The Hemingses of Monticello: An American Family (30 page)

Jefferson was an early believer in inoculation. In 1766, during his first trip to the northern part of what would become the United States, he went to Philadelphia for the specific purpose of being inoculated. In the months after his wife’s death, he took Patsy and Polly to undergo the procedure, personally caring for them at the Ampthill home of his friend Archibald Cary.
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While many religious people had deep reservations about the practice—thinking it somehow interfered with the will of God—forward-thinking people like Jefferson regarded inoculation as a milestone in the march of progress and reason. One scholar has written that the procedure was “regarded by the age itself as the greatest medical discovery since Hippocratic days” and “shared with Newtonianism a prominent position in enlightened scientific thought.” Newton was very famously among Jefferson’s trinity of personal gods, along with Francis Bacon and John Locke.
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When Jefferson wanted to have Sally Hemings inoculated in Paris, he had available to him, and Hemings got to meet, a member of the foremost family of inoculators in the world: the Suttons. In the mid-eighteenth century, Robert Sutton Sr., an English doctor, developed a more sophisticated method of inoculation. Building upon the work of earlier physicians, Dr. Sutton discovered that he could bring on a mild case of smallpox by eschewing “deep incisions that thrust the virus directly and dangerously in the bloodstream and that increased the chances of secondary infections.”
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Sutton also took the inoculum from patients who had been inoculated rather than from individuals suffering from a full-blown case of smallpox. Dr. Sutton and, later, his six sons “reduced variolation [inoculation] to a slight pricking of the skin” that was so gentle that the patient might not even feel when it had happened.
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The “Suttonian method” or “Suttonian system” was very well known in the American colonies, and Jefferson certainly had heard of the Suttons before he came to Europe and had to deal with getting Hemings inoculated.
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The mortality rate for the Suttons’ inoculations was remarkably low for what was, after all, a very dangerous undertaking because the men were especially adept at carrying out their own procedures. They personally inoculated thousands of people and lost only about one percent of their patients, which meant that the chances Hemings might die were extremely low. An additional advantage for Hemings was that Sutton’s method almost invariably reduced the amount of scarring down to the site of the pricking on the arm, leaving the kind of scar that would be familiar to millions of twentieth-century Americans who received smallpox vaccinations before entering kindergarten. Other inoculators were not as successful in reducing complications from the procedure, and their patients were sometimes grossly disfigured, even blinded.
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This, too, would have been of great importance to the vanity of a young girl in a world where the appearance of females (at all strata of society) was more important than that of males: a man with pock-marks on his face suffered fewer social consequences than a woman with even just a few. Voltaire appealed to Frenchwomen’s vanity in the cause of persuading the French to inoculate, reminding them how a full-blown case of the disease could ruin “their beauty.”
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After inoculating entire communities in England, for it was thought safer to inoculate on a mass basis rather than run the risk that one inoculated person would imperil a village, the Suttons eventually branched out to other parts of Europe and were invited by members of the nobility and heads of states on the Continent to perform inoculations. Although they emphasized their services to the poor in England, their reputation for beneficence was exaggerated. They certainly came to the Continent to make money, and the patients of the brothers who practiced there tended to be rich and aristocratic. The family operated very much as a business, keeping aspects of its method secret, sharing it only with designated inoculators in the manner of a franchise operation.
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Jefferson wrote that he paid “Dr. Sutton for inoculating Sally” about three months after she arrived in Paris, and he paid an enormous sum indeed—about forty dollars, the equivalent of roughly one thousand dollars today.
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That was very much in keeping with the Suttons’ practice of charging wealthy patients, in this case the owner of the patient, very high fees. One nineteenth-century detractor noted that the Suttons had been especially “popular” with the “nobility who paid them immense sums for their services,” and suggested that an air of celebrity surrounded the Suttons that outstripped their true medical skill. The Suttons, he pronounced dismissively, had merely discovered the importance of hygiene to the process of inoculation, referring to their “device of cleanliness” as if it were some devious and underhanded strategy.
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Modern observers know that the discovery of the role that hygiene plays in
all
medicine transformed the field. Certainly, the attention to hygiene contributed to the Suttons’ ability to prevent scarring on their patients. Then, as now, it was hard to argue with success. Jefferson and others were willing to pay the high price because the Suttons’ demonstrated skill and success rate were so great and the disease they were fighting so nightmarish. And while the brothers’ reputation tumbled greatly after the advent of Jenner’s vaccine, inoculation was the only pre-Jenner alternative for those who did not want to risk developing the disease in uncontrolled circumstances.
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Hard businessmen that they were, the Suttons insisted upon payment before services were rendered. So unless Jefferson was able to persuade Dr. Sutton otherwise, Hemings must have been inoculated on the day of or sometime just after his November 7 notation that he had made the payment.

Jefferson did not say which Sutton inoculated Hemings. Robert Sutton Sr. had died by 1787. The most famous of his sons was Daniel, who fashioned himself grandly as “Professor of Inoculation in the Kingdom of Great Britain and in all the dominions of his Britannic Majesty.”
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All of the sons were in the inoculation business, each setting up his own practice in various parts of England and on the Continent when that market opened up, with Robert Jr. having the greatest presence in France. Robert Jr., whose bad experience with inoculation when he was a boy had prompted his father’s interest in the subject, was in charge of the Suttons’ inoculation house outside of Paris. In 1774 he, and perhaps at least one of his brothers, Joseph, was brought in to try to help King Louis XV. Given the patient’s prominence, the Bourbons would have brought in all six Sutton brothers if that had been necessary to save him, although there is evidence that at least some of the French physicians resented having the Suttons in the role of last-resort rescuers.
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A French biographer of the king when describing Louis’s final days wrote of the arrival of “
les
Sutton,
les
célèbres inoculateurs anglais,” and “
leur
remède” as if there were more than one Sutton present at the king’s bedside during those days working together to save this famous and powerful patient. But the efforts of whatever number of Suttons were to no avail. King Louis was beyond anyone’s help.
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Inoculation carried with it the great risk of touching off an epidemic because the patient was, for a time, contagious—another important reason beside religious zealotry for skepticism about the practice. To guard against that problem, patients were quarantined for a period of weeks. When Robert Hemings was inoculated, Jefferson noted that he had paid “Ambo for lodging & nursing Bob four weeks.” When he mentioned paying to board “Martin & Jame,” he did not say how long they remained in isolation, but there is no reason to suppose that their situation was drastically different from their brother’s.
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As one might expect, things were a bit more rigorous in metropolitan France. There the quarantine was to last at least forty days after the day of inoculation, and it was illegal to inoculate anyone within the city limits of Paris.
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Sally Hemings was sent to an inoculation house outside of town to have the procedure performed.

But where did she go? The exorbitant fees the Suttons charged paying clients like Jefferson included the housing and feeding of the patients, though tea and wine were extra.
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Hemings’s inoculation was handled the same way the Suttons handled other patients in their two-tiered system of treatment. Poor patients back in England, usually treated in mass or group inoculations for nothing or next to nothing, stayed in their villages, which were then kept strictly quarantined. The Suttons made the rounds on a schedule to take care of them. Paying clients were sent away to comfortable inoculation houses that the Suttons set up in areas far from towns, and the brothers made the rounds there to look after them. Like these patients, Sally Hemings underwent the procedure “in private, quarantined from the community at large.”
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Indeed, by the time she arrived in Paris, the Suttons had long had their own inoculation house on the outskirts of the city.

In keeping with the brothers’ insular franchise mentality, which favored their relatives, the family impresario Daniel Sutton sent his father-in-law, Dr. Worlock, to set up the Suttons’ inoculation house in France. It was “an isolated house outside of Paris with fresh air, near Mont Louis, called P. Lachaise.” By 1804 the Sutton’s inoculation house was closed, and PèreLachaise became the site of “the most famous cemetery in Paris,” which still exists today, although now within the city’s limits.
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If it ever existed, no correspondence between Jefferson and Sutton survives, and none of his extant letters to anyone else mention the doctor. The record of all of Jefferson’s incoming and outgoing letters, the SJL (Summary Journal of Letters), can yield no clue. The pages covering the end of 1787, through October 1789, after he and the Hemingses had left Paris, are missing—the only part of this record that is not extant.
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Yet, the men must have communicated. How else would Jefferson have found Sutton and made arrangements for him to care for Hemings and receive payment for it? He probably dealt with Sutton face-to-face. The amount of money was too great, and Jefferson’s interest in the topic too long-standing and deep, to imagine that he passed up the chance to meet with a member of a family so esteemed in such an important field of medicine, an area that always fascinated him.
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While one could see Jefferson viewing Hemings’s inoculation from both his personal and his scientific perspective, the matter was probably almost all personal for her. Even with today’s greater knowledge of medicine and disease prevention, vaccination, a much less dangerous technique than inoculation, frightens many parents whose children undergo the process and some individuals who must be vaccinated as adults. The idea of being given a dread disease to prevent the dread disease quite naturally raises conflicting emotions: gratitude at the prospect of being spared a terrible sickness and, at the same time, fear of being among the tiny percentage of people who suffer as a result of the procedure.

James Hemings, Jefferson, and his daughters were living testaments to the benefits of inoculation when everything went well. But Sally Hemings knew what contracting smallpox meant. It was a disease of her time in a way that it is emphatically not in our own, and it affected all classes. While in Paris, Jefferson noted the death of a prominent society woman from smallpox. George Washington had had it as a young man and carried the scars of the disease. Hemings was old enough to have known of the turmoil and horrific suffering of the slaves who returned to Jefferson’s plantations after the war. Several of her close relatives had been at Yorktown, where the disease was notoriously rampant.

Jefferson knew the extent of the Suttons’ good reputation and that he could not have put Hemings in better hands. Hemings, however, probably had little reason to know about the Suttons, and even if Jefferson chose to act as the good patriarch and explain to her just who Sutton was and the significance of his involvement in treating her (and try to allay any fears), it could not have erased all doubt. Anyone with ordinary intelligence would have understood that a required quarantine of forty days indicated that one was about to undergo a very serious medical procedure and that there was always a chance that things could go wrong. After the trip over the ocean, the sojourn in London with Abigail Adams, and the stressful introduction to city living, new food, new faces, and new surroundings, Hemings faced yet another trial.

The Suttons religiously followed a strict regime that they believed was the key to their success. The method was all. After years of attempting to keep the exact nature of that method secret, Daniel Sutton published a book in 1796 revealing their protocol, complete with a handy chart of the daily routine that patients like Hemings were put through.
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Those who followed the Suttonian method, and those who did not, commonly prescribed a before-inoculation program for prospective patients. According to Sutton’s prescription, at the beginning of her confinement Hemings was to be put on a diet that restricted the amount and type of food. She was not supposed to eat any animal protein. She could not drink any alcohol, which was probably not yet a part of her routine anyway. The Suttons had turned away from the extensive use of the harsh purgatives, fasting, and induced vomiting in the pre-inoculation phase that other inoculators relied upon. Their approach was more moderate, although there were elixirs she had to take on a precise schedule.
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