Smallpox

The latest episode of "No Bones About It," The College of Physicians of Philadelphia's popular YouTube series, features historian Michael Willrich. Willrich recently spoke at the College for a well-attended History of Vaccines event and discussed his most recent book, POX: An American History, which chronicles the smallpox outbreaks at the turn of the 20th century. Before the event, he sat down with Robert Hicks, director of the Mütter Museum and the College's Historical Medical Library, and the host of "No Bones About It." In this episode, Hicks and Willrich discuss compulsory vaccination, the intersection between civil liberties and public health, and the beginnings of the American anti-vaccination movements in the late 19th century. More

Join us for a fascinating evening of medical, social, and legal history on May 12 at 6:30 pm, when Michael Willrich, PhD, discusses his book POX: An American History (The Penguin Press),  which offers a gripping chronicle of how the nation's continent-wide fight against smallpox in the early 1900s launched one of the most important civil liberties struggles of the twentieth century. Willrich explores the intersection of public health initiatives and private medical decisions as well as the polarizing debate about the morality, ethics, safety, and effectiveness of vaccines. The measures enacted to contain the disease--- quarantines, pesthouses, and "virus squads"--- sparked a wave of popular resistance among Americans who perceived them as a threat to their health and to their rights. More

Robert D. Hicks, PhD, Director, Mütter Museum/Historical Medical Library, The College of Physicians of Philadelphia, contributes today’s blog post. In preparation for an exhibit on Civil War medicine at the Mütter Museum in 2012, Dr. Hicks has been researching, among other topics, the occurrence of spurious vaccination in the Civil War. Spurious vaccination was smallpox vaccination that either did not produce immunity in the recipient or that resulted in a transfer of a communicable disease such as syphilis. While physicians in the United States frequently used humanized smallpox vaccine during the Civil War, French physicians at the time were popularizing a mode of smallpox vaccination that relied solely on serial propagation of vaccine in cows. Human transmission of smallpox vaccine disappeared by the turn of the century.

According to Joseph Jones, MD, Professor of Physiology and Pathology, University of Nashville, vital medical research was “brought to a sudden and unexpected close, by the disastrous termination of the civil war.” Writing in 1866, in a radically changed and changing South in the aftermath of the Civil War which ended the previous year, Jones expressed frustration that a Confederate medical investigation on smallpox vaccinations “was destroyed during the evacuation of Richmond.” Confederate medical records in Richmond, Virginia, disappeared after the victorious Union Army torched the city. Vexed by these circumstances, Jones surveyed physicians throughout the South who served in the Confederate Army to elicit data about “spurious vaccinations” and resurrect the destroyed report. Spurious cases were smallpox vaccinations of soldiers deemed “accidents” because they conferred no subsequent immunity to the disease or, compounding misery, introduced other diseases incident to vaccination, particularly syphilis. Jones paints a dire portrait of a Confederate Army that experienced far too many deaths and disabilities due to spurious vaccinations. More

We've recently acquired some photographs and documents from a smallpox epidemic that occurred in Milwaukee, Wisconsin, in 1925. Our own Dr. Bennett Lorber, President of The College of Physicians of Philadelphia and Professor of Medicine at Temple University School of Medicine, acquired these items originally collected by Dr. Merle R. French (d. 1961), a 1921 graduate of the University of Iowa School of Medicine. Dr. French, at the time of this outbreak, was the Superintendent of the Communicable Diseases Hospital in Milwaukee.

Dr. French wrote a note describing the patient pictured here: "Picture of smallpox patient taken at S.view Hospital a short time ago. Man was a Christian Scientist who thought that he could by power of mind prevent smallpox. Man died. This is the kind of smallpox we are having." We assume that Dr. French was referring to an outbreak of variola major, the more dangerous form of smallpox, rather than variola minor, which came to be the dominant form of smallpox in the 20th century, particularly in the West. This man seems to have suffered from a type of variola major known as hemorrhagic smallpox, of which there were 22 cases in this epidemic. Hemorrhagic smallpox usually was fatal. The other photographs show less severe, but clearly serious, cases. More

In anticipation of the launch of the full History of Vaccines website on September 29, we offer here an excerpt from our collection of smallpox information.

Dover's Title Page Dover's Title Page, The College of Physicians of Philadelphia Thomas Sydenham (1624-1689), a noted English doctor, had observed that the rich seemed to have a higher mortality rate from smallpox than the poor. This led him to conclude that contemporary medical treatments, largely inaccessible to the poor, might be more harmful than helpful in mild smallpox cases. And yet, the care he provided his own patients was quite elaborate. Thomas Dover, a patient of Sydenham and a future doctor, documented his treatment at Sydenham’s hands for a serious case of smallpox. Below is Dover’s description; it is likely that the year is 1684. More

You might not be able to make it to Rio de Janeiro, but you can join the conference“Smallpox Eradication after 30 years: Lessons, Legacies and Innovations.” Organizers are the SabinVaccine Institute,  Fundação Oswaldo Cruz, and the Fogarty International Center. The conference dates are August 24-27.

Live streaming video and a conference schedule are available at this link. (Rio is one hour later than Eastern Daylight Time.) We’re especially looking forward to Session 1, Lessons from Smallpox-Endemic countries: Illuminating experiences in program conception and execution, which is moderated by DA Henderson, MD. See our interview with him here: The History of Vaccines Interviews DA Henderson, MD.

Follow the smallpox symposium on Twitter using the hashtag #Smallpox2010. More

Guest post by Robert D. Hicks, Ph.D.Director, Mütter Museum & Historical Medical LibraryWilliam Maul Measey Chair for the History of Medicine

As the recipient of a research grant, I recently had the opportunity to travel to Minneapolis to spend a week at The Bakken Museum. Founded in 1975 by electrical engineer Earl Bakken, a pioneer in medical devices including the first wearable, externally-worn, battery-powered pacemaker, the Bakken’s collection of artifacts and texts have promoted the study of electricity in medicine. The mission has expanded to embrace electricity in American life. The object collection features about 3000 artifacts dating to the 18th century, including electrostatic generators, batteries, various devices for physiological application, and other medical stimulators. The library’s collection of 11,000 books, journals, and manuscripts illuminates “the history of electricity and magnetism with a focus on their roles in the life sciences and medicine,” to quote the Bakken. Among its treasures is a primary source collection of trade ephemera including advertisements, catalogs, pamphlets, postcards, and circulars. “Ephemera” is libraryspeak for literature never intended for permanent use or retention. Last year’s catalogs usually end up in the trash bin. Historians are grateful for all of those people who do not toss out such stuff. My own research involved electro-medical devices during the Civil War, which I will apply to designing a future exhibit on Civil War medicine at the Mütter Museum. More

Guest post by Annie Brogran, Librarian, Historical Medical Library

I feel very fortunate that I have the privilege of getting to dig around the treasure trove that is the Historical Medical Library of The College of Physicians of Philadelphia for a living. The volumes and manuscript material in the library certainly provide an extensive lesson on the history of medicine, from Galen to Gross and beyond. Every so often, though, I come across an item, be it a letter or a note, which highlights an aspect of medicine that is not always apparent in the telling of the great moments of medical breakthroughs or reading through the minutes of a committee meeting. I refer, of course, to the human aspect, where disease and medicine may not be the main focus of a document, but we see how they affect people’s lives. More

Smallpox, HIV, influenza: the names of these pathogens usually induce fear. Smallpox, although it has been eradicated for 30 years, killed millions in its time; HIV, a relative newcomer to the human race that appeared just a few years after smallpox was eradicated, infects 7,400 people each day. Influenza presents its own unique challenges with its tendency toward frequent genetic change, requiring new seasonal flu vaccines each year and sometimes surprising us with unexpected new strains.

Artist Luke Jerram examines these and other pathogens in Infectious Beauty, an exhibit of “glass microbiology” at the Heller Gallery in New York.  In creating these pieces, according to his website, Jerram explores “the tension between the artworks’ beauty, what they represent and their impact on humanity. ”

Jerram consulted with virologists before designing the sculptures, which were then created by professional glassblowers. His motivation stemmed partly from dissatisfaction with the way viruses and bacteria are typically portrayed: in color, even though the electron microscope photos usually used to capture them are black and white. Jerram, who is partially colorblind, considered how artificial coloring of these pathogens affected viewers’ understanding of them. More

In the not-so-distant past, smallpox was a scourge of mankind. It spread wildly through vulnerable populations, killing up to 30% of those it infected; those who survived were left scarred, some seriously disfigured or blind.

Smallpox ravaged the world’s population essentially unchecked for more than 3,000 years, sickening Egyptian pharaohs, British royalty, American presidents, and millions in between. But in the 1970s, the disease was nearing the end of its reign. Thanks to massive vaccination and surveillance efforts, smallpox became the first disease to be eradicated from the world. Today, we celebrate 30 years since the people of the world declared themselves free of its grasp.

The last stand

The final case of naturally occurring smallpox took place in Somalia in October of 1977, in a cook named Ali Maow Maalin. Personnel from the global eradication program immediately began efforts to find every individual Maalin had been in contact with, doing house-by-house searches and vaccinating anyone entering or leaving his town. By December 29, 1977, they completed a national search, and Maalin’s case proved to be the last. He survived. More