Embracing Innovation in Medicine

MARY WORTLEY MONTAGU, On Smallpox Inoculations (ca. 1717)

While medical progress in the eighteenth century was slow, there were some notable breakthroughs, as the combined impact of the Scientific Revolution and the Enlightenment led some to challenge medical orthodoxy. Such breakthroughs did not always come from within the medical profession. Mary Wortley Montagu (1689–1762) is a case in point. The daughter of an English aristocrat and an unusually well-educated woman, Montagu narrowly survived smallpox, an often fatal disease, in 1715. A year later, while accompanying her diplomat husband in Constantinople, Montagu witnessed what was a common practice in that part of the world, inoculation against smallpox. She subsequently had both of her children inoculated, and, upon returning to England, championed the procedure despite strong anti-"Oriental" sentiment against it. The following letter was written to a close friend; its substance was made public in the 1720s.

A propos of distempers, I am going to tell you a thing, that will make you wish yourself here. The small-pox, so fatal, and so general amongst us, is here entirely harmless, by the invention of engrafting, which is the term they give it. There is a set of old women, who make it their business to perform the operation, every autumn, in the month of September, when the great heat is abated. People send to one another to know if any of their family has a mind to have the small-pox; they make parties for this purpose, and when they are met (commonly fifteen or sixteen together) the old woman comes with a nut-shell full of the matter of the best sort of smallpox, and asks what vein you please to have opened. She immediately rips open that you offer to her, with a large needle (which gives you no more pain than a common scratch) and puts into the vein as much matter as can lie upon the head of her needle, and after that, binds up the little wound with a hollow bit of shell, and in this manner opens four or five veins. The Grecians have commonly the superstition of opening one in the middle of the forehead, one in each arm, and one on the breast, to mark the sign of the Cross; but this has a very ill effect, all these wounds leaving little scars, and is not done by those that are not superstitious, who choose to have them in the legs, or that part of the arm that is concealed. The children or young patients play together all the rest of the day, and are in perfect health to the eighth [day]. Then the fever begins to seize them, and they keep their beds two days, very seldom three. They have very rarely above twenty or thirty [pockmarks] in their faces, which never mark [i.e., leave scars] and in eight days time they are as well as before their illness. Where they are wounded [i.e., where pock marks appear], there remains running sores during the distemper, which I don’t doubt is a great relief to it. Every year, thousands undergo this operation, and the French Ambassador says pleasantly, that they take the small-pox here by way of diversion, as they take the waters1 in other countries. There is no example of any one that has died in it, and you may believe I am well satisfied of the safety of this experiment, since I intend to try it on my dear little son. I am patriot enough to take the pains to bring this useful invention into fashion in England, and I should not fail to write to some of our doctors very particularly about it, if I knew any one of them that I thought had virtue enough to destroy such a considerable branch of their revenue, for the good of mankind. But that distemper is too beneficial to them, not to expose to all their resentment, the hardy weight that should undertake to put an end to it. Perhaps if I live to return, I may, however, have courage to war with them. Upon this occasion, admire the heroism in the heart of

Your friend, etc. etc.

From Lady Mary Wortley Montagu, Letters of the Right Honourable Lady M — y W—y M—e: Written During Her Travels in Europe, Asia and Africa . . . , vol. 1 (Aix: Anthony Henricy, 1796), pp. 167–169.