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“I must go soon, my lady,” said Zabdiel when he met Lady Mary again.
“Go?” she teased. “You have only just arrived.”
“I am not talking about this instant,” he said. “I must go home, my lady.”
“To America?” she protested. “But you have interest at court, you have friends, you are building a reputation. Why will you not make your home here? In Boston, what will you be?”
There was a silence broken only by a tumble of coals in the grate. “A surgeon, my lady,” he said gently. “I belong there. My family is there, and my duty.”
“Your duty is to finish your book.”
“That is what I came to tell you,” he said. “I have finished.”
“You must forgive me,” she said ruefully. “I do not have friendships to spare just now. I would not lose yours without a fight.”
“I finished a book,” he said. “I did not say I finished a friendship.”
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At the beginning of May, Zabdiel's book came back, warm and damp from the printer. In the middle of the month, he was given leave to make a formal presentation of his book to the Princess of Wales, and received the triple gift of a royal blessing, a royal reward, and a royal dismissal.
On the nineteenth, he was invited once more to the Royal Society, where he presented the Fellows with another fine copy. They asked him, as was usual, to give them a short account of what was in it. He had not prepared for this, and momentarily froze. But he forced himself to his feet, recalling their kind reception of his ambergris paper, and took a deep breath. Calmly, concisely, he told them the story, from its beginning in Dr. Mather's letters, to his investigations among the town's Africans, to his terrifying experiment on his youngest son and two slaves. Pitilessly, he laid out before them the shortcomings of both the treatment and his usage of it: Esther Webb's infection from her inoculated parents, Bethiah Nichols's loss of both an eye and an unborn child, Mrs. Dixwell's suffering and death.
But he also gave themâas he had learned from Dr. Jurin, Dr. Arbuthnot, and the other mathematically inclined fellowsâthe numbers. Numbers that marched in line with Dr. Jurin's calculations for London: inoculation offered somewhere between a one-in-fifty and a one-in-a-hundred chance of dying, depending on how sanguine or skeptical you were about the deaths surrounding the practice. Natural smallpox forced a one-in-six or -seven chance upon its victims.
His audience, he noticed with surprise, was straining forward to catch every word. He cautioned them. It was not a victory: he could not in honesty tell them that. Smallpox still lived and breathed, scattering its terrible spotted death on large numbers of people. And yetâand yetâfor the first time in history, it had become possible to say following. He opened his book to a passage he had marked and read:
It is and shall be acknowledged to the praise and glory of God! By this happy discovery of transplantation, also called inoculation, a most wild, cruel, and violent distemper which has destroyed millions of lives is now become tractable, safe, and gentle
.
He looked back up. “So you see, gentlemen, we have tamed the small-pox.”
For a moment, no one said anything. Then Dr. Jurin rose to his feet, followed by Sir Hans, Dr. Steigerthal, Dr. Mead, Dr. Arbuthnot, and Mr. Cheselden. On and on around the room, his new friends and acquaintances rose, until Sir Isaac Newton himself rose tottering from the president's chair to join in the stamping and cheering of the standing ovation, while Dr. Boylston watched in utter amazement.
A week later, Dr. Steigerthal nominated him as a Fellow, and he was duly elected. On July 7, 1726, to general approbation, beaming, and applause, a still astonished Dr. Zabdiel Boylston was installed as the newest Fellow of the Royal Society. In the ensuing weeks, he lectured there and at the Royal College of Physicians, the new F.R.S. flapping proud and tall at the end of his name.
He sent a third fine presentation copy to a certain house in the Piazza, Covent Garden.
“I have found but one fault in your book, Doctor,” said Lady Mary with a wry smile, as Zabdiel called to take his leave. “False modesty.”
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A few weeks later, Dr. Zabdiel Boylston,
F.R.S.,
and his two black slaves took ship for Boston and home.
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Alone in her sitting room, Lady Mary penned the last sentence of her tale of torn love:
Abandoning the views he had of making his fortune, his interest at court, his friends, and reputation,
she wrote of her hero,
he left the kingdom as soon as possible and went to finish his life in the solitudes of America, where some of his relations were established, secure of less barbarity amongst the savages than (he thought) he had met with in the fairest princess of France
.
To Sir Hans Sloane
Boston, December 14, 1726
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Much Honored and Worthy
Sir,
A sense of gratitude for the many obligations you have laid me under will not suffer me any longer to rest in silence. After a long and expensive voyage, I am safe arrived to my family, friends, and country, from whom I have received a hearty welcome. I shall always acknowledge the honours done me by Sir Hans, and as often as I have opportunity to collect anything worthy of your notice, who are so nice a judge of Nature, I shall think myself in duty and honour bound to present you with it.
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For starters, he was enclosing a five-and-a-half pound stone taken from a gelding's belly. Had killed the horse, of course. But was hopefully a fine prize for a man so fascinated by bezoars. Perhaps this summer he would conduct some proper experiments on another of their shared interests: rattlesnakes.
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I am
Dear and honored Sir,
Your most obliged
and devoted servant,
Zabdiel Boylston
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P.S. I have not heard that any one of our anti-inoculators have said any
thing against the truth of my account given of the practice, and some of my
friends say there is but one fault in it, and that is that I was too modest in
debunking the opposers.
2
THE PRACTICE
BOSTON remained free of smallpox until September of 1729, when the speckled monster once again invaded from the sea, as a ship from Ireland disembarked infected passengers. The contagion smoldered until early in 1730, when it exploded once again into an epidemic.
Boylston immediately republished his
Historical Account
for the benefit of Bostonians; far more surprisingly, Douglass concededâhowever cautiously and ungraciouslyâthat the operation had its merits. Far from apologizing for his slurs against Boylston, however, he remained as churlish as ever toward his old rival, whom he still refused to grant the title of “doctor.”
I can but seldom have recourse to Mr. Boylstone's Accounts, because of their being so jejune, lame, suspected, and only in the nature of Quack bills
.
The town government was not yet ready to encourage inoculation, but resigned itself to the operation's inevitable popularity; there were no more attempts made to outlaw it. This time, about 4,000 people fell ill and 500 died. About 400 were inoculated, of whom 12 diedâabout 1 in 33: as Douglass remarked, these numbers were “not so favourable as in 1721.” They were still considerably better than the 1 in 8 odds of dying after catching smallpox in the natural way, however. Possibly the problems came from inexperience: in addition to Dr. Boylston and Dr. Douglass, many of the town's other doctors appear to have taken up the practice. Very probably, some of that dip in its success rate was due to European physicians' tendency to cut deeper and longer, and use more “matter” than was common in the folk practice.
The 1730 epidemic, however, passed off lightly in comparison to the catastrophe of 1721, and seems to have confirmed in many people's minds that inoculation was a lifesaver, though the opposers were by no means silenced. Again, the disease passed, and Boston was safeâfrom both the smallpox and inoculationâfor another twenty years.
Then, on Christmas Eve, 1751, a ship wrecked in Nahant Bay, and the people of the town of Chelsea poured out to the beach to rescue the survivors. In the chaos, the captain did not tell anyone that the smallpox was aboard; within a month many of the rescuers and their families died for their kindness. In Chelsea, somewhere between a fifth and a quarter of the population died.
Across 1752, the infection whipped through Massachusetts. Of Boston's 15,684 residents, 1,843 fled. Among those who remained, 5,545 caught smallpox in the natural way, and 539 (about 1 in 10) died; 5,589 were immune, having survived it before. It's the inoculation numbers that are really notable, though: 2,124 people were inoculated, and only 30 (1 in 70) died. As Dr. Douglass himself admitted, “The Novel Practice of procuring the Small-Pox by Inoculation is a very considerable and most beneficial Improvement in that Article of Medical Practice.”
The epidemic was not confined to Massachusetts; it spread up and down the coast through all the major port cities of Britain's American colonies. In Philadelphia, Ben Franklin became an ardent supporter of inoculation, using his editorial control of the press to trumpet the procedure's merits. Six years later, though, his four-year-old son Francis died from smallpox before he could be inoculated; Franklin blamed himself for that death for the rest of his life. After he became a wealthy man, he paid for large numbers of Philadelphia's poor to undergo the expensive operation.
Both directly and indirectly, inoculation had a major impact on the American Revolution. It certainly protected a number of the fledgling country's great statesmen. Boylston's great-nephew John Adams (the grandson of Zabdiel's older brother Peter) had himself inoculated in Boston in 1764. Meanwhile, his fiancée, Abigail Smith, was banished from his side, reduced to disinfecting his letters with smoke before she read them; she was so lonely she threatened to come to the hospital to wave at him through a window. Down in Virginia, Thomas Jefferson had himself inoculated after losing a beloved sister to the disease. When the Continental Congresses convened in Philadelphia in 1774 and 1776, members who had not yet had smallpox had to wrestle with the decision whether to inoculate themselves or stay away; most decided to inoculate themselves. The Declaration of Independence was written and signed in safety as smallpox stalked the streets outside.
After receiving good evidence that the British were using smallpox-infected blankets and refugees as an insidious weaponâand knowing the terrible vulnerability of most of his menâGeorge Washington had the entire Continental Army inoculated in 1777. Washington's own face was already famously scarred from an earlier bout with the disease, contracted on a visit to Barbados in 1751. But Martha had herself inoculated, so that she might visit her husband in the soldiers' camps with impunity; smallpox parties became popular among Revolutionary womenâincluding Abigail Adams and Mrs. John Hancock.
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In London, inoculation's popularity waxed and waned through the 1730s, with the force of the disease: in bad years, people flocked to be inoculated; in light years, the practice shrank. Inoculation was a securityâthe
only
securityâto cling to within the terror of an epidemic; in times of good health, however, it looked like a foolish flirtation with danger. (This is not unlike the
vaccination
for smallpox at present: in case of an outbreak of the disease, the vaccination is all that may stand between humanity and a massive, speedy die-off the likes of which this planet has not seen since the Black Death. In the absence of a real and compelling threat of smallpox, the vaccination itselfâwhich kills one to two in a million and can seriously harm many moreâis a danger not to be messed with.)
In 1743, inoculation became mandatory for the orphans of London's Foundling Hospital; after the disease ran amok in 1746, a dedicated Small-pox and Inoculation Hospital was established, originally for the “deserving” poor and for servants of its wealthy contributors (such establishments as the smallpox house in Swallow Street proving too small and unregulated). On the Continent, despite early support by such thinkers as Voltaire, it took decades for the practice to break through barriers of conservatism. Holland was the first country to experiment with it and adopt it widely.
In later years, a series of self-proclaimed innovators (particularly James Kirkpatrick and Robert Sutton) announced at different intervals that the practice had died out, but that they had invented a brand new “light” process that would make inoculation safe and easy. In effect, they were rein-venting the Turkish, Greek, and African wheels: reverting to scratches or very shallow cuts, and using tiny droplets of matter.
On the other hand, the physicians kept “improving” the process according to the best medical theories of the time. They preferred ever longer “preparations,” often involving bleeding, vomiting, and purging, as well as cordials containing antimony and mercury. Many of the scholars who have studied this history most carefully come away shaking their heads, with the conclusion that doctors unwittingly “took a (relatively) safe procedure and made it dangerous.”
Its danger and discomforts kept many people from risking it. In 1754, the uninoculated Prince of Wales fell ill with the smallpox, but survived to become King George III; the following year, the Royal College of Physicians formally endorsed the operation. In a terrible twist of fate, in 1783, this king's four-year-old son Octavius died as a result of being inoculated; the young prince was, however, the last royal Briton to suffer the disease.
For all its shortcomings, as Genevieve Miller has written, “Inoculation was the chief
medical
contribution of the Enlightenment, at least in the opinion of the age itself.”