332Chapter 18
of the disease as a “visitation of divine will.” Nonethe-
less, the death of Louis XV led to the inoculation of his
three sons.
While smallpox devastated all levels of society,
some epidemic diseases chiefly killed the poor. Typhus,
spread by the bite of body lice, was common in squalid
urban housing, jails, and army camps. Typhoid fever,
transmitted by contaminated food or water, was equally
at home in the unsanitary homes that peasants shared
with their animals.
The most famous epidemic disease in European his-
tory was the bubonic plague, the Black Death that
killed millions of people in the fourteenth century. The
plague, introduced by fleas borne on rodents, no longer
ravaged Europe, but it killed tens of thousands in the
eighteenth century and evoked a special cultural terror.
Between 1708 and 1713, the plague spread from Poland
across central and northern Europe. Half the city of
Danzig died, and the death rate was only slightly lower
in Prague, Copenhagen, and Stockholm. Another epi-
demic spread from Russia in 1719. It reached the port
of Marseilles in 1720, and forty thousand people per-
ished. Russia experienced another epidemic in 1771,
killing fifty-seven thousand people in Moscow alone.Public Health before the Germ Theory
Ignorance and poverty compounded the dangers of the
biological old regime. The germ theory of disease
transmission—that invisible microorganisms such as
bacteria and viruses spread diseases—had been sug-
gested centuries earlier, but governments, scientists,
and churches dismissed this theory until the late nine-
teenth century. Instead, the dominant theory was the
miasma theory of contagion, holding that diseases
spring from rotting matter in the earth. Acceptance of
the miasma theory perpetuated dangerous conditions.
Europeans did not understand the dangers of unsanitary
housing, including royal palaces. Louis XIV’s palace at
Versailles was perhaps the greatest architectural orna-
ment of an epoch, but human excrement accumulated
in the corners and corridors of Versailles, just as it accu-DOCUMENT 18.1
Mary Montagu: The Turkish Smallpox Inoculation
Lady Mary Wortley Montagu (1689–1762) was the wife of the
British ambassador to the Ottoman Empire. While living in Constan-
tinople, she observed the Turkish practice of inoculating children with
small amounts of smallpox and was amazed at the Turkish ability to
prevent the disease. The following excerpts are from a letter to a friend
in which Montagu explains her discovery.Mary Montagu to Sarah Chiswell, 1 April 1717:
I am going to tell you a thing that I am sure will make
you wish yourself here. The smallpox, so fatal and so gen-
eral amonst us, is here entirely harmless [because of] the
invention of “engrafting” (which is the term they give it).
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, people send to
one another to know if any of their family has a mind to
have the smallpox. They make parties for this purpose,
and when they are met (commonly 15 or 16 together),
the old woman comes with a nutshell full of the matter of
the best sort of smallpox [the fluid from a smallpox infec-
tion] and asks what veins you please to have opened. She
immediately rips open that which you offer to her with a
large needle (which gives no more pain than a common
scratch) and puts into the vein as much venom as can lie
upon the head of her needle, and after binds up the little
wound with a hollow bit of shell, and in this manner
opens four or five veins....
The children, or young patients, play together all the
rest of the day and are in perfect health till the eighth day.
Then the fever begins to seize them and they keep to
their beds for two days, very seldom three days. They
have very rarely above 20 or 30 [smallpox sores] on their
faces, which never leave marks, and in eight days time
they are as well as before their illness....
Every year thousands undergo this operation ...
[and] there is no example of any one that has died of it.
You may believe I am very well satisfied of the safety of
the experiment since I intend to try it on my dear little
son. I am a patriot enough to take pains to bring this use-
ful invention into fashion in England....
Montagu, Mary Wortley. The Complete Letters of Lady Mary Wortley
Montagu,ed. Robert Halsband. 3 vols. Oxford, England: Clarendon
Press, 1965.