Great inoculations
PATRICIA FARA appraises a pacy account of 18th-century European efforts to protect against smallpox
In the lottery of smallpox, declared French mathematician and explorer Charles-Marie de La Condamine, “everyone has his ticket, and many every year must draw the blank of Death”.
Viruses are not alive, yet they create more havoc than the most powerful monarch. Whatever anti-vaxxers may claim, Queen Elizabeth II faced only a minuscule risk when she received a Covid vaccination. The stakes were far higher for two earlier female royals, Caroline of Ansbach (who became the queen of George II) and Catherine the Great, who set national examples during the battle against smallpox by publicly endorsing variolation, an early form of protection that induced a week of sickness with no guarantee of survival.
In her new book, Lucy Ward provides a racy but detailed account of these initiatives. She begins with an episode that is already fairly well known, describing how Caroline whipped up popular support for the procedure shortly after another enterprising woman, Lady Mary Wortley Montagu, had introduced inoculation from Turkey. In 1722, the Hanoverian princess subjected two of her daughters to the painful ordeal: they both survived – though the procedure remained dangerous, later killing a son of George III.
Voltaire pithily summarised the rock-anda-hard-place aspects of variolation, remarking that, while Europeans condemned the English as “fools because they give their children smallpox to prevent their children catching it”, Englishmen regarded Europeans as cowards “afraid of giving a little pain to their children” and thus exposing them “to death from smallpox sometime in the future”.
By the time Catherine the Great became involved in the 1760s, the techniques had been improved and the odds were more favourable. Frustrated after being cooped up during an epidemic, the Russian empress resolved on a striking display of bravura: she volunteered as a test patient. This demanded courage; indeed, after summoning England’s expert, the Quaker physician Thomas Dimsdale, she was sufficiently worried about the experiment’s outcome to organise an escape route for him on a hidden yacht. Insisting on the strictest secrecy, she endured the inevitable fever and pustules that followed variolation before emerging triumphantly to advertise her courage and promote the procedure across Russia.
Ward’s book is informative, enthusiastically written and based on thorough research, but suffers from a somewhat breathless style. Seeking to emphasise Catherine’s commitment to rationality, Ward opens by complaining that sexual liaisons too often overshadow Catherine’s legacy – then, in the very next paragraph, confides that the empress and her physician concocted their secret plans while sitting on her bed with one of her lovers.
Unsurprisingly, Ward grounds her book in comparisons between the current global chaos and previous viral pandemics. But that is no longer an original approach: her book has been preceded by several others that explore connections and glorify unsung heroes. Perhaps I’m being over-cynical, but I anticipate that the next medical pot-boiler will be about Onesimus, the enslaved African who saved America by teaching his enslaver – a Puritan minister – about inoculation.
Patricia Fara is an emeritus fellow of Clare College, Cambridge. She is the winner of this year’s Abraham Pais Prize for History of Physics from the American Physical Society