The following are two excerpts from Ben Mutschler’s recent publication, The Province of Affliction: Illness and the Making of Early New England.  The book explores the place of illness in everyday life—the ways in which it shaped families and households and became bound up in governance at all levels. The passages below draw from the introduction to a chapter on smallpox and the politics of contagion, followed by a small portion of a case study based on the diary of Ashley Bowen.  The sailor, ship rigger, painter, poet, husband, and father chronicled the ravages of smallpox as it burned through his town of Marblehead, Massachusetts in 1773—an event at once terrifying and all-too-common in early New England.

Perhaps no other affliction in eighteenth-century New England received the attention given to smallpox. Even the most laconic of diarists noted its presence and charted its approach; others devoted entire journals to its rages. Letters written from infected areas to relatives, friends, and business partners survive despite authors’ pleas to burn such material lest the virulent distemper spread further. Newspapers reported on outbreaks throughout the Atlantic world. Chronologies of significant events compiled at the end of almanacs memorialized serious epidemics. Legislative records reveal extensive efforts to stop the communication of the disease, including last-ditch attempts to protect the members of the Massachusetts General Court, who on more than one occasion fled Boston for Charlestown, Cambridge, and Concord, and demanded that guards be posted at the doors of its sessions to keep out the infected.

Smallpox attracted such intense notice because of the threat of contagion. It was considered supreme among a host of “malignant infectious distempers” coursing through New England, diseases that were spread from infected persons (and objects with which they had been in contact) to other persons. “Throat distemper” in the 1730s and 1740s, yellow fever in the 1790s, measles outbreaks throughout the period, and sundry “camp fevers” associated with soldiers returning from colonial wars—debate raged during epidemics about whether they were infectious diseases. There was no such debate on smallpox. Shortly after exposure to infected persons or goods—New Englanders thought anywhere from a few days to a few weeks; present-day epidemiologists would say from ten to eleven days—those who had not already weathered the disease could expect a progression of symptoms: fever, backache, headache, nausea, and listlessness (days 12–14); small pimples that turned to pustules (days 15–24), which might remain distinct or run together (in a “confluent” and much more deadly form); scabbing (days 25–30); and finally scarring revealed as the scabs dropped off, leaving “pock” marks as evidence of surviving the disease. . . .

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Shortly after it became clear that his wife had been infected with smallpox, Ashley Bowen (1728–1813) sat down and wrote a “memorandum,” a short narrative that would assemble and inscribe in memory the events that had brought the scourge to his house. Bowen had long kept a meticulous diary of his work life. But smallpox required special attention, a separate journal to chronicle its ravages (and to keep track of other major afflictions, including disasters at sea). Several weeks earlier, on the first of June, a schooner had returned from Newfoundland’s fishery to Bowen’s hometown of Marblehead, Massachusetts. One of the major fishing communities in eighteenth-century New England with about five thousand residents in 1765, it was the sixth largest town in British North America. While on the schooner’s voyage, a crew member, William Mathews, had boarded a French ship, something that Bowen noted was “common for our fishermen to do,” and purchased a piece of Castile soap. When Mathews returned home, he gave the soap to his wife, Sarah, who used it to clean his soiled sea clothes. Two weeks later, Sarah Mathews “broke out and swelled to a great degree.” At this point a doctor was sent for, and everyone assumed Mathews had been poisoned.

As Sarah Mathews became violently ill during the following week, neighbors and relatives came to visit and help. Her sister Mary (“Mol”) Ingalls assumed a large portion of the care, washing her sister with “salt water and the liquor of elder” and perhaps also aiding the doctor who attended. Despite their efforts, Sarah Mathews continued to deteriorate and, worse still, others who had been with Mathews began to feel unwell. Mathews’s daughter, who had nursed her mother, fell ill, and she, too, was bathed by Ingalls while more “neighbors all round took their turns to watchings as in any other sickness.” Of perhaps greater concern for Mol Ingalls, however, was that her mother, the widow Sarah Shaw, had become dangerously sick. Some openly speculated that it was not poisoning but smallpox that afflicted the women. Ingalls steadfastly maintained that her seventy-nine-year-old mother was laboring under the infirmities of old age and “spaired no pains for to get assistance” to her. As Ashley Bowen later noted dryly, “tis supposed that nearly an hundred or more of Mother Shaw’s relations and friends frequented the house all the time from her first complaint.”

Bowen had been made privy to the alarming details of the outbreak by his second wife, Mary (Shaw) Bowen, who through her previous marriage to the late James Shaw was a sister-in-law to Sarah Mathews and Mol Ingalls and daughter-in-law to the elderly Sarah Shaw. Although Mary Bowen was not as deeply involved as Mol Ingalls in the care for Mathews and Shaw, she visited both women during their sickness and was especially worried about her mother-in-law. Ashley Bowen, as one of the principal riggers in Marblehead, was particularly harried in the summer months, and as he confessed in his memorandum, when his wife had initially informed him that “her mother was a-dying with old age,” he gave it “no great attention.” However, Bowen did become deeply concerned when he returned from his loft later that night and found his wife in bed with a fever. Mary Bowen’s sisters were summoned. They soon arrived, bound Mary’s head, and prepared a balm tea for her, leaving Ashley Bowen to sit up the fore part of the night with his wife to monitor her condition. The following day only one sister, whom Bowen noted “had had the smallpox,” came to attend; presumably others not immune to the disease feared that they might be infected if Mary’s “poisoning” was in fact the pox. By that night, Bowen could find no one to help. “I sent for a watcher, but the next news it was said to be the smallpox and that five or six was complaining of it at Mother Shaw’s, so could get nobody to watch.” Under the pressure and special conditions of the smallpox outbreak, the social network of healers who had formed so readily even a week earlier was now coming apart. And here, with smallpox poised to consume the affairs of the household, neighborhood, and town, Ashley Bowen ended his memorandum.

Ben Mutschler is associate professor of history at Oregon State University. 

The Province of Affliction: Illness and the Making of Early New England is available now on our website or from your favorite bookseller.