Professor shows how smallpox
injected math into medicineYou know the old adage about history repeating itself? Smallpox, once placed safely on the back burner after a successful worldwide vaccination program eradicated the contagious and sometimes fatal disease, is now back in the news, this time as a form of bioterrorism. In the wake of Sept. 11, 2001, laboratory stockpiles of the infectious virus are being viewed as weapons of war. As a result, the U.S. government is rapidly gearing up a vaccination program.
Smallpox was foremost in many people’s minds during the 18th century in Europe and Colonial America. The disease was epidemic and hard to stop. But how? A debate arose. At issue was the burning question: should people be inoculated against the disease or not?
The debate is a research focus of Andrea Rusnock, assistant professor of history. Her latest book, Vital Accounts: Quantifying Health and Population in Eighteenth-Century England and France, uses the smallpox debate, environmental medicine, and population studies to tell the story of numbers and their scientific application to medicine during the 1700s. Statistics, as we know them, had yet to be conceived, and a regular government census had yet to be developed.
“Applying mathematics to evaluate medical treatments had never been done before,” explains the URI professor who teaches the history of science and the history of medicine. “It gave a substantial boost to health care.”
To get inoculated against the smallpox disease in the 1700s, a person had to be infected with a small amount of human smallpox. Once a person recovered, the exposure could provide lifelong immunity. However, occasionally people died from inoculated smallpox and moreover, those inoculated were contagious and could spread the disease to others. (Inoculation and vaccination are not synonymous. Vaccination requires being exposed to the mild disease cowpox, which gives immunity from smallpox and is not contagious.)
During the European epidemic, two mathematically inclined London physicians introduced the new concept of quantification to the inoculation debates during the 1720s. Based on careful collection of data, analysis and tables, the doctors showed that the risks associated with inoculation were substantially less than the risks associated with natural smallpox. Expressed mathematically, the risk of death from inoculation was one in 100 whereas the risk of death from contracting smallpox was one in seven. The comparison allowed impartial evaluation, and moved away from the more common religious, moral or ethical arguments of the day.
Although the French didn’t embrace inoculation until Louis XV died of smallpox, inoculations were generally accepted by the end of the 18th century. Smallpox had ushered in the use of numerical arguments to persuade, which encouraged their application to other areas of medicine.
Rusnock, who has received fellowships from the National Endowment for the Humanities and the Wellcome Trust for past work, is now working on the history of smallpox inoculation and vaccination for her next book.
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