We here at TPIH could not agree more with the scholars who declare the smallpox to be "the disease of which every Englishman of [our time stand] in terror." (31) Known to our fellow Englishmen as the speckled monster, the disease has global roots and dates back to 10,000 BC in agricultural settlements in Africa. (32) It was first called smallpox only 250 years ago in the 15th century to distinguish it from syphilis, which was termed great pockes. (33)

Since this time, the disease has plagued the world and taken the lives of both poor and the rich, most recently with the death of King Louis of France in 1774. (34) It is predicted that the disease will cause 10% of the deaths on this continent by the year 1800. (35)

Because everyone is terrified of it, we are aware that some men have rejected women who have not had it as potential mates. Apparently, these men are afraid that if the disease should attack their wives after marriage, it will produce scarring and taint their complexions. (36)

In the medical community it is also becoming more of a common practice to use variolation. In this method of immunization we infect healthy persons by placing scabs into their nasal cavity in hopes to create immunity for the patient. (37) While we are able to set up appointments for family members of yours, let us discuss whether you have the disease.

Symptoms for men, women and children:

According to medical texts used at TPIH, those who are infected with smallpox usually experience difficulty breathing coupled with a fever for three or four days before any pimples appear. (38) The pimples itch, and while they first appear small, they grow and develop a crimson hue. (39) Fortunately, the fever diminishes after the eruption. Unfortunately however, when the face and head are covered by the pimples, the head is seized also and patients appear drowsy. (40) It is our belief and the belief of our contemporaries that the face is usually heavily affected because the pores on the face are exposed to cool air and develop a "rigidity" that restricts "the motion of the fluids passing that way." (41)

How did this happen to me?

Taking care of our loved ones infected with smallpox puts us at a higher risk for contamination. The disease is spread through respiratory discharges and therefore even being near a delicate sneeze of a loved one can infect the caretakers with the disease. Similarly, the disease is spread through contact with possessions of an infected person. So borrowing their veil or carriage could result in you catching the disease. (42)

But do not distress. There is much that can be done about it and with great success. The fatality rate only varies from 20-60% in these cases. (43)

Treatments:

Stage 1:

In order for patients to begin mending, it is necessary for their skin to be softened. (44) The physicians here achieve this by putting our patients in warm rooms, where the skin will open.

Stage 2:

The chefs at TPIH work diligently to ensure that our patients have the proper thin and plentiful diet to aid their recuperation. Because we want to dilute the poisons in the body, the diet is primarily liquid. As a result, our chefs cook up tasty gruels, sack-whey cyder-whey and sage tea. (45)

Stage 3:

Our goal is to provide patients with comfort. Because many of our patients affected by smallpox cannot sleep because of their throbbing irritation, we administer opiates. They can be given any time after the eruption of the pimples. (46)

Now that we have gone into detail about your treatment plan,let us tell you a bit more about variolation. This practice of infecting the healthy stemmed out of the Ottoman Empire. Lady Mary Wortley Montague, who was disfigured from the disease in 1715, brought the method to England after being in Istanbul with her ambassador husband. (47) Montague insisted that her son be inoculated with the disease by inserting infected fluids from smallpox patients into scratches on his arm. Montague then had her daughter inoculated in the presence of the physicians of the court and the practice spread. While nearly three percent of these purposely-infected patients did not survive, we consider these numbers to be better than the fatality rates that accompany the disease when it occurs on its own. (48)

We don't mean to prematurely excite you, but there is also word of a cure being developed. A very close associate of ours, Edward Jenner, has been keeping us posted on his work in the field with the disease. Jenner noticed that milkmaids who had experienced cowpox were immune to the disease. Next year, 1796, Jenner said he plans to infect a healthy boy with cowpox and then later try to infect him with the smallpox. He has a feeling the cowpox would have built up an immunity to the small pox. Jenner says if his plan works he would be able to create a "vaccination", vaca meaning "cow" in Latin. (49) We wish him the best of luck and will keep you posted.