Smallpox Inoculation in London and Boston

Lady Mary Wortley Montagu, wife of the British ambassador at Constantinople, learned of inoculation there in 1717 and had her son inoculated by an old Greek practitioner. The idea was to give a healthy person a mild case of smallpox on purpose, by putting smallpox matter under the skin. Back in England, in April 1721, she asked Charles Maitland, a Scottish surgeon who had been with her in Constantinople, to inoculate her daughter.

London went on carefully. At the urging of Montagu and the Princess of Wales, several prisoners and abandoned children were inoculated in 1721 and, months later, deliberately exposed to smallpox. None of them caught it. The procedure was judged safe and members of the royal family were inoculated. For a while Maitland was the only inoculator.

Boston tried it in the middle of an epidemic. Cotton Mather had learned of inoculation from Onesimus, an African man he held as a slave, and had read reports of it in the Royal Society's Philosophical Transactions. He publicized the method, and when smallpox broke out in Boston in 1721 the physician Zabdiel Boylston began inoculating, with Mather's support. Of 247 people Boylston inoculated in 1721 and 1722, 6 died.

The argument then turned on numbers. Boylston took his figures to the Royal Society in London in 1725 and published them the following year. James Jurin, a physician and mathematician who was secretary of the Society, gathered reports from inoculators. In a letter printed in Philosophical Transactions he estimated that one in five or six people of all ages who caught smallpox naturally died of it, against one in sixty of those inoculated as in New England. Inoculation still carried risks. A patient could die of it, and the mild case could spread smallpox to others.