Smallpox: inoculation and vaccination

Smallpox pustule gauge, Edinburgh, Scotland, 1870-1930

Smallpox in the Ancient and New World

The smallpox scars on the mummified features of pharaoh Ramses V testify to our long relationship with this disease, a disease unique to humans and one that has killed millions. Spread through contact with living sufferers or the bodies of the dead, it was especially cruel on previously unexposed populations - at least one-third of all Aztecs died after Spanish colonisers brought smallpox to the New World in 1518.

Smallpox and the Elizabethans

Survivors carried the legacies of smallpox for life. Some were left blind; virtually all were disfigured by scars. From the 1500s onwards the disease reached most parts of the world and ravaged pock-marked faces were a familiar sight. Some wealthier survivors used shapedbeauty patches to camouflage the damage or coated their faces with white lead powder. The ghostly pale face of Elizabeth I was as much a sign of her brush with smallpox as it was a fashion statement.

Combating the smallpox epidemic

Although damaged by smallpox, survivors gained an advantage over those left untouched - lifelong immunity. However, as immunity was not inherited, a city decimated by smallpox was ripe for another attack a generation later. The idea of pre-empting such epidemics by inducing immunity was first exploited in China. There a form of inoculation existed as early as the tenth century CE. Immunity was gained by provoking a mild form of the disease in healthy people, for example by blowing powdered smallpox scabs up their noses.

Preventing disease

This local knowledge was