An excerpt from First Patients: The incredible true stories of pioneer patients.

Unfazed by the village doctors’ refusals, the parish deacon forged ahead. Dr. Andrew Bell–preacher, educator, and doctor, possessed the temper and energy of a combustion engine. Nothing would stop him from carrying out his plan to vaccinate the three hundred inhabitants of the remote village of Swanage. Having recently returned from a trip to Edinburgh with a supply of vaccines against smallpox, it did not matter to Bell that the other doctors were hesitant to use this new remedy. He was certain it was superior to the prevailing practice of variolation.

Bell should know. Growing up in St. Andrews, Scotland, in the mid-1750s with the constant threat of smallpox, young Bell was one of the first patients in the city to undergo the dangerous practice of variolation. For any child, it must have been a terrifying ordeal. The practice involved slitting the forearm with a lancet infused with pulverized scabs or fluid from a boil of a smallpox patient. Done correctly, the recipient escaped with relatively mild symptoms and developed immunity from the torture of fulminant disease and horrific death. Done correctly (yes, still correctly), fever and weakness struck the inoculant, followed by a cloak of florid smallpox sores. Those who survived harbored and unwittingly passed on the virus, further spreading the epidemic.

Andrew Bell had survived his childhood variolation. Years later, he graduated from the oldest college in Scotland, St. Andrews University, became a Deacon in the Church of England, and even earned a medical degree. At age 34, he sailed to India where he held multiple chaplaincies and served as a superintendent of the Military Male Orphan Asylum, a school for orphaned, multi-racial sons of the military.

Bell’s forte was education, and it was in the Indian city, Madras, that he developed a system of instruction that would later be propagated across educational institutions. During this tenure, he witnessed people suffering the savagery of smallpox. The ancient scourge had spread over millennia to almost every continent, killing three out of ten people it touched, sometimes wiping out entire families. Many survivors bore lifelong scars or disfigurement. Too many had been children.

His years in India were otherwise productive, happy, and successful. After nine years and his health declining, Bell sailed the six-month voyage back to Europe. In 1801, he accepted an offer to be Rector for St. Mary the Virgin in Swanage, Dorsetshire. Bell was pleased with his new appointment and the fresh start in the English setting.

“Never was I so charmed with an English spring,” he wrote to a friend. The cooler climate of Swanage, suffused with sea air, must have done wonders for Bell’s health. Accessible by one street, the coastal village in southeast Dorset was home to three hundred and three families. It lay within the Isle of Purbeck, a misnomer given only three sides were bound by water. To the south and east were the undulating, majestic, chalk-white cliffs that met the crashing waves of the English Channel. The famed Purbeck ‘marble’, ancient limestone quarried there since Roman times, formed the storied twelfth-century Corfe Castle, the church, and most stone dwellings on the isle.

Bell found the people “well-disposed, orderly, intellectual, and full of science,” yet they lived with “primitive simplicity.” They tended gardens and orchards, farmed, fished, quarried, and attended church. He seemed to have settled in well and went about his priestly duties. As a priest and doctor, his mission was to protect the congregation from the devil and smallpox. Prayers and faith may save souls, but he would use a new tool—vaccination—to spare them from smallpox.

Bell was still in India in 1798 when Edward Jenner, a forty-nine-year-old doctor from Berkeley, Gloucestershire, self-published the results of an experiment he had conducted. While variolation inoculated smallpox virus drawn from an infected patient, this “country doctor” had the audacity to propose using cowpox virus instead.

Cowpox disease, the product of cowpox virus, revealed itself through reddish mounds with dark craters on infected cows’ udders. The virus could be passed through touch, as many servants and milkmaids had discovered. Apart from the unsightly and painful eruptions that formed on hands, the disease often produced mild symptoms. More importantly, Jenner realized, as did many other people for many years, those who had been exposed to cowpox never seemed to fall victim to smallpox.

He set out to test his theory on an eight-year-old boy, and later, on over a dozen other people. Jenner’s “An inquiry into the causes and effects of the variolæ vaccinæ…” described the seminal case reports and confirmed what dairy farmers had known for generations.

“The cowpox protects the human constitution from the infection of the smallpox,” he concluded. The word vaccination came from vaccinia, the cowpox virus.

Following his report, vaccination did not immediately catch on. Nonetheless, within a few years, through perseverance and help from influential connections, and despite intense opposition and derision, Jenner spread his message throughout England, Europe, and even the United States. Doctors across the world realized the value of vaccination: it was effective and a far safer option than variolation. Jenner earned worldwide fame and adulation. In 1802, Parliament granted him £10,000 in remuneration.

Bell was a believer. Despite facing some resistance, he vaccinated over six hundred people in Swanage and other parishes.

“Sir Isaac Newton, Dr. Franklin, Monsieur Lavoisier, and Harvey,” he wrote, “could not, in the same short period, boast of equal success in the spread of their respective discoveries.”

“I sent none away,” Bell wrote, boasting he had vaccinated infants to septuagenarians. “I did what was never done before in Swanage,” he wrote a friend, “preached twice, and the same sermon, both forenoon and afternoon, on cow-pock.”

It was probably in early 1803, as Jenner’s fame swelled and more doctors were adopting vaccination, when Bell met a farmer with a curious story. The farmer’s name was Benjamin Jesty, from the Downshay farm in a nearby village. Seeing the growing practice of vaccination, Jesty was eager to tell his story and claimed he deserved rewards just like Jenner. Bell, probably intrigued, recorded Jesty’s account.

Rod Tanchanco is an internal medicine physician and can be reached on Twitter @rodtmd. He is the author of First Patients: The incredible true stories of pioneer patients.

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