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The Life and Death of Smallpox

This is an engaging and fascinating story of a conditional human success story. Smallpox has been one of the most devastating scourges of humanity throughout recorded history, and it is the only human illness to have been eradicated, though may soon follow it to official extinction through human agency. However, while smallpox is officially extinct in nature, our fears that stocks of smallpox may return as a weapon of bioterrorists have led to the stockpiling of , and continuing vigilance, even though the official victory over smallpox is now 15 years old. The Life and Death of Smallpox presents the entire engaging history of our struggle and ultimate (?) victory over one of our oldest and worst enemies. The story of the campaign to track down and eradicate the virus, throughout the world – the difficulties, setbacks, and the challenges successfully met – is a highlight of a fascinating book, but we cannot be confident of the ending. The final chapter of the book clearly and authoritatively explains the current status of the threat from the deliberate release of smallpox or other potential agents of biological terrorism.

Ian Glynn is Professor Emeritus of Physiology at Cambridge University and Fellow of Trinity College. He is the author of An Anatomy of Thought (1999). Jenifer Glynn is a Cambridge historian and author of Tidings From Zion (2000).

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The Life and Death of Smallpox

IAN AND JENIFER GLYNN

© Cambridge University Press www.cambridge.org Cambridge University Press 0521845424 - The Life and Death of Smallpox Ian and Jenifer Glynn Frontmatter More information

PUBLISHED BY CAMBRIDGE UNIVERSITY PRESS 40 We s t 20th Street, New York, NY 10011-4211, USA http://www.cambridge.org

c Ian and Jenifer Glynn 2004

This book is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press.

First published in the United States of America and Mexico by Cambridge University Press 2004, under license from Profile Books

Printed in the United States of America

Typeset in Poliphilus

A catalogue record for this book is available from the British Library

ISBN 0 521 84542 4 hardback

© Cambridge University Press www.cambridge.org Cambridge University Press 0521845424 - The Life and Death of Smallpox Ian and Jenifer Glynn Frontmatter More information

Contents

List of Illustrations vi Acknowledgements ix

1 ‘The most terrible of all the ministers of death’ 1 2 From myths to mummies 6 3 Coming into focus: AD 0 to 1500 14 4 Smallpox in the age of discoveries: 1500–1700 30 5 News from the East 43 6 Kicking against the pricks 55 7 The heyday of inoculation 75 8 From cuckoos to cowpox 95 9 The world-wide spread 115 10 Confusion and compulsion 130 11 A hundred years on 143 12 ‘Bring hither the fatted calf’ 165 13 Sorting out the 177 14 Eradication: the beginning of the end 190 15 ‘Annihilation of the smallpox’ 200 16 ‘And out of good still to find means of evil’ 228

Notes 246 Index 269

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List of illustrations

1. A child with smallpox; the ‘recognition card’ used in the eradication campaign. Reproduced by permission of the WHO, Geneva 3 2. Sitala, Hindu goddess of smallpox. Reproduced by permission of the WHO, Geneva 8 3. Mummified pockmarked head of Ramses V. From Grafton Elliot Smith, The Royal Mummies, 1912 12 4. St Nicaise, the patron saint of smallpox, and his sister, on the north portico of Rheims cathedral. Photograph by Alain Tricot. Reproduced by permission of Rheims Cathedral 16 5. A Yoruba smallpox god from Nigeria. Reproduced by permission of the WHO, Geneva 32 6. Boys with smallpox in Mexico, 1538. Detail from Codex telleriano-remensis; reproduced by permission of the Bibliothèque Nationale, Paris 32 7. Stuart family tree (simplified); all those in italic type died of smallpox 39 8. Lady Mary Wortley Montague. Engraving from a miniature by Zincke 44 9. Artist’s impression of inoculation by insufflation in China 50 10. Bust of Hans Sloane, by Rysbrack. Reproduced by permission of the British Library 57 11. Portrait of Cotton Mather. (This is one of several similar versions based on a portrait by Peter Pelham) 57

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List of illustrations

12. The Sea-Horse arriving in Boston, 1721. Reproduced by permission of the WHO, Geneva 61 13. The Smallpox Hospital, King’s Cross, 1806. From the biography of Lettsom by James Johnston Abraham, 1933 72 14. John Coakley Lettsom, 1792, by T. Holloway. From the biography of Lettsom by James Johnston Abraham, 1933 80 15. Chinese illustration of smallpox. From The golden mirror of the medical tradition, 1743 85 16. John Haygarth, by J. H. Bell. From the biography of Lettsom by James Johnston Abraham, 1933 94 17. Edward Jenner. Mezzotint by W. Say, 1804, after portrait by Northcote; reproduced by pemission of the Edward Jenner Museum, Berkeley, Gloucestershire 96 18. Cowpox on the hand of Sarah Nelmes, used by Jenner to vaccinate James Phipps. From Jenner’s ‘Inquiry’, 1798; reproduced by permission of the Edward Jenner Museum 103 19. James Gillray cartoon, 1802. Reproduced by permission of the Edward Jenner Museum 110 20. Smallpox epidemic in Cape Town. Reproduced by permission of the Wellcome Library, London 124 21. Benjamin Waterhouse. From the biography of Lettsom by James Johnston Abraham, 1933 126 22. on board ship, for the Ashanti expedition, 1873. Reproduced by permission of the Wellcome Library, London 146 23. Russian lithograph, from the 1920s. Reproduced by permission of the Wellcome Library, London 149 24. Anti-vaccination campaign poster, 1896. Reproduced by permission of the Edward Jenner Museum 154 25. Resistance to vaccination in Montreal. From Harper’s Weekly, 28 November 1885 155 26. Smallpox hospital ships on the Thames estuary, late nineteenth century. Reproduced by permission of the London Metropolitan Archives 163

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The Life and Death of Smallpox

27. 'Triumph of De-Jenner-ation', Punch cartoon 30 July 1898 164 28. ‘Paris: la vaccination dans la rue’. From L’Illustration, September 1893 171 29. Camelpox, reproduced by permission of the WHO, Geneva 185 30. Maps showing countries where smallpox was endemic in 1900, 1959 and 1967. Reproduced by permission of the WHO, Geneva 191 31. Poster used in the eradication campaign in India. Reproduced by permission of the WHO, Geneva 198 32. Map of India showing the individual states and the Ganges plain. Reproduced by permission of the WHO, Geneva 210 33. Map of India showing the spread of smallpox from Jamshedpur in 1974. Reproduced by permission of the WHO, Geneva 215 34. Rahima Banu, the last case of naturally occurring variola major in the world. Reproduced by permission of the WHO, Geneva 219 35. , the last case of naturally occurring smallpox in the world. Reproduced by permission of the WHO, Geneva 226 36. The official parchment certifying the global eradication of smallpox, 9th December 1979. Reproduced by permission of the WHO, Geneva. 229

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Acknowledgements

riting the biography of a subject whose known life extended Wthrough three millenia and embraced five continents is a wide-ranging task, and we want to thank the many people whose help has made that task a pleasure. Graeme Mitchison, Douglas and Clare Fearon, Judith Glynn, Alan Glynn, Colin Franklin and Eckard Wimmer have read and criticised the entire text. Geoffrey Smith and Ian Ramshaw have given valuable advice on , Peter Lachmann on immunology, John Twigg on history. Seemingly endless questions have been answered by colleagues at Cambridge – Arnold Browne, Roger Dawe, John Easterling, Eric Handley, Simon Keynes, Sachiko Kusakawa, John Lonsdale, William St Clair, Peter Sarris. For errors that have survived this flood of advice, we accept responsibility. The World Health Organization’s massive 1988 publication Smallpox and its Eradication (by , Donald A. Henderson, , Zdenek Jezek, and Ivan D. Ladnyi) has been a mine of information, and we are very grateful to the Organization for generous permission to reproduce many illustrations. Laura Cordy has been a wonderful help in preparing these and other illustrations for publica- tion. We would particularly like to thank the director of the Jenner Museum in Berkeley, Gloucestershire, and the librarians of the Uni- versity Library, the Geography Library, the Medical Library, the Needham Institute, and Trinity College Library, in Cambridge, and of the Royal Society of Medicine in London.

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The Life and Death of Smallpox

Finally we want to thank our agent Felicity Bryan, our editor Penny Daniel, and our publisher Andrew Franklin, for encouragement, advice and understanding during the successive stages of the book’s production. Ian and Jenifer Glynn Cambridge

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