Smallpox was a terrible disease.
“Your body would ache, you’d have high fever, a sore throat, headaches and difficulty breathing,” says epidemiologist René Najera, editor of the History of Vaccines website.
But that wasn’t the worst of it.
“On top of that, you’d get a horrible disfiguring rash over your entire body – pustules filled with pus on your scalp, feet, throat, even lungs – and over the course of a couple of days, they would dry out and start falling off,” says Najera.
With the rise in global trade and the spread of empires, smallpox ravaged communities around the world. Around a third of adults infected with smallpox would be expected to die, and eight out of 10 infants. In the early 18th Century, the disease is calculated to have killed some 400,000 people every year in Europe alone.
Ports were particularly vulnerable. The 1721 smallpox outbreak in the US city of Boston wiped out 8% of the population. But even if you lived, the disease had lasting effects, leaving some of the survivors blind and all of them with nasty scars.
“When the scabs fell off, they’d leave you pockmarked and disfigured – some people committed suicide rather than live with the scarring,” Najera says.
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Treatments ranged from the useless to the bizarre (and also useless). They included placing people in hot rooms, or sometimes cold rooms, abstaining from eating melons, wrapping patients in red cloth and – according to one 17th-Century medic giving “12 bottles of small beer” to the patient every 24 hours. The intoxication might have at least dulled the pain.
There was, however, one genuine cure. Known as inoculation, or variolation, it involved taking the pus from someone suffering with smallpox and scratching it into the skin of a healthy individual. Another technique involved blowing smallpox scabs up the nose.
First practiced in Africa and Asia before being eventually brought to Europe in the 18th Century, and North America by an enslaved man named Onesimus, inoculation usually resulted in a mild case of the disease. But not always. Some people contracted full-on smallpox and all those inoculated became carriers of the disease, inadvertently passing it on to people they met. A better solution was needed.