We’ve recently acquired some photographs and documents from a smallpox epidemic that occurred in Milwaukee, Wisconsin, in 1925. Our own Dr. Bennett Lorber, President of The College of Physicians of Philadelphia and Professor of Medicine at Temple University School of Medicine, acquired these items originally collected by Dr. Merle R. French (d. 1961), a 1921 graduate of the University of Iowa School of Medicine. Dr. French, at the time of this outbreak, was the Superintendent of the Communicable Diseases Hospital in Milwaukee.
Dr. French wrote a note describing the patient pictured here: “Picture of smallpox patient taken at S.view Hospital a short time ago. Man was a Christian Scientist who thought that he could by power of mind prevent smallpox. Man died. This is the kind of smallpox we are having.” We assume that Dr. French was referring to an outbreak of variola major, the more dangerous form of smallpox, rather than variola minor, which came to be the dominant form of smallpox in the 20th century, particularly in the West. This man seems to have suffered from a type of variola major known as hemorrhagic smallpox, of which there were 22 cases in this epidemic. Hemorrhagic smallpox usually was fatal. The other photographs show less severe, but clearly serious, cases.
Though the graph here is difficult read with accuracy, it looks as if the case fatality rate was in the 20-30% range associated with variola major. And in fact, the American Journal of Public Health reported in 1926 that this particular epidemic resulted in 386 cases, of whom 87 people died (about 23%). Of the 386 cases, 327 had never been vaccinated, 46 had been vaccinated 10 or more years previously, 11 had been vaccinated more than 5 and less than 10 years previously, 2 had an uncertain vaccination history, and none had been vaccinated within the previous 5 years. About 400,000 vaccinations were performed during the epidemic, and quarantine measures and isolation of those infected were observed.
We just added a timeline entry on this outbreak to our smallpox timeline. Many thanks to Dr. Lorber for passing along the materials. If you’re interested in this era, take a look at the smallpox vaccine pamphlet on our Flickr stream from 1924, in which the H.K. Mulford Company raises the specter of black smallpox.