When inoculation against smallpox was introduced to Britain from the Middle East in the early 1720s, members of the Royal Society found themselves on the wrong side of both conventional wisdom and contemporary piety.
Publishing the Philosophical Transactions has now been under way for a month, and as we orient ourselves in the Royal Society archives we’re beginning to find fascinating historical material relating to the pitfalls of science publishing…
When inoculation against smallpox was introduced to Britain from the Middle East in the early 1720s, members of the Royal Society found themselves on the wrong side of both conventional wisdom and contemporary piety. Inoculation by variolation – deliberately infecting a healthy patient with a mild case of the disease – was introduced to Britain in 1721 by Lady Mary Wortley Montagu, the wife of the English ambassador at Constantinople.
Fellows of the Royal Society were among the early champions of the technique but it also became the subject of much wider scrutiny when members of the Royal Family, fearful of the series of outbreaks of the disease in 1721 but equally fearful of its cure, agreed to a singularly inhumane clinical trial. Six condemned prisoners were to be subjected to the procedure in exchange for clemency if they survived. They did, and the royal children were duly inoculated. The treatment soon became widespread, though physicians kept a careful eye on the outcomes and compared notes.
One of these was James Jurin, then Secretary of the Royal Society. He was also the editor and publisher of the Philosophical Transactions, and he used the journal to track and promote the success of inoculation in England. He solicited accounts of trials from physicians up and down the land and published them in Phil Trans as they arrived. It’s a striking early instance of an attempt to co-ordinate medical research. It also suggests the extent to which the journal could be used as a mechanism of persuasion, a means of promoting a particular medical agenda.
This was the more necessary because, despite the notoriety of the royal inoculation, the technique hadn’t gained straightforward acceptance everywhere. It met with resistance from people who assumed, not wholly unreasonably, that to infect oneself intentionally with smallpox was to invite disaster; and from the pious, who argued that to attempt to cure or prevent smallpox was to presume against God, who visited the disease upon its victims as a trial, a punishment, or a blessing, according to interpretation. Edmund Massey preached a striking sermon on the folly of inoculation in 1722, taking Job’s boils as his text. Reading him, one suspects that his objections extend beyond the practice of inoculation to medical intervention as such: and indeed, half way through the text, he suggests that most patients would be better off if their doctors left off doctoring and prayed for them instead.
The case for inoculation was finally unanswerable: fewer than 2% of those inoculated died of the procedure, where the death rate among those who caught the natural disease during an outbreak could be anywhere between 10 and 25%. In absolute terms, Jurin calculated, 7% of all deaths were caused by smallpox. Jurin and his colleagues began to collate those figures in the Phil Trans from early 1723, and the article was republished as a pamphlet when new information became available. Jurin also published updated accounts annually.
However, reports also began to be spread in the London newspapers of patients dying of the treatment. Fear of the disease was very high, and in the summer of 1722 it was never out of the papers, in the form of reports of the epidemic in Paris, the deaths of prominent victims, accounts of successful and unsuccessful inoculations (as in a letter from Salisbury reporting on the death of an MP’s daughter in Nathaniel Mist’s Weekly Journal of 26 October and inveighing against the 'wicked and sinful' practice), and adverts for patent medicines and specifics against it. Some of these had spectacular names – the 'only true original royal chemical washballs' which were advertised in issue after issue of the Daily Courant and the Weekly Journal, for instance.
One reference in particular caught the eye of Thomas Nettleton, a physician in Halifax, who saw it reported in several papers sent up from London (unfortunately he doesn’t say which ones) that a patient of his had died from being infected with smallpox in the name of inoculation. In fact the patient had done no such thing, but Nettleton was too anxious about the damage this could do to his reputation, and to the cause of inoculation more broadly, to let it pass without a speedy rebuttal. He wrote about the matter to Jurin, who consulted with a colleague and paid for space in the London Daily Journal to refute the assertion and print certificates to that effect from the physicians and families of those involved. It’s a powerful indication that when contentious research or new treatments were misreported, the usual channels of scientific communication, highly respectable but slow to appear and limited in their circulation, weren’t adequate to address the mistake; more public action was needed.
In a world where popular and ephemeral print was gaining ever more traction – and particularly when new medical procedures or new research were counter-intuitive and frightening in their implications – medical researchers and natural philosophers had to defend themselves on two fronts, gathering data and establishing the credibility of their work through the learned journal on the one hand, and venturing into the rather less controlled environment of the Grub Street press on the other. The ways in which developments in other media impinged upon the Philosophical Transactions, whether to make the journal more publicly engaged or less, will be one of the key themes of our project…
Portrait of James Jurin, by James Worsdale, ca. 1740s © The Royal Society