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Monday, October 21, 2019

Smallpox, pioneer scourge

Smallpox. Among the many hardships that the early Washington County pioneers endured was illness, often severe and sometimes fatal. There was bilious fever, scarlet fever, malaria, yellow fever, cholera, and .....smallpox. I read about smallpox often in stories of early settlers. It was only when I saw this photo that the devastation of the disease sank in. 

Young girl in Bangladesh with smallpox, from Wikipedia.

Smallpox has been around for centuries. The first evidence of the disease was from Egyptian mummies dating from the third century BCE. Smallpox occurred in outbreaks all over the world. An estimated 200 million died in the twentieth century alone; many survivors suffered blindness and severe scarring.

Your author was surprised to learn that immunization techniques for smallpox were developed several centuries ago, likely in Asia. Tissue from smallpox sufferers was rubbed or inserted into a scratch in the skin of the person to be immunized. That person would contract smallpox, usually in a less severe form, and thereafter would be immune. This treatment, referred to as variolization, was imported into Europe around 1720. It was a crude and not always successful form of immunization which preceded more modern vaccination techniques. It was widely used in the 1700’s, including at Marietta. 

Yet smallpox remained a scourge which impacted pioneer settlers. Many contracted the disease. Dozens died. Survivors could be blind or disfigured by scars. Courageous doctors and caregivers risked their lives to treat those infected.

Reverend Manasseh Cutler treated smallpox patients in his native Massachusetts. There was an outbreak of the disease in 1772 at Marblehead, MA. Patients were to be admitted to a hospital at Cat Island where Cutler visited. Local residents panicked fearing that the influx of infected patients would spread the disease. They burned down the hospital. The specter of smallpox appeared again in early 1779. Cutler by then had become a physician after training during the previous year. He inoculated and treated 40 or more patients during that period.

The original work party headed to Marietta in 1788 was slowed by smallpox. A group under Major White struggled west from Massachusetts over rough Pennsylvania terrain. In February 1788 they arrived at Simrill’s Ferry on the Youghiogheny River to build boats for the trip down the Ohio River to Marietta. The boat building was delayed by, among other things, smallpox which afflicted five of the party.

The initial outbreak of smallpox at Marietta began in January, 1790. A boat bound for Kentucky stopped at Marietta with a sick passenger, a Mr. Welch, and his family. He was taken to the home of James and Mary Gardner Owen. His disease was the dreaded smallpox. Residents met and decided to build a “pest house” (a building for quarantine and treatment of contagious disease patients, including smallpox) near where Marietta College is now. Mr. Welch was moved there but died a few days later. Mrs. Owen became ill with the disease but later recovered. 

London Pest House image, from Wikipedia. Pest houses originated for epidemics in Europe, such as bubonic plague. Some buildings were quite large. Burial grounds (the “plague pit” in this image caption) were often near the pest house, away from public areas.


Residents were concerned about contagion because of living in close quarters at Campus Martius. There was a town meeting at the northwest blockhouse at Campus Martius. They decided to build more pest houses and to have everyone “inoculated” (using the variolization technique described above). Several of these houses were built “on the plain,” probably in area where Fifth Street and Marietta College are now. One house held 23 patients; another occupied by Colonel Stacy and his family had 20 people. Of the hundred plus people inoculated, only two died. Six people died who became sick by contagion. Doctors Jabez True and Thomas Farley cared for the sick.

Apparently some pest houses were quite small and the quarters cramped. Master builder Joseph Barker stayed in one for a while. He and his wife Elizabeth Dana Barker moved to Marietta in 1789. When the January 1790 smallpox outbreak occurred, Mrs. Barker moved to Belpre to live with her parents until the danger passed. Joseph Barker remained in Marietta and was inoculated with smallpox and moved into a pest house. He rather cheerily described it in a letter to his wife: “I am living in a little clean log cabin that is six feet wide, seven feet long and four and a half high.” He could sit up but not stand up. “We lodge very well.” He survived the sickness and was reunited with his wife and infant son Joseph Jr. a few weeks later.

Mary Bird Lake provided invaluable assistance in this smallpox outbreak. She was a native of England who married Archibald Lake and emigrated to the colonies. She served as a matron of two hospitals caring for wounded and sick Revolutionary War soldiers, including those with smallpox. She received personal thanks from George Washington for her work. Washington commented in 1777 that smallpox was a potentially greater threat than “the sword....of the enemy.”

The Lakes moved to Marietta in 1789 with their eight children. Williams’ History of Washington County Ohio (hereafter, “William History”): "The spring after their arrival the small pox broke out, and during the terrible pestilence Mrs. Lake served a crucial role as nurse." She was familiar with the inoculation technique and guided the physicians who had no experience with smallpox treatment. 

1793 brought an extensive smallpox outbreak in Washington County. In August, scarlet fever and then smallpox appeared in Marietta at Picketed Point, spread from militia soldiers in Colonel Haskell’s command. The Court of Quarter Sessions met on August 7 and ordered removal of the infected persons to Mixer’s spring. The Court met again August 9 and ordered the sick relocated to Devol’s Island, presumably a more isolated location, on the Muskingum River.

Smallpox broke out in September 1793 at the beleaguered Belpre community, which had endured famine, Indian threats, and scarlet fever in recent times. A scout named Benjamin Patterson brought the disease; he had been inoculated in Marietta. The Belpre community initiated “heroic measures,” knowing of the contagion risk of living in close quarters. They sent for Dr. Jabez True from Marietta to inoculate the entire community at Farmer’s Castle (the fortified enclosure at Belpre), which became “one great hospital.” Dr. Samuel Barnes also cared for smallpox patients at Belpre. 

The immunization effort protected the community from devastation. About a hundred were inoculated. Most survived the resulting mild form of smallpox. Five people died, though, testimony to the imperfect inoculation method. 

The family of Simon Deming moved to Rainbow on a donation tract in 1796. They erected a cabin there and cleared an area for farming. Williams’ History has a curious commentary: “During the following season an epidemic of smallpox spread across the county, and the young men of the neighborhood made the Deming cabin a pest house.” Several families of the Deming clan were “confined within this one cabin, where they were waited on by a physician from Virginia.” Who were the “young men”? Were they providing a needed community service or enforcing a quarantine vigilante style? And were the Demings forced to stay in this cabin?

Early physicians were often called on to minister to smallpox patients, in addition to other illnesses. Dr. Jabez True “was many times exposed to the attacks of the Indians, as he passed up and down the Ohio (River) in his visits to Belpre and still lower on the river, to minister to the sick...., numerous trips were made in a canoe, accompanied, generally, by two men.” 

Settlers in Washington County endured much the first few years. Williams’ History captured the essence of what they suffered: ...the terrible scourge had been prevented from doing its worst. Though sorely tried, (they) were destined to neither succumb to the Indian, to famine, to fever, nor to pestilence.”

In 1796 English surgeon Edward Jenner developed an improved vaccine using cowpox virus. Persons vaccinated could be immunized from smallpox without being sickened by it. Jenner had noticed during his surgeon apprenticeship that milk maids and dairy farmers who had suffered from the less virulent cowpox were immune from smallpox. Dr. Jenner devised a vaccine and inoculated an eight year old boy who proved immune from smallpox. Jenner presented his findings; years of suspicion and controversy followed. Finally, in 1800, his method was widely adopted.


Dr Edward Jenner performing his first vaccination on James Phipps, a boy of age 8. 14 May 1796. Painting by Ernest Board (early 20th century). He noticed that milk maids who had been sick with cowpox were immune from smallpox and developed a vaccination
 process using cowpox.


Millions of people were saved from smallpox, yet millions of the unvaccinated died into the twentieth century. With improved vaccine and wider distribution, smallpox was finally eliminated as a health hazard. The last reported case was in 1977.





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