EP 016: The Slave Who Killed the Pox

EP 016: THE SLAVE WHO KILLED THE POX Historycal: Words that Shaped the World

What is the juice of smallpox, and when it is it best served? In this episode, we explore variolation, milkmaids, and how a slave in Boston helped change the world.

We’re going to start with our very first disclaimer, because today’s topic might get as close to ‘topical’ with a capital T as a comedy history podcast can get. So before anyone gets excited, upset, or any other feeling with symptoms that include elevated heartrate and a strong desire to Tweet – we are 100 percent absolutely, definitely NOT going to talk about the COVID vaccine. In about 45 years, if we’re still going, we might circle back, but, to paraphrase Tolkien, Today is not That day.

What we are going to talk about is African medicine, smallpox, and the very early beginnings of vaccine-like technology.

I sincerely hope that nobody in today’s audience has ever suffered with smallpox, but it’s not impossible that some of you may have encountered it in some way. Smallpox was only declared irradiated in 1980, just 42 years ago, well within the lifetime of roughly 36 percent of the world’s population. And thank goodness – and Onesimus – that it isn’t more. Smallpox is, in a nutshell, horrific. Historians aren’t able to say with certainty where it originated – which is unsurprising, because most academics seem to avoid saying pretty much anything with certainty. Its why we make for bad party guests. But the earliest evidence of smallpox seems to date to around the third century BCE, in Egyptian mummies. It’s a virus, which means it’s contagious, and starts off with a fever. Once that’s raging away, you could expect nausea and vomiting, and then – just to make really sure that you weren’t having a good time – ulcers in the mouth and a rash over your body. The rash would turn into very closely spaced blisters, which – if you survived – would scar and, frequently, leave people permanently disfigured. In some cases, you were left blind.

There are two strains, one more serious than the other, but even so – the risk of death after catching smallpox was about 30%. In the last one hundred years that it was around, smallpox may have killed an estimated 500 million people. To put that into perspective, that’s about the entire population of the European Union, before Britain decided to go play alone in the corner. It’s a lot of people.

So with all those numbers floating around, it shouldn’t be a surprise to learn that many places around the world developed ways of trying to solve the problem. And that’s where Onesimus comes in.

Onesimus was a slave in Boston in the early 1700’s. Not much is known about his life prior to this, because he was a slave in Boston in the early 1700’s. In fact, Onesimus wasn’t actually his real name. The records suggest that he was given as a gift to a Puritan minister, by his congregation. The minister’s name was Cotton Mather, who did some interesting scientific work during his lifetime, but is mainly remembered badly for defending the Salem Witch Trials. It was he who gave Onesimus the new name, which is unfortunately the only one still remembered in the history books. Apparently, Mather noticed that Onesimus was a highly intelligent individual, and took him into his household to give him an education in reading and writing in English. Literacy, that this time, was often associated closely with religion, so we can speculate that he probably spent a great deal of time being taught to read the Bible. Much to Mather’s disappointment, he never converted to Christianity. Or frankly, expressed any interest in doing so.

What he did express interest in was medicine. Sometime around 1716, Mather reported in a letter that Onesimus had explained to him the way that his society had been inoculated against small pox. We think that Onesimus was from the Ghana region, but there are reports of similar practices from all over the world, including multiple parts of Africa, Asia, and India. Basically they would take some infected liquid (usually pus) from an infected person, and then rub it into a small cut made in the arm of a healthy person. As Mather described in his letter “People take Juice of Small-Pox; and Cut the Skin, and put in a drop.”

Juice of smallpox is probably not something you want to try in place of your morning coffee – or ever, frankly – but administered like this, it was very effective. The healthy person would develop a mild version of the disease under the supervision of a doctor, and then, usually, make a complete recovery. With the not inconsequential bonus that they were then immune from the disease.

This method of inoculation is called variolation. It wasn’t not without risk – there was, of course, the danger that the patient would get a little too sick, and it wasn’t as sterile as a modern day vaccine. Mind you, not much about the 18th Century was as sterile as a modern day vaccine. There was also the possibility that the inoculated person, while they were ill and recovering, would spread the disease to those who weren’t inoculated, because, of course, they became carriers for a brief time. But generally speaking it was considered relatively safe – and certainly far safer than the 30% chance of kicking the bucket you took if you actually caught smallpox without meaning to.

Exactly how the diaspora of far flung societies came upon this knowledge is, unfortunately, mostly lost. But we can take an educated guess. Edward Jenner, for example, did some very important work on the smallpox vaccine almost a century later. At one point in his research, he noted down that milkmaids were generally considered to be immune to smallpox. What they did get quite often was cowpox, which is a disease that can jump quite easily from species to species. The poor milkmaids would get blisters all over their hands, from coming into contact with the udders of infected cows. If that sounds like a fairly dreadful way to spend a morning – I completely agree. But cowpox is far less serious than smallpox, so painful hands was probably a fair trade off for immunity.

Whilst Jenner seems to have been the first to make the cowpox-smallpox leap (which sounds like a dance move Dad’s might do at Discos), we can imagine that Jenner’s observations of trends within communities is not dissimilar to how communities all over the world figured out the variolation method. Perhaps someone noticed that those caring for the victims never seemed to get as sick, or died less frequently. Perhaps there was a trend amongst siblings in which one child was severely ill, and the others made it through. There are probably thousands of different versions of this tale, and mostly – heartbreakingly – lost to us.

Nevertheless, variolation happened, Onesimus was inoculated, and Onesimus explained the process to Mather. And fortunately for Boston, Mather was open minded enough to let the information in. In 1721, there was an outbreak of smallpox in the city. Mather promoted Onesimus’s method, but – unsurprisingly – he was met with a great deal of resistance. A number of people – including doctors – worried that such a method would cause the disease to spread further and run rampant. Others were worried that the smallpox was sent by God, who, they assumed, would not take the thwarting of his plague in an appropriately jocular fashion. Still others saw it as an attempted uprising by the slaves. This latter group obviously failed to realize that, if inoculation was a hoax, the slaves would still be susceptible and were far less likely to survive the disease, and if it wasn’t, giving up the secret would be a pretty poor battle tactic.

Nevertheless, Mather and Onesimus were widely ridiculed. But one physician, Zabdiel Boylston, listened. He began with two slaves in his own household, and his 6 year old son. His actions were met with such outrage from the rest of the medical community that he was forced to hide in a secret room in his house for two weeks. Later, a hand grenade was thrown through the window of his house, and only the fact that the fuse fell off saved his family from an untimely and fatal splattering. Dr. Bolyston persevered however, and during the course of the outbreak, managed to inoculate around 280 people, using Onesimus’s method. Of these, only 6 died. This was of course, devastating for the 6 (and, one imagines, the doctor) but was a staggeringly lower percentage than those who perished after actually contracting smallpox – 2,2 percent, versus 14,3.

Not much is known about the man who made this all possible, outside of what Mather wrote about him. Onesimus earned a sufficient wage to allow him to keep a small household of his own, and was married with two children. Tragically, they both died before the age of ten. Onesimus was able to purchase his freedom, and many people believe that Mather’s feeling of failure for never having managed to convert him to Christianity contributed in no small way to his agreeing. After that, he fades from the history books.

Onesimus wasn’t recognized for his contributions to medicine until 2016, when he was named among the top 100 Bostonians of all time. And rightly so – As historian Ted Widmer writes “Onesimus reversed many… traditional racial assumptions… [h]e had a lot more knowledge medically than most of the Europeans in Boston at that time.”

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