Smallpox was an extremely contagious disease. The mortality rate was at least 30%.
George Washington’s Decision
Shortly after the battles of Lexington and Concord in mid-1775, George Washington, a former Colonel of the Virginia Militia and the highest ranking professional soldier in the American colonies, was appointed General of the Continental Army. He was sent to Boston to consolidate the militia troops, bring order, train them to their purpose, and prepare for all contingencies. It was a daunting task.
When he arrived in Boston, he found himself in the middle of a smallpox epidemic. British soldiers were affected; militia recruits from all over New England were affected; runaway slaves who had fled north to enlist were affected; the general populace was affected. Smallpox was highly contagious. The sickness and death rate was frightening.
George Washington had contracted smallpox when he was in his late teens. He recovered, grateful that his pock marks were not too disfiguring, but mostly because once recovered, he was immune to smallpox thereafter.
Realizing the potential danger to his men, his army, and their cause, he isolated those who were already immune. He quarantined anyone who showed even the slightest sign of the disease, and immediately restricted all soldiers from any contact with Boston civilians, where the disease was rampant. He improved sanitary conditions within his camps. And he insisted that his soldiers be inoculated.
He felt so strongly about it, that he insisted Martha Washington be inoculated as well. When she was in Philadelphia, she bit the bullet, went through the frightening procedures, and spent a month “recuperating” from her ordeal. Her recovery was considered relatively mild.
Inoculation for Smallpox
In 1775, inoculation against smallpox was not new; it had been used in America for several decades with reasonable success, albeit with great danger. It was also very controversial.
A cut was made in the healthy arm, and a small amount of skin lesions from infected pustules were introduced. Then the arm was bandaged. It purported to give the patient a “light” case and subsequent immunity. Many people could not understand the concept of this practice, however it had a high success rate. A patient needed at least a full month for preparation, for the inoculation to be administered, to take hold, to “suffer the light case” – sometimes far more severe than anticipated, to recover, and to be no longer contagious.
In short, it was not to be undertaken lightly.
The Adams Family Inoculations
John Adams had been inoculated as a young man prior to his marriage, and long before the practice had become more acceptable in the Colonies. He had suffered greatly during his three-week recuperation in a hospital “with headaches, backaches, knee aches, gagging fever and eruption of pock marks”.
His wife Abigail had not been inoculated, but certainly knew about it, and in July, 1776, when the epidemic was particularly virulent, she bit the hard and dangerous bullet. She and the four Adams children, all under eleven, and a few other family members and townspeople, went ten miles from their home in Braintree to Boston, to be inoculated by Dr. Thomas Bullfinch, an expert at the procedure. Her aunt and uncle who lived in Boston offered the medical hospitality of a furnished house – except for bedding.
According to Abigail, “…We had our Bedding &c. to bring. A Cow we have driven down from [Braintree] and some Hay I have had put into the Stable, wood &c. and we have really commenced housekeepers here…All our necessary Stores we purchase jointly.”
Abigail Adams further noted, “God Grant that we may all go comfortably thro the Distemper, the phisick part is bad enough I know. I knew your mind so perfectly upon the subject that I thought nothing, but our recovery would give you eaquel pleasure, and as to safety there was none.”
In early July, 1776, while Abigail was preparing for this dreaded event, John Adams was preoccupied in Philadelphia, shepherding thirteen divergent colonies to unite and declare their independence from Great Britain. Once the Declaration of Independence had been signed, he had an equally formidable task of a different nature: helping to govern a generally dis-united new country.
Abigail, the Children, the Reactions
Earlier practices of inoculation included a week of preparatory purging via self-induced vomiting. Dr. Bullfinch did not subscribe to that practice completely, although he had prescribed some distasteful medication. Abigail advised her husband that “the little ones are very sick and puke every morning,” but that afterwards they are comfortable.
Abigail suffered a mild form of the disease, and was soon able to nurse the children through their respective ordeals. John Quincy, who had just turned nine, appears to have suffered the least.
Nabby Adams, their eleven-year-old daughter, was very sick with fevers, terrible body aches, and erupting pustules.
Neither Charles (aged 6) and Thomas (aged 4) responded to the inoculation, and it had to be repeated. For Charles, it had to be repeated three times – the last, with a more “active” scraping, insuring that he would contract the dreaded disease as if he had contracted it naturally. The little boy suffered horribly, and was delirious for two days. It took weeks for him to recover.
It would take even more weeks before Abigail could take the children home again.
But they would never have to worry about contracting smallpox. They were immune. They had been inoculated.
Gelles, Edith B. – Abigail and John: Portrait of a Marriage – William Morrow, 2009
Levin, Phyllis Lee – Abigail Adams – St. Martin’s Press, 1987
Massachusetts Historical Society – Letters from Abigail to John Adams, 13-14 July, 1776