Mary Wortley Montagu championed the use of inoculation against smallpox, but her pioneering work is often overlooked, says Jo Willett
31 March 2021
WITH the world’s attention on vaccines, now feels like a good moment to sing the praises of an often forgotten contributor to their development. Three hundred years ago this month, Lady Mary Wortley Montagu got her daughter inoculated against smallpox with a technique that was unfamiliar to people in Britain at the time – making her child the first person in the West to be protected in this way. Without Montagu’s willingness to adopt a practice she had learned from other cultures, the introduction of vaccines around 80 years later would never have taken place.
Montagu was an aristocrat with no formal scientific training. She first witnessed inoculation when she accompanied her husband to Turkey in 1717, where he had been appointed as the British ambassador. News had already reached the Royal Society in England that people in Turkey used a process called inoculation against smallpox and that the disease was far less serious there than in the West as a result, but it wasn’t taken seriously.
Inoculation had started in eastern regions of Asia, probably in China, as early as the 10th century AD. Montagu observed how older women in Turkey were sent to take a tiny amount of pus from a person with smallpox. They then used needles to make cuts on people’s wrists and ankles and added the pus to their bloodstream. This typically resulted in a very mild case of smallpox and people gained immunity from future infection in the process.
Like other visitors to the country, Montagu took steps to ensure that her son was inoculated during her time in Constantinople. This worked well, but she knew that trying it in England would be far more controversial. Inoculation performed by unlicensed amateurs would threaten doctors’ professional standing and potentially rob them of valuable income. Clerics also disputed the practice, as they saw it as interfering with nature.
Back in England, Montagu observed the increased severity of the raging waves of smallpox infections. Eventually, in April 1721, she decided to use the Turkish practice to have her daughter inoculated. As she had experienced smallpox as a young woman and lost her only brother to the disease, she believed that the rewards would outweigh the risks. After a safe time had elapsed following the inoculation, Montagu allowed a select group of doctors and aristocratic friends to examine her daughter.
Doctors in Britain gradually accepted the practice, but insisted on a punishing six-week procedure of bleeding and purging before the inoculation itself. The pioneering physician Edward Jenner had such a miserable experience being inoculated as a child that he was determined to find a better way. This led to his realisation that vaccination using material from a cow with cowpox would work even better than inoculation.
He is rightly lauded for his contribution, but the throughline from China to Turkey and from Montagu’s introduction of the practice in Western Europe to Jenner’s own inoculation has often been overlooked.
Montagu felt it was best to keep quiet about her involvement, a decision that inevitably frustrated her. Eventually, she wrote and had published an anonymous article, arguing the case for inoculation. As she put it to her sister, there are “some fools, who had rather be sick by the doctor’s prescriptions, than in health in rebellion to the college [of physicians]”.
As recently as last century, academics argued that Montagu was no more than an enthusiastic amateur with a vindictive attitude towards the medical profession. In truth, hers was a vital scientific contribution towards finding the cure for smallpox – an infectious disease that was only finally eradicated in 1980.
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