LivingSmallpox Heroes

Smallpox Heroes


On November 30, 1803 , the same day that the Spanish flag was lowered from the fortresses of Louisiana and this fertile territory returned to the hands of France, on the other side of the Atlantic, oblivious to the ups and downs of international politics, the embarked expeditionaries In the corvette María Pita they left La Coruña for America with an extremely valuable cargo for the health of the colonies: the smallpox vaccine .


At the end of the 18th century, epidemic diseases were spreading with terrifying virulence throughout all European countries. One of them, smallpox, killed 400,000 people every year in the Old Continent alone. However, with the turn of the century there were reasons for hope.


In 1796, the English surgeon Edward Jenner inoculated a healthy 8-year-old boy with fluid from a gallbladder that had a milkmaid on one finger. She had contracted a disease typical of cattle when she was milking a beef. The child developed a mild pathology after a few days and a vesicle formed at the inoculation sites, but they disappeared without complications. The little boy had thus been protected from the smallpox disease. Soon after, it was discovered that the vaccine could be transferred from one individual to another without losing its properties , providing medical science with its first effective weapon to combat this pandemic.


Until then, to try to avoid death from smallpox, the healthy person was inoculated with the pus of an infected person . If all went well, the disease was overcome more or less benignly and was immunized for life, but for all intents and purposes, it was a Russian roulette that often caused the death of the inoculate.


Jenner’s finding sparked lively scientific and ethical debate about the appropriateness of vaccination. Among its detractors was part of the English clergy, who did not hesitate to describe it as a “hellish invention”. On the contrary, Francisco Javier Balmis , honorary chamber surgeon of the Spanish monarch Carlos IV, was from the first moment in favor of the novel practice.


The king himself, perhaps sensitized because some of the infants had suffered from the disease, or perhaps because he wanted to remedy the disastrous outbreaks that, as had occurred in Lima in 1803, periodically plagued the colonies, supported the practice of vaccination. This is what follows from the Royal Order published in the Madrid Gazette that, with these words, legitimized an expedition to take the vaccine to America and the Philippines: “The king wishes to occur to the havoc caused in his dominions of the Indies by frequent epidemics of smallpox, and provide those their beloved vassals with the aid dictated by humanity and the good of the state, has served to resolve that it spreads to both Americas, and if possible to the Philippines (…), the precious discovery of the vaccine , credited as a natural smallpox preservative. “

In September 1803, Charles IV , even willing to pay for the Expedition, issued an edict addressed to the officials of the crown where he ordered them to support Balmis to vaccinate as many people as possible, teach how to prepare the smallpox vaccine and organize meetings municipal vaccination.


The company was not a big fan of this Alicante doctor, although it was the culminating point of his career. Balmis, who belonged to a line of surgeons, had participated in the siege of Gibraltar in 1780 as a military doctor and had worked for more than a decade in different hospitals in America, where his memory and the memory of his work remain more alive today than in Spain. He is responsible for the translation of the first book on vaccinations published in our country, the Historical and Practical Treatise on the Vaccine, by the professor at the Liceo Republicano Moreau de la Sarthe, as well as various studies on the treatment of syphilis from begonia and the agave brought from the New World.


Bringing the smallpox vaccine to the other side of the sea was challenging, however. Without adequate storage and refrigeration systems, there appeared to be no way to ensure the survival of virus infectivity. In mid-1803, the Board of Chamber Surgeons approved its Route to conduct the true vaccine as soon as possible and ensure its propagation in the four viceroyalties of America, the provinces of Yucatan and Caracas, and in the Antillean Islands. The ambitious plan envisaged the use of a human chain made up of healthy children who would be successively inoculated with the virus extracted from the pustules of those vaccinated the previous week. This is how it was intended to conserve the precious fluid, in the organism of those little ones.


To ensure the success of the project, Balmis was assigned a budget of 200 doubloons and the María Pita, a 200-ton corvette that was to take him from La Coruña to America. The ship was loaded with canvas for vaccinations, 2,000 pairs of glasses to maintain the fluid, a pneumatic machine, barometers, thermometers and half a thousand copies of the work of Moreau de la Sarthe, which would serve as a manual for the dissemination of the practice of vaccination in the places where the expedition passed. In addition, Balmis should record the results of his work in six blank books, which would serve as testimony of his work upon his return to Spain.

Thus equipped, the Philanthropic Expedition , as it would be remembered later, set out for its first stop, the Canary Islands. There, hundreds of people received the vaccine directly from two of the 22 children who were shipped.


On February 9, 1804, the María Pita sighted Puerto Rico . The Caribbean island, however, reserved a cold reception for the expedition members. The local authorities had already obtained the vaccine through the Danish colony of Santo Tomás and had spread it among the population, so Balmis, after organizing a central vaccination board, decided not to waste any more time and leave for Venezuela, one of the the most important stopovers of your trip.


There, the members of the expedition, hailed as heroes by the multitude, managed to bring the vaccine to thousands of people in -villages and cities; Later, they decided to form two groups to optimize the work: one of them, led by Balmis himself, would tour the rest of Venezuela and Cuba , and then leave for Mexico , a place where the man from Alicante had worked for several years and was highly esteemed. The other expedition members, under the command of deputy director José Salvany y Lleopart, would visit Colombia, Ecuador, Peru, Chile and Bolivia and would send the vaccine to Portobelo and Panama . In 1810, after surviving a shipwreck on the way to Cartagena de Indias and enduring six years of illness and hardships, Dr. Salvany died in the town of Cochabamba (Bolivia).


But more than the adverse weather and the wild routes, it was the reluctance of a good part of the population that put the expeditionary’s ability to test the most. Thus, in Lima they were met with rejection by local doctors , who had made a small fortune marketing the vaccine . In other places, people did not understand how they could get rid of smallpox by having it. Many indigenous people even believed that the Spanish would pass the disease on to them. It was useless to show that in populations that refused to be vaccinated, smallpox outbreaks flared more strongly and with more devastating effects. And it was feared that person-to-person vaccination would facilitate the transmission of syphilis and other diseases and, in fact, many times it was preferred that it be done directly from a calf. At this point, too, there were suspicions, since in some places it was believed that this supposed a disgusting promiscuity with the beasts. Precisely, to avoid mistrust, in Santa Fe, the viceroy and his family were the first to be inoculated.


Despite the difficulties, in Nueva Granada and Colombia 56,000 people were vaccinated. Almost 23,000 did so in Peru and more than 7,000 in the city of Cuenca (Ecuador).


Once the planned tour of America was completed, Balmis embarked in Acapulco for the Philippines . On April 15, 1805, after a difficult journey of 67 days – when it should not have lasted more than 50 days – a ship with a group of Mexican children arrived in Manila with the cure for smallpox in their bodies. The lack of support from the authorities did not prevent Balmis and his assistants from fulfilling their mission in the Asian archipelago. Months later, the Portuguese in Macao and the English in Canton collaborated with the determined Spanish surgeon, whose vaccination office in this town was flooded by numerous Chinese citizens, frightened by an outbreak that was beginning to spread through the region. Until then, British efforts to introduce the vaccine had been in vain. Back in Europe, Balmis found that English reluctance even reached his compatriot Jenner. In Santa Elena, where the expedition stopped in June 1806, they even despised the work of the discoverer of the vaccine. Even so, the Alicante man managed to introduce it to the island. On August 14, after completing the round-the-world tour , Balmis arrived in Lisbon and a month later gave an account of the trip to the king.


Two centuries after the expedition of the vaccine, the Spanish scientific community is preparing the bicentennial of that unprecedented feat. The celebrations will begin near where Balmis started, in the Coruñeses Scientific Museums, where homage will be paid to the feat of the Spanish surgeon with a magnificent interdisciplinary exhibition. And it is that the trip of Balmis, which turned out to be the first example of vaccination on a global scale, was in the mouth of Jenner himself “the noblest example of philanthropy that exists in the annals of History.”









XII century a. of C .: in China it is discovered that by snorting the powder obtained from the dried pustules of a patient, a certain type of immunization can be achieved.


16th century : first documented case of smallpox in the West.


1721 : Mary Wortley Montagu, wife of the British ambassador to the Ottoman Empire (Turkey), introduces variolation in England, that is, immunizing an individual by transmitting the attenuated disease.


1796 : Edward Jenner first administers the smallpox vaccine.


1800 : Dr. Piguillem inoculated the vaccine for the first time in Spain, in the town of Puigcerdá.


1803 : Francisco Javier Balmis translates Moreau’s Historical and Practical Treatise on the Vaccine.


1803 : Balmis directs the Royal Vaccine Philanthropic Expedition, which will take it to the Spanish colonies of America and the Philippines.


1903 : By Royal Decree it is mandatory to be vaccinated in Spain.


1959 : The World Health Assembly decides to organize mass vaccination campaigns against smallpox.


1977 : The last natural case is registered in Somalia.


1978 : In the United Kingdom there is a fatal case contracted in a laboratory.


1979-1980 : A commission of eminent scientists certifies the global eradication of smallpox. The World Health Assembly endorsed it in May 1980.


1999 : The WHO decides to destroy in 2002 the last strains of the smallpox virus, kept in laboratories in Russia and the United States.


2002 : The crisis unleashed after the attacks of September 11, 2001 forces the WHO to postpone the destruction of the strains in order to be able to investigate vaccines that protect the population in the event of a biological attack.


Abraham Alonso.

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