From the Dissection Room: Smallpox

The lesions from these two specimens are from an early stage of smallpox in 1776. The disease is likely to have been contracted in utero. From the Hunterian Collection, Royal College of Surgeons, London.

DEFINITION: Smallpox is an acute contagious disease caused by variola virus, a member of the orthopoxvirus family. Smallpox, which is believed to have originated over 3,000 years ago in India or Egypt, is one of the most devastating diseases known to humanity.

For centuries, repeated epidemics swept across continents, decimating populations and changing the course of history. In some ancient cultures, smallpox was such a major killer of infants that custom forbade the naming of a newborn until the infant had caught the disease and proved it would survive…

Smallpox had two main forms: variola major and variola minor. The two forms showed similar lesions. The disease followed a milder course in variola minor, which had a case-fatality rate of less than 1 per cent. The fatality rate of variola major was around 30%. There are two rare forms of smallpox: haemorrhagic and malignant. In the former, invariably fatal, the rash was accompanied by haemorrhage into the mucous membranes and the skin. Malignant smallpox was characterized by lesions that did not develop to the pustular stage but remained soft and flat. It was almost invariably fatal. [World Health Organization]

Face of child who died from smallpox, 18th century [not related to infant specimens above]

DESCRIPTION: ‘December 30, 1776, I was sent for to Mrs. FORD, a healthy woman, about twenty-two years of age, who was pregnant with her first child. She had come out of the country about three months before. Soon after her arrival in town she was seized with the small pox, and had been under the care of Messieurs HAWKINS and GRANT, who have favoured me with the particulars here annexed.

I called upon her in the afternoon; she complained of violent griping pains in her bowels, darting down to the pubes. On examining I found os tinsae a little dilated, with other symptoms of approaching labour. I sent her an anodyne spermaceti emulsion, and desired to be called if her pains increased. I was sent for. The labour advanced very slowly; her pains were long and severe; she was delivered of a dead child, with some difficulty.’ [John Hunter, ‘Account of a Woman who Had the Small Pox during Pregnancy…’, Philosophical Transactions of the Royal Society 70 (1780): pp. 129-130.]

8 comments on “From the Dissection Room: Smallpox

  1. Celina Lolagne says:

    Smallpox, a highly contagious disease, is unique only to humans. The smallpox virus is caused by two virus variants called Variola major and Variola minor. Variola major is the more deadly form of the virus; it usually has a mortality rte of 20-40 percent of those that are infected with the virus. Variola minor on the other hand is much less severe and only kills 1% of its victims. Neither of the Variola’s are bugs that you want to get. Avoid them at all costs!.’

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  2. […] Fitzharris of The Chirurgeon’s Apprentice brings smallpox into her dissecting room, and a peek into the history of […]

  3. carolynloyel says:

    Oops sorry! I didn’t mean to reply twice.

    • From the case notes, it seems that she did but there is no follow-up on this particular case. Unfortunately, surgical casebooks from this period are often incomplete or patients do not return to the same practitioners for further treatments. But that is a very interesting question – I believe women who recovered from smallpox could go on to conceive (otherwise girls who suffered in childhood from mild bouts of the disease would not have been married off later in life – I say mild bouts because those who were terribly disfigured were unlikely to be married regardless of their ability to bear children). I will check into this!

  4. carolynloyel says:

    Do we know if the woman survived the Small Pox even after her fetus was removed? (Sorry to sound so clinical) It would just be interesting to know if she would ever be able to conceive again or if small pox would do too much internal damage to the reproductive organs.

  5. carolynloyel says:

    So do we know if the woman survived the Small Pox even if her fetus didn’t?

  6. As always, an incredibly interesting article! The only problem: it’s too short. Is there any website you can recommend so I can follow up on this subject? You have whetted my interested for smallpox. =)

    • Thank you! Yes – posts from the dissection room are always a bit short, but it got me thinking about smallpox and I plan to do a follow-up article on it very soon. Unfortunately, there is nothing I can point you to online that talks about smallpox in the early modern period. But if I come across something, I will let you know. There are, of course, plenty of books and scholarly articles on the subject though.

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