Smeeton Trail

Attached to the outside, southern wall of St. Wilfrid’s Church in Kibworth Beauchamp in Leicestershire is a memorial slate tablet which reads:

SlateLPW

"In Memoriam, Lewis Powell Williams, Surgeon. He departed life January the 9th 1771 in the 40th year of his age. He was the first that introduced into practice inoculation without preparation in this kingdom."

In 1995 Steven Lee, the then Rector of Kibworth, received an enquiry from a John Godwin who had moved recently from Lichfield to Leicestershire. Mr Godwin, a frequent contributor of historical articles to the Leicester Now monthly magazine, was puzzled by the tablet because he knew that smallpox inoculation had been introduced to the UK by Lady Mary Wortley Montagu in 1721.  Intrigued by this dichotomy, as a microbiology student, I contacted the Jenner Educational Trust to learn more about the treatment of smallpox and to try and find some additional information about Lewis Powell Williams.  Here are the results of my research.

Smallpox was already entrenched in parts of Europe, Asia and Africa when in the 16th and 17th centuries European colonists carried the disease to the Americas. In London, smallpox killed one person in twelve and left disfiguring scars on thousands of survivors. Queen Mary, wife of William III died of the disease in 1694, as did Queen Anne’s son in 1700.  Yet within 300 years, by May 1980, the World Health Organisation proclaimed the worldwide eradication of this devastating disease principally by the means of “vaccination”, a safer procedure invented by Edward Jenner (1749-1823) won much fame after noticing that milking girls, who contracted cowpox were also immune from the much more dangerous smallpox (see lithograph drawing below). However, Jenner was not the first to offer a means of acquiring immunity to smallpox. There are ancient records indicating that the Chinese used some form of inoculation as early as the 10th century. Immunity was apparently achieved by provoking a mild form of the disease in healthy people, for example by blowing powdered smallpox scabs up their noses!

However, by the 18th century a more intrusive form of inoculation was being used - the deliberate gashing of the arm and then placing of a large volume of fluid from a smallpox blister in the wound. The healthy patient was prepared with fasting and purging to lower the patient’s strength. This harsh treatment usually provoked a mild form of the disease, resulting in long-lasting immunity. There were risks, however, as it had a low success rate and patients could still transmit the disease to non-immune contacts for a few days after treatment.

Lady Mary Wortley Montagu (née Pierrepoint) was born in 1689 to an aristocratic family and lived in Thoresby Hall in Nottinghamshire. Mary eloped with Edward Wortley Montagu, the Whig MP for Huntingdon, and they married in 1712. A year later, Mary was shocked by the death of her brother, William, who had contracted smallpox. Mary caught the disease herself in 1715 but recovered with minimal scarring but her eyelashes never grew again!  She was a prolific letter and essay writer and friend of the satirist, Alexander Pope.  In 1716, Edward Wortley Montagu MP was appointed Ambassador to Turkey, a country which was friendly to Britain but at war with Austria. Mary and their newly born son, Edward, accompanied the new Ambassador together with a surgeon, Charles Maitland, and a large retinue of servants.

In 1717, while at Adrianople (modern Edirne), she heard that two Turkish doctors had published articles about a new procedure for protection against smallpox which was being used in Africa, India and the Ottoman Empire.  Mary took an interest and wrote to a friend about the practice of ‘ingrafting’ against smallpox. She described how, each September, the older women visited groups of young people by arrangement and simply placed a small quantity of "the matter of the best sort of smallpox" on the end of a needle and inserted it into a vein (known as variolation), after which the small wound was bound up. Eight days later the young people had a mild fever lasting two days, after which they were immune to smallpox. Thousands were treated each year and the procedure had an excellent safety record.

The following year, on 18th March 1718, she allowed her five year old son, Edward, to be treated. The ‘ingrafting’ was carried out by "an old Greek woman, who had practised a great many years" and supervised by Dr Maitland.  Edward Wortley Montagu therefore became the first native of the UK to undergo this operation.

Jenner

The Wortley Montagus returned to England, and in 1721 a smallpox epidemic swept the country. Mary had written articles anonymously about her experiences with smallpox treatment in Turkey, and she now asked Dr Maitland to inoculate her three year old daughter, Mary.  Later he inoculated other people in London, under Lady Mary’s patronage. Her campaign was helped by her friend, the Princess of Wales, who suggested the new treatment be tested on six condemned Newgate prisoners.  All six survived and, as recompense, were discharged as free citizens. The Princess’ two daughters were later inoculated with complete success using this variolation method. There were setbacks however, and it seemed the practice would not gain general acceptance. Some clergy believed the disease was one of God’s tools for shaping the destiny of man, so it would be sinful to try and outwit him! Then the Royal Society of London began to receive reports of the dramatic success of the technique in Massachusetts. The Rev. Cotton Mather, a Congregational minister in Boston, had read the Turkish accounts and despite opposition from sections of the clergy, remarkable results had been achieved. The 1721 Boston epidemic saw 6,000 afflicted with smallpox and 844 died. Mather encouraged all Boston doctors to use the method by informing them of the efficacy of ‘ingrafting’.

Who was Lewis Powell Williams? In a bid to discover more about him the Kibworth Parish Register for 1771 was inspected while it was still kept in the Vestry of St. Wilfrid's Church (now archived in the Leicestershire Records in Wigston). All entries for deaths during that year included the village or town of residence except for one entry - 9th January - Lewis Powell Williams -stranger. We can only presume he died suddenly while travelling through the parish as the King’s Highway (now the A6) was a major north-south route, and that sometime later relatives or friends erected the tablet. He still remained a man of mystery until in 1998 a local historian, Dr Christine Viall, gave me some more information that she had unearthed during research on Northamptonshire records.

Peter Razzell in his book, "Conquest of Smallpox" (1977) writes that the first inoculator to completely dispense with preparation was a surgeon by the name of Williams who placed an advertisement in the Northampton Mercury at the end of 1768:

‘INOCULATION WITHOUT PREPARATION (Established by a five years successful Experience, commonly called the Williams Short Method). Mr Williams . . . and a Number of Partners, have inoculated and lightly carried through many thousand persons without the usual tedious and too often injurious preparative Treatment by very strict Diet and strong Mercurial Purges ...’

So the "man of mystery" is now shown to have been an entrepreneurial doctor who took the Turkish variolation practice, simplified the technique so it could be used routinely, and set up in business in the Northampton area.

Twenty five years after Williams' death, Edward Jenner introduced in 1796 a truly safe form of inoculation with cowpox, a mild illness, and he showed that this also protected against smallpox. This new "vaccination" (after vacca - Latin for a ‘cow’) spread rapidly and childhood mortality greatly decreased. Inoculation with "live" smallpox was prohibited by law in 1840 but it was still practised in Afghanistan and China until the 1970s. Now, since the WHO 1980 proclamation, the smallpox virus can only be found in research establishments and even these final bastions are expected to be destroyed soon.

Published in Modern
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