Smallpox inoculation in the eighteenth century was the genesis of modern immunology. This new method of purposely contracting a disease in order to secure protection from it was an empirical folk practice from the New East that ran counter to traditional European habits of thought in both medicine and religion. Based on diligent research in all available sources, this detailed study brings into relief the significant factors that made smallpox inoculation acceptable to Western Europeans--namely, the increasing threat and fear of the disease, particularly among the upper classes; a strong program led by members of such respected scientific groups and the Royal Society in London and the Academic Royale des Sciences in Paris; the interest and participation of both the English and French royal families who furnished an example for their subjects to emulate. In presenting this account of an important development in medical history Genevieve Miller offers evidence to prove that, contrary to the usual view, most religious leaders were not opposed to the practice of inoculation and that a number of them were active proponents. She also points out how, in the sphere of medical thought, experience with inoculation clarified ides concerning the etiology of smallpox by supplying proof that it originated with a specific material substance introduced into the human body from without.

Devastating epidemics of untreatable smallpox caused not only deaths but dire disfigurements of face and body as well as one third of all blindness. In the 20th century mortality was estimated at 300 million up to 1978, the year it was proclaimed to be eradicated. Historically, the fact has been overlooked, often forgotten, that the preventative practice of variolation for smallpox was widely adopted internationally during the 18th century and was the precursor to refinement as cowpox vaccination. Never previously traced was the extensive global adoption of the technique or the impetus for this transmission and how, in these countries of its adoption, variolation was the prime mover for a national concept of public health with the establishment of free institutions. The global adoption of the first invasive medical prophylaxis for any disease, the origin of immunity, deserves its place in history.

A history of the global spread of vaccination during the Napoleonic Wars, when millions of children were saved from smallpox.

Rusnock shows how vital accounts became the measure of public health and welfare.