Rationalizing disease: James Kilpatrick's Atlantic struggles with smallpox inoculation.

This essay uses the career of the inoculating physician James Kilpatrick as an example of how itinerant medical entrepreneurs navigated the various knowledge spaces of the British Atlantic World. Moving from Ireland to Charleston and finally to London, Kilpatrick's involvement with smallpox inoculation in the diverse peripheries of the British empire in the early eighteenth century provided him with the experience of controversy and experiment that paved the way for his ascent as a philosopher of inoculation within metropolitan and continental medical circles. This article focuses in particular on Kilpatrick's time in Charleston, an area rich in African and British migrants and then an important outpost of medical information and experimental inquiry within the interrelated medical circuits of the Atlantic world. This article shows how Kilpatrick leveraged the circuits of information that defined the town in order to promote the practice of inoculation and to create a medical and scientific persona that fit the expectations of Lowcountry audiences. Kilpatrick's efforts to promote inoculation in Charleston ultimately failed, but he put his colonial experiences to work in the service of building a metropolitan identity, traveling to London and publishing a pamphlet on the practice of inoculation in Charleston. This paper argues that it was experiences of controversy and failure on the British periphery that taught individuals such as Kilpatrick how to establish their authority as they navigated the medical cultures of the Atlantic world. [ABSTRACT FROM AUTHOR]