Katy Sternberger, Archivist

After more than two years of living with the COVID-19 pandemic, we now have a unique sense of what it was like to witness pandemics past—quarantining, vaccine hesitancy, and reports of case numbers in the news are not novel. We just need to take a look in the archives. For example, the Portsmouth Athenaeum holds a 1782 ledger documenting the smallpox inoculation program that transpired on a small island off the coast of Portsmouth, New Hampshire.

Coinciding with much of the American Revolution, a smallpox epidemic broke out from 1775 to 1782. The virus came with a mortality rate upward of thirty percent and easily spread during the chaotic conditions of war. There were even attempts by the British to intentionally infect the Patriots. According to a letter received from Mount Independence, Vermont, and published in the New-Hampshire Gazette on June 14, 1777, Tories were “endeavouring to spread the Small-Pox in the Camp; but as there is the greatest care taken to prevent it, believe they will not succeed in their h[elli]sh designs.”

As a seafaring city, with ships arriving from around the world, Portsmouth in particular was determined to prevent the spread of smallpox. During the late eighteenth century, fumigation in a smokehouse was considered effective at inhibiting the transmission of smallpox. A July 24, 1776, notice appearing in the Gazette states, “The [Portsmouth] Select-men hereby notify the public that a Smoak-house is erected at the Great Swamp, where it is expected all persons coming from places infected with the Small Pox will stop to be properly smoaked and cleaned from infection, and that no traveller coming from any infected place will presume to enter this town by any other way.” Today, we know the Great Swamp as the Great Bog, comprising about 700 acres of wetlands off of Route 33.

While we now recognize that fumigating oneself is not effective at preventing disease, there was increasing awareness of the benefits of inoculation. Through inoculation, more precisely called variolation, a small sample of the live virus is inserted into a scratch in the skin to produce, generally, a milder form of illness and thus provide immunity. The practice of inoculation against smallpox occurred in Asia and Africa well before Europe; it was first used in North America in 1721, although Cotton Mather had learned of the technique from Onesimus, an enslaved man from Africa, in 1706. It was not until 1796 that Edward Jenner devised the smallpox vaccine, and local physician Lyman Spalding introduced it to Portsmouth in 1800.

As with vaccine hesitancy today, inoculation throughout the eighteenth century did not come without controversy. Indeed, there was a real threat of patients transmitting the disease after inoculation and causing severe infection in those who had no immunity yet. A February 25, 1777, notice in the Gazette announces a 1776 act by the State of New Hampshire to “prevent the spreading of the Small-Pox in this State.” The act forbade people from inoculating themselves or others without a license from the General Assembly, Committee of Safety, or town selectmen. The fine was thirty pounds.

Patients could transmit smallpox after inoculation, so the State of New Hampshire tried to prevent the spread by passing an act in 1776 that forbade people from inoculating themselves or others without a license. An article in the New-Hampshire Gazette informed the public that the fine was thirty pounds. Courtesy of Newspaperarchive.com.

Waves of the virus came and went during the epidemic. On July 7, 1778, the town of Portsmouth reported in the Gazette, “We have the Satisfaction to inform the Publick, that the Small-Pox in this Place is wholly at an end, not a Person having the Disorder either in Town or Hospitals, in the natural Way or by Inoculation.” The article reports that 1,100 people in Portsmouth received inoculations within three months, with only two “unfavourable” cases.

During a smallpox outbreak in Portsmouth in 1778, the New-Hampshire Gazette reported on July 7 that 1,100 people had been inoculated within three months. This served as a precursor to another inoculation program led by Joshua Brackett, Ammi Ruhamah Cutter, Hall Jackson, and John Jackson in 1782. Courtesy of Newspaperarchive.com.

Amid another outbreak in Portsmouth in 1782, local physicians Joshua Brackett (1732–1802), Ammi Ruhamah Cutter (1735–1820), Hall Jackson (1739–1797), and John Jackson (1745–1808, no relation to Hall Jackson) built a hospital on Henzell’s Island, which we now call Shapleigh Island. Hall Jackson was already well known for his pioneering treatment of smallpox patients in Boston in 1764. Using their collective experience from previous outbreaks, the four doctors initiated an inoculation program on the island.

Joshua Brackett kept the hospital’s ledger, recording the names of 365 patients who received inoculation between March and May 1782. A rare relic that provides insight into late-eighteenth-century medical practices, the inoculation ledger includes important data such as the patient’s age and residence, date they entered the hospital for their inoculation, date they were discharged from the hospital, and remarks about their condition during their stay.

After establishing a smallpox hospital on Henzell’s Island with fellow physicians Ammi Ruhamah Cutter, Hall Jackson, and John Jackson, Dr. Joshua Brackett recorded the names of 365 patients who received inoculation between March and May 1782. Courtesy of the Portsmouth Athenaeum, Henzell’s Island Inoculation Ledger, S0047.

Many Portsmouth residents, especially women and children as well as several people of color, are documented in the ledger. People also came from the vicinity, including Dover, Exeter, Greenland, Newmarket, and Stratham in hopes of enduring a milder form of the agonizing disease. According to the Henzell’s Island records, patients quarantined on the island for a minimum of twenty-one days. Most patients were listed in “favorable” condition, but some “erupted” in sores, the doctor carefully noting the dates at which this occurred. In addition, the ledger contains patient accounts from March to October 1782.

Detail from a 1782 French map showing the smallpox hospital located on Henzell’s Island, highlighted in the blue box, off the coast of Portsmouth, New Hampshire. Today, we know it as Shapleigh Island. Patients quarantined at the hospital for a minimum of twenty-one days after inoculation. (The rest of the map depicts fortifications and the French fleet during the American Revolution.) Courtesy of the Library of Congress, Rochambeau Map Collection, hdl.loc.gov/loc.gmd/g3744p.ar087600.

Athenaeum Archivist Katy Sternberger recently finished adding the names of all 365 patients to the online catalog, increasing the accessibility of the inoculation ledger. To learn more about the people who received inoculation at Henzell’s Island and the process of cataloging the ledger, stay tuned for the second article in this series, “Researching the 1782 Henzell’s Island Inoculation Ledger.”


To view the Henzell’s Island Inoculation Ledger, 1782 (S0047), click on the button.