The empiric procedures of medicine, which is still in its infancy, or “old wives” remedies are hardly in measure to be able to cure smallpox.  But all will change with the introduction and the diffusion throughout Europe of the innoculation procedure.  It is Lady Mary Wortley Montagu, the wife of His Gracious Majesty’s Ambassador to the Sublime Porte, who gives this method the publicity which will rapidly make it a success.  The smallpox epidemics which strike Istanbul in 1701 and 1709 reveal the positive effects of a preventive innoculation practised by two Greek fortune-tellers.  Informed by two Greek doctors of the protective consequences of the operation, Lady Wortley Montagu, who arrives in the Ottoman capital with her husband in 1717, is directly concerned by this question:  her brother died from the disease in 1713 and she caught it herself two years later.  She takes it upon herself to have her son innoculated and, upon her return to London, she does the same thing for her daughter, in April 1721, with the help of the surgeon Maitland.  In August 1721, King George I orders that the experiment be performed on six Newgate prisoners, who have been condemned to death, thereby saving them from hanging.  Five orphan babies, who are in turn innoculated, contract a completely benign smallpox and are therefore immunised.

In April 1722, it is the turn of the Princess of Wales’ children, and several hundred subjects are then innoculated over the course of the following months.

The death of a three-year-old child and that of an adolescent calm the enthousiasm for a while, but the practice remains, in spite of the polemics.  In the first line of attack, William Wagstaffe rebels, in the name of medical science, against this “old wives remedy”.  The Reverend Edmund Massey, for his part, calls upon the Holy Scriptures to condemn a practice considered to be diabolic.  On the other side, James Jurin refers to the statistical results and underlines that, out of 481 people innoculated between 1721 and 1725, 447 artificial smallpoxes were transmitted, only nine of which were mortal, which constitutes a more acceptable mortality risk compared to the usual ravages attributed to smallpox itself.  One death out of fifty people innoculated, while the illness kills one person out of ten, or even seven.  The risk still appears too high and, from 1727, the innoculations are practically stopped.

***

The Regent, Philippe d'Orleans.

In spite of the interest manifested in the beginning by the Regent, France remains reticent.  For certain members of the Faculty, it is unacceptable to introduce an illness germ into a healthy body.  This is notably the opinion of Doctor Hecquet in his work entitled Raisons et Doutes contre l’inoculation.  In England, this procedure is again used in 1743, on the occasion of an epidemic which is ravaging Middlesex.  Five years later, Doctor Tronchin of Geneva has his son innoculated in Holland and, in 1754, La Condamine presents before the Academie des sciences a Memoire historique et critique en faveur de l’inoculation.  That same year, a four-year-old child is innoculated in France, soon followed by a young noble of twenty.  On 12 March 1756, the Duke d’Orleans has his children innoculated by Tronchin, which makes people forget about the death of a young girl of fourteen, a victim of the operation.

There are roughly 200 innoculated people in the kingdom in 1758, and the method spreads to the whole of Europe, except for Spain.  In 1760, Bernouilli demonstrates, in his Mortalite causee par la petite verole et les avantages de l’inoculation pour la prevenir, that a generalization of the procedure to the whole of the kingdom’s population would be greatly beneficial, whatever the statistical risk of failure.  D’Alembert pronounces himself for innoculation also, but leaves each person the free choice of using it or not.

On 8 June 1763, the Paris Parliament delivers a famous judgement on the question.  It orders

“the Faculties of Theology and of Medicine to assemble, to give their precise opinions on the fact of innoculation […] and if it is appropriate to permit it, defend it or tolerate it;  and meanwhile, by provision, it is forbidden to practise this operation in the towns and outskirts of the court’s resort”.

Those who choose to have themselves innoculated will do it in the country and will remain there

“from the day that they are innoculated, until six weeks after their recovery”.

As for the virtues or dangers of the procedure, the doctors are divided on this question and are incapable of finding an agreement.

Louis XVI.

Meanwhile, Doctor Girod, who is helped in this by the support of Intendant Lacoree, sets up an impressive campaign of innoculation of the population, in Franche-Comte.  But it is in 1774, thanks to the decision of Louis XVI, his two brothers and the Countess d’Artois to use this practice, that it is going to develop.  So, 33,619 people will have been innoculated in Franche-Comte between 1765 and 1787 and it can be thought that, on the scale of the kingdom, 60,000 to 70,000 individuals are concerned, while there are over 200,000 in England.  Except for the exceptional case of Franche-Comte, it is the nobility milieux which use it in priority.  This has several reasons.  While, in the popular classes, the illness strikes in childhood, it touches those privileged by birth and fortune more often at adult age, and its effects are suffered with more difficulty for this reason.  It makes the risk of innoculation appear smaller when, once recovered from it, there is the guarantee of escaping the disease.  On top of that, the operation and the rest that it imposes, cost a lot and are not accessible to everyone.

A true caste privilege in most cases, innoculation causes, in spite of everything, a lot of worry.  The tears of the Duchess d’Orleans when her husband decides, in 1756, to have Tronchin innoculate their two children, the Duke de Chartres and Mademoiselle de Montpensier, show this.  In 1774, the Duke de Croy, whose grandsons had successfully submitted to the operation three years earlier, is, however, indignant that it has been decided to innoculate Louis XVI and his two brothers at the same time – it is too risky for the throne’s succession.  However, Empress Maria-Theresa of Austria had had all of her children innoculated in 1768.  And Empress Catherine II of Russia had submitted to the same operation three months later.

To be continued.

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