Inoculation and Disease in the 18th Century #research #HistoricalFiction #HistFic #amwriting #amreading #books #novel

Before I get to today’s topic, I’d like to share that I’ll be interviewed on StarStyle Radio about Becoming Lady Washington. I understand the interviewer, Cynthia Brian, does an excellent job with interesting questions, too. Am I nervous? A bit, since this airs on the Voice of America with over a million listeners… Here’s what you need to know if you’d like to listen:

Tune into the radio program StarStyle®-Be the Star You Are! with host Cynthia Brian on Wednesday, November 18, 2020 from 4-5pm PST (6-7 CST). You can listen from your computer by going to

If you miss the live show, you can find it archived at that site with photos and descriptions at

It’s only a few days from now and I’m excited to find out what she’ll ask. I hope you’ll tune in and let me know what you think. Now, on to today’s topic.

During this difficult time in world health, I have found myself frequently comparing our situation to that of people in the 18th century when so many devastating and deadly diseases abounded. Back then we didn’t know or understand how bacteria or viruses spread. We knew that when people who were sick spent time around others, the others were likely to be infected as well. But how exactly?

I’ve read about people setting up smudge pots in the streets to try to ward off yellow fever in Philadelphia. Shooting rifles in the air, too. Or wearing a pouch filled with herbs and mustard and other things. Anything to try to protect themselves. Given the number of people who died during the outbreak there in 1793, they were not successful. But they seriously didn’t know how to fight it. Here’s a short snippet from Becoming Lady Washington where Martha Washington is pondering the dire epidemic in the city:

By August, the city officials changed their story, admitting an epidemic ravaged the populace. Apparently, the refugees from the slave uprising in the West Indies brought more than rum and sugar on the ships sailing up the Delaware. They’d brought yellow fever, too. More than ever, I worried about George. He’d been under such strain during the last several months, would he be able to fight off the disease should he contract it?

The fever and its horrid effects—vomiting blood, bleeding from ears, nose and eyes, as well as delirium and jaundice—spread to our part of town. The number of deaths each day multiplied. The stench of tar burning in barrels placed around the city choked me, but they were necessary to ward off the disease. Likewise, men shot guns into the air to scare off the spread of the sickness. Lists of possible ways to ward off the fever were printed in the paper. I loathed hearing the rumble of a wagon, accompanied by the gravedigger calling “bring out your dead” in a booming, sorrowful tone. More than ever, I wanted to go home, away from the crowded living conditions that surely contributed to the raging epidemic.

Inoculation became available earlier in the 18th century for some diseases. Smallpox, for example. This process requires a person to be injected with a small amount of the live disease in order to stimulate the body’s immune system to fight it, thus providing a defense against it. Martha Washington’s brother Jacky died from smallpox when he was a teenager because Virginia didn’t allow people to receive the treatment. Here’s a short excerpt showing her brother’s losing battle:

Summer heat surrounded me as I hovered over my brother. The pungent odor of the medicine fought the smell of disease, combining to make me cough and my stomach to churn. Tucking the quilt into place over Jacky, I prayed for a miracle. I’d never seen any one so sick before, so weakened by a virulent attack of the dreaded smallpox.

“Don’t go…” Jacky’s scratchy voice emerged from dry lips.

His bloodshot eyes implored me to stay, but Mother had insisted I let him rest. Besides, I hated seeing his body covered in the raised flat blisters of pus. Hated seeing him feverish and aching. The pain he must be in, to writhe and moan for days. He’d complained of his back hurting, his head aching, of bone-deep fatigue. Mother had some experience with treating the often deadly disease, so I would follow her lead. And pray.

“I’ll be back soon.” I gathered the soiled linens off the chair where I’d placed them earlier. “You rest, like Mother advised, and you’ll pull through.”

He closed his eyes and rolled his head side to side. “I pray you’re right, but at the moment I have serious doubts.”

I clutched the bedclothes to my chest. Memories of riding together and playing pranks on our kinsfolk floated through my mind. If only the new smallpox inoculation didn’t kill as often as it saved, mayhap my brother wouldn’t be so sick. The Virginia assembly had banned the use of the inoculation, believing it spread the disease. Something certainly spread it, because it seemed to be everywhere. Fortunately, not every person who contracted smallpox died. If a person only had a mild case they’d be immune to it from then on, though they were marked for life by pox scars.

“You mustn’t think that way. You’ll be up and about before you know it.”

“You’re right.” He opened his eyes and stared at me for several moments. “I’m so very tired. I think I will take a nap.” He struggled onto his side and closed his eyes again.

I fought the panic rising in my chest, pushing into my throat. My young, strong, full of life brother couldn’t die. Even in repose, Jacky’s face held lines of tension, pain, and fatigue. I couldn’t do anything more at the moment. Helpless but not hopeless, all I could do was try to ease his pain, lower his fever, and help him sip water from a cup. I had no magic or miracle to heal him. Tears sprang to my eyes as I slipped out the door and pulled it closed.

Today we have vaccines to inoculate people against a variety of diseases. A vaccine uses an innocuous form of the disease, either a dead or weakened form of the disease targeted, rather than the full strength. A vaccinated person still gets the benefit of the immune system activating to build a defense to the disease but without the risk of having the live disease threatening their system.

I realize there are people who do not believe in vaccines. I know that Martha Washington longed for a way to prevent her loved ones from contracting any of the dreaded diseases prevalent during her lifetime: malaria, yellow fever, smallpox, etc. Indeed, when her son, also named Jacky in honor of her deceased brother, desired to go to Baltimore, Maryland to have the smallpox inoculation, she wanted him to be protected but didn’t want him to risk his life. Here’s a snippet from the book:

I skimmed the careful script on the linen pages trembling in my fingers. Jacky desired to travel to Baltimore in order to subject himself to the smallpox inoculation. The procedure was legal there, unlike in Virginia. If only he could have it done closer to home, then I wouldn’t mind to quite the same extent.

I thought of my brother, Jacky, and the horrible death he’d suffered because he didn’t have the opportunity to be administered the inoculation. But what if my son received the inoculation and died? The procedure involved inserting a pustule of the disease from an infected person into a cut in the arm. He dared risk his life to avoid contracting the dreadful disease. How could I agree when he may well be the only heir if Patsy succumbed to the epilepsy? Could a mother survive her son’s death, when the mother had given her permission for the potentially lethal procedure? Then again, how could I deny my son’s request when the results could prove beneficial to people in general? His act served an altruistic purpose, a desirable trait in a young man.

I sighed and picked up a pen. A few minutes later I sprinkled sand over the newly inked words granting permission to fix them in place on the page. As well as in my heart. I couldn’t deny my son anything.

Then later when she faced the choice of being inoculated herself, she had to consider the options available:

George nodded and the corners of his mouth twitched before resuming a solemn expression. “I must beg you to favor a request.”

I raised a brow and sipped my drink, intrigued. “I will certainly consider doing everything possible to please you. Pray continue.”

“The incidence of smallpox within the ranks of the army greatly concerns me. With you in camp and going out among the troops you may contract the disease. I want you here with me, as I know is also your desire. So it is a dilemma. Thus I ask you to consider going to Philadelphia to be inoculated.” He lifted his glass and held it aloft, torn between sipping and waiting for my response.

My brother’s death from the terrible sickness lingered in my memory. Would Jacky have lived if he’d received the medicine? My son had the inoculation and he had survived the introduction of what was a small amount of the virus. Apparently with no ill effects. Would I, though?

George sipped, ever patient as I pondered my answer. I should say something to let him know I was thinking about his surprising request. “Do you believe it is safe?”

He nodded again. “The doctors assure me they are refining the methods for achieving success to make the inoculants immune to the disease. After I had smallpox in Barbados when I was there with Augustine, I’ve not contracted it though I’ve been around people who have had it. With good fortune the resulting pustules will be few and your illness mild, leaving you immune to the affliction.”

“Surely I was exposed to it when my brother had it.” So maybe I was already somewhat immune to it. Having another small dose would ensure my health against the disease and I’d be permitted to stay with George. A compelling reason for agreeing. “Very well, my love. For you I will comply with your request.”

Now, I do realize this is my interpretation of how she felt about things in her life, based on her letters to family and friends and to my understanding of her relationships. Martha witnessed many family members suffer and die from diseases during her life. I can only imagine how thankful she’d be to have a way to prevent her loved ones from dying.

My husband and I volunteered for the Pfizer vaccine trial that is currently underway in hopes we can help bring about a vaccine for everyone as soon as possible. The more people who do get vaccinated once it’s available, the sooner we can end the pandemic and move on with our lives.

Wishing you all health and happiness as we enter the holiday season. Please stay safe and take care of yourself and your loved ones. Martha would want you to.

Happy reading!


P.S. If you haven’t already, please consider signing up for my newsletter, which I send out most every month, including news like new covers, new releases, and upcoming appearances where I love to meet my readers, along with recipes and writing progress. Thanks and happy reading!

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Martha “Patsy” Custis manages an immense eighteenth-century plantation in the Virginia colony. But as a young widow she’s hard pressed to balance her business and to care for her two young children. They need a father and protector. She needs a husband and business partner…one she can trust, especially now as tensions rise between the motherland and the American colonies. Her experience and education have sustained her thus far but when her life veers in an unexpected direction, she realizes she has so much more to learn.

Colonel George Washington takes an interest in her and she’s surprised to find him so sociable and appealing. They form an instant bond and she is certain he’ll be a likeable and loving husband and father figure for her children. She envisions a quiet life at Mount Vernon, working together to provide for their extended family.

But when trouble in the form of British oppression, taxes, and royal arrogance leads to revolt and revolution, George must choose between duty to country and Martha. Compelled to take matters into her own hands, Martha must decide whether to remain where she belongs or go with her husband…no matter what the dangerous future may hold.

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