Chapter III: Maitland’s Experiments

Lady Mary Wortley Montagu returned to England in 1718, but not until 1721 did she fulfil her intention of making war on the doctors, and incurring their resentment for the good of mankind. In the spring of 1721 she commenced action in earnest by the inoculation of her daughter--the infant that it was considered unsafe to “engraft” when at Pera in 1718. In Maitland’s words--

The noble Lady sent for me last April, and when I came, she
told me she was now resolved to have her daughter inoculated,
and desired me forthwith to find out matter for the purpose. I
pleaded for a delay of a week or two, the weather being then cold
and wet. I also prayed, that any two physicians whom she thought
fit, might be called, not only to consult the health and safety
of the child, but likewise to be eye witnesses of the practice,
and contribute to the credit and reputation of it. This was at
first denied me, it might be out of a design to keep it secret,
or lest it should come to nothing.

In the meantime having found proper matter, I engrafted the child
in both arms, after the usual manner. She continued easy and well
till the tenth night, when she was observed to be a little hot
and feverish. An ancient apothecary in the neighbourhood being
then called, prudently advised not to give the child medicine,
assuring the parents there was no danger, and that the heat would
quickly abate, which accordingly it did, and the smallpox began
next morning to appear. Three learned physicians of the college
were admitted, one after another, to visit the young lady; they
are all gentlemen of honour, and will on all occasions declare,
as they have done hitherto, that they saw Miss Wortley playing
about the room, cheerful and well, with the smallpox raised
upon her; and that in a few days after she perfectly recovered
of them. Several ladies, and other persons of distinction, also
visited this young patient, and can attest the truth of this fact.

One of the learned physicians who had visited Miss Wortley,
having some years since fully informed himself of this method
of practice, and being thoroughly satisfied of the safety and
reasonableness of it, at length resolved to try it in his own
family; he had formerly lost some children in a very malignant
kind of the smallpox, and therefore advised me to lose no time to
engraft the only son he had left. The boy (who was not quite six
years of age) being of a pretty warm and sanguine complexion, the
Doctor ordered about five ounces of blood to be taken from him;
and then, in ten days after, having found matter which he liked,
I inoculated him in both arms. This was performed the 11th of
May, 1721.

The learned physician here referred to was Dr. Keith, and the facility wherewith he adopted the novel practice supplies an instructive commentary on Lady Mary’s anticipation of the resentment of “the profession”--her first imitator coming from the ranks of the dreaded self-seeking obstructives. Furthermore, we have to observe how different is Maitland’s account from the heroic myth current of “the one woman confronting the prejudice and ill-will of the world.” Even Lady Louisa Stuart, who made it her business to correct many misconceptions as to her grandmother’s career, writes--

Only the higher motive of hoping to save numberless lives could
have given Lady Mary courage to resolve upon bringing home the
discovery. For what an arduous, what a fearful, and, we may add,
what a thankless enterprise it was, nobody is now in the least
aware. Those who have heard her applauded for it ever since
they were born, and have also seen how joyfully vaccination was
welcomed in their own days, may naturally conclude that when once
the experiment had been made, and had been proved successful,
she could have nothing to do but to sit down triumphant, and
receive the thanks and blessings of her countrymen. But it was
far otherwise.... Lady Mary protested that in four or five years
immediately succeeding her arrival at home, she seldom passed a
day without repenting of her patriotic undertaking; and she vowed
that she never would have attempted it, if she had foreseen the
vexation, the persecution, and even the obloquy it brought upon
her. The clamours raised against the practice, and of course
against her, were beyond belief. _The facility rose in arms to a
man_, foretelling failure and the most disastrous consequences;
the clergy descanted from their pulpits on the impiety of thus
seeking to take events out of the hand of Providence; the common
people were taught to look at her as an unnatural mother,
who had risked the lives of her own children.... We now read
in grave medical biography that the discovery was instantly
hailed, and the method adopted, by the principal members of the
profession.... But what said Lady Mary of the actual fact and
actual time? Why, that _the four great physicians deputed by
Government to watch the progress of her daughter’s inoculation_,
betrayed not only such incredulity as to its success, but such
an unwillingness to have it succeed, such an evident spirit of
rancour and malignity, that she never cared to leave the child
alone with them one second, lest it should in some secret way
suffer from their interference.[16]

Thus is History written! An apothecary and three doctors, selected by the Wortleys at discretion, and admitted singly to view a private experiment, are converted into “four great physicians deputed by Government,” rancorous and dangerous! Thus are myths generated!

Lady Mary was a woman of mark in society, fashionable and literary, and her exploit was naturally the talk of the town. Among her friends was Caroline, Princess of Wales, a lady of more than ordinary strength of mind and intelligence, with a taste for theology and philosophy, the patron of Butler, and his sympathetic student. It has been said, “There never was a clever woman that was not a quack;” and Princess Caroline was an illustration of its truth. The new remedy for smallpox caught her fancy, and she determined to put it to the test. She begged of George I. that six felons should be pardoned on condition of their submission to inoculation, and the King was pleased to comply with the extraordinary request. Maitland was then called upon to exhibit his skill, but he hesitated to act as hangman’s substitute; whereon Sir Hans Sloane, the court physician, was appealed to. Sir Hans held counsel with Dr. Terry of Enfield, who had practised physic in Constantinople, and knew something of inoculation; and fortified with Terry’s assurance, he was enabled to overcome Maitland’s scruples, real or affected. Accordingly, on the 9th of August, 1721, writes Maitland--

I performed the operation of inoculating the smallpox on six
condemned criminals at Newgate in presence of several eminent
physicians, surgeons, and others. The names of the criminals
were--

1. MARY NORTH, Aged 36 years
2. ANNE TOMPION, ” 25 ”
3. ELIZABETH HARRISON, ” 19 ”
4. JOHN CAWTHERY, ” 25 ”
5. JOHN ALCOCK, ” 20 ”
6. RICHARD EVANS, ” 19 ”

On Wednesday morning, 9th August, he made incisions in both arms and the right legs of the six. Thursday passed and Friday passed without any indications of constitutional disturbance, and, despairing of success, he obtained fresh pox on Saturday from Christ’s Hospital, and repeated the inoculation in new incisions in the arms of five of them. He had no matter left for Evans, who, it appeared, had had smallpox in September, 1720, and who therefore escaped hanging unwarrantably. The disease now “took,” and progressed satisfactorily. Says Maitland--

One day Mr. Cook, an eminent Turkey merchant, having seen the
persons engrafted in Newgate, and having fully considered their
incisions and eruptions, he openly declared they were the very
same as he had observed in Turkey, having seen a great many
instances; and that we might be assured they would never again be
infected with smallpox.

Dr. Mead suggested another experiment--that cotton dipped in pox should be inserted in the nostrils; and a young woman sentenced to death received her life on condition of submitting to the operation. Here we have Mead’s own account of the transaction--

A learned author has given an account of the practice of sowing
smallpox, as they call it, known to the Chinese above three
hundred years, which is this. They take the skins of some of the
dried pustules, which are fallen from the body, and put them into
a porcelain bottle, stopping the mouth of it very close with wax.
When they have a mind to infect any one, they make up three or
four of these skins, putting between them with one grain of musk
into a tent with cotton, which they put up the nostrils.

I myself have had an opportunity of making an experiment to
this purpose. For, when in the year 1721, by order of his
Sacred Majesty, both for the sake of his own family, and of
his subjects, a trial was to be made upon seven condemned
malefactors, whether or not the smallpox could safely be
communicated by inoculation; I easily obtained leave to make the
Chinese experiment in one of them. There was among those who were
chosen out to undergo the operation, a young girl of eighteen
years of age. I put into her nostrils a tent, wetted with matter
taken out of ripe pustules. The event answered: for she, in like
manner with the others, who were infected by incisions made in
the skin, fell sick, and recovered; but suffered much more than
they did, being, immediately after the poison was received into
the nose, miserably tormented with sharp pains in her head, and a
fever, which never left her till the eruption of the pustules.[17]

Finally, says Maitland--

On the 6th of September they were all dismissed to their several
counties and habitations. The thing has been successful on all
the five, far beyond my expectation, considering their age, habit
of body, and circumstances; and it has perfectly answered Dr.
Timoni’s account of the practice, and also the experience of all
who have seen it in Turkey.[18]

So Maitland asserted, but others were of a different opinion. Dr. Wagstaffe, who visited the patients in Newgate regularly, maintained in a letter addressed to Dr. Freind--

Upon the whole, Sir, in the cases mentioned, there was nothing
like the smallpox, either in symptoms, appearances, advance of
the pustules, or the course of the distemper. And it would puzzle
any one to conceive how it is possible that smallpox can ever be
prevented by inoculation. With the exception of one of the men,
the girl who had cotton dipped in matter thrust up her nostrils,
had as fair a smallpox as any in the place.[19]

Sir Hans Sloane and Dr. Steigertahl, physician to the King, to test the matter farther, “joined purses,” and had one of the women inoculated in Newgate sent to Hertford, where smallpox of a severe form was prevalent, to lie in bed with smallpox patients. This she did with impunity; but it was reasonably objected that many who were not inoculated did so likewise and escaped without harm.

The Newgate experiment, of course, caused great excitement, and induced many repetitions in town and country. The Princess of Wales was especially alive to the importance of “the great discovery;” and for her additional satisfaction, six charity children, belonging to the parish of St. James, were inoculated; and all but one “took” and did well; the exception being due to the craft of the child, who, for the sake of the reward, concealed the fact of having had smallpox.

Upon these trials, and several others in private families
[wrote Sir Hans Sloane], the Princess of Wales sent for me to
ask my opinion of the inoculation of the Princesses. I told Her
Royal Highness, that by what appeared in the several essays, it
seemed to be a method to secure people from the great dangers
attending smallpox in the natural way. That preparations by diet
and necessary precautions being taken, made the practice very
desirable; but that not being certain of the consequences which
might happen, I would not persuade nor advise the making trials
upon patients of such importance to the public. The Princess then
asked me if I would dissuade her from it: to which I made answer
that I would not, in a matter so likely to be of such advantage.
Her reply was, that she was then resolved to have it done, and
ordered me to go to the King, who commanded me to wait upon him
on the occasion. I told his Majesty my opinion, that it was
impossible to be certain, but that raising such a commotion in
the blood there might happen dangerous accidents not foreseen:
but he replied that such might and had happened to persons who
had lost their lives by bleeding in a pleurisy, and taking physic
in any distemper, let never so much care be taken. I told his
Majesty that I thought this to be the same case, and the matter
was concluded upon, and succeeded as usual, without any danger
during the operation, or the least ill symptom or disorder
since.[20]

The Princess Amelia, aged eleven, and Caroline, aged nine, were therefore inoculated on the 19th of April, 1722.

Let us return to Maitland, whose triumph for the moment appeared complete, and with it his assurance. To his detractors he professed boldly--

I could bring a great many cases of persons inoculated in Turkey
to prove _the constant and certain success of the practice_; in
all which I have never seen any miscarriage, except in one, which
was wholly due to the rashness and inadvertence of a surgeon at
Constantinople.

Is it not a matter of the greatest importance for us to know
how to prevent the mighty contagion of the smallpox, and how to
preserve our children from the violent attacks and fatal effects
of it?

To divine Maitland’s character--to determine how far he was deceiver or deceived is not easy. He obviously made professions in vast excess of his knowledge. One of his contemporaries writes--

I remember Mr. Maitland at Child’s Coffee House, when the
experiment was just begun at Newgate, was as confident and
positive of the success and security proposed by inoculation as
if he had had twenty years experience without any miscarriage,
which made those who heard him justly suspect he was more
concerned for the employ than for the success of it.[21]

He had not the proper craft of this conscious rogue, for alongside his assertions of absolute competence and safety, he set forth such confessions of ignorance and disaster, that one is impelled to pronounce him a purblind enthusiast. For example, take this case, which he published without apparently any sense of its scope--

_2nd October, 1721._--After due preparation of the body, I
engrafted Mary Batt, an infant of two years and a half old,
daughter of Thomas Batt, a Quaker, living at Temple, within three
miles of Hertford. The red spots and flushings appeared on her
face and neck the fourth day; and she kept playing about well
till the seventh or eighth, when she became a little heavy and
thirsty, with a fuller and quicker pulse; then the pustules came
out fresh and full, and the incisions discharged a thick and well
digested matter. She had not above twenty in all upon her; they
continued about three or four days, then dried away and fell off,
and the child recovered perfectly.

Thus far all was well; _but what happened afterwards was, I must
own, not a little surprising to me, not having seen or observed
anything like it before_. The case was in short this. Six of
Mr. Batt’s domestic servants, namely, four men and two maids,
who all in their turns were wont to hug and caress this child
whilst under the operation, and the pustules were out upon her,
never suspected them to be catching, _nor indeed did I_, were
all seized with the right natural smallpox, of several and very
different kinds; for some had the round distinct sort, some the
small continued, and others the confluent; all of ’em had a great
many, but especially the last, with the usual bad symptoms,
_and very narrowly escaped_. But they all (God be thanked) did
well (_except one maid_, that would not be governed under the
distemper, _who died of it_,) and now enjoy a perfect state of
health.[22]

Thus at the outset, smallpox and death were the products of inoculation--the peril to be averted was incurred and multiplied. Yet the man who thus records his own infamous ignorance, had the impudence in the same pages to assert--

_The practice prudently managed, is always safe and useful, and
the issue ever certain and salutary._[23]

Words are wasted on such reckless folly: we perceive how true is Carlyle’s observation, “Stupidity intellectual always means stupidity moral, as you will, with surprise or not, discover if you look.”

Before leaving Maitland, we may take another leaf from his experience. He writes--

_12th October, 1721._--I inoculated Joseph and Benjamin, sons of
William Heath, of Hertford; the first of about seven, and the
second three years of age; both with the same matter and at the
same time: the last had a gentle and favourable kind; but the
first, namely, Joseph, being a fat, foul, gluttonous boy, who
would not be confined to the rules and directions I had strictly
charged his mother withal, as to diet and keeping warm, was taken
very ill before the eruption, and after it had a great load of
the continued small kind, but at last recovered and did well.

What a mighty difference is here to be observed between those two
boys! The reason of it seems to be plainly this: the younger, who
had the favourable kind, was of a clean habit, moderate appetite,
and easily governed during the whole process. The elder was not
only of a gross foul constitution, but likewise had a voracious
appetite, always eating and filling his belly with the coarsest
food--as cheese, fat country pudding, cold boiled beef, and the
like, which I saw myself as I came in by chance the third day
after the operation; nor was there any care taken to restrain or
keep him within doors in cold, windy, frosty weather; he once
wet his feet in water--insomuch that had he taken the smallpox
by infection, the world could not have saved his life. Hence it
appears how necessary it is to cleanse thoroughly foul habits
before the operation, and, withal, to keep patients to a very
strict regimen under it.[24]

Verily, as Cobbett said, quackery is never without a shuffle. As we shall see, inoculation came to require a preparatory course of very strict regimen--so strict as to be impracticable for the rank and file of the world; but the practice was at first commended without any such conditions. What said Maitland’s patron, Lady Mary, in her famous letter from Adrianople?--

The smallpox, so fatal and so general amongst us, is here
entirely harmless by the invention of _ingrafting_.... Every year
thousands undergo its operation; and the French ambassador says
pleasantly that they take the smallpox here by way of diversion,
as they take waters in other countries. There is no example of
anyone that has died in it.

It was under cover of such seductive assurances that inoculation was introduced to England, and established in perversity and quackery.

FOOTNOTES:

[16] _Letters and Works of Lady Mary Wortley Montagu._ Vol. i. pp. 88-90. Ed. 1861.

[17] _On Smallpox and Measles._ By Dr. Mead. London, 1747.

[18] _Mr. Maitland’s Account of Inoculating the Smallpox._ 2nd. ed. London, 1723.

[19] _A Letter to Dr. Freind showing the Danger and Uncertainty of Inoculating the Smallpox._ By W. Wagstaffe, M.D. London, 1722.

[20] _An Account of Inoculation by Sir Hans Sloane, Bart., given to Mr. Ranby to be published_, 1736. _Philosophical Transactions_, Vol. xlix. p. 516.

[21] Isaac Massey to Sir Hans Sloane, 1722.

[22] Maitland’s _Account_, p. 27.

[23] _Ibid._ p. 33.

[24] Maitland’s _Account_, p. 27.