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Smallpox History

‘‘Tis true the Small-Pox were not known in those early Times…This is certain that London has been much less healthy, of late, than heretofore: and Diseases generally more mortal. These last eight Years there have dyed of the Small-Pox 14928. In the eight Years immediately foregoing, i.e. from the Beginning of the Century, to the Year 1708, inclusive, there dyed but 8386; which is not much more than half the Number; there having dyed 6542 more in the last, than there did in the first eight Years. The Measles have been at a Stand: and pretty near equal. But the Article of Fevers in general, is much inlarged; there dying, in the last eight Years, 4839 more than in the precedent. The Spotted Fever is increased by 757: and the Purples are very near doubled. There being a continual Increase of the Number of the Inhabitants of the Town, by the Access and Settlement of new Families here, the Births, these last eight Years, are indeed increas’d 2503. But the Burials are increas’d 13554. Which, being a Proportion greater than 5 to 1, must needs be allow’d to be a strange and very astonishing Increase of Mortality. To pass over the Venereal Affections, which are more frequent than ever, Vapours, and other Disturbances of the Head, Chagrin, Melancholy, Lassitude, Faintness, that Indisposition lately named a Fever of the Spirits, those called Nervine Affections, Disorders of the Stomach, the Collic, Pains in the Back and Limbs, and many other Ails, and Complaints, are in the Mouths of almost all, Men, Women, and Children; even those that are up, abroad in Business, and the Affairs of the World; which consequently are thereby much impeded, and interrupted: Life rendred a Burden, and oftentimes miserable. Such a Torrent of Death, and of Disasters, cannot but much startle and alarm those, who duely regard and observe these Things. ‘Tis what we are all greatly concerned in: and indeed requires the Interposition, and Care of the Government; the Good, the Happiness, and Security of the Subjects so greatly and generaly requireing and claiming it.’

John Woodward, The state of physick: and of diseases (London, 1718), pp 190-194.

Woodward, The state of physick (London, 1718), titlepage.

Woodward’s (1665/1668–1728) observation that smallpox had not been a major cause of death in earlier centuries is supported by the research of Carmichael and Silverstein (1987) who point to the fact that, though smallpox may have been endemic in European society during the Middle Ages the strain of smallpox in medieval and sixteenth-century Europe was most likely variola minor, a strain which would leave scaring but which had a much lower mortality rate that the far more virulent variola major. As these authors have shown, the Bills of Mortality outlined by John Graunt (1620–1674), and discussed in the Plague section of this website, point to a rise in smallpox epidemics in seventeenth-century England – particularly in the latter half of the century, which ultimately led to the major epidemics of the eighteenth and nineteenth centuries. It is therefore no surprise that Worth’s collection of works on smallpox focused on it as a very real and present danger to European society.

It is striking that all five of the texts collected by Worth were written by contemporaries: Worth’s earliest text on the subject, Woodward’s aforementioned text held views violently opposed to those of John Friend (1675–1728), and Richard Mead (1673–1754), – even leading to a sword-fight with the latter.

Portrait of John Freind: Courtesy of the National Library of Medicine.

Worth owned a copy of Friend’s letter to Mead, written in 1723, a work principally written in response to Woodward’s 1718 text. Another spur for Friend’s letter was Jean Claude Adrien Helvetius’s An essay on the animal oeconomy. Together with observations upon the small pox (London, 1723), which Worth bought in the English translation, rather than the 1722 Parisian edition in French. A work from the same year, Sir Richard Blackmore’s A treatise upon the small-pox (London, 1723) took issue with the innovatory method of smallpox inoculation – a practice which was strongly advocated by Worth’s only Irish publication on the subject, a Dublin pamphlet of 1722, which outlined the new procedure and the social reaction to it in Boston and England.

Certainly by the early 1720s (the publication date of most of Worth’s works), smallpox was endemic in Britain and, as Duncan, et al (1993) have shown, there were epidemics in London every 2-3 years. It was above all a disease of childhood as the rise of mortality in early eighteenth-century Britain demonstrates (Houston, 1996). Cormac Ó Gráda (1979) has demonstrated that smallpox was cited as the cause of about 20% of deaths in Dublin in the period between 1661 and 1745.
Selected Reading

Carmichael, A. G. and Silverstein, A. M. (1987), ‘Smallpox in Europe before the Seventeenth Century: Virulent Killer or Benign Disease?’, Journal of the History of Medicine and Allied Sciences 42, pp 147-68.
Duncan, S. R., Scott, Susan and Duncan, C.T. (1993), ‘The Dynamics of Smallpox Epidemics in Britain, 1550-1800’, Demography 30 no. 3, pp 405-23.
Guerrini, Anita (2004), ‘Freind, John (1675–1728)’, Oxford Dictionary of National Biography (Oxford: Oxford University Press).
Guerrini, Anita (2004), ‘Mead, Richard (1673–1754)’, Oxford Dictionary of National Biography (Oxford: Oxford University Press).
Houston, R.A. (1996) ‘The population history of Britain and Ireland, 1500-1750’ in Michael Anderson (1996), British population history. From the Black Death to the present day (Cambridge: Cambridge University Press).
Levine, J. M. (2004), ‘Woodward, John (1665/1668–1728)’, Oxford Dictionary of National Biography (Oxford: Oxford University Press).
Ó Gráda, Cormac (1979), ‘The population of Ireland, 1700-1900: a survey’, Annales de Démographie Historique 27, pp 281-299.
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