PART I.—VARIOLOUS INOCULATION.
CHAPTER I.
COTTON MATHER AND ZABDIEL BOYLSTON.
To the Turks we owe little, and in the little is included the practice of inducing smallpox artificially. The practice was first brought under English attention by Emanuel Timoni in a letter, dated Constantinople, December, 1713, communicated to the Royal Society by Dr. Woodward, and published in the Society’s Transactions for 1714.[1] About the same time, Pylarini, Venetian consul at Smyrna, described the practice in a Latin pamphlet printed at Venice, 1715,[2] and reproduced in the Philosophical Transactions for 1716. Mr. Kennedy, an English surgeon, who had visited Turkey, also reported the practice under the designation of “Engrafting the Smallpox.”[3]
Timoni was a Greek physician, who had studied at Oxford and Padua, and then established himself in Constantinople. He described “smallpox by incision” as having been practised in Constantinople for forty years, and that it had been found uniformly successful in warding off smallpox as naturally developed. The variolous matter was usually taken from healthy boys suffering from the spontaneous disease, and was applied to persons of all ages and temperaments, causing them no more than temporary and trifling inconvenience. The only preparation requisite for incision was abstinence from flesh and broth for twenty or twenty-five days.
It so happened that when Woodward read Timoni’s letter to the Royal Society, he at the same time produced a selection from the correspondence of Cotton Mather of Boston, Massachusetts—a curious jumble of facts and fancies. Mather had been elected a Fellow of the Society, and the selections from his correspondence, and Timoni’s letter appeared in the same number of the Transactions, No. 338, 1714.
Cotton Mather is one of the marvels of biography—a choice specimen of Puritanism developed without check. He was a man of boundless energy and incessant industry, of intense piety and unlimited self-confidence; and thus, without hesitation, he set himself to extirpate witchcraft, shrinking from no atrocity, until the frightful Salem tragedy of 1692 shocked the colony into mercy and common-sense.
Mather was just the sort of character to be impressed with Timoni’s description of the short and easy way with smallpox; and he who had hanged warlocks and witches with sublime assurance, was not likely to have scruples about inoculating the community when inwardly satisfied it was for the public good. The audacity and tyranny of conscientious conceit are proverbial. He had, however, to exercise patience in awaiting an opportunity to test the Turkish remedy, for there had been no smallpox in Boston for nineteen years—a fact worth noting by those who imagine smallpox was an omnipresent ailment until the advent of Edward Jenner. In 1721 a serious outbreak occurred, the deaths rising in October to 100 a week in a population of 15,000. Mather convoked a meeting of physicians, and laid before them the new prescription, but they would not listen to it. Dr. Boylston, however, was persuaded, and inoculated two of his slaves, and then his sons, aged five and six; whereon he was summoned before the justices and severely reprimanded. Undeterred by the State, and supported by the Church, he persevered, and by the end of September had inoculated 80, and by the middle of December, 250.
His custom was to make a couple of incisions in the arms, into which bits of lint dipped in pox-matter were inserted. At the end of twenty-four hours the lint was withdrawn, and the wounds dressed with warm cabbage leaves. On the seventh day the patient sickened and pustules appeared, sometimes few, sometimes hundreds. Mather and Boylston maintained it was a most wholesome operation, for after it “feeble, crazy, consumptive people, grew hearty, and got rid of their former maladies.”[4] To be poxed was to be rejuvenated.
Cotton Mather’s own account of the Boston experiment is worth reading. He wrote—
March 10th, 172 1 2 .
The distemper hath lately visited and ransacked the City of Boston; and in little more than half a year, of more than 5000 persons that have undergone it, near 900 have died. But how many lives might have been saved if our unhappy physicians had not poisoned and bewitched our people with a blind rage that it has appeared very like a Satanick Possession against the method of relief and safety in the way of the smallpox inoculated!
I have prevailed with one physician (and for it I have had bloody attempts made upon my life by some of our Energumens) to introduce the practice; and the experiment has been made upon almost 300 Objects in our neighbourhood, young and old (from one year to seventy), weak and strong, male and female, white and black, in midsummer, autumn, and winter, and it succeeds to admiration!
I cannot learn that one has died of it; though the experiment has been made under various and marvellous disadvantages. Five or six have died upon it, or after it, but from other diseases or accidents; chiefly from having taken infection in the common way by inspiration before it could be given in this way by transplantation.
Dr. Leigh, in his Natural History of Lancashire, counts it an occurrence worth relating, that there were some catts known to catch the smallpox, and pass regularly through the state of it, and then to die. We have had among us the very same occurrence.
It was generally observed and complained that the pigeon-houses of the City continued unfruitful, and the pigeons did not hatch or lay as they used to do all the while that the smallpox was in its epidemical progress: and it is very strongly affirmed that our dunghill fowl felt much of the like effect upon them.
We have many among us who have been visited with the Plague in other countries many years ago, who have never been arrested with smallpox after it, though they have been exposed as much as any other people to it; whence the belief now begins to prevail among us, that they who have had the Plague will never have the smallpox after it.
Considering the developed evidence that awaits us as to the character and results of inoculation, it would be superfluous to discuss this singular report, but we may remark the consummate audacity with which Mather assumes and maintains his position. What a masterly touch of the quack have we in these words—
I cannot learn that one has died of it. Five or six have died upon it, or after it, but from other diseases or accidents; chiefly from having taken infection in the common way by inspiration before it could be given in the way of transplantation.
We can readily understand how the hand that could give so adroit a turn to awkward disasters could in other days frame irresistible indictments for witchcraft.
The precise truth as to the extent of the Boston epidemic is far from easy to ascertain: it was the temptation of the inoculators to magnify the numbers of the afflicted and of their antagonists to minimise. Thus we read—
At a meeting by publick authority in the Town House of Boston, before His Majesty’s Justices of the Peace and the Select Men; the practitioners of physic and surgery being called before them, concerning Inoculation, agreed to the following conclusion:—
A Resolve upon a debate held by the physicians of Boston concerning inoculating the Smallpox on the 21st day of July, 1721.
It appears by numerous instances, that it has proved the death of many persons soon after the operation, and brought distempers upon many others which have in the end proved deadly to ’em.
That the natural tendency of infusing such malignant filth in the mass of blood is to corrupt and putrefy it, and if there be not a sufficient discharge of that malignity by the place of incision, or elsewhere, it lays a foundation for many dangerous diseases.
That the operation tends to spread and continue the infection in a place longer than it might otherwise be.
That the continuing the operation among us is likely to prove of most dangerous consequence.
The number of persons, men, women, and children, that have died of smallpox at Boston from the middle of April last (being brought here then by the Saltertuda’s Fleet) to the 23rd of this instant July (being the hottest and worst season of the year to have any distemper in) are, viz.—2 men, strangers, 3 men, 3 young men, 2 women, 4 children, 1 negro man, and 1 Indian woman, 17 in all; and of those that have had it, some are well recovered, and others in a hopeful and fair way of recovery.
By the Select Men of the Town of Boston.
Dr. Fleuart of Boston wrote to London that of 70 inoculated, 14 or 15 had died; and that at Roxbury, where there was no smallpox, 5 inoculated had died.[5]
Conflicting as are the testimonies, we must allow much to the natural aversion from an operation, not only novel, but disgusting; but taking the best that could be claimed for the new practice by an enthusiastic advocate, the benefit was trifling when seriously scrutinised. Dr. Boylston visited London after the Boston epidemic, and finding inoculation in high vogue he published an Account of the Smallpox inoculated in New England.[6] George I. and the Prince and Princess of Wales had taken Inoculation under their august patronage, and Boylston with loyal fervour burst forth—
Shall not physicians and surgeons recommend and bring it into greater esteem and practice, and save (under God) thousands and tens of thousands by it; and make further improvements in it; and set more vigorously about it when they consider their great Pattern and Example for it, namely, the greatest and wisest of Kings, their royal highnesses the Prince and Princess at the head of it; and that it has been used upon their Royal Issue with great success?
Boylston in his Account recites his cases with, we think, general veracity. He performed 244 inoculations, and says, “there were in the towns near Boston about 36 persons more inoculated, which all did well; namely, by Dr. Roby about 11, and by Dr. Thomson about 25, which, together with my 244, make up the number of 280; out of which number died only 6 persons, notwithstanding all the difficulties the practice laboured under.”
Beyond measure extraordinary was the bland assurance wherewith Boylston, in common with Mather and others, assumed and argued that the 280 inoculated had been thereby delivered from the plague of smallpox and death. Accepting the improbable supposition that the 280 were a fair average of 15,000 Bostonians, of whom one-third took smallpox, we have to abstract two-thirds of the 280, or 186 as superfluously inoculated, leaving 93 saved from smallpox. If we then inquire how many of these were saved from death, and resort to Boylston’s statistics, who says,—
In 1721 and beginning of 1722 there were in Boston 5759 persons who had smallpox in the natural way, out of which number died 844; so that the proportion that die of natural smallpox appears to be one in six, or between that of six and seven—[7]
We find the number no more than 15, from which, if we deduct the 6 who died under his hand, his trophies are reduced to 9, to save whom he put 280 into serious sickness and jeopardy—so serious indeed in some instances (as appears from his own notes) that there was slight reason to prefer inoculated to spontaneous smallpox.
Viewed thus in his own light—a light most favourable, how vain, not to say impudent, was such boasting as this—
Now, if there be any one that can find a faithful account or history of any other method or practice that has carried such a number of all ages, sexes, constitutions, and colours, and in the worst seasons of the year, through the smallpox; or indeed through any other acute distemper with better success, then I will alter my opinion of this; and until then, I shall value and esteem this method of inoculating the smallpox as the most beneficial and successful that ever was discovered to, and practised by mankind in this world.[8]
And, gaining courage through his own noise, he went yet farther, and proclaimed that smallpox was tamed and subdued—
It is, and shall be acknowledged, to the praise and glory of God, that whereas a most wild, cruel, fierce and violent distemper, and which has destroyed millions of lives, is now (by that happy discovery made of its transplantation) become tractable, safe and gentle.[9]
In the knowledge of the emptiness of this bounce, it may seem malicious to withdraw it from forgetfulness; but it serves to point the truth that human nature in 1726 was much the same as human nature at this day, and that the same arts of audacious assertion and rowdy rhetoric were in practice then as now. Indeed, whoever is sufficiently wicked to presume on the natural trustfulness of mankind, and will lie loud enough and long enough, may attain an appalling success—as our story, alas! will prove.
One thing goes to Boylston’s credit: he did not propose to make poxing universal—to poison and sicken everybody, and inflict certain injury to avert future and uncertain danger from a few. He proposed to reserve inoculation for emergencies—
When the smallpox left Boston, inoculation ceased; and when it shall please Providence to send and spread that distemper among us again, may inoculation revive, be better received, and continued a blessing in preserving many from misery, corruption and death.
The narratives of Mather and Boylston are of special importance because we have in them the true lineage of inoculation as introduced from the eastern to the western world. Boylston tells us that when smallpox appeared in Boston—
Dr. Mather, in compassion to the lives of the people, transcribed from the Philosophical Transactions of the Royal Society the accounts sent them by Dr. Timonius and Pylarinus of inoculating the smallpox in the Levant, and sent them to the practitioners of the town for their consideration thereon.[10]
For some inscrutable reason the true position of Cotton Mather in the history of inoculation is continually overlooked or mis-stated. For instance, in Mather’s biography in the excellent English Cyclopædia, it is said that he derived his information and impulse from the letters of Lady Mary Wortley Montagu; a statement repeated in the memoirs of that lady, which is entirely fabulous.
FOOTNOTES:
[1] Philosophical Transactions, No. 338, 1714.
[2] Nova et Tuta Variolas Excitandi per Transplantationem Methodus. Jacob Pylarinum. Venet. 1715. Reprinted in Philosophical Transactions, No. 347, 1716.
[3] An Essay on External Remedies. By P. Kennedy. London, 1715.
[4] Philosophical Transactions, Vol. xxxii. p. 35.
[5] Letter to Dr. Jurin by Isaac Massey. London, 1723.
[6] An Historical Account of the Smallpox inoculated in New England upon all sorts of persons, Whites, Blacks, and of all Ages and Constitutions. By Zabdiel Boylston. London, 1726.
[7] An Historical Account, p. 39.
[8] Ibid. p. 38.
[9] Ibid. p. 46.
[10] An Historical Account, p. 1.