LADY MARY WORTLEY MONTAGU – THE UNSUNG PIONEER FOR INTRODUCING “SMALLPOX INOCULATION”`

3 December 2019 — The World Health Organization commemorated the 40th anniversary of smallpox eradication, recognizing the historic moment of 9 December 1979. This day marked the end of smallpox where it was confirmed to have been eradicated. Five months later, in May 1980, the 33rd World Health Assembly issued its official declaration that ‘the world and all its peoples have won freedom from smallpox’.

Today the world mostly remembers Edward Jenner for introducing the smallpox vaccination in 1796 as he had the power and the skill to convince the world. Though it may seem strange but the idea of smallpox inoculation was first demonstrated by Lady Mary Wortley Montagu in the western medicine after witnessing it during her travel and stay in the Ottoman Empire in the Constatinople (present Istanbul).

Smallpox vaccination introduced from Turkey 1717, to England 1724, by Lady Montagu, wife of English ambassador at Istanbul. She came cross the Turkish method of vaccination, consented her son inoculated with cowpox by the Embassy Surgeon, Charles Maitland. Dr. Jenner later agreed pic.twitter.com/ellm0JPrc3

— History of Indian Subcontinent (@HISubcontinent) March 29, 2020

Tracing back her history, Lady Mary Wortley Montagu was a noblewoman born in 1689 to a rich, aristocrat Duke Evelyn Pierrepont. Being a duchess and the eldest in the family she was given utmost love, care and attention who grew up to be a beautiful, attractive and witty young lady. Many English men wished to marry her. She eloped with Edward Wortley Montagu, a Whig Member of Parliament, rather than accept a marriage that had been arranged by her father. She got married on 23 August 1712.

Very soon England witnessed the outbreak of a deadly viral infection, smallpox a.k.a “The speckled monster”, one of the world’s most-dreaded plagues, killing as many as 30 per cent of its victims, most of them children. Those who survived were permanently immune to a second infection, but they faced a lifetime of disfigurement and in some cases blindness.

It spread like a wild fire killing one in four people infected with it. Smallpox also took away the life of Lady Mary’s brother who died on 1 July 1713 at a young age of twenty. Lady Mary Wortley Montagu was also victimized by the speckled monster. Her beauty and elegance soon diminished as her skin spattered with suppurating pustules which later left behind deep marks on her face and limbs after recovery with the deadly viral infection.

Her husband, Edward Wortley Montagu was in 1716 appointed ambassador to Turkey, taking up residence with his wife and son in Constantinople (now Istanbul) where Lady Mary was astounded to find that the victims of the smallpox in the Ottoman Empire had minimal scars and deaths.

She observed the practice in Turkey, where the virus from an infected person is introduced into the previously uninfected person to produce a mild form of the disease, thus securing immunity. She had observed what today we would call an inoculation.

In her very famous series of letters, Lady Mary Wortley Montagu mentions about the inoculation procedure which was written on 1 April 1717 which states as follows –

I am going to tell you a thing that will make you wish yourself here. The small-pox, so fatal, and so general amongst us, is here entirely harmless. . . . 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 nut-shell full of the matter of the best sort of small-pox, and asks what vein you please to have opened. She immediately rips open that you offer her, with a large needle (which gives you no more pain than a common scratch) and puts into the vein as much matter as can lie upon the head of her needle, and after that, binds up the little wound with a hollow bit of shell . . . .

3 centuries ago #LetterToAFriend by Lady Mary Wortley Montagu written on 1April1717, explained #variolation, The process of introducing live #smallpox #virus into an uninfected person to achieve immunity.#vaccination#vaccines#VaccinesSaveLives pic.twitter.com/BX5hpuQCTo

— Zareen Fatima (@DrZareenFatima) April 1, 2020

Before they returned back to England in 1718, Lady Mary got her son inoculated making him the first English person receiving it. After returning to their home land Lady Mary Wortley Montagu introduced the idea of inoculation which was disdained by the western medical community as the English (the Christian community) showed prejudice against the Muslims (The Ottoman Empire) and did not follow their practices. The English men also had the pre conceived opinion on how a female aristocrat can guide physicians?

The idea of inoculation later gained popularity in England when another smallpox epidemic threatened London in 1721. During this time Lady Mary Wortley Montagu inoculated her second child (daughter) in front of the audience including the king’s personal physician. The physicians regularly observer the daughter’s recovery and compared with the recovery of other smallpox patients receiving their treatment (today this process is widely known as the clinical trials). Later the process of inoculation, once popular among the Muslims of the Ottoman Empire, soon became widely accepted in the England (almost two decades before the birth of Edward Jenner who was born in the year 1749 and developed the vaccine against the smallpox in 1796)

The role of Lady Mary Wortley Montagu has a key significance in laying the foundation for the development of vaccination against the deadly smallpox but her contribution in the field of medicine remains unacknowledged until recent times.