Lady Mary Montague - the pioneer of the smallpox vaccine

On the first attempts to bring the vaccine to Europe and the colonies in America and on the resistance of the church and how the smallpox preserved Britain's independence in Canada * Second article in a series on the disease that brought down three empires

For the first article in the series - the disease that brought down three empires

Lady Montague was born in 1689 in London to an aristocratic family. Already from childhood she was known for her beauty and wit, and her father spared nothing in her upbringing. At the age of 20, she was widely known as one of the most beautiful women in the royal court, even if her sharp tongue drove away most of her suitors. Her father insisted on finding her a suitable groom, and refused to accept the only man who was able to stand up to her prickliness - Lord Edward Wortley Montague. At the age of 23, she and Edward married in secret, much to the dismay and anger of Mary's father. Edward proved his worth when three years later he became the head of the treasury at the royal court. Throughout the couple's marriage, love and appreciation reigned between them, even though the marriage was marred by the Lady's frequent infidelities.

At the age of 26, Mary and her brother contracted smallpox. The brother died of the disease, but Lady Montague survived at a heavy price. Her skin was deformed and scarred, and she lost her eyelids. Despite the trauma she experienced, she quickly recovered, and even claimed with a wry smile that the loss of her eyelids only accentuated her eyes. Shortly after, the lady and her husband were sent as ambassadors to Istanbul, the capital of the Ottoman Empire.

Inoculation - the vaccination against smallpox - was practiced in Istanbul at that time. The Lady, who was a living example of the horrors of the plague, learned to her astonishment about inoculation and its ability to protect people from smallpox. She ended up saying to bring the vaccine to England, but felt obliged to check its validity first. She herself had already been vaccinated against smallpox, but her son Edward had not yet been infected and therefore was not vaccinated. The Lady vaccinated the 6-year-old boy in Istanbul, despite the chagrin of the embassy priest, who called the inoculation "a non-Christian practice that can only succeed for the infidels". However, despite his Christianity, young Edward became immune to the plague.

When Lady Montague returned to England, she invested her time in promoting the custom of inculcation. The doctors were not ready to believe her easily, and she was unable to find a professional who would try the new method on his patients. At that time, the smallpox epidemic broke out in London and caused panic in all strata of the population. This was probably the only reason that the nobles and the doctors agreed to listen to the lady who asserted that she had the cure for the disease. To prove the vaccine, the Lady vaccinated her 3-year-old daughter Mary, under the scrutinizing eyes of members of the Royal School of Medicine. The royal family in England was deeply impressed, but as the saying goes - 'one swallow does not bring spring'. The Lady's daughter survived the vaccination, but she was only one guinea pig. The royal family did not yet trust inoculation enough to vaccinate themselves. They ordered to try it, therefore, on other people.

In 1721, 6 prisoners sentenced to death were vaccinated with the smallpox virus - three men and three women, whose freedom was promised to them if they survived the experiment. All six were vaccinated under the eyes of the court doctors, and all survived the vaccination. Not one of them contracted smallpox upon later exposure to the disease, and all were discharged as promised. The royal family received the medical certificate they wanted. The Princess of Wales vaccinated her two daughters against smallpox, and the procedure was approved in England.

The initial opposition to inoculation came precisely from the doctors and the clergy. The doctors could not deny the effectiveness of the vaccine, but argued against it due to the risks in the inoculation process. It is important to understand that during the inoculation, the weakened virus still attacks the body and causes the development of the disease. Despite the weakness of the virus, it could still defeat the body's immune system and lead to the death of the vaccinated - as a direct result of the vaccine itself. According to statistics from that time, such a death occurred in about 3% of cases. Another problem was that at the time of the disease resulting from the vaccine, the vaccinated person could also infect all the members of the household with smallpox. Because of this, the vaccinated had to stay apart from their family while the controlled disease attacked the body. The first inoculations introduced in England caused an outbreak of the epidemic around the vaccinated people, because the doctors did not yet understand that the vaccinated person could transmit the disease himself, in the three weeks after the vaccination.

Another medical problem related to inoculation involved the way the virus was produced. The purulent fluid used for the vaccine was produced from the blisters of smallpox patients, and also contained other disease agents that those patients often contracted - such as syphilis and tuberculosis. The smallpox vaccine did prevent the vaccinator from contracting the disease, but it had a good chance of infecting him with one of the other serious diseases prevalent in Europe at the time, and imposing a death sentence on the head of the vaccinator.

The clergy opposed inoculation on completely different grounds. Smallpox was so common in those days that it was considered a natural part of the human life cycle. According to popular belief, each person is born with different disease agents in their blood, and they break out into the skin at different times. This belief explained why almost everyone developed smallpox at one point or another in their lives. Only the nerd god alone could determine who would develop the disease and when. According to this approach, the smallpox vaccine, according to the Church, provided a way for humans to escape divine punishment. In the words of the Reverend Edmund Massey in 1722, inoculation is, "a diabolical procedure which usurps the authority which does not originate in the laws of nature... and tends to expel the supreme providence from the world and increase the degree of evil and immorality."

Lady Montague found herself in trouble. She could not sit quietly and see how the inoculation was despised and slandered by the doctors and the clergy. She was an independent and proud woman, and loathed doctors and clergy in equal measure, as she believed that they were only working for personal gain. At the same time, as an aristocrat in her country, she could not afford to be officially involved in the controversy surrounding the vaccine. To get around the problem, in 1722 the Lady sent an 'anonymous' letter to a popular London newspaper, entitled, 'A Simple Report on the Inoculation of the Small Pox by a Turkish Merchant'. In the letter, published in full, she described the simple method of inoculation she had witnessed in Istanbul. [E] After the letter was made public, there was no doubt that it came from Lady Mary Montague. From reports from that time we learn that the Lady also used to visit the homes of smallpox patients, together with her daughter, and demonstrate her resistance to the disease. Despite becoming a cultural hero at a later stage, the Lady met with great displeasure from those around her for promoting inoculation.

Despite the initial objections to the method, inoculation took root in England and from there spread to all of Europe. Many aristocrats in Europe got vaccinated at that time, and the common people followed suit. Even Catherine the Great, the Tsarina of Russia, invited an English doctor to vaccinate her and her family, and awarded him the title of Baron of the Russian Empire and 20,000 lire a year as his salary.

Mary herself continued with her married life and lovers, side by side with her struggle for inoculation. In her old age she had to leave England as a result of a particularly problematic love affair that blew up in her face, when the lover tried to blackmail her. The stout lady took advantage of the forced exile to travel around Europe, while keeping in touch with her husband through letters. Judging by the content of those letters, even in these years the two loved and respected each other. Finally, the Lady complied with her daughter's request and returned to England, where she died a year later.

Mary Wortley Montague was widely considered to be the woman who brought the vaccine to Europe, and who introduced it to use by all classes of the people. In addition, to this day she serves as a role model for many women, and as a symbol of the sexual and intellectual independence of women. For all of these she is remembered throughout the world to this very day.

The inoculation in America

Although some of the clergy in Europe were opposed to inoculation for the disease, in America it was actually Reverend Cotton Mather who spread the inoculation to the masses. The priest was the proud owner of Onesimus, a particularly clever slave who had come to him from North Africa. When Mather asked the slave if he had already contracted smallpox, he answered with two words, "Yes and no."
When asked to elaborate, Onesimus explained that he had been inoculated as a child. He described the inoculation procedure to Mather and added that the procedure was common in West Africa. Mather, immediately realizing the implications for medical science, sent letters to several doctors in Boston and tried to convince them to vaccinate against the disease. He was met with overwhelming refusal and even hostility and ridicule.
It is possible that the penetration of inoculation into America would have been delayed, had it not been for the outbreak of the smallpox epidemic in Boston in 1721, side by side with its outbreak in London in Europe. One of the doctors who received Mather's letters agreed to treat his patients with inoculation, in the hope that they would not contract the disease. That doctor vaccinated 287 Bostonians, including Mather's son. 2% of the vaccinated died as a result of the intentional infection with the weakened smallpox virus, but this was a negligible percentage compared to the death rate from the disease, which was 14% towards the end of the epidemic in Boston. The vaccine also did not leave the terrible side effects of the disease - the blindness, infertility or the hideous scars on the face.

The success of the vaccine did encourage more doctors, but the general population was still largely opposed to the vaccine. Articles in the Mosheva newspaper claimed that Mather was spreading the virus under the pretext that he was vaccinating people from the disease. The spirits grew hotter, and towards the end of the epidemic in Boston an attempt was even made to assassinate him by throwing a bomb through the window of his house. Fortunately, the fuse of the bomb went off, and so we can tell that there was a note attached to it that read, “Cotton Mather, you damned dog! I will store you with it! Plague on your head!”

Although Mather published the results of the vaccine in public, it still took time for the vaccine to spread to the other colonies. Even when word of vaccination reached some of the colonies, the doctors did not know how to treat the vaccinated. Similar to England, many times the vaccinated were not separated from the rest of the population in the month after vaccination, and several small epidemics of smallpox broke out in the colonies. Some of the colonies learned the lesson and limited the vaccination procedure to well-controlled hospitals or private institutions. Other colonies and cities decided to prevent even this risk, officially opposed inoculation and prohibited its application in their territory. Even General George Washington opposed the vaccination of the American army against smallpox.

The clear result was that during the American War of Independence, under difficult conditions of lack of hygiene and overcrowding, the smallpox epidemic broke out in the American army. Only a few of the American soldiers were vaccinated and the disease claimed thousands of lives during the American siege of Quebec. Connecticut Governor Jonathan Trumbull, who visited the companies during the siege reported that, "I did not find a single tent or cabin that did not contain dead or dying soldiers." Compared to the American soldiers, the English who defended Quebec were not moved by the epidemic - they were all vaccinated against the smallpox. After the humiliating retreat of the American army from Quebec in 1775, General Washington ordered a general vaccination of the army, as well as the vaccination of every new recruit.

In the third article about Edward Jenner and the cowpox - third and last part.