The popular Origins of Inoculation.
Six years before the Greek inoculation was tried in London, Kennedy, the travelled Scot, had compared the Constantinople practice with one that he knew of in his native country: “So also in some parts of the highlands of Scotland they infect their children by rubbing them with a kindly pock.” This indigenous Scots practice was confirmed by Professor Monro, the first, of Edinburgh, in 1765:
“When the smallpox appears favourable in one child of a family, the parents generally allow commerce of their other children with the one in the disease; nay, I am assured that in some of the remote highland parts of this country it has been an old practice of parents whose children have not had the smallpox to watch for an opportunity of some child having a good mild smallpox, that they may communicate the disease to their own children by making them bedfellows to those in it, and by tying worsted threads wet with the pocky matter round their wrists.”
And, to make it clear that this was not the same as the method afterwards used of procuring the smallpox, he adds that the latter was not known in Scotland until Maitland introduced it, in 1726[881]. In Wales the curious practice of buying the smallpox was found to be indigenous[882]. One young woman in a village near Milford Haven testified in 1722 that, some eight or nine years before, she had bought twenty pocky scabs of one in the smallpox, and had held them in her hand, with the result that she sickened with the infection in ten or twelve days and had upwards of thirty large pustules in her face and elsewhere—at least ten more than she had bargained for. A schoolboy of Oswestry, who had since become an attorney and must have known the nature of an affidavit, bought, as he positively affirmed, for three-pence of a certain lady twelve pustules of smallpox (at a farthing each), and rubbed the matter into his hand with the back of his pocket-knife; a sore remained on the hand as well as pockpits in his face.
There was nothing remarkable in these methods of procuring smallpox except an occasional element of superstition or freak. It was not unusual in England for educated persons to let smallpox go through all their children after it had attacked one of them, just as it is regarded an economy by many to have done with the measles. On 15 September, 1685, Evelyn travelling to Portsmouth in the company of Pepys, stopped to make a call at Bagshot at the house of Mrs Graham, a former maid of honour to the queen. “Her eldest son was now sick of the smallpox, but in a likely way to recover, and others of her children ran about and among the infected, which she said she let them do on purpose that they might whilst young pass that fatal disease she fancied they were to undergo one time or other, and that this would be for the best.” It would be for the best because children from five to ten or fifteen (the older writers said even infants) ran far less risk from the attack than at the higher ages, and seldom died of it.
Similar means of procuring smallpox for children were used in other countries. La Motraye, who rode through the Caucasus in 1712, was told that children, to give them the smallpox, were placed in the same bed with one who had it, the mothers sometimes carrying them a whole day’s journey to any village where they heard of someone being attacked. He professes also to have seen a child of four inoculated with smallpox matter at five places (the region of the heart, the pit of the stomach, the navel, the right wrist and the left foot) by an old woman who used “three needles tied together[883].” The idea of barter was widely spread in those practices of procuring smallpox on favourable terms. We have seen that the Welsh had it. Bruce found it in his travels to the sources of the Nile[884]. African negroes are known also to have carried with them to the West Indies the practice of “buying the yaws,” which is also a contagious and inoculable disease of the skin. The earliest medical notices of buying the smallpox come from Poland in 1671 and 1677. A case having been published in the Miscellanea Curiosa of the Imperial German Academy, in which a quartan ague was alleged to have been got rid of by transferring it to a brute animal, Dr Vollgnad, of Warsaw wrote: “There is a similar superstition not uncommon among our nurses, who instruct the children under their charge to buy for a few farthings a certain number of pocks from one infected with the smallpox, in the belief that those who purchase that disagreeable commodity will be affected with a more scanty eruption and will be the sooner freed from the disease and with the less risk[885].” Six years after, Dr Simon Schultz, of Thorn, physician to the king of Poland, wrote that the same practice of buying the smallpox obtained also in that part of Poland: “What I have first to remark,” he says, “is that, in most cases if not in all, those infants that buy of the infected (whether in their proper persons or through others), while they may have few pocks, yet fall into a more serious illness than otherwise (gravius reliquis decumbant): which I remember to have happened to my younger brother Johannes, to say nothing of others[886].”
These early references to buying the smallpox were made à propos of the 17th century practice of sympathetic transference of disease from one to another, or from man to brute, or to plants, stones, holes in the ground, etc.[887], and were published as instances of “a similar superstition.” The case of a transferred ague which called them forth had been sent to the Curiosa of the Academy by Thomas Bartholin, the celebrated anatomist of Copenhagen. Ten years before, he had written in the Theatrum Sympatheticum Auctum[888] (to which also Dr Sylvester Rattray, of Glasgow, and Sir Kenelm Digby contributed): “I disclose a great mystery of nature. The transplantation of diseases is a stupendous remedy, by means of which the ailments of this or that person are transferred to a brute animal, or to another person, or to some inanimate thing”—various methods being instanced. He returned to the subject in 1673 under the title of the Transplantation of Disease, the name by which Pylarini first described the engrafting of smallpox[889]. It was the transfusion of blood, a foible of the time, especially at the Royal Society in London, which set Bartholin to his second essay. He expected that health, in the one case, or disease in the other, might be transplanted to another’s veins with the blood. It would be an incomparable addition to the amenities of life to be able to draw off in a syringe the diseased blood of a familiar friend and bring it to a better coction by one’s own juices[890].
Bartholin discovered the germ of these scientific developments in the scape-goat of the Israelites and in the miracle of the swine of Gadara[891]. In his own doctrine of transplantation, others in turn have found the germ of inoculation, Pylarini having actually adopted the 17th century name, with the proviso that the transplantation of smallpox was not sympathetic but res vera mera pura. The older idea of transplanting smallpox was to get rid of it. “Some persons in the smallpox,” says Slatholm, of Buntingford, in 1657, “keep a sheep or a wether beside them in the chamber, those animals being apt to receive the envenomed matter and to draw it to themselves[892].” The developments of folk-lore are erratic; one thing leads to another, but not necessarily in a logical sequence. Transference had somehow become the inoculation which Pylarini first found in the practice of a woman from the Morea or from Bosnia, being still in its superstitious stage. The woman drew blood and rubbed the smallpox matter into the bleeding points; but whether she did so with a physiological or a symbolical intent we shall probably never know. She told Dr Le Duc[893], who submitted to inoculation at her hands, that she had received the secret from the Virgin; during the operation she muttered prayers to the Virgin, and, on finishing it, requested an oblation of two wax candles to be sent to the shrine of the Virgin her patroness in Thessaly. She pricked the skin of the face at the four points which are touched in making the sign of the Cross, and at the points of the hands and feet which are pierced by the nails in the Crucifix. Voltaire says that Lady Mary Wortley Montagu’s chaplain objected to inoculation because it was an un-Christian practice. He must have been strangely ill-informed if he did so; for at Constantinople it was practised by the Christians only and not at all by the Mussulmans, who, by Kennedy’s account, were somewhat doubtful of its utility.
Pylarini and Timoni very properly dropped the symbolism of the Greek woman, and inserted the matter at any convenient spot, choosing usually the skin of the forearm. Therewith they took the practice under scientific protection. At the same time Pylarini was careful to explain that this transference of disease, although he called it by Bartholin’s old name of “transplantation,” was a real thing, and in no way akin to the sympathetic or magnetic transference whose name it bore. A real thing it undoubtedly was: a visible effect did follow in most cases—some ten, or twenty or thirty watery pimples on the skin. The effect being thus real, Pylarini and Timoni laid down at the outset the doctrine that the smallpox matter inserted in minute quantity was a ferment, which produced an ebullition in the mass of the blood. The common people, who had been procuring the smallpox for their children in other ways than by puncture and insertion, also knew that the transplanting was a real thing: it was smallpox, and nothing else, that they designed to procure, peradventure it might be mild smallpox.
While Pylarini used the name of Transplantation, Timoni used the name of Inoculation. Both names were figures of speech taken from the gardener’s art. Inoculation, or ineying, was a form of grafting, the taking of the “eye” or resting-bud of one kind of fruit-tree and fixing it upon the stock of another kind. The effect of a graft upon a fruit-tree is one of the most remarkable in nature: the incorporation of a bud from a nearly allied species at a particular part of the stock causes the whole tree to assume some characters of the other tree, the change being greatest in the fruit. An effect at once so real, so useful, and so familiar could not fail to take hold of the imagination. Accordingly we find the ineying or grafting of trees used in a correct figure, as in Hamlet’s “for virtue cannot so inoculate our old stock but we shall relish of it.” Between a fruit-tree modified as to its fruit by the permanent incorporation of a strange shoot, and an animal body infected of purpose with diseased matter, there is no very exact analogy. Figurative names, as well as metaphors, are apt to be mixed ideas. Correct science avoids the one vice, as correct style avoids the other. Transplantation had in any case too many fanciful associations to be retained as the name for the new practice in smallpox; inoculation, on the other hand, was still unspoiled as a medical term, while its wonderful effects were obvious in the familiar art of the gardener.
In all the developments or modifications of this practice, the intention was still to procure the smallpox by art. The idea of antidote or counter-poison did not enter into it at all. Yet the idea of a counter-poison was quite familiar, as in the following passage from a medical writer of the time of James I.[894]:
“But here a great doubt and controversie may arise: whether, as sometimes we see one poyson to be the expeller of another poyson, so in like sort, whether one stinking savour, and graveolent or ill odour, and vapour of some pestilent breath or ayre, may bee the proper amulet or preservative against any such poyson, to bee hanged about the necke: for at this time let it bee granted (to please some) that tabacco is of no good smell or sent, and that it is a little poysonous. For wee see some daily in the time of any generall or grievous infection of the plague, for avoidance thereof, and for preservation sake, will smell unto the stinking savour of some loathsome privie, or filthy camerine and sinke; and this they make reckoning is one of the best counter-poysons that may be devised against any pestiferous infection: for their nature being inured to these, they will afterwards not seeme to passe for any pestilent malignitie of the ayre, and dare boldly adventure without any prejudice, or impeachment to their health, into any place or companie whatsoever. And to perswade us the more easily to this, they object to us for example sake, those women that spend their dayes continually in hospitals for pilgrims, and for poore travellers, who are accustomed to every abominable savour of the sicke; whereof we shall never see, or very seldome, any of them either to be taken or die with any pestiferous infection though never so dangerous.”
While he admits these to be instances of counter-poisons having a prophylactic effect against epidemic sickness, he denies, what some had maintained, that “either the French Pockes or the quartan ague is a Superseder of the plague[895].”