Is It Worth the Risk?

This chapter details how Princess Caroline finally decided to have her children inoculated. Thereafter, the inoculation of royal and aristocratic children was covered in daily bulletins by newspapers. However, there were other privileged infants who developed full–blown smallpox from their inoculation and did not survive. These cases were also reported in the newspapers. In these cases, the name of the surgeon who carried out the inoculation was not mentioned. Thus, it was impossible to judge the dangers of 'this new practice' because the technique of inoculation was not described or disclosed. Lady Mary, in her diatribe in the Flying Post, believed doctors were 'murdering' their patients (her term was censored by the editor) because the potions and purges they used only served to weaken the latter. She went as far to suggest that the medical profession was deliberately making inoculation dangerous to protect their incomes, which came from treating the disease.

Sutton’s Swan Song

This chapter recounts how, once he had moved out of Sutton House, Daniel Sutton became itinerant, moving from one West End street to another in quick succession. In 1779, he announced that he had been 'engaged by the Governors of the General Inoculation Dispensary' and he had moved nearby to Southampton Street in Bloomsbury. Although he was still inoculating on his own account on his usual terms of 10 guineas, to have any kind of official post was out of character. Times had changed and he made it clear in yet another newspaper advertisement that he was well aware of the waning of his celebrity. Announcing his appointment to the dispensary, he felt it necessary to plead that he was the 'identical person who, in 1767 (by royal approbation) was complimented with a grant of the following honorary Patent for his singular and new method of inoculation'. This method, he claimed, was now 'very materially improved'. Once again the family coat of arms awarded to himself and his family was evoked. The chapter then looks at the publication in 1796 of Daniel's account of his discoveries as an inoculator.

The Battle for Vaccination

This chapter examines how the worldwide excitement for Edward Jenner's vaccine in the first flush of Cowmania promised a new era in which parents would clamour to have their children protected by this new and safe form of inoculation. This would have realised the dream of John Haygarth, who had imagined a national scheme and dismissed it on the grounds that it was unenforceable. But vaccination was not greeted with the enthusiasm that might have been anticipated. In the first decade of the nineteenth century, vaccination was favoured over inoculation by Parliament and by a majority of the medical profession, but not by the public. Faced with the threat of an outbreak of smallpox, the offer of free vaccination was often turned down in favour of tried and trusted inoculation in what was now the 'old method'. Authorities realised that, to be effective, a general inoculation had to offer the public a choice of Sutton or Jenner.

The Mystery of Immunity

This chapter assesses the mystery of immunity. Today, Edward Jenner is often referred to as the 'father of immunology'. But really, Jenner had no more claim to that title than Lady Mary Wortley Montagu, or the Greek women inoculating in Constantinople, or Daniel Sutton. None of them knew anything of the micro-organisms that Louis Pasteur and his contemporaries called 'germs'. It took well over a century after the deaths of Sutton and Jenner for an accumulation of scientific investigation to gain some understanding of what had been going on medically when the inoculators and vaccinators sought to bring smallpox under control. And it was a long time after the identification of 'germs', and the detective work that isolated the elements in them that caused specific infections, that it was understood that inoculation and vaccination worked because they triggered an immune response in the patient.

Sutton Misses the Boat

This chapter describes how, by 1766, Daniel Sutton had reached his zenith, apparently untroubled by the competition of Thomas Dimsdale and others who believed they had discovered the secrets of his success. It was then that Sutton learned that a whole new world of riches awaited him and his acolytes across the Channel. Smallpox was rife in Europe and Russia and yet inoculation was rarely practised and fiercely opposed where it was attempted. But news of the success of Suttonian inoculation, promoted indirectly by the translation of Dimsdale's guide to the 'modern method' attracted the attention of royalty, who were as vulnerable to the scourge of smallpox as their subjects. England produced the most skilled inoculators and a demand for their services grew. Sutton's name would be top of the list and an early approach was made to him.

A Rural Revolution

This chapter focuses on Daniel Sutton's method of 'Suttonian' inoculation against smallpox. It is not easy to appreciate now how it might be possible for a 'medical revolution' to take place when it involved absolutely no advance in the understanding of infections, nor any close studies of the effectiveness of different drugs or medical procedures. But 'Suttonian inoculation' was a genuine breakthrough, and was recognised as such at the time by most medical authorities. It evolved from a rejection of customary medical practice and a partial return to the simplicity of the Turkish method of inoculation. Lady Mary's anecdotal accounts of the work of the elderly Greek ladies were probably more influential than any theories about the nature of disease. It was a rustic kind of revolution which began in the Suffolk village of Kenton in the mid-eighteenth century.