How inoculation against smallpox became all the rage in Russia

The concept of vaccination evolved from 18th-century inoculation practices and many people contributed to the accretion of knowledge. This book focuses on two individuals: the Quaker doctor Thomas Dimsdale, who, from his small Hertfordshire surgery, pioneered a simple smallpox immunisation; and Catherine the Great, who summoned him all the way to St Petersburg to inoculate her and the teenage Grand Duke Paul. Despite success all round, though, it turns out that anti-vaxxers are nothing new.

After revealing the destructive force of smallpox – in one period of the 18th century, 400,000 perished annually in Europe – Lucy Ward, a journalist and former lobby correspondent, recapitulates the history of inoculation against the disease. The innovative Dimsdale worked to refine the practice of infecting patients with a controlled viral dose to ensure future immunity. He published a landmark treatise on the subject in 1767.

As the story unfolds, Ward writes of the first known example of the use of numerical quantification to evaluate medical endeavours, as opposed to subjective opinion based on just a few cases. As she says, although ‘medicine came somewhat belatedly to the empirical approach’, as the century wore on ‘the ground on which knowledge was built was changing irreversibly’.

After George I had his grandchildren jabbed (all subsequent Hanoverians were inoculation enthusiasts), word of Dimsdale and his prowess spread across Europe. The Empress and the English Doctor shifts between England and Russia until the bewigged Dimsdale and his son trundle off in a carriage to St Petersburg in 1768. Ward fills in her protagonists’ backgrounds, including Dimsdale’s expulsion from the Quakers and the arrival in Moscow of the 14-year-old German Princess Sophie Friederike August of Anhalt-Zerbst (later the Empress Catherine). Her marriage was traumatic. Ward comments gnomically: ‘There is no evidence Catherine ordered her husband’s death.’