Director of the National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, and Professor of Neurology, University of Liverpool, University of Liverpool
The remarkable progress with immunisation against COVID-19 has focused the world’s attention on the brilliance of vaccines. Many people know the story of Edward Jenner’s discovery of vaccination against smallpox in Gloucestershire nearly 250 years ago. But far fewer have heard of Lady Mary Wortley Montagu. She was the socialite whose pioneering inoculation experiments laid the groundwork for Jenner’s discovery, but whose contribution is all but forgotten. This year, the 300th anniversary of her extraordinary human experiments, provides a timely occasion to review her amazing contribution to public health.
Born Mary Pierrepont in 1689, she was a vivacious and headstrong woman who wrote poems and letters and held progressive views on women’s role in society. To avoid an arranged marriage, she eloped at the age of 23 and wedded Edward Wortley Montagu, grandson of the first Earl of Sandwich.
In 1716, Edward became England’s ambassador to Istanbul (or Constantinople as it was then), capital of the Turkish Ottoman Empire. From there Wortley Montagu wrote vivid descriptions of oriental life, especially the Turkish women, whose dress, lifestyle and traditions intrigued her. Most notable among these was their method of inoculation against the dreaded smallpox.
It had long been recognised that people could only get this disease once. If they survived, they were immune for the rest of their lives. Rather than take their chances with a natural infection and its high fatality rate, the older Turkish women sought to induce a mild case in children by “ingrafting” as they called it.
Smallpox causes blisters and scabs on the skin of those afflicted by the disease. The women would take the pus from one patient’s blister and scratch it into a cut they would make on the arm of the person they wanted to protect. This would usually lead to mild symptoms, followed by lifelong protection.
“There is a set of old women [here],” Wortley Montagu wrote, “who make it their business to perform the operation, every autumn … thousands undergo this … [and there] is not one example of anyone that has died in it.”
Wortley Montagu herself had survived smallpox but was left with facial scarring. Her brother had succumbed to the illness. She was keen to protect her young son from the disease and convinced the embassy surgeon to inoculate him.
“The Boy was engrafted last Tuesday,” she wrote in a letter to her husband, “and is at this time singing and playing, and very impatient for his supper.”
Wortley Montagu was determined to “bring this useful invention into fashion in England”. […]
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