PART I
An Engagement with Science
Chapter 1
āTo bring this useful invention into fashion in Englandā:
Mary Wortley Montagu as Medical Expert
Daniel J.R. Grey
Lady Mary Wortley Montagu is well known to modern audiences on three counts: her career as a writer, her account of life in the Ottoman Empire during the time her husband spent as ambassador,1 and for the introduction to Britain of inoculation against smallpox. Both her fiction and her ethnographic discussion of Turkish womenās lives have received substantial critical attention from scholars,2 aided since 1999 by Isobel Grundyās excellent biographical study.3 Surprisingly, however, the complicated relationship between Montagu and smallpox has received much less sustained attention, despite the fact that the procedure was totally unknown to medicine in the West at that time.4 In order to successfully introduce the practice to Britain, Montagu was thus forced to set herself up as an authority on the condition in her own right, occupying the uncomfortable position of a āfemale medical expertā on the grounds of her class and of the expanded geographical and cultural knowledge at a time when womenās participation in the early modern medical and scientific marketplace was precarious at best.5 What is particularly interesting and relevant here is the degree to which these joint factors made possible an effective intervention in British medicine by a woman who was undoubtedly an intellectual powerhouse, but whose personal scholarly achievements were otherwise primarily literary and linguistic, rather than scientific.6 As the Introduction of this collection has noted, āTravel was supposed to develop the understanding and broaden the mind but many questioned whether women could or should do eitherā.7 Moreover, after Montagu persuaded friends and family in Britain of the benefits of the Ottoman practice, ā[h]ard-hitting and frequently slanderous media warfare broke out, abusing and defending the procedure in newspapers and pamphlets, and even from the pulpitā.8 Depending on the perspective of the writer, Montagu was either hailed as a modern-day Minerva unlocking the secrets of science for the benefit of all, or a wicked mother gambling with her childrenās lives and in thrall to superstitious and ignorant foreign medical procedures.
In part, this gap in the research reflects the fact that smallpox itself as a phenomenon has only recently begun to receive sustained critical attention. Much of this work, while valuable, approaches the subject from a perspective concerned with the intricate details of science in the early modern world, rather than its cultural impact.9 As Michael Bennett has noted, however, the situation has also been exacerbated by āthe rather limited, dispersed and anecdotal nature of the source materialā relating to womenās historical involvement in the prevention and treatment of smallpox, and even Montagu is no exception to this general rule.10 Although her key intervention in British medical practice by encouraging inoculation has been widely acknowledged, when mentioned by scholars this tends to be relatively brief.11 Yet, for Montagu, who had nearly died from the disease herself, to persuade Britons of the efficacy of smallpox inoculation was nothing less than a national imperative: āI am patriot enough to take the pains to bring this useful invention into fashion in Englandā, she stated.12 Essential to this process, as Cynthia Lowenthal has noted, was Montaguās āposition[ing] herself in a broader Enlightenment traditionā.13 She took care to emphasise her status as an expert in her own right who was able to translate this potentially dubious āforeignā practice for other audiences through the advantages of her class, sex, and familiarity with Ottoman culture.14 Indeed, her experiences of doing so and the exposure to other cultures through her travels led to Montaguās writing taking on a much more explicitly political tone following her return to England in the 1720s.15 By focusing in particular on Montaguās experiences of smallpox and her attempts to understand and eventually eliminate the disease ā as sufferer, anxious parent, and scholarly authority ā and her position within the resulting vitriolic debates around inoculation, this chapter aims to offer a new perspective on both the history of smallpox and on womenās engagement with the intellectual world in eighteenth-century Britain.
Smallpox and Lady Mary at Home: 1713ā1717
A global and deadly disease known to have existed since antiquity, every nation in the early modern period developed ways of dealing with outbreaks of smallpox (variola major).16 According to Dr Charles Perry, writing in 1747, smallpox āis a Disease which is the Produce of every Country and Climate; and that it is the Lot of almost every Person to have once, who lives to an advanced Ageā.17 Estimates suggest that between 25 and 50 per cent of the population would have been left visibly marked by smallpox during the seventeenth and eighteenth centuries.18 While smallpox seems to have mutated and become most virulent during the early seventeenth century, its impact at both the personal and international level even before this date should not be underestimated:
Smallpox changed the course of wars, lives, royal families, and empire, and the frequent epidemics impeded the activities of the marketplace; epidemics erupted during migrations from country to city and through new circuits of global interchange.19
To a greater or lesser extent, most of the methods of dealing with smallpox across the world, including Britain, relied on luck. Since it was almost impossible to avoid the contagion altogether, parents across the world were often forced to decide whether or not they should risk deliberately bringing their children into contact with it and hope that the result was a relatively mild infection that would bestow permanent immunity from future outbreaks with little or no lasting damage to the childās health. However unsightly, the visible signs of having survived smallpox at an earlier point might even have acted as an additional incentive for employers to hire people in later life, as this graphically demonstrated that they were no longer liable to contract the disease.20 Yet this was a potentially deadly gamble, since any medical treatment for smallpox was largely ineffective. More than twenty different symptoms were noted by early modern physicians, including āa Pain of the backā21 and ātrembling of the heartā;22 but by far the most well-known and dreaded sign was the eruption of pustules across the skin, particularly across the face. These sores might be treated using the same sorts of medicines as for other skin complaints. One female author noted in a 1604 recipe book that her remedy in this case could also be used for any sort of infection that attacked the skin, including measles as well as smallpox.23 In its worst form, however, confluent smallpox ācaused the skin of the victim to become necrotic and peel away in large sheetsā.24 Unsurprisingly, this variant was generally fatal. One English surgeon suggested in the late seventeenth century that regular consumption of a small quantity of a mixture of brimstone and honey was a useful preventive measure. If this failed, he suggested the patients should return to their rooms and ādrink strong Beer, and now and then a Glass of Sack; and never fear increasing the Feaver by your so doingā25 in order to variously urinate, vomit or sweat out the illness as quickly as possible. Children and the elderly were the most vulnerable to its depredations and the disease killed between 14.2 and 25 per cent of its victims. Even parents of generally healthy infants could not rest easy when an outbreak occurred. Hannah Newton notes that prevailing medical theories suggested āstrongā children were actually considered more liable to catch smallpox and similar fevers than their peers.26 In London, smallpox fatalities increased steadily over time until they reached their peak during the 1760s.27 Sufferers of all ages could be left ā like Lady Mary Wortley Montagu herself ā with terrible scarring or other health complications, which might include blindness, deformed limbs, and increased susceptibility to other life-threatening conditions, notably tuberculosis, even if they survived the smallpox infection.28
Such obvious physical signs of survivors, especially pockmarks, were common and important enough to be routinely included in textual or visual depictions of individuals, and in both popular and official sources throughout the eighteenth century and well into the nineteenth century.29 In general, the best result that could be hoped for was that such pockmarks were both few in number and visually unobtrusive, a goal that is likely to have remained much the same for patients even after the advent of inoculation.30 The poet Anna Seward made references to the visible smallpox scars of the scientist Erasmus Darwin and his friend Thomas Day as part of the crucial āmental imageā that she set out for readers in her biography of the former.31 Conversely, Seward also recorded in the same volume that two female friends struck down with smallpox and nursed by Day, both of whom survived, ālost no beauty by their diseaseā.32 B...