The Speckled Monster: A Historical Tale of Battling Smallpox (review)

The Speckled Monster is a fine work of historical fiction. Based on assiduous research and disciplined but lively imagination, this book succeeds at a daunting task: bringing the world of eighteenth-century medicine to life for popular audiences without soft-pedaling scientific content or difficult questions. The undertaking is a worthy one, for the story that Jennifer Lee Carrell tells is not just dramatic and engaging but timely as well. Her chosen subject is not the familiar one of Edward Jenner's development of smallpox vaccination in 1796. Instead, she tells the earlier, more riveting, and equally important story of the Western world's "discovery" and limited acceptance of an earlier practice known as "inoculation" or "ingrafting." In today's medical lexicon, the procedure is most precisely termed "variolation," from variola, the smallpox virus. As the name implies, variolation entailed deliberately infecting a susceptible individual with the virus, usually through a small incision; the result in most cases was a mild case of smallpox and lifelong immunity. Inoculated smallpox was much less deadly than the "naturally" acquired disease. Before Europeans became aware of it, the procedure had seen usage in Africa, Asia, and the Middle East for hundreds (if not thousands) of years.

Carrell's drama unfolds simultaneously in two theaters: greater Europe, and colonial Boston. In Europe we follow the trials of the daring and iconoclastic Lady Mary Wortley Montagu. In 1712, at age twenty-three, Lady Mary eloped with an ambitious young Whig M.P. named Edward Wortley Montagu. Soon after her marriage, Mary's beloved younger brother died of smallpox, and in December 1715 she caught it herself—an encounter that nearly killed her and left her face so disfigured that she wore a mask in public for several months. Her unmasking came sometime before her August 1716 departure for Constantinople, where her husband served briefly as England's ambassador to the Ottoman Empire. It was among the Turks that Montagu learned the details of variolation, writing home with unfettered enthusiasm: "The small pox, so fatal, and so general amongst us, is here [rendered] entirely harmless, by the invention of ingrafting."¹ Before Lady Mary and her family returned home in 1718, she had her five-year-old son successfully inoculated.

Simultaneously, an analogous story unfolded on the far side of the Atlantic Ocean. Here, we follow the life of Zabdiel Boylston, a Boston physician who (like Montagu) bore the telltale scars of a smallpox survivor. Boylston, again like Lady Mary, was an iconoclast, at least in Carrell's portrayal. His approach was to "take knowledge wherever you find it" (p. 101), including African and Native American sources. As a consequence, when smallpox erupted in Boston in 1721, Boylston was receptive to a description of inoculation circulated among local physicians by the Puritan minister Cotton Mather. Mather, it turned out, had gotten his knowledge from his African bondsman, a "Coromantee" slave named Onesimus. When asked "whether he ever had y^eSmall-Pox," Onesimus had responded "Yes and No," explaining that he had had "an Operation, which had given him something of y^eSmall-Pox, and would forever præserve him from it."²

Smallpox swarmed through Boston and London alike in 1721, but in both places variolation met with skepticism and violence, despite its long-established effectiveness in other parts of the world. The second half of this historical novel details the quests of both Boylston and Montagu to gain acceptance for the procedure in England and her colonies. Their twin quests were fraught with obstacles, although Boylston faced the more treacherous path. In the end, both heroes emerge triumphant, and Carrell even has the two inoculation proponents meeting in 1725, during Boylston's visit to London for his induction into the Royal Society. It is not known whether...