Outbreak! Plagues That Changed History Read Online Free PDF Page A

smallpox—bleeding, enemas, purgatives, and prayer. They also used quarantine to some effect. But Asia and Africa already had a preventative that worked. For centuries, the Chinese had been using inoculation: deliberate infection with smallpox to create a mild form of the illness. In the Chinese procedure, smallpox scabs were ground into powder and blown up a person’s nose. Indians, Africans, and Turks used another variant: injecting scab power or smallpox pus directly into a wound in the skin. Either way, the patient would get sick, recover, and be immune for life. Inoculation had disadvantages: once inoculated, a person was fully infectious and could get others sick. Worse, one in fifty would die—not great odds, but better than those of an actual epidemic.

     
    Variolization was practiced for centuries in the Far East, the Middle East, and Africa before the Europeans adopted the technique to immunize people against smallpox. In the Chinese version, dried smallpox scabs were blown up a patient’s nose, causing a mild case of the illness. People so treated had a one-in-fifty chance of dying. Survivors were immune for life.
     

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    Inoculation was also called variolization, from
variola,
the official European term for smallpox.
Variola
was derived from the Latin
varius
(“spotted”) or
varus
(“pimple”). It came to be called “the small pox” to distinguish the disease from the symptoms of “the great pox,” a very different illness that appeared in Europe soon after Columbus returned from the New World. We call that disease syphilis.

     
    The variola virus
     
    Effective European efforts to prevent smallpox started in 1717 when Lady Mary Wortley Montagu, a smallpox survivor, learned about inoculation in Turkey. She called the procedure ingrafting. Later, it came to be called variolization. In 1718, Montagu hadher son inoculated. In 1721, she returned to England and had her daughter inoculated. They survived and were proved immune. But British leaders resisted. Male doctors scoffed at a woman’s medical suggestion. Religious officials worried that without disease as a whip, people wouldn’t fear God. It took successful experimentation on prisoners and orphans and acceptance by Montagu’s friends in the British royal family to popularize inoculation. Meanwhile, on the other side of the Atlantic, Reverend Cotton Mather learned about the African version of the procedure from his slave Onesimus. Mather introduced variolization to Boston. By the Revolutionary War, George Washington would inoculate the entire Continental army.
    The epochal year in smallpox prevention, however, was 1796, when British doctor Edward Jenner proved that inoculation with the harmless
vaccina
(cowpox) virus prevented infection with smallpox. He called this procedure vaccination. His discovery was published in a pamphlet that was translated into German, French, Spanish, Dutch, Italian, and Latin. Vaccination quickly spread around the world, but it took nearly two more centuries to wipe out the disease. By 1977, a heroic decades-long campaign of global vaccination by the World Health Organization finally broke the last link in the smallpox infection chain. Smallpox was eradicated from the wild. The virus still exists, though it is confined to a freezer. Two, actually: one in the United States, the other in Russia.

 

Too good to be true
    Survivors of certain infectious diseases are invulnerable to repeat epidemics. This immunity gives them the ultimate advantage. When the illness returns, they will remain healthy while others sicken and die. This difference between the immune and susceptible has sometimes had historically significant consequences. In the case of yellow fever, the significance was truly awesome: it helped bring an end to New World slavery.
    In the sixteenth century, Europe had conquered the Aztecs, the Incas, and the indigenous people of the Caribbean and much of Amazonia and eastern North America.