Paul:
Thank you for your reply to my post. Dont worry, I havent forgotten variolation preceded vaccination
as a procedure to try to prevent smallpox. I have also found that it may have originated in China, and
spread to the west. Other authors say that it may have developed independently in India. Definitely,
China, India, Persia and parts of Africa were the places where variolation began during the first
centuries of this millennium.
I found interesting your comment:..dried crusts of smallpox lesions being used, perhaps as an early
attempt at attenuation or inactivation of the virus. I havent thought of it that way. I imagined they
used the crusts because they could be stored without causing mayor visible changes on them and
would be always available when needed, as opposed to the liquid from the pustule that would be
harder then to preserve as such. It would be very interesting to know if anybody then ever thought of
the smallpox crusts as a debilitated form of what ever caused the disease. I wish that person had
written that idea down as a permanent record somewhere!
Variolation was done via different routes of administration of the smallpox matter: In China, the dried
crusts were inhaled. The Persians were reported to have swallowed the powder of dried pocks. In
India, the powder of dried pocks was given by a cutaneous route. In Greece, Turkey, Arabia, and
North Africa variolation was done by removing the thick liquid from a smallpox pustule and rubbing it
into a small scratch on the arm made with a needle. There are no records to compare which route of
administration would have been the best of the three.
Vaccination replaced variolation as a procedure to protect against smallpox because it was safer for
the recipient.
Reference:
1. Behbehani, A.M. (1988) "The Smallpox Story. In Words and Pictures" The University of Kansas
Medical Center, USA.
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Ana Maria Soler-Rodriguez
arodri03 at interserv.com
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