Smallpox

What do you think about when someone mentions Benjamin Franklin? Do you think of the statesman, the inventor, the man with the kite in the thunderstorm, or the first Postmaster General? Among his many activities and accomplishments, Benjamin Franklin also managed to include a little bit of epidemiology when he wrote the introduction to a pamphlet about variolation in 1759. Epidemiology is the study of “that which comes upon the people.” Two forms of epidemiology are descriptive epidemiology and analytical epidemiology. Analytical epidemiology is done through the use of statistics to research diseases and interventions based on the observations done through descriptive epidemiology. Franklin performed descriptive epidemiology in showing the number of cases of smallpox, the number of deaths attributable to smallpox, and similar descriptive numbers of people who received variolation in colonial Boston. More

When we think of vaccine, we think of injections. But when 18th century medical men thought of vaccine, they thought of cows. That’s because “vaccinae” is Latin for “of or pertaining to cows”, and the word entered the modern medical lexicon through the title of the famous 1798 work by Edward Jenner, “An Inquiry into the Causes and Effects of the Variolae Vaccinae, a Disease discovered in some of the Western Counties of England, particularly Gloucestershire, and known by the name of the Cow-Pox.”

Many generations of admiring doctors and historians have noted this title without observing that Jenner was engaged in a bit of sleight of hand. The disease he described was, indeed known as the Cow Pox by those who had bothered to give it a name: the dairymaids and farmers who were most susceptible to it. The disease, as he noted, appears on the nipples of cows, and then is communicated to the dairymaids, and then “through the farm, until most of the cattle and domestics feel its unpleasant consequences”. It was Jenner, perhaps after consultation with his medical mentors, like John Hunter, who gave it the Latin name, starting with Variolae – the Latin medical term for smallpox  -- and adding to it the designation Vaccinae – of or from cows. More

We set ourselves the task yesterday of examining a set of materials in the College’s Historical Medical Library from the Anti-Vaccination Society of America. This organization was active in the late 1800s and early 1900s, along with a collection of other anti-vaccination leagues of somewhat confusing overlap and origin. The materials we have seem to come from the period that the society was active from the Terre Haute, Indiana, home of Frank D. Blue. Blue served as secretary of the society and seems to have been responsible for much of its day-to-day activity, including editing the society’s periodical, Vaccination. The society’s president at the time, L.H. Piehn, was a Nora Springs, Iowa, banker whose daughter was reported to have died from the effects of smallpox vaccination in 1894. Blue corresponded widely with other anti-vaccination societies, including the American Anti-Vaccination League in New York and societies in Pennsylvania, Maryland, Massachusetts, and England. Moreover, he seems to have been involved with a collection of other reform groups active at the time, including anti-vivisectionists (who often objected to the idea that rabies was an infectious disease), temperance advocates, vegetarians, homeopaths, phrenologists, “scientific palmists,” and a society for the prevention of premature burial (that latter was a particular interest of British anti-vaccinator William Tebb). More

We were pleased to see Lisa Rosner, PhD, in the Historical Medical Library here at The College of Physicians of Philadelphia the other day. Rosner, who is professor of history at Stockton College as well as an advisor to History of Vaccines, is the recipient of an NEH grant in the digital humanities to develop a role-playing game about early smallpox vaccination in Scotland. She was in the library finding great materials for the game, and we’re looking forward to playing it and promoting it when it’s completed. Keep an eye on her blog to read about the progress her team is making on the game. You can also follow her on Twitter to enjoy her musings on the history of medicine and her book The Anatomy Murders. The post below is reproduced from her blog with her permission.

Imagine a world in which there are no antibiotics, no routine medical checkups, no blood tests, and no sterile surgery. Imagine a world in which people are surrounded by deadly microbes, with no way to hold them in check. And now imagine that there exists one, and only one, proven vaccine: the vaccine for smallpox. The trouble is, that vaccine is very new and largely untested.

Now imagine that you live in Edinburgh in 1802. A young doctor in the city, Alexander Robertson, is trying to set up a vaccination dispensary, to protect people from the deadly smallpox virus while establish a paying medical practice. More

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