King's College London
Online Exhibitions
The great leveller: humanity's struggle against infectious disease

Mead on smallpox

Smallpox, an airborne infection, is now no longer active. It is the only disease among those featured in this exhibition of which this can be said.

The last known case of naturally occurring smallpox was recorded in Somalia in 1977. For reasons which are unclear, although it was widespread during the medieval period, it became a major killer only in the 16th century. It bears a major share of responsibility for the demographic collapse of Amerindian societies after European conquest. In the Old World, it posed a clear and present danger to all social classes, unlike leprosy.

Opening showing title page and verso of flyleaf with inscriptionOpening showing title page and verso of flyleaf with inscriptionAt its height during the 18th century, when, despite the dissemination of inoculation, mortality from the disease was rising, it accounted for between 10 to 15 % of deaths in some European countries. For survivors, even though exposure to the disease conferred immunity, permanent disfigurement and blindness often resulted. Inoculation, or variolation, came to Europe via the observations of travellers to the Ottoman Empire during the first two decades of the 18th century, but had been used in much of Asia and Africa for many years before that.

Dried scabs of smallpox pustules were rubbed on to abrasions of the skin or on to membranes of the nose to produce a mild form of the disease which conferred lifelong protection. If the procedure was carried out without too deep incisions, and if patients were chosen carefully, the mortality rate caused by variolation was very low.

The St Thomas’s physician, Richard Mead (1673-1754) has a reputation today as an art collector and bibliophile whose activities in these areas were equalled in his day only by Sir Hans Sloane. However, to his contemporaries he was known as one of the leading and richest physicians of his day, the chosen successor to John Radcliffe’s lucrative practice, and as a medical theorist.

His treatise on smallpox, shown here, refers to an incident for which Mead has become notorious. While conducting trials of smallpox inoculation among Newgate prisoners in 1721 Mead experimented on one prisoner using the Chinese method of inoculation, by blowing smallpox scabs through the nostril. The Chinese avoided the risk of causing infection through the upper respiratory tract by ageing the scabs first. Mead ignored this precaution;  fortunately, the patient survived.

Mead’s treatise is chiefly remarkable for demonstrating that, while orthodox physicians viewed smallpox inoculation as a threat to their monopoly, orthodox medicine could absorb inoculation by surrounding it with embellishments, such as phlebotomy (bloodletting) and emetics, as well as more sensible regimen on diet, rest and the isolation of the inoculated person.

The ‘Dr. Taylor’ to whom the inscription in the image shown here refers is probably the physician Robert Taylor (1710- 62), physician to King George II. He gave the Royal College of Physicians’ Harveian oration in 1755, thus demonstrating that body’s endorsement of inoculation.

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