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Hugh Downman and smallpox inoculation
  1. J W Puntis
  1. The General Infirmary at Leeds, Belmont Grove, Leeds LS2 9NS, UK;

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Professor Dunn quotes Downman’s approval of Lady Mary Montagu in his fascinating account of the Exeter physician. Her contemporaries, however, were often less generous. This beautiful and literary lady contracted smallpox in 1715 and probably knew of the Turkish practice of “engrafting” or “variolation” against the disease from her own doctors. As Fellows of the Royal Society they may well have heard an account of it passed on from Timonius of Constantinople.1 The following year she had the opportunity of travelling to Turkey with her husband who had been appointed ambassador to the Ottoman Empire. Receptive towards Islamic culture she was struck by the relative absence of smallpox and learned that this was attributable to the deliberate infecting of subjects with material from smallpox victims.

In March 1718 she summoned the nurse who was Constantinople’s “general surgeon” for inoculation. The nurse pricked the wrist of Lady Mary’s young son with a needle, laid a tiny droplet of smallpox matter on the skin and mixed it with a drop of blood from the puncture. Some eight days later he became febrile and developed about 100 spots on his body. These quickly resolved without leaving scars.

Subsequently, the chequered success of variolation in the hands of English physicians, careless of the finer details of Turkish practice emphasised by Lady Mary, contributed to lifelong controversy. Most cruelly, her former friend Alexander Pope implied in one of his satires that she left people “pox’d by her love”,2 quite deliberately a defamatory double entendre as well as an attack on the safety of variolation.