicillin is the most widely used antibiotic in the world.

‘These documents represent the birth, in Western medicine, of three life-saving discoveries,’ says Mark Wiltshire, specialist in Christie’s Books & Manuscripts department. ‘At a moment when our debt of gratitude to scientists and medical professionals has never been greater, they remind us that the global battle against Covid-19 is being fought on the shoulders of giants.’