An 18th-century letter going up for auction in London Wednesday has very modern relevance, thanks to its subject: inoculations. As the New York Times reports, the scourge of the time was smallpox, and in the 1787 letter, Catherine the Great pushes for variolation, an early inoculation process. "Such inoculation should be common everywhere," she wrote to a governor-general, per auction house MacDougall's translation, "and it is now all the more convenient, since there are doctors or medical attendants in nearly all districts, and it does not call for huge expenditure."
The letter, part of a lot that also includes a portrait of Catherine, is expected to fetch up to $1.6 million. Variolation involves exposing people to material from a smallpox patient's infected pustule via small incisions in the arm. The death rate from the procedure was about 2% to 3%, well below smallpox's 30% death rate, Smithsonian reports. Catherine herself was inoculated in 1768, a move the Times reports was driven by a desire to show her people it was safe to do so as well as her deep fear of smallpox, which had infected her husband.
She had Dr. Thomas Dimsdale of England travel to Russia to perform the inoculation, and had a carriage and guards at the ready to spirit Dimsdale out of Russia in the event the inoculation killed her; it didn't. The AFP reports her letter to Piotr Aleksandrovich Rumiantsev suggests the mechanics of how inoculation be carried out in his province, suggesting abandoned monasteries and convents be used as lodgings for people who contracted smallpox from the procedure. (More Catherine the Great stories.)