Public Health and the Emergence of New Clinical Settings for Smallpox Inoculation in Boston, 1753 to 1764

This article explores the relationship between Boston’s public health policy and law and changes in the practice of smallpox inoculation from 1753 up to the 1764 smallpox epidemic. In concentrating on the lack of change in public health policy and methodological development, historians have dismissed the importance of nearly a decade of these inter-epidemic interval years and the changes that did occur during the 1764 epidemic. This study attempts to examine how inoculation hospitals were adopted in Boston and how these new clinical settings influenced the change of inoculation practices. In delving into these questions, this article will have focused examination on the following three points: First, this study examines the transformation of inoculation sites from private spaces to public spaces. It argues that the public profile of inoculation was important in stimulating physicians’ and patients’ comparisons of different inoculation methods and treatment. Secondly, it shows that Boston’s public health decisions were not necessarily an accurate manifestation of individual decisions. Despite the town’s collective decision for rigid regulation of inoculation methods and rejection of the proactive use of inoculation technology, the majority of Bostonians welcomed smallpox inoculation. Thirdly, it hopes to connect local medical history to a larger political context; it argues that the French and Indian War and the emergence of revolutionary conflict between American colonies and Britain partly impacted the dynamic tension in Boston between public health concerns, private practice, inoculation technologies, and inoculation hospitals.