As I was reading Charles Dickens’s Bleak House, I was interested to find a description of an illness that most likely was smallpox. The incident involves Esther Summerson, the self-sacrificing heroine. At one point in the book, she performs the kind of act of charity we so often read about in novels from the era – a kind woman ministering to the poor and ill. She walks into a house to which her maid has brought her and notices an unpleasant fact. “The place … had an unhealthy and a very peculiar smell.” Dickens’s mention of the smell immediately brought to smallpox to my mind. Indeed, ,any reminiscences of smallpox mention the characteristic smell of the disease. In “The Demon in the Freezer,” Richard Preston quotes D.A. Henderson, director of the WHO’s Smallpox Eradication Programme: “My God, they talk about the odor of smallpox. It is an odd smell, not like anything else…It’s a sickly odor, like rotting flesh, but it’s not decay, because the skin remains sealed and the pus isn’t leaking out….That smell is one of the mysteries of smallpox. No one knows what it is. ” A boy in the house is feverish, and Esther and the maid tend to him.
Within a few days, Esther’s maid Charley becomes ill, and Esther locks the two of them in her quarters to tend to her illness. Though Dickens does not name the disease, he seems to describe smallpox:
And thus poor Charley sickened and grew worse, and fell into heavy danger of death, and lay severely ill for many a long round of day and night. …I was very sorrowful to think that Charley’s pretty looks would change and be disfigured, even if she recovered—she was such a child with her dimpled face—but that thought was, for the greater part, lost in her greater peril….And Charley did not die. She flutteringly and slowly turned the dangerous point, after long lingering there, and then began to mend. The hope that never had been given, from the first, of Charley being in outward appearance Charley any more soon began to be encouraged; and even that prospered, and I saw her growing into her old childish likeness again.
As Charley recuperates, Esther becomes ill herself. Soon she finds it difficult to speak (smallpox pustules would frequently, and painfully, line the mouth and throat). She is blind for a time, and for several weeks is confined to bed.
After a long recovery, during which she notices that the looking glass has been removed from her room, she finally looks at herself in a mirror.
My hair had not been cut off, though it had been in danger more than once. …[I] stood for a moment looking through such a veil of my own hair that I could see nothing else. Then I put my hair aside and looked at the reflection in the mirror, encouraged by seeing how placidly it looked at me. I was very much changed—oh, very, very much. At first my face was so strange to me that I think I should have put my hands before it and started back but for the encouragement I have mentioned. Very soon it became more familiar, and then I knew the extent of the alteration in it better than I had done at first. It was not like what I had expected, but I had expected nothing definite, and I dare say anything definite would have surprised me.
I had never been a beauty and had never thought myself one, but I had been very different from this. It was all gone now.
Esther’s scarring is not surprising. In the smallpox chapter of Plotkin’s Vaccines, the authors write that 65% to 80% of people who recovered from smallpox infection had scarring for life. Lady Mary Wortley Montagu, who brought smallpox variolation from Turkey to England, was so scarred from smallpox that she wore a veil or heavy makeup to cover the traces (Carrell, The Speckled Monster, 2004).
Though Dickens does not refer to smallpox vaccination in Bleak House, he was a strong supporter of the practice. In an essay in the June 30, 1860, edition of All the Year Round, he advocated for mandatory vaccination and displayed a sophisticated understanding of smallpox history and vaccine production. He noted that in 1853, legislation mandated that all infants in England be vaccinated, with punishment in the form of a fine. At first, he wrote, people complied with the law. But seeing that no one enforced the law nor collected the penalty, they began to ignore it. He concluded his long essay with “Our present wants, therefore, are but two: firstly, some measure for the renewal of the vaccine matter: secondly, a system of compulsory vaccination that will include provision for the actual enforcement of its penalties.”
I’m curious about why Dickens wouldn’t explicitly use the term smallpox—was the disease so freighted with negative associations that the reader would lose sympathy for Esther? Or might he have chosen to avoid the term to keep the focus on Esther, rather than the disease? Or, because the chapter is narrated by Esther, perhaps Dickens is indicating that Esther would be too ladylike, or too afraid, or too appalled to utter the word smallpox. If you’re a Dickens lover, and won’t yell at me for trying to make a literary diagnosis, please chime in!