Less than a decade into her 34-year reign, Catherine II of Russia commissioned a commemorative medal from the engraver Timofey Ivanov of the St Petersburg Mint. On one side was a conventional image of herself in profile and on the other was something curious: a depiction of the Empress holding the hand of her son Paul and reaching out to a grateful mother and children. Behind her on the ground, below the classical façade of a temple, lay the slaughtered body of the multi-headed monster Hydra.

The scene was clearly allegorical, but what did it mean? To understand that we have to look at the date imprinted beneath: 12 October in the year 1768. On that day – six years after she overthrew her own husband to become Empress of Russia – Catherine had herself secretly inoculated against smallpox, the most devastating disease of the eighteenth century, by an English Quaker doctor named Thomas Dimsdale. The procedure was the forerunner of vaccination and it involved deliberately infecting a healthy patient with a minute quantity of live virus. It was safer than it sounds (and far safer than most modern medics realise), but it still carried risk.

Catherine decided she and her son should undergo inoculation to protect their own lives in the midst of a devastating wave of smallpox in St Petersburg, but she also had a second motivation: she wanted to overcome the widespread superstition over inoculation in Russia and introduce the procedure across her empire. There was a benevolent element to this – smallpox was a hideous disease that at the time struck almost everyone, killed at least one in five sufferers, and disfigured and often blinded those who survived – but there was also an economic purpose: every life saved increased the wealth of the state.

So, to return to the carefully curated image on the medal, we can see that the slaughtered Hydra represents not only smallpox, but prejudice itself. Supported by the power of the Orthodox Church – she had been careful to secure public praise from the Metropolitan Bishop of St Petersburg – Catherine has defied the monster and now receives the thanks of grateful Russia and her population. But there is a further resonance here, too; by casting herself in copper, Catherine is seeking to promote and immortalise not only this single political act but her leadership as a whole and Russia’s status on the world stage. Above the image are the words ‘she herself set an example’.

The phrase takes just three words in Russian – собою подала пример, but behind them lay a complex message. It is a very personal declaration: she herself has taken a risk, putting her own life on the line on behalf of her people, and now literally embodies an example of how to live. There is no dative object – the example is for everyone, all at once. Catherine is Empress, but her leadership is personal – and it is specifically female: this test has been conducted on her own woman’s body, with its weaknesses and frailties she willingly listed for her physician and told him to publish. Dimsdale dutifully obeyed: his Tracts on Inoculation – Written and published at St Petersburg in the Year 1768, By Command of her Imperial Majesty, The Empress of all the Russias included details not only of Catherine’s symptoms while recovering from smallpox, but of her general health including her headaches (from overwork), diet, drinking habits and bowel movements.

There were, it’s worth noting, other prominent women who played significant roles in promoting smallpox inoculation in the 18^th century – including Empress Maria Theresa of Austria, Caroline of Ansbach, wife of the future George II, and the British aristocrat Lady Mary Wortley Montagu – but they all used their inoculated children as examples. Only Catherine ran the risk herself, acting as a one-woman medical trial before having her son treated once her recovery was secure. Famously, her own body was, and remains today, the target of lascivious gossip and ridicule, yet it was an act of physical suffering that she promoted in a remarkable act both of self-creation as a leader and of statecraft. By projecting her actions through a battery of carefully managed weapons of influence, she helped stabilise her power at home and presented Russia, under her leadership, as a progressive, westward-looking European state. As we’ll see, the confidence she gained from protection from smallpox also appears to have influenced an act of imperial expansion that has dramatic resonance today.

Having taken her risk and recovered from the very unpleasant side effects of inoculation – she claimed to have got through the accompanying dizziness and fever by having the works of her beloved correspondent Voltaire read aloud to her as a kind of literary pain relief – Catherine’s first mission was to use her personal example to persuade her deeply sceptical subjects to follow suit. For that, she had to publicise the inoculation. Here, her brand of leadership began to emerge.

In a previously ignored sidenote in a treatise by Thomas Dimsdale on inoculation in Britain, the doctor describes a conversation with the Empress during her convalescence at the palace of Tsarskoe Selo, near St Petersburg. Admitting that she had bribed local villagers to be inoculated (and even joking over the fact that the ‘price’ they exact from her has gone up), Catherine explained that although as an autocrat she could compel her subjects to be inoculated, she preferred to use ‘persuasive means, rather than authority’. Coercion, she recognised, would not work when it comes to telling people what to do with their bodies – a familiar debate given new force during the Covid pandemic.

Instead, the Empress opted to associate an undoubtedly alarming and counter-intuitive invasive procedure – a scratch on the arm with a lancet followed by a dab of infected pus and some three weeks of sometimes severe discomfort – with an atmosphere of celebration. She marked her son’s and her own recovery with a huge national party: bells rang across the nation, buildings were lit up, fireworks cascaded skywards, and cannons roared. Having brought the Church onside – an Orthodox mass at the Winter Palace gave thanks for the whole episode and harnessed the full mystical might of Russian religious display – Catherine took a yet more popular step: declaring an annual national holiday each 21 November to mark her inoculation. The event had attained the same status as her birthday and coronation.

But the message was always more than ‘get yourself inoculated’ – which she underlined by building inoculation hospitals around her empire and by encouraging the practice for at least another two decades. Catherine’s campaign was also about promoting herself and her own leadership. Her grip on power was stronger in 1768 than after the coup and subsequent violent death of her husband, but she remained a usurper, and a foreigner. Through the Orthodox service and political speeches of gratitude, the German-born Empress had herself portrayed not only as ‘Matushka’, the ‘little mother’ of the Russian nation, but reached higher still for divine analogies. ‘Now all ages and both sexes embrace your feet and praise you in the image of God the healer,’ proclaimed Count Kirill Razumovsky on behalf of the Senate. In response, the Empress likened herself explicitly to a Christ-like Good Shepherd, giving his body to protect his people. She had elevated her physical act to a spiritual one, turning inoculation under her leadership into a sacrament.

With religious and civil celebrations completed, Catherine turned to the arts. Here, as with the commemorative medal, she appropriated classical mythology, commissioning an allegorical ballet entitled Prejudice Defeated, in which she is represented as Minerva defeating the fire-breathing monster Chimera, freeing the Russian people from both smallpox and the grip of ignorance. The mythological theme continued with a five-act theatrical spectacular, Triumphant Parnassus, depicting Catherine as the Russian Pallas, Minerva’s Greek counterpart, slaying the venomous dragon smallpox with her sword in one Herculean swipe. With the theatre symbolically illuminated, the play concluded with a lurch to contemporary politics and a stark warning to the Turks, now squaring up for war with Russia after a conflict in Poland had spilled over the border into Ottoman territory: ‘The monarch here was able to quash evil, And Asia will know about those tempestuous days. When she ignites from Russia’s spark… Turkey will know what it means to respect Russia.’

The connection between inoculation and war would bind ever tighter. But in the meantime, at the same time as building her image at home, Catherine turned abroad to maximise the promotional benefit of her inoculation. The Empress fired off a storm of letters to influential correspondents whom she knew would immediately publish them, representing herself as a western-orientated enlightened leader who trusted data and scientific facts, and as a hearty patient who had barely noticed her inoculation symptoms. She teased Frederick the Great, who had advised her not to risk the procedure, and boasted to Voltaire – an outspoken advocate of inoculation – that she had done it all as a tribute to him. With characteristically earthy wit, the philosopher wrote back admiringly, ‘You have been inoculated as easily as a nun taking an enema.’

For Britain, whose place in her Anglophile heart had been reinforced by the medical triumph of her English doctor, Catherine had special thanks. She exchanged flattering letters with George III, another staunch supporter of inoculation, who had fretted over her fate throughout the secret treatment, while at an Orthodox service the Metropolitan Bishop noted that the Russians had ‘borrowed assistance from Britain, that island of wisdom, courage and virtue’.

From this scratch of a lancet that took just a few seconds, Catherine fashioned a multi-faceted image of herself as leader: as loving mother, self-sacrificing spiritual healer, and a rational philosopher-scientist leading an enlightened and progressive nation. Her process of deliberate self-creation was not only skilled but profoundly recognisable today. For women in particular, it is a case of moving fast before someone else does it for them.

The inoculation was not the first time Catherine had shaped her own story. From 1756, she had been writing an account of her life up to the coup that brought her to power, continuing to edit and recraft the narrative right up to her death in 1796. The text concentrated on her childhood and her early and unhappy marriage to Peter, and its episodes were carefully selected and presented to portray her as intelligent, charming, energetic, ambitious, and destined to rule. Often, she used personal physical anecdotes to help define her character: she describes enduring a corset and a black ribbon tied across her body to correct the curvature of her spine, or her love of riding hordes astride, like a man, in order to gallop without restraint.

And here we can begin to see a pattern that prefigures Catherine’s public presentation of her inoculation. She not only made the personal – the intimate, even – political, but deliberately took examples of female bodily weakness and vulnerability and demonstrated how she has subverted them.

Catherine acknowledged norms and expectations around power and leadership – their fundamental associations with masculinity – and played on the tension with her own identity as a rare female leader: not the first to rule Russia, but the last to date. In her memoirs, she wrote that she had, ‘a mind infinitely more male than female. But for all that, I was anything but mannish, and in me, others found, joined to the mind and character of a man, the charms of a very attractive woman’. She did not, in other words, simply ape masculine qualities. Rather she celebrated and used her woman’s body as part of her construction of her particular form of power. Frailty, or the perception of it, could be reversed to become strength.

My own book about this episode in Catherine’s rule was written during the Covid pandemic. The parallels were obvious and startling: 250 years previously, she had recognised the power of personal example as a tool of influence in public health policy. As I researched her experiences, world leaders were rolling up their sleeves to be pictured receiving their Covid jabs, and debates were hotting up over vaccination compulsion – the course of action she had rejected in favour of encouragement despite her autocratic powers. Those resonances were unexpectedly literal. But others are almost as familiar: the conscious image-making of political leaders through careful crafting of personal narratives and, for women in powerful public roles, the delicate balancing of authority according to a masculine script with nods to a performed femininity. In the archives of Churchill College, Cambridge, one of Margaret Thatcher’s famous handbags – simultaneously a badge of womanliness and a symbolic weapon – is still one of the most popular exhibits in the archive.

Of course, women can never, truly, get this balance right. Catherine used inoculation to build her image as a female ruler, but by the last years of her reign – as Russia’s empire expanded threateningly westward – political cartoonists were routinely employing sexist and salacious imagery to cut her down to size. The most famous example, captioned The Imperial Stride, portrays her rival leaders – all men – looking up her skirts and making lewd remarks as she steps purposefully across the map between St Petersburg and Constantinople.

That brutal satire was still a long way in the future, though; at the time, Catherine had the medal minted to mark her inoculation and cast herself, literally, as a benevolent protector of her nation – as both mother and Hydra-slaying warrior. Just days after her recovery, in November 1768, she took another step that would define her even more clearly as a strong leader: she declared war on Turkey, igniting the conflict that would see Russia take Crimea and other territory that today lies, pulverised by Putin’s war, in southern Ukraine. In a letter to her new ambassador in London, Count Ivan Chernyshëv, she wrote gleefully that the pair had ‘only two subjects to discuss – first the war, and second, inoculation’. Just as the theatrical spectacular had yoked together the overcoming of disease with the prospective military threat to Turkey, so again the conquest of the virus (and of prejudice against inoculation) and the coming military campaign were inextricably bound together. Her victory in her inoculation against smallpox had made her feel invincible and drove her forcefully towards the war that would, ultimately, lead an ever more confident Russia to conquer Crimea and the Black Sea region that now lies in Ukraine.

Catherine, whose woman’s frame had survived its struggle with smallpox, would not go to battle herself, but she sent her troops off in the depths of the Russian winter to sacrifice their own bodies in combat in the cause of imperial expansion. ‘My soldiers go to war against the Turks as though they were going to a wedding,’ she wrote to Voltaire. The next act of her self-creation was beginning.