The creation of a Vaccination Guide

Around the 1800s, smallpox was one of the worst diseases you could contract. Your body would be full of small ulcers and blisters filled with a thick fluid. If you were lucky, they would fall off and create scars, but for approximately 30% of the infected, it would lead to death.

Oil painting of Edward Jenner
Edward Jenner

In 1796, the British doctor Edward Jenner figured out that people getting infected with the disease originating from cows would only get a small reaction, and later be immune to the disease. This is how the first vaccine was created.

Today we are worried how the COVID-19 vaccine will be transported and distributed, but back in the 1800s, this seemed like an impossible task. Edward Jenner was only able to infect people situated near other infected people. Once a person developed a blister, he would extract a bit of its fluid. On the next patient he would make a small incision in the skin and expose them to this fluid. When transporting the fluid over distance and time, the virus died, it lost its capabilities and therefore did not work.

Bust of Francisco Javier Balmis in the Faculty of Medicine of the UMH in San Juan de Alicante
Francisco Javier Balmis

In 1803, a Spanish doctor, Francisco Javier Balmis found the solution to the problem. He wanted to bring the “vaccine” to the Spanish colonies in Latin America. His solution was to use 22 orphan kids to carry the disease on the journey across the ocean. As a reward, they were promised plenty of food during the crossing, and a new adoptive family upon arrival. The strategy was to infect two of the kids before leaving, and subsequently transfer the disease from kid to kid during the journey. It almost failed, and on arrival, only one kid had one blister. As soon as they arrived, they started vaccinating, and withing two months, over 12000 persons had gotten the vaccine. With the same method they continued the journey throughout Latin America, and later to the Philippines (See map further down in the post or click here).

Francisco Javier Balmis would later write the book “Instrucción sobre la introducción y conservación de la vacuna” (Instructions for the introduction and conservation of the vaccine) where he explained his findings and experiences of the expedition.

The Translation

Bookpage from the book Tratado histórico-práctico
"Tratado histórico-práctico"

Before leaving on the expedition in 1803, Francisco Javier Balmis worked on translating the French “Traité historique et pratique de la vaccine” (Tratado histórico-práctico) by Jacques-Louis Moreau de la Sarthe. This was to be used as an official manual for vaccination and handed out where they started vaccinating. Balmis started the work on the translation in 1801 and from submission until final review it took approximately 16 months to finish it.

During the first review of the text, Balmis gets massive critique, as the translation contains various, and serious errors. Names and places, even whole procedures are omitted, or wrongly translated. Balmis had also taken the freedom to add or remove whole paragraphs in the text.

Errors in translation Balmis
Some of the errors in the translation

Five months later he presents his second edition for review. The second review is accepted, but still with criticism. The reviewer wrote: “I do not judge it to detract from the translation, but if you look at the original work it is not one of those that are unique in its genre or of outstanding and outstanding merit.”

Balmis had a wish of dedicating the book to the Queen but based on the reviewer’s findings the King did not allow the use of the Queens name, stating: "the King has been granted permission to have the two parts printed, but His Majesty has not seen fit to agree that the work bears the name of the Queen”. The book was finally dedicated to “the mothers of his family”.

This goes on to show the importance of independent review of translated documents and books.

Journey made on the Balmis Expedition
The "Balmis Expedition"

The book was later printed in several thousand copies and distributed throughout the Spanish colonies.

Parche distintivo que se entregó a algunas unidades que participan en la Operación Balmis
"Operation Balmis"

Francisco Javier Balmis has lived on in history as an important figure for the distribution and use of vaccines, and his work is still honoured today. In 2020, the Spanish Ministry of Defence named their military deployment in the fight against COVID-19 “Operation Balmis”.