170 ACTIVE IMMUNIZATION 



pox is greatly diminished by the introduction of the virus through the 

 skin is not known. But the principle was evidently already exten- 

 sively utilized in Turkey for prophylactic purposes early in the 

 eighteenth century. For in 1718 Lady Montagu, the wife of the 

 English ambassador at the Ottoman court, wrote to a friend as 

 follows: "The smallpox so fatal and general amongst us, is here 

 entirely harmless by the invention of engrafting which is the term 

 they give it. Every year thousands undergo the operation, and the 

 French ambassador says, pleasantly, that they take the smallpox 

 here by diversion, as they take the waters in other countries. There 

 is no example of anyone who has died in it, and you may well believe 

 I am satisfied of the safety of the experiment, since I intend to try 

 it on my dear little son. I am patriot enough to take pains to bring 

 this useful invention into fashion in England." 



As a matter of fact Lady Montagu's daughter was the first person 

 inoculated for prophylactic purposes in England. The material 

 used for this purpose was the purulent matter obtained from small- 

 pox pustules "of the distinct kind," which was then applied to two 

 small incisions just through the skin, on "Dossils of Lint." 



Of the subsequent occurrences, Dr. Allen, a fellow of the Royal 

 Society, then gives the following account: "About the eighth day 

 after the operation some Pustules begin to appear, not unlike to those 

 that are commonly seen in the distinct kind, a little Fever having 

 preceded the Eruption, and the other usual Symptoms, but more 

 mild and gentle. ... In the general it is observable that the 

 Smallpox procured by Inoculation are of the distinct kind, for the 

 most part void of danger, that the Pustules are few in number and 

 pit very little." With this method many thousands of persons were 

 subsequently treated. 



As regards the prophylactic value of these inoculations in England 

 accurate statistical reports are unfortunately lacking, but it seems 

 from the writings of contemporary observers that the protection 

 was regarded as complete. As regards the dangers of the process 

 there is some diversity of opinion. The Sutton brothers, who did a 

 great deal to perfect the technique of inoculation, thus claim to have 

 inoculated not less than 20,000 persons without losing one as the 

 direct result of the operation. Dr. Gregory, of the London Smallpox 

 Hospital, placed the mortality rate at one in five hundred. Sir 

 Thomas Watson writes: "No doubt the distemper was produced 



