The natives of New England likewise suf fered great losses by smallpox. Robertson writes: "At the same time, 1631, the smallpox, a distemper fatal to the people of the New World swept such multitudes of the natives that some whole tribes disappeared? In 1752 Boston had a severe epidemic of this dread disease. The population of Boston at that time was 15,684; of this number 5,998 had previously had smallpox. During the epidemic 5,545 persons contracted the disease in the usual manner and 2,124 took it by inoculation. Eigh teen hundred and forty-three people escaped from the town to avoid the danger of infec tion. There were, therefore, left in the city but 174 people who had never had smallpox. The population at the end of the epidemic prac tically consisted of persons who had survived an attack of this fear-inspiring malady.
Smallpox was essentially a disease of chil dren in former times; to such an extent was this true that the disease was called Kinds pockets (childpox or Kindsblattern). Owing to the pronounced contagiousness of the dis ease and the almost universal susceptibility to it, smallpox was largely contracted during child life, as measles is at the present time. But comparatively few adults contract measles at the present day because they are protected by a previous attack in infancy or childhood. The same conditions obtained with relation to small pox in the days before vaccination. The adult population represented mostly the survivors from smallpox in childhood. It was estimated that less than 6 per cent of persons were naturally insusceptible to the disease. Vac cination has totally changed the age period of smallpox. It is now excessively rare for a successfully vaccinated child under five years of age to die of the smallpox; it is even uncom mon for a successfully vaccinated child under 10 years of age to die of the disease, as was adequately proved in the testimony presented before the British Royal Commission on Vac cination. Smallpox, perhaps more than any i other disease, has inspired fear and terror in the popular mind because of its loathsome ap pearance, its extreme contagiousness and its disfiguring consequences. Lord Macaulay, writing of the untimely death from smallpox in 1694 of the young and beautiful Queen Mary of England, gives us a powerful pen picture of the ravages of this pestilence: "That dis ease over which science has since achieved a succession of glorious and beneficent victories, was then the most terrible of all of the min isters of death. The havoc of the plague has
been far more rapid, but the plague has visited our shores only once or twice within living memory; and the smallpox was always present, filling the churchyards with corpses, tormenting with constant fears all whom it had not yet stricken, leaving on those whose lives it spared the hideous traces of its power, turning the babe into a changeling at which the mother shuddered, and making the eyes and cheeks of the betrothed maiden objects of horror to the lover? During certain periods in England, a very large percentage of the people were pock marked. Ben Jonson, the Elizabethan dramatist, wrote: Envious and fouls diaease,could there not be. One beautie in an age and frw from thee.
Not only did the disease destroy life, dis figure and maim, but it was at one time the most common cause of blindness. The early records of the London Asylum for the In digent Blind showed that two-thirds of the inmates had lost their sight as a result of smallpox.
Smallpox was a great scourge before the introduction of vaccination. In London during the 18th century it caused one-twelfth of all deaths. Everyone felt that he had to pass through an attack of smallpox at some period of his life. One of Horace Walpole's corre spondents cWampole's 'Letters)) wrote: °Poetry is as universally contagious as smallpox: Everyone catches it once in a life time at least, and the sooner the better.° The Germans had a proverb which expressed the same thought : •From love and smallpox but few remain free.° Most children in London contracted smallpox before the age of seven.
Symptoms.—The patient during the early stages of a classic attack of smallpox suffers from a pronounced chill, followed by sudden fever and severe backache; nausea and vomit ing occur with great frequency, and the latter may persist for several days. Dizziness and general aches and pains are common. In severe cases, there is great weakness and prostration. During this stage, while the symptoms may be most suggestive of smallpox, no positive diagnosis can be made, as the °grip° and cer tain other infections may imitate the early symptoms of smallpox. Not until the eruption appears can one be absolutely sure of the nature of the disease. Many persons are commonly exposed to smallpox before the diagnosis can be definitely established.