Spain: Epistolary Medical Advice
"I beg you to give me your opinion and that of the other doctors on vaccine inoculation, which we have heard of here. We have pondered the method’s benefits. My husband’s family has been cruelly stricken with smallpox, and he himself has just suffered the disease, (...) there have been many serious cases; after having put his life at risk, he has been left extremely affected, although thanks to God, he has suffered no eye injury or any imperfection; two sisters have yet to catch the disease, (...) we would like to spare them the danger of such an epidemic, and therefore we await your opinion, as well as a description of the method to follow in the event of undertaking the inoculation; we have a good doctor, but he does not dare to proceed as he does not dispose of the fluid to be introduced and is not fully aware of this new way of inoculating." --Doña Juana Manuela Villachica y Llaguno (Duro Torrijos & Tuells, 2019, p. 4654)
Madrid ca. 1800
An engraving of the Paseo de la Florida in Madrid from the Poniente side, created around 1800 by Jean-Nicholas Lerouge and Francois Ligier
Madrid: Early 19th Century
1820 landscape by Giuseppe Canella of Madrid as seen from its western side
On December 3, 1800, Dr. Francisco Piguillem y Verdaguer of the Royal Medical Academy of Barcelona vaccinated four children with samples obtained from France, which had seen its first smallpox vaccinations just a few months beforehand. It is not Piguillem y Verdaguer, however, that historians see as the most significant figure in the proliferation of smallpox vaccination in Spain-- that would be Dr. Ignacio María Ruiz de Luzuriaga of the Royal Academy of Medicine of Madrid. In addition to introducing vaccination to the capital on May 22, 1801, Ruiz de Luzuriaga organized a national system of correspondence in which he would offer instruction to provincial contacts in exchange for records on the performance of the vaccine.
Ruiz de Luzuriaga's network encompassed at least 65 individuals and constituted both his medical colleagues and non-professionals interested in vaccination, typically aristocrats and government officials. This latter group of political contacts was receptive to the new smallpox treatment they had heard of and wanted to know how this lifesaving procedure could be spread to their corner of Spain. After hearing Ruiz de Luzuriaga's endorsement, they would continue to write to him to update him on the progress of vaccination in the area (e.g., when shipments had arrived safely) and sometimes described how they had personally tried to promote the practice, such as by publically vaccinating their children.
Chalres IV of Spain and His Family
Group portrait painted between 1800 and 1801 by Francisco Goya of the then-king of Spain, Charles IV (fifth on right, wearing black), and the royal family
Most of Ruiz de Luzuriaga's contacts, however, were his professional colleagues: not only doctors, but surgeons and bleeders, too. Unsurprisingly, these letters were more technical in their content, asking how to perform vaccination and how to keep track of results. These medical contacts could be quite influential figures in the kingdom: Ruiz de Luzuriaga knew the royal chamber physician Ignacio Jáuregui, who would bring vaccination into the royal court of King Charles IV. Also of note were Ruiz de Luzuriaga's colleagues in the Sociedad Basconga de Amigos del País (Basque Society of Friends of the Country), an organization that arranged for young Basque men like Ruiz de Luzuriaga to study abroad in France to learn the latest in medical research. Indeed, Ruiz de Luzuriaga corresponded with members of the Commission de Vaccine séante au Louvre (Louvre Vaccine Commission) to discuss the progress of vaccination in Spain.
Count of Castro Terreño
Portrait of the Count of Castro Terreño, pointed around 1800 by Agustín Esteve
Not every Spaniard was so enthusiastic to adopt vaccination, however. For one, practitioners of variolation were horrified by the prospect of losing their livelihood to a newfangled medical practice and tried to sew doubt about the safety and efficacy of vaccination. Additionally, vaccine skeptics publicized cases of children who died sometime after vaccination as proof of the alleged danger of the novel technique. Particularly sensational in the press was the death of the Count of Castro Terreño's son one week after being vaccinated. Ruiz de Luzuriaga wrote to several aristocrats and colleagues to assuage their doubts after this incident, and it appears his character and testimony were enough to maintain faith in vaccination. One noblewoman wrote to Ruiz de Luzuriaga to say "I have not hesitated to place my trust in you, knowing your love for humanity, and your eagerness to spread this good everywhere, the death of the child of Castroterreño somewhat worried me, but I do not think it is the effect of vaccination".