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Excerpts from the Annual Register of 1769 on Smallpox Inoculation (80-86)

A short account of the manner of inoculating the small-pox on the coast of Barbary, and at Bengal, in the East Indies, extracted from a memoir written in Dutch by the Rev. Mr. Chais, at the Hague; by M. Maty, M.D.S.R.S.

April 14, 1768.

Having long thought that the Arabs, who about the middle of the sixth century, were the first to write upon the small-pox, were likewise the first inventors of the method to prevent the fatal consequences of that cruel disorder, I was very desirous to get what information I could concerning the introduction of inoculation in Africa, and in the East-Indies.

About twenty years ago, Cassen Aga, a Tripolitan ambassador at London, informed the people about him, that inoculation was universally practiced, as well at his court, as at Tunis and Algiers; but that no certain account could be given, either of the introducers of the method, or of the place from whence it took its rise.

One of the chief ministers of the state in Holland was so good, on this information, and at my desire, to send a few queries on that subject, drawn up by myself, to a gentleman, who, for several years, has resided with a public character at Algiers. The following is a summary of his answers to my queries:

"The small-pox is, as well as in Holland, a contagious distemper at Algiers, Tunis, and Tripoli, and fully as destructive. In order to avoid the bad consequences of the natural disorder, many people have recourse to inoculation, which there is performed in a very different manner from what is used in our country. The person, who intends to be inoculated, having found out a house, where the small-pox is, and is of a good sort, goes to the bed of the sick person, if he is old enough, or, if a child, to one of his relations; and speaks to him in the following manner: I am come here to buy the smallpox; the answer is, buy if you please. A sum of money is accordingly given and one, three, or five pustules (for the number must always be an odd one, not exceeding five), extracted whole, and full of matter. These are immediately rubbed upon the skin of the hand, between the thumb and forefinger. This is sufficient to communicate the infection; and as soon as it begins to take effect, the inoculated patient is put to bed, carefully covered with red blankets; and heating medicines are given him with some honey of roses. He is allowed goat's broth for his nourishment, and for his drink an infusion of some herbs; notwithstanding this treatment, it seldom happens that the smallpox procured in this manner has any bad consequences; and almost never that any body dies of it; but hitherto the proportion of the mortality in the natural, to that in the artificial way, has not been ascertained. Lastly, though the time when this practice was introduced in Africa be unknown, yet it is there very old, and the Arabs are generally thought to have been the inventors of it."

From this account it plainly appears; 1. That in Africa the operation is performed as it is in Wales, by the rubbing in of the matter, and that this is done to prevent the fatal consequences too often following the natural infection; 2. that this inoculation is generally successful, notwithstanding the heat of the climate, and the bad management of the patients; and 3. that the origin of it is very ancient and ascribed to the Arabs.

Before I received this information these informations from Algiers, I had engaged some friends settled in three different parts of the East-Indies to procure me some accounts from thence, upon the same subject. I, at last, received an answer from one of them, who resides at Patna, in the province of Behaar, 180 leagues from Bengal.

"I have sent for several physicians, to be informed of the things you seem desirous to know about inoculation; the practice is hitherto not used in this province; but having met with a Bengalian doctor, he gave me the following account.

"That the first introduction of the operation at Bengal is now unknown, it has been in use in that country for a very long time, and is performed in two different ways.

"For the first, some of the variolous matter of a good kind having been gathered is kept for use. When a child is to be inoculated, the skin between some of the fingers is pricked by means of two small needles joined to one another. After having rubbed in a little of the matter upon the spot, a circle is made by means of several punctures, and matter is again rubbed over it. The wound is then dressed with lint; a fever ensues, and after some days, the eruption, which if the fever has been strong is observed not to be very copious. To excite the fever, the patient is made to bathe in a tub of water.

"As this way of managing the operation is very painful, a more easy one has been invented for people of quality and substance. A little of the matter is mixed with sugar, and swallowed by the child in any sweet and pleasant liquid. The same effect is produced, but the first method is thought to be the best."

The writer of this letter ought certainly to have been more particular in his inquiries; he might have asked whether any preparation previous to inoculation is used, and of what kind; what treatment the patients undergo after the operation, and lastly, how far the event warrants the goodness of the method. It appears, however, from what he says, that the people of Bengal have for a long while had recourse to inoculation, in order to avoid the dreadful consequences of the natural distemper in their country; and it is to be wished that farther inquiries be made, both there and elsewhere, about a subject which so nearly concerns the good of mankind.

An Account of Inoculation in Arabia; in a letter from Dr. Patrick Russell, Physician at Aleppo to Alexander Russell, M.D.F.R.S. preceded by a letter from Dr. Alex Russell to the Earl of Morton, P.R.S.

May 5, 1768

My Lord,

The inclosed account of inoculation in the East, I have just received from my brother at Aleppo, and though nothing farther seems wanting in this country to remove prejudices against that practice, yet I thought its being made public might be of some use to other European nations, where such prejudices still prevail; and as a matter of curiosity would not be unacceptable to the Royal Society, I have therefore taken the liberty to trouble your lordship with it for that purpose.

Just before my leaving Aleppo, I did hear that it was practiced amongst some of the Bedouins there, and went by the name of buying the small-pox; but being then much engaged with other business, it quite escaped my memory, and, indeed my information was so slight, that I did not think it right to mention it in my Natural History of Aleppo.

I shall only add, that my brother has been more prolix in the narrative than perhaps was necessary, had the facts come within his own knowledge; but so far as depended upon the intelligence of others, he thought it best to explain the foundation of his own belief. I have the honour to be,  My Lord, Your Lordship's Most Obedient Servant, Walbrock, April 18, 1768 signed Alex Russell.

Dear Brother,

From the manner in which inoculation is mentioned in the Natural History of Aleppo, I suspect the circumstance of its being a common practice among the Arabs must have escaped you. I myself was ignorant of it for several years after you left this country, and a mere accident brought it at last to my knowledge. About nine or ten year ago, while on a visit at a Turkish Harem, a lady happened to express much anxiety for an only child, who had not yet had the small-pox; the distemper at that time being frequent in the city. None of the ladies in the company had ever heard of inoculation; so that, having once mentioned it I found myself obliged to enter into a detail of the operation, and of the peculiar advantages attending it. Among the female servants in the chamber was an old Bedouin, who having heard me with great attention, assured the ladies, that my account was upon the whole a just one, only that I did not seem so well to understand the way of performing the operation, which she asserted should be done not with a lancer, but with a needle; she herself had received the disease in that manner, when a child; adding moreover, that the practice was well known to the Arabs, and that they termed it buying the small-pox.

In consequence of this hint, I set about the procuring more particular information from the Arabs of this place; and the result of my enquiry was, that the practice of inoculation had been of long standing among them. They indeed did not pretend to assign any period to its origin; but those of seventy years old and upwards remembered to have heard it spoken of as a common custom of their ancestors, and made little doubt of its being of as ancient a date as the disease itself. Their manner of operating is, to make several punctures in some fleshy part, with a needle imbued in variolous matter, taken from a favourable type of pock. They use no preparation of the body; and the disease communicated in this way being, as they aver, always slight, they give themselves little or no trouble about the child in the subsequent stages of the distemper.

This method of procuring the disease is termed, buying the small-pox, on the following account. The child to be inoculated carries a few raisins, dates, sugar plumbs, or such like, and shewing them to the child from whom the matter is to be taken, asks how many pocks he will give in exchange. The bargain being made, they proceed to the operation. When the parties are too young to speak for themselves, the bargain is made by the mothers. This ceremony, which is still practiced, points out a reason for the name given to inoculation by the Arabs; but, by what I could learn among the women, it is not regarded as indispensably necessary to the success of the operation, and is in fact often omitted.

The Bedouins at this place, who are employed in the service of the Harems, more rarely have recourse to inoculation, their children being often brought up in company with those of the Turks, by whom, as you justly observe, the practice is not admitted. But the Bedouins, less connected with the Turks, who dwell within the city; those who live in tents without the city walls, and the Arabs of the adjacent desart under the Emir, do commonly inoculate their children.

It is highly probable that a practice, which was so common in these parts, might be known also to the more Eastern Arabs, I applied for information to several Turkish merchants of Bagdat and Mousul, who occasionally reside a few months in the year at Aleppo. By those I was assured that inoculation was not only common in both the cities first mentioned, but also at Bassora; and that at Mousul particularly, when the small-pox first appeared in any district of the city, it was a custom sometimes to give notice by a public crier, in order that such as were inclined might take the opportunity to have their children inoculated.

I enquired at the same time of the Bagdat merchants, whether the Arabs who dwelt on the banks of the river between the city and Bassora used the same method of propagating the small-pox. They told me, they believed it to be common also among those Arabs; though . . . they owned they had never thought of enquiring about the matter, and might therefore perhaps be mistaken. But I afterwards had an opportunity of being better informed by the Arabs who come hither with the Eastern caravans; from whose accounts it would appear, that inoculation has, from time immemorial, been a practice among the different Arab tribes with which they were conversant; comprehending, besides those in the numerous encampments on the banks of the Euphrates, and the Tigris below Bagdat, other tribes in the vicinity of Bassora, and in the desart.

For these several years past, very few slaves have been brought from Georgia. From what I could collect among those already here, who remember any thing of their own country, inoculation was well known there: I have seen several old Georgian women, who had been inoculated, when children in their father's houses.

In Armenia, the Turkoman tribes, as well as the Armenian Christians, have practiced inoculation since the memory of man; but, like the Arabs, are able to give no account of its first introduction among them.

To what extent inoculation reaches in the Gourdeen mountains, I do not know with any certainty, it is practiced by the Gourdeens in the mountains of Bylan, and Kittis; and, I have reason to think, extends much further.

At Damascus, and all along the coast of Syria and Palestine, inoculation has been long known. In the Castravan mountains, it is adopted by the Drusi, as well as the Christians.

Whether the Arabs of the desart, to the south of Damascus, are acquainted with the manner of communicating the small-pox, I have not hitherto been able to learn; but a native of Mecca, whom I had occasion to converse with this summer, assured me, that he himself had been inoculated in that city.

It has already been mentioned, that the Turks at Bagdat and Mousul make no scruple to inoculate their children. I have seen also some Turkish strangers here, who had been inoculated at Erzeroon. Hence it is probable that the Turks, in other parts of the Ottoman empire, do not merely, as fatalists, reject inoculation; but that other considerations, which have influence in countries where fatalists are ridiculed or anathematized, concur likewise in Turkey, to oppose the reception of a practise so beneficial to mankind. The child of a Bashaw here, was by my advice inoculated about eight years ago; but that is the only instance I have known among the Turks at Aleppo.

. . . .

From the sameness of the name, as well as from the little diversity observable in the manner of performing the operation, it is probable the practice of inoculation in these countries was originally derived from the same source; and that it is of considerable antiquity, can hardly be doubted, if we consider the large extent of country over which it is found to have spread, and the obstacles it must have met with in a progress through various nations, of which some are separated by polity as well as religion, while others, peculiarly tenacious of their own customs, are little disposed to admit those of strangers.

. . . .

It appears from accounts communicated to the Royal Society in the year 1723, by Doctor Williams and Mr. Wright, that inoculation had been known in certain parts of Wales so far back as the last century; and it is remarkable that it there bore the same name, by which it is most generally known to the Arabs. I think it has also been discovered to be an ancient practice among the vulgar in different parts of the continent. . . . What may, perhaps, appear more strange, is, that after the year 1720, though the curiosity of the public has, at different times, been excited by the controversies relating to inoculation, the state of that practice in Syria, where there were so many European settlements, should have remained unknown both in England and in France, which probably was the case, as the advocates of inoculation have made no reference to it.

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