Episode 2

Smallpox Part 2: William Wagstaffe

Hello, and welcome back to the Poison Room, and part two of the story of some well-educated, rich, white men objecting to the idea of inoculation literally as soon as they heard about it.

Last time we covered the pamphlet produced by Reverend Edward Massey. He focused primarily on religious arguments, but gave a single footnote citation pointing the reader to Dr. William Wagstaffe for an opinion on the medical side of it. So that’s what we’re going do. Now, Wagstaffe is not a total nobody. At this point in his life, he’s a fellow of the College of Physicians, and he’d served as a censor for the college in 1720. There were four censors at a time, who held the appointment for a year. They became examiners for the college, and they could go after physicians for malpractice (Medical Heritage Guest Post 2015). He was also a fellow of the Royal Society, and was a physician to Bartholomew’s Hospital from 1720 to 1725. So that’s Wagstaffe. Like I said, not a total nobody.

Now, my intention with the podcast was to aim for episodes about 40-50 minutes long. I already overshot that in the first episode, and this one is going to be even longer, because Dr. Wagstaffe has 69 pages of opinion to share. So buckle in, guys.

His wonderful contribution to the topic is in the form of a letter to Dr. Freind which was dated June 12th, 1722. I don’t know the exact date it was published, but the only version of Wagstaffe’s letter I could find was already the second edition. Given the letter was dated June 12th, and the second edition is also published in 1722, that might suggest it was a rather popular pamphlet. Now, I couldn’t find whatever pamphlet, letter, or speech inspired Wagstaffe to write to Dr Freind, but I did find some interesting titbits about Freind’s life.

He was arrested for his role in the Jacobite plot in 1723, and spent a few months in the Tower of London. He made good use of his time there to write… a small treatise on Smallpox, which he sent as a letter to Richard Mead, and which was published in 1723. Obviously, it was anti-inoculation. Clearly this can’t be the publication Wagstaffe is responding to, since it was published later than Wagstaffe’s own pamphlet, but apparently Freind had already made his opinion on the matter known by 1722.

Wagstaffe starts by agreeing with a point that Freind apparently made: that they just don’t yet know enough about inoculation to justify using it (Wagstaffe 1722: 3-4). Of course, as we learned last episode, there were quite a few reports of inoculation being practiced in other countries, as well as the Newgate experiment conducted in London, of which he was well aware. Wagstaffe has read both Timoni and Pylarini’s accounts, as well as Maitland’s pamphlet, so he knows of all the other cases Maitland has performed, too.

So why is he claiming there’s not enough evidence? What’s wrong with the evidence they have already? Spoiler alert, parts of it are racism, misogyny, and good old British classism. Wagstaffe starts with the same old bigotry we all know and love: why should well-educated, English, white men listen to people who aren’t well-educated, English, white men?

He argues that all the accounts of inoculation that first brought the practice to their attention are being performed by people who aren’t physicians, so they can’t possibly understand the implications of what they’re doing. And of course, what he means by ‘physician’ is: ‘people I personally recognise as physicians in a very limited European sense of the word, which excludes women, the working class, and people who aren’t white, European, and Christian’. In his own words:

The Countrey from whence we ‘deriv’d this Experiment, will have but very little Influence on our Faith, if we consider either the Nature of the Climate, or the Capacity of the Inhabitants; and Posterity perhaps will scarcely be brought to believe, that an Experiment practiced only be a few Ignorant Women, amongst an illiterate and unthinking People, shou’d on a sudden, and upon a slender Experience, so far obtain in one of the Politest Nations in the World, as to be receiv’d into the Royal Palace. (5-6)

The ‘ignorant women’ is a reference to either, or both, Maitland and Pylarini’s accounts of a Greek woman demonstrating inoculation to them, and the ‘Capacity of the Inhabitants’ that they need to consider is a reference to Timoni’s account of inoculation among the Turks. And in the 1700s, ‘Turk’ was basically synonymous with ‘Muslim’. So yeah, not just misogyny: islamophobia, too. Now before anyone defends Wagstaffe as just a product of his time, everyone was like that back theeen, blah blah blah, remember that eventually, all the proponents of inoculation had managed to get over this – even the witch-hunting Cotton Mather.

But that’s not all. Bigotry aside, the other problem with all these people is that they just have very different blood from English people (who have good blood. The best blood) (7). The idea of climate and blood impacting health and personality is as old as Hippocrates, and was still generally accepted as A Fact. Bad ideas sometimes hang around a long time.

Having covered the differences in blood on a national level, Wagstaffe then claims that even within an individual, how well they react to inoculation is dependent on how their blood is doing at the time. Blood doing well? They’ll have a mild reaction. Blood doing badly? They’ll have a bad reaction (8-9). Which means that you shouldn’t inoculate anyone ever, I guess, even if their blood is doing well?

When Wagstaffe talks about whether someone will get a good or bad case of smallpox here, he refers to ‘the confluent kind’ and the milder kind. For the record, inoculators thought they should use gunk from the milder kind of smallpox. Today we know that there are different strains of the virus, some with a far higher mortality rate than others. But back then they knew that there were at least two different types of smallpox, and that one was far more fatal than the other.

Wagstaffe is suggesting that what type of smallpox someone gets is based on how their blood is doing at the time. Which is not how that works. This misunderstanding aside, it’s still a pretty weird argument, given that inoculation allows you to get someone’s blood into the best possible state before you give them smallpox, which is not what happens when you just catch smallpox naturally (10).

But this aside, inoculation would indeed be useful if we could be sure that we would only cause a mild case of smallpox, but we totally can’t. So there (10).

Wagstaffe’s next argument is that the idea of mixing blood with something other than blood is just offensive to Reason. I mean, that weird fad people went through of doing blood transfusions? That made more sense that this (11)! Yeah, blood transfusion as an idea took a while to take off, as well.

Anyway, transferring blood into blood might work, but we’ve had disastrous results with trying to add things that aren’t blood. People have done a bunch of experiments adding other things to blood, and it super didn’t work out when they tried it with mercury or sulphuric acid, so why would it end well with smallpox gunk? (12).

Injecting people with sulphuric acid and mercury: just a small part of the delightful history of Western medicine. Now, I don’t know about sulphuric acid specifically, but apparently some people had tried injecting mercury to help with smallpox. Shockingly, it doesn’t work.

Anyway, for Wagstaffe, these mercury and sulphuric acid experiments are exactly comparable to case of Mr. Smith, who tried to inoculate two people using gunk from a bad smallpox case, and one of them died (12).

So far then, the arguments are: bigotry, more bigotry, English people have different blood, someone’s blood might not be in the best state when you try to inoculate them so you might give them bad smallpox, and injecting people with mercury or sulphuric acid is bad so this must be too. He also adds a throwaway comment which was an idea that Massey made much of in his sermon: physicians aren’t supposed to cause diseases, they’re supposed to cure them (13-14). It’s an objection Maitland pre-emptively tried to counter, but Wagstaffe doesn’t seem to care.

But, he thinks, we don’t even need to look at actual smallpox inoculation patients to see that it doesn’t work. We all know that when smallpox gunk mixes with the blood of the person who actually has smallpox, bad things happen. So clearly bad things will happen if we mix it into someone else’s blood! (14-15). Of course, if you have smallpox then you have smallpox in your blood; but that requires an understanding of germ theory. So what exactly is he saying? When does smallpox mix with the blood, if it’s not the entire time you have smallpox?

His argument is that when smallpox pustules aren’t big or don’t burst, it means the gunk is mingling with the blood, and that’s what causes death or the worst long-term damage. And since inoculations generally result in a less severe flare up, the smallpox gunk must be mixing with their blood rather than being expelled into pustules. Why we can’t assume there’s just less gunk is beyond me, but there is a type of logic here that might appeal to his colleagues. Medicine at this time is a lot of balancing humors, and getting rid of excess blood, phlegm, and yellow and black bile, or supplementing those things to bring someone back up to the right amount. In someone with smallpox, they clearly have an excess of gunk, so it must be good when they have lots of pustules that burst, because the gunk is leaving their body! And if that doesn’t happen, then obviously the gunk is just building up in their blood instead.

He throws in after this a brief detail that one Doctor Nettleton has been recording his own experiments in inoculation, and that only a quarter of them seem to have developed a genuine case of smallpox (16). Which would mean that you could only be sure that the inoculation had taken in one out of four cases. Hardly a comforting ratio. If that’s actually what Doctor Nettleton is reporting. But it’s not. He actually only reports two instances of the inoculation not producing the desired results. One in which the child had already had smallpox, and another where they decided that the gunk was ineffective because it had been taken at a point where the pustules were starting to shrink and heal up, rather than when they’re nice and uh… juicy.

His next argument is that… well… you just can’t tell whether the person you’re wiping smallpox gunk on will actually get… smallpox. So we’ve gone from they might not develop the right type of smallpox to ‘they might develop something that’s not smallpox at all’ (17-19). Sometimes you try and inoculate people against smallpox and they develop gonorrhoea instead. Just like sometimes someone exposed to elephantiasis only gets leprosy.

Shockingly, that’s not true. People exposed to elephantiasis alone won’t get leprosy, but damage to the body caused by leprosy can cause elephantiasis. So sorry, Dr Wagstaffe. Those people were probably getting leprosy because they were, y’know, exposed to leprosy.

As for gonorrhoea? Well, take my word for it, it’s easy to see how second stage syphilis might have been mistaken by some for smallpox, and according to Lisa Smith, ‘In the early eighteenth century, many venereal symptoms were not immediately obvious to people. The skin rashes, pustules and chancres of late stage gonorrhoea might easily be confused with syphilis’ </ quote> (Smith 2013). So you can confuse gonorrhoea and syphilis, and syphilis and smallpox. Please don’t google image it. You can’t unsee some things, and you’ll be left wondering why the hell someone wants a photo of that on their mobile phone case. Seriously.

But perhaps if Wagstaffe and his colleagues had had phone cases with photos of gonorrhoea on them, they’d have been able to tell smallpox, syphilis, and gonorrhoea apart. As a side note, researchers are only just starting to have some initial successes with vaccines for gonorrhoea and syphilis. If you did try to inoculate someone against smallpox and accidentally used gonorrhoea or syphilis gunk, well, then you’ve just given that person gonorrhoea or syphilis. So, uh… gonorrhoea photo phone cases for all?

Wagstaffe’s next point is actually a pretty decent one: we don’t know the proper dosage yet, and if we don’t know the right dosage then:

We, who are the Guardians of Life and Health, may, not unjustly, be charg’d with acting like Empirics, and with throwing away the Lives of Mankind at all Adventures. He would be accounted rather a common Murder than a Physician, who is ignorant of the Dose of a violent purge, or the proper Quantity of Blood to take away upon any occasion. But in this Case, where half a Grain is sometimes sufficient to destroy us, certainly it would be very irrational to proceed without adjusting the Proportion, and being sure of the Quantity we inject. (19-20)

Wagstaffe’s argument is entirely based on a rational observation that with other medicines, dosages matter. Totally makes sense! But what he doesn’t have is any evidence at all that this is actually a problem. If you wanted to argue Wagstaffe’s corner for him, you could suggest that those cases where people did die of inoculation could be attributed to incorrect dosages. He doesn’t make that argument himself, though. Maybe because he knows that if it really were a problem, a lot more people would be dying, and he’d actually be able to provide some examples.

Anyway, even if we did know the correct dosage, we still can’t be sure someone will have the right type of blood at the time. This is an argument he’s made before, and honestly, I find it odd that he’s making it again since the entire point of medicine is about knowing what state the four bodily humors are in, and doing things to try and correct imbalances. You have to be able to identify what state someone’s blood is in. That’s your job, Wagstaffe. (23-24). But even if we did know both the correct dosage and the state of their blood, we still just can’t be sure how bad a case of smallpox the inoculation will cause. Because… Reasons.

His next argument is going to be that the symptoms of inoculation often just don’t match that of Smallpox, so it just can’t be actual smallpox that’s being produced (25). To do this, he reveals that he actually inspected the Newgate Prisoners of the Royal Experiment himself. But ironically, what he takes as proof of the inefficacy of inoculation is what others would see as proof of the benefit of it. Disappointingly, the side effects of the inoculation were incredibly minor. He gives an account of his visit:

I visited them every other Day from the Tenth, on which Day and the Twelfth, I found them very well. On the Fourteenth, they had some Eruptions, bearing no resemblance to the Small Pox, and their Incisions were inflam’d. One of them complained she had been a little sick; the rest said, they were very well, and all had a regular Pulse and no Fever. The Sixteenth, the Appearances were the same; and they all agreed in the same Story, that they had been out of Order, except one of the Women, who had forgot it, till she was put in mind by Mrs. North, the eldest and most Matronly of the Three, upon which she recollected, she had been Sick and in Pain the Day before. However they were all well now: Mrs. North’s Pulse I thought a little quicker than usual; and Mrs. Tompion had a perfect little Boil, with Matter in it, on her Arm; which had been the same from the first Day of Eruption, contrary to what happens in a true Small Pox; this was the only pimple she had, which had Matter in it. The Nineteenth, one of the Men; who had the Goal Distemper and an Itch, had some Pustules with Matter in them, tho’ without any Fever or quickens of Pulse. On the 20th, they vanished in a manner; some of the Incisions were Fester’d, and had some digested Matter. (26-27)

As a sidenote, ‘Goal Distemper’, is spelled g-o-a-l, but I’m pretty sure it’s supposed to be pronounced as ‘gaol’, because, well, that was another name for it. It was a fever associated, shockingly, with prisons, but more broadly with poor people, and the overcrowded, unclean conditions poor people had to live in. It’s not a phrase in consistent usage at the time, so we can’t know exactly what Wagstaffe thought it was in terms of modern medicine, but it’s what he’s calling the fever and disturbed waters John Alcock had on the sixth night.

Last episode I gave you a summary of Maitland’s account of the Newgate experiment, and even summarising it took longer than Wagstaffe’s entire account. He gives a lot more detail that Wagstaffe. This is a theme we’re going to encounter again and again in Wagstaffe’s letter: his accounts just lack detail, and can’t be verified. Maitland gives detailed accounts and for some of them he even provides sworn statements from the people involved as to the veracity of his account. Wagstaffe, on the other hand, sometimes bothers to actually give names.

Anyway, Wagstaffe’s point is that, according to him, they developed barely any smallpox symptoms. And the less like smallpox something looks, the more unfathomable is the idea that it can somehow prevent smallpox (28-29). He also thinks he’s got cases where inoculation completely failed to work. They didn’t get any symptoms at all. One is the case of Mr. Redacted, and it also happened in the son of a certain Nobleman (28-29). Really hot on the details, here. He also says that he’s already mentioned Mr. Redacted, and I’m pretty sure he hasn’t, so this might be something from a conversation or different communication between Wagstaffe and Freind.

Point is, even when there is a reaction, it doesn’t look much like smallpox. Chickenpox looks closer to smallpox than their reactions did, and we know chickenpox doesn’t give immunity to smallpox, so why would this thing work, when it looks even less like smallpox than that, if it has an appearance at all?

Given that he’s now managed to dismiss or ignore all the evidence he doesn’t like, Wagstaffe can argue that we won’t know without experimenting for many years that inoculation actually works (30). And of course, if someone gets smallpox forty years down the line, that won’t suggest that maybe inoculation works for years, but not perpetually – oh no, no, no, no, no – it would clearly mean that inoculation doesn’t work full stop.

Wagstaffe’s next line of attack is to declare that all those pro-inoculators are lying about their evidence:

If the Maxims laid down by the Patrons of Inoculation, as certain and undoubted Truths, are a little weigh’d and consider’d, we shall find them either contradictory, or false in Fact, or like that we have observ’d already, without any Proof that really comes up to the point. (30)

First of all, those pro-innoculators claim that they only take gunk from good cases of smallpox, but in the case of the Newgate prisoners, they took gunk from a servant with a really bad case, who afterwards died. (31). This is not a detail Maitland mentions. If you remember, he actually inoculated five of them twice, because he didn’t think it had taken the first time. He doesn’t say who or where the first batch came from, just that it’s 15-16 hours old, and it had been kept that long for ‘a very good, but unavoidable reason’ (Maitland 1722: 21). The second batch he tells us he got from someone at Christ’s Hospital, but not who it was (21).

Wagstaffe also claims he saw an inoculation performed using a bad case of smallpox with the kids of an unnamed noble Lord (30). That’s all the detail he gives. And just to be clear, this isn’t the same as the unnamed nobleman he previously mentioned.

Note that, even if this were the case, none of them died. Which might, if Wagstaffe were to think about it for a moment or two, actually suggest that there’s not much danger in getting material from a very bad smallpox case. But that’s just one more thing we’re gonna ignore.

Secondly, those awful inoculators claim that this inoculation can’t cause the disease in someone who’s already had natural smallpox, and this is wrong. There was, according to him, a man at St. Thomas’s Hospital who got smallpox from the inoculation even though he’d already had smallpox, as was evident from the scarring on his face (31).

The next claim that he’s out to debunk is the idea that no one has ever died from inoculation, and that the results are always favourable (31-32). Now, some inoculators might be claiming this is true, but others are aware that sometimes it can kill. When Cotton Mather convinced Zabdiel Boylston to start inoculations in Boston during the smallpox epidemic, Boylston recorded that 2.1% of the people he inoculated had died. That’s six people out of 280. For the record, he also notes that the inoculation was unsuccessful in another 6 people (Copp & Zanella 1993: 249). A 2.1% risk is not nothing, but personally, if I lived in a city where there were frequent breakouts of a disease that had a 30% chance of killing me, I’d take those odds. These particular statistics were not available to Wagstaffe at the time. Boylston’s work was officially published in 1724, although, as we saw last episode, Cotton Mather had reported on Boylston’s work already. Who knows what he’d’ve made of the exact figures. I suspect he’d just take it as proof that he was right and inoculators are all lying liars that lie. Shout out to Boylston, though, for recording this information. Would that Wagstaffe had also been so meticulous.

Wagstaffe reports two specific cases of inoculation deaths in England: that of Mr. Redacted, and that of Lord Redacted’s servant (32-33). Mr. Redacted died of the smallpox, apparently, if he died of anything, and when they did an autopsy (immediately after his death) they found some coagulated blood in the arteries and veins of his heart, and ‘water’ in the ventricles of his brain. I gotta be honest, I find this pretty confusing because… the ventricles are where cerebrospinal fluid is produced, so… this is what you’d expect to find in any autopsy? And Wagstaffe seems to acknowledge that in his next sentence (33). In fact, he suggests both articles are frequently instantaneous. Now, blood coagulating after death takes some time, and Wagstaffe would surely know this. So why does he assert that both are instantaneous? I guess one possibility is that he really does think that blood coagulates immediately after death, and this is therefore some modicum of academic integrity, but that’s not exactly what we expect to see from Wagstaffe. On the other hand, he could just be being incredibly sarcastic, and asserting that neither of these things are seen immediately after death. This would mean that Wagstaffe would have to think that liquid in the ventricles of the brain is not normal. On the third hand, it is possible that Wagstaffe’s just not giving enough detail to really understand what he’s talking about.

All of this aside, neither of these symptoms are what you’d expect to see in a smallpox autopsy. You’d be looking for evidence in the lungs, not the brain and heart.

And autopsy results aside altogether, it’s possible that whoever Mr. Redacted was, he was generally of ill health, because Wagstaffe brings up the possibility that he might have been of ‘weak constitution’ by saying that, even if this could be said of Mr. Redacted, it cannot be said of Lord Redacted’s servant (33-34). (And by the way, that would mean that the inoculation shouldn’t have been performed on Mr. Redacted in the first place).

Lord Redacted’s servant had been healthy, (34) but he got the bad kind of smallpox from the inoculation, and died from it. In his autopsy, they found the lungs were very inflamed. Unlike the first autopsy, this is what you’d expect to see with smallpox. So he’s got one case in which someone very possibly died from inoculation, and another in which the patient… very probably did not die from inoculation.

Wagstaffe does concede that these two examples do not in themselves a compelling argument make, but fear not! Wagstaffe might not mention Boylston or Mather, but there’s another Bostonian whose account he’s very aware of:

By Dr. Dolhonde’s Account before the Select Men of the Town of Boston in New England, we find this Experiment has always been attended with the same uncertainty. He there acquainted them, that about Twenty Five Years before he saw Thirteen Soldiers inoculated in the French Army at Cremona, of which Operation he declared, that Four died, Six recovered with abundance of difficulty and trouble, and that on the other three it had no effect. The first who were, tho’ in great danger of their Lives, recover’d, he Remarks, were seized afterwards with Tumours and Inflammations in the Throat; and that in one of the first who was opened, the Diaphragm was found Livid, the Pancreas swell’d, and the Caul Gangreen’d. (35-36).

Twenty-five years ago, in some other place, this Dolhonde guy saw thirteen soldiers get inoculated and it did not go well. For anyone. Either they died, they suffered a lot, or it didn’t work at all. Not a single one of them had a successful, easy inoculation. Seems a bit odd, doesn’t it, that there’s just this one doctor who reports such catastrophic results? Well, other people thought so too. We’ll get to them later, but I just want to point out one of them here. A guy called Noah Bolaine threw some serious shade Dr. Dolhonde’s way:

It is, surely, very incredible that so many extra-ordinary and uncommon Incidents should fall to the share of one Man, and one only, when so many others, who have been much more concerned with the same Practice, declare they have met with nothing like it. (1754: 83)

Bolaine knows of Dolhonde’s account, and he’s calling BS. But Bolaine is also writing about thirty years later, in response to a different sermon by another reverend. Which means this story is one that stayed in circulation and continued to be trotted out as an argument against inoculation. Dolhonde is their version of Andrew Wakefield.

Wagstaffe refers to Dolhonde pretty frequently. He, of course, happily accepts Dolhonde’s account. Oh, and just in case you’d forgotten that Wagstaffe is a massive xenophobic bigot, he goes on to add:

And no doubt, Sir, but these poor unhappy brave Fellows, were perswaded to have this Practice try’d upon them, by some sanguine Traveller from Turkey, who, from Hearsay and Report, was fond of broaching it; or for some other Reasons, was ready to pawn his Reputation on the Safety and the Success of it; And probably had his first Attempts been Successful he would soon have had Vouchers and Abettors ready to aver his Practice; and if any one had miscarried afterwards, to give out, that they had caught the Natural sort before they were inoculated. (36-37)

Those poor French soldiers were probably just duped by some damn Turk who thought he knew what he was doing! Or because he had some secret reason for doing this thing he knew wouldn’t work! And if someone had died, then they would have lied and said that it was because that person already had smallpox at the time. Damn liars that they are.

Next he points out that the Italians and French didn’t fall for this nonsense, even though they’ve had greater exposure to it (37-8)! Except, I guess, for those poor French soldiers. He references the House of Bourbon, which is a French family, and which had just been decimated by smallpox – would that it were true that inoculation worked! How beneficial it would have been to them.

It’s true that France and Italy had more interactions with Turkey at this time, but that doesn’t mean they paid attention to what the Turks were doing about smallpox. Also, y’know. France and Italy are very Christian countries at the time. Sooo… They just might not have trusted those evil, awful, Muslims, either.

Now, finally, on page 38, Wagstaffe brings up an argument where he actually is right. Well. According to him, proponents of inoculation are claiming that you cannot pass on smallpox during inoculation. He has evidence to back up his claim that you can, and he even gives a name to one of his sources. It’s one he got from Maitland. If you remember from last episode, Maitland recounted an instance where he inoculated the daughter of Mr. Batt, and afterwards, six of his servants caught smallpox, and one of them died.

As I said, Wagstaffe’s actually finally right about something: you can pass on smallpox whilst you recover from inoculation. But some proponents of inoculation clearly did know this – the reason Lady Montagu didn’t get her daughter inoculated when she was in Turkey was because the girl’s nurse hadn’t had smallpox, and she didn’t want to expose her to it. And given that Maitland uses the example of Mr. Batt’s daughter as a proof that it is indeed smallpox the inoculants are getting, he seems to accept it, too.

So… maybe not so on point with ‘inoculators are claiming that this doesn’t happen’, but accurate with the ‘inoculants are contagious’ point. So well done on successfully identifying an actual problem, Wagstaffe.

But Wagstaffe’s not quite done. He has it on good, anonymous authority, whose reputation is simply beyond question, that the town of Hertford (where the Batt family are) was notably disrupted by smallpox, which had been spread to them by these inoculations (39).

This being the case, Wagstaffe goes on to point out that:

the Operator has it in his Power to convey the Small Pox to distant Places and Persons, who neither avow his Practice, or desire his Experiment: And if ‘tis possible that the ingrafted Pox can be so poysonous as to communicate certain Death to all around, by this method, they may Ingraft as violent a Plague, as has been known among us. (39)

Now, not to understate the 30% death rate for the common deadly smallpox strain, that’s the entire reason we needed inoculation after all, but it is still less than a 100% death rate, so ‘certain Death’ is a slight exaggeration on Wagstaffe’s part.

And from this you could either conclude that physicians need to take care when they perform an inoculation and quarantine the patient until they’ve recovered, or you could conclude that inoculation is a terribad, awful thing and should just Not Be Done. No points for guessing which conclusion Wagstaffe opts for.

There’s a hint of an interesting ethical issue here. It’s one thing to inoculate a willing subject, but another if the inoculation spreads smallpox to someone who wanted no part of it. But as we’ve seen already, physicians in this period aren’t particularly hot on consent, and Wagstaffe doesn’t take this any further as an ethical issue. Instead, he compares it to a legal issue. Now, you’ve gotta understand, he’s totally not suggesting that the government should perhaps legislate against inoculation: that’s beyond his remit. He’s just sayin’ that if someone set a house on fire and a whole village burns down, then we legally hold them responsible for burning a whole village down. So, y’know. He’s not suggesting the Government should ban it, but he’s totally suggesting the Government should ban it (39-40).

But also, given that it was Maitland who inoculated the Batt family child, he’s basically accusing Maitland of having spread a deadly smallpox to the town. It’s Maitland he’s suggesting should perhaps be held responsible for burning a whole village down. Which… like…

Rude, Wagstaffe. Rude.

Finally (on page 40, for those of you keeping track), Wagstaffe reaches the most important argument, the fundamental axiom of inoculation: that it actually stops you from getting smallpox.

He’s got another whole two cases for his point here, and this time he gives both names. The first is the case of the daughter of a surgeon, Mr. Degraves. She was inoculated against smallpox, with some others, and then three months later she got natural smallpox. Wagstaffe himself visited her and confirmed it was smallpox. Here’s his account of it:

She lingered on for the space of Three Months in an ill State of Health; sometimes breaking out in Boils and Pimples; and about the Tenth of May last catching Cold, she was seized with a Pain in her Head and Back, and fell into the Symptoms preceding the natural Small Pox. (41-42)

Now. If she suddenly kept breaking out in boils and pimples after being inoculated, surely that suggests that the inoculation is causing this? But the fact that the inoculator explicitly claims that she won’t be able to get smallpox allows him to use this as an example of catching smallpox after being inoculated. This single instance, he thinks, is sufficient to discontinue the entire practice. ‘One case dismantles the argument as much as a thousand’, he says (42). One person catching smallpox after inoculation is indeed enough to disprove the claim that no one ever catches smallpox, but having to shift the claim from ‘0% of people have caught smallpox afterwards’ to ‘0.01% of people have caught smallpox afterwards’ is hardly a fatal admission. It’s still a way better rate of people not catching smallpox afterwards than catching it afterwards. But, eh. Statistics are worse than lies, after all, so who cares?

And if you did try to deny that she actually got “successfully” inoculated then that just proves that ‘the Experiment is good for nothing, of no Effect, and absolutely useless (43). Not quite sure how an admission of one mistake would prove that, but we’ve already established that Wagstaffe has a very tenuous grasp on what classes as a good argument.

Having just dissed his ability to understand what a rational argument is, Wagstaffe then goes on to make his second totally reasonable argument. Earlier he claimed that even if you give someone smallpox, they might magically get an entirely different disease; now he’s asking what happens if the material being used is carrying more than smallpox. What if the donor of the gunk had another disease as well, and we pass that on? What if you give them the King’s Evil? Or the Pox? Or Madness? Or some other inveterate Disease (45)?

King’s Evil is scrofula, the Pox is syphilis, Madness is, uh, madness, I guess? Of course, what ‘Madness’ means in the 1720s is a whole different story of delightful medical bigotry, ignorance, and social stigma.

But the central point, that you could infect the patient with a second blood borne disease alongside smallpox, is valid. This of course, relies on the physician not being able to notice that the donor has other diseases. This would mean that either those other diseases were asymptomatic, or they were indistinguishable from smallpox. Apparently that might be the case in syphilis, as we’ve discovered, but scrofula looks pretty different, and causes massive swelling in the neck. Kind of hard to miss when you look at someone.

After that digression, Wagstaffe turns to another example of someone dying despite being inoculated, and for this, he draws again on the emphatically reliable Dr Dolhonde. Being apparently a bad luck charm for inoculations, Dolhonde recounts a second story in which a Muscovite soldier at the battle of Almanza died after being inoculated seemingly successfully six weeks earlier. But then:

He was seized with a Frenzy, and his Body swell’d, as if he had been, as if he had been poisoned, of which he died suddenly. Upon opening him, his Lungs were ulcerated; and it was the concurrent Opinion of Dr. Helvetius, now Physician to the King of France, and two of the King of Spain’s Physicians, that the infused Matter had thrown it self upon that Vital Part, and occasioned his Death in this manner. (46-47)

Now, as Dolhonde acknowledges and Wagstaffe reports, these symptoms are rather like those of poisoning of some sort. And not really much like smallpox symptoms. But when they autopsied him is lungs were ‘ulcerated’, which is possibly smallpox, but is also possibly chemical pneumonia, which is what you get when you’re poisoned with something that attacks the lungs. This ambiguity is probably why Dolhonde goes on to stress the credentials of the doctors who decided it was the smallpox inoculation what killed him, and why Wagstaffe makes sure to include that in his retelling of it. They’re royal Physicians, so we can totally trust them to tell apart poisoning and smallpox.

But wait! There’s more! Dolhonde’s got one more fantastic account to add. He was himself given charge of a patient in Flanders, one Captain Hussart. The man had smallpox, and griped to Dolhonde that:

Ten Years ago I was inoculated five or six times, without that cursed Invention’s taking Effect upon me; must I then Perish? (47)

Wagstaffe confesses that he does not know Dr Dolhonde at all, but declares that there can be no reason to doubt his reports, because the Magistracy of Boston decided, based purely upon his accounts, to pass a bill banning inoculation (48).

Thanks for setting back the cause, there, Dolhonde.

Aaaaannyway, Wagstaffe seems to think that they should believe Dolhonde because the Bostonians did, and as we all know, they are the ultimate arbiters of truth.

To summarise the summary Wagstaffe then gives of his argument so far: it’s dangerous, it’s useless, you risk infecting other people, and if they don’t do it in Boston then we shouldn’t do it in England either. He adds to that, that for people with common sense, the idea of doing something that might cause immediate death to avoid something that might cause death thirty to forty years down the line is just not reasonable (50). Now, I’m sure that by now you’re all totally convinced that they should indeed abandon that inoculation nonsense, but for those few of you still on the fence, fear not! Wagstaffe is far from done.

And he starts with an excellent return to his standard form. People are giving so many varying accounts of what happens that we just can’t know which parts of their work to trust (51). Unless it’s Dolhonde, of course. Then we know which parts of his work we can trust, and that’s all of it. Because: reasons.

He takes Maitland to task here, and quotes first his example of what the symptoms of inoculation are, and then pointing out that these were *not the symptoms present in Montagu’s son, or Mr. Colt’s child, or Mr Heath’s sons. Mr. Heath was the one with the two kids, one that Maitland liked, and one that he really didn’t like. Y’know, the one who got his feet wet?? (51-52)

And speaking of getting one’s feet wet, surely this is a huge problem, unless Mr. Maitland:

Has forgot how the poorer People in his own Countrey, often run about with the Small Pox upon them, without either Shoes or Stockings. (53)

If this wet feet thing is a problem then, uh… have you seen how the poor people in Scotland live? Yeah, Maitland is Scottish. An Englishman having a dig at the Scottish. How novel.

Anyway. On top of the people who’ve died from inoculation, he could give so many examples, like that of another Lord [redacted]’s son, and that of, uh… mumble mumble mumble, where they’ve nearly died. He’s also heard from New England of:

some breeding Women, who, in the true sense of the Word, have actually Miscarried under this Experiment. (54)

Those pesky breeding Women. But this probably did happen. Inoculating pregnant people is generally not a good idea. Of course, they’d probably also miscarry, if not outright die, if they caught actual smallpox when they were pregnant. So I guess, uh… just hope you’re not pregnant during a smallpox outbreak?

However vague Wagstaffe’s references are here, he’s right that inoculation could make someone seriously ill. This is, after all, why Edward Jenner was seeking a better method. But there’s still a far smaller chance of this happening than there is if you get actual smallpox.

What next? After all these brilliant arguments, where could Wagstaffe go from here? Well. No real academic argument can truly be considered complete if you don’t throw some more shade at your colleagues. Remember Timoni? The guy who sent in his account of the widespread usage and success of inoculation in Turkey? How could we possibly explain the shocking difference between its efficacy according to Timoni and the irreproachable Dr. Dolhonde? Of course the problem is with Timoni’s work. And the differences are:

Enough, methinks, to make one believe, that as he had seen but little of the Practice himself, he was imposed on, and took it upon Trust from those who, thro’ Ignorance or Design, deceived him. (55-56)

Timoni was probably just a gullible hack who believed what other people told him and didn’t actually know anything about it himself, unlike the faultless Dr Dolhonde. OR: he just felt pressured into writing this account, so he just trusted his sources and sent along his report without fact-checking it (56). Wagstaffe accuses Timoni of being one of those pro-inoculation hacks who will just claim that someone got smallpox the natural way if they died just after inoculation.

Apparently it’s been too long since Wagstaffe’s last racist, islamophobic comment, because he then adds that if the reaction caused by inoculation was really always so mild in Turkey, and the actual smallpox was really just as deadly as here, then:

I can not imagine but the Native Turks, stupid as they are, notwithstanding their favourite Doctrine of Fatality, by seeing the Success of this Experiment every Day with their own Eyes, for many Years together, would have been convinc’d long before this, and have practic’d it among themselves: Yet neither this Author, nor any one besides, pretends to give us an Instance of an Inoculated Turk. (56-57)

Seriously, Wagstaffe, enough with the bigotry already.

So: despite all the other reports and evidence, Wagstaffe’s going to assume that they’re all lying or wrong about this because none of them give a specific instance of an inoculated Turk. Cool.

Anyway, the fact that they everyone is giving differing accounts of what the bodily reactions are to inoculation (apart from ‘not getting smallpox’, of course) just makes it seem like, well… like maybe they didn’t actually see the practice being performed themselves. Maybe they actually only heard about it second-hand. Maybe they’re all just lying liars who are lying again (59). Maybe.

Also, the fact that those damn Turks perform inoculations with incisions, but the Chinese do it by blowing powder up people’s noses just means that the two accounts contradict each other and therefore they’re both wrong (59). I mean, you could conclude that this means that two different methods of inoculation are possible, but why do that when you can just assume that the right conclusion in the one you want to be right?

Next on his list of arguments is a return to the ‘people die’ point. He’s heard from some unnamed people that you can take his word for it are people ‘of integrity and skill’ that there are several cases among high-ranking members of society where inoculation has gone so wrong that people’s bones literally decayed, or they got a recurring fever (60).

I don’t know why he didn’t mention this before, but y’know, it’s Wagstaffe: much like ‘treating smallpox’, ‘argumentative structure’ is not his forte.

SO. All of this shows that these ‘Newfangled Notions’ (yes, that’s literally the phrase he uses), and just utter nonsense and:

‘tis repugnant to common Sense, of the most pernicious Consequence to a Populous and Trading City, and entirely destructive to the Good of the Publick, and the very Being and Intention of a Community. (63)

Now I know by now you’re all staunch supporters of Wagstaffe’s cause, but wait! If you thought that was the conclusion of his rhetorical masterpiece, you’d be wrong. He’s still got more things to say. Six more pages of things to say, to be precise. For instance, the fact that it’s been practiced a lot on children means that we can ignore that evidence, too, because at the moment there’s no smallpox outbreak and hardly one child in one hundred has died from smallpox this season (63). If there’s minimal chance of a kid dying from smallpox anyway, then we can’t assume that them not dying has anything to do with inoculation.

Also, it’s not inevitable that someone will get smallpox in their lifetime. Some people never do. So why do something to try and prevent them getting it (63-64)? Wagstaffe’s hot on the idea that inoculations may cause outbreaks, but not so much on the idea that they might prevent outbreaks if most people get inoculated. The idea of herd immunity won’t be properly articulated for a couple more centuries.

Wagstaffe also makes a really interesting comment, here. He actually suggests not only that some people won’t get it, but that in all probability they can’t get it. That somehow, they’re just completely immune to it. Today we know that natural passive immunity is passed on during pregnancy and lasts for a few months, and that this time period can be extended by breastfeeding. But an understanding of that is still over a century away, too, so it’s not what Wagstaffe is talking about. Instead, he seems to think that some people are just inexplicably immune to it. Example, you ask? Certainly.

Mr Nicholson, the present Master of the Apothecary’s Company, is an unquestionable Instance; who from the Extensiveness of his Business, for near Fifty Years together, has attended as many perhaps in this Distemper, as any Man now living, and he has never lay under he least Apprehension, for he had never the least Disorder on that Account. (63-64)

I wonder if Nicholson had caught cowpox as a kid. Anyway, the fact this one guy seems to be immune to smallpox without catching it is somehow compelling evidence that other Physicians shouldn’t get inoculated. And, uh, we’re going to ignore the idea that maybe the reason there’s only one physician who hasn’t caught it after fifty years of exposure is, in part, because the other doctors didn’t last fifty years. Because, y’know. They caught smallpox. To a bunch of physicians, who might very well themselves have caught smallpox in the past, this example of one doctor appearing to be immune probably doesn’t make a compelling argument for abandoning inoculation. But it is to Wagstaffe, at least. Not like there might be some cherry-picking going on here.

But no, there couldn’t possibly be any bias here, because doctor Wagstaffe really wishes inoculation worked. He’d totally be the first to admit it if it really did. He goes on for a page about how much he’d totally be the main supporter if it did work. It would be just so beneficial to the country if it worked. And also it would mean doctors didn’t get blamed when someone with a bad case of smallpox died despite their best efforts. (64-65) Perhaps some personal experience there, Wagstaffe?

He’s also sure that Dr. Freind himself would love to be proved wrong about inoculation, too. They’d both just be delighted to be proven wrong – of course they would be! But alas, the only conclusion they can reach is that sometimes an inoculation will at least induce a real case of smallpox.

Given this, there literally couldn’t be a worse use of this inoculation practice than rich people using it. To be fair, if a bunch of rich people die of smallpox, there will be fewer rich people for the poor to eat come the revolution, but for some reason I doubt that’s what Wagstaffe means.

Finally, have we considered biological warfare?

Certain it is, that if some future Inoculator can be drawn into any ill Design, he might be as sure of a Method of silently communicating any Poyson, as they are in those Nations, the most famous for this artful practice. (68-69)

What if one of those untrustworthy lying inoculators was convinced to do something of ‘ill Design’? If he practices inoculation he also knows how to secretly poison people, just like those damn foreign heathens do. Thanks for putting that idea into people’s heads, Wagstaffe. Weird argument to finish on, but okay.

Finally, finally, Wagstaffe is done. Just in case he waffled on so long that you forgot what all of his points are, here’s the tl;dr:

That’s undeniably a lot of arguments, though equally undeniably, very few good ones. Wagstaffe has thrown every objection he can think of at this, in the hopes that enough of them will stick to make his point. He’s been massively bigoted; cast some serious shade at his peers; used some highly selective, frequently anonymous sources; ignored the inconsistencies in his own argument; and very occasionally, made an actually good point. But what he hasn’t done is prove that inoculation never works, or that it rarely works, or even that it works less often than it doesn’t.

Had his point been that people needed to be careful with inoculation because it wasn’t actually 100% successful, with a 0% mortality rate, as claimed, he could have reasonably made his point – and made it sans the bigotry and shade. Unfortunately, his stance is that inoculation doesn’t work at all, should probably be made illegal, and that everyone who supports it is a liar and a hack, not that people need to be more careful and that maybe they need to try and gather more data.

Wagstaffe’s letter is finally over, buuuut! There’s a postscript.

Imagine how excited I was when I found this out.

One doctor Alexander Stuart, to whom we are all eternally grateful shared with Wagstaffe some letters from Dr. William Douglass. If only there was some way we could repay him. Wagstaffe attaches some extracts from those letters. The first extract is from the 20th of December 1721, and provides a diametrically opposed account of the successes Dr. Boylston was having in Boston. Their inoculation attempts were actually widely unsuccessful! Supposedly, Boylston (and our beloved Cotton Mather) chalked up the failures in their second attempt to everyone they inoculated having already caught smallpox just before they were inoculated. And then they tried again for a third time and people died from it (1-2). The only part of the account that that comes close to matching Boylston’s own account is that they tried it on around 200 people (Boylston’s exact figure is 280) with varying success.

Then he attacks Timoni and Pylarini in the same way Wagstaffe had. They’re probably lying. But Douglass also adds something else. Apparently the ‘operatrix’ (that ignorant old Greek woman) told Pylarini that you couldn’t use the gunk from someone who got smallpox from inoculation to perform further inoculations. Pylarini suspects that it might actually effectual and result in an even more benign case of smallpox, but he hasn’t tried it. Douglass, on the other hand, has tried it out himself, and it didn’t go well. He doesn’t give any more information than that. Just trust him, I guess.

Then he has a go at Timoni, who reports that no one who was vaccinated ever caught smallpox. But again, Douglass knows this is not true (3). No, you can’t have any details. Timoni also says that the symptoms are always very slight, but then reports that, out of a group of fifty people who were inoculated, four got pretty bad symptoms (3-4). That does, of course, mean that 46 of them did have mild symptoms. 8% is undeniably higher than 0%, but it’s still a 92% chance it’ll be mild. He’s also heard a few personal reports of people having a bad reaction. In fact, they had worse symptoms than had they caught smallpox naturally. Except for death, of course. None of them had the symptom of being dead.

Then he gets into some really bad racism. Everyone knows that black slaves are the biggest liars in the world, so we just can’t take their account to be true. Screw you, Douglass. Screw. You.

After that he complains that the supporters of inoculation just ignore evidence that shows that inoculation is dangerous, or find ways to explain away cases that don’t support their claims (4-5). Mind you, he also complains that, when provided with evidence that inoculation never killed, they just dropped that particular claim.

The next thing he says is so… well. He says:

Their daring Practice on Women with Child, who Miscarried while under Inoculation, they do not mention, as if procuring Abortion were a very innocent Practice; I forbear the Names of some who are Instances of this Wickedness. (5)

Gotta admit, I did not expect to find abortion used as a counter-argument when I first started reading about smallpox inoculations. Women are getting inoculated and not just miscarrying, they’re getting inoculated in order to get an abortion. There you have it. An anti-abortion conspiracy theory from 1721. Wonderful.

But despite all this, so far, Douglass thinks that they should do more experiments (6). Either it will turn out to be useful, and we all benefit from it, or it won’t work, and those who supported it will be branded as murderers. So it works out either way.

However. There are some reasons he doesn’t think the present practice should continue. For him to support it, they’d have to make a few changes. Because there is a risk of people dying from inoculation, there should be an act of parliament… not to ban inoculation, as Wagstaffe thinks, but to exempt medical professionals from liability in those instances. Next, they need to stop dismissing cases that disagree with their stance, because it wouldn’t be dismissed in a court (7-8).

Third, they need to be more careful when inoculating to make sure that it can’t infect people around them who are still vulnerable to smallpox. And again, he brings this back to a legal issue.

Just do it in a way that won’t get us arrested, guys.

Next, Douglass returns to that old, reliable theme of just saying other people’s accounts can’t be trusted.

I am sorry the World cannot reap the Benefit from this Rash and Bold Experiment, that might have been expected: The chief Promoter, who sends Accounts Home not always to be depended on, is Credulous and Whimsical; the Operator is Rash and Unthinking. Who knows but they who have* Dy’d* or Suffer’d much under Inoculation, if they had had better Management, might have had better Fate. (9)

The chief Promoter is Cotton Mather. The Operator is Boylston. One’s unreliable and gullible, the other is a hack. And maybe if those who died from inoculation under their care had had a better doctor, they would have survived the inoculation just fine.

His summary of what he’s learned about inoculation over the last five or six months is:

  1. That smallpox can indeed be communicated by inoculation (but not always).
  2. That the reaction to inoculation is frequently milder than actual smallpox, and less likely to result in death. Though it might still be pretty bad.
  3. No one has died of inoculation in the last five to six months, assuming you trust those inoculators when they try to explain away all the cases and lie about it.

That’s the end of the first letter. Now, there’s definitely an undercurrent of sarcasm in many parts of this letter, but I don’t think the whole thing is sarcastic. At this point, he really does think that they should let proponents do some better experiments with inoculation, and either it’ll turn out to be really useful, or they’ll ruin their reputations and no one will believe their nonsense ideas ever again.

The next letter is dated February 15th. 1722, and it’s more critical of inoculation than the first one. Douglass seems to have made up his mind that it’s bad. It starts with a report that the process has been banned in Boston. He repeats some of the information about inoculation experiments in Boston, and adds some information about recent outbreaks and spread of smallpox in the area, and suggests that attempts at inoculation made some of those outbreaks worse (11-13).

The final letter is from April 27th 1722, and reports that the practice of smallpox no longer has any credibility in Boston. The council had tried to ban it by law, but the governor refused to sign the law until they heard about how the practice was doing in England (13). He gives examples of inoculation going badly to argue its inefficacy (13-14). Standard stuff.

The final point in this final letter makes a comment about something we haven’t seen mentioned before:

All of them, while Ill and their Sores running, have a foetor peculiar to Inoculation; they all, while Ill, complain much of their Head, and dejection of Spirits; and therefore it is that Mr. Mather, in his Publications, says it is not to be practiced on Hysterick and Hypochondriacal People. (14)

Sores produced by inoculation have a weird smell, and it’s also supposedly negatively impacting people’s mental health. Obviously, I had to look into whether this was true or not, and I regret to inform you that on the first page of the Google results was an anti-vaccine website making this exact argument to discourage elderly people from getting flu-shots. It gives itself the veneer of credibility by citing articles in respectably journals. But in every single reference I checked, it turns out that the article does not actually say what the anti-vaxxer is claiming it says. There is no proof that vaccines cause mental health issues.

So what do we make of Douglass’ report? There’s no proof that contemporary vaccines have a negative impact on people’s health, but we do know that being physically ill generally can negatively affect mood. Given that inoculation still generally made people get a far milder form of the disease, it’s perfectly plausible that, as with all physical illnesses, inoculation could sometimes negatively impact people’s mental health while they were ill. Just like it would in people with actual smallpox. But Douglass’ claim is that smallpox never negatively impacts people’s mood, and that inoculation always does. But he doesn’t provide any evidence at all for this. It’s not been mentioned in any of the previous reports. Not even the eminently reliable Dr Dolhonde mentions it. So I’m calling BS on this sudden, unexpected, new claim.

That’s the end of the extract, and the end of the postscript, and, finally, the end of Wagstaffe’s letter. Honestly, I was sort of hoping that there wouldn’t be anything new in the postscript, because this episode is already longer than I intended, but I think those nuggets about abortion and mental health were worth it.

For those of you who love historical context, Wagstaffe died in 1725, three years after this letter was written and published. A collection of his works was posthumously published the next year. It’s not particularly clear to me who wrote the introduction, but it states that:

The cheerfulness of his temper, before his spirits were oppressed by misfortunes, which he suffered to be brought upon himself by the easiness and indolence of his nature, was such as made him not only beloved by the gentlemen of his own profession, but likewise rendered his conversation agreeable to all sorts of people. (viii)

It goes on to say that:

He was a person indeed who did not greatly apply himself to study in his later years, otherwise than the business of his profession; and some public exercises which he had taken upon him, obliged him sometimes to consult books, which if he had thoroughly read and studied, as some others have done, his parts and abilities were such, that none of the profession would have made a better figure, either as a gentlemen, scholar, or physician. (viii)

Tl;dr. He got lazy and spent more time partying than studying. Had he applied himself properly, he’d have been the best at whatever he did. Who knows what his opinion on inoculation would be had he actually fully researched it.

It’s not entirely clear what he died of. The author of the introduction says:

A weight upon his spirits, occasioned by a sense of the misfortunes he had inadvertently fallen into, brought an illness upon him. Which is since thought he might have recovered, if he had unburthened his mind to some who had a more than ordinary value for him, and who would have spared neither cost nor pains to have made him easy til he could have made himself so. He took a journey to Bath, in March 1724-25, for the recovery of his health, where he had not been many weeks before he relapsed; and, continuing to grow worse and worse, he at length departed this life, on the 5th of May, 1725, in the fortieth year of his age, very much lamented by all who had ever been acquainted with his character and conversation. (ix)

Basically, he got lazy, realised he’d got lazy, was probably broke, got depressed about it, didn’t tell anyone about it, and then died. After he died, people suggested that, had he actually talked to the people who cared about him, he might have survived. It’s not written anywhere, but to me, that sounds like it was probably suicide.

Seriously, people. Please take care of your mental health. It’s not shameful to be ill, and it’s not shameful to get help. Tell someone.

Now, when I first started writing this episode, I assumed I’d get to cover some of the responses to both Wagstaffe and Massey, too. But I vastly underestimated just how much opinion Wagstaffe had to share, and I didn’t realise there was a postscript. Hence, there’s going to be a part three, where we look at a some of those responses.

So thanks for listening. If you like the show, please subscribe on whatever podcatcher you use. Rate and review the show, especially on iTunes. If you’re the type of person who can be convinced to leave a review for the prospect of getting a shout-out, start the review with the word ‘postscript’ and I will bless you with this most esteemed honour.

If you have questions, comments, feedback, want to suggest a topic, etc. You can find the podcast on twitter @poisonroompod, or send an email to: poisonroompodcast@gmail.com

Alternatively, write a really long letter, then get someone you know to write another an overly long letter to one of their friends, and attach your letter as a postscript. And then get it printed as a pamphlet.

Transcripts of this episode are available at poisonroom.com, where you can also see the references and bibliography. Some sources are, unfortunately behind paywalls, but if there’s a link in the bibliography that means it’s publicly accessible. This includes Wagstaffe’s letter, should you want to read the whole thing yourself.

You have been listening to The Poison Room, a podcast that is definitely trustworthy and reliable, you can take my word for it.


--- (2015) ‘The Censors of the Royal College of Physicians’.

Bolaine, N. (1754) Remarks on the Rev. Mr. Delafaye’s Vindication of his Sermon, Intitled, Inoculation an Indefensible Practice, R. Baldwin.

Copp, N. & Zanella, A. (1993) Discovery, Innovation, and Case Studies in Science and Technology, MIT Press.

Drake, S. G. (1870) A Particular History of the Five Years French and Indian War in New England and Parts Adjacent. S. G. Drake.

Mather, C. (1722) An account of the Method and Success of Inoculating the Small-Pox, in Boston in New-England. ’ J. Peele.

Moore, N. & Loudon, J. (2004) William Wagstaffe Oxford Dictionary of National Biography.

Pylarini J. (1716) Nova et tuta variolas excitandi per transplantationem methodus, nuper inventa & in usum tracta.’ Philosophical Transactions of the Royal Society, Vol. 29: 393–9. - Rowlinson, J. S. (2007) ‘John Freind: Physician, Chemist, Jacobite, and Friend of Voltaire’s’ Notes and Records of the Royal Society of London, Vol. 61: 109-127.

Smith, L. (2013) ‘Suffering Venereal Disease in the Early Eighteenth Century’ The Sloan Letters Project.

Timonius, E., & Woodward, J. (1714) ‘An account, or history, of the procuring the smallpox by incision, or inoculation; as it has for some time been practised at Constantinople. Being the extract of a letter from Emanuel Timonius, Oxon. & Patav. M.D. S.R.S dated at Constantinople, December, 1713’ Philosophical Transactions of the Royal Society, Vol. 29: 72–82.

Wagstaffe W. (1722) A letter to Dr. Freind; showing the danger and uncertainty of inoculating the small pox London.

--- (1726) Miscellaneous Works of Dr. William Wagstaffe. J. Bower.