Sunday, 14 May 2017

TODAY IN HISTORY - MAY 14, 2017: ENGLISH PHYSICIAN DISCOVERS SMALLPOX VACCINATION, NEARLY 3 DECADES AFTER EPIDEMIC ALMOST KILLS MOZART feat. Did You Know?

Doctor Edward Jenner
221 years ago today an English country physician by the name of Edward Jenner would unexpectedly discover a crucial breakthrough in the annals of medical science and instill into the history books a newfound terminology: “vaccination" – or, "vaccine.”

The year was 1796, and Europe was in the throes of a full-blown epidemic. The culprit was the highly infectious – and often deadly – respiratory disease variola virus, otherwise known as “smallpox.”

The prognosis for those unfortunate souls inflicted by the 18th century viral scourge was as horrendous as it was catastrophic: some 400,000 Europeans perished annually from the disease; with infant fatalities skyrocketing to 80-98 percent in London and in Berlin by the close of the millennium.

The classical music sphere nearly lost one of it’s most prized representatives of the genre in the autumn of 1767, when an 11-year old Wolfgang Amadeus Mozart, having recently traveled to Vienna – on tour with his sister, “Nannerl,” his father, Leopold, and mother Anna Maria – became infected with the smallpox virus after fleeing the pox-ravaged city a touch too late upon arrival. Nannerl, Mozart’s co-prodigy on this family tour, would also become stricken by the pox.

Both would survive – in Mozart’s case, just barely. Statistically, one-third of those infected with the smallpox virus in 18th century Europe would survive with some – or many forms - of handicap. The most notable side effect of overcoming the disease was a total and/or permanent loss of vision. Again, in the case of Mozart, lady chance would prevail: the young musician had only suffered ‘blindness’ for the duration of nine days, according to the writings of sister Nannerl:
 
“He caught the smallpox, which made him so ill that he could see nothing for nine days and had to spare his eyes for several weeks after his recovery.”

For some two weeks (three for Nannerl), a feverish Mozart would toe the line between life and the very real possibility of death as he battled the virus now coursing through his veins. For Leopold, who had gripes about the status of his employment and financial status back in Salzburg (where the family would hastily return upon receiving word in Vienna of the outbreak), Mozart’s illness could not have come at a worse time – the senior Mozart had high hopes of repeating the scale of adulation recently lauded upon his children at the royal courts of England, France and Holland at the Imperial Capital. He had planned to wow the Viennese with his wunderkind son during the celebrations for the marriage of the Archduchess Maria Josepha – daughter to Empress Maria Theresa. Mozart had already entertained the Empress and her daughter Maria Antonia (later Marie Antoinette, Queen of France) some five years earlier when he famously performed for the royal court as a keyboardist. Now was the time to curry favor as a composer. Unfortunately, the Mozart clan had been forced to flee Vienna weeks before the royal marriage took place and would not return to the city and the Imperial court until some four months later, in January of 1768.

Mozart in 1767.
The Empress herself was not safe from the pox: proving that virulent strains of infectious disease knows no class distinctions, the otherwise robust ruler would lose three of her own children to the disease by the time the Mozarts returned to Vienna.

It would cause Maria Theresa to do something Leopold Mozart would not: convert to the concept and practice of inoculation.
 

In the days preceding Dr. Jenner’s discovery of the smallpox vaccine, the only safeguard against the disease lay in the primitive practice of variolation (inoculation). The procedure was far from a cure-all – quite by contrast, it functioned only as a preventative measure against the virus, and was therefore administered only to the non-infected. It was also a risky undertaking for both doctor and patient: the rather crude method of insertion involved instilling into the veins infected pus from the lesion of a poxxed individual under the skin by means of a lancet. In an age of dicey hygienic awareness, the accidental transmission of other bloodborne, potentially fatal diseases – such as syphilis – was an inevitable possibility.

Whilst “anti-vaxxers” may look to Leopold, who refused to inoculate a healthy Mozart (and Nannerl) before either child contracted the virus, as somewhat of a heroic figure, given that both children survived (with minimal long-term side effects, save for pockmarks on the face of his son), care must be taken to consider the facts:

a) no other effective preventative, nor treatment, was made available the time; and 

b) the risks associated with instilling into a healthy subject diseased matter from an infected individual carried with it the possibility of disease and, especially where children were concerned, death. The fact that the Mozart children survived at all is purely the result of serendipity. Had there been an effective treatment for an already affected individual, it is highly probable that Leopold would have changed his tune - given the tenure of the following extract - taken from the personal correspondence of the senior Mozart to his landlord and friend Lorenz Hagenauer in February of 1764:
“They are trying to persuade me to let my boy be inoculated with smallpox. But as I have expressed sufficiently clearly my aversion to this impertinence they are leaving me in peace. Here inoculation is the general fashion. But for my part I leave the matter to the grace of God. It depends on His grace whether He wishes to keep this prodigy of nature in this world in which He placed it or to take it to Himself”
In the video below, British historian Dan Snow depicts a reenactment of the primitive inoculation procedure (at 50 minutes, 15 secs in) whist researching life in revolutionary Paris, itself ravaged by smallpox. It is easy to see why such a brute method would instill fear into the father Mozart:


It would be some three decades following the contraction of smallpox by the Mozart children that Dr. Jenner would put to the test an age-old hypothesis: that of inoculating a healthy patient with cowpox (note: not "small" pox), scraped from the infected pustule of a bovine udder in order to induce in the patient a potential immunity from the disease (as is the case with survivors of smallpox).

Dr. Jenner inoculating James Phipps
The doctor had developed an interest in cowpox prevention during his student years, after having heard tales of dairymaids who developed an immunity to the disease after having handled the teats of infected cows and subsequently becoming infected themselves. He surmised that if cowpox pus could prevent cowpox itself in healthy individual, then it stood to reason that the same procedure could also prevent smallpox. 

To put his theory to the test, Dr. Jenner would procure pus from the infected lesions of a dairymaid, called
Sarah Nelms, and instill it under the skin of an 8-year-old boy by the name of James Phipps. Phipps would fall ill for some ten days following the procedure, after which point he recovered. Jenner would then infect the boy with pus from a smallpox (note: not "cow" pox) lesion, fully expecting that the child’s newfound immunity to cowpox would double over and prevent him from falling ill to the smallpox matter now coursing through his body.

As it turned out, little James Phipps never did develop the disease, and thus, the vaccination was born.

Did You Know?
  • Dr. Jenner coined his procedure “vaccination” after the Latin word for the source of his thesis: the cow (vacca), and after the Latin term for cowpox (vaccinia).
  • Mozart, in spite of having previously been confined to a sickbed for some four months in Salzburg after becoming stricken with smallpox and resulting temporary loss of vision, never skipped a beat upon his recovery: by January 16, 1768, 12-year old Mozart would complete his Symphony no. 7 in D major (KV45) - just three days after his arrival back in Vienna! Listen to a recording of the work below:



-Rose.

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