Variolation was a form of inoculating a person with the smallpox virus in an effort to minimize the severity of the disease. I first became intrigued by the concept while watching a movie about John Adams, the second president of the United States. To my surprise, the scene that depicted Abigail Adams purposely infecting her children with smallpox had really taken place. But John and Abigail Adams lived during the eighteenth century. What about the seventeenth?
The technique predates vaccination as we know it, and apparently had its origin in eighth century India. Records indicate that China used variolation by the tenth century. In the West, Lady Mary Wortley Montague is credited for bringing it to England in 1721 after witnessing the practice being used by a doctor in Constantinople.
Again, I thought this would be a plot point that I would have to bypass since I'm writing about seventeenth-century Virginia. Then, I did a little more reading. In Massachusetts, Cotton Mather had heard about variolation from a slave in 1706. The slave, from western Africa, had been inoculated as a child which according to him was common practice there. This gave me the lead I needed as the slave would have grown up during the seventeenth century.
According to medical historians, variolation made its way to Egypt during the thirteenth century. When north and western Africa learned of the technique remains a question, but it was definitely known by the late seventeenth century and most likely earlier.
With this knowledge, I reasoned, why couldn't I write such a scene? The circumstances were very similar in seventeenth-century Virginia as Massachusetts. Because my scene takes place during mid-century, the Africans were usually indentured servants, rather than slaves, but the knowledge could have been available. Even during the eighteenth century in the colonies, variolation was often thought of as African black magic, therefore frequently discredited among the medical community.
The process consisted of collecting the virus with a lancet from a pustule of an infected person and transferring it under the skin in the arm or leg of the person without the disease. Unlike modern vaccination, this procedure gave the noninfected person an active case of smallpox. However, with the use of variolation, the person, hopefully, contracted a milder form.
Death resulted in 2-3% of the cases where variolation was used. Whereas, the normal fatality rate was 20-30% with much higher percentages for children and Native Americans. Most survivors were left with disfiguring scars, while blindness and limb deformities were less common complications.
The obvious disadvantage was that people infected through variolation could spread the natural severe form of the virus to others. But in a time before routine vaccination, the risks seemed to far outweigh the consequences.