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Letters on England
LETTER XI - ON INOCULATION
Voltaire
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       _ It is inadvertently affirmed in the Christian countries of Europe
       that the English are fools and madmen. Fools, because they give
       their children the small-pox to prevent their catching it; and
       madmen, because they wantonly communicate a certain and dreadful
       distemper to their children, merely to prevent an uncertain evil.
       The English, on the other side, call the rest of the Europeans
       cowardly and unnatural. Cowardly, because they are afraid of
       putting their children to a little pain; unnatural, because they
       expose them to die one time or other of the small-pox. But that the
       reader may be able to judge whether the English or those who differ
       from them in opinion are in the right, here follows the history of
       the famed inoculation, which is mentioned with so much dread in
       France.
       The Circassian women have, from time immemorial, communicated the
       small-pox to their children when not above six months old by making
       an incision in the arm, and by putting into this incision a pustule,
       taken carefully from the body of another child. This pustule
       produces the same effect in the arm it is laid in as yeast in a
       piece of dough; it ferments, and diffuses through the whole mass of
       blood the qualities with which it is impregnated. The pustules of
       the child in whom the artificial small-pox has been thus inoculated
       are employed to communicate the same distemper to others. There is
       an almost perpetual circulation of it in Circassia; and when
       unhappily the small-pox has quite left the country, the inhabitants
       of it are in as great trouble and perplexity as other nations when
       their harvest has fallen short.
       The circumstance that introduced a custom in Circassia, which
       appears so singular to others, is nevertheless a cause common to all
       nations, I mean maternal tenderness and interest.
       The Circassians are poor, and their daughters are beautiful, and
       indeed, it is in them they chiefly trade. They furnish with
       beauties the seraglios of the Turkish Sultan, of the Persian Sophy,
       and of all those who are wealthy enough to purchase and maintain
       such precious merchandise. These maidens are very honourably and
       virtuously instructed to fondle and caress men; are taught dances of
       a very polite and effeminate kind; and how to heighten by the most
       voluptuous artifices the pleasures of their disdainful masters for
       whom they are designed. These unhappy creatures repeat their lesson
       to their mothers, in the same manner as little girls among us repeat
       their catechism without understanding one word they say.
       Now it often happened that, after a father and mother had taken the
       utmost care of the education of their children, they were frustrated
       of all their hopes in an instant. The small-pox getting into the
       family, one daughter died of it, another lost an eye, a third had a
       great nose at her recovery, and the unhappy parents were completely
       ruined. Even, frequently, when the small-pox became epidemical,
       trade was suspended for several years, which thinned very
       considerably the seraglios of Persia and Turkey.
       A trading nation is always watchful over its own interests, and
       grasps at every discovery that may be of advantage to its commerce.
       The Circassians observed that scarce one person in a thousand was
       ever attacked by a small-pox of a violent kind. That some, indeed,
       had this distemper very favourably three or four times, but never
       twice so as to prove fatal; in a word, that no one ever had it in a
       violent degree twice in his life. They observed farther, that when
       the small-pox is of the milder sort, and the pustules have only a
       tender, delicate skin to break through, they never leave the least
       scar in the face. From these natural observations they concluded,
       that in case an infant of six months or a year old should have a
       milder sort of small-pox, he would not die of it, would not be
       marked, nor be ever afflicted with it again.
       In order, therefore, to preserve the life and beauty of their
       children, the only thing remaining was to give them the small-pox in
       their infant years. This they did by inoculating in the body of a
       child a pustule taken from the most regular and at the same time the
       most favourable sort of small-pox that could be procured.
       The experiment could not possibly fail. The Turks, who are people
       of good sense, soon adopted this custom, insomuch that at this time
       there is not a bassa in Constantinople but communicates the small-
       pox to his children of both sexes immediately upon their being
       weaned.
       Some pretend that the Circassians borrowed this custom anciently
       from the Arabians; but we shall leave the clearing up of this point
       of history to some learned Benedictine, who will not fail to compile
       a great many folios on this subject, with the several proofs or
       authorities. All I have to say upon it is that, in the beginning of
       the reign of King George I., the Lady Wortley Montague, a woman of
       as fine a genius, and endued with as great a strength of mind, as
       any of her sex in the British Kingdoms, being with her husband, who
       was ambassador at the Porte, made no scruple to communicate the
       small-pox to an infant of which she was delivered in Constantinople.
       The chaplain represented to his lady, but to no purpose, that this
       was an unchristian operation, and therefore that it could succeed
       with none but infidels. However, it had the most happy effect upon
       the son of the Lady Wortley Montague, who, at her return to England,
       communicated the experiment to the Princess of Wales, now Queen of
       England. It must be confessed that this princess, abstracted from
       her crown and titles, was born to encourage the whole circle of
       arts, and to do good to mankind. She appears as an amiable
       philosopher on the throne, having never let slip one opportunity of
       improving the great talents she received from Nature, nor of
       exerting her beneficence. It is she who, being informed that a
       daughter of Milton was living, but in miserable circumstances,
       immediately sent her a considerable present. It is she who protects
       the learned Father Courayer. It is she who condescended to attempt
       a reconciliation between Dr. Clark and Mr. Leibnitz. The moment
       this princess heard of inoculation, she caused an experiment of it
       to be made on four criminals sentenced to die, and by that means
       preserved their lives doubly; for she not only saved them from the
       gallows, but by means of this artificial small-pox prevented their
       ever having that distemper in a natural way, with which they would
       very probably have been attacked one time or other, and might have
       died of in a more advanced age.
       The princess being assured of the usefulness of this operation,
       caused her own children to be inoculated. A great part of the
       kingdom followed her example, and since that time ten thousand
       children, at least, of persons of condition owe in this manner their
       lives to her Majesty and to the Lady Wortley Montague; and as many
       of the fair sex are obliged to them for their beauty.
       Upon a general calculation, threescore persons in every hundred have
       the small-pox. Of these threescore, twenty die of it in the most
       favourable season of life, and as many more wear the disagreeable
       remains of it in their faces so long as they live. Thus, a fifth
       part of mankind either die or are disfigured by this distemper. But
       it does not prove fatal to so much as one among those who are
       inoculated in Turkey or in England, unless the patient be infirm, or
       would have died had not the experiment been made upon him. Besides,
       no one is disfigured, no one has the small-pox a second time, if the
       inoculation was perfect. It is therefore certain, that had the lady
       of some French ambassador brought this secret from Constantinople to
       Paris, the nation would have been for ever obliged to her. Then the
       Duke de Villequier, father to the Duke d'Aumont, who enjoys the most
       vigorous constitution, and is the healthiest man in France, would
       not have been cut off in the flower of his age.
       The Prince of Soubise, happy in the finest flush of health, would
       not have been snatched away at five-and-twenty, nor the Dauphin,
       grandfather to Louis XV., have been laid in his grave in his
       fiftieth year. Twenty thousand persons whom the small-pox swept
       away at Paris in 1723 would have been alive at this time. But are
       not the French fond of life, and is beauty so inconsiderable an
       advantage as to be disregarded by the ladies? It must be confessed
       that we are an odd kind of people. Perhaps our nation will imitate
       ten years hence this practice of the English, if the clergy and the
       physicians will but give them leave to do it; or possibly our
       countrymen may introduce inoculation three months hence in France
       out of mere whim, in case the English should discontinue it through
       fickleness.
       I am informed that the Chinese have practised inoculation these
       hundred years, a circumstance that argues very much in its favour,
       since they are thought to be the wisest and best governed people in
       the world. The Chinese, indeed, do not communicate this distemper
       by inoculation, but at the nose, in the same manner as we take
       snuff. This is a more agreeable way, but then it produces the like
       effects; and proves at the same time that had inoculation been
       practised in France it would have saved the lives of thousands. _