In the history of mankind, the "smallpox" that has been raging for more than 3,000 years has been completely eradicated

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Smallpox is a disease that is somewhat unfamiliar to young people nowadays, but many people have also heard of it in film and television dramas. In fact, in ancient times smallpox was an extremely terrible disease.

Smallpox is a virulent infectious disease caused by the smallpox virus, because the infected person will be covered with a rash all over the body at the onset of the disease, then scab, and finally will leave a permanent scar on the face, commonly known as pockmarked seeds, so it is named smallpox.

The most important feature of smallpox is that "everyone is equal", and its pathogen smallpox virus has a strong ability to infect and reproduce, and after the death of the patient, the virus can still survive for several months, so that regardless of race, status, age, or gender, as long as it is a person, it is possible to be infected with smallpox.

After the smallpox pandemic in the 16th century, the incidence was as common as the cold today. In history, many nobles and even kings died of smallpox, such as Pharaoh Ramses V of ancient Egypt, Queen Mary II of England, Tsar Peter II of Russia, King Louis XV of France, King Louis I of Spain, Prince Yu of the early Qing Dynasty, Emperor Shunzhi, Emperor Tongzhi (another said to have died of "Hualiu disease") and so on. In addition, Queen Elizabeth I of England, King Louis XIV of France, and Emperor Kangxi of the Qing Dynasty were also disfigured by smallpox (with pockmarks on their faces).

Above_ Aixin Jueluo Xuanye (1654-1722), also known as the Kangxi Emperor

Smallpox is also one of the oldest recorded infectious diseases, and the first recorded case of smallpox was the ancient Egyptian pharaoh Ramses V, so it can be inferred from the year of Ramses V's death (1145 BC) that smallpox has ravaged at least 3,000 years in human history.

The mortality rate of smallpox is about 30%, although it is much lower than that of plague, tuberculosis and other infectious diseases, but because of its "equality of all" characteristics, its destructiveness to human society is also ranked in the forefront of many infectious diseases, many historians even evaluate the smallpox epidemic as "the largest genocide in human history", and the number of deaths caused by smallpox is more than hundreds of millions. In addition, the most annoying thing about smallpox is that it will be disfigured, whether it is ancient or modern, appearance is pursued by everyone, and the existence of smallpox greatly reduces the appearance of human beings. There is such a proverb among Chinese folk - "only half of the child is born, and smallpox is considered complete", because the incidence is too high, it is very likely that if you find a random person on the street in ancient times, it is likely to be "pockmarked face".

However, such a terrible disease was declared completely eradicated in May 1980, becoming the only infectious disease that mankind has completely eradicated so far.

Above_ "Elbow Reserve Emergency Prescription", an ancient Chinese medicine prescription work, the original version was called "Elbow Rescue Prescription", "Elbow Behind", written by Ge Hong during the Eastern Jin Dynasty

So, how was smallpox eradicated?

Ge Hong, a famous physician in the Eastern Jin Dynasty, was the first person in ancient China to record the condition of smallpox and propose a cure. In his book "The Prescription for Saving the Pawn Behind the Elbow", he once described the onset of smallpox: "When there is a disease in the year, it is a sore on the head, face and body, and it must be around the turn, like a fire wound, all with white pulp, and it will be born with the decision." If it is not cured, the dramatists will die more, and those who are poorly cured will have purple and black sores and will be extinguished before they die, and this vicious atmosphere will be extinguished";

The treatment prescription he gave was "take good honey and rub it on the body, you can also decoction the cohosh with honey, and count the food;

Starting from Ge Hong, the traditional Chinese medicine treatment of smallpox in all dynasties basically followed his method: internal administration of detoxification and fire removal decoction, external application of swelling and stasis medicine. However, the therapeutic effect can be basically determined from the mortality rate of smallpox, and the effect is not very good.

Above_ Luofu Mountain Ge Hong's mound of clothes

In fact, although the flower has been eradicated today, strictly speaking, until today, human beings have not been able to develop a special medicine that can treat smallpox, let alone the ancient people who had extremely poor medical standards and treatment methods were limited to the level of "dancing gods" and "repentance to God". At that time, once people contracted smallpox, they had to resign themselves to fate - those with mild symptoms and good body immunity would be cured by leaving a pockmarked face, and those with severe symptoms and poor body immunity could only die with a whimper. Therefore, in ancient times, people still focused on prevention of smallpox.

The ancients discovered a phenomenon in their long-term experience: those who have been cured of smallpox will never get smallpox again in their lives. Although the ancients did not understand the principle of immunology, its practical value is reflected. The Chinese ancestors, who were good at summarizing, had the idea that if a mild smallpox patient could infect a normal person, after the disease was cured, it would not cause death, but also give people the ability to prevent smallpox for the rest of their lives. This idea was put into practice, and a method of preventing smallpox was invented, the human pox inoculation method. There are four specific operations: pox coating method, pox slurry method, dry seedling method, and water seedling method. The pox method is to let normal children wear the clothes of smallpox patients, while the pox slurry method, dry seedling method, and water seedling method are all to remove the pox pulp or acne scab from the mild smallpox patient to touch the nasal cavity of normal children.

In the fifteenth century, China used the scabs of smallpox patients, dried them and processed them into powder, which was blown into the human nasal cavity to play an immune role

There are many theories about the origin of the human pox inoculation method:

1. In the Tang Dynasty medicine king Sun Simiao's "Qianjin Fang", it was recorded: "The prescription for treating red and black defects in children: in the feet of the needle, take blood and paste the defects to eliminate them; "From Sun Simiao's life, it is inferred that human pox inoculation originated in the early Tang Dynasty.

2. In the late Qing Dynasty medical scientist Dong Yushan's "New Book of Cowpox", it is recorded: "There is no pox in the world, and the Zhujing Tang Kaiyuan period, the Jiangnan Zhao family, the first method of planting pox in the nose seedlings..."

3. Yu Tianchi, a medical scientist in the early Qing Dynasty, recorded in the "Collection of Acne Treatments", formerly known as "The Collection of Acne Departments": "The method of smelling pox began in Taiping County, Ningguo Prefecture (now Taiping, Anhui) during the Longqing period of the Ming Dynasty (1567-1572)... This spreads all over the world. The time and place are more detailed, originating from the Taiping Mansion during the Longqing period of the Ming Dynasty.

Above_ The pox knife style in "Acne Strategy", the 1832 edition of the 12th year of Daoguang in the collection of the Medical Literature Museum of the Republic of China

At present, the mainstream view of historiography is that the first promotion of the human pox inoculation method at the official level should be during the Longqing period of the Ming Dynasty, but the earliest time of its appearance should be in the Tang Dynasty, but at that time it was only circulated in a small range of people.  

The human pox inoculation method was fully popularized during the Kangxi period of the Qing Dynasty. The Qing dynasty originated in the northeastern region, far from the Central Plains, and had little exposure to smallpox, resulting in a lack of immunity to the disease. Therefore, the Qing army was persecuted by smallpox at the beginning of its entry. The above-mentioned Qing Dynasty Prince Yu Duoduo and Emperor Shunzhi both died of smallpox, and neither of them was more than 40 years old when they died. Therefore, Emperor Kangxi, who survived smallpox, paid more attention to the prevention of smallpox.

In the twenty-first year of Kangxi (1682), he ordered the popularization of the human pox vaccination method throughout the country. In his later years, he once said to his children in the "Maxims of Court Training": "At the beginning of the country, people were afraid of pox, and until I got the pox prescription, all the children and your children were all safe from pox." Now the forty-nine banners outside the border and the Khalkha domains are all ordered to plant pox, and all that is planted will be healed. When I tried to remember the first planting, the old man still thought it was strange, but I insisted on it, so it was a coincidence that all the tens of millions of people were born?" It can be seen from this passage that Emperor Kangxi is quite confident in his contribution to the popularization of the human pox inoculation method. Indeed, the widespread use of the pox inoculation method greatly reduced the smallpox mortality rate in the Qing Dynasty, which also became an important factor in the skyrocketing population of the Qing Dynasty.

Above_ "Maxims of Court Training: Classics of Chinese Studies" was written by Emperor Aixin Jueluo Xuanye (1654-1722) of the Kangxi Emperor of the Qing Dynasty

The human pox inoculation method was later introduced to Japan, Russia, Turkey, and later to Europe via Turkey. However, Turkey's pox inoculation method uses needles to puncture a child's skin and allow the scabs to come into contact with the skin. In 1717, the famous English epistolist Mrs. Mary Ottley Montague followed her husband to Turkey (Mr. Montague was then the British ambassador to Turkey) when she discovered the effects of the human pox inoculation and brought it to England. However, the British at that time did not believe it and refused to accept it. Madame Montague persuaded King George I of England to carry out an experiment on death row prisoners, and after success, it began to spread throughout the country, and by the end of the 18th century, the method of vaccinating people had spread to Europe and the Americas.

The Chinese method of inoculating human pox has made an indelible contribution to the fight against smallpox, and the French philosopher Voltaire once praised: "I have heard that for a hundred years, the Chinese have been in this Xi habit; this is a great precedent and example of one of the wisest and most polite people in the world." ”

Unfortunately, however, it has also been found that human pox vaccination is not completely safe. There is a mortality rate of about 2%, and there are often some sequelae such as tinnitus. Therefore, humans need to find safer ways to prevent smallpox.

Above_ Edward Turner (1749-1823 AD), a British physician who researched and popularized the cowpox vaccine against smallpox

In the mid-18th century, an English country doctor named Edward Turner (sometimes translated as Jenner, Suina) stumbled upon a milkmaid who discovered that cowpox could prevent smallpox. After more than 20 years of research and experimentation, the cowpox inoculation method was finally invented.

The biggest advantage of the vaccinia inoculation method is that the safety is greatly improved, because after people are infected with cowpox, in addition to causing mild lymphadenitis, it will not cause acne, let alone fatal. In 1798, he published a paper entitled "A Study of the Causes and Effects of Cowpox" at his own expense, hoping to promote the vaccinia inoculation method throughout England. However, what is surprising is that the United Kingdom, which has basically completed the transformation of modern society, strongly resisted Chenna's cowpox inoculation method, and some people even directly said that Chenna was a liar who sold his reputation, and some people said that after vaccinating with cowpox, people would grow cow horns and body hair.

In the face of criticism and slander, Jeanne did not flinch, and in 1799 published five articles about cowpox, and returned to his hometown to continue to vaccinate the local people with cowpox, the advantages of cowpox inoculation were accepted by more and more people, and in just a few years, the incidence and mortality of smallpox were greatly reduced, and the British official finally recognized it.

The British Parliament awarded Zenner £10,000 and £20,000 in 1802 and 1807 respectively. Over the next decade or so, vaccinia inoculation spread across the European continent and the Americas.

Above_ Children vaccinated against vaccinia

In 1805, Alexander Pearson, a physician of the East India Company, brought the cowpox inoculation method to Canton. It is also surprising that the Qing Dynasty, who had been in seclusion for many years and had always been ignorant, did not resist the cowpox inoculation as the British, and this advanced technology soon spread in China and eventually replaced the human pox inoculation.

According to the guidance in the famous Qing Dynasty doctor Qiu Xi's "Introducing Pox", the main method of inoculating cowpox in Chinese since the Qing Dynasty is to dip a small amount of cowpox pulp with a small blade, and then cut a wound one to two centimeters long on the arm, and the inoculation is successful.

In January 1823, he died at the age of 74. We should always remember this great country doctor, whose achievements were not only in the victory over smallpox, but more importantly, in the discovery of the most effective way to prevent infectious diseases - vaccination, thus opening up a new field of medicine - immunology, so that later generations revered Edward Chinner as the "father of immunology".

Lu Xun, a famous modern writer in mainland China, also wrote in the article "Napoleon and Sui Na (Qinna)": "When we look at our arms, there are probably a few scars, which are the traces of cowpox, which have freed us from smallpox." Since the existence of this cowpox method, I really don't know how many children have been saved in the world. ”

Above_ French stamp on the 100th anniversary of the vaccination against cowpox in Chenna, issued in 1896

Although the effect of cowpox inoculation has been remarkable since the 19th century, the vast regions of Asia, Africa and Latin America have been suffering from poverty and backwardness and long-term wars. Therefore, until the end of World War II, in the 50s of the 20th century, smallpox was still rampant. In order to completely solve this terrible disease, countries around the world began to unite to encircle and suppress it.

In 1948, the World Health Organization was established, and smallpox was listed as the first infectious disease that should be controlled;

In 1953, Chisholm, the first Director-General of the World Health Organization, first set the goal of eradicating smallpox worldwide;

In 1958, the Soviet delegation proposed a global campaign to eradicate smallpox, which was approved by the General Assembly, and the main method of the plan was to vaccinate or re-vaccinate more than 80% of the world's population.

In 1966, the 19th General Assembly of the World Health Organization (WHO) once again adopted a resolution on a large-scale campaign to eradicate smallpox, and invested huge manpower, material and financial resources.

Above_ Poster of the Health Department of Jilin Railway Administration on "Prevention of Smallpox and Vaccinia Vaccination".

In 1967, there were still 46 countries in the world with smallpox epidemics (the mainland eradicated smallpox in 1961 through several large-scale health campaigns in the early days of the founding of the People's Republic of China), and through mass vaccination of cowpox in countries such as Central Asia, West Asia, South America and Africa, it dropped to 31 countries after only one year.

In 1975, when the world was reporting that only Ethiopia was still endemic with smallpox, the World Health Organization mobilized a large number of people and materials to Ethiopia and eradicate smallpox in the country a year later. Unfortunately, the former Ethiopian herders brought smallpox to neighbouring Somalia, which had been declared extinct, and the World Health Organization had to move to Somalia.

On 26 October 1977, Ali Mao Martin, the last smallpox cook, was cured;

On May 8, 1980, the 33rd session of the World Health Organization officially declared that smallpox had been completely eradicated.

The war between humans and smallpox lasted for more than 3,000 years, and it was finally declared victorious, and smallpox became the only infectious disease that mankind has completely eradicated so far. This demonstrates the indomitable fighting spirit of human beings, and it also tells the world with facts sonorously and forcefully that as long as human science and technology continue to progress, any disease will be defeated!

Above_ In 1910, the second year of the Qing Dynasty, the arch of the "Tung Wah Pox Bureau" in Hong Kong

Here, I can't help but ask the question, why can smallpox be completely eradicated from so many infectious diseases?

First, the smallpox virus is a DNA virus, and it is a double-stranded DNA virus, which makes it almost impossible for it to mutate, and there are only two subtypes of smallpox virus circulating for thousands of years, which ensures that as long as you are vaccinated against vaccinia, you will definitely gain immunity.

Second, the smallpox virus is only hosted by human beings, which means that once all human beings are immune to it, smallpox will have no place to live and can only go extinct.

Third, although vaccinia and smallpox are two completely different diseases, their pathogens vaccinia virus and smallpox virus share cross-reactive antigens, which is why humans can be immune to smallpox by vaccinia, while vaccinia is almost harmless to humans.

Above_ University of Birmingham Old photo

Now that smallpox has been eradicated, does it mean that the smallpox virus has been completely eradicated from the earth? Unfortunately, this is not the case. In fact, the cure of Ali Mao Martin, the last smallpox patient in Somalia in 1977, can be said to have been eradicated. However, there is no smallpox virus in nature, but there is one in the laboratory, but the smallpox virus is very strict in terms of preservation, and accidents can occur if you are not careful.

In August 1978, a smallpox virus sample leak occurred in the laboratory of the University of Birmingham Medical School in the United Kingdom, resulting in the death of five people. The World Health Organization had to urgently order that all laboratories around the world must destroy samples of the smallpox virus. It was not until two years later, in August 1980, that the World Health Organization officially announced that smallpox had been eradicated.

At present, there are only two laboratories in the world with a high safety factor that still contain the smallpox virus: one is the US Centers for Disease Control and Prevention, and the other is the Russian State Research Center for Virology and Biotechnology. The reason given for the retention is that the samples must be kept for scientific research, and at least two specific drugs for smallpox and an absolutely safe smallpox vaccine can be found before they can be completely destroyed.

Above_ Smallpox virus

Since the outbreak of 911, countries around the world have feared that the smallpox virus could be used as a biological weapon for terrorists to launch attacks, and since 1980, when the World Health Organization declared smallpox eradicated, countries around the world have stopped vaccinia vaccination. As a result, people born after 1980 are not immune to smallpox, and an epidemic of smallpox would have very serious and catastrophic consequences. As a result, more than 20 countries, including the mainland, have resumed production and stockpiling of smallpox vaccines, and on December 13, 2002, the U.S. government announced the resumption of smallpox vaccination, which had been discontinued in the 70s of the 20th century.

Resources: 

[1] Ge Hong, "Behind the Elbow to Save the Pawn"  

[2] Sun Simiao, "A Thousand Golden Squares"  

[3] Dong Yushan, "New Book of Cowpox"  

[4] Yu Tianchi, "A Collection of Acne Explanations"  

[5] Aixin Jueluo Xuanye, "Maxims of Court Training"  

[6] Edward Chenner, A Study of the Causes and Effects of Cowpox, 1798  

[7] Lu Xun, "Napoleon and Sui Na (Qinna)"  

[8] Kwong Li-sze and Ma Bo-ying, "Review of Smallpox Virus Laboratory Preservation Errors and Reflections", 2013

(This article only represents the author's point of view and does not represent the position of this number)

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font-size:16px}*{margin:0; padding:0}.rich_media_content *{max-width:100%!important; box-sizing:border-box!important;-webkit-box-sizing:border-box!important; word-wrap:break-word!important}.rich_media_content p{clear:both; min-height:1em}td p{margin:0; padding:0}@media(prefers-color-scheme:dark){body:not([data-weui-theme=light]) .rich_media_content img:not(.wx_img_placeholder){filter:brightness(.8)}}@media screen and (min-width:1024px){body:not(.pages_skin_pc) :root{--appmsgPageGap: 20px}}:root{--articleFontsize: 17px}:root{--sab: env(safe-area-inset-bottom)}:root{--wxBorderAvatarRatio: 3}:root{--discussPageGap: 20px}:root{--appmsgPageGap: 20px}

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