Smallpox Variolation in 17th Century Turkey and It's Introduction In England

Reading more of the 18th century "Commonplace Book of William Byrd of Westover", came upon this interesting item regarding the history of inoculation:

<<...of ingrafting or inoculateing the small[pox was fir]st brought out of the northern part of Ne[. . .]a into Turky, where it has now been in [use] about 70 years. At first they kept a Register [at Con]stantinople of all Persons who under went Inoculation, and out of all that number, there was only one old woman miscarryd by being very disorderly and ungovernable, and now this practice is grown so universal in Turky, that they have left off keeping any Register of them.>> https://www.scribd.com/book/322769715

The page in Byrd's notebook is damaged and the entry is unsourced, but, as Byrd wrote this likely in the 1720s (and the source may be a bit older), this would put variolation in Turkey in the mid-17th century and in "Ne[...]a" earlier than that.

It turns out that variolation was brought out of Turkey by a Lady Mary Wortley Montague after her travels there from 1716-1718. Byrd was an avid reader of travel narratives and may have read of the procedure from her accounts. On her return to London she demonstrated the process by having one of her children inoculated in the presence of the royal court.

<<The English aristocrat and writer Lady Mary Wortley Montagu (1689-1762) is today remembered particularly for her letters from Turkey, an early example of a secular work by a Western woman about the Muslim Orient. When Lady Mary was in the Ottoman Empire, she discovered the local practice of variolation, the inoculation against smallpox. Unlike Jenner's later vaccination, which used cowpox, variolation used a small measure of smallpox itself. Lady Mary, who had suffered from the disease, encouraged her own children to be inoculated while in Turkey. On her return to London, she enthusiastically promoted the procedure...>> but its spread was limited to high society for some time. ( https://muslimheritage.com/lady-montagu-smallpox-inoculation-england/ )

It is also likely that Byrd read about it in reports to the Royal Society of London, published in the society journal. Byrd was a member of the Royal Society when he was in London and later corresponded with it in Virginia.

<<Variolation was also practiced throughout the latter half of the 17th century in Turkey, Persia, and Africa. In 1714 and 1716, two reports of the Turkish method of inoculation were made to the Royal Society in England...>> (ibid)

This history is drscribed in more detail in a 2007 piece, "The introduction of variolation 'A La Turca' to the West by Lady Mary Mantagu and Turkey's contribution to this" published in "Vaccine" (abstract: https://www.sciencedirect.com/science/article/pii/S0264410X07002770 ; PDF: https://www.academia.edu/12549034/The_introduction_of_variolation_A_La_Turca_to_the_West_by_Lady_Mary_Montagu_and_Turkeys_contribution_to_this ).

The struggle in variolation was to reliably cause enough of an infection to generate lasting immunity without causing full-blown smallpox or causing a local outbreak. Some 18th century practitioners were extremely good at this, others less so. Abigail Adam's, who, like Lady Montagu, made sure her family was inoculated, describes recovering from the process in a 1776 letter. The eventual replacement of smallpox variolation with cowpox "vaccination" largely solved this problem.