Disease Fighting Woman: Mary Montagu

Annmaria on Monday

Lady Mary Wortley Montagu did not invent inoculation.  She found out about the practice in the 18th century, from Turkish women.  Sad to say, history did not record the Turkish women's discovery, so we cannot laud them for their priceless contribution to disease prevention. But at least, today, I can set the MIE record straight on part of the contribution of women to this critical endeavor.

Last Wednesday, my colleague Kwei Quartey told us about early advances in immunization, beginning with the Scots physician Edward Jenner's fight against smallpox.  A brilliant contributor, no doubt, but Jenner was only thirteen years old when my entry into this pantheon. Lady Mary Wortley Montagu died.  She had already brought inoculation to England.

Lady Mary and Alexander Pope

I first learned about Lady Mary while studying 18th Century lit with my mentor and forever hero Sister Mary Catharine O'Connor PhD, PhD.  (Aside: This is not a typo.  This woman who had entered the convent at fourteen had two PhDs, both from Columbia University!) While teaching the works of Alexander Pope, SMC, as those who still love her called her, told us of Mary Montagu - her relationship with Pope and her many accomplishments.

Therefore, I already knew about Mary Montagu's medical exploits when Kwei told us, last week, about Onesimus, an African slave, who introduced the Bostonian Cotton Mather to the technique of inoculation.  Kwei quite rightly decried the fact Onesimus was left out of the history he had had read as a child.  Stan also quite rightly blamed Eurocentrism as the culprit.  I applaud anyone who corrects the historical record, especially when it comes to the almost total emphasis on the accomplishments of the white men.  Today I am here to correct the record on behalf of Lady Mary, a largely ignored woman when it comes to fighting disease.

Mary Pierrepont - born 15 May 1689 - aristocratic, beautiful, powerfully intellectual, owed her accomplishments entirely to herself.  Ignoring the "superstitious tales and false notions" that her governess tried to foist upon her, Mary, as a child and young woman, spent just about all her waking hours everyday in her father's extensive library, teaching herself Latin, mastering the classics in many subjects, and beginning extensive correspondences with a couple of Bishops who added to her self-education.

A celebrated beauty, even as a small child, she was on her way to being auctioned off to the highest bidder. Her father was putting the finishing touches on her marriage contract: an alliance with the most valuable possible suitor, a man with the absurd name of Clotworthy Skeffington.  But Mary was already in love with a friend's brother, Edward Wortley Montagu.  Just in the nick of time, the young couple eloped.

In the early 18th century, smallpox was a huge curse on humanity.  Intensely infectious and deadly - it killed twenty-five percent of the people who caught it.  Those who got out of it alive remained disfigured with scars.  Standard medical practices at the time included purging with emetics and bleeding, either through cuts in the flesh or the application of leeches.

Just a year after Lady Mary married, her favorite brother died of smallpox.  Two years later (1715), she herself contracted the dreaded ailment.  She survived, but her legendary beauty was spoiled.

 Meanwhile, her husband's career was going well.  He was named Ambassador to the Ottoman Empire.  She and their children went with him to Constantinople.  Her greatest claim to fame today comes for the letters she wrote while there.  As a woman, she was allowed to visit the women's quarters in Turkish court homes.  She wrote into the record vivid first-hand accounts of how those women lived.

She also learned how they prevented smallpox.  By taking live bacteria from the mildly infected and scratching it into the skin of well people.  Women practiced this technique.

Intent on protecting her own children, she talked over the issue with the British Embassy Surgeon, Charles Maitland.  Though he wasn't exactly keen on the idea, he did agree when she decided to have her nearly five-year-old son inoculated.  Young Edward Wortley Montagu was the the first English person ever to receive such a preventative treatment.  As was the ordinarily the case, the boy became mildly sick, recovered in a few weeks, and was safe from smallpox for the rest of his life.

Caroline, Princess of Wales

The family was back in England in 1721, when a major outbreak occurred.  Maitland, also then in London, agreed to inoculate Lady Mary's daughter - the first time such a treatment was used in Britain.  The medical profession was outraged.  But sisterhood took over.  Lady Mary convinced the the Princess of Wales, Caroline Ansbach to sponsor a test of the procedure.  Seven prisoners awaiting execution in Newgate Prison got an offer they couldn't refuse.  If they would agree to inoculation, they would earn their release.  They all survived and lived free.  The outcry against the procedure ramped up.  But the women involved stuck it out.  The Princess had Caroline and Amelia, her two daughters inoculated the following year.  In Russia, Catherine the Great herself and her son Paul, the future Tsar were inoculated later in the century.

In those early days, when the procedure was in its infancy, there were some dangers.  A small percentage of the people treated did develop serious cases.  But most lived on with immunity.

When Lady Mary died in 1762, Edward Jenner was still a child.  He did, as Kwei reported last week, develop a safer protection against smallpox using cowpox bacteria.  I maintain that these later improvements, while certainly great achievements, would not have been possible were not for the pioneering work done by the anonymous Turkish women and Lady Mary's insistence that the technique had merit.  They led the way.  The men who came along later built on the base of the women's idea.  And took the credit.