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To Save the Children: Smallpox Inoculation, Vaccination, and Public Health in Guanajuato, Mexico, 1797-18401

Published online by Cambridge University Press:  11 December 2015

Angela T. Thompson
Angela T. Thompson*
Affiliation:
East Carolina University, Greenville, North Carolina
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Extract

When smallpox threatened the Mexican province of Guanajuato in October 1797, Juan de Riaño, the Intendant of Guanajuato, instituted a program of inoculation to protect the children of his province against the disease. Realizing that many parents would resist having their children inoculated, he decided to provide an example by having his own six children inoculated first, thereby encouraging other parents to bring their children forward. Accordingly, a physician made deep scratches in the arms of his children, three of whom were under the age of five, and rubbed organic matter containing live smallpox virus into the wounds. Thanking Riaño for this gesture, Dr. Juan de Islas praised him for showing “true mercy for your children, banishing the timidity from the minds of others.” Nor was their timidity entirely unjustified. People occasionally died from inoculation, for inoculation provided immunity by artificially inducing a case of smallpox, but one that was usually benign. The risk of dying from inoculation was much lower than from contracting smallpox naturally. That was the point Riaño was trying to make to the people of Guanajuato.

Type
Research Article
Information
The Americas , Volume 49 , Issue 4 , April 1993 , pp. 431 - 455
Copyright
Copyright © Academy of American Franciscan History 1993

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Footnotes

1

I would like to acknowledge the assistance of Paula Petrik, Jason Thompson, David Harley, Rosa Alicia Pérez Luque, the staff of the Archivo Histórico de Guanajuato, and the anonymous reviewers. A National Endowment for the Humanities Travel to Collections Grant, an Albert J. Beveridge Grant for Research in the History of the Western Hemisphere from the American Historical Association, and an East Carolina University Research Grant helped to fund research in Guanajuato, Mexico, during the summers of 1991 and 1992.

References

2 Archivo Histórico de Guanajuato, Salubridad y Asistencia (hereafter cited as AHG, SA), Tomo I, 1692–1797, Exp. 17, October 8, 1797, and February 12, 1798.

3 For a comprehensive discussion of the risks of inoculation, also called variolation, and vaccination and the problems of administering them see Hopkins, Donald R., Princes and Peasants: Smallpox in History (Chicago: The University of Chicago Press, 1983), pp. 49–69,Google Scholar 83–89.

4 The cause of variola major, the strain of smallpox involved in the 1797 epidemic in Mexico, was a brick-shaped virus. Variola major could cause an infection that ranged from fulminating, which often resulted in death, to benign, which the victim usually survived with lifelong immunity. See Hopkins, , Princes and Peasants, pp. 3–5.Google Scholar

5 The increasing interest in children, for humanitarian as well as socioeconomic and political reasons, as a result of the Enlightenment and of the formation of liberal republican government in Mexico is discussed in Thompson, Angela “Children in Family and Society: Guanajuato, Mexico, 1780 to 1840” (Ph.D. diss., The University of Texas, 1990).Google Scholar For a discussion of liberal attitudes toward social assistance see Vergne, Teresita Martinez, “The Liberal Concept of Charity: Beneficencia Applied to Puerto Rico, 1821–1868,” in Szuchman, Mark, ed., The Middle Period in Latin America: Values and Attitudes in the 17th-19th Centuries (Boulder: Lynne Rienner Publishers, 1989), pp. 167–70.Google Scholar

6 Hopkins, , Princes and Peasants, pp. 3,Google Scholar 12; Cooper, Donald, Epidemic Disease in Mexico City, 1761–1813 (Austin: University of Texas Press, 1965), pp. 56–69 Google Scholar; Archila, Ricardo, “The Balmis Expedition in Venezuela. Part II: Founding of the Central Vaccination Board, 1804,” in Bowers, John Z. and Purcell, Elizabeth F. eds., Aspects of the History of Medicine in Latin America (New York: Josiah Macy, Jr. Foundation, 1979), pp. 149–50.Google Scholar

7 Public health is “the science and art of preventing disease and promoting health through organized community activity.” Blake, John B., Public Health in the Town of Boston, 1630–1822 (Cambridge: Harvard University Press, 1959), p. 7.Google Scholar The period 1750 to 1830 was a pivotal period in the development of modern public health, according to George Rosen. During this period government increased its involvement in disease control and in the provision of health care, health education, and sanitary environments. The purpose was to reduce mortality and to improve the health of the entire community. Efforts to prevent smallpox played a prominent part in this process. Rosen, George, A History of Public Health (New York: MD Publications, 1958), pp. 131–91.CrossRefGoogle ScholarPubMed For a discussion of the role Spanish colonial government and government agencies played in public health in the late eighteenth and early nineteenth centuries see Lanning, John Tate, The Royal Protomedicato: The Regulation of the Medical Profession in the Spanish Empire, edited by TePaske, John Jay (Durham, NC: Duke University Press, 1985), pp. 351–86.Google Scholar

8 Brading, David, Miners and Merchants in Bourbon Mexico, 1763–1810 (Cambridge: Cambridge University Press, 1971), pp. 226–33.Google Scholar

9 On the 1797 epidemic and inoculation, see Cook, Sherburne, “The Smallpox Epidemic of 1797 in Mexico,” Bulletin of the History of Medicine, 7:8 (October 1939/40), 937–69Google Scholar; Price, Robin, “State Church Charity and Smallpox: An Epidemic Crisis in the City of Mexico 1797–98,” Journal of the Royal Society of Medicine, 75 (May 1982), 356–67Google Scholar; Pérez Luque, Rosa Alicia, “Bosquejo de la viruela en México y la epidemia de 1797–98 en Guanajuato,” Testimonios: Organo de Divulgación del Archivo Histórico de Guanajuato, 2 (Octubre 1987-Enero 1988), 48–64 Google Scholar; and Cooper, , Epidemic Disease, pp. 86–156.Google Scholar On various aspects of the 1804 royal expedition organized to vaccinate children in the Spanish Empire, see, for example, Smith, Michael, The “Real Expedición Marítima de la Vacuna” in New Spain and Guatemala (Philadelphia: Transactions of the American Philosophical Society, New Series, Volume 64, Part 1, 1974)Google Scholar; Archila, , “The Balmis Expedition,” pp. 142–77Google Scholar; Lanning, , The Royal Protomedicato, pp. 378–86Google Scholar; Rigau-Pérez, José G., “The Introduction of Smallpox Vaccine in 1803 and the Adoption of Immunization as a Government Function in Puerto Rico,” Hispanic American Historical Review, 69:3 (August 1989), 393–425.CrossRefGoogle ScholarPubMed

10 Endemie means that a disease never disappeared, but was continually present in a population erupting in an epidemic every 5 to 15 years or so. A disease became epidemic when widespread infection flared after enough susceptible individuals were born or moved into an area. This was the case with smallpox in Guanajuato and other parts of Mexico by the middle of the eighteenth century, if not earlier. See Hopkins, , Princes and Peasants, p. 8.Google Scholar Cook found that in the 1797 smallpox epidemic even in the Indian villages of Oaxaca only children were affected so the disease must have become endemic even among Indians. Cook, , “The Smallpox Epidemic of 1797 in Mexico,” pp. 939–40.Google Scholar

Although I have yet to find evidence that smallpox was epidemic before 1706 or between 1706 and 1762 in Guanajuato, that does not mean that cases did not exist there even in epidemic proportions. In Mexico City and the Central Valley in the eighteenth century smallpox epidemics occurred in 1711, 1734, 1748, 1761–62, 1779–80, and 1797. Gibson, Charles, The Aztecs under Spanish Rule (Stanford: Stanford University Press, 1964), appendix IV, pp. 448–51.Google Scholar

11 Marmelejo, Lucio, Efemérides Guanajuatenses (Mexico City, 1967), 2, p. 120.Google Scholar

12 AHG, SA, Tomo I, 1692–1797, Exp. 17, April 1, 1797.

13 The smallpox inoculation was publicized in England in 1721 by Lady Mary Wortley Montagu, and the technique was slowly accepted in official circles in Europe and elsewhere, only after serious debate. AHG, SA, Tomo I, 1692–1797, Exp. 17, January 26, 1798. For additional information on the dissemination of smallpox inoculation see McNeill, William H., Plagues and Peoples (Garden City, NY: Anchor Press/Doubleday, 1976), pp. 249–50.Google Scholar

14 Hopkins, , Princes and Peasants, pp. 6–7.Google Scholar AHG, SA, Tomo I, 1692–1797, Exp. 17, January 26 and February 3, 1798.

15 Cooper, , Epidemic Disease, p. 66.Google Scholar

16 Viceroy Branciforte’s edict of February 28, 1797, is quoted in Riaño’s letter to the Guanajuato ayuntamiento. AHG, SA, Tomo I, 1692–1797, Exp. 17, April 7, 1797. The viceroy ordered local communities to offer inoculation, but only on a voluntary basis.

17 AHG, SA, Tomo I, 1692–1797, Exp. 17, September 20, 1797.

18 AHG, SA, Tomo I, 1692–1797, Exp. 17, October 8, 1797. Funds came from donations and the city treasury. In the final accounting slightly over 11,093 pesos were spent during the crisis between October 26, 1797 and January 27, 1798. Individuals and institutions donated 11,451 pesos, leaving a surplus of 358 pesos. AHG, SA, Tomo II, 1798–1816, Exp. 3, Report on expenses, October 26, 1797 to January 27, 1798.

19 AHG, SA, Tomo I, 1692–1797, Exp. 17, October 8, 1797.

20 AHG, SA, Tomo I, 1692–1797, Exp. 17, February 3 and March 1, 1798.

21 AHG, SA, Tomo I, 1692–1797, Exp. 19, November 27, 1797, and Exps. 20–24, December 4–31, 1797.

22 AHG, SA, Tomo I, 1692–1797, Exp. 17, March 1, 1798, and Exp. 29, January 29, 1798.

23 For mortality as a result of inoculation, see Hopkins, , Princes and Peasants, p. 8.Google Scholar It is likely that some cases resulting in death and reported as naturally contracted cases were actually caused by inoculation and that authorities deliberately obscured them in order to convince more people to have their children inoculated.

24 AHG, SA, Tomo I, 1692–1797, Exp. 17, February 3, 1798.

25 AHG, SA, Tomo I, 1692–1797, Exp. 17, March 1, 1798. These reports also indicated that blindness and pockmarks resulted from smallpox. Another lasting effect was male infertility. See Hopkins, , Princes and Peasants, p. 5.Google Scholar

26 AHG, SA, Tomo I, 1692–1797, Exp. 17, February 3 and March 1, 1798.

27 AHG, SA, Tomo I, 1692–1797, Exp. 17, November 24, 1797.

28 1 931 were inoculated in the district of Celaya; 1803 received treatment in the town of Celaya; no one was inoculated in fifteen of the twenty rural pueblos around Celaya. AHG, SA, Tomo II, 1798–1816, Exp. 6, March 1, 1800.

29 AHG, SA, Tomo II, 1798–1816, Exp. 1, December 26, 1797, and Exp. 6, November 14, 1799.

30 AHG, SA, Tomo I, 1692–1797, Exp. 17, October 31, 1797, Branciforte to the Ayuntamiento of Guanajuato.

31 In at least one instance, Tomás Alamán and Martin de la Riva from ward number three reported that an inebriated father verbally abused ward officials when they tried to check on his dying daughter. They threatened him with jail, but the mother’s tears convinced them to overlook the abuse. AHG, SA, Tomo I, 1692–1797, Exp. 23, December 25, 1797.

32 Cooper, , Epidemie Disease, pp. 126–54.Google Scholar

33 AHG, SA, Tomo II, 1798–1816, Exp. 6, March 10, 1800.

34 Previously inoculated persons could also provide matter for further inoculations, but initially the matter had to come from a person who had been naturally infected. See Hopkins, , Princes and Peasants, pp. 58–60.Google Scholar

35 Jenner’s findings were published in London in a pamphlet, An Inquiry into the Causes and Effects of Variolae Vaccine, a Disease, Discovered in some of the Western Counties of England, particularly Gloucestershire, and known by the Name of Cow Pox. See Hopkins, , Princes and Peasants, pp. 79–81.Google Scholar

36 The World Health Organization finally proclaimed the eradication of smallpox in 1979. See Hopkins, , Princes and Peasants, pp. 310,Google Scholar 317.

37 The vaccine had already been introduced into the hemisphere, and Balmis, who intended to be the first to introduce it to the entire Spanish Empire, found that several areas where he stopped had already acquired it. Puerto Rico was one example, see Rigau-Pérez, , “The Introduction of Smallpox Vaccine,” p. 394.Google Scholar

38 Smith, , The “Real Expedición Marítima de la Vacuna”, p. 68.Google Scholar The preservation and production of lymph for vaccine did not regularly occur until the latter part of the nineteenth century when it was found that the vaccine could be preserved in glycerin in 1891. Rosen, , A History of Public Health, p. 279.Google Scholar Other areas in Latin America also tried to sustain the vaccine although erratically, so Guanajuato was probably not unique. See, for example, Rigau-Pérez, , “The Introduction of Smallpox Vaccine,” pp. 419–23Google Scholar; Archila, , “The Balmis Expedition,” pp. 142–77,Google Scholar and Lanning, , The Royal Protomedicato, pp. 378–86.Google Scholar

39 Balmis planned to introduce smallpox vaccination to New Spain and the Philippines. He intended to send trained assistants to Guatemala and South America. Smith, , The “Real Expedición Marítima de la Vacuna”, pp. 15,Google Scholar 20.

40 Rigau-Pérez, , “The Introduction of Smallpox Vaccine,” p. 394.Google Scholar

41 AHG, SA, Tomo II, 1798–1816, Exp. 9, October 26, 1804, Exp. 10, November 23, 1804.

42 Cooperation was not always forthcoming. The apparent egotism of Balmis and of some local officials and physicians often made cooperation difficult. Rigau-Pérez, for example, focuses on the dispute that developed between Balmis and Puerto Rican officials and physicians. Rigau-Pérez, , “The Introduction of Smallpox Vaccine,” pp. 393–94.Google Scholar

43 AHG, SA, Tomo II, 1798–1816, Exp. 9, October 26, 1804. This is a copy of the original order which was dated September 1, 1803.

44 AHG, SA, Tomo II, 1798–1816, Exp. 10, November 20 and 21, 1804.

45 AHG, SA, Tomo II, 1798–1816, Exp. 10, November 23, 1804.

46 AHG, SA, Tomo II, 1798–1816, Exp. 10, November 23 and December 13, 1804.

47 AHG, SA, Tomo II, 1798–1816, Exp. 10, November 20, 1804.

48 AHG, SA, Tomo II, 1798–1816, Exp. 10, November 25, 1804, and January 17, 1805.

49 AHG, SA, Tomo II, 1798–1816, Exp. 10, July 4 and August 16, 1810 and Exp. 13, December 31, 1808. Drs. Rafael Fernández and Francisco Duran directed the vaccination program from November 1804 until January 1809. AHG, SA, Tomo II, 1798–1816, Exp. 13, January 21, 1809.

50 Green, Stanley C., The Mexican Republic: The First Decade, 1823–1832 (Pittsburgh: Pitt Latin American Series, University of Pittsburgh Press, 1987), p. 105.Google Scholar Green argues that some local health committees, or boards as he calls them, were formed during the independence period, some as a result of decrees issued by the Cortes of Cádiz in 1813. The evidence suggests that such a committee did not exist in Guanajuato before the mid-1820s, although there was a committee of public instruction. Martinez Vergne points out that juntas de beneficencia formed in some places in 1821 in response to legislation from the Spanish Cortes which delegated the ayuntamientos to monitor activities that involved social welfare and public health: Vergne, Martinez “The Liberal Concept of Charity,” p. 170.Google Scholar

51 Smith indicates that a consequence of the Balmis expedition was that he left in his wake trained physicians and local administrators who directed a program of “intercommunicating local organizations” to assure the “continual” availability of vaccine. See Smith, , The “Real Expedición Marítima de la Vacuna”, p. 49.Google Scholar In 1842 Dr. Leopoldo Río de la Loza, president of the newly created national Superior Council of Health, listed in a report the basic reponsibilities of public health in Mexico. He said that vaccination was one of the basic activities for which public health institutions had been created. Cited in Alamilla, David Molina, “Introducción,” Guía del Fondo Salubridad Pública (México: Archivo Histórico de la Secretaría de Salud, 1991), 2, p. 6.Google Scholar

52 AHG, SA, Tomo II, 1798–1816, Exp. 33, October 29, 1814.

53 AHG, SA, Tomo II, 1798–1816; Exp. 35, March 10, 1816.

54 AHG, SA, Tomo III, 1817–25, Exp. 50, June 28, 1822.

55 AHG, SA, Tomo III, 1817–25, Exp. 50, June 19, 1822.

56 AHG, SA, Tomo III, 1817–25, Exp. 48, July 6, 1825.

57 AHG, SA, Tomo III, 1817–25, Exp. 50, April 23 and June 19 and 28, 1822 and September 11, 1825.

58 The expedition found infected cattle only in Durango, Puebla, and Michoacán. Smith, , The “Real Expedición Marítima de la Vacuna,” p. 49.Google Scholar

59 AHG, SA, Tomo III, 1817–25, various expedientes; a list of juntas in 1825 is in Exp. 48.

60 AHG, SA, Tomo IV, 1826–27, Exp. 8, No. 92, September 20, 1826 and December 17, 1827.

61 AHG, SA, Tomo III, 1817–25, Exp. 48, July 6, 1825. Guanajuato, , Constitución Política del Estado Libre de Guanajuato, April 1826,Google Scholar Título Dos, sección segunda, número 109.

62 In recognition of his contributions to the welfare of children, Guanajuato’s largest public primary school is now named after Carlos Montesdeoca. A relative, Demetrio Montesdeoca, also provided local leadership in health and education, as did others, such as Antonio Camacho and José Victoriano Aguilar who served as president of the Junta Muncipal de Sanidad in 1825 and 1826, respectively. AHG, SA, Tomo II, 1798–1816, Exp. 13, January 19, 1809; Tomo III, 1817–25, Exp. 48, September 11, 1825; and Tomo IV, 1826–1827, Exp. 8, January 4, 1826.

63 In 1826, for example, Guanajuato’s municipal public health committee discussed opening a hospital for women. Five years later the Committee still had not taken any action for lack of funds. Then, a bequest of 30,000 pesos from the Countess of Valenciana allowed the Committee to open a hospital for women in the early 1830s. AHG, SA, Tomo IV, 1826–27, Exp. 8, No. 92, September 20, 1826 and December 17, 1827; Tomo V, 1827–28, Exp. 6, January 22 and March 27, 1828; Tomo VII, 1834–38, Exp. 3, July 30, 1834.

64 When fluid was needed, a non-immune child was vaccinated and sent with a chaperone to the place where vaccine was needed. The cost of the chaperone and transportation was paid by the town council. In 1831 the city of Guanajuato had no live vaccine. Efforts to inoculate with “three crystals” sent from Mexico City were unsuccessful. AHG, SA, Tomo VI, 1830–33, Exp. 4, February 14, 1831. Likewise, Pénjamo reported in May 1830 that there were no more children in that city to vaccinate and thus none with which to preserve the vaccine. AHG, SA, Tomo VI, 1830–33, Exp. 7, May 19, 1830.

65 AHG, SA, Tomo III, 1817–25, Exp. 26, October 28, 1825.

66 AHG, SA, Tomo IV, 1826–27, Exp. 8, Circular June 23 and 24, 1826.

67 AHG, SA, Tomo IV, 1826–27, José María Arrieta from León to President of the Junta de Sanidad, July 8, 1826 and September 9, 1826; Balthasar de Pesquera from Silao to Junta de Sanidad, March 2, 1826; Manuel Gómez de Linares from Celaya, February 28, 1826; Manuel Diaz de la Madrid from Chamacuero, May 31, 1826.

68 AHG, Memoria del Gobierno, 1826.

69 AHG, SA, Tomo IV, 1826–27, Exp. 15, July 24, 1826; and Exp. 11, “Nacidos, Matrimonios y Muertos,” León, 1827.

70 Birth and death figures from parish reports in AHG, SA, Tomo III, 1817–1825; and from Romero, José Guadalupe, Noticias para formar la Historia y la Estadística del Obispado de Michoacán presentados a la Sociedad Mexicana de Geografía y Estadística en 1860 (México: Imprenta a Vicente García Torres, 1862), p. 93.Google Scholar

71 AHG, SA, Tomo VI, 1830–33, Exp. 4, April 26, 1830.

72 AHG, SA, Tomo VI, 1830–33, Exp. 4, May 18 and 31, 1830.

73 AHG, SA, Tomo VI, 1830–33, Exp. 4, May 31, 1830.

74 AHG, SA, Tomo IV, Exp. 4, Dr. José Francisco Contreras to Junta de Sanidad, March 24, 1830; AHG, Memoria del Gobierno, 1826.

75 AHG, SA, Tomo VI, 1830–33, Exp. 4, June 7, 1830.

76 The number who died in Guanajuato was 1054 and in the nearby parish of Santa Anna (also part of the municipality of Guanajuato) was 262: AHG, SA, Tomo VI, 1830–33, Exp. 4, November 2 and December 17, 1830. The population figure for 1830 was taken from Romero, , Noticias para formar la Historia y la Estadística, p. 93.Google Scholar

77 That the vaccine did not always provide permanent immunity was one of the most common criticisms of it by those who questioned its use. On revaccination see Hopkins, , Princes and Peasants, pp. 84,Google Scholar 88.

78 AHG, SA, Tomo VI, 1830–33, Exp. 4, (month illegible) 12, 1830.

79 Hopkins, , Princes and Peasants, p. 85.Google Scholar

80 Ibid.

81 This calculation is based on the following: In 1792/93 the population of Guanajuato and its suburbs was slightly over 55,000. By 1800 it has been estimated at between sixty to sixty-six thousand. During the 1797 epidemic 2169 children died in Guanajuato and its suburbs, which is 3.6 per cent of 60,000. In 1797, the population of that area was probably somewhat lower than 60,000, so deaths as a percentage of the population was actually slightly higher than 3.6 per cent in 1797. In 1797 there were over 27,000 children at risk. Although I do not have a breakdown by age of the population in 1830, based on the number of births and deaths of children during the previous six years, I suspect that the number of children at risk was probably about 15,000. But migration has not been factored in and that could affect the age structure of the population. Figures from AHG, SA, Tomo I, 1692–1797, Exp. 29 and Tomo II, 1798–1816, Exp. 6 (listed in Table 3 of this article); AGN, Padrón, Vols. 30–33; de Humboldt, Alejandro, Ensayo político sobre el reino de la Nueva España (3rd ed.; Mexico: Editorial Porrúa, 1978), p. 41 Google Scholar; and Romero, , Noticias para formar la Historia y la Estadística, p. 93.Google Scholar

82 AHG, SA, Tomo V, 1827–1829, Report from Salvatierra, December 8, 1827.

83 AHG, SA, Tomo VIII, 1838–43, Exp. 30, March 27, 1840, Exp. 31, March 30, 1840, and Exps. 32–34.

84 Puerto Rico tried to make vaccination compulsory in 1818. Rigau-Pérez, , “The Introduction of Smallpox Vaccine,” p. 419.Google Scholar Uruguay did so in 1850. Hopkins, , Princes and Peasants, p. 229.Google Scholar

85 AHG, SA, Tomo X, 1850–52, Exp. 10, March 1850; Exp. 49, March 15, 1851; and Exp. 62, Aprii 22, 1851.

86 Francisco Balmis, in his instructions about promoting the vaccine that he sent to municipalities in the Spanish empire, gave an economic justification for vigorously promoting the vaccine. Whether this was merely a reason used to get both the Spanish Crown and towns within the empire to participate and pay for a vaccination program or whether he was really more interested in promoting the economy of Spain by making its colonies more productive is unclear. See AHG, SA, Tomo II, 1798–1816, Exps. 9 and 10.