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posted June 2006

    Here are three historical articles by Fred B. Rogers, MD, from The New England Journal of Medicine
    Dr Rogers was Professor of preventive medicine, Temple University School of Medicine, Philadelphia.

270 (13): 664-666. 26 Mar 1964. Drs. Francis Wicks (1755-1836) and Hugh George Donaldson (1757-1812), of Falmouth Massachusetts

276 (6): 322-324. 9 Feb 1967. Dr. Samuel Lord and the Smallpox epidemic of 1765-66 at Chatham, Massachusetts

278 (1): 21-23. 4 Jan 1968. "Pox Acres" on old Cape Cod.


SPECIAL ARTICLE

PIONEER INOCULATORS ON CAPE COD

Drs. Francis Wicks (1755-1836) and Hugh George Donaldson (1757-1812), of Falmouth Massachusetts

Fred B. Rogers, M.D.
Philadelphia

664

    Near the end of the eighteenth century, in the Cape Cod town of Falmouth, two physicians, Francis Wicks and Hugh George Donaldson, made noteworthy contributions toward erasing smallpox from Massachusetts. These men instituted the practice of variolation at inoculation hospitals that they established at Falmouth Heights and Wood's Hole; they later promoted vaccination after its introduction by Benjamin Waterhouse of Cambridge in 1800. The obscurity of information concerning the lives of these remarkable doctor citizens and their roles in the struggle against a dreaded scourge warrants this brief account.

    Smallpox was so common in the eighteenth century that only the more severe epidemics were recorded, seven such major outbreaks occurring in Boston between the years 1721 and 1792.1 In Massachusetts, as a result, after prolonged controversy, inoculation hospitals for the practice of variolation were approved and set up by the General Court as well as by private physicians between 1764 and 1800, the first public hospitals for this purpose being opened in the vicinity of Boston in the former year. Variolation was not of course, by modern standards, a good method of prevention. Several European monarchs submitted to it, however, and it was obviously better, in the epidemic setting of the eighteenth century, than no protection at all.

    Late in 1800 Waterhouse published an account of his work, A prospect of exterminating the small-pox, and by 1808, physicians in Massachusetts had accumulated sufficient evidence favoring vaccination to accept unanimously a verdict by the Massachusetts Medical Society recommending that physicians who performed vaccinations should also carry out subsequent tests by direct smallpox inoculation, "for which service, the fellows of this society will not charge any additional fee." The public was thus given additional notice of professional faith in this form of prophylaxis. Wicks and Donaldson, had early espoused the cause of inoculation, were among those who promoted the improved procedure of vaccination in the Commonwealth.

    Francis Wicks, whose forebears were early settlers at Nobska (Wood's Hole), was born in 1755, a kinsman, William Weeks (sic), having been selectman of the Town of Falmouth in 1733-34.2 During the Revolutionary War, Francis served as surgeon's mate to David Jones, of Abington, with the 38th Massachusetts Regiment, stationed at Chelsea from July through December, 1775.3 When the British Army evacuated Boston in March, 1776, small-pox appeared; to prevent its spreading to the people and the troops stationed there, inoculation was widely practiced. Hospitals for the purpose were established at Boston, Cambridge and Brookline, and over 2000 persons were inoculated in a single year.

    The war caused the seaport of Falmouth to be in a state of constant anxiety, and Francis Wicks returned to medical practice there amid these many alarms. An inoculation hospital had been set up at Great Hill (Falmouth Heights), on the outskirts of the town, in 1777; in the following year smallpox

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raged in nearby Sandwich and Yarmouth, the Indians being recorded as the principal sufferers.4 The extent or results of the variolation performed at this hospital are not known, but a generation later, in the face of an epidemic of smallpox, the town still voiced caution concerning its public use.5

    During the Revolution, not only the British but also Tories operating from Martha's Vineyard, the Elizabeth Islands and Nantucket were a menace to shipping and to the town of Falmouth. In 1778, after pillaging New Bedford and Fairhaven, the British planned to do the same thing in Falmouth, but found the local militia prepared to resist them. The marauders burned one vessel and carried away four others, but avoided combat and moved on to plunder Martha's Vineyard. In the spring of 1779 the Royal Navy, again forsaking an organized assault on Falmouth because of military resistance, bombarded the town and its breastworks. To the ravages of war were added the toll of sickness; Wicks and Donaldson were busy with professional and military concerns throughout the conflict.

    After the War smallpox continued to be endemic on Cape Cod. In 1843 the Falmouth historian, Charles W. Jenkins,6 wrote:         

The subject of vaccination for the small-pox had been discussed with considerable warmth and the town had declared by vote that ''inoculation should not be set up in this town." But in 1797 a more liberal spirit prevailed and Dr. Francis Weeks was allowed to establish a hospital for this purpose under the regulations of a committee consisting of Gen. Dimmick, Col. Bassett and Thomas Jones. This hospital was located at Nobsque and the building used for this purpose was the one now occupied as a dwelling house by Mr. John Weeks on the Shore Road.

    Resolutions recorded by the town clerk note the initial controversy over variolation: "to set up inoculation March 13, .. . not to set up inoculation April 3, ... to carry on inoculation August 10, 1797." Nobska, a point of land on Vineyard Sound about 2 miles from the center of Falmouth, was considered to be a safe distance away for an isolation hospital.7 Writing in 1959, Robert Elphick8 cited Francis Wicks as "famed for his battle against smallpox epidemics in the Falmouth area."

    A prominent citizen, Wicks, about 1790, had built a mansion near the Village Green that, since 1934, has housed the Falmouth Historical Society (Fig. 1). Open to the. public, it has one of the few widow's walks in Falmouth and an old-fashioned garden. A member of the First Congregational Church of Falmouth. he served from 1795 to 1796 on the committee that supervised the construction of the present edifice with its church bell, cast by Paul Revere, which still rings from the belfry.9 In 1798 the doctor was one of twelve charter members of the Marine Masonic Lodge of Falmouth, serving as its first Worshipful Master and being re-elected to that office in 1803 and 1808.

    Records of the town clerk refer to public service by Wicks: he was one of a committee appointed to provide a "poor house," served as a petty juryman in 1791 and in 1798 assisted financially the building of a new schoolhouse. In 1806 he was elected to the state legislature for a four-year term, and in the following year was named a justice of the peace for Barnstable County.

    The War of 1812 again brought alarms to Falmouth: defied by the local militia, guns of H.M.S. Nimrod blazed away at the town, damaging houses and saltworks along the harbor. After the war Falmouth, along with the rest of Cape Cod, settled down for an era of peace and prosperity. The town contributed its full quota of seamen and sea captains during this golden age of the Cape's maritime history.

    Francis Wicks' wife, Elizabeth (1767-1829). bore him a daughter, Susan B. Wicks, who married Captain John Crocker, of Falmouth, in 1806. Wicks died on August 25, 1836, at the age of eighty-one, and was interred beside his wife in the Burying Ground on Mill Road, where their gravestones can be seen today.10

    Hugh George Donaldson (Fig. 2, pupil and colleague of Wicks, was born in London, England, on June 21, 1757, the son of Thomas Clement and Mary George. He is said to have run away from home because his father designed a military career for him and he wanted to become a physician. Hugh adopted the surname Donaldson before arriving at Falmouth in 1776: later, a son, Clement, by his second wife, bore the family name. Coming to Falmouth at the age of nineteen, he found the towns-folk suspicious that he might be a British spy, but he was taken in by the Squire Palmer family, with whom he stayed until his marriage in 1783. He taught school while pursuing medical studies under Wicks. The preceptee became a champion of his adopted country during the War for Independence, being in formal military service from July to November, 1780, as sergeant in Captain Matthias Tobey's company, Lieutenant Colonel Enoch Hallet's

Wicks house
Figure 1. Homestead of Francis Wicks, Built about 1790 (now the Museum and Garden of the Falmouth Historical Society).  

Donaldson silhouette
Figure 2. Contemporary Silhouette of Hugh George Donaldson.

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regiment of troops detached to reinforce the Continental Army in Rhode Island.

    Donaldson shared his preceptor's interest in variolation and vaccination. According to George N. Munsell,11 of Harwich (1890) :

... At the time of a great small pox excitement he became convinced of the truth of Doctor Jenner's theory of vaccination and sent to London to that medical benefactor for vaccine virus and was the first to introduce it into practice here. To prove the efficacy of the treatment to those who were incredulous and prejudiced, he placed members of his own family in the small pox hospital after vaccinating them.*

    Munsell also recorded of Donaldson that "he was much interested in the galvanic battery, then little used. He made one and experimented largely with it in his efforts to obtain knowledge of the wonderful power of electricity over disease."

    A respected townsman, Donaldson was a school-committee member during 1802-10, and attended the "House for Poor" from 1803 to 1812. With Wicks, he was a charter member of Marine Lodge, A.F. & A.M., when that body was organized in March, 1798. He served as first senior warden and secretary of the Lodge. Described as "a man of golden character," he was a leading member of the Falmouth Methodist Church, organized in 1808.

    Donaldson married three times and sired 13 children. He was wed first, in 1783, to Chloe Dimmick (1761-1797) ; their fifth child, a son born on February 22, 1797, was named George Washington Donaldson. The doctor's second wife, whom he married in 1800, was Susannah Snow (1773-1806). and his third wife, wed in 1807, was Hannah Doane Hatch (1774-1848). Donaldson's house and office stood on East Main Street in Falmouth, at the site of the present Surrey Room.12 He was an amateur silversmith, as his still extant self-made initialed teaspoon attests. Donaldson's chaise in which he made his rounds is now owned by the Falmouth Historical Society. He died of "a malignant fever which prevailed in Falmouth at the time" on June 20, 1812. and was buried beside his wives in the Burying Ground on Mill Road, where headstones mark the graves.

*     *     *     *

    From sparse surviving records two Cape Cod physicians from the American past are recalled. In a remote village, a setting less conspicuous than the city's larger stage, these doctors waged battle against pestilence during several outbreaks of smallpox. Esteemed physician citizens, Wicks and Donaldson contributed to the progress of their country, the medical profession and humanity.

*John F. Donaldson, of Falmouth, a great-grandson of Dr. Donaldson, reminiscing in the Falmouth Enterprise (1935), claimed that his forebear had met Jenner in London before emigrating to Massachusetts and later corresponded with him, William R. LeFanu. librarian of the Royal College of Surgeons of England and author of the Bio-bibliography of Edward Jenner 1749-1823 (1951), however, has been unable to locate any correspondence between Dr. Donaldson and Jenner.


    I am indebted to Miss Ruth Donaldson, of Falmouth, a great-great granddaughter of Dr. Donaldson, Mrs. Hazel C. Atwood, Falmouth Public Library, Mrs. Ralph H. Grinnell, Falmouth Historical Society, Mrs. George I. Flint, Eastham Public Library, Dr. Whitfield J. Bell, Jr., American Philosophical Society, Mr. George A. Hough, Jr., Falmouth Enterprise, the Reverend Percy F. Rex, of Pocasset, and Dr. Henry R. Viets, Boston Medical Library, for their assistance.

References

1.    Thacher, J. American Medical Biography: Or memoirs of eminent physicians who have flourished in America. 2 vol. Vol. 1. Boston: Richardson & Lord, 1828. Pp. 21-24 and 28-30.

2.    Freeman. F. The History of Cape Cod: Annals of the thirteen towns of Barnstable County. 2 vol. Boston: W. H. Piper & Co., 1869. Vol. 1. P. 786. Vol. 2. Pp. 464, 467 and 488.

3.    Massachusetts Soldiers and Sailors of the Revolutionary War. 16 vol. Boston: Wright & Potter Co. (State Printers), 1898-1907 Vol. 4. P. 864. Vol. 16. P. 791.

4.    Swift, C. F. Cape Cod, the Right Arm of Massachusetts: An historical narrative. 391 pp. Yarmouth: Register Publishing Co., 1897. P. 212.

5.    The Celebration of the Two Hundredth Anniversary of the Town of Falmouth, Massachusetts, June 15, 1886. L. F. Clarke: 168 pp. Falmouth: 1887. P. 141.

6.     Jenkins, C W. Three Lectures on the Early History of the Town of Falmouth Covering the time from its Settlement to 1812. 124 pp. New Haven, Connecticut: E. H. Jenkins, 1889. P. 94.

7.    Geoffrey. T. (Wayman. D. G.). Suckanesset, a History of Falmouth, Massachusetts. 168 pp. Falmouth: The Falmouth Publishing Co., 1930. Pp. 55, 56, 67, 69 and 70.

8.    Elphick, R. Falmouth Past and Present. 100 pp. Falmouth: Kendall Printing Co., 1959. P. 14.

9.    Digges, J. Cape Cod Pilot. 485 pp. Provincetown and New Modern Pilgrim Press and the Viking Press, 1937. P. 386

10.    Falmouth Historical Society, list of inscriptions in Old Burying Ground on Mill Road. Falmouth Enterprise (November 14) 1903 and (February 13), 1904.

11.    Munsell. G. N. Medical profession. In History of Barnstable County Massachusetts. Edited by S. L. Deyo. 1010 pp. New York H. W. Blake & Co., 1890. Pp. 226, 227, 468, 643 and 659.

12.    Falmouth-by-the-Sea: The Naples of America. 198 pp. Falmouth: The Board of Trade & Industry, 1896. P. 144.


NEJM 276 (6): 322-324. 9 Feb 1967. Dr. Samuel Lord and the Smallpox epidemic of 1765-66 at Chatham, Massachusetts

SPECIAL ARTICLE

DR. SAMUEL LORD AND THE SMALLPOX EPIDEMIC OF 1765-66 AT CHATHAM, MASSACHUSETTS

Fred B. Rogers, M.D.
Philadelphia

322

    A SOLITARY gravestone by the roadside in a pine forest near Chatham Airport today recalls a heroic physician, Dr. Samuel Lord, and his role in an epidemic of smallpox that devastated the town of Chatham on Cape Cod two centuries ago. Located beside Training Field Road near its intersection with Old Comers Road, the inscription on this gravestone states (Fig. 1):

Lord gravestone
Figure I. Gravestone of Dr. Samuel Lord (1707-66)

    Here lies buried Dr. Samuel Lord who died of smallpox after devoted service to the citizens of Chatham in the epidemic of 1765-66.
    This monument was erected by the Town of Chatham in 1941 to perpetuate his memory.

    A historical marker, installed across the road by the Chatham Historical Society, directs the visitor to this remote grave. Though obscured by the passage of two hundred years, it is appropriate now to re member Dr. Lord and his efforts in a tragic episode of pestilential disease.

    Severe attacks of smallpox were noted from the earliest English settlements on Cape Cod. The native

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inhabitants were particularly decimated by this and other infectious diseases. The peaceful Indians around Chatham, the Monamoyicks, from whom land was first purchased in 1656, had almost disappeared by 1712, the year in which the town was incorporated.1 Local ravages of smallpox among the white settlers, in 1765-66, added significantly to the earlier toll of sickness and death. In the present relative freedom from this scourge owing to Jennerian vaccination, it is difficult to comprehend fully the extent of suffering from such a malady in the past.

    The first census of Massachusetts, taken by order of Royal Governor Francis Bernard in 1765, enumerated a population of 678 for the farming and fishing community of Chatham in Barnstable County.2 This population comprised 127 families in ##5 houses scattered over an area of approximately ## square miles. In his History of Chatham, Smith,3 ascribing the smallpox outbreak that followed the census, wrote as follows:

The population and resources of the town were . . . depleted by an unexampled epidemic of smallpox. Isolated cases of the disease had previously appeared in the town from time to time among soldiers returning from frontier armies or sailors from the West Indies. Unusual precautions were always taken to prevent the spread of the dreaded disease, and in nearly every case it had been confined to the person or family first attacked. In the autumn of 1765, however, it appeared in the town in its most virulent form and in a short time became epidemic ... It raged throughout December 1765 and January 1766. In all 61 persons were attacked, of whom only 24 recovered.

    Dr. Samuel Lord, the town's physician, served unstintingly in caring for the sick before falling victim himself and dying on January 12, 1766.

    Dr. Lord began medical practice at Chatham in about the year 1735. The sixth of 8 children of the Rev. Joseph Lord (1672-1748) and his wife, Abigail, a daughter of Massachusetts Governor Thomas Hinckley, he had been born at Charleston, South Carolina, where his parents were then living, on June 26, 1707. His father, a graduate of Harvard College in 1691, was the pastor of the First Congregational Church of Chatham from its incorporation in 1720 until his death. The pastor also practiced medicine and imparted this knowledge to his sons, Joseph and Samuel. Dr. Joseph Lord (1704-1788), who graduated from Harvard College in 1726, settled at Athol, Massachusetts, where he was physician, preacher and judge. Samuel came to Chatham from Barnstable with his father's family. He received by bequest, upon his father's death, the former's "English books that relate to Physick and Chirurgery," appraised at a value of 8, s.15. Dr. Samuel Lord, who did not marry, lived on a farm near Burying Hill and the triangle of land between Queen Anne's, Old Comers and Training Field Roads where the colonial militia drilled. His remains were buried on this farm.4

    The smallpox epidemic of 1765-66, according to contemporary reports, began in the family of Deacon Paul Crowell, a prominent citizen. One account stated that it emanated from a bale of cotton imported from the South and sold at a store near the residence of Reuben Rider, who contracted the disease. Another alleged that it was brought in with a package of clothing from the West Indies garments washed in the house of Deacon Crowell. Selectman James Covel,5 of Chatham, compiled a chronologic list of persons who died during the epidemic; this, he noted, was "drawn from my own journal and compared with several others by me." Of 37 deaths recorded, 17 occurred in 1 family! Commenting on the devastation, Chatham historian Smith6 wrote:

Medical science was then in its infancy and the nature of the disease, which appeared at first seemingly without cause, was not suspected until many had been exposed to infection. The local physician, Dr. Samuel Lord, early succumbed to the disease. Mr. Thomas Freeman, who lived at Harwich at the head of Pleasant Bay not far from the Chatham line, and was considered skillful in medicine, also caught the disease and died on January 19. [Smith noted in 1917. "His gravestone may still be seen in the field at So. Orleans near where he lived."] . . . Every known method of combatting the disease was employed. Schools were closed, business abandoned, and the community was in a state of fear and consternation. Whole families were almost wiped out. Mr. John Rider and his wife, aged and well-to-do people, were taken away, their maiden daughter Bethiah, their son Zenas and his wife, their son Stephen, his wife and nine of his ten children and the wife of their son Reuben. Deacon Stephen Smith, his wife and two of his daughters died and other families lost two or three members each . . . To avoid the danger of spreading the disease, the usual funeral services were omitted, and the bodies of the deceased were taken out by the members of the family and buried in the rear of their

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respective farms, where many of them lay buried today, their resting places being marked in some cases by substantial slate gravestones. . . . Some of these stones may still be found in the fields north west of the former residence of the late Samuel Clifford. Others have been removed to cemeteries in the town.

    The plight of the Chatham people elicited sympathy from the neighboring towns of Harwich, Eastham and Yarmouth. Money was raised in several Cape Cod churches for assistance to the bereaved. Mr. John Hawes, of Chatham, was chosen to receive this money, and a committee, consisting of Messrs. John Young and Barnabas Eldredge and 3 selectmen, was designated to distribute these funds. Mr. Eldredge (and later Captain Joseph Doane) was appointed town agent to the General Court of the Colony to solicit additional recompense for the widowed, orphaned and infirm. A petition on behalf of the town, accompanied by written evidence from its selectmen, in 1768, was recognized by Court Statute two years later. This device remitted the sum of 98, s.7, d.9, from Province Tax monies for the year 1769, "for the Relief of Poor Persons and others, who were visited with the Small Pox in said town from the first of November 1765 to the first of August 1766."7 Some of these charges doubtless included the expense of demolishing houses to erase contagion. The executor of the estate of Hezekiah Eldredge, for example, charged off the following items: 'House and Barn taken down of Necessity by reason of the Small Pox and appraised at 17."

    Thomas Hamilton, Jr., who had been born at Chatham in 1739, was so moved by the disaster that he wrote a letter of condolence to the survivors. Entitled, "Some Account of the Small Pox in the Town of Chatham in the year 1766," this melancholy epistle was printed in pamphlet form at the request of the townfolk the first printed record by a native of the village.8

    The smallpox epidemic was a lingering grief in the town annals. Speaking at the Chatham Bicentennial Celebration in 1912, the Honorable James W. Hawes cited it first under the heading, "Calamities", and described the epidemic in the following terms9:

The town has not been free from tragic events. In the fall of 1765 an epidemic of smallpox broke out in this town, and between November 23, 1765 and May l, 1766 thirty-seven persons died, and twenty-four had the disease and recovered, so that over sixty per cent of those attacked died. The cases numbered nine per cent of the population. Among the deaths was that of Dr. Samuel Lord, . . . the first physician in the town. He fell a martyr to his professional duty, as so many physicians had before and have since. This disease, which modern science has robbed of its terrors, was rendered so fatal by lack of medical assistance and ignorance of its proper treatment then. . . . In addition to this visitation, many of the inhabitants during the same period were visited with a grievous fever, whereof divers adult persons died and several families lay sick a long time.

    More recently, Scott Corbett, in his informal history, Cape Cod's Way (1955),10 also mentioned this period of pestilence among the events which have affected the people of Chatham on the elbow of Cape Cod during their long and colorful history.

    I am indebted to Mrs. Eleanor M. Page, librarian, Eldredge Public Library of Chatham, Mrs. H. V. Caldwell, Chatham Historical Society, Incorporated, and Dr. Frederick P. Rogers, of South Orleans, Massachusetts for assistance.

References

1.    Freeman, F. The History of Cape Cod: Annuls of the thirteen towns of Barnstable County. 2 vol. Boston: W. H. Piper & Co.. 1869. Vol. 1, Pp. 122, 298 and 396. Vol 2. P. 360.

2.    Swift, C. F. Cape Cod, the Right Ann of Massachusetts: An historical narrative. 391 pp. Yarmouth: Register Publishing Co., 1897. P. 362.

3.    Smith, W. C. A History of Chatham, Massachusetts, with genealogical notes. Part IV. 85 pp. Harwich: Chatham Press. Inc., 1947. Pp. 325-330.

4.    Munsell, G. N. Medical profession. In History of Barnstable County Massachusetts. Edited by S. L. Deyo. 1010 pp. New York: H. W Blake & Co., 1890. Pp. 236, 601 and 627.

5.    Massachusetts Archives. 242 vols. Boston: Secretary of State. Archives Division, arranged by Joseph B. Felt, 1836-46. Vol. 87. Fols. 370 and 371.

6.    Smith, W. C. A History of Chatham, Massachusetts, formerly the Constablewick or Village of Monomoit, with maps and illustrations and numerous genealogical notes. Part III. 103 pp. Hyannis: F. B. & F. P. Goss, 1917. Pp. 282, 290-293.

7.    Acts and Resolves, Public and Private, of the Province of the Massachusetts Bay. 21 vols. Vol. 18, P. 453. Boston: Wright & Potter Co. (State Printers). 1869-1922.

8.    Smith, W. C.3 Pp. 329 and 330.

9. Hawes. J. W. In The Two Hundredth Anniversary of the Incorporation of the Town of Chatham, Massachusetts: A memorial or report of the celebration of August 1st and 2nd, 1912. and of the Sunday Services, August 4th, 1912. 120 pp. Chatham: Published by authority of Town Celebration Committee, 1913. Pp. 46 and 47.

10.    Corbett, S. Cape Cod's Way: An informal history. 340 pp. New York: Thomas Y. Crowell Co., 1955. P. 187.


NEJM 278 (1): 21-23. 4 Jan 1968. "Pox Acres" on old Cape Cod.

"POX ACRES" ON OLD CAPE COD

Fred B. Rogers, M. D.

21

    New England has an advantage over some other American folklore regions in that its lore is part of a defined and documented tradition. All tradition, including folklore, is a matter of living memory in addition to written record. On Cape Cod, a site of early colonization in Massachusetts, memorials of folklore were fostered by regional provincialism. A blend of history and legend, these Yankee memorials have been collected by writers such as Elizabeth Reynard1 and Jeremiah Digges.2 The latter compiler, in his book, Cape Cod Pilot, published in 1937, cited the fear with which smallpox was once held in that region. And rightly so, for the disease had decimated the native Indians and the early European settlers during the seventeenth and eighteenth centuries. (This medical historical reference to the past toll of pestilence suggests the technic

22

of retrospective epidemiology exemplified by the studies of Dr. Ernest Caulfield, of Connecticut, using mortality data recorded on old New England gravestones.3)

    In Digges's chapter about the Town of Wellfleet, one reads4:

    In the surrounding woods, too, there are several small old cemeteries, some of them "pox acres." These were where the Old Colony buried its victims of the dread smallpox far from the settlement and where Cape Cod folks continued to bring the bodies of such unfortunates until late in the Nineteenth Century.

    Hidden away in many wooded parts of Cape Cod, the "pox acres" are avoided to this day by many an old-timer who remembers what they are for. I have succeeded in getting them to tell me where the lots are located, but not in getting them to go with me. "'I know there ain't been no burying there for forty year," one of these old men explained to me, "but I jest don't never go there anyway. It's a notion I have." And if you care to read of the ravages of the pox in centuries past, you will understand why the Cape still has "a notion."

    Several of these isolated burial plots are presumably within the confines of the present Cape Cod National Seashore on the lower Cape. Since local public-health matters do not usually receive much attention in general history, these and other remote gravesites are now mostly lost to legend. Epidemics have always intrigued man; they have brought out much of the good in human nature and less of the really bad. Recorded facts concerning the destructiveness and grief caused by smallpox in past centuries attest to the veracity of Digges's allusion to an aura of mystery about this scourge in folklore.

    For several decades before the coming of the Pilgrims in 1620, the Algonkian Indians of coastal New England had increasing contact with foreign fishermen, traders and would-be settlers. Communicable diseases thereby introduced spread rapidly and repeatedly through a highly susceptible native population. The most devastating epidemic (probably smallpox) raged from 1617 to 1619, and killed almost nine tenths of the Indians along the Massachusetts coast. Contemporary accounts chronicled the desolation in their camps: William Bradford and Roger Williams wrote that smallpox was the Indians' worst enemy.5

    By 1636, the year in which Harvard College was founded, there were roughly 5000 colonists living in Massachusetts Bay Colony a rugged lot by virtue of contact with infectious diseases in Europe and survival of hazards of Atlantic crossings in tiny, crowded ships. In contrast to this growing number of sturdy immigrants, the Indian population was dwindling owing to disease and rum. The native way of life, moreover, was destroyed as the new-settlers took more and more land and cut down the primeval forests. In 1685 there were 994 "Praying Indians" in Barnstable County, not counting children; thirteen years later there were 515. The Indian meeting house and burying ground at Potenumacut (South Orleans), for example, has vanished without visible trace. The old Indian Church Mashpee, built in 1684 and recently restored, alone remains as a reminder of these Christian converts. Smallpox was so common in the eighteenth century that only the more severe epidemics were recorded; seven major outbreaks occurred in Boston between the years 1721 and 1792. In his History of Cape Cod, (1858-62), the Rev. Frederick Freeman, writing about the Town of Eastham in 1763, noted:

    Exposure to the ravages of small-pox, at this time, induced an application of the town to the Court of Quarter Sessions, to authorize a fine of any persons who, having been exposed to infection, and having knowledge of the fact, should neglect to give timely notice to the selectmen. The population of the town was now 1331. The decay of the Indians a subject of melancholy interest was now almost consummated; the census returns for 1765 show that there were but four remaining in Eastham. The Nausets, once numerous and powerful, were soon to be like the mammouth, only known to have existed.6

    Serious episodes of smallpox, before 1800, occurred at Chatham in 1765-66,7 Sandwich and Yarmouth in 1778 (at the latter place the Indians were the principal sufferers),8 Wellfleet in 17939 and Falmouth and Yarmouth in 1797.10

    The procedure of variolation was promoted, after considerable controversy, by the Massachusetts General Court as well as by private physicians between 176## and 1800. Several doctors on Cape Cod are known to have practiced variolation at local inoculation hospitals during this period. Such hospitals were established at Great Hill, near Falmouth (Falmouth Heights) in 1777,11 and twenty years later at Nobska (Woods Hole, and at Great Island (Point Gammon), near Yarmouth.12

    Intentional infection with variola virus variolation was not, by modern standards, an effective method of prevention. It was better, however, in the epidemic setting of the eighteenth century, than no protection at all. The consternation evoked among townfolk by a case of smallpox was told by Scott Corbett13 in his informal history, Cape Cod's Way:

    One of the less welcome trophies that seamen sometimes brought home was smallpox, as did two Harwich men in 1747. Fear of the disease was so great that, when at a later date a case appeared in the family of John Wing in the North Precinct, "all passing was forbidden in the neighborhood, and the 'King's Road' barred," Anybody who wanted to pass through the town had to go by way of the shore or by Poverty Lane (now Tubman Road in Brewster),

    Even half a century later, when inoculation was common, fear of the disease was still so great that, after a case had appeared and the victim had recovered, someone set fire to the building which had been used as the "pest house" and burned it to the ground.

    Simeon L. Deyo, editor of a voluminous History of Barnstable County (1890), narrated an anecdote about a similar fright14:

In 1778 the smallpox appeared among the inhabitants of Sandwich, causing more alarm than would a British fleet if anchored within gunshot of the town. The action taken to suppress this contagion was prompt and effective A pest-house was erected, the roads were fenced, nurses were provided, red flags prevented intrusion to its vicinity,

23

and even stray dogs and cats were sacrificed to prevent a spread of the contagious disease.

    The improved procedure of Jennerian vaccination, first introduced to this country by Benjamin Waterhouse, of Cambridge, in 1800, led to a gradual decline of smallpox in the Commonwealth. Late in 1800 Dr. Waterhouse presented an account of his work, A prospect of exterminating the small-pox, and by 1808, physicians in Massachusetts had accumulated sufficient evidence favoring vaccination to accept unanimously a verdict by the Massachusetts Medical Society recommending that doctors who performed vaccinations should also carry out subsequent tests of immunity through direct smallpox inoculation, "for which service the fellows of this society will not charge any additional fee." The public was thereby given additional faith in this form of prophylaxis.

    Despite lingering opposition to vaccination by a few-people, this effective preventive greatly reduced sickness, disfigurement and death from smallpox during the nineteenth century. By this means a dreadful affliction, now practically unknown in the United States, faded in memory to become a terror only in anecdote and legend,

    In A Treasury of New England Folklore (1947), a book that contains among much else a witty account of "getting vaccinated," the editor, B. A. Botkin,15 commented perceptively:

Since folklore is universal in diffusion and local in adaptation, there is no such thing as a purely regional folklore any more than there is a purely national folklore. The nearest approach to it is place lore. Here belong local place-name stories, local foods, local anecdotes, and local characters guaranteed to awaken nostalgia in all New Englanders as well as any one who has ever lived or vacationed in the region. Here, too, belong the characteristic tales and traditions (many of them local in origin but national in scope) of the kind and the people, and their struggle tor freedom and survival.

    I am indebted to Mrs. Mary S. Freeman, of Wellfleet, and her daughter, Mrs. Helen F. Olsen, R.N.. of East Weymouth, Mrs. George I. Flint, librarian, Eastham Public Library, Miss Lydia D. Newcomb, curator of the Wellfleet Historical Society, Incorporated, Mrs. Esther G. Rockwell, of Orleans, Donald P. Consodine, bookseller at Brewster, and Dr. Henry R. Viets, consultant for the Historical Collection, Francis A. Countway Library of Medicine, and, formerly, curator of the Boston Medical Library, for assistance.

References

1.   Reynard, E. The Narrow Land, Folk Chronicles of Old Cape Cod. 326 pp. Boston: Houghton Mifflin, 1934.

2.   Digges. J. Cape Cod Pilot. 403 pp. Provincetown and New York: Modern Pilgrim Press and Viking Press, 1937.

3.   Stevenson. F. G. The Historical Writings of Ernest Caulfield. J. Hist. Med. 20:38-42. 1965.

4.   Digges.2 P. 203.

5.   Wood. P. H. Sickness and settlement: disease as factor in early colonization of New England. The Pharos of Alpha Omega Alpha 27:98-101. 1964.

6.   Freeman. F. The History of Cape Cod: The annals of the thirteen towns of Barnstable County. 2 vol. Boston: Geo. C . Rand &. Avery, 1862. Vol. 2. P. 396.

7.   Rogers. F. B. Dr. Samuel Lord and the Smallpox Epidemic of 1765-66 at Chatham, Massachusetts. New Eng, .J. Med. 276:322-324. 1967.

8.   Swift. C. F. Cape Cod, the Right Arm of Massachusetts: An historical narrative. 391 pp. Yarmouth: Register Publishing Co., 1897. Pp. 212 and 334.

9.   Freeman. F.6 P. 677.

10.   Deyo, S. L. History of Barnstable County, Massachusetts. 1010 pp. New York: H. W. Blake & Co.. 1890. Pp. 17-18 and 274.

11.   Rogers. F. B. Pioneer Inoculators on Cape, Cod: Drs. Francis Wicks (1755-1836) and Hugh George Donaldson (1757-1812) of Falmouth, Massachusetts. New Eng. J. Med. 270:664-666. 1964.

12.   Deyo.10 P. 467.

13.   Corbett, S. Cape Cod's Way: An informal history. 310 pp. New York: Thomas Y. Crowell Co. 1955. Pp. 154 and 155.

14.   Deyo.10 P. 274.

15.   Botkin. B. A. A Treasury of New England Folklore: Stories, ballads and traditions of the yankee people. 934 pp. New York: Crown Publishers, 1947. Pp. xxiv. 92 and 93.