Lady Mary Wortley Montagu: Poems

Ottoman smallpox inoculation

Memorial to the Rt. Hon. Lady Mary Wortley Montagu erected in Lichfield Cathedral by Henrietta Inge

Smallpox inoculation

In the 18th century, Europeans began an experiment known as inoculation or variolation to prevent, not cure the smallpox.[34] Lady Mary Wortley Montagu defied convention, most memorably by promoting smallpox inoculation to Western medicine after witnessing it during her travels and stay in the Ottoman Empire.[3] Previously, Lady Mary's brother had died of smallpox in 1713, and although Lady Mary recovered from the disease in 1715, it left her with a disfigured face.[35] In the Ottoman Empire, she visited the women in their segregated zenanas, a house for Muslims and Hindus, making friends and learning about Turkish customs.[36] There in March 1717, she witnessed the practice of inoculation against smallpox – variolation – which she called engrafting, and wrote home about it in a number of her letters.[35][37] The most famous of these letters was her "Letter to a Friend" of 1 April 1717. Variolation used live smallpox virus in the pus taken from a mild smallpox blister and introduced it into scratched skin of the arm or leg (the most usual spots) of a previously uninfected person to promote immunity to the disease.[38] Consequently, the inoculate would develop a milder case of smallpox than the one he/she might have contracted.[34]

Lady Mary was eager to spare her children, thus, in March 1718 she had her nearly five-year-old son, Edward, inoculated there with the help of Embassy surgeon Charles Maitland.[35] In fact, her son was the "first English person to undergo the operation."[37] In a letter to a friend in England, Montagu wrote, "There is a set of old women [here], who make it their business to perform the operation, every autumn…when then great heat is abated…thousands undergo this operation...[and there] is not one example of anyone that has died in it."[39] Afterwards, she updated the status of Edward to her husband: "The Boy was engrafted last Tuesday, and is at this time singing and playing, and very impatient for his supper. I pray God my next may give as good an account of him."[40] On her return to London, she enthusiastically promoted the procedure, but encountered a great deal of resistance from the medical establishment,[3] because it was a folk treatment process.[1]

In April 1721, when a smallpox epidemic struck England, she had her daughter inoculated by Maitland, the same physician who had inoculated her son at the Embassy in Turkey, and publicised the event.[1] This was the first such operation done in England.[35] She persuaded Caroline of Ansbach, the Princess of Wales, to test the treatment. In August 1721, seven prisoners at Newgate Prison awaiting execution were offered the chance to undergo variolation instead of execution: they all survived and were released.[1] Despite this, controversy over smallpox inoculation intensified. However Caroline, Princess of Wales, was convinced of its value. The Princess's two daughters Amelia and Caroline were successfully inoculated in April 1722 by French-born surgeon Claudius Amyand.[35] In response to the general fear of inoculation, Lady Mary, under a pseudonym, wrote and published an article describing and advocating in favour of inoculation in September 1722.[35] Later, other royal families soon followed Montagu's act. For instance, in 1768, Catherine the Great of Russia had herself and her son, the future Tsar Paul, inoculated. The Russians continued to refine the process.[39]

Nevertheless, inoculation was not always a safe process; inoculates developed a real case of smallpox and could infect others.[39][3] The inoculation resulted in a "small number of deaths and complications, including serious infections."[41] Subsequently, Edward Jenner, who was 13 years old when Lady Mary died in 1762, developed the much safer technique of vaccination using cowpox instead of smallpox. Jenner's method involves "engrafting lymph taken from a pustulate of cowpox on the hand of a milkmaid into the arm of an inoculate."[41] Jenner first tested his method on James Phipps, an eight-year-old boy, and when Phipps did not have any reaction after the procedure, Jenner claimed that his procedure "bestowed immunity against smallpox."[41] Then, after spending the next few years experimenting his new procedure, he discovered that his hypothesis was correct.[41] As vaccination gained acceptance, variolation gradually fell out of favour. In the 20th century, a concerted campaign by the WHO to eradicate smallpox via vaccination would succeed by 1979.[42] Lady Mary Wortley Montagu's introduction of smallpox inoculation had ultimately led to the development of vaccines, and the later eradication of smallpox.


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