"An Alteration in the human countenance": Inoculation, Vaccination, and the Face of Smallpox in the Age of Jenner

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While rarely considered a ‘skin’ disease per se, smallpox has nearly always been seen as an imprintation of the skin. e story of smallpox contains two gures who visibly exhibited the disease: the pustuled su erer and the pitted survivor. Its terrible symptoms and sequela were undeniably unique and practically universally recognizable. Robert John ornton’s description of smallpox in 1805 maintained that ‘no disease … presents a more melancholy scene’. Following the earliest symptoms of backache, intense fever and delirium, an eruption of pimples mature into pustules, which then ooze pus before sinking into depressions on the skin. ese distinctive ‘pocks’ cluster on the face, neck and arms, and mark an individual as a smallpox su erer. In severe cases, the ‘human face divine, bere of every human feature, then exhibits the most distressing sight, being one mass of corruption’. O en permanent, these seams and scars also identify the smallpox survivor. Fortunately, a single attack conferred immunity to the disease; if it had not, ornton believed, ‘the human race would have presented a frightful spectacle of corroded scars and mangled deformity, or, what is more probable, would have become extinct’.1

Chapter of

A Medical History of Skin


Kevin Patrick Siena