Inoculation and Marginalization: How Smallpox Was Eradicated in Western Europe

“The cow-pock – or – the wonderful effects of the new inoculation”


London, England

James Gillray (1756-1815)

colored engraving, published by H. Humphrey

Library of Congress

Smallpox was massively influential on western European society before the eighteenth century. Half of all people would contract the disease, one fourteenth of all people would die from it, and most survivors were left with blindness, lameness, or scarring. There was no proven prevention, treatment, or cure. The most effective method was isolation of any contaminated persons, but this was difficult to achieve effectively due to the quick-spreading nature of the virus.

A very different situation existed on the other side of the continent. Throughout the Middle East and Africa, the tradition of “buying the small pox” had been occurring since before recorded history. This procedure, typically practiced by the old women of a community, involved making a small incision on the forehead or arm, and then inserting a pock from a smallpox victim. It was typically performed on young children. The child would experience an extremely minor form of the disease, before recovering with an immunity to the smallpox virus. This practice existed from Armenia to Zanzibar to Ghana, spreading along trade routes, and had existed for long enough that no one had any record of how the procedure was discovered. Due to the shared name, it is believed that it originated in a single location before spreading across multiple continents, but when that occurred is unknown.

This lack of knowledge is largely due to the fact that buying the small pox was not viewed as a medical procedure. It was performed by old women without formal medical training, and it operated more like a ritual than an operation. In the Arabic tradition, children would come to the women with raisins or dates in exchange for the pox. In Ethiopia, it was surrounded by celebrations akin to those of a religious festival. When scholars, such as Avicenna, set out to compile Arabic scientific and medical knowledge, they either did not know of the practice or they did not deem it suitable for their texts.

This is a likely cause for why western European doctors remained ignorant of smallpox inoculation long after it gained prominence in the east. While they had had access to the works of famous Muslim scholars for centuries, few had reached out into the communities of the Bedouin tribes or of first-generation Senegalese slaves to question their low death rates. Those who had heard of it often reacted with fear or scorn, perceiving it as foreign mysticism rather than a scientific innovation. However, in the eighteenth century, multiple English people came into contact with these communities, and began to ask these questions. Notable among them were Reverend Cotton Mather, who introduced the idea to the Royal Society and began experiments in Boston, and Lady Mary Wortley Montagu, who informed the upper echelons of London society of the practice, thus causing the royal family to support the institutionalization of inoculation in Britain. By 1721, the procedure was well-known and spread throughout the nation.

Works Cited

Barnes, Diana. “The Public Life of a Woman of Wit and Quality: Lady Mary Wortley Montagu and the Vogue for Smallpox Inoculation.” Feminist Studies 38, no. 2 (2012): 330-62.

Gillray, James, Artist. The cow-pock – or – the wonderful effects of the new inoculation / Js. Gillray, del. & ft. Great Britain, 1802. [London: pubd. by H. Humphrey, th] Photograph.

Herbert, Eugenia W. “Smallpox Inoculation in Africa.” The Journal of African History 16, no. 4 (1975): 539-59.

“Inoculation.” The Encyclopedia of Diderot & d’Alembert Collaborative Translation Project. Translated by Antoinette Emch-Deriaz. Ann Arbor: Michigan Publishing, University of Michigan Library, 2016. (accessed November 12, 2018). Originally published as “Inoculation,” Encyclopédie ou Dictionnaire raisonné des sciences, des arts et des métiers, 8:755–8:769 (Paris, 1765).

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May, Maisie. “Inoculating the Urban Poor in the Late Eighteenth Century.” The British Journal for the History of Science 30, no. 3 (1997): 291-305.

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