Three puzzles in the history of smallpox in Latin America

Three puzzles in the history of Three puzzles in the history of smallpox in Latin Americasmallpox in Latin America

• 1. 1. Smallpox and catastropheSmallpox and catastrophe: What was the : What was the role of smallpox in the demog. catastrophe? role of smallpox in the demog. catastrophe? 2. 2. Genes or exploitation and experienceGenes or exploitation and experience: : Why did natives suffer so greatly from the Why did natives suffer so greatly from the disease? disease?

• 3. 3. Smallpox and recoverySmallpox and recovery: Did smallpox : Did smallpox become less virulent? What was the effect become less virulent? What was the effect of public health campaigns (quarantine of public health campaigns (quarantine inoculation, and vaccination), versus inoculation, and vaccination), versus population densities on smallpox mortality.population densities on smallpox mortality.

Not a puzzle:Not a puzzle:• 1. First smallpox epidemic struck Mexico City in 1. First smallpox epidemic struck Mexico City in

1520, killing many of its inhabitants (1/5 - 1/2).1520, killing many of its inhabitants (1/5 - 1/2).• 2. From 1803-06, the Balmis expedition carried 2. From 1803-06, the Balmis expedition carried

vaccination around the world.vaccination around the world.• 3. Smallpox is credited with population recovery 3. Smallpox is credited with population recovery

in the 18th century and often blamed for slow in the 18th century and often blamed for slow growth in 19th century Latin America. growth in 19th century Latin America.

• 4. The last case of smallpox in Mexico occurred 4. The last case of smallpox in Mexico occurred February, 1951 (and, in the world, in Somalia, February, 1951 (and, in the world, in Somalia, 1977).1977).

• 5. Evidence on genetic immunity and smallpox is 5. Evidence on genetic immunity and smallpox is rarely examined--and weak. rarely examined--and weak.

Demographic catastrophe in 16th Demographic catastrophe in 16th century Mexico: 50%+ declinecentury Mexico: 50%+ decline

1.1. Smallpox and catastrophe Smallpox and catastrophe: : What was the role of smallpox in What was the role of smallpox in

the demog. catastrophe (Mexico)? the demog. catastrophe (Mexico)? • Epidemic of 1520 was devastating; 1538 less Epidemic of 1520 was devastating; 1538 less

soso• More severe was cocoliztli of 1545-6 and More severe was cocoliztli of 1545-6 and

matlazahuatl of 1577-79matlazahuatl of 1577-79• Most chroniclers list few smallpox Most chroniclers list few smallpox

epidemics epidemics • Exploitation weakened native population Exploitation weakened native population

Fr. Bernardino de Sahagun’s Fr. Bernardino de Sahagun’s General HistoryGeneral History ( (Florentine CodexFlorentine Codex, ,

1576), native voices: smallpox1576), native voices: smallpoxMexico, 1520:Mexico, 1520:““...Indeed many ...Indeed many

people died of people died of them (pustules), them (pustules), and many just and many just died of hunger. died of hunger. There was death There was death from hunger; from hunger; there was no one there was no one to take care of to take care of another; there another; there was no one to was no one to attend to attend to another.”another.”

1520: Death of Montezuma’s 1520: Death of Montezuma’s successor, from smallpoxsuccessor, from smallpox

“…“…he governed only 80 days…”he governed only 80 days…”

corpse enshrouded in corpse enshrouded in glyphs for smallpoxglyphs for smallpox

15381538“This year of This year of

seven rabbits of seven rabbits of 1538 many 1538 many people died of people died of smallpox.”smallpox.”[note pustules [note pustules on arms and on arms and legs.]legs.]

Testimonies: Virgin of Guadalupe Testimonies: Virgin of Guadalupe procession 1545:procession 1545:

» ““The precious friars gathered a great many The precious friars gathered a great many children, female and male, who had just reached children, female and male, who had just reached the age of six or seven; they went along flogging the age of six or seven; they went along flogging themselves. … As soon as they arrived at her themselves. … As soon as they arrived at her churchly home, the friars offered very many churchly home, the friars offered very many prayers. And God the giver of life willed that prayers. And God the giver of life willed that through the intercession and prayers of the through the intercession and prayers of the compassionate personage, his precious, revered compassionate personage, his precious, revered mother, the epidemic would begin to subside. mother, the epidemic would begin to subside. The next day, not many people were being buried The next day, not many people were being buried any longer, and finally perhaps two or three any longer, and finally perhaps two or three people as the epidemic came to an end.”people as the epidemic came to an end.”

Rhetorical exaggeration vs. Rhetorical exaggeration vs. evidenceevidence

• Smallpox epidemic of 1520 “raged across the Smallpox epidemic of 1520 “raged across the continent”, but note how slowly it spread from continent”, but note how slowly it spread from Veracruz to Mexico City, 300 miles, 3 to 5 Veracruz to Mexico City, 300 miles, 3 to 5 months (May to September or October).months (May to September or October).

• ““In Mexico, ever since 1520, the natives had In Mexico, ever since 1520, the natives had suffered from severe smallpox epidemics suffered from severe smallpox epidemics recurring every seventeen or eighteen years.” --recurring every seventeen or eighteen years.” --Stearn and Stearn, 42.Stearn and Stearn, 42.

• Yet, of 17 colonial epidemics to 1745 listed by the Yet, of 17 colonial epidemics to 1745 listed by the chronicler Cayetano Cabrera y Quintero only 3 chronicler Cayetano Cabrera y Quintero only 3 are for smallpox.are for smallpox.

9 other epidemics were probably as 9 other epidemics were probably as or more devastating than smallpoxor more devastating than smallpox

• tepitonzahuatltepitonzahuatl (measles), (measles), 1531.1531.• cocoliztlicocoliztli (?), (?), 1546-471546-47• matlazahuatlmatlazahuatl (typhus?), (typhus?), 1576-771576-77• famine and typhusfamine and typhus, , 16921692• typhustyphus, , 1737-391737-39• the great hungerthe great hunger, , 1786-881786-88• typhustyphus, , 18131813• choleracholera, , 18331833• influenzainfluenza, , 19181918

2. 2. Genes or exploitation and Genes or exploitation and experienceexperience: Why did natives : Why did natives

suffer so greatly from the disease?suffer so greatly from the disease?• GenesGenes: Stearn and Stearn (1945): “...even in the : Stearn and Stearn (1945): “...even in the

nineteenth century when some immunity had nineteenth century when some immunity had already been acquired by this race...”already been acquired by this race...”

• Exploitation, the social context of epidemicsExploitation, the social context of epidemics: : Audiencia Judge Alonso de Zorita (~1560) “So Audiencia Judge Alonso de Zorita (~1560) “So the Indian returns home from his toil [for the Indian returns home from his toil [for Spaniards] ... famished, unhappy, distraught, and Spaniards] ... famished, unhappy, distraught, and shattered in health. For these reasons pestilence shattered in health. For these reasons pestilence always rages among the Indiansalways rages among the Indians.”

Genes: Francis Jennings, Genes: Francis Jennings, The Invasion of AmericaThe Invasion of America (1975:22) (1975:22)

• ““...the Europeans’ capacity to resist certain ...the Europeans’ capacity to resist certain diseases made them superior, in the pure diseases made them superior, in the pure Darwinian sense, to the Indians who Darwinian sense, to the Indians who succumbed.” succumbed.”

• ““smallpox was smallpox...the Indians on the smallpox was smallpox...the Indians on the north [bank of the Rio Grande] had as little north [bank of the Rio Grande] had as little biological immunity to this epidemic scourge as biological immunity to this epidemic scourge as the Aztecs had.”the Aztecs had.”

• Must differentiate genetic vs. lifetime immunity. Must differentiate genetic vs. lifetime immunity.

Science: F. Black (1994)Science: F. Black (1994) and Peter J. Bianchine & and Peter J. Bianchine & Thomas A. Russo (1995)Thomas A. Russo (1995)

• BlackBlack: “Smallpox was clearly more virulent in : “Smallpox was clearly more virulent in the Americas than in Europe but the causes for the Americas than in Europe but the causes for this remain an open question.”this remain an open question.”

• Bianchine & RussoBianchine & Russo: “given comparable care : “given comparable care when ill and knowledge regarding the potential when ill and knowledge regarding the potential for surviving the illness, the for surviving the illness, the death rates for death rates for virgin-soil Indian populations and repeatedly virgin-soil Indian populations and repeatedly exposed Caucasian populations for measles were exposed Caucasian populations for measles were similarsimilar.”.”

Smallpox mortality in London: Smallpox mortality in London: 10-20% of deaths 1720-179710-20% of deaths 1720-1797

Evidence from chronologies and Evidence from chronologies and parish burial booksparish burial books

• Recall 17 epidemics 1520-1745:Recall 17 epidemics 1520-1745:7 in 16th century; 7 in 16th century; 6 in 17th c; 6 in 17th c; 4 in 18th to 1746; 4 in 18th to 1746; only 3 of smallpox: 1520, 1538, 1733/34. only 3 of smallpox: 1520, 1538, 1733/34.

• 18th century was the century of smallpox 18th century was the century of smallpox epidemics in Mexico: 1733/4, 1761/62, 1779, epidemics in Mexico: 1733/4, 1761/62, 1779, 1797. 1797.

• Evidence from parish burial books (Mexico): Evidence from parish burial books (Mexico): Center (Puebla), South (Chiapas), and North Center (Puebla), South (Chiapas), and North (Chihuahua).(Chihuahua).

Smallpox, 1650-1810 (near Mexico City)Smallpox, 1650-1810 (near Mexico City)Smallpox, typhus and famine were the big killers in Old MexicoBurials in Cholula (region near Mexico City)

loga

rithm

ic s

cale

The Age of Pestilence and Faminevertical lines denote smallpox crises

1661 1676 1708 1734 1761 1779 1797

10

20

50

100

200

500

1000

2000

5000

10000

20000

typhus

faminetyphus

typhus

typhus

famine

smallpox

smallpoxsmallpox smallpoxsmallpox

smallpoxsmallpox

smallpoxsmallpox

Burials: by “calidad” (near Mexico City)Burials: by “calidad” (near Mexico City)

Others

Indians Indians

Chiapas (South): after 1693, no Chiapas (South): after 1693, no recoveryrecovery

Another parish in Chiapas: disaster Another parish in Chiapas: disaster in 1770in 1770

Epidemics Center, North and SouthEpidemics Center, North and SouthCrisis year marked by first letter of parish nameVertical lines indicate crisis years in Central Mexico

Region and race in a long century of epidemics 1690-1814Note high volatility and synchronous phasing of series

Epidemics throttled demographic growth of Indian settlementsDevastating epidemics occurred repeatedly over the decades

no. o

f bur

ials

(log

scal

e)

A. Center: Cholula, Acatzingo, and Tula--Indians1692 1737 1762 1779 1797 1813

10

20

4070

100

200

400700

1000

2000

40007000

10000

20000

T

T

T

T TT

T

TAAA

A

A A

A

A

A

AA

A

A

A

AA

AA

CC

C

CC

C CC

C

C

C

C

CC C

C

C

T

T T

T

T

T

T

TT

Epidemics occurred later in Bajio and Parral than in the centerCompare verticals for Center with timing in North

C. Bajio/North: San Luis de la Paz, Leon, Marfil, Parral1692 1737 1762 1779 1797 1813

10

20

4070

100

200

400700

1000

2000

40007000

10000

20000

L L

LL

LL

L

L

S

S SSS

S SS S

S

S

SSS

S

S S S

SMM

M

M M

M MM

P

P

P PP P

P PP P P P

PP

P

For Non-Indians epidemics hit later, were not as devastating Letters mark crisis years for Indians in same parish above

no. o

f bur

ials

(log

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e)

B. Center: Acatzingo, Tula--non-Indians1692 1737 1762 1779 1797 1813

1

2

47

10

20

4070

100

200

400700

1000

2000

TT T

TT

T

T

TT

T

T T T TT

A AA

AA AA A

AAAA

A

A AA A A

Some epidemics occurred later in the south; others earlierTeopisca never recovered from 1693; Ocozocuautla from 1769

D. South: Ocozocuautla, Teopisca--Indians1692 1737 1762 1779 1797 1813

1

2

47

10

20

4070

100

200

400700

1000

2000

O

OO O

O

OO

OO

O

O

O

O

O

T

T

T

T TT T

T

T T

T

T

TT T T

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Ethno-racial composition, New SpainEthno-racial composition, New SpainIndians predominant through end of colonial regimeMestizaje proliferated from late 16th-century

estim

ated

pop

ulat

ion

(thou

sand

s) --

log

scal

e

Ethno-racial scenarios for New Spain, 1520-1810Cook & Borah (maximalists), Rosenblat (minimalist), & Aguirre-Beltran

1519 1570 1646 1742 1810

1247

10204070

100200400700

1000200040007000

1000020000

25.6 mil

Maximal4.5 mill Minimal

Indian

3.7 mill

Afromest

20,000African

Indomest

700,000

Euromest

7,000European 12,000

3. 3. Smallpox and recoverySmallpox and recovery: Did : Did smallpox become less virulent?smallpox become less virulent?

Yes, but only after 1797 Yes, but only after 1797

• Inoculation, 1797: Yes.Inoculation, 1797: Yes.• Public health campaigns, 1797Public health campaigns, 1797• Vaccination, 1804-1960sVaccination, 1804-1960s

Spain: inoculation introduced in Spain: inoculation introduced in 1768; and New Spain in 1797.1768; and New Spain in 1797.

• Opposed in Spain: Protomedicato feared Opposed in Spain: Protomedicato feared increased frequency of epidemics and exposure increased frequency of epidemics and exposure of uninoculated to higher risks. of uninoculated to higher risks. Public health versus private practice. Public health versus private practice.

• New Spain, 1797: Mass campaign in various New Spain, 1797: Mass campaign in various regions of Mexico was effective in checking the regions of Mexico was effective in checking the epidemic of 1797 (e.g., Chiapas, Durango)epidemic of 1797 (e.g., Chiapas, Durango)DurangoDurango illill dieddied death ratedeath rateInoculatedInoculated 38243824 3939 1% 1%NotNot 478 478 6363 12%12%

Mass Inoculation Worked for Mass Inoculation Worked for IndiansIndians

Charity campaign not begun until Charity campaign not begun until week nine of epidemic (1797)week nine of epidemic (1797)

First world-wide public health First world-wide public health campaign: Balmis smallpox campaign: Balmis smallpox

vaccination expedition, 1803-1806vaccination expedition, 1803-1806• Jenner's Jenner's InquiryInquiry (1798) immedidately captured (1798) immedidately captured

the interest of the Spanish Crown. Nov. 30, 1798, the interest of the Spanish Crown. Nov. 30, 1798, Charles IV issued an order that vaccination be Charles IV issued an order that vaccination be extended throughout the Spanish dominions. extended throughout the Spanish dominions.

• SpainSpain: the Royal Academy de Medicine approved : the Royal Academy de Medicine approved publications on this topic quickly. “se ha publications on this topic quickly. “se ha propagado en Espapropagado en Españña con indecible rapidez, …”a con indecible rapidez, …”

• Spanish AmericaSpanish America: Francisco Xavier de Balmis : Francisco Xavier de Balmis (1803-6) extraordinary philanthropic odyssey (1803-6) extraordinary philanthropic odyssey from Spain to the Americas and the Phillipines. from Spain to the Americas and the Phillipines.

Smallpox: not a big killer in 19th Smallpox: not a big killer in 19th century Mexico Citycentury Mexico City

Smallpox not a big killer in 19th Smallpox not a big killer in 19th century Northern Mexicocentury Northern Mexico

Conclusion: three puzzles require Conclusion: three puzzles require more research and careful analysismore research and careful analysis

• 1. 1. Population catastrophe and carePopulation catastrophe and care: smallpox : smallpox probably less severe than other epidemics, probably less severe than other epidemics, although more frequent by 18th century. although more frequent by 18th century.

• 2. 2. GenesGenes: role is probably exaggerated; ruthless : role is probably exaggerated; ruthless exploitation and lack of experience with exploitation and lack of experience with epidemics greatly increased mortality.epidemics greatly increased mortality.

• 3. 3. Public healthPublic health: inoculation, charity and : inoculation, charity and vaccination reduced smallpox mortality but only vaccination reduced smallpox mortality but only at the very end of the colonial period.at the very end of the colonial period.