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Catherine the Great, medical heroine

By Daily Herald - | Apr 17, 2007

History often celebrates the wrong people or fixes in the public mind images of others that are significant distortions. Let’s review a couple such cases.

Many times, I have been told the history of smallpox vaccination, and always it is how in 1798 one Edward Jenner, an English doctor, vaccinated young James Phipps with some fluid from the pustules of cows afflicted with cowpox.

Sometime later he gave Jimmy some actual smallpox pustule fluid, and Jimmy did not get sick. And so, the story goes, the science and practice of vaccination was born.

But the practice did not begin with Jenner. At least six people are known to have used cowpox to generate smallpox immunity before Jenner did it. And it seems that the practice of inoculation itself had been going on for centuries, though not with cowpox. Rather, one took pus from people with very light cases of smallpox and used that to inoculate others. The recipients usually got very light cases themselves but were subsequently immune to further attack.

Some sources say the practice actually started in the Orient, perhaps China, and came by way of Arab physicians into Europe. It seems to have been called inoculation during those years. Only when cowpox came into use did the term vaccination (from Latin: vacca, cow) come into use. So we can give Jenner credit for energetically promoting the use of cowpox, which carries less risk than using actual smallpox pus, but he certainly did not invent the idea. And frankly, James Phipps deserves more credit than he’s usually given (his name is rarely mentioned). Jenner was just doing an experiment; Phipps was gambling his life!

Another who similarly gambled was Catherine the Great, Empress of all the Russias. And she preceded Jenner and Phipps by 30 years. I’ve usually heard of Catherine as an ambitious and avaricious lady who overthrew (some say killed) her husband to become sovereign of Russia and who was involved with a sordid series of romantic affairs. These stories seem to be considerable distortions of history, but my interests today have to do with smallpox.

Catherine came to power in 1762; Russia was a poor and struggling country. In 1767, a smallpox epidemic in Siberia wiped out some 20,000 people, and Catherine came to believe that reducing its terror would be a great step forward for her people. So at considerable expense she recruited the services of Dr. Thomas Dimsdale of England, the most famous inoculator of the day.

The March 24 issue of New Scientist takes the story from here. Catherine wanted herself and her son to be the first inoculated, to prove to the people that this was a safe and effective procedure. Dimsdale wanted to try his skills with some commoners first, since he was not fully certain that Russian smallpox would behave like the English versions. His attempts were not successful, and Catherine felt that she must take matters into her own hands to establish the credibility of Dimsdale and his work. So on Oct. 12, 1768, she was inoculated. She developed a light case of smallpox but was fully recovered by Oct. 28. And to disprove the popular idea that taking pus from a donor patient would kill that patient, she herself donated pus for inoculation of several members of her court. She and they all survived and inoculation quickly became widely accepted.

Catherine went on to establish the first Russian College of Medicine, and hospitals for civilians. She thus saved the lives of thousands of her people, and seems quite deserving of the nickname she disdained in life: Catherine the Great.

Duane Jeffery is a professor of zoology at Brigham Young University.

This story appeared in The Daily Herald on page B6.

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