Inoculation

[3][failed verification] The term inoculate entered medical English through horticultural usage meaning to graft a bud from one plant into another.

The usual route of transmission of smallpox was through the air, invading the mucous membranes of the mouth, nose, or respiratory tract, before migrating throughout the body via the lymphatic system, resulting in an often severe disease.

[6] A Song dynasty (960–1279) chancellor of China, Wang Dan (957–1017), lost his eldest son to smallpox and sought a means to spare the rest of his family from the disease, so he summoned physicians, wise men, and magicians from all across the empire to convene at the capital in Kaifeng and share ideas on how to cure patients of it until an allegedly divine man from Mount Emei carried out inoculation.

However, the sinologist Joseph Needham states that this information comes from the Zhongdou xinfa (種痘心法) written in 1808 by Zhu Yiliang, centuries after the alleged events.

[citation needed] Inoculation was reportedly not widely practiced in China until the reign of the Longqing Emperor (r. 1567–1572) during the Ming dynasty (1368–1644), as written by Yu Tianchi in his Shadou Jijie (痧痘集解) of 1727, which he alleges was based on Wang Zhangren's Douzhen Jinjing Lu (痘疹金鏡錄) of 1579.

Needham quotes an account from Zhang Yan's Zhongdou Xinshu (種痘新書), or New book on smallpox inoculation, written in 1741 during the Qing dynasty (1644–1912), which shows how the Chinese process had become refined up until that point: Method of storing the material.

The best material is that which had not been left too long, for when the yang potency is abundant it will give a 'take' with nine persons out of ten people – and finally it becomes completely inactive, and will not work at all.

This pustule produces the same effect in the arm it is laid in as yeast in a piece of dough; it ferments, and diffuses through the whole mass of blood the qualities with which it is impregnated.

There is an almost perpetual circulation of it in Circassia; and when unhappily the small-pox has quite left the country, the inhabitants of it are in as great trouble and perplexity as other nations when their harvest has fallen short...[9]Voltaire does not speculate on where the Circassians derived their technique from, though he reports that the Chinese have practiced it "these hundred years".

The outside world was exposed to it later on, as evidenced by the French scholar Henri Marie Husson, who noted it in the journal Dictionaire des sciences médicales.

[14] Holwell's extensive 1767 description included the following,[14] that points to the connection between disease and "multitudes of imperceptible animalculae floating in the atmosphere": They lay it down as a principle, that the immediate cause of the smallpox exists in the mortal part of every human and animal form; that the mediate (or second) acting cause, which stirs up the first, and throws it into a state of fermentation, is multitudes of imperceptible animalculae floating in the atmosphere; that these are the cause of all epidemical diseases, but more particularly of the small pox.

[19][20] A landmark anthropological study by Ralph Nicholas described the mid-twentieth century rituals of appeasement to Śītalā, the Indian goddess of smallpox, in Bengal.

Subsequent visitors who described this practice included the British traveller William Cornwallis Harris and Dr. Petit of the French scientific mission of 1839–1841.

[23] An enslaved African named Onesimus in the Province of Massachusetts Bay explained the inoculation procedure to Cotton Mather during the 18th century; he reported to have acquired the knowledge from Africa.

In January 1714 the Philosophical Transactions of the Royal Society published an account of a letter John Woodward had received from Emmanuel Timonius in Istanbul.

She witnessed firsthand the Ottoman use of inoculation in Istanbul,[48] and was greatly impressed:[49] she had lost a brother to smallpox and bore facial scars from the disease herself.

[citation needed] The practice is documented in America as early as 1721, when Zabdiel Boylston, at the urging of Cotton Mather, successfully inoculated two slaves and his own son.

Mather, a prominent Boston minister, had heard a description of the African practice of inoculation from Onesimus, an enslaved man in his household, in 1706 and later from Timoni's report to the Royal Society.

The effectiveness of the procedure was proven when, of the nearly three hundred people Boylston inoculated during the outbreak, only six died, whereas the mortality rate among those who contracted the disease naturally was one in six.

In Britain, Europe and the American Colonies the preferred method was rubbing material from a smallpox pustule from a selected mild case (Variola minor) into a scratch between the thumb and forefinger.

The recipient would develop smallpox; however, due to being introduced through the skin rather than the lungs, and possibly because of the inoculated individual's preexisting state of good health, the small inoculum, and the single point of initial infection, the resulting case of smallpox was generally milder than the naturally occurring form, produced far less facial scarring, and had a far lower mortality rate.

[citation needed] In 1798, British physician Edward Jenner published the results of his experiments and thus introduced the far superior and safer method of inoculation with cowpox virus, a mild infection that also induced immunity to smallpox.