Good Reading : September 2009
BOOKBITE 3 frequently practised. many women in the turkish sultan’s harem in Istanbul had been variolated during childhood on parts of their bodies where scars would not be seen. reports describing the method of variolation used in turkey reached england in the early 1700s when smallpox was running rampant. members of the royal society of London, the esteemed and prestigious national academy of science that had been founded in 1660, became aware of the practice but it was not immediately embraced by physicians. It was an english aristocrat, a woman, Lady mary Wortley montague, who is credited with introducing variolation to england and western europe where it was also called inoculation. Lady mary had experienced the scourge firsthand in 1715. Once a reputed beauty, her face was ravaged by the speckled monster which had also robbed her of her brother. In 1717 Lady mary’s husband, edward Wortley montague, was appointed as ambassador to turkey and within two weeks of arriving, Lady mary wrote to her friend sarah Chiswell, describing how variolation, which she called ‘ingrafting’, was used at the Ottoman court. material from the pustules of people who had contracted a mild case of smallpox was introduced he carried out on six prisoners at Newgate prison on 9 August 1721. the ethics of this may be questionable from a 21st-century perspective but the prisoners were promised a full pardon if they submitted. All six survived variolation and were released. One prisoner was then exposed directly to smallpox and proved to be immune. After the next successful trial, which maitland carried out on six children from a charitable institution in London, the princess of Wales allowed her two daughters to be treated. the actions of Lady mary had saved more children than her own but sadly her friend, sarah, with whom she had shared her discovery, died from smallpox a few years later. Not surprisingly, with a royal imprimatur, variolation soon gained general acceptance but it was not foolproof. two to three per cent of people who were variolated died because success depended on physicians identifying a mild strain of smallpox and some people were inadvertently infected with other lifethreatening illnesses such as tuberculosis study to assess the effectiveness of the procedure and promoted it enthusiastically. In 1766, during the War of Independence, American soldiers under George Washington were unable to wrest Quebec from the english because a smallpox epidemic halved their troop numbers. british troops on the other hand had been variolated and did not succumb. being a witness to the success of variolation, George Washington made the practice mandatory for all his soldiers. by the time edward Jenner was born in 1749 variolation was widespread throughout england. As an indication of how enormous the social and economic repercussions of smallpox were, the London smallpox and Inoculation Hospital, dedicated to the treatment and prevention of smallpox, had been established. In both england and europe doctors began variolating on a large scale and many built up lucrative businesses. During the 1750s when the young edward suffered his ordeal many of the nobility of europe were ensuring that their children were given a chance to escape smallpox. empress marie-therese of Austria and Smallpox took up residence in all corners of the globe. to the healthy through scratches or a puncture made on the arm. Convinced that the method was a way to protect her children, in march 1718 Lady montague instructed the embassy surgeon, Charles maitland, to variolate her five-year-old son. When she returned to London in April 1721, Lady montague had her four-year-old daughter variolated by Dr maitland in the presence of physicians appointed to the english royal court, including the king’s physician, sir Hans sloane. Consequently members of the english royal family became interested in the possibility of saving their own children through variolation. Charles maitland was granted a royal Licence to conduct a trial, which 52 goodreading ı september 2009 or syphilis. An even greater risk was that those who were inoculated with a virulent strain, apart from losing their own lives, were potentially the source of new smallpox epidemics. However, mortality rates were ten times lower amongst those who caught smallpox from variolation than those who caught it naturally. In 1722 James Jurin, a physician and secretary to the royal society, conducted one of the first medical statistical surveys and found that the mortality rate in non-variolated children was one in 14 but for the inoculated, it was one in 91. In the Americas variolation found powerful supporters as well. benjamin Franklin, whose son died of smallpox in 1736, also carried out a statistical her children and grandchildren were variolated as was King Louis XVI of France and his children, and Catherine II of russia and her son. Variolation remained the only defence against smallpox until Jenner’s vaccine became an accepted replacement in the mid19th century. Fortunately for us all, edward Jenner recovered from the trauma of his experience with variolation and the road to salvation for generations of people began five years later, when at the age of thirteen he embarked on his long and exceptional medical career. Smallpox, Syphilis and Salvation by Sheryl Persson is published by Exisle, rrp $34.99.