Historiann realizes that she’s been blogging a lot about lady parts recently–my apologies for those of you who don’t have lady parts, or who aren’t particularly interested in getting close to anyone else’s lady parts. Blame the wandering uterus, if you must, but if you’ve been following the ridiculous public conversation recently on Gardasil, the miracle anti-cancer vaccine that can benefit our students, younger sisters, daughters, granddaughters, goddaughters, and nieces, and all other people with lady parts, you’ll be interested to read our friend Pal MD’s brief review of the latest research at WhiteCoat Underground. Predictably, instead of rejoicing at the discovery of a cure for cancer, there are a lot of people who are worried that this vaccine is going to unleash the inner slut inside all of our girl children.
Smallpox inoculation in the eighteenth century provoked even more anxiety and fear than vaccination does today in some tiny but stubborn sub-cultures. In all fairness, inoculation (also known as variolation) was in fact a risky procedure, unlike modern vaccination, which involved infecting a healthy body with live virus to induce a mild course of the disease that would render the patient immune to future infection. People who were inoculated were infectious to others, and some died from the resulting illness. Many, many articles and books in the history of medicine that have addressed inoculation, but to my mind, the best of them are explorations of cultural history, and view disease and disease prevention as a window into past worlds. Elizabeth Fenn’s Pox Americana: The Great Smallpox Epidemic of 1775-82 (2001) includes a nice overview of smallpox inoculation in colonial America, in addition to exploring the course of a disease and its effects on a continent.
Robert V. Wells’s essay, “A Tale of Two Cities: Epidemics and the Rituals of Death in Eighteenth-Century Boston and Philadelphia,” which appeared in a collection called Mortal Remains: Death in Early America (2003), edited by Nancy Isenberg and Andrew Burstein, actually managed to elicit some sympathy in me for Cotton Mather, who although a horrible warmongering racist, was also a pioneering advocate for inoculation. Mather’s life was tragically deformed by a measles epidemic in 1713, which took the life of his second wife, a daughter, newborn twins, and a servant girl in his household when he was forty. Eight years later when smallpox came to Boston, he inoculated two of his sons and was rewarded for his brave public advocacy by a “fired granado” thrown into one of the bedrooms of his house, with a note that read, “Cotton Mather, you dog, damn you: I’ll inoculate you with this, with a pox to you.” (Fortunately the bomb fizzled, and Mather continued to promote inoculation.) And there is an almost brand-new book by David E. Shuttleton called Smallpox and the Literary Imagination, 1660-1820 (2007), which includes a chapter about inoculation and the specifically racialized and gendered fears surrounding the procedure, which was first promoted in England by Lady Mary Wortley Montagu (herself a possesor of lady parts) after she witnessed its successes on a trip to Turkey (scandalously exotic!) in the early 1720s.
So, please follow in Lady Montagu’s (and–uuggh–Cotton Mather’s) footsteps. Fight the woo–get your kids the Gardasil vaccine.
Historiann 
I might add that, as problematic as variolation was, it saved many lives before the advent of vaccination. It was, interestingly, a woman (I believe Mary Wortley Montagu) who brought variolation to England via a diplomatic sojourn in the Ottoman Empire.
The Church hated it, but the Crown decided to do one of the first medical experiments in history by trying it out on prisoners, then orphans. Finally it caught on.
I’ve been in the process (a slow process) of translating a 18th century French medical tract on inoculation, which reads surprisingly like the anti-vaccine folks of today.
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Oops, bad reader…didn’t see you mentioned her already.
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Pal MD–thanks for dropping by. I don’t know if anyone other than you and me would be interested, but I’d love for you to post on that French medical text someday. I work in 18th C French (Canadian) documents, with my haphazard 8th grade French, so I feel your pain…
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Funny you should mentioned variolation. Just read a book called City of Dreams by Beverly Swerling. It’s the story of an English family of Surgeons, Apothecaries and Physicians who settled in Nieuw Amsterdam. It follows the family from 1661 to 1798. The surgeons advocated variolation and mention Cotton Mather as their reference. This is a fictional work but highly absorbing. I read it in less than a week – all 591 pages. It was amazing to see how physcians and the various churches viewed this now common practice. Not to mention blood transfusion. I must say that were I to have a daughter today I would most certainly be in line for that innoculation. Keep up the good work!
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Hi there,
I’m teaching about this in my topics in American Medicine and Public Health class this week. One thing we need to keep in mind is that in Mather’s time inoculation was a risky procedure — there was no certainty that the patient would not develop a full-blown case of smallpox, the patient could still transmit smallpox to others, and because inoculation consisted of introducing pus or scabs under the skin, the risk of infection at the inoculation site was not insignificant. So, we should be careful about attributing opposition to Mather solely to ignorance — there were legitimate concerns about the safety of the procedure which were raised by physicians and laypersons alike. For more on this issue, see Maxine VandeWetering, “A Reconsideration of the Inoculation Controversy.” New England Quarterly 58/1 (1985): 46-67.
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Hi Historiann! Thanks for writing a great, informative post. Before reading your post I did not know about Gardasil.
Thanks for recommending Shuttleton’s Smallpox and the Literary Imagination. I think I might find it of use.
Have you read Lennard J. Davis and David B. Morris’s “Bioculutres Manifesto” (New Literary History 38 [Summer 2007]: 411-418)? You might find it of interest.
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Thanks for the cite, Ortho. I hadn’t seen the Davis and Morris “Manifesto”–it looks good. (Although, when even history and literature have trouble co-existing sometimes in cultural studies, I see a lot more problems with interdisciplinarity across the sciences and humanities.) Still, the smartest scientists seem to have an appreciation for at least the history of their profession and for how science has changed over time, and even the dimmest historians try not to say too many dumb things about science…
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Thankfully, the text I’m working on was written by an English physician in France, so his French is nearly as simple as mine. I was actually thinking about posting what I have so far.
Much of his section on the history of smallpox is lifted directly from Herodotus and, of course, Hippocrates. The Herodotus surprised me though. He doesn’t really site sources, so I had to get lucky with a “hmm, that sounds familiar…”
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I’m not sure I understand how Historiann’s post can be labeled “presentist.” She mentions the substantial risks associated with variolation in the eighteenth century–both to those inoculated and to those who supported it. The ironic point I think she’s making is that the new HPV vaccine–while not 100% effective–is better than 0% and that 21st century conservatives [predictably] oppose it. Like any good historian, she’s interested in charting change over time, or the lack thereof.
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Perhaps I can explain this better than I did the first time. Yes, you do indicate the risks associated with inoculation. My point was that Mather was touting the procedure, and others were opposing it, for much different reasons than those who support/criticize HPV vaccines. In other words, you seem to be projecting a modern scientific framework onto the past.
As to the modern-day controversy surrounding HPV vaccine, I think it needs to be seen within a longer history of human experimentation and health care for women. From my perspective, the science is sound, the vaccine appears safe, but I also have concerns about whether this is the best way to use public health resources.
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Heather–thanks for clarifying. I don’t know enough about scientific frameworks, past or present, to project them anywhere–that’s not my point of entry as a historian. The point of my post was just to suggest that there is a long history in our culture of suspicion of/hostility to the practice of inoculation and vaccination, and to draw attention to the work of scholars who have looked at eighteenth-century practices from different angles, as bl suggests. And, I found it interesting that the history of inoculation, as both David Shuttleton and Pal MD have noted, is perhaps deeply implicated in fears and suspicions about women’s authority in medical science.
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Okay, understood. I agree entirely with your last comment.
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Thanks for coming over to play today, Heather! I think you would be interested to read about Pal MD’s perspective too over at WhiteCoat Underground.
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BTW, just to rant a little further, many who argue “rationally” against Gardasil claim (correctly) that pap smears have made huge strides in the fight against cervical ca. However, dissecting that idea, first, paps have to be available, women must seek them out regularly, and it is a cancer surveillance system rather than strict primary prevention.
So,let’s say you have an abnormal pap…great, now the follow up colposcopy, possibly surgery like a LEEP.
Why not circumvent all that and get the damned vaccine???
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PalMD makes very good arguments about access to pap tests. How do we ensure that everyone who needs it has access to the vaccine? Should boys also be vaccinated to create herd immunity?
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As soon as studies prove safety and efficacy, Gardasil should be given to males. First, it is most often males who transmit HPV to females.
Second, HPV causes penile and anal cancers in men.
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Over at PalMD someone made the observation that Gardasil prevents 70% of cervical cancer cases. Won’t there still be a need for routine pap smears to catch the other 30%?
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Absolutely. It will not negate the need for screening, even if we ever achieve universal vaccination.
Very few diseases are eliminated…smallpox is still a pretty lonely success.
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YES!!! Boys should get vaccinated!!!! HPV is responsible for the majority of oral and throat cancer in men that do not use tobacco. Plus I don’t want my son to possibly infect his partner and possibly the mother of my grandchildren.
I do not know if your Doc will want to give it to your son yet. My sons are 2 and 7 so we aren’t ready yet. My hubbie is a prosthodontist (a dental specialist), and he wants all his young male patients to get the vaccine.
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Anne–yes, vaccinating boys makes a great deal of sense. Maybe they’ll have time to do the testing before your children are old enough (at least your younger boy, anyway.) Thanks for visitng and commenting!
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