Smallpox 1710

Dublin Intelligence - Saturday 26 August 1710

We have also advice that Major Lloyd ... has been lately killed in a Duel with an Irish Gentleman. Madam Brownlow, one of the Daughters of Sir John Brownlow, is lately dead of the Small Pox: her fortune, said to be about £40,000 [£8 million in 2021] falls to her Four Sisters. We hear Her Majesty's Ship the Tartar has taken a French Prize in the Streights [of Gibraltar] valued at £20,000.

The Dublin Intelligence was filled with news of the Battle of Almenar in Spain during the War of the Spanish Succession. An Allied force of British, Portuguese, Dutch and Austrian troops had defeated the Spanish-Bourbon army of Philip V and Louis IV of France.

Sandwiched within the columns lay the brief news of Margaret Brownlow's death from smallpox. Her father's memorial has her buried on August ye 9th 1710.

We have no first-hand evidence relating to Margaret's death. This article investigates using,

1. The natural history of smallpox in the early C18

2. The friendship between the Brownlow sisters and the instigator of smallpox prevention, Lady Mary Wortley Montagu

3. The letters of Isabella Lady Wentworth (1653-1733)

4. John Trigg, Steward, he offers the only contemporaneous details via his Belton financial accounts (pages 136 to 138 transcript)

Bills of Mortality

Weekly Bills of Mortality for parishes within the City of London began in 1604 sporadically, but almost continuously from 1661. “Searchers,” were employed to inspect the corpses and interview relatives of the recently dead to establish the cause. Because of the characteristic appearance of severe smallpox, the figures are considered a reasonable estimation of disease activity.

Main image, Bill of Mortality, London, for the year 1710 recording 3,138 deaths from smallpox, ~13% of the total mortality. Above, two sisters infected with smallpox on the same day from the same source. Upper figure girl aged 15 unvaccinated. Lower figure her 21-year-old sister vaccinated in infancy with a few pustules only (Leicester Isolation Hospital 1901).

Epidemiology

Charting the London mortality indicates that the Brownlows' infection occurred during one of the five peaks over a 40 year period.

Analysing the pattern of smallpox indicates in 1710 that the peak acquisition was in the summer months. The seasonal force is attributed to population movements during harvesting and when the weather was cool and dry. Geographically, Lincolnshire was relatively free from smallpox. Acquisition came from conurbations like London or the sea port of Boston.

Direct transmission of the virus requires fairly prolonged close, face-to-face contact, e.g. within families. The virus is transmitted through the air by droplets when an infected person coughs, sneezes or talks. But It can also spread through contact with contaminated clothing and bedding.

Lady Mary Wortley Montagu pioneer of British smallpox eradication (NPG). Fierengraw (2018) comments that her poem Flavia makes an implicit critique of a society in which women are made to feel that physical beauty is the only way in which they can contribute.

Infection

The asymptomatic incubation typically lasts 12 days (10 to 14), during which period the person is non-infectious. Then a fever arises,

They at first are generally taken with a pain in the Head and the Back, coldness of Feet or vomiting ... The Doctor says it is best to bleed on the Apprehension of the Smallpox

Ellis 1750

A few days later the pustules erupt. One in three die within 5 to 16 days of illness due to kidney failure and viral pneumonia. For example, Queen Mary II of England exhibited a smallpox rash on December 21st 1694. She died aged 32 at 12.45am on 28th December. The diarist, John Evelyn's 19-year-old daughter died likewise 7 days after onset. For survivors, crusts slough off ~14 days after rash onset, meaning they are no longer infective. A variant, haemorrhagic smallpox induces bleeding into the skin and was invariably fatal within a week of onset.

Protective variolation (inoculation of a small dose of live-virus smallpox-infected fluid from a vesicle) introduced by Lady Mary Wortley Montagu began in 1721. Her three-year-old daughter was one of the first to be inoculated. But it was dangerous killing George III's sons, Alfred & Octavius. Use of Jenner's vaccination with cow pox only began in 1796.

Devastating facial scarring and blindness were possible consequences. For female survivors this could affect their marriage prospects. Wortley herself suffered smallpox with scarring in 1715 when she wrote Flavia aged 26,

The wretched Flavia on her couch reclined, Thus breathed the anguish of a wounded mind. A glass reversed in her right hand she bore, For now she shunned the face she sought before. ‘How am I changed! alas! how am I grown A frightful spectre, to myself unknown! ... Men mock the idol of their former vow ... Plays, operas, circles, I no more must view! My toilette, patches, the world adieu!

Treatment

A late C17 smallpox patient recorded his doctor's management,

fell ill on the Twelfth Day [after contact]. In the beginning I lost twenty two Ounces of Blood [from venesection ~one pint]. He gave me a Vomit, but I find by Experience Purging much better. I went abroad, by his [doctor's] Direction, till I was blind, and then took to my Bed. I had no Fire allowed in my Room, my Windows were constantly open, my Bed-Clothes were ordered to be laid no higher than my Waste. He made me take twelve Bottles of Small Beer, acidulated with Spirit of Vitriol [sulphuric acid], every twenty Four hours.

But Thomas Dover did survive. Theophilus Lobb's A treatise of the small pox records his medical practice dating from 1709.

The Remedy book used at Belton in the early C18 advises,

To keepe the small pox from holing Make a Buttermilk posset and take of the Curd as cleere as you can the Drink being warme, wett a cloath in it and therwith bath all the bealings [pustules/scabs] as oft as you can

Less pleasant for smallpox marks is the Grimsthorpe receipt, allow veal to putrefy and breed maggots. Take the maggots on a wire and roast them over a fire. Collect and apply the drippings (Chilvers 2010, page 105).

Before variolation, one form of 'prevention' was to permit children to mix with smallpox cases to encourage presumed lifelong immunity and the trauma of adult acquisition and death (John Evelyn).

Mary Wortley Montagu's connection with the Brownlows

Mary Wortley Montagu, born Mary Pierrepont was related to the Holme Pierrepont Hall family. She was brought up at Thoresby Hall, Nottinghamshire and her father's London home in Arlington Street. Evelyn Pierrepont, father, died there 1726. Her best friend Anne Wortley succumbed to smallpox in 1709 or 1710, her brother from the same in 1713.

The Wortley Montagu's neighbours in Arlington Street were William Brownlow, paternal uncle of the Brownlow girls and also their cousin, later Viscount Tyrconnel, at 23 Arlington Street. Mary's father-in-law took over as the MP for Peterborough from William Brownlow. Francis, 2nd Baron Guilford lived in Arlington Street from 1698 to 1724. He married Alicia the second eldest of the Brownlow sisters in 1703. Lady Louisa Stuart, Mary's granddaughter writes that Mary Pierrepont would play with the younger Brownlow girls when they stayed with sister Alicia. Amusingly, she relates how they would have secret conversations over the wall for fear of the old mother, Alice, until Eleanor, or Nelly as Mary calls her, had an unfortunate accident injuring her nether regions. See also Grundy (1999). Jane Brownlow was born the same year as Mary, 1689. Eleanor Brownlow was 2 years younger, Margaret, 2 years older. Chilvers (2010, page 164) quotes one letter of 27th March 1710 from Mary to her friend Frances Hewett on the forthcoming wedding of Margaret to Lord Willoughby and says the lady [Margaret] has made an acquaintance of me after the manner of Pyramus and Thisbe, I mean over a wall 3 yards high, that separates our gardens from Lady Guilfords. There is some confusion here as the original letter is dated 1711 (page 151) and so may have been written after Margaret's demise.

Grundy (1994) states that Mary encouraged her friend, Jane (Brownlow) Bertie, Duchess of Ancaster to have her children variolated against smallpox. Likewise, Lucy (Sherard) Manners, Duchess of Rutland. Mary mentions the Brownlows in Farewell to Bath, one of her poems.

Lady Isabella Wentworth

She attempted an arranged marriage with Alice Brownlow between her son, Lord Raby, and Eleanor Brownlow, Alice's youngest daughter. This is discussed in another article. She reports Margaret's death and Eleanor's recovery in a letter to Lord Raby,

I sopose that the eldist Brownloe of those unmarred was to have Lord Sherwood, and that match broak ofe ; and she had her weding cloaths made and was in a few days to be marryed to Lord Willoby, but fell ill of the small pox and is dead, soe the others will be vast fortunse, and the youngist has had the smal pox, but it has not spoyled her buity.

22nd August 1710

Lord Willoughby de Eresby, later 2nd Duke of Ancaster, of Grimsthorpe Castle, was Margaret's intended. He would marry a 'replacement', Margaret's younger sister, Jane in June 1711.

Margaret Brownlow 1710 by Michael Dahl

How did the Brownlows get infected?

We know that Margaret was alive and well, witnessed by Lady Wentworth around June 11th 1710 attending a service in Whitehall Chapel, St James's Palace. During that London stay, Margaret had her portrait painted by Michael Dahl whose studio lay in Leicester Fields, today's Leicester Square. His awaited catalogue raisonné may confirm a more precise date. Another, less flattering portrait by Kneller would again demand a London stay. There is a gap in the Belton accounts from November 1709 to 30th June 1710. Trigg's summary accounts confirm that the family were absent from Belton. The Brownlows were likely staying in their rented apartment in Holland House, as in 1701 and 1703 or with Alicia.

Burial registers show that bodies typically remained above ground for between two and four days. But in the height of Summer and with the risk of infection from the body this meant a rapid burial for the deceased Margaret, even the same day. Virus in crusts survives for at least 13 years! John Evelyn's daughter was buried 2 days after her smallpox death in 1685. Death then within two days before or on the 9th August. Taking the time from virus acquisition to death of 12 to 30 days as described above, confirms that Margaret was infected during July 1710 - apparently at Belton or in its vicinity.

Trigg's accounts

The natural history of smallpox means that Margaret's death must have occurred within 30 days of infection, i.e. an infection acquired no earlier than the second week in July 1710.

Trigg makes up on his records on a Friday and starts a new week the following day on a Saturday. The first Saturday available is 1st July 1710. This allows us to look for events that could have introduced smallpox to Belton. Relevant extracts are listed and discussed below,

Expenditure during the weeks beginning:

July 1st & July 8th no unusual events, mainly food items

July 15th 6 yds of Cloath for Strainers for the Dary 4s 6d [£41]

The dairy was in the Offices by 1698 with a butter room in the basement near the Chapel. Smallpox transmission possible via a fomite. The accounts show interaction of at least Jane with milk maids. Milk maids are immune to smallpox because of their exposure to cow pox. This is what led Jenner to develop vaccination, from vacca a cow.

July 22nd to a poor man with a cake to my Lady 2s 6d

John Haygarth’s 18th-century ‘rules of prevention’ for eradicating smallpox was based on his experience of managing smallpox in Chester. He had no concept of microscopic pathogens. He believed transparent miasms (miasma) in the air transmitted the infection via the smells from the pustules. He deduced that the ‘variolous poison’ was quickly diluted in air and that contact closer than about 18 inches was necessary to pass on the infection. The only exceptions were where there had been contact with clothes, household goods or foodstuffs contaminated by a pustular patient.

Let us reflect how widely and fatally this poison is dispersed among all ranks of people. It may be conveyed into any house unobserved, from a great variety of families, adhering to clothes, food, furniture.

Thus the poor man with a cake is a potential source.

July 22nd a letter from Mr Eele 3d

A feasible source. In 1901, articles in 2 medical journals incriminated letters as sources of 2 separate epidemics of smallpox in the U.S.A. The New York Medical Journal reported that smallpox had developed in a young lady in Saginaw, Michigan, after she received a letter from her sweetheart, a soldier in Alaska. He had written it while recovering from this disease. The infection subsequently spread to 33 other persons in Saginaw.

The British Medical Journal reported an outbreak of 5 cases of smallpox at the Mormon headquarters in Nottingham, England, apparently after receipt of "letters or other fomites" from Salt Lake City, Utah, where smallpox was widespread as Mormons opposed vaccination.

Vinegar was used to decontaminate letters. Later chemicals like chlorine and sulphur were used with a hairbrush-size instrument consisting of 2 hinged metal plates (jaws), one of which held several rows of nails or small metal spikes to perforate the letters (image left).

July 29th Paid to the Coachman 10s he paid for a dogg at London 10s

provides a direct contact with London and its epidemic of smallpox attested by the 1710 Bills for Mortality. The previous week had the highest number of London small pox deaths for 1710. Only monkeys can be infected with smallpox, but dogs, cats and squirrels are recorded as eating smallpox scabs. It is unknown what happens to the virus in the gut of these animals, whether it is destroyed, altered, or excreted as such with infectious ability. Any dog brought to Belton is an unlikely source, but the coachman isn't.

July 29th 2 poringers and a Tinn Sasspann 7d

Porringers, left, were small food bowls used when feeding the sick. That they were bought during this week suggests that the sisters were now symptomatic. Diet was an important part of the treatment; patients were forbidden to eat meat or acid, salty, or highly spiced foods, which might raise the fever. Woodward 1718 recommended a bland diet of gruels, vegetables, fruits and broths.

August 5th Hungary water 1s

Bought after the smallpox had started. Hungary water is an infusion of rosemary used as a cure all. In this context, being either ingested or rubbed on the head to treat the headache and fever, or as a cosmetic to reduce the facial pustule inflammation,

Hungary Water is not only useful by way of embrocation to bathe the face or any other part affected with pain or debility

August 12th Paid my Expences att and on the Road from Ld Lindseys 2s 6d

The week after Margaret's burial, Trigg made the 34 mile round journey to Grimsthorpe Castle to see Robert Bertie, 4th Earl of Lindsey (1701), later 1st Duke of Ancaster & Kesteven (1715). His son, Peregrine Bertie, Lord Willoughby, was Margaret's intended husband. Doubtless, Trigg informed that family of the tragedy.

August 19th Js Garnar for thred Tape etc as from bill 19s 6d (£177)

James abbreviated to Js and thred, a Trigg shorthand for three hundred [yards?]. It is uncertain what this is and whether it related to Margaret's burial/funeral. Alternatively, could it relate to the imminent wedding that had been planned?

The C17 Old Rectory (Parsonage), Main Street, Belton, where the sisters were isolated and nursed during their smallpox.

Grantham has a Pest House, built in 1584. The lease on the house issued by the Aldermen and Burgesses of Grantham states that if the town was "visited with the plague called the pestilence or any other smiting disease or contagious sickness it shall be thought good to divide the infected people from the whole". From the 1660s, when the plague abated, smallpox became the main fear. It ceased use after 1876.

August 26th a nurse for two weeks looking after the maids at the Parsonage 6s

a nurse for five weeks for looking after the same at 5s [a week] £1 5s (£227)

The 'maids' were quarantined in the Parsonage as soon as smallpox was diagnosed - the late C17, Old Rectory, on Main Street, Belton. It was known that smallpox survivors became immune. They were asked to nurse the afflicted. Hence, the 'nurses' would be familiar with the disease from personal experience. Perchance, they worked at Grantham Pest House 2 miles away, built on land leased from the Brownlows. Parish smallpox nurses earned between 3s. and 8s. per week (table 5.2). The lowly pay was less than the daily rate of 1s, for women who did the Belton laundry, more than the 4d a day for women for scowering (the pans & dishes), but would have included food and lodging. Around 12% of London women were employed in nursing in the first half of the eighteenth century. Only in the C19 did nursing become a profession.

Apart from isolation for smallpox, frequent recommendations were to burn the clothing and bedding of the sick to prevent transmission. Noteworthy is that in the months following Belton's smallpox, Trigg spent £25 15s 11d [£4,678] on cloth, from a Mary Anderson. Where specified, this was flaxen cloth to make undergarments and bed sheets. Again supportive of a fomite cause of smallpox transmission.

Timeline of Smallpox

We can plot out a possible timeline of events below. Orange bars are events noted by Trigg in his weekly accounts & Lady Wentworth's letter. Grey/black bars are events based on the natural history of the infection including haemorrhagic smallpox.

Discussion

Margaret's contact with smallpox happened in July 1710. The incubation period would be unfeasibly long if a London-acquired infection in June were posited. It is unlikely that she would voluntarily encounter a very obvious pustular smallpox case, fomite transmission via the 6 yards of cloth is a possibility. The diarist, John Evelyn used another person’s bed when travelling, without changing the sheets because he was ‘heavy with pain and drowsiness.’ He wrote; ‘I shortly after paid dearly for my impatience, falling sick of the smallpox.’

Haemorrhagic smallpox with an incubation of 7 days and death 5 days after symptom onset, i.e. 12 days from infection to death points to contact on the days before the 28th July. Therefore, the letter from Mr Eeles & poor man with a cake events remain possible sources. The coachman from London is too late in the projected incubation period.

The Dublin Intelligence published Port Letters from London within a week. Jane Brownlow's marriage on June 14, 1711 was reported exactly 19 days after in Dublin. Hence, Margaret's death on the day of interment or 2 days earlier is a reasonable supposition for an August 26 newspaper report.

Eleanor's recovery ran parallel with the predicted course of a July infection with recovery by 22 of August - stated by Lady Wentworth. Reference to the 'maids' in the plural after Margaret's burial confirms that Jane as well as Eleanor suffered smallpox. Nursing that continued beyond the usual time for recovery when the scabs come off, with an additional nurse employed 3 weeks after the first one, hints that Jane acquired the infection later on, conceivably off Margaret or Eleanor.

Mystery remains about the absence of funeral costs. Was Margaret interred in a coffin already in storage? This could be the case with a large Belton establishment of servants. A morgue exists adjacent to the Chapel in the Mansion. A payment to Mr True for a Silver Plate used on Miss Brownlow's coffin of 2s 6d [£23] is made in March 2nd 1710 (1711, Gregorian). Possibly, the coffin lay in a crypt awaiting the plate. Richard Brownlow had constructed a crypt for his mortal remains. The only available plan of Belton's church lists the remains for 19th century Brownlows, but not earlier. Margaret's burial location is unknown. The chancel of the church was rebuilt in 1721. Additionally, there were later alterations perhaps removing traces of any crypt interments or concealing any crypt.

Why are there no doctors' bills? Dr Thomas Sydenham observed that the rich had a higher mortality rate from smallpox than the poor. He concluded that 'quack' medical treatments, inaccessible to the poor, did more harm than good - see 'Treatment' above for one example. Furthermore, the smallpox-afflicted Queen Mary sent away anyone who had not previously had it to avoid spread of the miasma. She refused to see her pregnant sister, the later Queen Anne, to protect her. Mary's father-in-law and two nieces, Anne's daughters, had died of smallpox, and so Mary recognised its lethal outcome.

Trigg's accounts show no change in food consumption or hint of grief, following Margaret's death. No doubt the heartbreak was there, but Belton's life continued.

Smallpox would later claim the life of Viscount Tyrconnel's sister-in-law, Catherine Cartwright in 1740.

Smallpox is still held in a laboratory in Russia’s State Research Center of Virology, located in the city of Koltsovo in Siberia. The other samples are kept at the U.S. Centers for Disease Control and Prevention in Atlanta. As recently as 2014 vials of viable smallpox were found long forgotten in storage, left over from the 1950s.

Bank of England inflation calculator used for all financial conversion to 2021

Chilvers A (2010) The Berties of Grimsthorpe Castle

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