Smallpox

One of our ancestor’s greatest fears was the highly contagious smallpox, a disease that has thankfully been considered to be eradicated from the earth since 1977.

There were two variants of smallpox: Variola major, the more severe variant,  with 30-50% fatalities  and Variola minor, the less severe variant, with 1-2% fatalities.

Within seven to seventeen days after being exposed to smallpox, the victim would experience fever, chills, headache, nausea, vomiting and severe muscle aches for two to four days. By the fourth day, the fever would drop and the rash would appear.  Once the rash appeared, the patient was infectious, but was often isolated at the appearance of the fever. The rash begins as flat or raised spots called macules which became raised papules. The papules enlarge and become filled with fluid and are then called vesicles. As the fluid changes from clear to pus-like, the spots are called pustules. Fever during the appearance of the rash is common.  After time, the pustules crust over and eventually the scabs fall off. This process can take from three to four weeks and scarring is common. The infectious period ends only when the last scab has fallen off.

Smallpox is generally spread by close contact (less than six feet) but may also be caused by contact with lesions or contact with contaminated bedding or other materials.

Variolation and Vaccination

Variolation, or the process of inoculation with smallpox, is thought to have been introduced to England by Lady Mary Worley Montagu, wife of the British ambassador to Ottoman Constantinople in 1721, who, along with her two daughters, had the procedure performed, and during an outbreak of smallpox in 1721, escaped infection. In a letter by Lady Montagu to Sarah Chiswell, dated 1 April 1717, she describes the treatment:

However, the practice of inoculation was dangerous, and sometimes the resulting case of smallpox was severe enough to cause death. Many preferred to take their chances with the possibility of contracting the disease naturally, rather than risk possible death from the inoculation.

In 1796, Dr. Edward Jenner, after noticing that those who worked with cattle and had been infected with cowpox never contracted smallpox, used cowpox to inoculate James Phipps, an eight-year old by who was the son of Jenner’s gardener. He inoculated Phipps in both arms. After Phipps recovered from a brief fever, Jenner subsequently injected him with smallpox and he showed no signs of infection.

There was much debate as to which type of inoculation should be used. Controversy raged until 1840 when legislation was passed banning variolation. In 1853, further legislation was passed, making vaccination compulsory for every child within three to four months of their birth. Failure to do so, would result in a £1 fine, payable to the local poor-rate.