Curiously, until the very end of the eighteenth century, opposition was strongest among those most enlightened--the Royal Protomedicato in Madrid and in Mexico City. The Royal Protomedicato's aversion was based not on religion, dogma or tradition, but on its own scientific investigations regarding the merits of inserting live smallpox matter into the bodies of healthy individuals who then might be permitted to expose themselves to the general populus and thereby spread the contagion.
Among Spanish authorities the practical, conscientious attitude against exposing innocents to the disease prevailed until the entire dispute was made moot by the publication of Jenner's Inquiry in 1798. What damned the practice for Spanish authorities, before 1798, was precisely that inoculation propagated the disease. Perez de Escobar's Avisos Medicos, populares y domesticos, published in 1776--with the Protomedicato's license--, argues that experience reveals the falsity of the inoculationists' rhetoric:
Por la verdad se haría creible el discurso, si no estuviera la experiencia en contrario. Ninguno de los inoculadores niega, que las viruelas artificiales son igualmente contagiosas que las naturales: y todos conocen por la observacion, que ... se comunica el contagio a los pueblos vecinos, y de allí á toda una region (Perez de Escobar 1776:106).
Until 1796, the very year that Jenner concluded his experiments which proved vaccination by cowpox to be a safe remedy against smallpox, Spanish authorities continued their efforts to control and regulate inoculators to protect the public against epidemics produced by the physician's art. The "Ordenanzas para el Gobierno y Dirección del Real Colegio de Medicina" is representative of the official position:
habiendose observado que la inoculación, aunque útil a los particulares, al Estado y a la población, esparce con una profusión peligrosa los miasmas variolosos, fomenta y multiplica la viruela natural, se prohibe absolutamente que en las estaciones en que no haya epidemias de viruelas en los pueblos y sus barrios, ningún Facultativo médico o cirujano pueda inocular sin dar cuenta a la Junta de Gobierno, la que con acuerdo con la Superioridad, tomará las providencias convenientes, bien para que el inoculador, el inoculado y sus asistentes salgan de la población, bien para que no traten con nadie durante todo el tiempo en que pueda comunicarse el contagio.1
Strangely, medical historians, particularly of Spain and Spanish America, ignore the vigilance of Spanish authorities and instead celebrate each manifestation of the inoculationist's art as a victory for medical progress. Indeed, a recent study chronicles the practice on the peninsula, tallying 19,141 inoculations doctor-by-doctor, place-by-place, and year-by-year.2 The chronology also notes the unsettling phenomenon of natural epidemics erupting with uncanny timing almost everywhere inoculations were practiced. To the skeptical mind this happenstance suggests that inoculators spread the disease, whereas inoculationists invariably interpreted this as confirming both the urgency of their work and their fortuitous timing!3
Today, medical historians often portray the inoculation debate as a struggle between science and religion--just as proponents of transplantation did in the eighteenth century--, a struggle between progressive ideas of the enlightenment against medieval obscurantism and religious dogma. Spanish medicine is treated even more harshly. The peninsula's "backward" medical practices are often portrayed as confirmed by a royal pragmatic of November 1798, requiring inoculation in orphanages, hospitals and similar institutions. Coming as it did two years after Jenner's successful experiments with vaccination (image at 14 days), the edict seemingly substantiates the deficiencies of Spanish medicine and the persistence of medieval mentalities on the peninsula (Nadal 1991:109, Bustamante 1982:80). In contrast, I argue that Spanish practice with its emphasis on preventing the spread of an epidemic was probably the most effective use of inoculation, which after-all was a dangerous prophylaxis (image at 14 days).
Smallpox caused great devastation in Mexico, from its first appearance in 1520 until the beginning of the twentieth century, when vaccination became common, if not universal. One of the deadliest epidemics occurred in 1779-80, when burials doubled or even quadrupled over normal years. This disaster fanned the desire of authorities to prevent future eruptions by means of strict quarantine, and failing that, inoculation.
The first authenticated application of inoculation in New Spain dates to 1779, with the outbreak of an extraordinarily mortiferous epidemic in Mexico City. With reports of isolated cases of smallpox in Veracruz and Jalapa in August and September, the authorities began to prepare measures against the epidemic, and inoculation was proposed.4 Dr. Esteban Morel was placed in charge of an experiment to test the procedure and persuade the public of its utility. Convinced of the historic importance of what he was about, Morel chronicled how the privilege of "la primera inoculada en los paises civilizados de esta N.E." was bestowed on "la señorita Da. Barbara Rodriguez de Velasco," and how mild her case was: "Ynoculada el dia 4 de octubre, desde antes del festivo dia de San Carlos, ha gozado de la sociedad dentro y fuera de su casa, sin rezelo" (Morel 1780:59-60). In all, fourteen individuals participated in the experiment, including:
seis [Yndios y Yndias, de edad de tres años a diez, quienes] estubieron inoculados, en mi casa, en donde los mantube todo el tiempo necesario, y los acomodé de cobihas y demas menesteres, a mi costo, por caridad y para dar exemplos de los aciertos de la inoculacion, aun en los Yndios (Morel 1780:59).
The demonstration was a "success". The inoculated survived, Viceroy Martín de Mayoraga endorsed the procedure, the Protomedicato of the City bestowed its approval, and the Ayuntamiento authorized the establishment of a clinic in the Convent of San Hipólito, at some distance from the city. A handbill prepared by the Ayuntamiento informed the public that:
Los admirables efectos que ha producido en muchos Paises de la Asia, de la Africa, de la Europa, en algunos de la América, y aun en esta Ciudad, la inoculacion de las Viruelas, no solo adaptada, sino executada en las Soberanas Personas de los Reyes, quienes han hecho construir Hospitales, en que se administre á sus Vasallos: atendiendo esta N.C. [Noble Ciudad] á los felices sucesos que se refieren de esta operacion, y deseando auxiliar á su Público por todos los modos posibles, con previa aprobacion del Excmo. Señor Virrey, y consulta de Facultativos, resolvió abrir un Hospital de inoculacion en el Convento de San Hipólito, para los individuos de ambos sexós de tres años arriba, que quieran lograr este beneficio, y que estará preparado para el dia primero de Noviembre, en el que los que ocurrieren, serán cuidados y atendidos con la caridad y esmero posible, asistidos por el Dr. D. Estevan Morel, exercitado y Perito en la materia (AACM, Salubridad, vol. 3678, expediente 1, f. 1, "Aviso al publico"; see also Cooper 1965:64).
Few availed themselves of the Ayuntamiento's offer or Dr. Morel's "charity". Indeed, he sued the Ayuntamiento for failing to publish his treatise on the subject (and was awarded five hundred pesos) and for refusing to cover expenses incurred in outfitting the clinic. The total number inoculated was probably small (Michili 1979:203). Morel speaks of only fourteen by his own hand (for which, thanks to his suit, he received two hundred pesos compensation!). He refers to another case "mal inoculada por un facultativo bien intencionado, pero inexperto" so we must presume that other doctors were inoculating at the same time (AACM, Salubridad, vol.3678, exp. 2, f. 61v). Meanwhile, the epidemic radiated from the capital reaching Huehotzinco and Puebla in October 1779, Valladolid and Aguascalientes in January 1780, Parral (Chihuahua) in May, Ocozocautla (Chiapas) in June and Santa Gertrudis (Baja California) in October 1781.5
The National Archives of México contain references to a second inoculation campaign to fight the same epidemic, in the south of New Spain, in the district of Tehuantepec. One Juan Pasqual Fagoaga, in a letter to the subdelegate of Nexapa dated February 13, 1796, advocates inoculation as a means of stemming the spread of smallpox to that region. The text refers to a successful experience with inoculation some sixteen years before:
Para el caso en q. no sea posible contener el daño como pretendo, quisiera q. VM. sacase del Sr. Ynted. permiso pa inocularlos, cuya operacion practique aqui diez y seis años haze con buen exito [my emphasis], y a q. hoy no me resuelvo, sin tal fiar, por q. la mente de los superiores es conocidamte. dirijida a la destruccion radical de este mal, y mi idea parece seria opuesta, pues la estendia en aquella vecindad de 88 casados; sin embargo antes me parece qe se podria asi cortar mas facilmte con respecto a los demas pueblos pr qe la inoculacion las exita a los siete u ocho dias y todo el periodo de ellas despues hta. secarse seria de veinte dias o poco menos, segun entiendo en este tmpo. y en el qe. asignen los medicos pr. combalencia, es mui facil, y de poco costo, hazer observa a qn tiene mis conocimtos qe la incomunicacion se guarde religiosmte. con aquel Pueblo, lo qe a la larga, y confiada a Yndios es smpre. arriesgada (AGN Historia 531, expediente 3, f. 71)
In the 1790s, accounts of sporadic cases of smallpox were reported to the viceroy in Mexico City, but most reports proved to be false alarms. Then in March 1793, an outbreak was confirmed in the port of Campeche, introduced perhaps by slavers from Cuba. Quarantine slowed the march of the disease, but by February 1794 cases were reported in Tabasco (Widmer 1988/89:73). Shortly, evidence of the pestilence began to appear in the burial registers of the province of Ciudad Real. By July it had erupted in Ocozocautla, where 190 succumbed to the disease (compared to 159 in 1780). Within the month the pox invaded Tuxtla (525 deaths versus 751 in 1780), then continuing its march, it surfaced in Teopisca in October (122:116), Chamula in November (618:712), and Amatenango by the end of the year (148:120). In the eastern lowlands smallpox erupted in February 1795, carried there by means of an inoculation campaign. In Bachajón only 59 deaths were recorded, compared with 342 in the epidemic of 1780. Inoculation saved lives in Bachajón. Two months later the plague extended to the far west into the Pacific lowlands to Tonalá (Soconusco) and reached Juchitán, Oaxaca in September, 1795. Meanwhile in Chiapas, the last great epidemic of the eighteenth century had come to an end.
During the epidemic of 1794-95, 2,031 smallpox deaths were registered in nine Chiapanecan parishes studied for this report compared with 2,785 during the epidemic of 1780, a decline in deaths due to the pox of 27%. The greatest decrease, 83%, occurred in Bachajón, a parish where systematic inoculation was performed on some three-fourths of the non-immune population. Of the 806 individuals inoculated, only 30 died--instead of perhaps 200 or 250, if natural smallpox had prevailed. In other parishes, particularly in those with the largest declines in burials, at least some inoculations may have been performed, but I have not found direct evidence to confirm this.6
Direct evidence is available, however, for 33 towns and villages in a detailed account authored by Sor. Coronel Dn. Agustin de las Quentas Zayas which documents a remarkable inoculation campaign in "1796".7 In this report morbidity and mortality statistics were compiled both for the inoculated and for those who were not, but who fell ill with natural smallpox. Figures are recorded for 33 locales--parishes, towns, villages, hamlets, and haciendas--stretching from the highland parish of San Bartolomé north eastward into the tierra caliente to the parish of Tila. These parishes constitute extremes, both geographic and epidemiological. In San Bartolomé 1,168 inoculations were performed but natural smallpox killed 550 individuals, because over 3,000 uninoculated parishioners were stricken with the disease. In Tila, only 700 individuals were inoculated, but this probably constituted almost the entire population of susceptibles for only 21 individuals succumbed to natural smallpox.
The power of transplantation to smother an epidemic as suggested by these examples is confirmed by an analysis of the complete report (Table 1).8 Totals in the report show deaths due to smallpox shrinking from 9,943 in the first epidemic (1780) to 3,312 in the second. Inoculation accounts for much of the difference. In the second 3,094 succumbed to natural smallpox (28.1% of those who were not inoculated), but only 218 from transplantation (2.4% of the inoculated). The general mortality rate during the second epidemic was 15%. The inoculation fatality rate of 2.4% is consistent with the figure of 1-3% for other well-recorded places, such as Boston from 1721-1792, when 24,069 inoculations yielded a case fatality rate of 1.4% (Fenner 1988:257). If the campaign in this region of Chiapas had been totally successful (if 11,000 more inoculations had been performed), almost 3,000 additional lives could have been saved. On the other hand, if the 8,915 inoculated had not been "engrafted" with the disease, probably 2,200 additional lives would have been lost.
The report implies--by comparison with total burials in the earlier epidemic--that over 6,000 lives were saved due to inoculation. However, the "lives-saved-due-to-artificial-smallpox" figure falls short, because the second epidemic was less severe than the first, particularly among adults. Adults accounted for one-fifth of smallpox mortality in the first epidemic, but in the second this fraction was halved--everywhere inoculation was practiced. In Bachajón for example in 1780 sixty-one adults died of smallpox, but only six in 1795. In parishes where no inoculations were performed, such as Chamula and Aguacatenango, smallpox mortality, although lower at the later date by 15-20%, was much higher for both adults and children than in parishes where inoculation was common. Apparently, when inoculations were performed, adults were certain to participate.
Figure 1 shows that the correlation between inoculation and a reduction in smallpox mortality between the epidemics of 1780 and 1795 is strong (R**2=.62) and statistically significant (P<.001). The regression equation indicates that at the village level, for every ten percent of individuals artificially infected with smallpox, survival chances for the village population as a whole improved by six percentage points above 1780. The regression also shows that, even with an inoculation rate of zero, mortality was about 35% lower in the second epidemic than in the first.
Inoculation saved lives in Chiapanecan villages threatened by an outbreak of smallpox, just as it did elsewhere in the Americas and Europe. Inoculationists hoped that mortality from the procedure could be reduced to zero by simply preparing the patient for the operation, following the proper procedures, adopting the correct regimen for recovery, etc. In fact, mortality could be reduced, but never eliminated as shown in Boston, London and other centers where inoculation was practiced widely. In Chiapas, the authorities thought that it was method that made the difference, as can be seen from the detailed description of how the transplantation was performed:
Se hazia la operazon. en la parte menor del brazo por arriba del codo, por qe. no pudiesen rascarse, o en la carnosidad qe hase entre el dedo police y el Yndice un poco avierta la mano, y como un dedo pulgar arriba de la orilla, se introducia con una lanzeta la materia qe. con atencion a la edad, y robustez se conceptuaba necesaria por haver observado desde el principio qe. segun la porcion assi eran las viruelas que salian, despues se apretava aquella parte, y fletava con los dedos, a los siete u ocho dias las dava calentura y empezavan a arrojar la Viruela: se procurava preservarlos del aire, aunque casi imposible en las casas de los Yndios pero con todo se abrigaron en lo posible, y se las quitó de dentro de ellas el fuego qe comunmte. tienen: el alimto. caldo de frijol caracoles pescaditos, y nada de frutas; la vevida Agua cozido con palo mulato qe se da en tierra caliente, mesclava con azucar blanca, tambien Aguado Borraja, y algunos Jarave de Rosa (AGI Estado, 37, N. 55, imágenes 5-6).
The report assures us that the artificial pox was of such mild character that this method was widely accepted, particularly by Indian populations, so much so that, just as the Royal Protomedicato of Madrid feared, the illness spread ("pegar") naturally:
Luego que conocieron las Yndias [my emphasis] los buenos efectos de la Ynoculazn. trahian a sus hijos de pecho para que los curasen, de tal modo qe se hizo la operason. hasta con criaturas de doze dias de nacidas a las qe se les ponia poca materia y sanavan saliendola hasta el corto numero de ocho viruelas. Tambien se hizo con Yndios de 30 y 40 anos y sanaron. Algunos muchachos no inoculados se mesclaron con los qe. ya tenian viruela buena, y les dio de la propia calidad, y todos sanaron, en algunas Haziendas huvo dos o tres Ynoculados, y estos avitando con otros en una misma cassa, les pegaron la enfermedad, de tal modo qe. se juzga un medio pa qe muchos tengan buena viruela, y por esta razon aunque se espresa el numero de inoculados, y los qe de estos murieron deve, reputarse como efecto de la inoculacion el total de sanos, por qe se advirtio que las inoculados pegaron la buena viruela a otros qe benian a los Pueblos y havitavan juntos o inmediatos.
Whether this reasoning was wishful thinking or rationalization, it is not supported by the statistics. Indians in Comitan did not respond in this way; few were inoculated and many of those who contracted the natural pox died (1223 ill, 199 inoculated, and 278 total burials). In contrast, Ladinos in Comitan were inoculated in large numbers and few died (969, 428, and 70, respectively). Then, too, on the haciendas almost all those who fell ill did so by means of inoculation ("Las Haciendas" 314 of 319, Comitan 393 of 442, and Escuintenango 95 of 102) and deaths were relatively few (9, 77, and 39, respectively). Whether these were Indians or Ladinos is not stated.
Figure 1 reveals some subtleties of the interplay between inoculation, mortality, and local conditions. Places with better than expected survival for the observed level of inoculation (that is, the greatest outliers above the regression line) were the large urban parish of San Bartolome and tiny Coneta with only fourteen ill. Those with worse than expected survival were two parishes with no inoculation (Amatenango and Teopisca), the relatively small settlement of Soyatitam (where half the ill were inoculated but deaths among this group were five-times the average), Socoltenango (with high death rates for both groups), and the pueblo of Escuintenango (248 burials in 1780, but only 28 ill in 1795, almost one-third of whom died).
To explain the unfortunate deaths of many from the natural pox, Quentas Zayas offered the following reasoning:
los muertos sin inocular fueron los que adquieron mala viruela, de cuias observaciones resulta que los 16888 sanos fueron efectos de la inoculacion, y del cuidado qe huvo con los Enfermos...
And the occasionally high mortality among the inoculated was blamed on the "air":
conociendo todos los comisionados qe los muertos inoculados fue por causar de haverlos dejado airear, pues con los qe observaron el cuidado devido todos sanaron, pero ya con esta esperiencia no causara la asolacion de los Pueblos de Indios tributarios, una epidemia que los aniquilava... (AGI Estado, 37, N. 55, imágenes 5-6).
Five years after the epidemic reached Chiapas, in March 1800, the last smallpox epidemic of the eighteenth century ultimately flared in Parral, Chihuahua and beyond. In contrast, the epidemic of 1779-80 spread rapidly from Mexico City, reaching Parral in the North in March 1780 and in the South the remote Chiapan village of Bachajón in September before sweeping on to Guatemala. The "1797" epidemic began in Campeche in 1793. More than a year passed before it reached Bachajón, a couple of hundred miles distant. Thanks to quarantine, care (massive provisions of food, clothing, and shelter), and inoculation the epidemic's march was slowed, but not stopped. In June 1795, smallpox appeared on the border between Tehuantepec and Oaxaca.9 Viceroy Branciforte in an edict dated July 14, 1796, ordered that strict isolation be enforced for those who became infected.10
Nevertheless, the epidemic continued its halting march northward. On October 10, 1797, viceroy Branciforte issued an edict, commanding that an energetic, but voluntary inoculation campaign be undertaken. The edict was circulated, from parish to parish, throughout the archbishopric of Mexico, reaching forty-six parishes by April 6, 1798.11 Priests seem to have readily responded to the order, but some opposition was expressed by both civil authorities and the public:
"En consecuencia de la circular de S.E. Y dirigida a sus curas a efecto de que, con las razones mas vivas, penetrantes, y eficazes, exhortemos a nuestros Feligreses a la inoculacion;...remitiendole yo, el pus, mas electo, que me ha prestado los medicos mas abiles. ... La gente de los Pueblos, es de corto animo, y horrorizada con las amenazas de la Justicia, se han retrahido de una operacion, tan util a mi vecindario, y que si se impide, ocasionara en el, el mismo estrago, que se ha llorado en las epidemias anteriores. El tiempo preste. es din duda, a proposito para la inoculacion en aquel Pueblo, pues, apenas llegar a tres, los viruelentos.12
Inoculation began in Mexico City in early September, 1797 and by October over 3,000 had been performed (Robin 1982:361; Romo de Rodríguez 1997). Shortly in a report to the King dated October 30, 1797, Branciforte observed: "...despues de haber vagado mas de dos anos la terrible epidemia de viruelas por las Provincias de Oaxaca, Puebla y Veracruz se habia manifestado en Mexico, aunque con lentitud y benignidad...."13
Meanwhile in Guanajuato, authorities hurriedly inoculated some four-fifths of the city's children with pus from live smallpox virus. Only one in a hundred of the inoculated died--in contrast to the suffering of some 3,000 who went untreated, 28% of whom perished (Thompson 1993:440), many probably infected unintentionally by the spread of the disease from the inoculated. The presumption is that doctors waited until the disease erupted before initiating inoculation. But note that in the case of Guanajuato, in preparation for the epidemic, one hundred boys and girls were inoculated so that subjects would be available to go where-ever matter was needed in the town or province (Thompson 1993:437). It strains credibility that a hundred children could be kept isolated or quarantined while the community waited for an epidemic to strike. A close scrutiny of the timing of inoculation with the eruption of the epidemic should provide the circumstantial evidence to show whether the epidemic began naturally or was provoked artificially by inoculators. In the nearby Villa of León where the authorities had carried out only 200 inoculations by mid-December and as the epidemic began to erupt, many villagers remained opposed to inoculation.14
Probably one of the most successful inoculation campaigns in all of New Spain was conducted in the city of Durango, where of 4,302 who came down with the pox, 88.9% did so by inoculation. The mortality rate was exactly 1% among the inoculated compared with 13.2% for natural cases of the pox. The authorities concluded that their success "puede atribuirse sin ligereza a la inoculacion general de este Vecindario, que sin duda contribuyo a que se cortase la Epidemia" (Esquivel 1799:21).
In Monterrey the experience was much less successful, and inoculation could well have sparked the eruption of the epidemic. The population of the district numbered 43,739 of whom only 454 were inoculated. Of these, three died, in contrast to more than a thousand of the 11,026 who became infected with the natural pox (Salinas Cantu 1975:38).
When the epidemic struck San José de Parral in March 1800 the authorities were prepared to provide care, but not inoculation. There is no evidence that the procedure was used. What is striking is that the number of deaths (176) was almost exactly the same as in 1780 (170).15
Quarantine could not only slow the march of smallpox, but it could actually stop its spread. Guatemala was afflicted by the epidemic of 1779-80, as the pox extended southward from Chiapas. However, subsequent epidemics in Chiapas, including that of 1794-95, had been halted at the border by means of quarantine. Once the method of cowpox vaccination became available, Guatemalan authorities sought to obtain sufficient supplies of the matter so that smallpox could now be fought at less expense, without disruption and with greater efficiency. Consider the following testimony, a request for cowpox vaccine, dated January 1, 1805:
"Desde el ano de 780 no se han padecido viruelas pestilentes en las mas de esta provincias [de Guatemala]. Los dos tercios a lo menos de sus habitantes estaban expuestos al estrago de aquella cruel enfermedad. Todo este numero necesitaba vacunarse. Lo necesitaba prontamente, pues el riesgo amenaza con frequencia por la comunicacion y comercio con otros paires. No ha tres anos que a la provincia de Chiapa llego el contagio; el atajarle, para que no pasase a las jurisdicciones limitrofes, causo bastantes gastos, y motivo providencias muy activas.16
Smallpox mortality was substantially greater in the epidemic of 1779-80 than in that of 1793-1800. Although in the later case quarantine measures were much more widely used and with greater effect, the authorities became convinced that inoculation was principally responsible for their success, as shown by the testimonies cited above. Even in Mexico City, where only a modest fraction of the population was inoculated, the authorities thought that this prophylaxis brought down the death rate:
Si en la epidemia inmediata pasada de viruelas del año de 1797 se socorrieron por la Junta Principal de Caridad de esta Capital, como 8 mil enfermos mas que en la anterior del año de 1779, y en esta murieron un duplo mas que en aquella, debe atribuirse el buen éxito de la de 1797 (a mas de las activas providencias que por la Junta se tomaron, y el distinto tratamiento curativo) a la inoculacion de la viruela, que aunque no adaptada generalmente por capricho y timidez, con todo se verificó una gran parte de lo principal de esta Capital, y aun en muchos pobres, ratificandolos para que se dexasen inocular... (Junta Superior de Sanidad de Mexico 1824:14).
In Chiapas, almost three times as many inoculations were performed as in Mexico City, and the campaign was probably more successful in terms of lives saved. I have not been able to determine whether or not inoculation spread the disease during this last epidemic of the eighteenth century. Yet, at least one contemporary thought that it did. Quentas Zayas's successor was horrified by his predecessor's lax concern about artificial smallpox:
A mediados de marzo ultimo [1802] se ausento de la raya de esta Provincia de Chiapa su Jefe Proprietario el Sr. Dn. Agustin de las Quentas Zayas resuelto a usar de la lizencia real que obtuvo para pasar a España por dos años...
Con los mismos mozos que fueron a encaminar al expresado Jefe tube la noticia de hallarse infestados de la horrorosa epidemia de virhuelas la Provincia de Merida de Yucatan, y los Pueblos de los rios de Usumacinta que son del Gobierno de Tavasco, como tambien los quatro primeros Pueblos de esta Provincia conlindantes por el Norte con los de aquella Jurisdiccion: a saber los del Salto de Agua y Playa de Cataraja, Palenque y Tumbala.
Al punto di cuenta con justificaion a la Capitania Gral. De Guatemala prohiviendo desde luego la comunicacion de los pueblos apestados con los sanos...
Hasta de presente, y con el favor de Dios he conseguido que no se haya contagiado ningun otro Pueblo de esta Provincia, y aun el que se baia sofocando dicha epidemia en su origen...
Consta en el expediente y asegura el Gobernador que las viruelas debieron su origen a la inoculacion que se executo en dos niños, de orden de su antecesor en aquel Gobierno [my emphasis] para probar la energia de un pus varioloso, que por encargo del Capitan General de aquel Reyno se remitia a su Capital, desde el Palenque donde se habia padecido aquella enfermedad.17
After 1799, vaccination with cowpox would quickly establish itself as a highly effective remedy against smallpox in Europe, Spain and Spanish America. On the one hand for the individual, vaccination--unlike inoculation--caused only the slightest eruption on the skin and seemingly killed no one. Then for the society at large, unlike inoculation, vaccination posed not the slightest threat to public health. Vaccination did not disseminate natural smallpox. Consequently no great care had to be taken with the treatment. Spanish authorities quickly recognized the advantages of vaccination. The same public health impulses that produced such heroic efforts to defeat smallpox--quarantine, care, and, finally in the closing decades of the eighteenth century, inoculation--were quickly redirected toward the use of vaccination.
It is remarkable that although Spain was considered to be the most backward nation in Europe, a Spanish monarch, Charles IV, would be the first head of government to sponsor a world-wide vaccination campaign. Begun within five years of the publication of Jenner's Inquiry, Spanish authorities sought to eradicate the dreaded disease by what proved to be the only truly effective means of combating smallpox, vaccination (Fernández del Castillo 1960). In any case, Dr. Andres Piquer, a member of the Royal Protomedicato which prohibited the publication of La Condamine's dissertation in Spanish in 1757, deserves the final word: "Guardamos, pues, los Españoles un medio en estas cosas..." (Dictamen, 1757 [1785]:112).
Unfortunately in New Spain, even as strenuous efforts to vaccinate the population continued during the war for independence, Viceroy Felix Maria Calleja authorized the publication of a pamphlet which endorsed inoculation by means of "artificial" smallpox whenever cowpox vaccine was not available (Calleja 1814). Inoculation continued to be publicized in Mexico as an effective prophylaxis against smallpox as late as 1830 (Muñoz 1830). Whether in independent Mexico inoculation protected people from smallpox or propagated the disease remains untested.
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