| Fled from Boston for safety. | Had neither Smallpox by nature or art. | Had Smallpox either by nature or art. | ||
| 1843 | 174 | 5998 |
Under these heads the entire population of 15,684 was accounted for, with the important exception of the discrimination of the 5998, whose immunity was presupposed, into subjects of induced and spontaneous smallpox. The deaths, 569, were less numerous than in 1721, when 884 died, but the disease was more widely diffused, upwards of one-third of the inhabitants, 5545, being attacked. The epidemic exhausted itself within four months, the record standing thus—
| January, | died, | 1 | June, | died, | 203 |
| February, | ” | 2 | July, | ” | 31 |
| March, | ” | 2 | August, | ” | 5 |
| April, | ” | 119 | September, | ” | 1 |
| May, | ” | 205 | —– | ||
| 569 |
The diffusion of the epidemic was largely due to the extensive variolation that went on, no fewer than 2124 having been inoculated in the panic, and they moving freely about in the assurance of safety, spread the distemper on every side. For every five who had the smallpox, so to say, naturally, two had it artificially, and the one sort was almost as “catching” as the other. It was an instance of a community (excepting the 1843 who fled) rushing into smallpox to escape from smallpox. The deaths of 24 Whites and 6 Blacks from variolation gave rise to much concern, and by some they were spoken of as so many murders. Against this fatality was, however, set the low death rate of the regular sufferers, 539 out of 5545, or less than 1 in 10. The Rev. T. Prince, who communicated an account of the epidemic to the Gentleman’s Magazine for 1753, p. 413, was puzzled to account for the variation from the London standard—
Dr. Jurin computes that there generally die in London in the natural way 2 in 11 or 18 in the 100; but in Boston we see that not more than 1 in 10 died; whilst in the inoculated way the deaths were more numerous than is commonly allowed. What were the natural causes, under their Divine Director, of Smallpox in the natural way being less mortal in Boston than in London, and more mortal in Boston than in London in the inoculated way, may be worthy of our humble inquiries.
The difference was broader than Prince perceived. An outbreak of smallpox in which a third of the population was affected never occurred in London, and a mortality proportionate with that of Boston among a third of the Londoners would have appeared like a recurrence of the Plague. I am in nowise concerned to minimise the ravages of smallpox when conditions are prepared, as of design, for its development; but I do insist on their accurate definition. Boston suffered severely, but was by no means “decimated”—the invariable rhetorical phrase. The deaths were at the rate of 1 in 27, and, as observed, smallpox replaced other forms of fever. The 539 deaths from smallpox were not extra deaths; the excess was less than half that number, and might fairly be attributed to the extraordinary energy displayed in propagating the disease by inoculation.
Spite of such adverse experience, variolation continued to be a common, though intermittent, practice in America, and especially in New England, where the habit of doctoring for the cure of present ailments, and the prevention of anticipated ones, was established and inveterate. In Boston the practice became systematised, and the inoculated were confined for three weeks to an hospital situated on a promontory in the Charles River, where they were treated as veritable centres of infection—a course widely different from that pursued in the epidemic of 1752. Nevertheless, it is not to be supposed that smallpox was ever endemic in New England as it was in London. Dr. Waterhouse writing in 1787 observed—
I do not believe there is at present a single person infected by Smallpox in all the four New England Governments, that is, not one in a million of people.
The disease broke out now and then, and was always traced to some wayfarer, or ship, or parcel of goods—never to bad drainage, or no drainage, or the stenches that pervaded the domestic interiors of last century, whether in America or Europe. In this matter, the exercise of a little imagination is requisite to realise the historic facts: they are disagreeable; but if people will insist on comparing the smallpox of the 18th century with that of the 19th, it may become necessary to be explicit as to certain domestic details concerning which there is a conventional reserve.
It was by Dr. Benjamin Waterhouse, Professor of the Theory and Practice of Physic in the University of Cambridge, Massachusetts, that vaccination was introduced to America. He described the new rite in the Columbian Centinel of 12th March, 1799, as “Something Curious in the Medical Line”; and formally promulgated the novelty a year afterwards in a pamphlet thus entitled—