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Colonial America | Culture | Smallpox

Smallpox was rampant in early colonial America, with Boston facing no fewer than four epidemics of the infectious disease before 1723. Smallpox is a contagious disease, typically spread by direct contact with people or contaminated objects such as clothing and blankets. In colonial times, the infected persons were placed under quarantine, where one in six died as a result of the deadly disease.

Reverend Cotton Mather proposed and then pushed into practice a radical prevention—inoculation against smallpox. Inoculation is the deliberate infection of a healthy person with a mild case of the disease in order to create future immunity. This idea scared and angered Puritans and earned Mather and his associates scorn instead of accolades.

The Epidemic of 1721

Symptom of Smallpox: Lesions

One symptom of smallpox is lesions on the
face and body.

Many supply ships from the Caribbean docked in Boston in the spring of 1721. One, the Seahorse, brought with it a crewmember carrying smallpox. Although officials placed him under quarantine, by autumn the disease had spread throughout Boston, as well as the surrounding cities. Smallpox hit the young and elderly especially hard, and death rates ranged between 10–25 percent.

Cotton Mather, a respected pastor and Harvard graduate, was an avid follower of advances in science and medicine. A Fellow of the Royal Society of London, Mather read an interesting 1714 article that had been published in the Society's newsletter. In the report, Emanuel Timonius, an English-trained physician practicing in Constantinople, reported that the Turks had developed a way to prevent smallpox. They collected fresh pus from a victim's sores and inserted it into a scrape or cut on a healthy person's arm. This act gave the subject a mild case of smallpox. The mortality rate of the inoculated persons dropped to only 1–3 percent.

The article confirmed what Onesimus, an African slave of Mather’s, had told him in 1706. Onesimus had undergone a similar procedure as a child in Africa. Deeply fascinated and inspired by the possibility of preventing smallpox, Mather became a crusader for colonial inoculation (later termed variolation). He also felt a personal stake in the matter, having seen three of his children suffer from smallpox. Always eager to spark controversy and debate, Mather began to campaign publicly that New England doctors adopt the practice of variolation.

DID YOU KNOW?
The threat of a smallpox
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When the 1721 outbreak began, Mather printed pamphlets describing the reports he had read in the Royal Society's newsletters. He distributed the pamphlets to all medical practitioners in the Boston area, who ignored, ridiculed, or chastised Mather. William Douglass, a Scots physician, spoke openly against variolation. He feared that inoculation might be worse than ineffective—it might kill the healthy and spread the disease. Even Mather's fellow clerics disagreed with the practice based on moral grounds.

Frustrated at the resistance of Boston's physicians, Cotton Mather turned to Dr. Zabdiel Boylston, a family friend. Although he was both skilled and respected as a local practitioner, Boylston had no formal medical training, having only apprenticed under his father to learn the medical trade. Despite public opposition, Boylston agreed to try the risky inoculation technique.

Inoculation in Practice

On June 26, 1721, Boylston inoculated his own six-year old son and two of his slaves. All three contracted a mild case of smallpox but soon recovered and showed resistance to further exposures. Encouraged by this success, Boylston inoculated 247 more persons, 6 of whom still died as a result of the disease. It was certainly a risk, but those who survived were protected for life.

It did not take long for news of Boylston and Mather's experiment to spread in a town of 11,000 residents. Although the experiment appeared to be successful, many people opposed the practice, fearing it spread the disease rather than prevented it. Mather and Boylston endured verbal abuse and even death threats from the infuriated public, including a failed firebomb attempt on Mather's house. Despite these threats, as well as the Selectmen's order for Boylston to stop, Boylston continued to inoculate anyone who requested the procedure. After the epidemic ended, Dr. Boylston was invited to London to receive honorary membership in the Royal Society of London.

From Inoculation to Vaccination: Edward Jenner

General acceptance of inoculation against smallpox did not come until late in the 18th century, thanks to a physician named Edward Jenner. Dr. Jenner studied medicine in London and worked beside Dr. John Hunter, a respected surgeon. Jenner's medical practice in the country, however, led him to investigate an idea he had learned from farmers—that if someone contracted cowpox, they did not catch smallpox. Cowpox, contracted mostly by those who milked cows with the disease, was a mild disease resulting in temporary lesions and mild discomfort. Excited by this prospect and eager to learn if the farmers' claims were true, Jenner consulted Dr. Hunter, who encouraged him not to speculate about cowpox, but to experiment.

Learn more about Dr. Edward
Jenner and read about how he
conducted the first successful
vaccination against smallpox.

Taking a page from Boylston's book, Jenner successfully inoculated 8-year-old James Phipps with cowpox. James not only exhibited no signs of cowpox, he also displayed an immunity to smallpox. To distinguish his procedure from previous experiments in smallpox variolation, Jenner called it "vaccination," taken from the Latin word vacca, which means "cow." Despite facing a strongly negative reaction from the public as Mather and Boylston had, Jenner's procedure eventually became widely accepted in England and in the American colonies. In fact, vaccination against many diseases is still in practice today.

In 1967, the World Health Organization (WHO) began an active global campaign to stamp out smallpox permanently. Owing much to the efforts of early pioneers like Cotton Mather, Zabdiel Boylston, and Edward Jenner, smallpox was officially declared eradicated in 1980.

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Also see Diseases.

Smallpox | Bibliography

Smallpox | Image Credits

  • Face Lesions on Boy | Photo by Cheryl Tyron; Centers for Disease Control
    and Prevention

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