We are all familiar with Louis Pasteur and his work with vaccinations in the later part of the 19th century. Not as well known is that the concepts behind vaccinations were developed long before that.
The origins of inoculation
Early in the 18th century, variolation (referred to then as ‘inoculation’) was introduced to Britain and New England to protect people likely to be at risk of infection with smallpox. This triggered a number of important developments. Among them were early examples of what we refer to today as ‘evidence-based medicine’ – immunization, and quantitative measures of disease severity.
Establishing the protective effects and subsequent spread of variolation paved the way for recognition that inoculation with cowpox (vaccination) also conferred protection. The definitive experiments that established that vaccination was protective showed that variolation did not ‘take’ following vaccination, thus confirming that immunity had been achieved. Vaccination led ultimately to the eradication of smallpox, one of the great achievements of medicine. Given the central role of variolation in these significant events, it is worth investigating where the practice originated.
Inoculation in parts of the Ottoman Empire and Europe
Working backwards in time from the first variolations in Britain and colonial Massachusetts in 1721, it is possible to trace the practice back for at least a century in parts of the Ottoman Empire and Europe. In 1714, a letter written by Emanuel Timonius at Constaninople was circulated around Europe and read to the Royal Society by John Woodward.
‘The writer of this ingenious discourse observes, in the first place, that the Circassians, Georgians, and other Asiatics, have introduced this practice of procuring the smallpox by a sort of inoculation, for about the space of forty years, among the Turks and others at Constantinople.’