J. L. BELL is a Massachusetts writer who specializes in (among other things) the start of the American Revolution in and around Boston. He is particularly interested in the experiences of children in 1765-75. He has published scholarly papers and popular articles for both children and adults. He was consultant for an episode of History Detectives, and contributed to a display at Minute Man National Historic Park.

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Thursday, October 15, 2009

The “Suttonian Method” of Fighting the Smallpox

So what was the Suttonian method of smallpox treatment that Dr. James Latham offered in Salem in 1773-74?

Donald R. Hopkins’s The Greatest Killer: Smallpox in History says this was a medical regimen developed by the English physician Dr. Robert Sutton, and then used and modified by “his six sons.” One of them, Dr. Daniel Sutton, claimed to have changed the treatment and broken with his father in 1763, but other medical men and the public wrote as if there was a single “Suttonian method.”

In Public Health in the Town of Boston, 1630-1822 John B. Blake described the first part of the treatment this way:

the practice involved a diet of puddings, gruel, sago, milk, fruits, and vegetables for nine or ten days proceeding the operation and abstention from meat, butter, cheese, liquor, spices, and other heating foods. The typical patient also received relatively mild dosing with a preparation of mercury and antimony and with Glauber’s salt.
This was actually a shorter period of dieting than what earlier British doctors had insisted on.

Furthermore, in October 1768 Benjamin Rush, then studying medicine in London, wrote that “Dr. Sutton’s method is now universally advocated by most of the physicians in England,” but few patients were taking mercury.

The Suttons’ biggest improvement over previous British forms of inoculation was inserting the virus (though they didn’t know that’s what they were doing) through a shallow cut rather than a deep one. Solomon Drown, a Brown College student, underwent the procedure in New York in 1772. He wrote:
We are inoculated after the Suttonian Method, which is this, the doctor with his lancet just scratches up the skin so as to fetch blood, then fixes a piece of thread, infected with the matter [from a previous patient], into the scratch, upon which, a very tenacious plaister is applied, and a bandage around the arm.
Ironically, as Hopkins points out, the Suttons’ innovations—the shallow cut, less fasting and purging, less of that yummy mercury—brought the procedure closer to what doctors in Turkey had done for centuries. Lady Mary Wortley Montagu had published a description of that treatment in London in 1721.

I think British doctors had chosen to make the inoculation regimen more elaborate and more trying for two reasons. The first might well have been fee-for-service: the more patients saw them doing, the more they got to charge. Second, the eighteenth-century British seem to have believed that if a treatment didn’t cause major, uncomfortable side effects, you couldn’t be sure it was working.

A Dr. Thomas Dimsdale described some of the Suttonian method in print in 1767, and one of his pamphlets was reprinted in New York four years later. The Suttons themselves kept their secrets as long as they could, publishing nothing until 1796. Instead, they trained other doctors, who had to keep the secrets and probably kick back some earnings. William Sutton—presumably another son—licensed Dr. Latham to practice the Suttonian method in the northern American colonies, as described yesterday.

Another Suttonian inoculator I’ve found was an Oxford-educated doctor named Robert Houlton. In 1768 he moved to Dublin and published Indisputable Facts Relative to the Suttonian Art of Inoculation, advertising himself as authorized by the Sutton family to bring their methods to Ireland. Houlton also wrote poems, musical plays, and newspaper essays. His last recorded writing, alas, consisted of pleas for assistance from Fleet Prison in 1796.

At that time, the “Suttonian method” was still the most advanced protection against smallpox in the English-speaking world. But two years later Dr. Edward Jenner published his findings that cowpox protected against smallpox, and inoculation with live smallpox was on its way out. (Of course, some people feared the new method; the caricature above shows small cows bursting from the mouths of people Jenner has just vaccinated.)

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