Washington, Adams, and Smallpox: An MHS Interview

Gabrielle Birchak/ October 7, 2025/ Archive, Early Modern History, Modern History

PODCAST TRANSCRIPTS

[Gabrielle Bir­chak]

I believe in the Unit­ed States. I believe in our resilience and I believe that this exper­i­ment that is known as Amer­i­ca can do so much bet­ter if we trust sci­ence. And after today, I hope you have the same revelation.

Today’s very spe­cial episode includes an inter­view with the Direc­tor of Research at the Mass­a­chu­setts His­tor­i­cal Soci­ety, Dr. Kanisorn Wongsrichanalai. Stick around. Dur­ing the prepa­ra­tion and the inter­view, I had the oppor­tu­ni­ty to learn so much more about the Rev­o­lu­tion­ary War as well as the greater bat­tle that our fore­fa­thers endured.

It was a bat­tle that was writ­ten in the mar­gins of our his­to­ry books that many do not know about. Though many talk about the Rev­o­lu­tion­ary War and how 250 years ago we banned it togeth­er and fought for our inde­pen­dence, a big­ger pic­ture was writ­ten in the mar­gins that many of us nev­er knew about. While the fore­fa­thers were strug­gling with devel­op­ing a coun­try that we could have hope and faith in, the con­ti­nent was strug­gling with the dead­ly dis­ease of smallpox.

From the indige­nous peo­ple of the north­ern con­ti­nent to Cana­da to the Con­ti­nen­tal Army, it is approx­i­mat­ed that around 130,000 peo­ple died between 1775 and 1782. The heav­i­est loss­es fell on indige­nous peo­ples and the com­mu­ni­ties in Span­ish Amer­i­ca. It was dur­ing this time that our fore­fa­thers had the where­with­al to con­sid­er try­ing inoculation.

And that bat­tle was not an easy one. It was not like walk­ing into a CVS and get­ting a shot and then binge-watch­ing for a day. It was a pro­ce­dure that required weeks of gath­er­ing sup­plies, block­ing out sev­er­al weeks of recov­ery time, and hop­ing that one sur­vived the inoc­u­la­tion process.

And our brave lead­ers, includ­ing their wives, Martha Wash­ing­ton and Abi­gail Adams, took it upon them­selves to inoc­u­late. For George Wash­ing­ton, Martha’s actions to inoc­u­late val­i­dat­ed Wash­ing­ton to inoc­u­late the Con­ti­nen­tal Army. I have to believe that the foun­da­tions of this coun­try was built on trust in the unknown.

And that includes sci­ence. By trust­ing sci­ence, they were able to save the towns­peo­ple and save our mil­i­tary and help us become who we are today. And who we are today may not be per­fect, but I would like to believe that the spir­it of our fore­fa­thers still has a foothold on its legacy.

And it’s up to us to remem­ber the courage and the strength that they endured as they came togeth­er and ral­lied around sci­ence. That being said, please enjoy this inter­view that I had with Dr. Kanisorn Wongsrichanalai. And I hope that you enjoy the infor­ma­tion and the insight that he shares.

And I hope that you enjoy lis­ten­ing to the let­ters exchanged between Abi­gail Adams and John Adams, as well as the sto­ries of cor­re­spon­dence between John Adams and George Wash­ing­ton. Dr. Kanisorn Wongsrichanalai is Direc­tor of Research at the Mass­a­chu­setts His­tor­i­cal Soci­ety. He is the author of North­ern Char­ac­ter, Col­lege Edu­cat­ed New Eng­lan­ders, Hon­or, Nation­al­ism and Lead­er­ship in the Civ­il War Era.

He is the co-edi­tor of So Con­ceived and So Ded­i­cat­ed, North­ern Intel­lec­tu­als in the Civ­il War Era. And he is the co-edi­tor of Wars, Civ­il and Great, the Amer­i­can Expe­ri­ence in the Civ­il War and World War One. He co-direct­ed the Nation­al Endow­ment for the Human­i­ties Spon­sored Project, West Tex­ans and the Expe­ri­ence of War, World War One to the Present, while work­ing as an Asso­ciate Pro­fes­sor of His­to­ry at Ange­lo State University.

He is a grad­u­ate of Bow­doin Col­lege and earned his PhD in Amer­i­can His­to­ry at the Uni­ver­si­ty of Vir­ginia. Dr. Kanisorn Wongsrichanalai, thank you so much for join­ing me here at Math Sci­ence History.

[Dr. Kanisorn Wongsrichanalai]

It is a plea­sure to join you. And I’m look­ing for­ward to our conversation.

[Gabrielle Bir­chak]

I am too. There’s so much to con­sid­er right now with all that’s going on with vac­cines. And I love the sto­ry that is behind George Wash­ing­ton and the inoc­u­la­tions and smallpox.

I know some of my lis­ten­ers are not famil­iar with what small­pox is. Could you briefly describe what it is and how it evolved to becom­ing lit­er­al­ly a dan­ger to the Con­ti­nen­tal Army?

[Dr. Kanisorn Wongsrichanalai]

I’m hap­py to do that with the caveat that I’m not a med­ical pro­fes­sion­al. And so what we have here is his­tor­i­cal doc­u­men­ta­tion about the rav­ages of the dis­ease small­pox. But I should also men­tion that I work at the Mass­a­chu­setts His­tor­i­cal Soci­ety, which is the home of the Adams fam­i­ly papers of the John Adams, Abi­gail Adams, John Quin­cy Adams.

And this being the 250th anniver­sary of the start of the Amer­i­can Rev­o­lu­tion in Mass­a­chu­setts, we are very hap­py to high­light some of these col­lec­tions. And they relate to small­pox, which is actu­al­ly some­thing that is gen­er­al­ly left out of the his­to­ries of the rev­o­lu­tion. So I think we’ll talk a lit­tle bit about that and then we’ll lead up to George Washington.

But to go to your ques­tion, small­pox is a con­ta­gious, very con­ta­gious and very dead­ly and dan­ger­ous dis­ease, which thank­ful­ly does not exist with us here in 2025. It presents with flu like symp­toms. And this then lat­er on leads to the devel­op­ment of red spots, includ­ing inside a per­son­’s mouth.

These are sores or pox, and they’re filled with mucus and it’s spread through con­tact with flu­ids pro­duced by infect­ed indi­vid­u­als. There­fore, cloth­ing or sheets or if some­one has sores inside their throat and they cough on a per­son, that’s how these germs spread. So it’s a virus.

The strain that is lethal to humans that was the most prob­lem­at­ic is viri­o­la major. And the fatal­i­ty rate was as high as 30 per­cent. It was absolute­ly devastating.

It was absolute­ly ter­ri­fy­ing for peo­ple who had it. And Abi­gail Adams calls it a pesti­lence that walketh in darkness.

[Gabrielle Bir­chak]

Wow. And when did she write that?

[Dr. Kanisorn Wongsrichanalai]

That is 1776. That is right after she had just under­gone the inoc­u­la­tion process with the four of her chil­dren. So this is dur­ing the Amer­i­can Revolution.

And she is locked down in the town of Boston, hav­ing under­gone this treat­ment. We have many doc­u­ments to share with your lis­ten­ers about this, but we’ll get to that shortly.

[Gabrielle Bir­chak]

Won­der­ful. So now, from what I under­stand, George Wash­ing­ton actu­al­ly got small­pox when he was younger, before he actu­al­ly start­ed work­ing in the Amer­i­can mil­i­tary. Is that correct?

[Dr. Kanisorn Wongsrichanalai]

Yes. So George Wash­ing­ton had con­tract­ed small­pox when he trav­eled to the Caribbean with his broth­er. His broth­er was suf­fer­ing from anoth­er ill­ness which required treatment.

Prob­a­bly get­ting to a trop­i­cal or warmer cli­mate was sup­posed to help. I believe it was tuber­cu­lo­sis, but I’m not sure on that.

[Gabrielle Bir­chak]

Yes, it was.

[Dr. Kanisorn Wongsrichanalai]

Yes, it was. Very good. Well, while there, Wash­ing­ton con­tracts small­pox in the phrase of the time, the nat­ur­al way, which is he gets it and he’s not inoculated.

He gets sick. He sur­vives it. So he does have immunity.

So when he’s com­man­der of the Con­ti­nen­tal Army, he is some­one who already has this immu­ni­ty. It is unclear when he learns of the dif­fer­ence between inoc­u­la­tion and get­ting infect­ed in the nat­ur­al way, because he seems to con­fuse those two in some of his cor­re­spon­dence. But we can talk about when we get to that point in 1776 and 77, when he final­ly gets on board with this, what con­vinces him and when he learns that there is a real dif­fer­ence between catch­ing it the nat­ur­al way or inoc­u­lat­ing one­self against smallpox.

[Gabrielle Bir­chak]

When did the first inoc­u­la­tions begin in the Unit­ed States? Was it effec­tive? Did it help quell the small­pox or was it experimental?

[Dr. Kanisorn Wongsrichanalai]

Right. So the process in North Amer­i­ca, in the Eng­lish colonies, begins before there was a Unit­ed States. So many decades before that, in fact.

And actu­al­ly, it takes place here in the city of Boston. At the town was not the city, town, but this is a med­ical, one of many med­ical inno­va­tions that take place here in Boston. In 1706, the parish­ioners of a pop­u­lar preach­er by the name of Cot­ton Math­er, whose papers are also at the Mass­a­chu­setts His­tor­i­cal Soci­ety, I’ll point out, present Cot­ton Math­er with an enslaved man named Onesimus.

And Math­er asked this indi­vid­ual, Ones­imus, whether or not he had ever con­tract­ed small­pox. Ones­imus told him that in Africa, where he was free, before he was enslaved, he had been inoc­u­lat­ed. And he showed him evi­dence of this scar on his arm.

So this is where they made the cut to insert the small­pox pus from the infect­ed per­son. Now, Math­er con­firmed this with oth­er enslaved peo­ple from Africa who’d under­gone this pro­ce­dure. So he knew that this is some­thing that oth­er civ­i­liza­tions had performed.

Fast for­ward to 1721, and there is a small­pox out­break in Boston. Math­er attempts to con­vince the physi­cians in Boston to try this process of inoc­u­la­tion, say­ing that he had heard this from Ones­imus and had con­firmed it by speak­ing with oth­er enslaved Africans. Now, the physi­cians in Boston, many of them did not think that they could trust infor­ma­tion from enslaved people.

And they cer­tain­ly doubt­ed that peo­ple who they had enslaved were capa­ble of acquir­ing med­ical knowl­edge that was beyond their own skill and knowl­edge. There were also some min­is­ters who claimed that inoc­u­la­tion chal­lenged God’s will, and so were against this. But Math­er final­ly con­vinced a physi­cian by the name of Zab­diel Boylston.

He’s actu­al­ly John Adams’s great uncle. Yes. There’s a fam­i­ly con­nec­tion there.

[Gabrielle Bir­chak]

Yeah, I thought that was interesting.

[Dr. Kanisorn Wongsrichanalai]

It’s a small town, and even today, Boston’s a small city, so there are a lot of con­nec­tions. But Dr. Boyl­ston attempt­ed this inoc­u­la­tion process. He tried it on his six-year-old son and sev­er­al enslaved peo­ple as well.

This is con­tro­ver­sial, and Math­er is threat­ened. There’s some­one who throws an incen­di­ary through his win­dow at his home, but Boyl­ston push­es ahead. And in the end, the facts and the results speak for themselves.

The small­pox out­break in Boston went from 1721 to 1722. And dur­ing that time, about 5,700 peo­ple, 5,759 peo­ple, caught small­pox nat­u­ral­ly. 842 of them died as a result.

That’s a 14.5% mor­tal­i­ty rate. But the peo­ple who Boyl­ston inoc­u­lat­ed, he inoc­u­lat­ed 242 peo­ple. Only six died.

That’s a 2.5% mor­tal­i­ty rate. So if you’re look­ing at this, and there are oth­er out­breaks where we can talk about the stats, it is very clear that your chances of sur­viv­ing inoc­u­la­tion are far high­er than sur­viv­ing catch­ing small­pox through the nat­ur­al way.

[Gabrielle Bir­chak]

So it was proof that the inoc­u­la­tions worked. What was the recep­tion like at that time?

[Dr. Kanisorn Wongsrichanalai]

Well, Boyl­ston is actu­al­ly hon­ored in Lon­don for his dis­cov­ery, for his exper­i­ments, I should say. And he pub­lish­es his find­ings, so this knowl­edge is spread through the Eng­lish med­ical com­mu­ni­ty. He cred­its Cot­ton Math­er with telling him this, but there’s no men­tion of the fact that this knowl­edge actu­al­ly came from Onesimus.

The prob­lem is that even though this knowl­edge of inoc­u­la­tion is out there in the world, it is still very con­tro­ver­sial. And that’s because when one is inoc­u­lat­ed with small­pox, one is still con­ta­gious. That four to six week win­dow that we talked about ear­li­er is still in play here.

And so it still is a pub­lic health threat. If peo­ple are inoc­u­lat­ing them­selves against small­pox with­out telling oth­ers, they risk spread­ing that to oth­er indi­vid­u­als who could then die as a result. And that’s a pub­lic health issue.

So it’s very con­tro­ver­sial for a long time. So then the oth­er inno­va­tion that takes place in Mass­a­chu­setts is real­ly about pub­lic health law. And in the 1730s, the Mass­a­chu­setts Gen­er­al Court, along with the lead­ers of Boston, the select men, cre­at­ed a struc­ture to deal, a pol­i­cy rather, to deal with small­pox outbreaks.

They knew that they had the abil­i­ty to quar­an­tine the sick. They could put up flags out­side of a home. They could fence off an area of a home and keep peo­ple quar­an­tined in that area.

In 1731, they passed a law that for­bade peo­ple from hid­ing the effects of small­pox. The head of a house­hold was sup­posed to noti­fy offi­cials, select men in Boston, if some­one in their home came down with small­pox, they would then go through the process of warn­ing oth­er peo­ple to stay away from this par­tic­u­lar home. There’s also a caveat to that rule, which is that once 20 fam­i­lies had to be quar­an­tined, that is, small­pox had spread to 20 house­holds, then the quar­an­tine rule was off because then the select men, the town lead­ers, knew that they could not con­tain this out­break, that that it was too far gone for these attempts to just close off cer­tain homes or cer­tain areas to be effective.

Once 20 house­holds had been infect­ed, the town had reached this mark to begin inoc­u­la­tion. And at this point, peo­ple from out­side of the town where the infec­tion was was spread­ing could also come in and get inoc­u­lat­ed as well. And they would, of course, close down the town.

This is very dis­rup­tive to trade, espe­cial­ly for a port town like Boston, right? Or Salem or any oth­er of these places that rely on this trade from the Atlantic world. But it’s a pub­lic health issue.

They know they can­not con­tain it. And they know that the only way to reduce deaths is to inoc­u­late. And this is what we see hap­pen lat­er on in in the 18th cen­tu­ry when there are out­breaks, that they would shut down the town, that they would have inoculations.

Peo­ple would come in because peo­ple believed in inoc­u­la­tions and they would get their own nat­ur­al immu­ni­ty as a result. In 1752, there was a small­pox epi­dem­ic that struck Boston again. And dur­ing this par­tic­u­lar out­break, about 5,567 peo­ple caught small­pox naturally.

About 514 of them per­ished as a result. That’s a 9 per­cent mor­tal­i­ty rate. The town did go through the process of inoculation.

Two thou­sand one hun­dred and nine peo­ple received inoc­u­la­tions. And of those, 31 peo­ple died. That’s one point five percent.

So once again, this is show­ing that inoc­u­la­tions are much safer. They’re still a risk, of course, but they are cer­tain­ly safer than con­tract­ing small­pox in the nat­ur­al way. Doc­tors who were here in 1752 also learned that per­haps some indi­vid­u­als were not suit­able for inoculations.

Preg­nant women, infants or those who were elder­ly risked get­ting a severe ill­ness from the inoc­u­la­tion. So they rec­om­mend­ed that these indi­vid­u­als actu­al­ly leave the area while this process was being under­tak­en. We can go to some let­ters when­ev­er you’re ready in 1764 with John Adams.

[Gabrielle Bir­chak]

And if peo­ple are inter­est­ed in see­ing them, are they on the website? 

[Dr. Kanisorn Wongsrichanalai]

So some of them have been scanned or avail­able on the web­site. They have been tran­scribed and peo­ple can search through the Adams papers col­lec­tions by name of recip­i­ent, of author, of sub­ject, by date.

It’s real­ly quite an oper­a­tion. And one gets a sense of the life of peo­ple liv­ing in the 18th cen­tu­ry to see the orig­i­nals. They’ll have to come to the Mass­a­chu­setts His­tor­i­cal Society.

We are free and open to the pub­lic. And we love show­ing these won­der­ful arti­facts from the past.

[Gabrielle Bir­chak]

See, now I’m com­ing. I got to come to Boston. I got to come to Mass­a­chu­setts to see these letters.

[Dr. Kanisorn Wongsrichanalai]

Yes, please do. We see our­selves as the care­tak­ers of these items. They belong to the people.

And so we real­ly invite the pub­lic to come and take a look at these let­ters, which are not just a tes­ta­ment to life dur­ing the Amer­i­can Rev­o­lu­tion in the ear­ly days of the repub­lic, but also of a love between two indi­vid­u­als who were just deeply engaged with each oth­er for much of their adult lives. That’s beau­ti­ful. Well, let’s hear the letters.

All right. So this first let­ter is from John Adams from 1764. Sat­ur­day evening, eight o’clock, 7 April 1764.

So this is John Adams writ­ing to Abi­gail Smith. This is before they’re mar­ried. You’ll note that they use nick­names for each other.

He called her Diana, and she referred to him as Lysander. So that’s who these peo­ple are ref­er­ences to when we get to those por­tions of the let­ters between the two of them. For many years past, John writes, I have not felt more serene­ly than I do this evening.

My head is clear and my heart is at ease. Busi­ness of every kind I have ban­ished from my thoughts. My room is pre­pared for a sev­en days retire­ment and my plan is digest­ed for four or five weeks.

My broth­er retreats with me to our prepara­to­ry hos­pi­tal and is deter­mined to keep me com­pa­ny through the small­pox. Your uncle, by his agree­able account of the doc­tor and your broth­er, their strength, their spir­its and their hap­py prospects, but espe­cial­ly by the favor he left me from you, has con­tributed very much to the felic­i­ty of my present frame of mind. For I assure you that as noth­ing which I before expect­ed from the dis­tem­per gave me more con­cern than the thought of a six weeks sep­a­ra­tion from my Diana.

My depar­ture from your house this morn­ing made an impres­sion upon me that was severe­ly painful. I thought I left you in tears and anx­i­ety and was very glad to hear by your let­ter that your fears were abat­ed. For my own part, I believe no man ever under­took to pre­pare him­self for the small­pox with few­er than I have at present.

I have con­sid­ered thor­ough­ly the diet and med­i­cine pre­scribed me and am ful­ly sat­is­fied that no durable evil can result from either and any oth­er fear from the small­pox or its appur­te­nances in the mod­ern way of inoc­u­la­tion I nev­er had in my life. Thanks for my ball next Fri­day for cer­tain with suit­able sub­mis­sion. We take our depar­ture for Boston to Cap­tain Cunningham’s.

We go and I have not the least doubt of a pleas­ant three weeks, notwith­stand­ing the dis­tem­per. Good night, my dear. I am going to bed.

So you’ll note from that real quick that they some­times refer to small­pox as dis­tem­per. OK, I think it’s real­ly impor­tant for the lis­ten­ers to real­ize just the human toll and the fear that these peo­ple are going through. There is a chance that he’s not going to come back.

There is still a chance that one could have a com­pli­ca­tion from inoc­u­la­tion and pass away as a result. This is a long sep­a­ra­tion. This is not as we have today with vac­cines, which is you walk into your local phar­ma­cy or doc­tor’s office and get a shot and you might not feel good for a short peri­od of time, but you’re not con­ta­gious and you’re free to go about your dai­ly life.

This is some­thing that requires weeks and weeks of prepa­ra­tion and weeks of weeks of being isolated.

[Gabrielle Bir­chak]

That’s true. I did­n’t think about that as he’s writ­ing her is it could pos­si­bly be his last let­ter to her. Yes, that’s real­ly it is.

It’s very heart­break­ing. And I can’t imag­ine what she was going through receiv­ing these and won­der­ing when she might get the next let­ter and hop­ing she gets the next letter. 

[Dr. Kanisorn Wongsrichanalai]

Exact­ly.

[Gabrielle Bir­chak]

We’ll be right back after a quick word from my advertisers.

[Dr. Kanisorn Wongsrichanalai]

So he then writes an update on the 13th of April, a few days lat­er, and he talks about the process that he under­goes to receive this inoc­u­la­tion. Okay, so this is John Adams. Dr. Perkins demand­ed my left arm and Dr. War­ren, my broth­ers, they took their lancets and with their points divid­ed the skin for about a quar­ter of an inch and just suf­fer­ing the blood to appear, buried a thread about half a quar­ter of an inch long in the chan­nel. A lit­tle lint was then laid over the scratch and a piece of a rag pressed on and then a ban­dage bound over all my coat and waist­coat put on and I was big to go where and do what I pleased. The doc­tors have left us pills red and black to take night and morn­ing, but they looked very saga­cious­ly and impor­tant­ly at us and ordered my broth­er larg­er dos­es than me on account of the dif­fer­ence in our con­sti­tu­tions. The doc­tors hav­ing fin­ished the oper­a­tion and left us, their direc­tions med­i­cines took their depar­ture in infi­nite haste.

I have one request to make, which is that you would be very care­ful in mak­ing Tom smoke all the let­ters from me very faith­ful­ly before you or any of the fam­i­ly reads them. For although I shall nev­er fail to smoke them myself before seal­ing, yet I fear the air of this house will be too much infect­ed soon to be absolute­ly with­out dan­ger and I would not you should take the dis­tem­per by let­ter from me for mil­lions. I write at a desk far removed from any sick room and shall use all the care I can, but too much can­not be used.

My love to all, my hearty thanks to Mama for her kind wish­es. My regards is due to Papa and should request his prayers which are always becom­ing and espe­cial­ly at such times when we are under­tak­ing any­thing of con­se­quence as the small­pox. Undoubt­ed­ly though, I have not the least appre­hen­sion at all of what is called danger.

[Gabrielle Bir­chak]

This let­ter is so heavy, it just shows the weight of him­self and what the com­mu­ni­ty was going through. Yes. Deal­ing with not just the small­pox but also the inoc­u­la­tion process.

Wow.

[Dr. Kanisorn Wongsrichanalai]

Yes, it’s a lot and of course they’re not able to eat and go any­where they please. They’re not able to eat nor­mal­ly. There is a let­ter he writes, talks about in a lit­tle bit.

Please con­tin­ue. So four days lat­er, John writes again to tell Abi­gail of the process of liv­ing through this inoc­u­la­tion while he’s wait­ing for the infec­tion to run its course. So this is John on April 17, 1764.

Yours of April 15th, this moment received. I thank you for it and for your offer of milk, but we have milk in vast abun­dance and every­thing else we want except com­pa­ny. You can’t imag­ine how fine­ly my broth­er and I live.

We have as much bread and as much new pure milk, as much pud­ding and rice as we please. And the med­i­cine we take is not all that nau­seous or painful and our felic­i­ty is the greater as five per­sons in the same room under the care of Lord and Church, those are some doc­tors, care­givers, are starved and medici­mat­ed with the utmost sever­i­ty. No bread, no pud­ding, no milk is per­mit­ted them, i.e. no pure and sim­ple milk. They are allowed a mix­ture of half milk and half water. And every oth­er day they are tor­tured with pow­ders that make them as sick as death and as weak as water. All this may be nec­es­sary for them for what I know, as Lord is pro­fes­sive­ly against any prepa­ra­tion pre­vi­ous to inoc­u­la­tion, in which opin­ion I own I was ful­ly agreed with him till lately.

But expe­ri­ence has con­vinced me of my mis­take and I have felt and now feel every hour the advan­tage and the wis­dom of the con­trary doc­trine.” He goes on to talk about how oth­er peo­ple are sur­viv­ing, are going through the process. Let me fast for­ward to this por­tion where John talks about some­one who has caught the dis­tem­per, small­pox, through the nat­ur­al way.

Those who have it in the nat­ur­al way are objects of as much hor­ror as ever. There is a poor man in this neigh­bor­hood, one bass, now labor­ing with it in the nat­ur­al way. He is in a good way of recov­ery but is the most shock­ing sight that can be seen.

They say he is no more like a man than he is like a hog or a horse, swelled to three times his size, black as bacon, blind as a stone. And how was Abi­gail’s recep­tion to his let­ters? Well, she of course is very con­cerned, as you could tell from the pre­vi­ous let­ter, she was offer­ing to send any­thing she could.

She is also some­one who believes in inoc­u­la­tion and would have gone with him to under­go the process, but her father for­bade it. And it’s not until 1776, at the start of the Amer­i­can Rev­o­lu­tion, that she is able to get inoc­u­lat­ed with, at that point, their four chil­dren. And so John and Abi­gail are very con­vinced that inoc­u­la­tion works.

And I think this is prob­a­bly one of the moments in their rela­tion­ship where they wish they could have been togeth­er to go through this process. But per­haps they rea­soned that at least one of them would, if they sur­vived, if John sur­vived inoc­u­la­tion, be safe from it for the rest of his life. Well, John has a lot of time, of course, to think about the procedure.

He’s quar­an­tined for many weeks after all. And in this let­ter where he describes what he’s eat­ing, how peo­ple are going through the process, he con­trasts that very clear­ly with some­one who’s caught small­pox through the nat­ur­al way, as he says. And for him, based on this obser­va­tion, as well as the evi­dence of oth­er inoc­u­la­tion cam­paigns, inoc­u­la­tion is the way to go.

It is much safer. And so here’s a quo­ta­tion that I think is real­ly strik­ing and real­ly gets to what he thinks about the process of inoc­u­la­tion. This is John again, quote, I would think myself a delib­er­ate self-murderer.

I mean that I incurred all the guilt of delib­er­ate self-mur­der. If I should only stay in this town and run the chance of hav­ing it in the nat­ur­al way.

[Gabrielle Bir­chak]

There’s just so much to unrav­el here with that state­ment. Ques­tion­ing, are men ratio­nal? Those that would go through it the nat­ur­al way ver­sus those that would choose inoculation.

And it’s inter­est­ing how we’re still ask­ing that same ques­tion today. Yes. Thank you for shar­ing that.

And so was this let­ter shared or was it just direct­ed to Abigail?

[Dr. Kanisorn Wongsrichanalai]

It’s direct­ed to Abi­gail, but I sus­pect that it is some­thing that oth­er peo­ple would have talked about. This is a very big debate. It was a big debate at that par­tic­u­lar time in the 18th cen­tu­ry, and as it is a big debate for us today.

This is always going to be a mat­ter of life and death. It’s always a mat­ter that peo­ple find of great inter­est to talk about choic­es and pub­lic health and what­not. But once again, I’ll point out that while John has gone through this process, he’s fine.

He emerges and with his immu­ni­ty, that out­break in 1764 ulti­mate­ly has a sim­i­lar out­come, which is that about 699 peo­ple con­tract­ed small­pox nat­u­ral­ly. 24 of them died. That’s a 17.5% mor­tal­i­ty rate. 4,977 received inoc­u­la­tions. That’s almost 5,000 peo­ple received inoc­u­la­tions with only 46 deaths. That’s 0.9%. So you can com­pare the num­bers and those who believe in this process can point to these irrefutable facts that it saves lives.

[Gabrielle Bir­chak]

And at this time, he was still engaged to Abi­gail, cor­rect? Okay. So at what point did she decide to do it?

Did she inoc­u­late her­self or did she have some­one inoc­u­late her as well as her children?

[Dr. Kanisorn Wongsrichanalai]

She had some­one inoc­u­late her and her chil­dren. And it is a whole process. This is, from what I’ve read to you so far, as we’ve talked about, inoc­u­la­tion is a try­ing process under nor­mal peace­time circumstances.

But imag­ine that Abi­gail Adams has to go through this process in the mid­dle of the start of the Amer­i­can Rev­o­lu­tion. And that adds sev­er­al fac­tors of anx­i­ety, but also a great deal of a threat from oth­er sources as well. So if we fast for­ward to 1776, the sum­mer of 1776, this is when Abi­gail Adams has the oppor­tu­ni­ty to inoc­u­late both her­self and her children.

And that’s because there’s anoth­er small­pox out­break in Boston at that time. So the town shuts down again, there’s a small­pox inoc­u­la­tion process, and Abi­gail and her chil­dren come in. They’re not liv­ing in Boston at the time, but they come in from where they are, and they go through the process.

And I’m hap­py to share some of her expe­ri­ences with that. Please do. So this is Abi­gail writ­ing to John, and John Adams at this time is in Philadel­phia to debate the pros and cons of inde­pen­dence and what to do with regards to the colony’s rela­tion­ship with the moth­er country.

In fact, this let­ter is after inde­pen­dence has been declared. This is the 13th of July in 1776. And she’s already under­gone the process.

So she writes, she starts with an apol­o­gy to John, quote, I must begin with apol­o­giz­ing to you for not writ­ing since the 17th of June. I’ve real­ly had so many cares upon my hands and mind, with a bad inflam­ma­tion in my eyes, that I have not been able to write. I now date from Boston, where I yes­ter­day arrived and was with all four of our lit­tle ones inoc­u­lat­ed for the smallpox.

We had our bed­ding, etc. to bring. A cow we have dri­ven down from Brain­tree and some hay I have had put into the sta­ble, wood, etc.

And we have real­ly com­menced house­keep­ers here. The house was fur­nished with almost every arti­cle except beds, which we have free use of and think our­selves much oblig­ed by the fine accom­mo­da­tions and kind offer of our friends. All our nec­es­sary stores we pur­chased jointly.

Our lit­tle ones stood the oper­a­tion man­ful­ly. Dr. Bullfinch is our physi­cian. Such a spir­it of inoc­u­la­tion nev­er before took place.

The town and every house in it are as full as they can hold. I believe there are not less than 304 per­sons from Brain­tree, this is the town they’re liv­ing in for peo­ple unfa­mil­iar with the area. 304 per­sons from Brain­tree, she means hav­ing come to Boston for the inoculation.

God grant that we may all go com­fort­ably through the dis­tem­per. So that’s the start of it. Now, the next day she writes again, I had many dis­agree­able sen­sa­tions at the thoughts of com­ing myself.

But to see my chil­dren through it, I thought my duty and all those feel­ings van­ished as soon as I was inoc­u­lat­ed. And I trust a kind Prov­i­dence will car­ry me safe­ly through. I have enough upon our hands in the morning.

The lit­tle folks are very sick then and puke every morn­ing. But after that they are com­fort­able. I shall write you very often.

Pray inform me con­stant­ly of every impor­tant trans­ac­tion. Every expres­sion of ten­der­ness is cor­dial to my heart, unim­por­tant as they are to the rest of the world. To me, they are everything.

So there’s a lot to unpack there too. Of course, she’s talk­ing about how she had fears about going through this process her­self, but she did this for her chil­dren. And she’s also hint­ing at the iso­la­tion they feel being quar­an­tined here, and how she wants to hear about what’s going on where he is, which is where this great debate about inde­pen­dence is tak­ing place.

[Gabrielle Bir­chak]

So now she’s wrestling with the same emo­tions that he strug­gled with in the fear of not just los­ing her­self, but also her kids. And so and then the let­ter starts with an apol­o­gy. I’m sure it has had to be a shock for him receiv­ing it, as well as a com­fort know­ing that they’re tak­ing actions.

And what did that mean for ordi­nary Amer­i­cans watch­ing her exam­ple? Did this influ­ence the desire to be inoc­u­lat­ed in oth­er individuals?

[Dr. Kanisorn Wongsrichanalai]

Peo­ple, by and large, want­ed, of course, to be free from this hor­ri­ble dis­ease. They knew that being inoc­u­lat­ed or sur­viv­ing small­pox meant that they would nev­er have to wor­ry about it again. That much they knew.

They also under­stood that inoc­u­la­tions low­ered the risk of dying as a result. But the prob­lem is some­times in many cas­es dur­ing the colo­nial peri­od and the rev­o­lu­tion­ary peri­od, one of eco­nom­ics. What kind of peo­ple have the means of not work­ing for one month or six weeks?

What kind of peo­ple have the means of find­ing sup­plies for them­selves and their loved ones who are iso­lat­ed, under­go­ing this treat­ment, suf­fer­ing through this? This is some­thing that points to a class divide. There is a class ele­ment here that’s some­times the wealthy, the well to do, the mid­dle class are able to go through this process.

And the dan­ger, of course, is that if any of those peo­ple who are being inoc­u­lat­ed break that quar­an­tine, they risk spread­ing that ill­ness to every­one else who does not have the abil­i­ty to get inoc­u­lat­ed. So there are seri­ous issues that many Amer­i­cans had to con­tend with this par­tic­u­lar time.

[Gabrielle Bir­chak]

And are there any let­ters from Abi­gail where she talks about the relief she felt after being inoculated?

[Dr. Kanisorn Wongsrichanalai]

Abi­gail and the chil­dren have dif­fer­ent reac­tions to the inoc­u­la­tion process. It is pos­si­ble that some­one under­go­ing inoc­u­la­tion will actu­al­ly not catch small­pox. And that means the inoc­u­la­tion has not worked.

So as it turns out with Abi­gail, Abi­gail’s works. But for some of her chil­dren, they have to under­go the process sev­er­al times. There are no symptoms.

They don’t show any symp­toms. And that’s how they know that they’ve not con­tract­ed it after a cer­tain amount of time. And so their quar­an­tine actu­al­ly has to be extend­ed for much longer because they have to make sure that all of the chil­dren have gone through this dis­tem­per, have con­tract­ed it and then have survived.

And ulti­mate­ly they do. And there’s enor­mous relief in Abi­gail’s tone when she writes to John say­ing that all the chil­dren have sur­vived the process.

[Gabrielle Bir­chak]

What was the time­line between their first inoc­u­la­tion and her kids final­ly being recep­tive to the small­pox inoculation?

[Dr. Kanisorn Wongsrichanalai]

So this is Abi­gail Adams to John Adams on the 30th of July in 1776. Quote, I am com­fort­able. John­ny is cleverly.

Nab­by, I hope, has gone through the dis­tem­per. The erup­tion was so tri­fling that to be cer­tain I have had inoc­u­la­tion repeat­ed. Charles and Tom­my have nei­ther had symp­toms nor eruptions.

Charles was inoc­u­lat­ed last Sab­bath evening a sec­ond time. Tom­my today, the three times from some fresh mat­ter tak­en from Becky Peck, who has enough for all the house beside. This sus­pense is painful.

I know not what to do with them. It length­ens out the time which I can but ill afford. And if they can have it, I know not how to quit till I can get them through.

Youth. Youth is the time they have no pains but bod­i­ly, no anx­i­ety of mind, no fears for them­selves or oth­ers. And then the dis­ease is much lighter.

The poor doc­tor is as anx­ious as we are, but begs us to make it cer­tain if repeat­ed inoc­u­la­tions will do it. There are now sev­er­al patients who were inoc­u­lat­ed last win­ter and thought they passed through the dis­tem­per but have now tak­en it in the nat­ur­al way. So this is a real anx­i­ety, right?

Because if some­one goes through it, does not actu­al­ly have the immu­ni­ty because they were not infect­ed through inoc­u­la­tion. They are still sus­cep­ti­ble to it. And then the next day, the very next day, the 31st of July, she writes again.

I have the plea­sure to tell you this morn­ing that I think Tom­my’s sec­ond inoc­u­la­tion has tak­en as he was very ill last night and the erup­tive fever seems com­ing on his 10 days since the sec­ond. So you want to see a reac­tion. You want to see the body respond to this as a sign that the infec­tion has tak­en place and the inoc­u­la­tion process has gone through.

[Gabrielle Bir­chak]

I can’t imag­ine when myself and my kids were going through the first COVID shots, you’re watch­ing your kids strug­gle and you’re not only feel­ing a sense of relief that, okay, great, they’ve tak­en it, they’re respond­ing to the inoc­u­la­tion, but now will they sur­vive this? And on top of it, she’s deal­ing with time­lines and she’s pressed for a struc­ture of time because she’s a busy mom and her hus­band just hap­pens to be John Adams. There’s just so much there in that let­ter that I think every mom can asso­ciate with and go, oh my good­ness, I get this.

That is real­ly just brings back the human­i­ty of his­to­ry. It makes us real­ize how, you know, you were say­ing it’s not writ­ten in his­to­ry. In a lot of our his­to­ries, they don’t bring up the small­pox epidemic.

So it real­ly high­lights every­thing that they were deal­ing with, not just a war, but also smallpox.

[Dr. Kanisorn Wongsrichanalai]

Well, I think dis­ease is the great lev­el­er and it shows peo­ple as peo­ple, they’re human, all of them, all of us are, whether you’re rich or poor, you’re human and you’re affect­ed by all of these awful dis­eases. And so when you read the let­ters of peo­ple who we revere as great Amer­i­cans and see the every­day pain and the anx­i­ety and the con­cern they have for their chil­dren, that they suf­fered, you see them as human beings. And that gets us, I think, to real­ly under­stand that his­to­ry is not foreordained.

It’s not made by peo­ple who knew all the answers. His­to­ry is made by peo­ple like you and me, every­day peo­ple who are try­ing to nav­i­gate events that they face, life and death, how to take care of your chil­dren and how to get to a bet­ter life. And so I think study­ing this, bring­ing this ele­ment of health care to the pub­lic at this moment, the 250th anniver­sary of the start of the Amer­i­can Rev­o­lu­tion, may help us bet­ter under­stand these indi­vid­u­als and per­haps give us a bet­ter under­stand­ing and appre­ci­a­tion for history.

[Gabrielle Bir­chak]

Very well stat­ed. I agree with you a hun­dred per­cent, espe­cial­ly in light of the anniver­sary of the rev­o­lu­tion. Right.

We’ll be right back after a quick word from my adver­tis­ers. And so in light of all of this, was John Adams also com­mu­ni­cat­ing with George Wash­ing­ton? And you were talk­ing about how Wash­ing­ton’s wife was like the cat­a­lyst in him agree­ing to inoc­u­late his army.

[Dr. Kanisorn Wongsrichanalai]

Yes. So there’s a great line from John Adams where he writes lat­er on about his expe­ri­ence hav­ing under­gone the inoc­u­la­tion process. And he talks about how when he was recov­er­ing, they fed him this concoction.

He does not men­tion it in the let­ters I quot­ed to you, but he talks about how they’re also feed­ing them mer­cury. And as a result of this, the teeth in his mouth, his gums were wob­bling. And that gave him some­thing in com­mon with George Wash­ing­ton, who as your lis­ten­ers may know, had hor­ri­ble teeth.

That by the end of his life, he only had a sin­gle tooth remain­ing in his mouth. But Wash­ing­ton him­self, there are many pres­sures on Wash­ing­ton on the mat­ter of small­pox, and he has physi­cians and gen­er­als who are advo­cat­ing it. He knows that the men in the ranks are inoc­u­lat­ing them­selves against orders.

And then he has this oppor­tu­ni­ty to see the inoc­u­la­tion process work with his own wife, Martha Wash­ing­ton, who’s inoc­u­lat­ed in Philadel­phia. And it seems as if right after she emerges from this, hav­ing sur­vived it, he has this change of heart. And it’s as if in the win­ter of 1776 and 77, when the army is encamped, so this is actu­al­ly a qui­et time, there’s not much one can do mil­i­tar­i­ly in the win­ter in the 18th cen­tu­ry, in 18th cen­tu­ry war­fare, hav­ing this evi­dence of small­pox rag­ing across the coun­try, hav­ing this evi­dence of his wife hav­ing sur­vived the process and hav­ing these demands from the men, he orders that the army be inoc­u­lat­ed. So this is a let­ter that Wash­ing­ton writes to William Ship­pen Jr. from his head­quar­ters in Mor­ris­town in win­ter camp, quote, find­ing the small­pox to be spread­ing much and fear­ing that no pre­cau­tion can pre­vent it from run­ning through the whole of our army, I have deter­mined that the troops shall be inoc­u­lat­ed. This expe­di­ent may be attend­ed with some incon­ve­niences and some dis­ad­van­tages, but yet I trust in its con­se­quences will have the most hap­py effects. Neces­si­ty not only autho­rizes, but seems to require the mea­sure for should the dis­or­der infect the army in the nat­ur­al way and rage with its usu­al vir­u­lence, we should have more to dread from it than from the sword of the ene­my. Under these cir­cum­stances, I have direct­ed Dr. Bond to pre­pare imme­di­ate­ly for inoc­u­lat­ing in this quar­ter, keep­ing the mat­ter as secret as pos­si­ble and request that you will with­out delay inoc­u­late all the con­ti­nen­tal troops that are in Philadel­phia and those that shall come in as fast as they arrive. You will spare no pains to car­ry them through the dis­or­der with the utmost expe­di­tion and to have them cleansed from the infec­tion when recov­ered, that they may pro­ceed to camp with as lit­tle injury as pos­si­ble to the coun­try through which they pass. If the busi­ness is imme­di­ate­ly begun and favored with the com­mon suc­cess, I would feign hope they will be soon fit for duty and that in a short space of time, we shall have an army not sub­ject to this, the great­est of all calami­ties that can befall it when tak­en in the nat­ur­al way.

[Gabrielle Bir­chak]

That is a bold state­ment. And it was a let­ter that he wrote to William Ship­per, correct?

[Dr. Kanisorn Wongsrichanalai]

It’s a let­ter to William Ship­pen, who’s in charge of the troops in Philadel­phia. Yes.

[Gabrielle Bir­chak]

Okay. So was this kept a secret? Like for fear of moles, maybe infor­ma­tion being shared with the oppos­ing military?

[Dr. Kanisorn Wongsrichanalai]

I think they cer­tain­ly tried to keep it a secret. But of course, if you’re inoc­u­lat­ing thou­sands and thou­sands of peo­ple, word will spread. Of course, the good news is this is, as I men­tioned, in the mid­dle of win­ter and it’s very dif­fi­cult for any troops in the 18th cen­tu­ry to mobi­lize to fight dur­ing this time.

So it’s actu­al­ly a safe time to do this. I just am always struck by what Wash­ing­ton calls this at the end of his the­sis, the great­est of all calami­ties that can befall it when tak­en in the nat­ur­al way. Yes.

This is a sig­nif­i­cant change in how peo­ple view inoc­u­la­tion, that when the Con­ti­nen­tal Army inoc­u­lates its troops wher­ev­er they are, it changes how peo­ple, civil­ians in the colonies, regard it as well. Con­necti­cut, for exam­ple, had had very strict laws ban­ning inoc­u­la­tion and it ulti­mate­ly had to repeal these because sol­diers were being inoc­u­lat­ed in Con­necti­cut dur­ing the war itself. And peo­ple under­stood that this was a real­ly impor­tant innovation.

And if the com­man­der of the Con­ti­nen­tal Army is order­ing it and sees its effec­tive­ness, then that car­ries a lot of weight with indi­vid­u­als, too. It’s still a dam­ag­ing dis­ease. His­to­ri­ans esti­mate that about 100,000 peo­ple died dur­ing the small­pox epi­dem­ic dur­ing the Amer­i­can Revolution.

But I think that Wash­ing­ton’s actions not only saved a lot of lives, but may have saved the army and there­fore saved the rev­o­lu­tion as well.

[Gabrielle Bir­chak]

No doubt. And it was, I’m sure, incred­i­bly influ­en­tial on the com­mu­ni­ty at large. What was the oppo­si­tion, like those who are anti-inoc­u­la­tors, who felt like it was God’s will, what did that look like?

Was there any dis­cus­sion between pos­si­bly Adams or Wash­ing­ton or oth­ers dis­cussing those who opposed it?

[Dr. Kanisorn Wongsrichanalai]

To my knowl­edge, there is none of that. I think that the reli­gious objec­tions to this, which we saw ear­ly in the 18th cen­tu­ry, had real­ly been mut­ed by the time we get to the late 18th cen­tu­ry and clos­er to the rev­o­lu­tion. I mean, the facts are, well, to take John Adams quo­ta­tion from a dif­fer­ent con­text, facts are stub­born things and you can­not deny the suc­cess of this.

So, for exam­ple, in 1776 in Boston, this out­break where Abi­gail Adams has her­self and her fam­i­ly inoc­u­lat­ed, there are, once again, if you look at the math, if you look at the sta­tis­tics, 304 peo­ple in Boston con­tract small­pox the nat­ur­al way, 29 of them die, that’s nine and a half per­cent mor­tal­i­ty, 4,988 are inoc­u­lat­ed, that’s almost 5,000 peo­ple inoc­u­lat­ed, 28 peo­ple die, that’s 0.6 per­cent mor­tal­i­ty. There is just no ques­tion that this reduces your chances of death from smallpox.

[Gabrielle Bir­chak]

And there it is, the facts that are very stub­born things, they tend to be the ulti­mate influ­ence in the ulti­mate decision.

[Dr. Kanisorn Wongsrichanalai]

And I have a line for you and your lis­ten­ers, this is a pod­cast, math, sci­ence, his­to­ry, so I’m going to say do the math, believe the sci­ence, learn your history.

[Gabrielle Bir­chak]

Oh my good­ness, I’m going to have that print­ed out and put in a frame.

[Dr. Kanisorn Wongsrichanalai]

Well, right, do the math, look at the stats, believe the sci­ence, believe what the inoc­u­la­tion does and learn your history.

[Gabrielle Bir­chak]

Yes, and learn his­to­ry. It’s like I always say, his­to­ry, they’re the ulti­mate in show­ing us where the red flags of dan­ger lie. Yes, his­to­ry is the ulti­mate in show­ing us what we can learn from it.

This is, it’s a won­der­ful tool to have and hope­ful­ly that will nev­er be destroyed under our watch or any­body else’s watch for that matter.

[Dr. Kanisorn Wongsrichanalai]

Well, if the MHS can help it, that’s not going to happen.

[Gabrielle Bir­chak]

And that’s why I love the MHS. I love the work that you pro­vide for the com­mu­ni­ty and for the coun­try and for the world at large to see this won­der­ful exper­i­ment that is the Unit­ed States and how it came to be and where it could pos­si­bly go. So I want to, I want to ask, so when we look at George Wash­ing­ton’s deci­sion to inoc­u­late the army and Abi­gail Adams’ choice to inoc­u­late her fam­i­ly, her chil­dren, and the way Amer­i­cans embraced the inoc­u­la­tion after the rev­o­lu­tion, and this goes back to where we are today, what does that tell us about how the rev­o­lu­tion­ary gen­er­a­tion bal­anced their per­son­al risk, their pub­lic health, and their sur­vival of a new nation? And what does that tell us about how we can do the same?

[Dr. Kanisorn Wongsrichanalai]

That is a very good ques­tion. Peo­ple say that his­to­ry repeats itself, but that’s not entire­ly true. There’s no way to repli­cate the con­di­tions of the past that brought Amer­i­can soci­ety together.

And I would argue that there was a greater con­sen­sus in the colonies that would become the Unit­ed States about the effi­ca­cy, the suc­cess of inoc­u­la­tion than there per­haps was over the issue of whether or not we should be an inde­pen­dent nation from Great Britain. These were issues of health, of pub­lic health, issues of pol­i­tics are always divi­sive. But unlike pol­i­tics, whether domes­tic or inter­na­tion­al, as I said, going back to what we dis­cussed ear­li­er, pub­lic health, the health of the soci­ety is some­thing that one can­not escape.

And I think that at that par­tic­u­lar time, there was a real under­stand­ing that we all are in this togeth­er. For exam­ple, if you live in a town where a small­pox has bro­ken out, you are wor­ried about your­self, you are wor­ried about your loved ones, and you under­stand that the only way that you’re going to sur­vive, that the com­mu­ni­ty is going to sur­vive, is that every­one gets involved. Every­one gets inoc­u­lat­ed or every­one adheres to the quarantine.

This is some­thing that’s very dif­fi­cult for us to under­stand now because, of course, we do not live under the threat of as awful a plague as small­pox. We do not live under the threat of numer­ous dis­eases that have been, if not defeat­ed, as small­pox has been, but cer­tain­ly lim­it­ed in what they do, their effects on humankind. Yel­low fever, for example.

And I think that we are at a point in our his­to­ry where our lux­u­ry, our bless­ings of sci­ence have got­ten us to a place where we can, to the detri­ment, per­haps, of the greater good, where we can’t ignore or chal­lenge or say that we’re not going to get involved in some­thing that is ben­e­fi­cial to all. And so this is why it’s real­ly impor­tant to under­stand his­to­ry and the con­text of his­to­ry and the full sto­ry of his­to­ry. It’s not just about the revolution.

This is also about Amer­i­cans fight­ing off and com­ing togeth­er and find­ing con­sen­sus and ral­ly­ing around the idea of inoc­u­la­tion to fight this hor­ri­ble scourge. It gives us a sense of the impor­tance of that and a threat that big requires a uni­fied response. Per­haps that’s some­thing that we shall see again.

I cer­tain­ly hope so. But it cer­tain­ly brings a com­mu­ni­ty togeth­er in a way that very few oth­er events do.

[Gabrielle Bir­chak]

And that was beau­ti­ful. I think what you’ve high­light­ed so pow­er­ful­ly is that pol­i­tics has always been divi­sive, but health leaves no room to stand apart. And the part that real­ly res­onates today is that the rev­o­lu­tion was­n’t only one on the battlefield.

It was held togeth­er by com­mu­ni­ties who trust­ed sci­ence and cared for one anoth­er. Yes. Well, I will let you wrap up.

[Dr. Kanisorn Wongsrichanalai]

Sure. So just a few years after the Amer­i­can Rev­o­lu­tion, actu­al­ly after the peri­od of con­fed­er­a­tion, after the Con­sti­tu­tion­al Con­ven­tion, this is actu­al­ly 1796, which is the year that John Adams is elect­ed pres­i­dent. Edward Jen­ner, on the oth­er side of the Atlantic, noticed that dairy­maids who had been affect­ed by cow­pox were immune from smallpox.

I’ll point out also that small­pox is some­thing that only humans get. No oth­er ani­mal species get small­pox. They have their own forms.

But humans can get cow­pox. And it’s a very mild response from the human body, this reac­tion, but it builds up immu­ni­ty to small­pox. And so Jen­ner and oth­er physi­cians come up with the idea of vaccination.

And the word vac­cine is from this time peri­od. So it’s cow­pox, cow vac­cine. So to give some­one cow­pox is a way to pre­vent them from get­ting smallpox.

It builds up the same immu­ni­ty one needs. And one is not infec­tious dur­ing that time. So one can­not spread it because one does not have smallpox.

And so this is much safer. You do not need to quar­an­tine. You do not need to shut down trade.

You do not need to shut down a town. And it is safe. And this is the start of this under­stand­ing of how to ulti­mate­ly com­bat small­pox, which is erad­i­cat­ed, as we know it, as a threat.

In the 20th cen­tu­ry, in 1980, the World Health Orga­ni­za­tion declared that it had seen the last of small­pox. And the last out­break in the Unit­ed States took place in 1949. But there was a real con­cert­ed effort in the 1960s to do this, and they were suc­cess­ful by the 1970s.

So there are sev­er­al gen­er­a­tions of humans that have now lived in a world where there is no smallpox.

[Gabrielle Bir­chak]

I did not know that. So it’s almost as if they aren’t even aware of poten­tial threats. Yes.

[Dr. Kanisorn Wongsrichanalai]

And I should spec­i­fy that although no one that we know of has small­pox and there have not been any out­breaks, the Unit­ed States has a small sam­ple of it. And Rus­sia has a small sam­ple of it. Both of these super­pow­ers are keep­ing this for poten­tial research.

And this is a huge debate in the sci­en­tif­ic com­mu­ni­ty about whether or not to just com­plete­ly erad­i­cate this, just destroy the sam­ple, lest it get out again. In fact, I think the last per­son to actu­al­ly have con­tract­ed small­pox and died of small­pox was in the Unit­ed King­dom. And it was from a lab leak of some sort.

But this was decades ago. So there are still sam­ples that exist, but this is beyond my field of exper­tise. I’ll leave this to med­ical pro­fes­sion­als, sci­en­tists and eth­i­cal experts, philoso­phers to talk about what to do with these samples.

But no one has been infect­ed with small­pox that we know of for sev­er­al decades.

[Gabrielle Bir­chak]

That is the per­fect ques­tion to end the pod­cast on. It makes us reflect back on our ethics. And what does the sci­ence say?

Do we observe these sam­ples or do we destroy them? And would that be an act of igno­rance or would that be an act of curios­i­ty and sci­en­tif­ic study? That’s wonderful.

I love this. I love leav­ing out a ques­tion. Well, thank you very much for your time, Dr. Wongsrichanalai. If my lis­ten­ers want more infor­ma­tion, where can they go to either see some of these let­ters, read them or learn more about the Mass­a­chu­setts His­tor­i­cal Society?

[Dr. Kanisorn Wongsrichanalai]

We invite peo­ple to vis­it our web­site at www.masshist.org online so you can learn about our col­lec­tions. You can see the Adams Papers, links to the Adams Papers project. And you can also, if you are in the city of Boston, come vis­it us in the Back Bay.

We are very close to Fen­way Park and we are free and open to the pub­lic. Come see the trea­sures that belong to the Amer­i­can peo­ple that we hold in trust for them, for future gen­er­a­tions and for pos­ter­i­ty. Yes, please visit.

It was a plea­sure speak­ing with you. This was a lot of fun.

[Gabrielle Bir­chak]

It was. And thank you so much for your time. I believe that his­to­ry does­n’t just live in our textbooks.

It lives in the choic­es we make today. Two hun­dred and fifty years ago, George Wash­ing­ton, Martha Wash­ing­ton, John Adams and Abi­gail Adams chose to risk the unknown to place their trust in sci­ence. And in doing so, they safe­guard­ed a frag­ile nation’s future.

Their courage reminds us that progress has always required faith, not blind faith, but faith ground­ed in evi­dence, in resilience and in the shared hope of build­ing some­thing greater than our­selves as we face the chal­lenges of our own coun­try. Now, may we remem­ber that lega­cy. May we remem­ber that courage is not just found on bat­tle­fields, but in the qui­et, deter­mined choice to trust knowl­edge, to pro­tect one anoth­er and to look for­ward toward the future and toward sci­ence with resolve.

Thank you for join­ing me today. And thank you again to Dr. Kanisorn Wongsrichanalai for his invalu­able insight. Until next time, stay curi­ous, stay coura­geous and nev­er for­get the pow­er of sci­ence that will car­ry us forward.

Until next time, Carpe Diem.