Earliest Smallpox Inoculations In China And Africa


Smallpox vaccine
From Wikipedia, the free encyclopedia

Smallpox vaccine, derived from the Latin word for cow, was developed by Edward Jenner in 1798. The introduction of fluid from the cowpox sores that milkmaids developed into the skin proved to protect his patients from smallpox, the more dangerous human form of the variola virus. The term vaccination came to replace the term vaccine inoculation. In 1881 Louis Pasteur continued to use the term for other disease inoculations.

The following information is taken directly from the Wikipedia article “Smallpox Vaccine.” I searched this subject to verify a statement in a well-known biography of Benjamin Franklin, Benjamin Franklin An American Life by Walter Isaacson. In that book it is stated that inoculation against smallpox was widely practiced among slaves from Africa, much predating Edward Jenner's work. The following quotation gives a history of the practice.


“Variolation

Before the introduction of a vaccine, the mortality of the severe form of smallpox—variola major—was very high, up to 35% in some outbreaks.[4] Historical records show a method of inducing immunity was already known. A process called inoculation, also known as insufflation or "variolation" was practiced in India as early as 1000 BC.[5]This interpretation is disputed, however; other investigators contend the ancient Sanskritmedical texts of India do not describe these techniques.[6] 

The first clear reference to smallpox inoculation was made by the Chinese author Wan Quan (1499–1582) in hisDouzhen xinfa (痘疹心法) published in 1549.[7] Inoculation for smallpox does not appear to have been widespread in China until the reign era of the Longqing Emperor (r. 1567–1572) during the Ming Dynasty.[8] In China, powdered smallpox scabs were blown up the noses of the healthy. The patients would then develop a mild case of the disease and from then on were immune to it. The technique did have a 0.5–2.0% mortality rate, but that was considerably less than the 20–30% mortality rate of the disease itself.

Variolation was also practiced throughout the latter half of the 17th century by physicians in Turkey, Persia, and Africa. In 1714 and 1716, two reports of the Ottoman Empire Turkish method of inoculation were made to the Royal Society in England, by Emmanuel Timoni, a doctor affiliated with the British Embassy in Constantinople,[9] and Giacomo Pylarini. Lady Mary Wortley Montagu, wife of the British ambassador to Ottoman Constantinople, is widely credited with introducing the process to Great Britain in 1721.

Source material tells us on Montagu; "When Lady Mary was in the Ottoman Empire, she discovered the local practice of inoculation against smallpox called variolation."[10] In 1718 she had her son, aged five variolated. He recovered quickly. She returned to London and had her daughter variolated in 1721 by Charles Maitland, during an epidemic of smallpox. This encouraged the British Royal Family to take an interest and a trial of variolation was carried out on prisoners in Newgate Prison. This was successful and in 1722 Maitland organized the variolation of two of the daughters of Caroline of Anspach, Princess of Wales. The success of these variolations assured the British people that the procedure was safe.[9]

Stimulated by a severe epidemic, variolation was first employed in North America in 1721. The practice had been known in Boston since 1706, when Cotton Mather (of Salem witch trial fame) discovered his slave, Onesimus had been inoculated while still in Africa, and many slaves imported to Boston had also received inoculations.[12] The practice was, at first, widely criticized.[13] However, a limited trial showed six deaths occurred out of 244 who were variolated (2.5%), while 844 out of 5980 died of natural disease (14%), and the process was widely adopted throughout the colonies.[14]

The inoculation technique was documented as having a mortality rate of only one in a thousand. Two years after Kennedy's description appeared, March 1718, Dr. Charles Maitland successfully inoculated the five-year-old son of the British ambassador to the Turkish court under orders from the ambassador's wife Lady Mary Wortley Montagu, who four years later introduced the practice to England.[15]

An account from letter by Lady Mary Wortley Montagu to Sarah Chiswell, dated 1 April 1717, from the Turkish Embassy describes this treatment:

'The small-pox so fatal and so general amongst us is here entirely harmless by the invention of ingrafting (which is the term they give it). There is a set of old women who make it their business to perform the operation. Every autumn in the month of September, when the great heat is abated, people send to one another to know if any of their family has a mind to have the small-pox. They make parties for this purpose, and when they are met (commonly fifteen or sixteen together) the old woman comes with a nutshell full of the matter of the best sort of small-pox and asks what veins you please to have opened. She immediately rips open that you offer to her with a large needle (which gives you no more pain than a common scratch) and puts into the vein as much venom as can lye upon the head of her needle, and after binds up the little wound with a hollow bit of shell, and in this manner opens four or five veins. . . . The children or young patients play together all the rest of the day and are in perfect health till the eighth. Then the fever begins to seize them and they keep their beds two days, very seldom three. They have very rarely above twenty or thirty in their faces, which never mark, and in eight days time they are as well as before the illness. . . . There is no example of any one that has died in it, and you may believe I am very well satisfied of the safety of the experiment since I intend to try it on my dear little son. I am patriot enough to take pains to bring this useful invention into fashion in England, and I should not fail to write to some of our doctors very particularly about it if I knew any one of them that I thought had virtue enough to destroy such a considerable branch of their revenue for the good of mankind, but that distemper is too beneficial to them not to expose to all their resentment the hardy wight that should undertake to put an end to it. Perhaps if I live to return I may, however, have courage to war with them.'”