Variolation facts for kids

Variolation was an old way to protect people from smallpox, a very serious disease. It involved giving someone a small amount of the smallpox virus on purpose. This was usually done by scratching their skin and rubbing in a tiny bit of material from someone who had a mild case of smallpox.

The idea was that the person would get a mild version of the disease. They might feel a bit sick and get some spots, but it was much less dangerous than catching smallpox naturally. About 1 or 2 out of 100 people who got variolation died from it. But if you caught smallpox naturally, about 30 out of 100 people died.

Variolation is not used anymore. It was replaced by the smallpox vaccine, which was much safer. Vaccines are now used to protect us from many other diseases.

When variolation was done, the virus usually entered the skin. This often led to a milder infection than if the virus entered through the nose or mouth. Even with a mild infection, the person's body learned to fight the virus. This made them immune, meaning they were protected from smallpox in the future. After a few weeks, the symptoms would go away, showing they had recovered and were now safe.

This method was first used in places like China, India, parts of Africa, and the Middle East. It came to England and North America in the 1720s.

What's the Difference: Variolation and Vaccination?

It can be a bit confusing to talk about how smallpox was prevented.

• Variolation meant giving someone a small amount of the actual smallpox virus.
• Vaccination is different. It started in 1800 when Edward Jenner found a safer way to protect people. He used material from cowpox, a milder animal disease, to protect against smallpox. The word "vaccination" comes from the Latin word for cow.

Later, a famous scientist named Louis Pasteur used the word "vaccine" for any way of making someone immune to a disease. So, while variolation and vaccination both aim to make you immune, they use different methods.

Where Did Variolation Start?

People used variolation in different parts of the world a long time ago.

China's Method

The Chinese were among the first to use variolation, possibly as early as the 11th century. They had a unique way of doing it:

• They would grind up dried smallpox scabs into a powder.
• Then, they would blow this powder up a person's nose.
• They often used scabs from people who had very mild cases of smallpox. This was to make sure the new infection was also mild.
• Sometimes, they even used a silver blowpipe. For boys, they used the right nostril, and for girls, the left.
• People who had been variolated were kept away from others until they were fully recovered. This was because they could still spread the disease.

India's Practice

Some stories suggest variolation was also practiced in India for many hundreds of years. Doctors who performed this procedure were called Tikadars. The word tika is still used today in many Indian languages to mean 'vaccination'.

Sudan's Ways

In Sudan, people had similar methods.

• One method was called Tishteree el Jidderi, meaning 'buying the smallpox'. A mother would visit a child with smallpox and agree on a price for each smallpox spot. Then, she would tie a cloth from the sick child's arm onto her own child's arm.
• Another method was Dak el Jedri, or 'hitting the smallpox'. This involved taking fluid from a smallpox spot and rubbing it into a cut on the skin. This method was similar to what was used in the Ottoman Empire and later in England.

Variolation Comes to Europe

Variolation was known in Wales as early as the 1600s. Later, a doctor named Emmanuel Timoni wrote about the method he saw in Constantinople (now Istanbul, Turkey) in 1714. His report caught the eye of people in England and America.

Lady Mary Montagu's Story

Lady Mary Wortley Montagu was a British diplomat's wife living in the Ottoman Empire. She had suffered from smallpox herself and lost her brother to the disease. She saw how common variolation was there.

• In 1718, she had her five-year-old son, Edward, variolated. It worked well.
• When she returned to England, she had her four-year-old daughter variolated in front of royal doctors in 1721. This was also successful.

After this, an experiment was done at Newgate Prison in London. Six prisoners who were sentenced to death were variolated. They were promised freedom if they survived. They all survived, and this helped variolation become more popular in England.

The Sutton Family's Improvements

The Sutton family, led by Robert Sutton, greatly improved variolation in England.

• In 1762, Robert Sutton started advertising "A New Method of Inoculating for Small-Pox."
• He kept his method a secret, sharing it only with his three sons.
• Their method was very successful. They treated over 300,000 people by 1770.
• The secret was finally revealed by his son Daniel in 1796. Their method used a very shallow scratch on the skin. They also carefully chose donors who had only mild smallpox. They avoided harsh treatments like bloodletting, which doctors often did before variolation.

Johnnie Notions from Scotland

Johnnie Notions was a self-taught doctor from Shetland, Scotland. He developed his own successful way to variolate people in the late 1700s.

• He collected smallpox pus and dried it using peat smoke.
• Then, he buried it in the ground with camphor, which helped keep it from going bad.
• He would keep this material for many years to make it less strong.
• When he used it, he would make a tiny cut in the patient's arm with a special knife he made himself. He would put a small amount of the material into the cut and cover it with a cabbage leaf.
• Johnnie Notions was very successful. He variolated about 3,000 people and is said to have never lost a single patient.

Variolation Becomes Well-Known

By the mid-1700s, variolation was widely accepted in England. It was even added to a famous encyclopedia called Chambers' Cyclopædia in 1738.

• England became a center for variolation, attracting people from all over the world.
• For example, Thomas Dimsdale, a doctor, was invited to Russia in 1769 to variolate Catherine the Great and her son. They both survived, and Dimsdale was greatly rewarded.
• France was slower to accept it, but after a smallpox outbreak in Paris in 1752, it became more popular there too.
• In Japan, a Chinese merchant introduced the nasal method after an outbreak in 1744.

By the end of the 1700s, variolation was seen as a huge medical success worldwide.

Variolation Spreads to America

In America, the idea of variolation came from Cotton Mather, a minister in Boston. He learned about the technique from his West African slave, Onesimus, in 1706. Onesimus told him that his people already had a way to protect themselves from smallpox.

• In 1721, Boston had a smallpox outbreak. Mather pushed for variolation, even though some people were against it.
• Many people argued against variolation for religious reasons. They thought it was wrong to interfere with God's will. Some believed smallpox was a punishment for sins.
• However, Mather found supporters, like surgeon Zabdiel Boylston. Boylston successfully variolated 300 patients, and only six of them died. In contrast, 1,000 out of 6,000 people who caught smallpox naturally died during the same time.
• From Boston, variolation spread. In 1775, George Washington ordered that the Continental Army be variolated during the American Revolutionary War. By the end of the war, variolation was widely accepted in American cities.

From Variolation to Vaccination

Even though variolation was a big step forward, it had problems.

• It sometimes failed to protect people for life.
• It still required skill, and some doctors didn't do it properly.
• The biggest problem was that people who were variolated could still spread smallpox to others. This meant that variolation itself could cause new outbreaks.

In the 1760s, doctors started looking at using material from cowpox, an animal disease, to protect against smallpox.

• In 1796, Edward Jenner famously vaccinated a boy named James Phipps using cowpox material.
• Jenner showed that cowpox protected against smallpox and was much safer than variolation. It also rarely spread to other people.
• Soon, the smallpox vaccine became widely used. Many countries, like Russia in 1805, made variolation illegal.

Vaccination was a huge step forward. It led to the complete eradication of smallpox, meaning the disease no longer exists in the world. The idea of vaccination also led to the development of many other vaccines we have today, like those for measles, mumps, and flu.

The End of Variolation

Variolation eventually stopped being used in most places, but it lasted longer in some remote areas. During the World Health Organization's campaign to get rid of smallpox, they sometimes found people still practicing variolation in places like Pakistan and Afghanistan. However, over time, the variolators couldn't get fresh smallpox material, and the practice died out.

Other Similar Ideas

Even though variolation is gone, it influenced other ideas. For example, some people still hold "pox parties" where children are intentionally exposed to diseases like chickenpox to gain immunity. Public health officials strongly advise against this because it can be dangerous.

There's also a modern idea related to this: some scientists think that wearing face masks during outbreaks (like COVID-19) might lead to milder infections. This is because masks could reduce the amount of virus a person breathes in or out, making the infection less severe.