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Black History Month: Onesimus Spreads Wisdom That Saves Lives of Bostonians During a Smallpox Epidemic

By 

René F. Najera, DrPH

February 7, 2020

In the early 1700s, about a century before , was going through New England and other American colonies. In Massachusetts, colonists saw smallpox arrive with cargo ships to Boston over and over again. There was not much the authorities could do beyond imposing quarantines and treating the sick. This changed in the epidemic of 1721 thanks to the wisdom passed on by Onesimus, an African man sold into slavery to Cotton Mather, an influential minister in Boston. (You might remember Mather from learning about the Salem Witch Trials.)

Mather held Onesimus in slavery in 1706, conversing with him, and learning about Onesimus' past. When Mather asked Onesimus if he had ever had smallpox back in Africa, Onesimus described the .  consisted of first taking infectious material (like pus) from the blisters of smallpox patients. A healthy person then receives the material through a cut in the skin in a controlled manner and under the supervision of a physician. This was done so that the smallpox symptoms would be milder, but still confer some sort of immunity in the future. Of course, the procedure was not without risk. People still developed severe symptoms and even died from smallpox via variolation, but those who died were much smaller in proportion than those who acquired it naturally from another person. ().

After hearing Onesimus' story, Cotton Mather began to research the practice of variolation. He found that it was practiced in many parts of the world, not just Africa. Or, as he recorded in his diary, "the new Method used by the Africans and Asiaticks, to prevent and abate the Dangers of the Small-Pox, and infallibly to save the Lives of those that have it wisely managed upon them." Places like and had their own versions of variolation, based on the same principle of exposing a person under controlled circumstances, rather than allowing them to contract it naturally. The practice was so effective in conferring immunity that enslaved Africans sold in Massachusetts were considered more valuable if they bore the scar of variolation.

This research and correspondence with medical experts at the time encouraged Cotton Mather to push for variolation in the colonies. He burned some of his political and social capital in advocating for variolation before the next epidemic hit Boston. Needless to say, his proposal met resistance. According to The Boston Globe, :

“As word spread of the new medicine, the people of Boston were terrified and angry. According to Mather, they “raised an horrid Clamour.” Their rage came from many sources; fear that inoculation might spread smallpox further; knowledge that the bubonic plague was on the rise in France; and a righteous fury that it was immoral to tamper with God’s judgment in this way. There was a racial tone to their response as well, as they rebelled against an idea that was not only foreign, but African (one critic, an eminent doctor, attacked Mather for his “Negroish” thinking). Some of Mather’s opponents compared inoculation to what we would now call terrorism—as if “a man should willfully throw a Bomb into a Town.” Indeed, one local terrorist did exactly that, throwing a bomb through Mather’s window, with a note that read, “COTTON MATHER, You Dog, Dam You; I’l inoculate you with this, with a Pox to you.”

In 1721, half of Boston's residents were infected with smallpox, about 11,000 people. Zabdiel Boylston, a physician who believed Cotton Mather and Onesimus on variolation, inoculated his own son and the enslaved people working in his household. The result was that one in forty people inoculated by Boylston died from smallpox. In those who acquired it naturally, one in seven died... A risk ratio of 5.7, meaning that people who acquired the disease naturally were almost six times more likely to die than those who acquired it by variolation.

At the end of the epidemic, 14 percent of the population of Boston was dead. Based on this experiment with variolation, the practice became more accepted in the colonies facing smallpox epidemics. By 1796, Edward Jenner would develop the vaccine based on the cowpox virus. By the mid-1800s, variolation was discontinued in favor of immunization with cowpox, as immunization was safer and more effective than variolation. Onesimus would partially purchase his freedom, but still remained in the service of Cotton Mather. Not much beyond that time is known about him, where he went or how he lived the rest of his life. However, his contribution to the understanding of smallpox and its prevention lives on today.

References:

  • Cotton Mather Anguishes Over the Consequences of His Son's Inoculation Against Smallpox. T. E. C. Pediatrics May 1974, 53 (5) 756. Available online at:  
  • “How an African slave helped Boston fight smallpox” from The Boston Globe:
  • “How an African Slave in Boston Helped Save Generations from Smallpox” from History.com:

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