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In 1721, Lady Mary Wortley Montague introduced the practice of smallpox inoculation to England. She had learned about the procedure in Turkey, where she had already survived the illness as well as having her young son inoculated.

She wrote to a friend:

“…I am going to tell you a thing that I am sure will make you wish yourself here. The small-pox, so fatal, and so general amongst us, is here entirely harmless by the invention of ingrafting, which is the term they give it. There is a set of old women who make it their business to perform the operation every autumn…. The old woman comes with a nut-shell full of the matter of the best sort of smallpox, and asks what veins you please to have opened…. She immediately rips open that you offer her with a large needle … and puts into the vein as much venom as can lie upon the head of her needle…. Every year thousands undergo this operation…. There is no example of any one that has died in it; and you may believe I am well satisfied of the safety of the experiment…. I am patriot enough to take pains to bring this useful invention into fashion in England; and I should not fail to write to some of our doctors very particularly about it, if I knew any one of them that I thought had virtue enough to destroy such a considerable branch of their revenue for the good of mankind.”

Clearly, the procedure was well established in Turkey at that time, so my question is: When did smallpox inoculation (not vaccination) begin in Turkey, and who invented/introduced it?

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    What I got from a quick look (perhaps this will help someone else with a proper answer) is that I could find no obvious source for this happening in Turkey outside of Lady Mary's own correspondence (doesn't mean it doesn't exist, but someone's going to have to do some serious searching), and also that the practice was known to be going on in China before that, so it seems quite likely people in Istanbul (who after all sat right on the pre-Columbian spice/silk routes) borrowed the idea from there.
    – T.E.D.
    Apr 14, 2022 at 23:47
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    ncbi.nlm.nih.gov/pmc/articles/PMC3407399 seems relevant to this question, including a report of inoculation in Turkey predating 1721 by a few years. Apr 15, 2022 at 13:40
  • @kimchilover Fascinating, thank you! That document provides evidence that the practise was known in Greece, North Africa, Syria, Iraq, Wales, China &, Bengal, which suggests either trade route transmission or multiple independent discoveries. If you want to convert your comment into an answer then it will be worth an upvote and acceptance..
    – DrMcCleod
    Apr 15, 2022 at 14:53
  • @ DrMcCleod Emperor Joseph I died of Smallpox in Vienna on 17 April 1711. And I dimly remember reading somewhere, possibly in Charles W. Ingrao, In Quest and Crises: Emperor Joseph I and the Habsburg Monarchy, 1979, that Joseph refused to be inoculated against smallpox. If that memory is correct, inoculation would have known in Vienna by 1711.
    – MAGolding
    Apr 15, 2022 at 18:22
  • @MAGolding I'd be grateful if you could somehow check what you remember. Apr 16, 2022 at 20:42

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This question is addressed in a wikipedia article with a long list of references, which I have not explored. The article has considerable overlap with a 2012 paper on the same subject, The origins of inoculation by A. Boylston, published in the Journal of the Royal Society of Medicine. According to a 1713 letter of Emanuel Timonius published (in a reputable journal) in 1714:

The writer of this ingenious discourse observes, in the first place, that the Circassians, Georgians, and other Asiatics, have introduced this practice of procuring the smallpox by a sort of inoculation, for about the space of forty years, among the Turks and others at Constantinople.
That although at first the more prudent were very cautious in the use of this practice; yet the happy success it has found to have in thousands of subjects for these eight years past, has put it out of all suspicion and doubt; since the operation, having been performed on persons of all ages, sexes, and different temperaments…none have been found to die of the smallpox.

Timonius asserts he had seen successful inoculations performed in the period 1706-1713, and suggests that the practice was a comparative innovation, having been introduced about 40 years previously, that is, in the late 1600's.

(See the 2020 paper "Smallpox inoculation: translation, transference and transformation" by Anne Eriksen for an informative discussion of who TImonius was, the cultural context of Timonius's letter, etc.)

The rest of Boylston's paper addresses the question of how did inoculation reach Turkey. It gives references proving that inoculation had been practiced in China and in India before its Turkish appearance, but does not give proof of how it came to Turkey.

In tracking down this paper's references I found a citation to a 2009 paper in Chinese whose title translates to "Were the Turks in the 18th century variolated against smallpox? the analysis of a typical example of misconception in medical cross-cultural transmission". The translated abstract is

There has been a continuing misconception for almost three centuries since the transmission of variolation from Turkey (actually the Ottoman Empire) to England that this was a practice of the Turkish Muslims. There are many sources of cogent evidence that variolation in the 18th century in the Ottoman Empire was opposed by Muslims due to their religious beliefs. This article uses cultural anthropology in its analysis of the reasons for the misconception.

I would like to know what this paper says. Alicia Grant, its author, has written a book Globalisation of Variolation, The Overlooked Origins of Immunity for Smallpox in the 18th Century, which I would like to read.

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