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  • 0 300th anniversary of inoculation in Britain

    • History
    • by Gavin Weightman
    • 10-02-2021
    0.00 of 0 votes

        “The Noble Lady sent for me last April, and when I came, she told me she was now resolved to have her daughter inoculated…..having found proper matter I ingrafted it in both arms…Three learned Physicians of the College were admitted, one after another, to visit the young Lady… they saw Miss Wortley playing about the Room, cheerful and well, with the Small Pox rais'd upon her; and that in a few Days after she perfectly recover'd of them.”   This is an account by a Scottish surgeon, Charles Maitland, of the first immunisation ever performed by a doctor in England in the Spring of 1721. In the midst of a smallpox epidemic Lady Mary Wortley Montagu boldly decided to get her three year old daughter “engrafted”. She knew there would be disapproval, as did her surgeon Maitland, but she believed fervently inoculation was the only way to save her child from disfigurement or death from smallpox.   Lady Mary had lived in Constantinople where her husband had been posted as Ambassador. It was here that she was astonished to learn that engrafting of children with poisonous smallpox matter was routine. She had travelled to Turkey in 1716 with her young son and stayed until 1718 during which time her daughter was born. Maitland was with her and she managed to persuade him to investigate the local practice of engrafting with a view to protecting her son.   It was a strange experience for a Scottish medic for he had to seek out one of the elderly Greek ladies who specialised in this treatment, keeping their supplies of infective smallpox matter collected from the pustules of sufferers in walnut shells. When the time came for the engrafting of Lady Mary’s son, Maitland recalled that the Greek inoculator was equipped only with a “ blunt and rusty” needle. He finished the job with his surgeon’s lancet.   Maitland was naturally anxious about the rustic nature of the procedure, but in Constantinople he was far away from the prying eyes of the British medical profession. It was a much more worrying prospect for him to carry out the same engrafting in London. If Lady Mary had had her way she would have kept her daughter’s inoculation secret. But Maitland persuaded her that there should be observers to endorse this new prophylactic.   The crudity of the smallpox inoculation three centuries ago is barely imaginable now. It was unadulterated virus itself which was injected into the arm, and sometimes arms and legs, of the patient. It is not surprising therefore that Lady Mary was vilified rather than congratulated on her brave experiment. However Royalty endorsed it when the King’s daughter Princess Caroline, fearing for the safety of her daughters,, sponsored a trial to test the safety of engrafting the smallpox. London’s notorious Newgate Gaol, where prisoners were manacled awaiting the gallows or transportation, was chosen as a convenient laboratory.   Six Newgate inmates, three men and three women, were chosen as volunteers. If they agreed to be engrafted they would be pardoned and allowed to go free. None was a murderer: they were just petty thieves at a time when stealing anything worth more than £5 worth of goods carried the death penalty. Their chief qualification as volunteers was that they should not have had smallpox.   Charles Maitland carried out the engrafting watched by a gathering of largely hostile physicians and surgeons who doubted the value of such a crude operation. To Maitland’s great satisfaction all the volunteers survived: five had quite severe reactions, one had none as he had lied about not having had smallpox. One of the volunteers was used to prove that the inoculation worked: she was made to lie in a bed with a boy suffering from smallpox. Released from her role as guinea pig she went back to stealing and was transported to the West Indies.   There was one further trial in which orphans in Westminster were the guinea pigs was a success and the inoculation of the Princess Caroline’s daughters went ahead without mishap.   However, take up of inoculation with smallpox was low. Many of the leading doctors opposed it. In a letter to a friend, William Wagstaffe, a physician at Barts Hospital in London wrote in 1722:   “The country from whence we derived this Experiment, will have but very little influence on our faith, if we consider either the Nature of the Climate or the Capacity of the inhabitants, and Posterity perhaps will scarcely be brought to believe that an experiment practiced (sic) only by a few ignorant women (his italics) amongst an illiterate and unthinking people should, of a sudden, and upon slender experience, so far obtain in of the Politest Nations in the World, as to be received in the Royal Palace”.   Those in the medical profession who practised it by engrafting ridiculously elaborate and more dangerous than it needed to be. After bleeding the patients and starving them the smallpox infection was introduced with a gash rather than a pinprick. For children it could be traumatic. Edward Jenner was inoculated in this old fashioned way when he was about eight years old in 1756-57. As he recalled years later he was bled and fed all kinds of horrible potions so that for the rest of his life he slept fitfully. It has been suggested that this experience influenced his search for a safer form of inoculation later in life, though Jenner never claimed that himself.   It was about the time Jenner was inoculated that a revolution in the way in which the operation was offered and administered was begun in the rural practice of a surgeon in Suffolk. Robert Sutton had been shocked by the severe a reaction his grown up son, aged 24 and fit, had to inoculation. Already in his fifties and new to inoculation, Sutton set out to return the procedure to something closer to the Turkish original, with a minimal incision and less elaborate preparation.   Very soon inoculating became a lucrative business. The surgeon would rent a house especially for inoculating the smallpox and advertise for patients who would pay an all found fee with meat and veg thrown in for the two or three weeks they would be treated. It was important to isolate them as it was known that after inoculation a patient was infectious for two or three weeks. Where a group of patients were inoculated together it did not matter as they were all protected.   Sutton set up a kind of franchise where other surgeons would pay to use his name to indicate they were approved for best practice. He did well but he was soon out gunned by his second son, Daniel, who thought his father’s methods could be improved upon. Daniel cut down the time for inoculation and introduced a crucial innovation: while recovering from the side effects of the procedure his patients were encouraged to stay in the open air as much as possible which helped to reduce their fever.   Daniel Sutton opened his own practice in the Essex village of Ingatestone in 1763 and within a few years had made a fortune. His reputation was founded on his ability to give his patients the mildest attack of smallpox which nevertheless gave immunity. He claimed never to have lost a patient, a claim that was often disputed but never shown to be false. Like his father he franchised his methods all over the country and soon his fame spread abroad. Requests were made for him to save the lives of nobility in Russia and Prussia. But for reasons which have never been explained, Sutton did not travel. Instead his technique was pirated, and others made their fortunes from what became known as the “Suttonian” or the “New method” of inoculation.   English inoculators were regarded as the best in the world having far greater experience than their rivals abroad. Two profited handsomely from Sutton’s reputation and the export of his methods. In 1767 Thomas Dimsdale published a hugely influential pamphlet The current method of inoculating the smallpox which contained only an oblique reference to Sutton though it was put together from a quizzing of his patients.   Dimsdale answered the call to inoculate Catherine the Great of Russia and her son for which he was rewarded with a fabulous income for life and given the title Baron. A Dutch inoculator Jan Ingen-Houz learned the technique in London and was similarly feted in Prussia.   Towards the end of the century there was no reason to believe that anything might surpass the widely respected and successful Suttonian method of inoculation. There were many mass immunisations in which whole villages and towns were inoculated at once, the fees of the surgeons paid by the parish or wealthy patrons. There was even a proposal by the eminent doctor John Haygarth to create a national inoculating service which would eliminate the disease for ever. In 1796 Daniel Sutton published his only work, The Inoculator; or Suttonian system of inoculation, fully set forth in a plain and familiar manner.   Two years later Edward Jenner, by then established as a country surgeon, published the results of his investigation into the relationship between smallpox and a disease of cattle in his native county of Gloucestershire. Jenner practised Suttonian inoculation extensively. This involved on a number occasions involvement in general inoculations of whole communities. These always threw up a puzzle: some individuals appeared to be immune though they had not had smallpox.   Every inoculator, including Sutton, noticed this. Sutton thought they must have been infected as infants or they had simply forgotten. Jenner, who spent most of his life in his native Gloucestershire, thought he would have known if any of his patients had had smallpox. He recalled in his account of the origin of his investigations that those who had had smallpox were immune to a disease which occasionally infected cattle, known colloquially as “cowpox”. Any farmworkers, male or female, who milked cattle could catch cowpox which was not dangerous but unpleasant enough for them to be off work for a few days. When this happened those who had had smallpox were drafted in.   Jenner was a great observer of nature and believed in a fundamental connection between humans and animals. Over time he considered the idea that cowpox might protect against smallpox. If it did then it could be substituted for smallpox itself. This, in theory, would be a safer form of inoculation. He began to collect case studies in which he would ask those who were immune if they had ever had cowpox. Most of them had, though it had never occurred to them that it might have made them immune.   There is a fairy tale that Jenner got his inspiration from the observation that dairy maids never had their looks spoiled by smallpox. He makes no mention of this, and it would not make sense as cowpox appeared only intermittently. And as many men as women were immune to smallpox.   In the end Jenner took the bold decision to test his theory. He waited for a case in which a woman had caught cowpox while milking. She developed pustules on her hands reminiscent of those caused by smallpox. He chose as his guinea pig a boy called James Phipps whose family he knew. Phipps had not had smallpox. Jenner took some cowpox matter from the infected hand of the woman and, using the Sutton method, used his lancet to introduce the infection. It took and the boy experienced the symptoms of cowpox. A few weeks later he had the boy inoculated with smallpox. It did not take. Eureka!   When he came to write up his findings Jenner thought to give the rustic name cowpox a bit of Latin dignity. He invented the term variole vaccinae to mean literally “smallpox of the cow”. The Royal Society would not accept his paper on what soon became known as vaccination for lack of convincing evidence. So he published it privately.   Very soon vaccination was greeted as a new wonder drug, a safer form of inoculation. And it turned out it was, in two respects. Firstly as a milder disease there would be fewer fatalities than with inoculation. Secondly, those vaccinated were not infectious. It was a miracle that it worked for there was absolutely no understanding at the time of the nature of viruses or of the human immune system.   Jenner’s discovery did not come out of the blue. By the time he began to promote vaccination, the use of cowpox instead of smallpox, the public was used to the idea of injection with the surgeon’s lancet. He had learned Sutton’s technique of miniscule incisions. All he had to do was swap one infection for another.   There were no inoculations for any of the other infectious diseases that plagued the eighteenth and most of the nineteenth century. Vaccination meant the use of cowpox to protect against smallpox. However in 1881 the French chemist Louis Pasteur who had discovered by chance a way of inoculating poultry against Chicken cholera proposed that all inoculations from then on should be called vaccinations in honour of Jenner.   The heroic early years of inoculation, which were crucial for Jenner’s discovery of vaccination, were erased from medical history. In 2021, while waiting for our Covid Jab we might set the record straight with a cheer for Lady Mary and Daniel Sutton whose rustic talent turned her inspiration into a vital contribution to national health.   Word count 2260                      

  • 0 perpendicular drinking

    • Thoughts
    • by Gavin Weightman
    • 17-09-2020
    0.00 of 0 votes

    What a joy it is to go to a pub now that they are open and new safety precautions are in force to protect us against the scourge of Covid-19. No standing at the bar, just waiter service at a table which will have been scrupulously cleaned and sanitised: no old peanut bags or pungent beer stains. Of course the old atmosphere is not there, the desperate scrum at the bar waving ten pound notes and debit cards in an effort to attract the attention of staff who seems to be favour everyone but yourself. It was the Victorians who were to blame for this unseemly form of downing pints while standing at the bar which in its pioneer days was called “perpendicular drinking”. It the 1830s it was a novelty of the new palace like beer houses put up by the big breweries. They were out to capture a new urban passing trade of workmen who had little time to relax on their way home. It was not a place for women: no respectable lady would join the scrum at the bar and the ritual of “buying rounds”. The only women were the barmaids, chosen for their looks and easy banter, and the prostitutes looking for trade. Toilets for women were not introduced until the 1930s.   It was very different in the old inns where there was no bar and the legendary serving staff were the “buxom wenches” of Tom Jones tradition. No social distancing then, of course, but I think the atmosphere now in pubs with the ban on perpendicular drinking perhaps recalls the old pre-Victorian days when a beer house was no more than someone’s front room. Old folk like myself prefer it like that and can find in the dark clouds of Covid oppression at least one silver lining: the toppling of the perpendicular drinker.

  • 0 Death of Iona Opie

    • Thoughts
    • by Gavin Weightman
    • 29-10-2017
    0.00 of 0 votes

    The death of Iona Opie who, with her late husband Peter, brought to light the rich and often amusing culture of children's playground games and rhymes, sparked a memory of filming in a primary school for an episode in the ITV series Seven Ages shown back I the late 1970s. I had been fascinated by the Opie's work for a long time with their maps of the different “truce” terms children use to get out of playground games and meticulous recording of regional variations in nonsense songs. My film was set in Colchester in Essex where I hoped to find a decent cross section of the population of all ages from infants to the elderly. I cannot remember now how we alighted on the primary school we chose to film five to eleven year olds but we got a friendly reception despite the belief amongst the staff that the kind of juvenile folk culture the Opie's once recorded no longer existed. The teachers were startled when I and the director took a couple of classes and asked the children what games they played during break time. To give them the idea that we did not mean football I would ask what they said and did when they wanted to get out of a chasing game. Hands shot up and they all called out “ Veinites” ( there is no correct spelling) and crossed their fingers. It was the same truce term that we had a primary school in north London in the 1950s. We learned most in the playground with the camera crew mingling with the children and capturing the skipping rhymes and chasing games. There was “ Here comes Sally Walking down the alley” sung with the girls in two rows facing each other with one always peeling away to walk between them to the chorus of “ All night Long”. The Opie's had recorded more or less the same playground game in the United States. In fact many of the games and rhymes were international. How this could come about was a mystery because the culture was kept alive by a very narrow age group of children between seven and eleven. The songs and games disappeared rapidly in secondary schools. Many of the ditties were very naughty indeed and we chose not to broadcast them. However the clapping song “ When Susie was a baby…..” which goes through the life cycle from infant to grandma was so catchy we put it in the title sequence for the series. Here is a version from the very amusing Online Dictionary of Playground Slang: When Susie was a baby,A baby Susie wasShe went a cry, cry, cry, cry (rubs eyes) When Susie was a toddler,A toddler Susie wasShe went a scribble, scribble, scribble, scribble (scribbling action) When Susie was a child,A child Susie wasShe went a 'whyyyyyy? whyyyyyy? whyyyyy? whyyyy?' (pouting) When Susie was a teenager,A teenager Susie wasShe went a 'ooh, ahh, I lost my bra,I left my knickers in me boyfriend's car' When Susie was a married,A married Susie wasShe went a 'aahh, unnnnggggghh, aaaahhhhh, unnnnnngggggh' When Susie was a mother,A mother Susie wasShe went a bake, bake, bake, bake (rolling pin action) When Susie was a grandma,A grandma Susie wasShe went a knit, knit, knit, knit When Susie was a skeleton,A skeleton Susie was she went a (silence) We did not use the whole of the rhyme in the title sequence. The composer Jim Parker picked up on the girls' singing to create a catchy theme for a collage of images and we faded out of the Susie song with the teenage verse. This did not go down well with some of the popular newspapers. The Daily Express I remember wondered what kind of mentality would teach such a song to young girls clearly finding it incomprehensible that they had taught us the words. Though I have not explored playground lore in recent years I imagine it is still there, still as creative and comically wicked as ever. With the death of Iona Opie I feel sure there will be others to record the oral tradition of the playground which reveals a wealth of creativity that is largely hidden from the teachers of the national curriculum. There is a wealth of material here https://sounds.bl.uk/Oral-history/Opie-collection-of-children-s-games-and-songs-

  • 0 Russian Outrage

    • Issues
    • by Gavin Weightman
    • 21-09-2016
    0.00 of 0 votes

    News that a Russian aircraft carrier and accompanying warships are in the English Channel on their way to the eastern Mediterranean should put fear into the hearts of North Sea fishermen. Here, from my book The Industrial Revolutionaries is an account of what happened in 1904 when a Russian fleet, en route to Vladivostok to confront the Japanese Navy, mistook Hull fishing boats for the enemy. The illustration above is from a postcard captioned the "Russian Outrage!". On the afternoon of Sunday 23 October 1904 two fishing trawlers limped back to Hull on the north east coast of England, their flags flying at half mast. Those who came to greet them were at first puzzled, then horrified. The boats, the Mino and the Moulmein, were riddled with shell-holes. On board they carried the bodies of Henry Smith who had been skipper of another of the Hull Gamecock fleet, the S.T Crane, and his boatswain William Arthur Leggett. There were six wounded. It was a wonder that there were no more casualties, although in time the explanation for that became clear: the Hull trawlermen had been attacked at night by a huge armada of Russian ships whose nervous crews had rained shells on the fishing grounds of the Dogger Bank in the North Sea in a blind panic. Astonishingly, they thought they were being attacked by Japanese torpedo boats. As the Russian fleet of forty eight destroyers, cruisers, supply ships, torpedo boats and a motely collection of superannuated craft steamed on to the English Channel, not stopping to inspect in daylight the damage they had caused or to offer assistance to the stricken trawlermen, British Naval Officers arrived in Hull by train. What they heard was soon to be published in the Times and other newspapers under the headline of the "Dogger Bank Outrage. " Alongside the fleet of trawlers was a "Mission Ship" the Joseph and Sarah Miles which picked up one of the survivors of the Crane who gave the first and most vivid account of that terrible night. "We had just hauled and shot away again," he said, "and were in the fish-pound cleaning the fish and passing jokes about the war vessels, which we could see quite plain, and heard their firing, when suddenly something hit us. The third hand said,'Skipper, our fish-boxes are on fire; I'm going below out of this,' and walked forward, the skipper, who was on the bridge, laughing at him for being frightened. We were hit again forward, and someone called out and said, 'The bosun is shot.' I went forward to look, and found the boatswain bleeding and a hole through our bulwarks, and the fore companionway knocked away. I went to tell the skipper. Before I got aft a shot went through the engine-casing, and I began to feel frightened. I could see that the skipper was not on the bridge. I went aft, passed the chief, who was bleeding, gave him my neckcloth to stop the blood, went right aft and saw the skipper lying on the grating. I said, 'Oh, my God, he is shot!' I picked him up and saw that his head was battered to pieces. I dropped him, rushed down the forecastle, and saw the boatswain lying on the floor, with his head battered in. "Another shot came and hit us, I didn't know where. All hands were shouting out they were shot. I jumped on the bridge to blow the whistle, but that and the steampipe were knocked away. I tried to alter the wheel, but the wheel-gear was smashed. I then found we were sinking. I went to the boat, cut the grips,plugged her up, and put the painter on the winch to heave her aft, but found some of the winch smashed. Then something hit me on the back. I saw the GULL launch her boat. I dragged the skipper forward and got the third hand up on the deck and went for the chief. He was unconscious. By this time the GULL's boat came alongside and we put in the skipper and bosun, and got in ourselves - how, I don't know. "When the boy came to me and said, 'Where is my father?' that was a pill I could not swallow. For the life of me I could not tell the boy what had happened to his father. "The searchlights made everything like day. The fireman, while he was in the engine-room, saw the warship that was firing on us - saw her through the hole they made in the ship's side. They made a target of us. They meant doing for us. They needed no lights to see what we were. The searchlights told them plain enough." While British naval vessels followed the Russian armada as it headed down through the English Channel urgent diplomatic negotiations were begun. Admiral Rozhdestvenski in command of the Russian fleet insisted that torpedo boats had been sighted, and that one had been sunk. However he had realised that his crews, most of whom he despised, were firing on fishermen who were desperately holding up their catch to indicate that they were neither Japanese nor combatants. The London Times thundered: " For twenty minutes, we are told, the Russians poured shrapnel on the helpless fishing boats. They then steamed off without waiting to ascertain what was the character or nationality of the craft on which they had directed, without warning, this deadly fire, and without making the slightest effort to rescue the crews of the boats they had sunk.....It is almost inconceivable that any men calling themselves seaman, however frightened they might be, could spend twenty minutes bombarding a fleet of fishing boats without discovering the nature of their target.....The only surmise we can make with our present knowledge of the facts is that the Russians were themselves the victims of a disgraceful panic. The telegram from our Copenhagen Correspondent shows that they were in a state of extraordinary nervousness as they passed through the Danish waters. All sorts of cock-and-bull stories about the preparations made by Japanese spies for blowing the Baltic fleet sky-high ...." For a few tense days the possibility of war between Britain and Russia was discussed in London Clubs and amongst the highest authorities. The Russian Baltic Fleet had been directed to the Far East by the Tsar, Nicholas ll to confront and defeat the Japanese who had come to challenge territorial control of Manchuria and Korea. The Japanese wiped them out at the battle of Tsushima.

  • 0 Claude Shannon

    • History
    • by Gavin Weightman
    • 30-04-2016
    0.00 of 0 votes

    I was pleased to see that Google chose on Saturday 30 April to celebrate the birth of Claude Shannon, one of the forgotten geniuses of the age of the computer. His name was unknown to me until I studied the history of the personal computer for my book Eureka: how invention happens (Yale 2015). I had been writing about another genius from an earlier era, George Boole, inventor of "Boolean logic" when I discovered that it was Shannon who had made practical use of this to create the digital age. This is what I had to say about him:  "It was a young American who realised that Boolean algebra could be used to process information electronically. Claude Shannon's thesis, written in 1937, had the unexciting title A Symbolic Analysis of Relay and Switching Circuits but came to be regarded as the most influential paper of twentieth-century electronics. As with so much innovation at the time, it was a proposal for solving some serious problems with the telephone networks, which were becoming overloaded. Working for Bell Labs, Shannon used Boolean logic to devise a way of sending information in the form of pulses rather than waves. His revelation had come about because he had, most unusually, taken courses in both logic and electronics. In his history of the microprocessor, The Chip : How Two Americans Invented the Microchip and Launched a Revolution, T.R. Reid says of Shannon: 'If society allocated fame and fortune on the basis of intellectual merit, Claude Shannon would have been as rich and famous as any rock idol or football star.' Shannon was born in the small town of Gaylord , Michigan in 1916; his father was a judge and businessman and his mother the principal of the high school. He studied electrical engineering and mathematics at the University of Michigan, graduating in 1936. From there he went to MIT, where he had the opportunity to work with Vannevar Bush on a computer rather like a semi-electronic version of Babbage's Differential Engine. Shannon became intrigued by the work of the relays and wrote his thesis on A Symbolic Analysis of Relay and Switching Circuits; in it he drew on the logic of George Boole. This work alone, which he completed when he was twenty-two, would have been sufficient to gain him a prominent place in the history of electronics for it showed how Boolean symbolic logic could be used to analyse complex systems such as the switching systems of a telephone exchange.  Later, working at Bell Labs, he went on to propose a theory of communication in which all electronic information could be reduced to a common unit represented as a 1 or 0, what he called a "binary digit" soon shorted to "bit". This became the measure of a computer's memory: more bits, more memory. Though he did little to popularise his work, which is perhaps why he is not well known to the public (like a number of other prominent engineers he has no entry in the American Dictionary of Biography), Shannon is regarded as 'the father of the digital age'. He died aged eighty-four in 2001 after suffering from Alzheimer's for a number of years. His obituary in the London Times captured something of his eccentric character under the heading 'Playful genius who invented the bit, separated the medium from the message and laid the foundations for all digital communications'. [ex] To colleagues in the corridors at the Massachusetts Institute of Technology who used to warn each other about the unsteady advance of Shannon on his unicycle, it may have seemed improbable that he could remain serious for long enough to do any important work. Yet the unicycle was characteristic of his quirky thought processes, and became a topsy-turvy symbol of unorthodox progress towards unexpected theoretical insights ….  Like Charles Babbage, Shannon was known by his contemporaries as 'the Irascible Genius'. When he returned to MIT in 1958, he continued to threaten corridor-walkers on his unicycle, sometimes augmenting the hazard by juggling. No one was ever sure whether these activities were part of some new breakthrough or whether he just found them amusing. He worked, for example, on a motorised pogo-stick, which he claimed would mean he could abandon the unicycle so feared by his colleagues …." It was Shannon's revolutionary information theory that provided the logic for the digital age.

  • 0 A surgeon thrown out of Trafalgar Square

    • History
    • by Gavin Weightman
    • 13-03-2016
    0.00 of 0 votes

    While the imperialist Cecil Rhodes survived a recent campaign to have his statue removed from an Oxford University college, a little known bid to have the statue of an internationally renowned doctor returned to its rightful pedestal in London has been continuous for more than 150 years. Edward Jenner was the country surgeon who proposed in 1798 that a safer way of protecting against smallpox was to inoculate with a disease which affected cattle rather than the smallpox virus itself. Though the Royal Society refused to publish his proposal when it appeared as private paper it became an international sensation. Jenner called his miracle medicine variola vaccinae meaning literally "smallpox of the cow". Its use soon became known as vaccination. In Jenner's day it meant only inoculation against smallpox but was later applied to immunization against a great variety of infections in honour of his pioneering work. There were problems with vaccination as there was no scientific understanding of how it worked. Many doctors were opposed to it and Jenner's reputation rose and fell during his lifetime. When he died in 1823 friends and supporters asked for him to be interred in Westminster Abbey but the request was turned down. He was buried in the parish in Gloucestershire where his father had been a pastor and he had his medical practice. Nobody from London attended. From the earliest days of Jenner's promotion of vaccination his fame was far greater abroad, in Europe and America in particular, than in Britain. When in the 1850s the sculptor William Calder Marshall proposed to a group of doctors that he create a memorial to Jenner they were enthusiastic but had difficulty in raising the necessary funds. The money was not found until an appeal was made to the medical profession abroad. The United States, which had introduced vaccination for smallpox soon after Jenner's 1798 paper was published, made the largest donation, followed by Russia and in third place, Great Britain. When in 1858 it was learned in Parliament that permission had been given by Queen Victoria to provide a plinth for Jenner in Trafalgar Square there were immediate protests. In the Commons Thomas Slingsby Duncombe MP was reported as saying: "Cowpox was a very good thing in its proper place, but it had no business among the naval and military heroes of the country. Everybody who heard of the statue spoke of it with ridicule and disgust……he trusted that the House would pass a resolution calling upon them not to pollute or desecrate the ground by erecting a statue there to the promulgator or cowpox throughout the country." Clearly Duncombe was anti-vaccination, but the chief objection expounded in the newspapers was that Trafalgar Square was reserved for military heroes and Jenner had no right to be there. Jenner's statue, covered before its unveiling, had been placed next to that of Sir Charles James Napier an army officer, and a number of newspapers remarked on the incongruity of a mere benefactor of mankind being afforded the same status as a brave leader who risked his life for his country. " Why should Dr Jenner be found in such formidable society? " asked the Times. Nevertheless, the unveiling of Calder Marshall's statue went ahead in May 1858 with Prince Albert performing the inauguration ceremony. It remained there, despite many objections, until early in February 1862. The fact that Prince Albert had approved of the statue being in Trafalgar almost certainly extended Jenner's residence there: his removal would have been seen as a snub to Royalty. Albert died on 14 December 1861 and Queen Victoria went into mourning. Just a few weeks later there were reports of a mysterious appearance of a statue of Jenner on a new site to the west of Trafalgar Square. "During the last few days vistors to Kensington-gardens have been surprised by the appearance of the statue of Dr Jenner, of small-pox vaccination celebrity standing – or rather sitting– with its natural air of placidity on a new pedestal……This statue,it will be remembered, was some time ago, promoted to a distinguished position near the Nelson Column… but it has been furtively removed to Kensingon-gardens without any cause for its 'translation' being assigned". No fuss was made about this quiet act of demotion: most newspapers just remarked on the fact that Jenner gone from Trafalgar Square. The satirical magazine Punch could not resist publishing a few puns on "spots" including a little verse: England's ingratitude still blotsThe escutcheon of the brave and freeI saved you many million spots,And now you grudge one spot for me. For many years Jenner's statue was ignored. But his reputation has risen in recent years to perhaps its most illustrious level. The statue is smartened up and has a proper dedication on the plinth: Edward Jenner MD FRS1749-1823Country Doctor who benefited Mankind In Jenner's time smallpox was a dreaded disease worldwide and caused many deaths particularly of children. Survivors were left badly scarred and often blinded or deformed. In 1769 Jenner vaccinated James Phipps with cowpox and showed that the boy was immune to smallpox. He predicted the worldwide eradication of smallpox. This was finally achieved in 1980. So far efforts to have him re-installed in Trafalgar Square have failed despite the backing of the British Medical Journal and a culture in which a medical man with a world-wide reputation might be regarded by the public and in Parliament as a good deal more worthy of adulation than a military leader.