"Just and True"

"But see, think, judge; do as the Lord our healer Shall direct you."

            Bright red flags went up over more and more front doors of Boston homes in 1721. Some had the words "God have mercy on this house" emblazoned on them. Smallpox had returned. The flags meant: "Quarantine. Do Not Enter."

            The plague had struck this thriving city of more than 10,000 colonists years earlier. Remembering its horrors, more than 1,000 people fled to the countryside. "This grievous Calamity of the Small-Pox has now entered the Town," wrote the prominent minister Cotton Mather (shown below). He called the disease "the destroying Angel." Smallpox typically killed half of all the children and old people who contracted it and about 15 percent of all other sufferers.

            Mather had a rare knowledge of smallpox. Five years earlier when a journal published one of his essays, he chanced up an article in the same issue describing the strange Turkish practice of "Inoculation" against the disease. The report said that when liquid from the pox (or material from their resulting scabs) was placed under the skin of those who had not had the disease, a great number of the resulting cases were less severe than if the disease had been contracted naturally.

“be WARILY proceeded in”

            Mather had evidence of this in his own home. Years before he had bought a slave and named him Onesimus which means "Beneficial." How fitting it was, for Onesimus told Mather that he had been inoculated and showed him the procedure's scar.

            He did further research and learned that this strange ritual was performed among the "heathens" and "'primitives" not only in Africa but also in Asia and Russia. Mather then wrote a leading Boston physician. "How many Lives might be saved by it, if it were practiced?" he asked and recommended that it "be WARILY proceeded in."

            When the letter was forwarded to other doctors, none showed an interest—except the surgeon Zabdiel Boylston. Perhaps the others were wary of being associated with Mather. He had been a leading figure in the Salem Witch Trials, and his efforts had led to 20 executions.

            Boylston was controversial, too. He had recently performed the first mastectomy in America, cutting off a woman's cancerous breast. Other doctors were appalling, saying that it was impossible to cure the disease that way. He had also removed bladder stones from children, a practice associated with quacks.

            He clearly didn't care what others thought. He charged more than other physicians and had no qualms about suing patients who failed to pay. He also had the weird habit of changing his clothes and bathing after visiting patients. Perhaps worse, he had not studied at Harvard.

“Ravings and Deliriums”

            Boylston knew first-hand what smallpox could do. He was a smallpox survivor. His case had been horrendous and had left him with a ravaged pockmarked face.

            Here is how he described the symptoms of smallpox in the worst cases: "Purple spots, the bloody and parchment Pox, Hemorahages of Blood at the Mouth, Nose, Fundament, and Privities; Ravings and Deliriums; Convulsions, and other Fits; violent inflammations and Swellings in the Eyes and Throat; so that they cannot see, or scarcely breathe, or swallow anything, to keep them from starving. Some looking as black as the Stock, others as white as a Sheet; in some, the Pock runs into Blisters, and the Skin stripping off, leaves the Flesh raw….Some have been fill'd with loathsome Ulcers; others have had deep, and fistulous Ulcers in their Bodies, or in their Limbs or Joints, with Rottenness of the Ligaments and Bones: Some who live are Cripples, others Idiots, and many blind all their Days."

            He had another reason for wanting to pursue inoculation. None of his six children had had the disease. He decided to perform the procedure on his adult slave Jack, the slave's son, and Thomas, his six-year-old son. He could not expect Bostonians to submit to the procedure unless at least one of his family members had undergone it. As for his slaves—they were, in the thinking of the day, his valuable property, and he did not want to lose them.

            Mather implored Boylston to proceed, writing him, "See, think, judge; do as the Lord our healer Shall direct you."

            Thomas and the other child developed fevers and twitchings lasting more than a week before the children regained full health, while Jack barely became ill.

            When Bostonians learned what Boylston had done, "the immediate reaction was shock," one historian wrote. He published a statement saying he was on solid medical ground because the accounts from far-away lands were "just and true" and his three patients had survived without lasting ill effects.

“Infusing…Malignant Filth”

            Boston's leading citizens convened a hearing. Boylston suffered through its verbal abuse. Its report declared that he was "infusing…malignant Filth" in patients and that what he was doing was well known to have "prov'd the Death of many Persons." Two days later Boylston was inoculating others.

            Someone hurled a firebomb into his home, according to one account. It failed to explode. Another person wanted to embarrass Boylston by secretly spreading tar on his saddle. The dirty deed failed when the vandal accidentally put the tar on another man's saddle and "spoil'd his Breeches."

            Over time, Boylston inoculated 280 people. Only six died or 2.4 percent, far lower than the usual fatality rate. Acclaim followed. Boylston wrote the book "An Historical Account of the Small-Pox Inoculated in New England." He offered a 15-step guide to performing inoculations, described each of his cases, and made conclusions based on a statistical analysis (at a time when the word 'statistics' did not exist). He even proposed that tiny, unseen creatures caused the disease by entering its victims via skin contact, respiration, or through contaminated food or water.

            Sometimes it's courageous to get under people's skin, but it helps if you are a medical professional.

MORAL: Your mother was right—
Wash your hands.

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