Hektoen International

A Journal of Medical Humanities

“Satturday” by Lady Mary Wortley Montagu, who helped introduce smallpox inoculation to England

Cristóbal Berry-Cabán
Fort Liberty, North Carolina, United States

Lady Mary Wortley Montagu with her son, Edward Wortley Montagu, and attendants. Attributed to Jean Baptiste Vanmour, oil on canvas, circa 1717. (Courtesy National Portrait Gallery)

Lady Mary Wortley Montagu1 was born in 1689 to an aristocratic family. She was highly intelligent and self-educated by having access to her father’s library, studying the classics, and even learning Latin. In 1712 she rejected her father’s choice and eloped with Edward Wortley Montagu, a young Whig politician. She survived an attack of smallpox in 1715 and continued to write letters and poems which were published under a pseudonym in The Spectator. Between 1715–16, she wrote Six Town Eclogues, a series of short poems in which there is one for every day of the week except Sunday.2 The poems were not officially published until 1747.

 In “Satturday; The Small Pox”, Montagu satirizes physicians, medical experts, and the patriarchy. Montagu employs the perspective of a girl called Flavia, who has lost her beauty to smallpox. Following this loss, the speaker retreats to the countryside, bidding farewell to urban life. In the city, she would face mockery and ridicule for her altered appearance. In nature, she finds peace of mind and soul.

The wretched Flavia on her couch reclined,
Thus breathed the anguish of a wounded mind.
A glass reversed in her right hand she bore,
For now she shunned the face she sought before.
“How am I changed! alas! how am I grown
A frightful specter, to myself unknown!

Montagu describes her own experience of smallpox as isolating her from polite society:

Adieu ye Parks, in some obscure recess…
There let me live, in some deserted Place,
There hide in shades this lost Inglorious Face.
Ye Operas, Circles, I no more must view!

Lady Mary shifts from an external narrator to Flavia’s own voice enabling her to vividly convey the psychological impact of her physical scarring. With her appearance permanently altered, Flavia feels “to [her]self unknown,” and the rest of the poem unfolds from her perspective as she grapples with a profound loss of self-worth tied to her diminished beauty. This self-worth, primarily derived from the power her good looks afforded her over men from various walks of life, is emphasized through her recollection of past conquests:

For me the patriot has the House forsook,
… the soldier has soft verses writ;
For me the beau has aimed to be a wit…
The bashful squire…
Fired by one wish, all did alike adore;
Now beauty’s fled, and lovers are no more.

The poem provides no indication that Flavia possesses any qualities beyond her physical attractiveness. It describes how, in the past, Flavia would gaze into her dressing room mirror, reflecting on her beauty: “While hours unheeded passed in deep debate, How curls should fall, or where a patch to place.”

Later, Flavia spitefully criticizes women she considers less beautiful than her calling them “meaner beauties”, claiming, that if “pitying heaven” restored her former glory, her now successful rivals “still might move unthought of and unseen.”

Mocked by the portrait of her former self, Flavia feels somewhat responsible for her situation. This is, of course, completely untrue; having survived an illness like smallpox, she is genuinely lucky to be alive. However, her unconscious self-blame for her appearance implies that she sees it as her duty to look beautiful. Her success or failure as an individual, her entire worth as a person, is defined by her appearance. As the poem concludes, Flavia’s problem is not just the loss of her identity but also her inability to reclaim a life in a society that prioritizes surface appearance over substance. She has lost not only her sense of self but also her capacity to influence others and be respected as an individual. Flavia exclaims:

But oh, how vain, how wretched is the boast
Of beauty faded, and of empire lost!
What now is left but weeping to deplore
My beauty fled, and empire now no more?

Her beauty faded but her spirit remained intact. A year later, when her husband was assigned to Constantinople as British Ambassador, she insisted on traveling with him and bringing their young son. She turned her long stay into a series of sharp-eyed, evocative letters home that were later gathered into a volume that has become an early classic of travel writing.1 Once settled in the Ottoman Empire, she immersed herself in writing about this exotic exciting world. Among many findings she noted the beautiful skin of the locals, who exhibited almost no scarring from smallpox. Upon discovering the remarkable reason for this, she eagerly wrote about it in a 1717 letter:

The small-pox, so fatal, and so general amongst us, is here entirely harmless. . . . There is a set of old women, who make it their business to perform the operation, every autumn, in the month of September, when the great heat is abated . . . Then an old woman comes with a nut-shell full of the matter of the best sort of small-pox, and asks what vein you please to have opened. She immediately rips open that you offer her, with a large needle (which gives you no more pain than a common scratch) and puts into the vein as much matter as can lie upon the head of her needle, and after that, binds up the little wound with a hollow bit of shell.3

She had observed the practice of variolation in the local bazaars and immediately recognized its potential health importance. As her three-year-old son was with her, and her husband had just learned that they were being recalled to England (where her son would be threatened by smallpox) she acted swiftly and secretly and arranged for a visit by old woman with a needle. (In eighteenth-century Turkey, inoculation was a common folk practice, typically carried out by illiterate old Greek and Armenian women).4

As a result of her endeavors, her son became the first Englishman to ever be vaccinated against smallpox inoculation and would never contract the disease. Determined to bring the technique home, Lady Mary introduced it in London, where at first she met resistance from the medical community. Undeterred, Lady Mary inoculated her daughter during a smallpox epidemic in 1721, showcasing the procedure’s success before an audience including the King’s physician. Although King George I initially refused to allow his grandchildren to be inoculated without further testing, successful trials on prisoners and orphans paved the way for the inoculation of some royal family members. Her efforts initiated the acceptance and spread of smallpox inoculation in Europe, opening the door for further medical advances.1,4

Mary Montagu lived into her early seventies, gaining some fame for her writing, traveling in Europe, and mingling with the great minds of her time. She fended off admirers and fell in love with a brilliant Venetian count, ultimately leaving her husband for him. Lady Mary’s poem “Satturday, The Small Pox” provides a poignant portrayal of the physical and societal devastation caused by smallpox, particularly emphasizing the impact on women such as her character Flavia. Lady Mary’s personal experience of the disease’s effects likely motivated her later advocacy for inoculation against it through personal contacts and through her literary work.1


  1. Hager T. How one daring woman introduced the idea of smallpox inoculation to England. Time. March 5, 2019, https://time.com/5542895/mary-montagu-smallpox/
  2. Lady Mary Wortley Montagu. Town eclogues: Saturday; The small-pox. Six Town Eclogues. 1716. doi:https://www.poetryfoundation.org/poems/44766/town-eclogues-saturday-the-small-pox
  3. Lady Mary Wortley Montagu. Embassy to Constantinople: The Travels of Lady Mary Wortley Montagu. Century; 1988.
  4. Koplow DA. Smallpox: The Fight to Eradicate a Global Scourge. University of California Press; 2003.

CRISTÓBAL S. BERRY-CABÁN, PhD, has over 30 years’ experience conducting research on military health as an epidemiologist at Womack Army Medical Center, Fort Liberty, North Carolina and the Geneva Foundation, Tacoma, Washington. He is the author of over 125 research articles, including several on the history of medicine.

Spring 2024



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