Arizona author documents historical battle

By Leigh E. Rich

The Speckled Monster: A Historical Tale of Battling Smallpox
By Jennifer Lee Carrell
Dutton
June 2003
451 pages
$24.95

Today, 23 years after the World Health Organization confirmed the worldwide eradication of smallpox, there are only two places one might bump into the Variola virus that causes the horrific disease—in containment labs at the Centers for Disease Control in Atlanta, Ga., and at the State Research Centre of Virology and Biotechnology in Koltsovo, Russia.

But for at least the past 3,000 years, the brick-shaped virus has ravaged human populations, killing a third of those it infects, disfiguring the fortunate who survive, and creating much consternation among medical experts of every kind.

Though officially eliminated in 1980, the path to eradication was nothing if not windy and treacherous—as well as well traveled by many long forgotten to history. And it is a piece of this global tale that Harvard Ph.D. in English and American literature Jennifer Lee Carrell narrates in her first book, The Speckled Monster.

A historical account of two unlikely heroes written in the vein of a period novel, The Speckled Monster is a catching page-turner despite its rather imposing thickness and sober topic. Split into three parts plus an “Aftermath,” Carrell’s tale bridges the cities of London and Boston during the 1721 smallpox epidemic, when proponents of “engrafting” or “variolation”—i.e., inoculation—began to emerge in these societies.

The idea of protecting oneself from the ominous disease by intentionally inflicting a less virulent form of it via incisions in the arms was not new when Carrell’s heroes, Lady Mary Wortley Montagu and Zabdiel Boylston, took up the practice. In fact, Lady Mary, whose beauty was cruelly scarred by her own bout with the monster, was first introduced to the concept by Turkish ladies when her husband was the British ambassador to the Ottoman Empire.

Witnessing the milky complexions of the Turkish maids firsthand, Lady Mary wrote to her countrymen back home: “There is a set of old women who make it their business to perform the operation. … 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 and asks what veins you please to have opened.”

Though such a scene from part one of The Speckled Monster may evoke images of an early Botox party, engrafting didn’t come without its risks. Anywhere from about one in 41 to one in 100 risked death from a smallpox inoculation; though left unprotected and to nature’s unpredictable whimsy, the outcome was a bleak one in six or seven. Such risks associated with engrafting decreased after 1796 when Edward Jenner began using cowpox—a closely related virus that infects cows—as the inoculation agent (and, hence, the source of the term “vaccination”). But smallpox vaccination even in the 20th century remained risky enough and the likelihood of importation of smallpox into the United States diminished enough that recommendations for routine smallpox vaccination were rescinded in 1971.

In Lady Mary’s and Boylston’s day, moreover, no one quite understood how inoculation worked, and the idea of deliberately giving a healthy individual smallpox remained ludicrous for many. Lady Mary and Boylston—themselves oddities as they were both pockmarked and educated and respected beyond their expected stations in society—were reviled by their critics as much as they were cherished by those they inoculated.

Making matters worse, at least politically, Lady Mary discovered the remedy for the disease that killed her brother and nearly herself in the hands of foreign women, while Boylston was apprised of the practice because it had long been used by Africans and, thus, African slaves. To the educated medical powers that be, such as the Royal Society in London and learned physicians like Dr. William Douglass in Boston, medical preventives from such marginalized groups were suspicious at best.

But Boylston, an exceptional though informally trained surgeon who apprenticed under his surgeon father, had long borrowed medical knowledge from the Native Americans and was more curious than dubious of the Africans’ method of smallpox prevention.

Gathering information from any African-born person he could find while tending to his smallpox patients, Carrell writes of Boylston’s inquiries in part two of her book: “To a man, to a woman, every person Zabdiel spoke to all day long upheld that story. Not exactly: not as if they had been discussing it among themselves. Some displayed scars in the fleshy parts of an upper arm or leg; some showed the back of the hand, or the thin web of skin between thumb and forefinger. … [T]hey had been infected with a small bit of pock-matter. They had sickened briefly. And they had survived to face down the speckled demon, unscathed and unafraid.”

The separate stories of Lady Mary and Boylston, which Carrell carefully revisits with an air of adventure in the first two parts of The Speckled Monster, are intertwined in part three, moving back and forth between London and Boston at the turn of every chapter. Not only does this tactic serve Carrell’s plan to infuse history with the lives and characters of those who made it, it also allows for a comparative analysis of how medical and political circles in both London and Boston first refused the procedure and then begrudgingly began to accept it, often adding modifications of their own.

While Boylston faced legal sanctions and regular tar-and-feathering by irate mobs for continuing to inoculate, Lady Mary had to urge the London physicians not to make such long (and dangerous) incisions at the sites of inoculation and to refrain from purging and bleeding patients before the procedure.

The plights of Lady Mary and Boylston did eventually converge, when the latter traveled to London to present his meticulous descriptions of his inoculations before the Royal Society. And though it is their stories that dominate much of The Speckled Monster, it is clear from Carrell’s take that both were well aware of their many companions in the battle against smallpox.

That the eradication success was a collaborative effort of many, from different cultures and eras, is Carrell’s point well made: The Speckled Monster is a most enjoyable history lesson with a moral that—unless he’s Atlas—no one man can move the world. 

Rich, L. E. (2003, June 27). Slow death of a monster. [Review of the book The Speckled Monster: A Historical Tale of Battling Smallpox by Jennifer Lee Carrell.] Rocky Mountain News.