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Smallpox and measles were highly contagious diseases that decimated Europe from ancient times to the modern era, killing more people than all the world's wars combined. In 1967 smallpox was targeted for eradication by the World Health Organisation, and was officially certified as eradicated in 1980. In 1655, four of Queen Elizabeth’s physicians conveyed the common belief that susceptibility of children to many diseases, especially smallpox and the measles, was transmitted by the menstrual blood of pregnant women.
Isbrand Diemerbroeck, a teaching physician from Utrecht University, one of the oldest universities in the Republic of the Seven United Provinces (now the Netherlands), and the author of an extended medical treatise on smallpox and the measles, agreed that a child’s vulnerability to the disease was formed in the uterus. Early modern medical practitioners considered other external causes that could lead to either smallpox or measles. The first symptom to arise for both smallpox and measles, as observed by many early modern physicians, was a fever. Ambroise Pare a famous French physician and surgeon from the sixteenth century, argued that smallpox and measles could not be distinguished from one another until the third or fourth day after the spots began to show upon the skin.
The French surgeon also distinguished the two diseases based on the severity of the corrupting matter which caused each illness. In their treatises, medical authors typically outlined various treatments after providing extensive descriptions of the diverse symptoms that could indicate the presence of either smallpox or measles. Michael Underwood recommended using phlebotomy (or bleedings) as another way to help alleviate the heat of a fever, both before and after the fever had broken, as long as the child was old enough to bear the procedure (usually after the child had their first set of teeth).(12) However, Underwood, Pechey and Diemerbroeck urged caution when treating children taking into account their age, health and temperament. After the fever had abated and the only traces of the disease that remained were the welts upon the skin, many rich individuals would request the operation of the golden needle, which was used to break and drain the pustules in an attempt to speed along the healing process and reduce scarring. A Comparison between Vaccinated (Cowpox) and Smallpox pustules from the 3rd to 20th day of the disease. Diemerbroeck argued against the use of the golden needle, claiming that it was a useless operation demanded by spoiled court ladies who were too impatient to wait for the pustules to heal on their own.
Letting the disease run its course was the only cure known for the either disease, as all the treatments recommended by early modern physicians were meant to manage the symptoms and speed along the progress of the illness. In contrast to these various discussions and treatments, it seems clear that modern inoculations and vaccines have completely eradicated smallpox, while global vaccination rates of some 83 percent have reduced the spread of measles substantially. The most effective step in the prevention of smallpox was in the invention of the vaccination by Englishman Edward Jenner in the late eighteenth century, and it was the first widely used vaccine in medical history. 20)Michael Underwood, A treatise on the Diseases of children with directions for the management of Infants from the Birth. Smallpox was first recorded in Europe sometime between 160-180 AD, likely brought from the east by Roman legions and it was known as the Plague of Antonius, named after the ruling roman emperor Marcus Arelius Antonius.(1) Several populations, such native tribes throughout the Americas that had never encountered smallpox before it was brought to their shores by Europeans during the sixteenth and seventeenth centuries and they were decimated as they had no natural resistance or immunity, which was transmitted through contact with the disease.
If the mother was exposed to an unnaturally high body temperature, either through a fever, weather conditions, or excessive physical labour, the mother’s blood became corrupted. His theories explained why, in his opinion, men were more likely to contract the diseases because women sloughed out the corrupt maternal blood every month, while it only continued to fester inside a man.(4) The early modern view of menstrual blood was both positive and negative when it concerned a child’s susceptibility to contract smallpox and measles. According to John Pechey (of the college of Physicians in London, 1697) the fever that accompanied the measles could be so mild that it could go unnoticed.
When a child was stricken with smallpox, the spots would fill with putrid cream coloured liquid by the third or fourth day, creating white caped pox marks which would eventually scab and fall away.

He argued that when compared, measles’ temperament was subtle and less biting than the matter which caused smallpox. During the fever both Queen Elizabeth’s physicians and Ambrose Pare recommended the best treatment was to keep the sick separated from the rest of the household, covered in warm, preferably red blankets and allowed to sweat out the fever. Bleeding was widely understood to cure the diarrhoea (looseness of the bowels) which was one of the most deadly side effects that accompanied both smallpox and measles. According to him, this operation should be performed only when the welts had formed white caps, indicating that they would soon scab and fall away naturally. Diemerbroeck provided the details of many remedies designed to strengthen the internal organs, to aid with a suffering child’s breathing, and to speed up the progression of the fever, but concluded that time was the only true cure.
In 1798 Edward Jenner published an account of Europe’s first successful vaccination, which was highly effective in the prevention of even the most sever cases of smallpox in those who had been treated. Smallpox was a prime candidate for eradication because it was exclusively spread by human contact, had a short incubation period and had no natural animal host; it was theorised to be possible to eradicate the disease entirely. Researching hotly debated topics and presenting sourced pros and cons, facts, and expert opinions to encourage nonpartisan education and informed citizenship.
This corrupt blood mixed with that of the unborn child in the womb, leaving the child vulnerable to smallpox and measles. Menstrual blood was argued to give women an advantage in terms of health and gave them a stronger resistance to diseases as they could purge themselves of corruptions found in their blood.
Although smallpox also began with a fever, it was typically much hotter and was accompanied by convulsions, intense back pain, a running nose, rapid heart rate, and difficulty breathing.(7) The spots would first appear on the face and then spread to the hands, feet and chest.
The colour red was considered to be both therapeutic and harmful for its ability to provoke further inflammation in the sick. Bleeding cured this looseness because, in keeping with early modern humoural medicine, it prevented the inflamed and corrupted blood from rushing to the bowels of the sick person, a situation that could be deadly.(13) Queen Elizabeth’s physicians recommended bleeding from the arm if the pox had not yet been raised to the skin, but only if the sick person was more than fourteen years of age. He also stated that draining the fluid would dry the skin underneath, leaving it incapable of growing back and exacerbating the scarring. Diemerbroeck admitted that many parents (especially wealthy ones) did not like to hire a physician who would do little for their sick child. The practice involved deliberately exposing children to a mild form of the smallpox (variola minor) introduced by injecting the material taken from the pustules of those with mild smallpox into the arms of those who had never suffered from the disease.
His technique involved injecting a small amount of cow pox -a strain of smallpox found only in cows- which caused small pustules on the human skin which came into contact with the infection. With a targeted response teams formed by WHO, whose soul purpose was to monitor any outbreaks, and were charged with installing strict quarantines zones and mandatory vaccinations of the towns and surrounding areas where the disease had been reported. However, because those corruptions were formed in the uterus, children, especially boys, were argued to have had a much higher risk of contracting these deadly diseases. Pustules could also appear on the inside of the throat, ears, nose, beneath the eyelids, and on the internal organs which could cause internal bleeding. If they were younger, then the treatment might do more harm than good, as young children were already considered to be too weak to withstand bleedings, and after further corruption caused by illness, they would almost certainly die. He recommended letting things run their course, allowing the skin to heal naturally rather than attempting needless action.

This resulted in a mild form of the disease and gave children resistance to the most virulent and deadly strain of the disease, known as variola major.
The difference between cow pox and smallpox is exemplified in the adjacent image, where the smallpox, on the right, forms many more pustules and does not form a scab until much later in the development. The welts in the throat could also suffocate the victim, which is why the disease was much more dangerous than measles. Red blankets were observed and recorded by many practitioners to provoke the disease much faster than any other colour of blanket. There were many risks associated with inoculations and debates over at what age children should be treated, and its value as a preventative treatment, given that inoculations generally killed every one in everyone two hundred children who received the treatment. Jenner’s trial involved injecting cow pox material taken from the hand of a young mild maid, Sarah Nelmes, who had cowpox pustules through contact with an infected cow, and injecting it into his test subject James Phipps, the eight year old son of Jenner’s gardener, as shown in the painting on the right. 2, 2014, 8,000 cases of pertussis were reported to the California Department of Public Health. Early modern authors described smallpox welts that rose to form white caped wells in the skin which were filled with the putrefying humours that the body was attempting to dispel. Phipps was purposefully exposed to small pox six weeks later, and did not demonstrate any symptoms of the disease. Medical practitioners argued that the faster that these white caps formed and the fever broke, the better the prognostic was for the suffering person.
Jenner claimed that the vaccine provided protection for an entire lifetime, but it was highly criticised by the public as it was eventually proven that Jenner’s vaccine only provided protection for a maximum of ten years.
If the welts did not arise quickly, or if they sank back into the flesh after surfacing, early modern practitioners inferred that the putrid humours were inflaming the internal reaches of the body, leading to an extended fever and possible death or else to a lifetime of disability.
In 1840 the Vaccination Act passed in Britain provided free vaccinations for all children in an attempt to control the continuing smallpox epidemic. However, the early modern medical images do not convey the horror, and severity of the disease.
If children were inoculated while they were still breast feeding they could be exposed to too much heat from their continual contact with their mother’s warm skin, which could turn a mild fever to one that was much worse, making inoculations extremely dangerous.
This act also made inoculations, which had more potential to spread the disease than to prevent it, illegal.
Each image isolated smallpox into close up images showing only one or two pustules, which separates the physical effects of the disease from the suffering of the child.
The only way to comprehend the severity of the disease is to compare the early modern images with photographs from the early twentieth century which show the full effects of the disease.
This provides a well rounded understanding of the physicality of the disease, by combining a detailed view of the individual pustules with an image that shows the symptoms over a child’s entire body.

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