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BMJ. 2007 December 15; 335(7632): 1267.
PMCID: PMC2137060
Between the Lines

English lessons

Theodore Dalrymple, writer and retired doctor

Voltaire’s Philosophical Dictionary has several entries relating to medicine. In Voltaire’s day educated men were expected to know something about everything, because so little was known about anything. Voltaire it was who introduced the French to the work of Sir Isaac Newton; he also introduced them to the idea of inoculation against smallpox.

His entry on inoculation in the dictionary starts: “It is said in Christian Europe that the English are madmen and hotheads; madmen because they give smallpox to their children to prevent them getting it; and hotheads, because they willingly give their children a horrible disease for certain with the idea of preventing one in the future that is uncertain.”

In the part of the entry that was written in 1727, Voltaire says that inoculation originated in Circassia. The Circassians, he says, raised their beautiful daughters for sale to the harems of the Persian and Turkish court, expending a great deal of money on their education in the arts required to arouse the flagging sexual interests of their future lords and masters.

Unfortunately, epidemics of smallpox often either killed or maimed their daughters. “The smallpox striking a family, one daughter died of it, another lost an eye, a third survived with a deformed nose.” This left the parents destitute, their hopes of a profitable sale to the Persian or Turkish courts blasted.

But, says Voltaire, “a commercial nation is always alert to its own interests,” and luckily the Circassians noticed that smallpox never struck twice, at least not seriously; they also noticed that when it occurred early in life it rarely had the terrible effects it had later in life. From these observations they deduced the practice of inoculation, which meant that their daughters’ expensive training in caressing men, lascivious dancing, and voluptuous artifice would not go to waste; and soon the Turks, “an intelligent people,” adopted inoculation for themselves.

Of every hundred people in the world, says Voltaire, 60 contract smallpox at some time in their life; 10 die from it and 10 are left with permanent sequelae. “Thus,” he continues, “a fifth part of mankind dies or is made ugly by it.”

Madame Vortley Montaigu (Wortley Montague) introduced inoculation into England, whereupon the princess of Wales, “who was born to encourage all the arts and to do good to mankind” experimented with it on four men who had been condemned to death, thus doubly saving their lives, first from the gallows and second from the disease that would otherwise quite likely have killed them. No ethics committees in Voltaire’s day.

Voltaire contrasted unfavourably the ready acceptance of inoculation in England with the indifference or resistance to it in France. If only the French had followed the English example, he says, 20 000 people who died from the Parisian smallpox epidemic of 1723 would still be alive. “What then?” he asks. “Is it that the French don’t care at all for life? Is it that their women don’t care about their beauty?” He says with bitter irony that perhaps the French will take it up in 10 years’ time, if their priests and doctors let them; or in three months’ time, if the English suddenly decide to abandon the practice.

Voltaire used England as an exemplar in almost everything. Who, I wonder, would do so now, in anything?

If only the French had followed the English example, Voltaire says, 20 000 people who died from the Parisian smallpox epidemic of 1723 would still be alive


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