Childhood diseases like mumps, measles, and whooping cough were serious but commonplace during the eighteenth century. Epidemics, occurring seemingly at random, were much more alarming. One of the most feared diseases was smallpox because of its relatively high mortality rate and the severe scarring that marked survivors. This acute contagious disease was especially devastating in America because its inhabitants were less likely to be immune to it than Europeans who had been exposed to it. Even with the isolation of individuals and the quarantine of ships, smallpox flared up every few years, especially in urban areas. Native Americans were particularly vulnerable. It has been claimed that the British, aware of the contagious nature of the disease, weaponized it by deliberately distributing blankets that had been used by smallpox victims to the Indian population.
The term used to describe protection against smallpox in early eighteenth century America was variolation. This involved the use of the smallpox virus and was known in fifteenth century China and later in India. In the Middle East and Africa two methods were in use. In one called “buying the smallpox,” the mother of an unprotected child would visit the house of a child who had the disease, tie a cotton cloth around the infected child’s arm and haggle over the cost of each pistule. After agreeing on a price the mother would tie the infected cloth around her own child’s arm. A second method involved taking some fluid from a smallpox pistule, called “hitting the smallpox,” and introducing it into a cut in a patient’s arm thereby inducing, hopefully, a mild case of the disease. The term vaccination refers to the development of a method of prevention in the late 1700s, particularly by Edward Jenner, involving a vaccine derived from cowpox. A safer alternative, it replaced variolation.
Lucy Flucker Knox, wife of General Henry Knox. decided that she and their daughter Lucy would be inoculated using the technique of variolation. From Brookline, Massachusetts, she wrote on April 31, 1777 to her husband:
Join with me my love in humble gratitude to him who hath preserved your Lucy and her sweet baby; and thus far carried them thro the small pox—no persons was ever more highly favored than I have been since it came out—but before for three days I suffered exceedingly—I have more than two hundred of them twenty in my face which is four times as many as you bid me have but believe some of them will leave a mark—Lucy has but one—and has not had an ill hour with it—both hers and mine have turned and are drying away. …
I have no glass but from the feel of my face I am almost glad you do not see it. I don’t believe I should yet get one kiss and yet the Dr. tells me it is very becoming.
Eliza Yonge Wilkinson of Mount Royal, Yonge’s Island, South Carolina, was thankful that she was not too badly scarred by smallpox. She wrote on May 19, 1781:
I have just got the better of the small-pox, thanks be to God for the same. My face is finely ornamented, and my nose honored with thirteen spots. I must add, that I am pleased they will not pit, for as much as I revere the number*, I would not choose to have so conspicuous a mark. I intend, in a few days, to introduce my spotted face in Charlestown.
* Wilkinson is, of course, referring to the thirteen states.
Smallpox has been eradicated through the process of compulsory vaccination. The last case of the disease occurred in the world in 1978. The United States stopped vaccinating the general population in 1972, but continued to vaccinate military personnel until it was officially stopped in 1990.
The letters appear on page 177 of In the Words of Women. Refer to this ARTICLE for the history of variolation and vaccination.The image of Lucy flicker Knox is from the Montpelier, the General Henry Knox Museum.