Sarah Irawa
Parañaque City, Philippines

Stefan Zweig, Marie Antoinette’s biographer, wrote of his heroine as “the most signal example in history in which destiny will at times pluck a human being from obscurity and, with commanding hand, force the man or woman in question to overstep the bounds of mediocrity.” The same could be said of Sophie von Anhalt-Zerbst, the teenage princess of a tiny principality bordering Saxony in Germany. Thanks to her maternal uncle’s betrothal to Elizabeth of Russia and his fateful death, young Sophie captivated the Empress, who selected her as the bride to her heir and nephew, Peter. All Sophie then needed were a wedding, Elizabeth’s death, an unpopular husband, and a bloodless coup to be installed as Catherine II.

As Empress, Catherine ventured to westernize Russia by corresponding with philosophical stalwarts, Diderot and Voltaire, perusing Montesquieu and intending to entrench his ideas into her legal code, and importing thousands of magnificent art pieces by van Dyck, Rubens, and Holbein, to name a few. But most outstandingly, Catherine addressed an aspect of Russian life long neglected by her predecessors – public health.

It came about that in the spring of 1768 Countess Anna Sheremeteva, the fiancée of the Empress’ principal minister Nikita Panin, caught smallpox (a disease caused by the variola virus that  had “killed more people than any other microorganism”¹) and died within a few  weeks. As Panin himself underwent quarantine, Catherine remained in Tsarskoe Selo while waiting for reports of his recuperation. But across the rest of Europe, a novel yet divisive preventive process was gaining fame among the nobles and the bourgeoisie.

It was variolation. Before Edward Jenner was conferred the sobriquet The Father of Immunology there was Lady Mary Montagu, an ardent promoter of women’s emancipation and also of smallpox variolation, an immunological technique she had seen in Constantinople.² There Turkish mothers would have their children inoculated with “the purulent matter from the sores of a person who had become infected with smallpox.”³

Returning to Britain, Lady Montagu introduced the procedure to George I and his wife, Queen Caroline, who arranged for the inoculation of seven convicts and six orphans. Its success convinced George I to have two of his grandchildren undergo the procedure. This was a triumph, and inoculation before Jenner became the universal precautionary method against smallpox.

Although variolation assured smallpox immunity and a death rate of only 1 to 2% versus a daunting 30% for those who contracted the malady in nature,² it was never harmless. The patient could die from it, and the procedure itself could cause an outbreak. Despite these considerations Catherine summoned to Russia a Scottish physician, Thomas Dimsdale, to inoculate her and her son, the Tsarevich Paul.

Concerned that the Russian smallpox might behave differently from the British, the doctor proposed that he should first try inoculating female commoners of her age. This the Empress resolutely refused. Dimsdale also requested that he could discuss the method with her court physicians. Catherine equally rebuffed the idea, regarding it unnecessary. But she agreed to wait when the Scot insisted he wanted to test the method on several young natives.

After numerous trials, the doctor and the Empress concurred on the date of inoculation. On October 12, Dimsdale inoculated Catherine with pus from a smallpox-infected child, Alexander Markov. To recover and isolate herself, the Empress travelled south to Tsarskoe Selo where “despite some slight uneasiness” she continued her two-hour daily outdoor exercise and “developed a moderate number of pustules that dried up in a week.”⁴

Dimsdale’s declaration that Catherine’s inoculation was a success led to the subsequent variolation of the Tsarevich, 140 nobles, and fifty Muscovites. The founding of inoculation clinics in Russia’s largest cities, St. Petersburg, Moscow, and Kazan, followed. By the beginning of the nineteenth century, around two million Russians, including the Empress’ first grandson Alexander, had undergone inoculation.

Catherine had no particular love for physicians. In fact, she reluctantly agreed on hiring a personal doctor, and seldom followed his medical advice. But in the face of smallpox threatening her subjects’ wellbeing, she overcame whatever private antipathies she possessed. Allowing herself to be inoculated when most monarchs would not have done so was a feat not even the valiant Frederick the Great would have considered.

Notes

1. Christine L. Case & Chung King-Thom, “Montagu and Jenner: The Campaign Against Smallpox,” SIM News,1997 accessed on August 18, 2013 from http://www.smccd.edu/accounts/case/biol675/docs/Montagu-Jenner.pdf
2. US National Library of Medicine, “Smallpox: A Great and Terrible Scourge,” National Institutes of Health, accessed on August 18, 2013 from http://www.nlm.nih.gov/exhibition/smallpox/sp_variolation.html
3. Jean Mercer, “Lady Mary Wortley Montagu: A Contributor to Public Health,” Psychology Today, September 3, 2009 accessed on August 18, 2013 from http://www.psychologytoday.com/blog/child-myths/200909/lady-mary-wortley-montagu-contributor-public-health
4. Robert K. Massie, Catherine the Great: Portrait of a Woman (United States of America:  Random House Trade Paperbacks, 2011), 388.

References

1. Case, Christine L. & King-Thom, Chung. “Montagu and Jenner: The Campaign Against Smallpox.” SIM News,1997accessed on August 18, 2013 from http://www.smccd.edu/accounts/case/biol675/docs/Montagu-Jenner.pdf
2. Hamilton, Adrian. “The empress strikes back: Catherine the Great exhibition at the National Museum of Scotland.” The Independent. August 15, 2012 accessed on August 25, 2013 from http://www.independent.co.uk/arts-entertainment/art/the-empress-strikes-back-catherine-the-great-exhibition-at-the-national-museum-of-scotland-8046701.html
3. Massie, Robert K. Catherine the Great: Portrait of a Woman .United States of America:  Random House Trade Paperbacks, 2011.
4. Mercer, Jean. “Lady Mary Wortley Montagu: A Contributor to Public Health.” Psychology Today. September 3, 2009 accessed on August 18, 2013 from http://www.psychologytoday.com/blog/child-myths/200909/lady-mary-wortley-montagu-contributor-public-health
5. Russell, John. “Catherine, Also Great As a Collector.” The New York Times. October 1, 1998 accessed on August 25, 2013 from http://www.nytimes.com/1998/10/01/arts/art-review-catherine-also-great-as-a-collector.html
6. US National Library of Medicine. “Smallpox: A Great and Terrible Scourge.” National Institutes of Health. accessed on August 18, 2013 from http://www.nlm.nih.gov/exhibition/smallpox/sp_variolation.html