Early Public Health Measures
Illustration of inoculation in Turkey, circa 1020. Courtesy of Pictures from History.
Aztec illustration of smallpox, 16th century. Courtesy of Oxford University Press.
Japanese manuscript illustrating smallpox. Courtesy of Wellcome Collection.

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Early Public Health Measures


Smallpox was one of the scourges of humanity until it was eradicated in 1980. Dubbed “the speckled monster” by the British, it had a 30% mortality rate and left survivors with disfiguring smallpox scars. It was recognized as a threat around the world. 

Incident of the Smallpox Epidemic. Courtesy of The Canadian Encyclopedia.
Sanitary precautions against smallpox. Courtesy of the Science Photo Library.

QUARANTINE


Before the introduction of inoculation, quarantine was a common practice. The government took away peoples’ rights to free movement while preventing the spread of the disease. Because of this, quarantine seemed like a punishment in people’s eyes. ​​​​​​​

"… The time
Then held it an inexorable Crime,
To visit a sick friend: Strange Stoure, wherein
Love was a fault, and Charitie a sin'
When Bad did fear infection from the Good,
And men did hate their cruel Neighbour-hood …
A sickness comfortless; when we do fear
To see those friends whom we do love most dear."

- Abraham Holland, criticizing the quarantine policy in "I. D. Salomon's Pest-House", published 1630.

INOCULATION


In 1721, Lady Wortley Mary Montagu introduced inoculation to Europe from Turkey. This practice became popular among the nobility, with nobles inoculating themselves and their children. Likewise, George Washington mandated inoculation among his troops in the Revolutionary War. Unfortunately, inoculation was still dangerous, with a death rate of 2%. Therefore, people worried that this method would cause smallpox to spread and attack its victims with full force. ​​​​​​​

Lady Wortley Mary Montagu, 1830. Courtesy of the National Portrait Gallery.

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Developing smallpox pustule and tools used for inoculation. Courtesy of the National Library of Medicine.

Benjamin Franklin, 1785. Courtesy of the National Library of Medicine.

"In 1736 I lost one of my sons, a fine boy of four years old, by the smallpox taken in the common way. I long regretted bitterly and still regret that I had not given it to him by inoculation. This I mention for the sake of the parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it; my example showing that the regret may be the same either way, and that, therefore, the safer should be chosen."

- Benjamin Franklin, Autobiography, published 1791.

"Finding the smallpox to be spreading much and fearing that no precaution can prevent it from running thro’ the whole of our Army, I have determined that the Troops shall be inoculated. This Expedient may be attended with some inconveniences and some disadvantages, but yet I trust, in its consequences will have the most happy effects. Necessity not only authorizes but seems to require the measure, for should the disorder infect the Army, in the natural way, and rage with its usual Virulence, we should have more to dread from it, than from the sword of the enemy. "

- George Washington, in a letter to Dr. William Shippen Jr. Courtesy of National Archives.

George Washington. Courtesy of The Clark Museum. 

George Washington at Valley Forge, 1911. Courtesy of Library of Congress.

Order requiring inoculation of soldiers by George Washington, 1777. Courtesy of Library of Congress.