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She Survived Smallpox and Then Swayed Doctors

Natalia Pasternak, PhD

Disclosures

April 29, 2022

Lady Mary Montagu's face was disfigured by smallpox. The British aristocrat, born in 1689, survived the disease that killed her brother. Naturally occurring and caused by the variola virus, the contagious illness affected people for thousands of years before it was wiped out worldwide after an unprecedented global immunization campaign.

But before the first vaccine was developed and implemented by Edward Jenner at the end of the 18th century, the most popular method to prevent smallpox was a practice called inoculation.

It consisted of collecting fluid from a smallpox pustule in a sick person and transferring it to a healthy individual. It wasn't as safe as a vaccine, of course, and people did sometimes get sick and even die, but when it worked, the inoculated were protected for life.

This pre-vaccine technique was not new in the East and was practiced in China since the year 1000. By 1661, it became an official public policy in China. Jenner himself was inoculated as a boy. And while observing that milkmaids infected by cowpox were protected from human smallpox, he had the idea of using that to create the first vaccine.

Jenner might not have known this, but he owes his discovery to a woman with a disfigured face who helped make the practice of inoculation popular in England during his time.

Lady Mary Montagu was not a doctor or even a scientist. She was a young woman born to a wealthy family. She refused the marriage arranged for her by her parents and at age 23 eloped with Edward Wortley Montagu, a prominent politician at the time. Her husband was sent to Turkey to work as the British Ambassador, and she decided to join him.

During her time in Turkey, Lady Montagu noticed that few people had smallpox scars like hers. A major smallpox outbreak continued in England, and when her husband was called back to work in the region, she was concerned about the health of their 3-year-old son.

Lady Montagu asked other mothers how they were protecting their children, and she learned about a group of wise older women who were practicing inoculation. The procedure was not without risks, but it was far better than having the disease. She decided to have her son inoculated. The procedure went well, and Lady Montagu was determined to share what she learned back home in England, with the hope that inoculation would help others.

But the medical community was outraged by the idea. What could a woman, who was not even a doctor, know about health and medicine? And basing a practice on an Eastern technique? What could the people there possibly know? Western medicine, built on bloodletting and laxatives was, of course, superior, they argued.

Lady Montagu, facing negative feedback and an attack on her reputation, convinced the Princess of Wales, Caroline of Ansbach (who was married to the future King George II), to run a clinical trial of sorts studying inoculation. Clinical trials were very different back then, so the experiment consisted of inoculating prisoners and orphans. Fortunately for the test subjects, it worked well. The princess went on to inoculate her own daughters. Her sons were deemed too valuable to experiment with.

Lady Montagu also had her daughter publicly inoculated to set an example. British surgeon Daniel Sutton standardized the procedure, against the recommendations of many other doctors.

It took time for the technique to become popular in Britain, but it was catching on by the mid-18th century.

The work paved the way for Jenner to come up with the world's first vaccine in history. And it is in no small part thanks to Lady Mary Montagu, one of the world's first science communicators and diplomats. She survived smallpox, protected her children, advocated for others, and earned her place in the history of life-saving vaccines.

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About Dr Natalia Pasternak
Natalia Pasternak, PhD, has a bachelor's degree in biology from the University of São Paulo and a PhD and postdoctoral fellowship in microbiology (bacterial genetics) at the Institute of Biomedical Sciences. In 2018, she founded the Instituto Questão de Ciência in Brazil, the first Brazilian institute for the promotion of skepticism and critical thinking. She is the publisher of Questão de Ciência magazine; a columnist or contributor for O Globo newspaper, CBN radio, and The Skeptic magazine (UK); and a fellow of the Committee for Skeptical Inquiry (US). Currently, she works as a research fellow in the Vaccine Development Laboratory at the University of São Paulo, is a visiting professor at the Public Administration School at Fundação Getulio Vargas, São Paulo, and is a senior adjunct research scholar at Columbia University's Center for Science and Society.

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