“Cotton Mather, you dog, dam you! I’l inoculate you with this; with a pox to you”: smallpox inoculation, Boston, 1721
- Department of Epidemiology and Biostatistics, Case School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Correspondence to: Professor D Neuhauser Department of Epidemiology and Biostatistics, Case School of Medicine, Case Western Reserve University, Cleveland, OH 44106-4945, USA;
The semi-literate quotation in the title comes from a note attached to a bomb thrown into Cotton Mather’s house in Boston, Massachusetts on 14 November 1721 because of Mather’s public advocacy of the most important healthcare improvement of the colonial American era—smallpox inoculation.1
Smallpox has a long history, with descriptions as early as 1350 BC in Egypt. Epidemiologists believe it originated in north eastern Africa about 10 000 BC. The mummy of Pharaoh Rameses V of Egypt who died about 1160 BC had lesions on his face that were thought to be caused by smallpox. Europeans brought “small pox” to the New World and received, in turn, “the great pox”, or syphilis. Other names for smallpox are “red death” and the “speckled monster”.2–4
The disease arrived in the western hemisphere in 1507 on the Caribbean island of Hispañola and went on to devastate the natives, making European conquest of the Americas possible. Later, there are reports of colonists giving North American Indians smallpox infected cloth in an early form of bioterrorism.5 New England had periodic epidemics in the 1600s and again in 1702. Those who survived were then immune and for 19 years there were no more smallpox epidemics in Boston.
On 22 April 1721 the HMS Seahorse, a British ship arriving from Barbados, docked in Boston harbor. Within a day of passing the customary inspection a crew member exhibited symptoms of smallpox. He was quarantined in a house near the harbor and a red flag was put up in front of the house that read “God have mercy on this house”.6–8 …