Some fatherly advice from the king

What right do we have to subject our children to potentially dangerous medical intervention in the interests of sparing them from a devastating disease that they may never contract? In the early 18th century several British royal children were inoculated against smallpox in a new procedure that involved a small but significant risk of death – perhaps 2%.

Did moral considerations weigh in the mind of members of the British royal family when they presented their children for treatment? Perhaps not, in an age when children were deemed to have the status of chattels rather than independent persons. But there is no reason to think that 18th century royalty loved their children any less than we do, so there must have been a compelling reason to take the risk. The reason of course was the much greater risk of death from smallpox, which seems to have been about one or six, or roughly 17 %, in early 18th century Britain.

A letter written by George I, King of England (1714-1727) to his daughter Sophia Dorothea, Queen of Prussia, in May 1724, and now preserved in the Wellcome Library, sheds light on both the fear of smallpox and the urgency with which the newly-introduced but risky practice of inoculation with smallpox virus was embraced by the Hanoverians in their desire to protect their children.

The letter is one of several surviving letters from George I to his daughter, with whom he corresponded in French – all apart from this one are now in the Prussian Privy State Archives in Berlin. The Wellcome letter was purchased from a dealer in Paris in 1932 and the reasons why it strayed from its archival home are shrouded in mystery.

In the letter George I refers to the alarm that he had felt on hearing that Sophia Dorothea’s son – the future Frederick the Great – had contracted smallpox (“la petite verolle”), especially as he had learnt the news via unofficial channels and consequently feared the worst. In fact, as he now understood, Prince Frederick of Prussia had recovered, but the King went on to urge his daughter to inoculate all her children after the example of another of his grandsons, Prince Frederick of Hanover, son of the future George II.

Two of George II’s daughters, Amelia and Caroline had also been inoculated, but their elder sister Anne had contracted smallpox in April 1720, and although she recovered she was permanently scarred. The King refers to this episode in his last known letter to his daughter in Berlin dated 12 January 1725. He mentions the recent portraits of his granddaughters that had been painted by the Prussian court painter Antoine Pesne the previous year: the works had been well received even though Anne still bore the marks of smallpox.

Smallpox was a killer that respected no class boundaries, but it was unusual as an infectious disease in bequeathing a potentially disfiguring legacy even to those who survived, in the form of a pock-marked face. It may be that the upper classes were unusually sensitive to this feature of the disease, especially as regards their female members, who depended upon good looks to secure propitious marriages.

A female ruler might be doubly sensitive, as a woman and a queen: Elizabeth I caught smallpox in 1562 and though only lightly scarred powdered her face to disguise the marks for the remainder of her life.

We do not know whether Sophia Dorothea took her father’s advice and had her other children inoculated against smallpox. At all events all her children who were alive in 1724 or were born subsequently survived into adulthood. When he became king, Frederick the Great was a keen promoter of inoculation among his subjects. It would be nice to think that this may have owed something to the influence of his old grandfather in England.