NINE months on from the start of the pandemic, debate is still raging over just how serious Covid-19 is. But 300 years ago, no one had any doubt about the deadliness of another virus that was then rife in Britain – smallpox.
It was a cruel, repugnant disease of ‘prodigious loathsomeness’ that had killed millions throughout history.
In its worst form, smallpox meant a horrific, lingering, fever-ravaged death as thousands of pustules erupted over the face and body and inside the mouth, with the infection often penetrating to internal organs.
The disease was spread through close contact with a sufferer, or via contaminated items such as clothing or bedding.
Generally, the mortality rate was between ten and 30 per cent, but it could reach 90 to 100 per cent depending on the particular strain. Those who survived were left dreadfully disfigured by pock marks and many were blinded or enfeebled.
Then in 1721, Britain’s first real battle against the ‘monstrous distemper’ began, inspired by Lady Mary Mortley Montagu, wife of Britain’s former ambassador to Turkey.
While living in Constantinople with her husband Edward, Mary – herself a scarred survivor of smallpox – had learned that inoculation or ‘variolation’ against the disease had been successfully practised in Turkey for many years, as well as in China, Asia and parts of the Near East.
It was done by making an incision in a healthy person’s arm and inserting pus from a smallpox blister. The patient usually went on to develop mild symptoms, but in most cases recovered completely and was henceforth immune.
In 1718, Mary had her five-year-old son Edward successfully inoculated in Turkey, with the help of Charles Maitland, a surgeon attached to the British Embassy.
In early 1721, after the family had returned to Britain and there was a smallpox outbreak, she had Maitland inoculate her three-year-old daughter Mary, publicising the process in the hope that it would become accepted.
Despite her demonstration of the effectiveness of inoculation, and the support of the Prince and Princess of Wales, scepticism remained among the medical profession and the public.
So in June 1721, the royal couple sponsored a remarkable experiment in which prisoners under sentence of death who had not had smallpox were offered pardons if they would agree to be inoculated.
The President of the Royal College of Physicians, Sir Hans Sloane, and his colleagues chose six poor wretches languishing in London’s infamous Newgate Jail awaiting the hangman – three men and three women aged between 19 and 36, all of whom had been convicted of theft.
Maitland was recruited to perform the inoculations and on August 9, he inserted smallpox pus into incisions in the prisoners’ arms and legs.
As physicians closely monitored the experiment, five of the convicts developed mild symptoms, but barely a month later were fully recovered.
One, 19-year-old Richard Evans, failed to contract the disease and then admitted to Maitland that he had lied about never having smallpox – he had had the disease the previous year. In the event, his deception was helpful, proving that natural infection conferred immunity.
So on September 6, Evans was freed under the terms of the pardon along with four of the others – ‘all dismiss’d to their several Counties and Habitations’.
However, one of the convicts, 19-year-old Elizabeth Harrison – who had been sentenced to death for stealing 62 guineas from her mistress – was kept on to help further verify the success of the experiment.
Maitland took her to Hertford, where smallpox had broken out. Elizabeth was put to work nursing a servant who had the disease, then for six weeks lay every night in the same bed with a ten-year-old boy who was suffering from smallpox. She emerged perfectly well – proving that inoculation gave immunity from naturally-occurring smallpox as well as the induced version.
There was still a long way to go before the disease could be conquered. But in 1796 came the gigantic leap forward when Edward Jenner showed that protection against smallpox could be given by using an inoculation of the much milder cowpox. Thus the words vaccine and vaccination – from vacca, the Latin word for cow – entered the language.
From there, smallpox was under siege and on May 8, 1980, the World Health Organisation declared that it had been eradicated – the only human disease so far to have been wiped out.
Whether Covid-19 will meet a similar end now that we have vaccines remains to be seen. But the controversy over the pandemic shows no sign of ever being eradicated.