The first written account of variolation describes a Buddhist nun practicing between 1022 and 1063 AD. She would grind up scabs taken from a smallpox-sufferer into a powder, and then blow it into the nostrils of someone not yet immune. By the 1700s, this method of variolation was common practice in China, India, and Turkey. It was not risk-free: up to 2% of people died after variolation. However, compared with the danger of contracting the disease naturally, inoculation was well worth it, decreasing the total number of smallpox fatalities ten-fold.
Lady Mary Wortley Montagu, wife of the British Ambassador in Constantinople, came across the practice in 1717 when she witnessed local women performing inoculations at seasonal ‘smallpox parties’ by spreading matter from smallpox scabs into a scratch in the skin. Lady Mary had caught smallpox herself at 26 and was left with many pitted scars on her face and no eyelashes. She wore veils and heavy make-up to cover the scars. Her only brother had also caught it but did not survive.
She was determined that her own children should be safe. She had her son inoculated while still in Turkey, and during a smallpox epidemic in London in 1721 had her three-year old daughter inoculated by Charles Maitland, a physician who had been at the embassy in Turkey. The event was highly publicised in order to spread the word about the practice, and was attended by other medical men as well as various ‘persons of distinction’. At this point inoculation was still controversial, but it was gradually becoming an accepted form of preventive medicine.
One prominent supporter was Caroline of Ansbach, the Princess of Wales. She had caught smallpox shortly after her marriage to the future George II and was keen to protect her children, though she had reservations. To put her mind at rest she requested a monitored trial.
Dr Mead was a keen supporter of the method, and along with Maitland and Sir Hans Sloane conducted a trial in Newgate Prison.
Six convicted criminals were told that they would be released without charge if they underwent the trial. Five developed symptoms and then recovered; the sixth had lied about never having had smallpox and so was already immune. Mead tested the Chinese method of inhaling smallpox matter on another prisoner which, understandably, ‘gave great uneasiness to the poor woman’. All the prisoners were then released. To make sure that it had worked they sent one of the prisoners to Hertford where there was a particularly deadly outbreak of the disease. The, now ex-prisoner, nursed an infected patient and even shared a bed with them but did not suffer a relapse.
The Newgate trial had been a success but the Princess promoted another trial before she was ready to have her own children inoculated. Six ‘charity-children’ from St. James’s Parish were inoculated. Five came down with symptoms and then recovered. Again, the sixth had in fact had it before. Caroline was then happy for the ‘royal inoculations’ to go ahead.
Some aristocratic families followed suit, despite some highly publicised cases of inoculation being fatal, and the practice became more generally accepted. However, this was still a method of personal prevention rather than a public health strategy, and the end of smallpox was still a long way off.
Find out more about Mead’s role in inoculating against smallpox in eighteenth-century London by visiting The Generous Georgian: Dr Richard Mead, which runs at the Founding Museum until 4 January 2015.
My next post will be an interview with Dr Mead himself, where I ask him about the circumstances of the alleged duel he fought over smallpox.