Smallpox: History of the Deadly Disease

This is an original draft by David Mayes. Not meant for citation.

Throughout multiple studies of the past, historians have determined that one type of occurrence has changed societies, and the earth as a whole, more than any of it's other proceedings. These reoccurring problems came in the form of epidemics, pestilences, sicknesses or plagues and devastated people expediently. If it weren’t for certain diseases it would have been possible for Native Americans to withstand attacks from the Europeans and fight back against their foreign conquerors. Without diseases, the Athenian Plague would have never happened and Athens would have continued its dominance over the Mediterranean ocean, instead of falling to other powers. Without diseases the earth would simply be different. It is possible that the earth would be even more overcrowded and that different types of government would be in place in countries around the world.

One of these devastating diseases, that has seemed to consistently make an appearance in textbooks and in epidemiologists’ books, is smallpox. Smallpox is considered a dead disease, meaning it has been cured and considered a low-threat for many civilized countries, at the time this paper was written, but, before a vaccination was created, this disease ravaged numerous civilizations and destroyed countless virgin peoples.[1] Some populations that are thought to have been affected by smallpox, at some time in history, were the Native American Indians, the Southern Asia Indians, the Europeans, the Chinese, and the Africans. Being attributed to so many problems in different areas all across the globe made such a disease extremely frightening, mysterious, and seemingly unpredictable.

SMALLPOX ORIGINS

Many scientists believe that the smallpox virus most likely came from the continent of Africa. The thought is that the disease was most likely found in rodents in approximately 20,000 B.C. This disease then traveled from Africa to Asia, probably with animals or early civilizations, and transformed into the more severe form of smallpox called variola-major around 600 A.D. Another form of the disease is thought to have adapted to conditions in the Americas and certain parts of Africa prior to variola-major, called alastrim minor.

SMALLPOX IN INDIA AND CHINA

There have been numerous historians throughout the centuries that have described diseases terrorizing communities many centuries ago. Many of these historians give descriptions that have provided evidence of the appearance of smallpox epidemics in their countries. In medical writings from ancient China in 1122 B.C., and India, in 1500 B.C., diseases were described that had symptoms and signs of a smallpox outbreak. The best evidence to date remains in the bodies of many mummified Egyptians. These smallpox ridden bodies are the most ancient, credible source of smallpox, dating to approximately the tenth century B.C. With this evidence, it is thought that smallpox traveled from Egypt with its traders to India; then further inland and along the coast to Chinese civilizations.[2] Parallel descriptions of smallpox in India never really surfaced until approximately the seventh century A.D., while there were similar descriptions earlier in China, around the fourth or fifth century A.D. After the disease reached China, it was only a matter of time before it made the short trip to the population living in Japan. Once smallpox reached Japan, 735-737 A.D., the disease destroyed most that came in contact with it. It is believed that smallpox killed nearly one-third of Japans population within the three year span. The disease caused dread amongst the entire Asian population and led people to turn to religion for help and answers. Many deities were designated to the prevention and administering of smallpox to people.[3] In India the goddess Satala Mata is worshiped in many temples by Hindu observers.

SMALLPOX IN EUROPE

It is still somewhat unclear when smallpox actually arrived in Europe, because clear descriptions of Old Testament, New Testament, Greek, and Roman literature provide details that could attribute the plagues to numerous different diseases.[4] William H. McNeill states in his book, Plagues and Peoples, that‘any of the familiar civilized infections could have proved the sort of sudden outbreak of mortality recorded in the Bible.’[5] The more serious of the strands, variola-major, most likely did not reach Europe because of the diseases reliance on heat to stay alive and effective. The Antonine Plague, that hit the Roman Empire swiftly in the late second century A.D., is thought to be an example of a disease that could have been a strand of smallpox, in one of its mutated states. This disease was so terrible that no other disease was considered as strong. McNeill writes:

‘[Prior diseases] paled before the disease that began spreading through the Roman Empire in A.D. 165. It was brought to the Mediterranean initially by troops that had been campaigning in Mesopotamia and dispersed generally throughout the empire in the following years. As usual, it is not possible to identify this “plague” definitely with any modern disease, though smallpox has often been suggested.’[6]

Another theory is that Arabic armies may have carried the first strand of smallpox into Southern Europe during the late seventh century A.D. late that Arab armies first carried smallpox out of Africa to Southwestern Europe during the 7th and 8th centuries AD. Later, during what is now called the Middle Ages, smallpox was only seen sporadically throughout much of Europe. After some time the disease began to gain speed and infect more of the populations. This is thought to be mostly due to the fact that many European communities were secluded and was located distances away from any of the diseased cities. Also, the population in Europe was very low and some families were self-sufficient and had no need to come close to the cities, were goods and diseases were traded with foreigners.[7] This all held true until the populations became more mobile and numerous. By the 16^th century smallpox had taken hold of many kingdoms in Europe and began killing as much as one-third of its infected people, mainly those under the age of fourteen. It was true that the populations did grow to be immune to smallpox on a certain scale and was able to recover but McNeill says:

What mattered even more was the fact that this episode inaugurated a process of continued decay of the population of Mediterranean lands that lasted, despite some local recoveries, for more than half a millennium.[8]

The movement of the disease to Europe is of great importance because as it moved into the ports of Europe, it was moving out of the port to the New World. After the Middle Ages, European exploration really began on a much larger scale than before. Many of these explorers were headed to the Americas in search of wealth, while unknowingly destroying the population of most of the Native American communities.[9]

SMALLPOX IN THE AMERICAS

It tends to be common knowledge amongst most historians that there is very little reputable evidence that shows the presence of smallpox in the Americas before the arrival of European explorers. The area thought to have been devastated by the disease first is the Caribbean island of Hispaniola, in 1507 A.D. The disease eventually spread to the mainland as the Europeans began to move north, south and west to settle in Mexico and look for more valuables further inland approximately twenty years later. The settlers were mostly Spanish people who were previously in Hispaniola. When they moved inland they brought the smallpox virus with them.[10]

Smallpox very quickly spread to the large and prosperous civilizations of the Inca and the Aztecs. Spanish settlers from Hispaniola arriving in Mexico brought smallpox with them. The Spaniards took advantage of the disease ravaged locals and conquered the Amerindian’s quickly dwindling populations. Before being completely wiped out the Aztecs were able to push Cortez and his army back, but once the disease struck the Aztecs fell. A quote from McNeill tells the story best:

‘For four months after the Aztecs had driven Cortez and his men from their city, an epidemic of smallpox broke out among them, and the man who had organized the attack on Cortez was among those who died. Such an epidemic, striking an entirely inexperienced population, was dreadful in itself, and no one knew how to respond or what to do. Since the population lacked an inherited or acquired resistances, something like a quarter to a third of them presumably died from the initial onslaught.’[11]

Once the European settlers decided to colonize the Americas with permanent residents, smallpox was spread along North Americas east coast Indian tribes. When pilgrims came to create their civilization, in search of religious tolerance, they brought the virus with them. The pilgrims landed near Plymouth, Massachusetts in 1633 A.D. The fall of the Native American Indians followed almost immediately. One unforeseen occurrence during this time was the reappearing of the disease amongst Anglos.[12] Many native-born colonists began to catch smallpox just like the Amerindian populations. The Native American Indians were hit harder than many of the other civilizations, as nearly ninety percent of their populations died after contracting the disease. Aboriginal populations in Australia suffered some deaths between 1780 and 1870, but it was nowhere near that of the Native Americans.[13]

By approximately the mid-18th century, the disease of smallpox had become a major epidemic in nearly every place on earth. The only exception to this epidemic was a few smaller islands away from infected areas and the majority of Australia’s people. Europe was not as lucky though. During this same time period, smallpox had become the leading cause of death throughout most of Europe, killing almost 400,000 people per year. In the eighteenth century infants died at alarming rates and many people did not live through their teenage years.

FIGHTING THE DISEASE

Many places began using inoculation to keep their citizens from contracting the disease. Inoculation most likely began in the east, in places like China or the Ottoman Empire. After visiting the Ottoman Empire, the use of inoculation was spread to places like Great Britain and its North American colonies. The down side of the inoculation was that in most societies only the rich and upper class citizens were able to pay for the inoculation. This led to further separation of upper and lower class while creating a stigma that smallpox was a poor person's disease. The process of inoculation was described as such:

Private philanthropists also took the lead in promoting inoculation against smallpox, a disease that was responsible for ten percent of all deaths in Europe at this time. Inoculators used dried scabs of smallpox pustules to induce a mild form of the disease that conferred lifelong protection; the matter was usually rubbed on to abrasions on the skin or on the membranes of the nose. The practice was well established in many areas of Asia, Africa and the Balkans, but in Western Europe it was not generally known until the eighteenth century.[14]

Later on the creation of vaccination became popular and the thoughts on disease went from what Noble David Cook says:

‘The human agony of the first great smallpox epidemic to hit the New World was impossible to ignore, and even Bartolome de las Casa, in his less popular writings, noted it. Even while it was happening, observers reported on the destructive reaping of the aboriginal population.’[15]

to a much more positive outlook in the nineteenth century A.D. While the presence of smallpox was recorded in the United States and South Africa, the disease has remained in check for the most part.

In 1950, the Pan American Health Organization made the first ever attempt to complete destroy smallpox. The attempt was successful in North America but did not meet its goal in countries like Brazil and Argentina. This type of success led to the calling of the World Health Assembly, where Viktor Zhdanov wanted to completely destroy the disease from the face of the earth, not just his own country or just ‘civilized countries.’ The proposal was pondered by the committee of gathered people but after little deliberation and questioning was passed as Resolution WHA11.54 in 1959. This attempt fell way short of its goal and many places among the African and Indian populations continued to suffer dearly.

The World Health Organization decided to strengthen their attempts to rid the world of smallpox in 1967. To achieve such a great feat the World Health Organization decided that the only way to really demolish the disease is to provide $2.4 million annually to the effort. At the beginning of WHOs fight against the disease they faced a few problems. The first large problem was that it did not have adequate reporting of all smallpox breakouts, with many of them going unnoticed and unannounced. According to McNeill ‘The World Health Organization actually succeeded in eliminating smallpox from the face of the earth in [1976]’[16]

The Horn of Africa was the only place that smallpox was still running rampant in the mid-1970s. In places such Somalia and Ethiopia, the vaccination squads had trouble reaching many of the small civilizations because there are very few roads, while those that do exist are in terrible condition. In many other countries, like the Congo areas, civil war created a much harder obstacle to get around. In countless other African areas famine and drought took hold and caused a barrier between the much needed medicine and vaccinations and the people that needed it.^[17]In 1977 though, a system was set up that allowed the World Health Organization to monitor many different areas that were labeled as hot beds for outbreaks.

As mentioned before the elimination of smallpox was verified by numerous countries at a committee of scientists in 1979 and was signed off on in 1980. The committee’s agreement became known as Resolution WHA33.3 which began as such: “Having considered the development and results of the global program on smallpox eradication initiated by WHO in 1958 and intensified since 1967 … Declares solemnly that the world and its peoples have won freedom from smallpox, which was a most devastating disease sweeping in epidemic form through many countries since earliest time, leaving death, blindness and disfigurement in its wake and which only a decade ago was rampant in Africa, Asia and South America.”

CONCLUSION

The fact is that smallpox was one of the most detrimental diseases in history. This disease destroyed the Amerindians and multiple other situations. Such diseases were devastating but if it were not for these types of disasters the world would be a completely different place. Once the inoculation and vaccination treatments were created the disease was nearly eradicated completely. There is still a ways to go, but with some more work the world could be healed from this disease completely.

[1]Noble David Cook,Born to die: Disease and New World conquest, 1492-1650(Cambridge: Press Syndicate of the University of Cambridge, 1998),259.

[2] Mark Harrison, Disease in the Modern World: 1500 to the Present Day (Cambridge: Polity Press, 2004), 51.

[3] Cook, 69.

[4] Harrison, 95.

[5] William H. McNeill, Plagues and Peoples (New York: Anchor Books Editions, 1998), 97.

[6] McNeill, 130.

[7] Harrison, 65.

[8] McNeill, 131.

[9] Harrison, 11.

[10] Cook, 99.

[11] McNeill, 20.

[12] Cook, 233.

[13] Harrison, 123.

[14] Harrison, 54.

[15] Cook, 25.

[16] McNeill, 9-10.

[17] Cook, 258.