follow us at c-span history. american history tv is on social media. >> in 1796, dr. jenner created the world's first vaccine to combat the smallpox virus, a contagious disease that killed early percent of those infected. karen sherry gives the history of the vaccines development and looks at the controversy surrounding its distribution. she is an exhibition's curator

at the virginia museum of history and culture. karen: as we enter the second year of dealing with the global covid 19 pandemic, it seems like kind of a -- an opportune moment to look back at the history of other infectious diseases. um, and i wanted to talk about smallpox because there are many parallels, as you will notice over the course of this talk, between smallpox and the coronavirus and how society has dealt with it. also, smallpox is ultimately a success story because it has been eradicated so in these days where we are struggling to stay vigilant to deal with the hardships, struggles, and deaths

--the gloom's experience during the coronavirus, i hope this history of smallpox gives us hope. today's talk, we will explore the history of smallpox. how humans beat it. let's go ahead and -- go to our first slide. this thing is not advancing. there we go. there we go. all right. as i say, throughout this talk, you will notice some parallels between our current pandemic and -- of covid-19 and smallpox. the story of smallpox, disgorge of the species, is highly contagious and deadly, a viral

disease that had been quaking human for millennia. -- humankind for millennia. mortality rates range between 20 to 60% so one third of people with smallpox died on average. those are high with especially young children. in the 20th century, smallpox killed an estimated 300 million people. it gives you a sense of its scope. if you were lucky enough to survive, you were often left with disfiguring scars, very often also blind. about a third of the people who caught smallpox went blind. as you can see, one of the characteristics --characteristic symptoms of smallpox are as

series of impressionable that dry to scabs to cover the body. particularly around the face and eyes but then down across the rest of the body. it is a really pretty horrific disease. as i said, it is also a major public health victory for the world. it is the only disease -- the only human disease that has been completely eradicated in the fight against smallpox, the fight to eradicate it, and helped establish certain scientific and health protocols that have been applied to fighting other infectious diseases like measles, the flu, coronavirus, and so forth. it it really is very important --story in the larger history of the fight against infectious diseases. let's look at the history of smallpox.

we don't know for sure but we think it has been around since at least 10,000 before the common era -- 10,000 bce. it appeared in ancient egypt. at the top left of the screen, you will see the mummified skull of ramses v, one of the pharaohs of ancient egypt. his mommy shows the scars of smallpox. we think he may have died from that disease. there is also evidence of smallpox in europe, around the year 500. it appears in ancient chinese text from the 14th century, ancient indian text from the seventh century, and from various places, smallpox spread around the world. it it is very much a story of

human movement because smallpox is infectious and passes from person-to-person when people moved around the globe -- person-to-person. when people moved, they took smallpox with them. it when various countries went to war or rent on exploratory expeditions or traveling the globe, they took small, -- smallpox with them. because of that, smallpox was incredibly devastating in the americas in north -- the north and south americas which hadn't experienced smallpox until spanish and portuguese and other european explorers and settlers later came to the americas and brought smallpox with them. because the indigenous inhabitants of the americas had never experienced smallpox before, they had no immunity to it.

smallpox decimated native populations of north and south america. it --because it decimated at least a third of indigenous populations, it laid the groundwork for colonization and settlement of the new world. as smallpox spread around the globe, it continued to afflict populations through the centuries up until 1980 when it was eradicated -- when smallpox was virtually gone appear to essentially gone from the face of the earth. it -- so how was it eradicated?

how did humans slay what was also called the spotted monster? that's what we are going to turn to now. there are two key phases in the fight for smallpox. the first part has to do with very elation. -- variolation, a form of inoculation using the smallpox virus. we don't know for sure when it originated -- who originated it. we think that the chinese were using it perhaps as early as the first century, definitely by the 10th century. variolation was also used -- practiced in asia and the middle east and africa by the 1700s. what people noticed is that if

you survive smallpox, you would never get infected again by smallpox. they started inoculated people by taking samples of smallpox, usually scraping out liquid from a pestual or scraping off a bit of a dried scab and inserting it into the body of the patient you wanted to inoculate. either by cutting into the skin and inserting the smallpox under the skin or inhaling it through the nose. generally, you would take the smallpox sample from someone who had a very mild case of the disease because the patient was -- who was inoculated would develop smallpox and the hope was if you started with a small

mild hazel of the these vaccination would have a similar name -- similarly mild case and you would be immune to smallpox and survive. humans didn't really understand virology or what a virus was, how immunity was built up in the system by reacting to the presence of that virus in the body of developing antibodies and so forth. they didn't understand those until modern medical developments in the 19th and 20th centuries. through observation and practice, they recognized variolation was a way to protect people against smallpox. as i say, asia, the middle east, africa, had been practicing variolation by the 1700s. it wasn't known in europe until

the early 18th century and the woman pictured on the right side of the screen -- lady mary wortley montague was a key figure in transmitting mileage about variolation -- knowledge about their relation to europe. she was a poet and the wife of the british ambassador to the ottoman empire. when her family was stationed in constantinople -- present-day is simple interpret -- turkey -- she learned about the practice of variolation and she had suffered smallpox and survived it but she was terrified of her children touching it. she learned about variolation and in 1718, decided to have her son and are deleted. a couple of years later in 1721, she was back in england and

started telling her influential friends -- doctors, scientists, and even royalty. she helped spread the word about variolation, convinced the royal family to get inoculated, and became a lifelong advocate for the practice of variolation. beginning in the 18th century, the practice of variolation spreads throughout europe and from europe it moves to the british colonies in america. a really interesting piece of the history of variolation involves an enslaved man named onse -- onesimus. we don't know much about him.

this is a generic painting of a black person. it is not a portion of -- portrait of him. he was captured from africa and brought to boston. i 1706, he was enslaved by reverend kotten mather, a puritan minister known for his involvement in the salem witch trials. onesimus had known about variolation from africa. when there was a smallpox epidemic in boston, onesimus told cotton mather about the practice. here we have an instance of technical medical knowledge transported from africa to america throu thegh slave trade.

practices, iron working, technologies and so forth are by slaves. they brought variolation to the americas, too. through the knowledge that cotton mather gained from awesomeness -- onesimus, they were able to combat an outbreak of smallpox in boston in 1721. through the success of that, word spread throughout the colonies and the practice of variolation followed. benjamin franklin was an advocate. several virginia founding fathers were as well, including thomas jefferson. jefferson traveled to philadelphia as a young man in 1766 to get inoculated by variolation. george washington, he was a

smallpox survivor. he had smart -- caught smallpox at 19 oh well he was traveling in barbados. he recognized the strategic value of variolation pretty keen late during the revolutionary war. after the american forces were soundly defeated during an attack on quebec and a reason for their defeat was so many soldiers had been killed or laid out by smallpox. recognizing that problem, george washington declared in 1777 that all soldiers in the continental army should be inoculated by variolation. now variolation was a very

controversial practice, pretty much from the beginning in both europe and america and you see pro-and anti-variolation factions developed. because it involved infecting a healthy patient with smallpox, people opposed to variolation were afraid that patient would die from smallpox. they were also afraid the person infected and inoculated would infect others in the community and lead to a smallpox outbreak. also, the variolation process. because you are transferring biological matter from one person to another, there is a risk can transfer other diseases as well. people did not understand the biology of that but through

their observation, they noticed some diseases were passed along by variolation. syphilis and others. some oppose variolation on religious grounds. they felt any attempt to stop a god-given disease was counter to god's will. there was a lot of controversy sounding -- surrounding the practice. even though its mortality rates were far lower than if you had smallpox without variolation, 2% mortality rate from the smallpox you got through variolation versus 30% mortality rate if you just develop smallpox naturally. the people who supported variolation very much embraced its protective measures that

lead to lower mortality rates. we see, um, the controversy over inoculation corrupt in norfolk virginia -- norfolk, virginia in 1768 and 1769. there were riots. i am not making this up. during this period, there were small epidemics of smallpox in williamsburg and north town -- yorktown. citizens were on edge about the epidemic coming to their town. dr. archibald cambo engaged the services of another doctor to inoculate his family and neighbors. he probably learned about contacts in the medical community. also through our in article that the doctor had published in the burgeon you because that -- v

irginia gazette hyping his services as an experienced inoculate her. dr. campbell hired him to inoculate himself, his family, and a group of their neighbors. other citizens were upset about this because they were afraid the inoculation process would lead to an outbreak of smallpox. the anti-vaxxers --i will use a modern term -- tried to get the local magistrates to stop these plans. the magistrates didn't want to step in. these antibacterials basically -- anti-vaxxers basically fired up a mob that marched to dr. campbell's home, broke windows, set his house on fire, and they did the same to the home of the other doctor.

they also did --forced campbell's family to march off to the pest house -- the quarantine hospital that was set up to deal with smallpox outbreaks. tensions erupted the following year, as well. you have two riots in norfork involving the same group of people in 1968 and 69. the charges were filed by the pro-and anti-inoculation sides. cases were tied up in courts for years. interestingly when he was a young lawyer, thomas jefferson represented the pro-vaccination party in this. these riots also led virginia's general assembly -- the house of burgesses -- to pass a law in 19 -- 1770 that prohibited

inoculation unless you got a special permit from the local magistrate. that effectively stopped the inoculation process in virginia. in 17777, -- 1777, it revise the law to an out -- allow inoculation if the majority of your neighbors within a two mile radius agreed to allow you to inoculate and also, if you maintained proper quarantine. these debates in virginia led to legislating over the status of inoculation and the ability to practice variolation. now, that's kovach to a broader picture -- let's go back to a broader picture. back to virginia and what was going on in norfork to the world stage again from the 1960's.

here we come from part two of how humans eradicated smallpox. this brings us to vaccination. vaccination, unlike variolation, which used a bit of the smallpox virus and inserted that into the body of the patient so that patient would build up immunity to smallpox -- vaccination was a form of inoculation that used the cowpox virus rather than smallpox. the cowpox virus is related to smallpox. they are part of the orthopox virus family. cowpox generally only manifests in cows, as the name suggests, and when humans get it, it is generally not deadly and your

symptoms are much milder than they would be with smallpox. there -- they are two different viruses. vaccinia and smallpox is variola. an english country doctor develop the practice of vaccination using the -- cowpox virus. he is a key figure in this part of stamping out smallpox. he, as a country doctor, noticed that women who worked as dairy maids and milk maids -- they generally didn't get smallpox. that got him to thinking about taking the practice of variolation, but instead of using smallpox, using cowpox. it is a story that involves account, a dairy maid, and a gardeners son.

it sounds like the cast of a baroque farce or something like that. but dr. edward jenner, he collected the cowpox virus from -- excuse me, no. one of his cows, a cow by the name of blossom, that cal transmitted cowpox to a dairy maid named sarah gnome's. dr. jenna -- sarah nelms. he took a sample of the virus from the poxins she developed, transferred the cowpox to his subject -- to his patient, i'd boy -- a boy named james phipps. this happened on may 14, 1796. dr. jenner conducted this experiment with this new process. it he waited --he waited until

james came down with cowpox. he had a mild case of it and fully recovered. in july of 1776, phipps infected james with the actual smallpox virus. james did not come down with smallpox. jenner concluded james was now in munich to smallpox. -- immune to smallpox. james didn't understand the virology but because these viruses, cowpox and smallpox, are related, cowpox provides crossover immunity to smallpox in humans. with further experiments, jenner was able to -- to perfect his practice and publish his findings in a book in 1798 that

started to spread the word about this new practice of vaccination. a quick note about the term vaccination, it comes from vaccinia, the cowpox virus. and that is derived from the latin word for cow, which is vaca, and the way i will be using it today, vaccination, is distinct because vaccination involves immunizing someone with the cowpox virus rather than the smallpox. until the late 18th century, vaccination as a term was used specifically to describe immunization with cowpox, but in the late 19th century, that term became applied more broadly to all kinds of immunization products, but for these purposes

, i will be using it to describe vaccination with the cowpox virus. in his 1798 book, which is titled "an inquiry into the causes and effects of the vari ole vaccine, dr. jenner outlining his progress, and he also expected, the smallpox, eradication of this dreaded disease might be the final thought of this practice. because of his experimentation and codification of this process, dr. jenner is widely recognized today as one of the founding fathers of the field of immunology and his discovery would have a profound impact on the world.

as the practice of vaccination started to spread, it also turned up some of the same controversy that surrounded the very elation, people met this practice of the same skepticism, concerned about introducing infection into a healthy patient and you can see that some artists took the fear of -- or exploited the fear around vaccination for satirical purposes, and this is a satirical cartoon from 1802 that shows dr. jenner standing in the center, inoculating a woman, and his other patient who already received the vaccine are manifesting all kinds of crazy symptoms. they have cow heads and other

parts of cow's bodies, and the bursting out of their limbs, nose, their face, bursting out of their body. this cartoon artist is playing upon people's fears and skepticism of this new practice of vaccination. despite the controversy, many people did support the practice of vaccination and jenner's ideas started to spread beyond england into europe and also to america, and a boston doctor, benjamin waterhouse, professor at -- dr. jenner who originated the vaccine, he passed it on to one of his fellow doctors, dr. hagar's, who then passed it on

to the american dr. benjamin waterhouse. waterhouse brought it back to boston and started to not only practice vaccination, but this read the news about it and to share samples of cowpox with others, including thomas jefferson, these two men knew each other and dr. waterhouse convinced jefferson to try vaccination in virginia. kind of a somewhat unfortunate call back to this is that jefferson agreed to do so and he tested it out on three of his enslaved people. he took of them as the guinea pigs for the vaccination. jefferson ended up vaccinating more than 200 people, including members of his family, his neighbors, and his enslaved

workers. jefferson, who has been a proponent of varialation became just as strong an advocate of vaccination and spread word of the practice throughout virginia and also to others while in washington, d.c. as president. just to give you a sense of jefferson's admiration for dr. jenner, he wrote to dr. jenner saying, yours is the comfortable reflection that mankind can never forget that you live too. future nations will know by history only that the low some smallpox had existed -- loaths ome smallpox has existed and by you has been extra paid -- e

xtirpated. even in the 1806, jefferson recognized what had been wiped out as such is scored on the human race. by the 1840's, vaccination largely replaced variolation, and dr. started carrying the tools for vaccination as a standard part of their medical kit. various community set up vaccination clinics throughout the 19th century. anti-vaccination efforts persisted in 1879, the anti-vaccination society of america was established. running various efforts to try and stop communities from setting up these clinics and mandating vaccination.

there were debates about whether or not vaccination should be compulsory, and such debates went all the way to the supreme court which in 1905, it upheld the constitutionality of mandatory vaccination laws passed by state but the courts said you could do it if it was for public health. despite any opposition, vaccination efforts really started to explode the 20th century. they ramped up in the delivery of the vaccine and that made the whole process much more efficient and here on the slide, you just see a couple of artifacts showing how widespread vaccination was becoming and

here is from the 1930's, chicago department of health, reminding people to get vaccinated. the photograph shows several employees getting the smallpox vaccination, and by the 1940's, virginia and other states required that students have the vaccination before they were allowed to enter school. we see more and more americans getting smallpox vaccination. by 1952, smallpox was eradicated in the united states following the year, and also eradicated in europe on a wide scale with the vaccination efforts, and public health officials also decided to take the campaign global.

the world health organization, it started to be that in the 1950's, but it really committed to these efforts in 1967 into a global eradication. eradication campaign. in 1967, the disease was still present in 31 countries, and it was killing an estimated 2 million people a year. it was still a major global health problem even though it was starting to be eradicated in some parts of the world. the results of that masses campaign -- massive campaign, 1977 saw the last natural case of smallpox. amanda in -- a man in somalia, ali maow maslin, survived but he is the last known case of someone naturally catching

smallpox. in 1980, the world health organization declared smallpox eradicated. smallpox is still the subject of medical interest, even though it has been eradicated, the world cheered, everybody patted themselves on the back, this horrible scourge that had killed tens of millions of people over the course of thousands of years of history, and have been wiped off the face of the planets, it is still a subject of medical interest, particularly in the context of biological warfare and terrorism, their fears that surviving samples of the disease if they get into the wrong hands or they somehow get out of their secure locations, they could be weaponized and turned against the human race or create a new pandemic, because people are no

longer regularly getting smallpox vaccination. so people are not immune to it anymore. by international agreement, their only two stores of the smallpox virus in the world. one is in the u.s., at the cdc in atlanta, and the other in an analogous organization in russia. they are still testing going around -- going on with new vaccines, and just in the event that the worst case scenario happened. i now have a few more minutes before we opened it up to the q&a. a few artifacts in the collections that are related to the history of smallpox. we don't have a lot, but we do have images about the

introduction of the vaccine and the controversy and skepticism it was met with. these are analogous to some of the satirical cartoon i showed you and in the lower right, the french, you see the speckled monster shown as this email with this moss figure covered with this red spots, and we have images related to the fight against smallpox, the treatment of it, and that is for quarantining smallpox patients, and delivery of the vaccine. postcard in the lower right shows a vaccination effort at camp lee in virginia, and soldiers lined up out the door waiting to get their job.

we have -- jab. we have items such as this one with a collection with pages for my photo album with pages from maryland volunteers who have served in the confederate army, and one page has their photos, in the second page gives notes about the fate of the men pictured, these maryland volunteers, and the circled man was john craig lake that cap is noted that he died from smallpox in 1864. both of the armies try to require vaccination, they did not always have the means to deliver on that requirement, so smallpox continue to ravage during the civil war.

the 20th century, we see that we wanted to travel internationally in addition to packing your passport, you needed to take a certificate of vaccination such as this one and the yellow document is the international certificate of vaccination and indicates that in february 1960, he got smallpox vaccination. the letters in which virginians talk about the ways in which they experience smallpox, and that is from a confederate soldier, will -- he was writing from mr. miss sam baker. he was stationed in georgia and he wrote this letter to them and november 1862, in which he talks about the smallpox was scattered through the country like

soldiers. though it may be too late to do any good, for i may have with it somewhere on the road for i met and traveled with a great many six soldiers, ike should be uneasy for six weeks. traveling around with soldiers moving from place to place and he got exposed to smallpox. he was vaccinated but he was not sure he was vaccinated in time. this is a letter that really resonates with some of the current debates we are having about mask mandates, about getting the coronavirus vaccine and so forth. this letter is a draft of a letter to an editor from abingdon virginia.

he wanted newspaper to publish this letter which made him very strenuous terms the argument for vaccinating. dr. preston wrote, this is a loathsome disease and that appeals here to humanity who are often loud and strong and the criminal neglect is appalling. talking about authorities that will not mandate vaccination. are public authority sufficiently aware of their duty and responsibility under the law in these cases and are they sufficiently prompt and energetic and putting into effect the means to prevent needless suffering and death? we think not. he is expressing his frustration and distrust with local authorities. the final object is a letter from william massey, he was

writing from richmond to his father henry massey and charlottesville. -- in charlottesville. it included a little piece of paper on the right side of the screen that was folded up and pinned to the inside of the letter. and when the father opened the letter and open this little enclosure, he would have found this, a smallpox gab, and william wrote to his father saying that he basically was sending his father a scab so his father could inoculate members of the family. william wrote to his father henry. dr. harrison says, the peace i enclose is perfectly fresh and was taken from an infant's arm yesterday, but that you must let him know whether it takes and if it does not, he will send you

another scab. he will continue, dr. harris says the enclosed scab will vaccinate 12 persons, but if you want maury, you must send for. i will pay in this to the letter so that you cannot lose it as you did before. much of the letter, william has expressed frustration with the scab because he sent an earlier sample and his dad lost it. so william is adamantly telling his father, don't lose this one, i am pinning it to the letter so that can't happen. this is a scab that william got from the related virus to smallpox and he was sitting it -- sending it so the scab could be used as a basis for vaccinating his relatives in charlottesville. for those of you who are

longtime visitors to the virginia museum of history and culture, if you saw an exhibition, you would have seen this letter and the sleigh -- on display. i think a scab sent along with a letter could be used for vaccinating against smallpox and certainly classified. the director of the cdc happened to be visiting, and he saw this scab and he was concerned that if the scab was still infectious and if it was a smallpox scab, that it could create a public health emergency. the cdc employee notified and

send a representative down to the vmhc, and i kind of imagine it like the scene from the et, you have the student to goons come sweeping into the museum covering everything with plastic and wearing their protective gear, biohazard -- it was not actually like that. that is just how i imagine it in my mind, but the cdc staff, they came to the museum, they took the scab off of exhibition, they confiscated it which they have the authority to do for an infectious disease like smallpox, and they took it back from the space in atlanta. but they found that it contained

the virus used for vaccination, so it contained the cowpox, not the smallpox virus. nevertheless, they did a radiate -- did eradiate the scab and this is how we got it back, and is plastic tube. it is back in our collection in storage along with the letter, the original letter from william massey, and the hopes that he would protect his own family against smallpox. the ways in which humans are able to stand out and eradicate this deadly, deadly disease. i am happy to take your

questions, please add your questions into either facebook or youtube, and let me turn to -- your questions. it was my understanding that viruses were not known specifically in the 18th century, so use of that word is modern usage. yeah, that is correct. as i mentioned, people from observing news as you can pass diseases like the v bonnet plague and smallpox, they knew that they got transmitted, but they did not understand the medical science behind it. it was not until later in the 19th century with the development of germ theory, and development of the medical equipment that could look at these pathogens on an anatomical

level that they -- did they really understand how virus works, but i was using the modern understanding of virus just for clarity sake here. thank you for the question. another question, how do the dairy made to get the cowpox? milkmaid and people who work closely with cows would often pick up cowpox and the cows themselves. like smallpox, cowpox is an infectious disease, and it can jump from cow to human. cowpox can, smallpox can't, smallpox is limited just to humans. because smallpox and cowpox are related, the cowpox vaccination provided cross immunity for

smallpox. the dairy made that dr. jenner knew in the experiment, she caught it from being in close proximity to cows, milking them and send them out the passing -- pastor and so forth. did massey ever use the scab to inoculate his family? we are not sure, because we have the scab, the suggestion is that maybe he did not use it. but we cannot be sure because it was a larger scab and scraped off part of it and got what he needed to inoculate the other members of his family, we just don't know, we don't have the records that tell us what happened with the matthew family, although, around this, there were not any who died of

smallpox, so perhaps indeed they did use parts of the scab and that enough of it survived to come down to us to be preserved in our collections with this weather. are there different variants of smallpox like there are for covid? if so, where the cowpox vaccinations effective against all the variants? yes. i should have prefaced this entire talk with the caveat that i am not a medical doctor, i do not have that level of medical expertise so if there any doctors in the audience who want to chime in with maybe more specific and precise answers, please do, but i do know there are two variations ofv -- of

variola, variola major and minor, and major leads to much more severe symptoms, high probability of death, whereas variola mminor causes mild forms of smallpox. there are two versions of the smallpox virus in the vaccination based on the cowpox virus is affect of against the of those. there is another question that i am sorry, i just don't have the medical expertise to answer. someone is asking if the vaccine for chickenpox is similar to the smallpox vaccine?

i don't know genetically if smallpox is related to chickenpox. i don't know if chickenpox fits into that or if it's another species of virus entirely. i do know that the general premise of how vaccinations work, that you in fact a healthy patient with a virus that prompts a response from the immune system but then builds up immunity to protect the patient against that virus. i know that that basic concept of this vaccination process has actually been used in the chickenpox vaccine, i just don't know if the two viruses are genetically and biologically related.

i think -- i think that all the questions we have gotten, looking at the history of smallpox and we have found some interesting things not only about the disease of smallpox, and the ways in which it was eradicated, but i hope you also found interesting the many parallels to our current situation, dealing with how do we infectious disease at the time of a global pandemic. i know that the coronavirus vaccines are controversial in the same way that they coronavirus vaccines work, and regardless of your position, and hope you all stay healthy

and well, but hopefully future curators will be able to give a similar talk about stamping out covid-19, let's hope for that. >> american history tv on c-span, every weekend documenting american story. funding comes from these television companies and more. including comcast. >> you think this is just the community center? no, it is way more than that. comcast is partnering with 1000 community centers, so students from low-income families and get the tools they need to be ready for anything. ♪ >> comcast along with these television companies, support american history tv on c-span3 as a public service. >> it has been 50 years since daniel ellsberg. a defense department analyst in 1971, released up papers to the new

york times without permission. it documented the pattern of united states interest in vietnam over the previous three decades. next on history bookshelf from 2002, mr. ellsberg talks about his book "secrets." once the pentagon papers were published, the united states government won a restraining order against the new york times, preventing further publication. the government indicted mr. ellsberg on theft, conspiracy, and we cover this event as a part of this --