Smallpox Vaccine: How Europe Learned Immunization from the Ottomans?

You will be astonished when you learn about the importance given by the Ottoman Empire to the vaccination policy in the 17th century!!!

In this article you will find information on:

  • The pioneer of modern smallpox vaccine
  • Population based vaccine policy in Ottoman Empire
  • World’s first official letter on vaccine implementation outcomes, as well as first technology transfer in the 1700s
  • World’s first law on mandatory vaccine administration

17th century…

All of Europe was struggling with with smallpox infection…

Please do not confuse smallpox with chickenpox, which is eradicated by vaccines due to the similarity in name,

Smallpox, one of the deadliest diseases that humanity has fought against, had the power to kill three of the 10 people it infects and “stamp” the remaining seven for the rest of their lives!!!

However, in the same period, the “variolation” method, which is considered the pioneer of modern smallpox vaccination, was widely used in the Ottoman Empire.

And smallpox had long ceased to be a feared problem in this region…


The first written records of the use of vaccines belong to the “variolation” technique applied by the Chinese in the 15th century,

This method was discovered by the Chinese…

Then it spread from China to Central Asia and reached the Caucasus,

The Turks also carried the technique they learned from the Chinese to all the regions they migrated to.

However, it was the Ottoman Empire that most widely used the variolation technique, put it into community-based practice, and brought it to Europe !!!

First Trials:

Emanuel Timoni, who voluntarily had variolation in 1714 in Istanbul, and Giacomo Pilarino in 1716, wrote a detailed letter describing the variolation technique to the Royal Society of London.
However, the British Royal physicians said that this practice was absurd and that such a method would not be allowed, and cut the way for this method.
For this reason, the variolation technique, which was the pioneer of the smallpox vaccine for a while, could not enter England.
However, shortly after this event, Lady Montagu, wife of the British Ambassador to the Ottoman Empire, Edward Wortley Montagu, observed all the features of variolation.
Moreover, Lady Montagu herself was very susceptible to the disease, as she had scars due to smallpox.

At first, she was very surprised when she witnessed with her own the variolation and its impressive results, which were widely practiced in the Ottoman Empire.

Afterward, when she saw that the children who underwent this procedure were not sick, she immediately had her children vaccinated against smallpox.

When Lady Montagu observed that her children were immune to smallpox, she got excited to report this to her home country and wrote her famous letters.

Lady Montagu shared all the details of these practices to England in a detailed report.

In the mentioned letter , she states that ” something called smallpox vaccine ” was administered against smallpox in Istanbul and that the people who were administered did not suffer from this deadly disease.

Letters written by Lady Montagu, took their place as the first and oldest official document on vaccination in the history !!!

Convincing England for Smallpox Vaccine:

Here is an excerpt from Lady Montagu’s letter to her country:

They are preventing many common and cruel smallpox diseases with a vaccine they discovered here…

The craft of many crones is just to do this surgery.

The best time for vaccination is the end of the hot days in summer, and the beginning of autumn.

It is then that the family heads find out if there is anyone in their family with smallpox, and several families gather.

Fifteen or sixteen family groups call one of these vaccinating crones, and if they want the smallpox vaccine filled in walnut shell to be opened from which vein, they open that vein with a large needle and put the vaccine as much as the tip of the needle into this vein, then they tie the wound and stick a walnut shell on it.

During this whole operation, even the slightest pain is not felt.

They do the same thing with four or five more veins…

Closed parts of the body are preferred for vaccination.

Vaccinated children play for eight days, and nothing happens. Then they get a fever that stays in bed for two or three days.

Twenty or thirty pimples appear on their faces. But within eight days, they appear as if they have not been infected at all. The wounds that are opened drain the poison of the flower through their illness and prevent it from spreading to other parts.

Every year, the same operation is performed on thousands of children…

Nobody dies from the vaccine.

Because I believe in the usefulness of the vaccine, I decided to have it done to my beloved children as well.

Since I love my homeland very much, as a patriot I would like the vaccine to be introduced there as well….

(Lady Montagu, Türkiye Mektupları, 1717-1718, çev. Aysel Kurutluoğlu, s. 66-67)

Wide Use of Smallpox Vaccine in Europe:

Lady Montagu used this experimental method on her children for the first time in Istanbul, in her son,

She is later remembered as the person who introduced the smallpox vaccine into England by administering it to his daughter in front of the Royal Family in London.

It was only after these letters and testimony that variolation began to spread in England.

This process, which passed from the Ottomans to England, was applied to everyone in French schools in the 1750s.

This method, which was learned from the writings of the Ottoman physician Emanuel Timonius and the writings of Lady Montagu, spread rapidly in Russia, Sweden, and Italy.

In the beginning, the higher classes of the society were vaccinated with this technique, soon after variolation started to be applied to the lower classes gradually.

Then it was introduced to America…

However, after a while, a scientist named Edward Jenner in England developed a different scientific method for smallpox vaccination.

His definition of the ” Jenner method ” , which will be named after him, in 1801 is considered one of the important milestones in the history of vaccination.

Only 3 years after the discovery of Edward Jenner, smallpox vaccine was produced according to the “Jenner method” in Istanbul.

World’s First Law on Mandatory Administration of Smallpox Vaccine

The Ottoman Empire gave great importance to vaccination and public health.

Well, did you know that the first law in the world regarding the obligation to apply vaccination was enacted in the Ottoman Empire???

According to the law enacted in 1885 with the name of “ Çiçek Nizamnamesi ”, it is known that people who did not get smallpox vaccination were not admitted to join military and boarding schools.

In the following years, articles such as vaccinating newborn babies and penalizing families who did not have their children vaccinated had been added to the regulation.

In the last regulation dated 1915, everyone living in the Ottoman Empire was obliged to be vaccinated three times, at the age of six months, at the age of seven, and until the end of the age of 19.

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