The first inoculator: Charles Maitland
Laying the foundations for widespread use of the smallpox inoculation
Smallpox was a dreaded disease, no respecter of status, and responsible for the deaths of millions of people, particularly children. There was no cure or preventative measure available until, 300 years ago in April 1721, Aberdonian surgeon Charles Maitland performed the first inoculation against smallpox to take place in Great Britain. He inoculated Mary, the young daughter of Lady Mary Wortley Montagu. When Sir Edward Wortley Montagu was the ambassador to the Ottoman Empire Maitland had served as surgeon at the embassy. Whilst there he had not only witnessed inoculation but by his own account, published in 1722, also had some involvement in the procedure when Lady Mary’s young son, also called Edward, was inoculated by a local ‘old woman’.
There are two versions of the smallpox variola virus, variola major and variola minor. The
variola minor virus caused a lesser fever and possible scarring but was much less dangerous than the
variola major, which was often fatal. Importantly, variola minor provided lifelong immunity from smallpox. In the eastern Mediterranean it had become common for children to be deliberately infected with smallpox. A local ‘old woman’ healer would make a scratch on the arm, insert lymph into the scratch and then bind the wound to await the development of smallpox. The lymph was taken from the blisters of another child infected with
variola minor, although quite how the ‘old woman’ knew which virus was the source of the infection isn’t clear, and occasionally children died as a result of the procedure, which became known as inoculation.
At the time of Edward’s inoculation Lady Mary had a baby daughter, also called Mary. Fearful of infecting the baby’s nurse with smallpox, her mother had decided against having her inoculated. It has been suggested that this was because Lady Mary was well aware of the infectious nature of inoculation and the risk it posed to anyone who had not already suffered from an attack of smallpox and so was vulnerable to being infected. Shortly after young Edward had been inoculated, his father was recalled to London. However, it was when a smallpox epidemic took hold in London in 1721 that Lady Mary again called upon the services of Charles Maitland to come and inoculate her daughter Mary.
AN INOCULATION FIRST
Mr. Maitland’s Account of Inoculating the small-pox described his involvement with inoculation both in Turkey and in England, explaining how he had been summoned in April 1721 to inoculate Lady Mary’s daughter. Initially Maitland wanted to delay the procedure as the weather was cold and wet, and admitted in his Account that he was ‘unwilling to venture on an experiment altogether new and uncommon here, in a cold Season’. Maitland also wanted two physicians present when he inoculated little
Mary, both to consult about the health of Lady Mary’s daughter and also to act as independent witnesses to the procedure.
Lady Mary was initially reluctant to agree to Maitland’s request as she distrusted medical men and physicians in particular. Whether Maitland was reluctant to inoculate Lady Mary’s daughter is not known, but it would not be surprising if he had some reservations. In England there was a clear demarcation between the roles of physicians and surgeons, although this was not quite as rigid in Scotland. Physicians were university educated gentlemen whereas surgeons were the hands-on practitioners of medicine, quite often from the tradition of barber surgeons or apothecaries. It was a serious matter for anyone, let alone a surgeon, to use these untested techniques (particularly those used by ‘old women and foreigners’) in London almost under the eyes of the College of Physicians. Perhaps Maitland was concerned about the politics of the situation in addition to the risks associated with the procedure.
Following her inoculation, Maitland wrote that little Mary was examined by three members of the College of Physicians as well as being observed as something of a curiosity by ‘several ladies and Persons of Distinction’. Mary grew up and married John Stuart, the 3rd earl of Bute and later recalled these visits when she was treated as something of a curiosity by her mother’s aristocratic friends. No doubt these ‘Persons of Distinction’ were curious about this new technique which offered the possibility of protection from a deadly disease that attacked all sectors of society.
Maitland subsequently inoculated the children of aristocratic parents and medical men. Dr James Keith, one of the physicians who observed Mary Wortley Montagu’s inoculation, had himself lost several children to smallpox and was sufficiently convinced by the procedure that he had Maitland inoculate his surviving son Peter. Keith was a fellow Aberdonian and it has been suggested that he was a student with Maitland at Aberdeen University. It has not been possible to verify that James Keith was a contemporary of Maitland at Aberdeen.The Fasti Academiae Mariscallanae Aberdonensis, Selections from the Records of the Marischal College and University 1593-1860, published in 1898, lists more than one student named Charles Maitland. Against one, described as a ‘Tertian of 16991700 paying Chamber Maills’ a footnote says ‘Surgeon London, First Inoculator for small-pox.’ Tertians were students of natural philosophy. Whatever the truth of the relationship, Keith and Maitland were obviously good friends and ‘Dr. Maitland’ was named as one of three ‘worthy friends’ to guide Keith’s daughter in her capacity as executor of her father’s will when he died in 1726.
Several authors have argued that Mary Wortley Montagu influenced Caroline of Ansbach, the princess of Wales and wife of the future George II, to have her daughters inoculated, although there is no documented evidence to support this suggestion.What is known is that the princess was anxious for the welfare of her daughters and familiar with the procedure. She consulted Sir Hans Sloane, president of the Royal College of Physicians about its safety. An experiment was proposed whereby six prisoners awaiting execution in Newgate prison
would be inoculated, and should they survive, would be pardoned. Some have suggested that this was, in effect, the first ever clinical trial.
Some years after the event, in 1736, Sir Hans Sloane wrote an account which was finally published 20 years later. Sloan wrote that Maitland was initially reluctant to inoculate the prisoners. Sloane consulted another doctor who had practised medicine in Turkey, Dr Edward Tarry of Endfield (sic).Tarry reassured Sloane that ‘not one in eight hundred had died of that operation’. It was only after discussing the matter with Sloane that in August 1721 Maitland agreed to inoculate the prisoners using the method he had observed in Turkey, with the exception of a female prisoner who had the powder from dried smallpox pustules inserted in her nose. In an experiment to test the efficacy of the procedure, when the prisoners had recovered, Sloane and another of the king’s physicians, Dr Steigertahl, paid for a female prisoner to go to Hertford during an outbreak of smallpox. She nursed an infected patient and shared a bed with an infected child and remained free of further infection.
Maitland’s account of events names the prisoners as Mary North, Anne Tompion, Elizabeth Harrison (the prisoner sent to Hertford), John Cawthery, John Alcock and Richard Evans. He provides a diary of the visits and examinations of the prisoners. Richard Evans had previously suffered an attack of natural smallpox and did not suffer any symptoms, unlike the other prisoners.The experiment was considered to be a success and the prisoners were duly pardoned.The experiment was widely reported in the press including in the Caledonian Mercury and Newcastle Courant newspapers, although the report in the St James’s Evening Post of 26 August and shared in the Caledonian Mercury of 4 September 1721 misidentified Maitland as Thomas rather than Charles.
Sir Hans Sloane reported favourably to the princess of Wales on the Newgate experiment but she required further reassurance. Another experiment was conducted in late February 1722. The guinea pigs on this occasion were orphan children from the parish of St James Westminster. Again, Maitland performed the inoculations for which the princess paid, although according to Sloane one of the orphans inoculated had previously contracted natural smallpox.The experiment was also deemed to be a success. At the time no one appears to have considered the ethics of deliberately infecting people with smallpox. For
the prisoners it was an opportunity to avoid execution or transportation but the orphans would certainly not have understood, nor been able to consent to being inoculated.
BY ROYAL COMMAND
The princess of Wales was reassured by results of both experiments and Maitland supervised the king’s surgeon Claude Amyand when her daughters, the princesses Amelia and Caroline, were successfully inoculated in April 1722. Maitland’s own account of events fails to mention any reluctance on his part to be involved with the Newgate experiment, nor, unlike Sloane’s account, does it name any other medical professional. Rather, his account relates that at the command of the prince and princess of Wales he inoculated six condemned prisoners in Newgate prison in the presence of several eminent physicians and others. No doubt much to Maitland’s relief, both princesses recovered from their ordeal.
In 1724 Maitland had another royal command to visit Hanover where he inoculated Frederick, prince of Wales, the brother of Amelia and Caroline. Maitland’s obituary in the Aberdeen Press and Journal mentions that Maitland was ‘an excellent surgeon and famous for inoculating the smallpox, and the person appointed by the present majesty to go to Hanover and inoculate his Royal Highness Frederick Prince of Wales and was handsomely rewarded’. A pamphlet, A Pioneer of Inoculation, Charles Maitland, published in 1930, confirmed that Maitland was paid £1,000 from the privy purse for his services – a handsome reward indeed.
Maitland returned to Scotland in 1726 where he performed a number of inoculations in his native Aberdeenshire. Sadly, not all patients survived and it was another 20 years before inoculations were performed in Aberdeenshire again. The Caledonian Mercury of 30 August 1726 reported that Maitland had, on 29 July, inoculated the son and two daughters of Captain Alexander Abercromby, MP and that the children recovered fully. Maitland was made a burgess and freeman of Banff in recognition of his achievements.
In 1765, Alexander Munro Senior, professor of medicine and anatomy at the University of Edinburgh published An Account of the Inoculation of Small Pox in Scotland. Munro confirmed that inoculation was unknown in Scotland until Maitland introduced the procedure and related his experiences in Aberdeen. Munro also identified Dumfries as the first location in Scotland where inoculation was regularly performed from 1733 onwards, where Dr Ebenezer Gilchrist performed 560 inoculations and reported just nine deaths. Munro’s pamphlet named the other Scottish physicians and surgeons who performed inoculations, the locations, the number of patients treated, and the number of deaths reported following inoculation. Munro’s pamphlet confirms that 40 years after Maitland first introduced inoculation against smallpox, the procedure had become widespread across Scotland.
Little more was heard about Maitland until his death in 1748. His obituaries were fulsome in their praise for his skills as an excellent surgeon and his fame as the inoculator of his royal highness Frederick, prince of Wales. They reported he had amassed what The Caledonian Mercury described as a ‘handsome fortune acquired by his own efforts’ and that he had often generously ‘relieved his friends in Want, during his own Lifetime’. Leaving the bulk of his fortune, in excess of £5,000, to relations, he also made provision for the poor, which the Caledonian Mercury described as ‘A Worthy Example to Others, by reasonably remembering the Poor without hurting their relations!’ Maitland’s obituary in the Aberdeen Press and Journal said he was descended from ‘an honourable Aberdeenshire Family, the Maitlands of Pitrichy [sic]’ and identified his relations as Alexander Bannerman of Frendraught and Charles Cheyne, a merchant of Edinburgh his cousins; the poor in question belonged to the parish of Methlick, a village about 25 miles north of Aberdeen and where
Maitland was born.
Maitland had made provision for the poor prior to his death by means of a heritable bond which had a value of 6,000 merks Scots money. Rather than making a will, he made his bequest by a deed which was registered in the Aberdeen sherriff court in 1746. Making his mortification, Maitland assigned the bond to the then minister (Alexander Knolls) and members of the kirk session, and their successors. In his deposition Maitland said the heritable bond was the best way he could find to secure the funds for the benefit of the poor.The income was to be paid twice a year, at Whitsunday and Martinmass. Seemingly Maitland was very concerned about the number of poor people reduced to begging, and he gave very precise instructions to the minister and kirk session about how he wanted his mortification to be used. In addition to supporting the common poor of the parish, he wanted to support local tradesmen and families who had fallen on hard times, in order that they would not be reduced to begging. Maitland further instructed the kirk session that he wanted them to use all the income and not to allow the capital to accrue.The details of his bequest are recorded in the minutes of the July meeting of Methlick kirk session.The kirk session minutes also record that when Maitland was buried in 1748, the cost of hiring the mortcloth at the time of the burial was some £2 8s, a not inconsiderable amount to add to the poor fund of the kirk.
EXPLORING MAITLAND’S FAMILY HISTORY
Maitland was obviously an educated man and may well have been familiar with the method of inoculation before arriving in Turkey. Another member of the Wortley Montagu household in Turkey was the Italian physician Emanuel Timoni who had written to the Royal Society in 1713 describing the operation of inoculation which was published in Philosophical Transactions of the Royal Society in 1714. It is easy to imagine that Maitland would have taken the opportunity to discuss inoculation with Timoni, who was a graduate of the University of Padua and was also an alumnus of Oxford University.
Nevertheless, at a time when the position as surgeon to the ambassador to the Ottoman Empire would surely depend on patronage, the puzzle remains: who was Charles Maitland and what were his connections? Very little is known about Maitland’s life. He left little trace in the historical record other than a few newspaper accounts, his pamphlet on inoculation and a letter amongst the Sir Hans Sloane collection in the British Library. In light of the fortunes bestowed upon his cousins following his demise, an investigation of the Maitland, Cheyne and Bannerman family connections might offer some suggestions.
Maitland died in Aberdeen on 28 January 1748 and was interred in Methlick kirk on 7 February. He was buried in the crypt with his parents Patrick Maitland, late of Little Ardoch (Little Ardo), and his mother Jean Robertson, and, according to the memorial inscription, several of his siblings. Charles Maitland paid for the stone which now stands against the wall of the kirkyard. The parochial registers record that Patrick Maitland from Little Ardo was buried on 22 December 1687 and that Jean Robertson was buried on 17 April 1684.
Maitland was aged about 80 at the time of his death, however it is not possible to pinpoint his birth or baptism.The baptismal records for the relevant period were not, according to the New Statistical Account, ‘regularly kept owing to the neglect of parents in not attending to the registration of the births of their children’, much to the frustration of family historians and other researchers.The surviving Methlick parish registers report the baptisms of four other Maitland children who were the offspring of Patrick Maitland: John, Lodvik, Anna and James.The baptismal records also identify that James Chiyne [sic] witnessed Lodvick’s baptism in 1675 and James Chyn [sic] Anna’s in 1678.
It was suggested in a booklet published in 1930, A Pioneer of Inoculation Charles Maitland, that the Patrick Maitland whose name appears in the 1696 volume List of Pollable PersonsWithin The Shire Of Aberdeen, a tenant of Newplace, Cairnbrogie in Tarves, close to Methlick, could have been Charles’s father. However the 1696 date makes this seem unlikely. From the Inquisitionum ad Capellam
domini regis retornatorum,Volume
I it is known that between 1678 and 1681, Little Ardo was held by Richard Maitland of Pittrichie [sic] before it was transferred to the earls of Aberdeen in 1683.Whilst Patrick Maitland could have removed from Little Ardo to Newplace, equally he could have been the son of Patrick Maitland of Little Ardo and his baptism was not recorded anywhere.
Methlick was also the birthplace of another prominent 18th-century physician, Dr George Cheyne, who was baptised at Methlick on 24 February 1674 and died in 1743 in Bath, where he had a very successful practice. George was the son of James Cheyne and Maria Maitland, the daughter of Richard Maitland of Pittrichie [sic].
The witnesses to this baptism were John Maitland and Patrick Maitland, and whilst there is no evidence to confirm that this Patrick Maitland was Charles Maitland’s father, nevertheless it is not impossible. Patrick Maitland was a witness at the baptisms of several of James and Marie’s children, including James, baptised in 1678, and Charles, baptised in 1683. On occasion, the parish register records him as Patrick Maitland of Litel [sic] or Little Ardo, which would strongly suggest that there were significant family connections between the Maitland and Cheyne families, with James Cheyne witnessing Maitland baptisms and vice versa.
A second candidate to be the beneficiary of Maitland’s fortune was another Charles Cheyne.This one, the son of James Cheyne, was baptised in 1701 at Methlick. However the burial of a child called Charles, the son of James Cheyne, was recorded in the parish register the following month, thus ruling him out.
The third and most likely candidate to be the beneficiary of Charles Maitland’s generosity was the Charles Cheyne baptised in Edinburgh on 25 November 1718. He was the son of James Cheyne, writer to the signet and his wife Elizabeth Maitland, the daughter of Sir Charles Maitland of Pitrichie [sic]. James and Elizabeth married in Edinburgh on 13 September 1714. It is suggested that this James Cheyne was the son of James Cheyne and Marie Maitland of
Methlick.There are baptism records of three other children born to James and Elizabeth: George in 1714, Alexander in 1715 and Jean in 1717.
In July 1748, Edinburgh merchant Charles Cheyne (b.1718) had married Ann Gordon in Edinburgh and died there in 1760. His testament dative and inventory mentions two infant daughters: Margaret Elizabeth and Isobel. His wife, Anne Cheyne or Gordon, died in October 1756, making it important to make provision for his daughters. Unfortunately no baptism records for Margaret and Isobel have been located, nor is there any age given for Charles at the time of his death.
WHO INHERITED MAITLAND’S FORTUNE?
A further clue as to which of the three Charles Cheyne candidates inherited Maitland’s fortune comes from the Edinburgh Advertiser of May 1821, which reported the death of Miss Cheyne in Lunenburg, Nova Scotia in 1821. She was the eldest daughter of Charles Cheyne merchant of Edinburgh and grand-niece of Dr George Cheyne.
Dr George Cheyne’s will provides more evidence about the probable identity of this Charles Cheyne. George Cheyne left a legacy to his nephew Alexander and a codicil again mentions this Alexander and also Alexander’s brother Charles, to whom he had already given a legacy of £1,000 ‘in a Legacy of that value bestowed on my Family by Mr Charles Maitland surgeon at Aberdeen’.
The evidence strongly suggests that Charles Cheyne, the son of James and Elizabeth Maitland and the nephew of the physician George Cheyne, was the beneficiary of Charles Maitland’s largesse.
The identity of Alexander Bannerman is easier to confirm, as is his connection to the Maitland family. In February 2019, Nicholas Kingsley discussed the baronets Bannerman of Elsick and Crimondmogate, on landedfamilies.blogspot.com, and identified Alexander Bannerman who was born in 1715 as the son of Sir Patrick Bannerman and his wife Margaret, daughter of Sir Charles Maitland of Pitrichie [sic]. Kingsley commented that Bannerman had inherited ‘part of the considerable property of Dr Charles Maitland of Aberdeen, physician’.Whilst there is nothing to suggest Bannerman was a Jacobite sympathiser, his father Sir Patrick Bannerman (1678-1733), a merchant and the provost of Aberdeen in 1714-15 was known as a Jacobite. James Francis Edward Stuart, the Old Pretender, knighted Patrick Bannerman at the time of his return to Scotland.
Was there a Jacobite connection? Lady Mary Wortley Montagu’s sister was Frances Countess of Mar, wife of the Jacobite John Erskine who participated in the battle of Sherrifmuir in 1715. Did Frances know of Charles Maitland and recommend him to her sister?
There is one other footprint left by Charles Maitland: a court of chancery record from 1719 held at the National Archives in Kew. Maitland is named as a defendant in a case brought against Sir Edward Wortley, the husband of Lady Mary Wortley Montagu, Charles Chavelier and Maitland by Richard Oxpring of Ecclesfield in the County of Yorkshire and Barbara his wife, the only sister and next of kin of Grace Ward.
The case against the defendants was that Grace Ward, who had been a servant in the Wortley household in Constantinople, was owed unpaid wages and money for items she had purchased at her own expense at the direction of Sir Edward or Lady Mary. It was also alleged that Grace had loaned Charles Chavelier some £40 which had not been repaid by the time Ward had died in around June 1718. £40 was a phenomenal amount of money for a servant to possess. It was further alleged that Ward had made her will in 1718, leaving a legacy of £20 to her brother John Ward to be paid from the money owed to her by Wortley and Chavelier, with the remainder of monies, goods and chattels to be returned to Barbara Oxpring. Charles Maitland had been witness to the will, and when the Wortley household returned to England, had custody of the will and brought items of jewellery including rings and other things to England.
Maitland had, it was claimed, delivered the said will, jewellery and
other items to Charles Chavelier. The Oxprings however alleged that Maitland had kept and converted to his own use a diamond ring valued at £10.The Oxprings argued that Wortley refused to take action to discover what had happened to all the items. Whilst some unpaid wages had been paid to the Oxprings, they alleged that both Wortley and Maitland had concealed several of the goods and chattels previously belonging to GraceWard.The outcome of the allegations is unknown but Maitland’s reputation did not seem to suffer and Lady Mary Wortley Montagu was happy to call upon his services a few years later to inoculate her daughter Mary.
Charles Maitland remains something of an enigma. A skilled surgeon, not out of place amongst society, a benefactor of the poor, generous to his family but accused of collusion in theft. By introducing and promoting inoculation across Britain, he made people, albeit the wealthier ones, realise it was possible to protect themselves against a deadly disease for the first time. By standing up to religious and medical opposition to inoculation, his example made it possible for other medical men to follow his lead and inoculate local communities. In turn, philanthropists supported inoculation of the children of the less affluent, saving many lives. Whilst Edward Jenner certainly deserves his place in history for his work on the use of cowpox as a much safer method of protecting against smallpox, Charles Maitland is another Scotsman whose role in the history of preventative medicine deserves wider recognition.
Sylvia Valentine is a PhD candidate at the University of Dundee researching ‘Opposition to Compulsory Smallpox Vaccination in Scotland between 1864 and 1918. An enthusiastic family historian, she is a member of the Association of Scottish Genealogists and Researchers in Archives, (ASGRA) and is a Director of the Register of Qualified Genealogists (RQG).
The author would like to thank fellow genealogist Caroline Gurney QG® for her advice and translating the entry in the Inquisitionum ad Capellam domini regis retornatorum.