The Conquest of Smallpox: The Impact of Inoculation on Smallpox Mortality in Eighteenth Century Great Britain by Peter Razzell, and: Edward Jenner's Cowpox Vaccine: The History of a Medical Myth by Peter Razzell (review)

advance are conceived by Bronowski as significant pressures—and models—for humanizing all of man's activity. This, then, is a useful collection for anyone who wants to know what an eminent and articulate scientist thought of his art. The only criticisms I have are these: first, the title is a little misleading (how about "A Sense of Science"?); and, second, there is some repetition of thought—such as in chapters 7 and 8 and in chapters 12, 13, 15, and 16—which might possibly have been eliminated. This book is especially useful in an era when faith in science is unfashionable, for Bronowski's faith was enormous. On the suppression of science, this gentle man said, "Whoever discovered the destructive effect of atomic energy [or before that nitroglycerine or the radiation effects of long-lived cobalt or long-lived strontium isotopes] and withheld that discovery from mankind is a maniac." In spite of his intimate involvement with Dachau, Hiroshima, and Nagasaki, he acutely observed, "We are not afraid of the future because of a bomb, we are afraid of bombs because we have no faith in the future." He, for one, was not afraid. R. J. Doyle Department of Biology University of Windsor, Ontario The Conquest of Smallpox: The Impact of Inoculation on Smallpox Mortality in Eighteenth Century Great Britain. By Peter Razzell. Firle, Sussex: Caliban Books, 1977. Pp. x+190. £8.00. EdwardJenner's Cowpox Vaccine: The Hktory ofa Medical Myth. By Peter Razzell. Firle, Sussex: Caliban Books, 1977. Pp. 130. $16.50 (soft cover). The titles of the two books reviewed here give away at first glance their message and content; they aim to dispel a long-held and long-cherished belief in medical history. It is clear that Dr. Peter Razzell, an English sociologist and historical demographer, attributes the population growth in eighteenth-century England not to the introduction of vaccination against smallpox but to the increased use ofinoculation. In the second and shorter book, he attempts to dispel what he calls the myth of Jenner's use of pure cowpox vaccine as the major instrument in the eradication of smallpox. In both of these volumes, the author makes the point that there actually scarcely was a health measure such as pure vaccination with cowpox vaccine but that inoculation was always practiced simultaneously. In fact, he makes his point rather convincingly by giving us a "genealogy of the virus" with which a patient was inoculated and by tracing it through all subsequent patients who were vaccinated with the substance derived from the first patient. In support of the point that, rather than vaccination by means of pure cowpox matter, the vaccine contained a substantial admixture of smallpox inoculate, Razzell carries in the genealogy a listing of the number of pustules that were the result of inoculation. As cowpox vaccine generally elicits but one pustule at the vaccination site, he considers the multiple eruptions (up to 530 in one patient) as incontrovertible Perspectives in Biology and Medicine ¦ Spring 1979 | 455 proof thatJenner used a mixture ofvaccine and smallpox matter. In fact, Razzell traces the provenance of Jenner's vaccine to a London physician by name of Woodville who had first approached Jenner for a supply of his cowpox lymph and had subsequently contaminated it with actual smallpox matter. Whether this contamination occurred deliberately or accidentally by means of unclean lancets cannot now be established. At any rate, Woodville and several other physicians had previously worked in inoculating hospitals where patients, or rather "customers ," went to "buy the smallpox," that is, to become intentionally infected in order to achieve life-long immunity, and could there have contaminated his lancets. It is evident that in these inoculation hospitals the lymph was derived from patient to patient and thus became attenuated and only rarely led to severe illness or death; nevertheless, smallpox by inoculation—even though relatively mild—was contagious and could lead to an epidemic. From his own records, it became evident that Woodville vaccinated 200 patients with the lymph he had obtained from Jenner directly. However, those of the vaccinated patients who did not show eruptions in the first 5 days were given "booster doses" of variolation, whereupon...