United Kingdom: Variolation Goes West
“[Variolation] was brought to Constantinople about fifteen years ago by a Greek woman. In 1706 there was a severe epidemic among the inhabitants of Pera and Galata, two areas inhabited mainly by Christians. A Greek lady from the Morea made eight to ten incisions in the skin in various parts of the body to apply three dried crusts of pustules. The inoculated patient’s symptoms were always favorable and in 4000 patients there were no fatalities.” (Grant, 2019, p. 21)
In 1716, Lady Mary Wortley Montagu arrived in Constantinople (now Istanbul, Turkey) alongside her husband, Edward, who had been appointed as an ambassador to the Ottoman Empire. Lady Mary became enchanted with the local culture: she learned Turkish, adopted local fashion, and gained unprecedented access to the Imperial Harem, acquiring new insight into the lives of Ottoman women. Her most historically significant cultural discovery, however, was that of a medical practice she called "ingrafting", known to us today as "variolation". Lady Mary observed how Greek families would throw "parties" for children at which an elderly woman would prick the kids in attendance with a needle and then introduce smallpox scabs to the wounds in order to induce a mild case of the disease.
Smallpox Vaccination
A vaccinator vaccinating a young child held by its mother, with other members of the household looking on, painted by Louis-Léopold Boilly, 1807
Having lost her brother and her beauty to the ravages of smallpox, Lady Mary leapt at the opportunity to spare her young son Edward Jr. a similar fate, and enlisted a Scottish surgeon to replicate the procedure in 1717. In 1721, back home in England, Lady Mary had her daughter publically variolated as part of a campaign to popularize the procedure. Thanks to Lady Mary's popularity in the royal court, variolation began to turn heads in elite British society, eventually catching the attention of Princess Caroline.
Caroline persuaded her father-in-law, King George I to conduct a royal experiment to officially determine the efficacy of variolation. Six inmates at Newgate Prison agreed to be test subjects in exchange for a royal pardon for their death sentences, and in 1721 a series of tests were conducted that showed that variolation indeed protected patients from smallpox. Princess Caroline, however, wanted proof that the practice was not harmful for children, and so in 1722 another set of experiments was conducted. This time six orphans and eleven charity children were variolated, again successfully. Shortly afterwards, Caroline's two daughters were variolated.