Inoculation was key to victory over the scourge of smallpox

Brick Wall, Northiam, East Sussex, is a handsome Jacobean mansion that was home to the Frewen family for 300 years. Thomas Frewen was born there in 1704 and became a pioneer in the medical field of immunology.
Brick Wall, Northiam, East Sussex, is a handsome Jacobean mansion that was home to the Frewen family for 300 years. Thomas Frewen was born there in 1704 and became a pioneer in the medical field of immunology.

Lots of people are right now queuing up to have a vaccination against the flu.

Doubtless a wise precaution but not one I’ll be taking. Once bitten, twice shy applies to me as I have never forgotten how bad I felt after taking anti-malaria tablets in the course of a trip to the Far East around two decades ago.

I accept I’m a stubborn fool. Vaccination has saved countless lives and has even led to the worldwide eradication of that terrible affliction, smallpox. Thinking upon this led me to investigate Sussex connections to epidemics down the years.

I’ve written before about the deadly impact of the medieval Black Death on our county and how diarist John Evelyn (who was schooled in Lewes) described the devastation wrought on London’s population by the Great Plague in 1665. This time I move on to the next century when medicine men were slowly concluding that a disease’s most deadly foe might be the disease itself.

Smallpox was then ever-present. In Lewes in 1742 a “pest-house” was established on the site of the old Saint Nicholas Hospital at St. Anne’s to combat the “current scourge of smallpox”.

Enter Thomas Frewen. Born in 1704 in Northiam, East Sussex, he was a descendant of John Frewen who had called his two sons “Accepted” and “Thankful”. This was in the Puritan tradition. “Accepted” was destined to become the Archbishop of York while “Thankful” became Rector of Northiam. He was grandfather to Thomas who grew up to be a surgeon and physician. At a young age he acquired an apothecary in Rye and later had a medical practice in Lewes.

Thomas became keenly interested in the propagation of inoculation to prevent infection by smallpox. He published a pamphlet in which he asserted that people were generally distrustful of injections even though in his own experience he had found that just one out of 335 individuals so treated had subsequently died from smallpox. Frewen employed “variolation”, a treatment that involved administering a tiny dose of the actual smallpox virus. In 1759, he published another paper on the subject: “Reasons against an opinion that a person infected with the Small-pox may be cured by Antidote without incurring the Distemper.” It was Frewen’s riposte to other doctors who advised that the post-inoculation ingestion of a mercury-related mineral would reduce the risk of catching full-blown smallpox. Frewen believed taking the mineral was unnecessary and potentially harmful. With mercury being a poison I’m sure he was right. Thomas Frewen died in Northiam on 14th June 1791, aged 86.

Frewen’s life in medicine overlapped with that of Edward Jenner (1749 -1823), the man regarded as the “father of immunology”. Jenner developed a very successful vaccine against smallpox that involved injecting a dose of the related but far less virulent disease, cowpox, after he noticed that milkmaids who commonly contracted the latter infection seemed to acquire immunity to the killer strain. Indeed the very terms “vaccine” and “vaccination” were coined by Jenner and derive from the Latin “variolae vaccinae” meaning “smallpox of the cow”.

Variolation was made illegal in 1840. Even so Frewen had accomplished much valuable pioneer work in respect of immunisation. Indeed, in 1794 2,890 people underwent the variolation treatment in Lewes four years before Jenner’s discovery of his cowpox-based vaccine in 1798. Nearly 50 of those who were treated subsequently died from smallpox but this figure needs to be considered against the fact that in those days around one in ten could expect to succumb to the disease. In 1694 a British monarch, Queen Mary II, fell victim to smallpox. In fact even at the beginning of Queen Victoria’s reign (1837), around 12,000 Britons died from it each year.

By the middle of the last century, smallpox had been largely eradicated in most parts of the world. So imagine the consternation caused when an outbreak was declared in Brighton on 27th December 1951. Father and daughter Elsie and Harold Bath were diagnosed with the disease by doctors at Bevendean Isolation Hospital. Fevered efforts were made to identify the source before highly contagious smallpox could sweep the nation. The carrier turned out to be Elsie’s boyfriend, an officer in the RAF who’d been serving in Pakistan but had flown home for Christmas. The officer had felt unwell but put it down to a bout of malaria.

Emergency vaccination centres were opened in Brighton. Elsie’s father was a taxi driver who had transported hundreds of passengers while he had been incubating the disease; everyone needed to be traced. RAF personnel and Elsie’s colleagues at the Post Office where she worked also required vaccinating. Beryl Reid and the rest of the cast of the pantomime “Mother Goose” at the town’s Theatre Royal were quarantined to avoid infection. When deaths started to occur, some funeral directors refused to handle the bodies. A café in Chichester displayed a notice declaring: “Visitors from Brighton not welcome”. It was also claimed that some platform staff at Victoria Station called out “All aboard the Plague Special” to passengers catching Brighton-bound trains. Although it had claimed 10 lives, by 6th February the smallbox outbreak was ended. Thanks to the swift reaction of the authorities just 30 cases were identified. Sadly, 10 of those infected had died.