Angel of Death: The Story of Smallpox

by Gareth Williams

The story of the rise and fall of smallpox, one of the most savage killers in the history of mankind, and the only disease ever to be successfully exterminated (30 years ago next year) by a public health campaign.

Genres: Nonfiction, History, Science, Medicine, Health, Medical, History Of Medicine

455 pages, Hardcover

First published May 17, 2010

Reviews

[Ange · Rating 4 out of 5]

Angel of Death covers a lot of territory - history, science, and the early days of medicine and surgery. It's a fascinating tale with a long list of characters, some well known ones such as Edward Jenner and John Hunter, and many less well known ( at least to me) such as Lady Mary Wortley Montagu. I have read quite a lot of non- fiction books on the history of science ( such as those by well known authors like Lisa Jardine, Jared Diamond and co.) and I think this medical history of smallpox, variolation and vaccination stands up really well against those luminaries. Williams covers a lot of the history of smallpox, and the many traditions surrounding traditional methods of variolation and then its gradual replacement with vaccination. The book covers a lot of the science of variolation and vaccination but I think it has a high level of accessibility for general readers. My own background is in science, including biochemistry, public health and a bit of infectious disease, so most of the concepts were familiar - but I think that any reader with an appreciation of detail and a love of history and science would find this an absorbing read. There are quite a number of illustrative plates, some are very confronting, but they indicate the horror of the disease that killed so many people over such a long period. Importantly, the book also illustrates the incremental nature of scientific progress. Though vaccination showed great effectiveness at stalling smallpox outbreaks during the early days, there were numerous associated problems, some of which were studiously ignored by Jenner and others at the time. The latter part of the book deals with the campaign of the WHO to wipe out smallpox - I am sure there is the basis for a thrilling movie here - it was an enthralling end to the disease that had such terrible impact over the centuries.

[Eri]

A long read, but done by a great story-teller. It reminds me of how lucky I am to live at a time that good plumbing and sewage has already been designed. Although the medical knowledge is imperfect, I'm amazed at how much has been discovered within the past century, and how the future will handle the corona virus.

[Olly Colluphid · Rating 4 out of 5]

Surprisingly readable and engaging book on a horrid subject.

There is some repetition but I think that adds to clarity of the chapters. The authors interest shines through.

[Peter Stuart · Rating 4 out of 5]

Innovation. Conflicting ego's more focused on being seen as correct than being right in approach.

The ability, or even willingness, to consider, test and honestly report as opposed to staying close minded and non-considerate of potential alternatives or improvements.

The ability to learn from the experience of others who are using the experiences and techniques of those who have come before vs seeing them as "backward" or "uneducated" due, in effect, to xenophobia or an attitude of superiority.

Mistakes covered up. Successes also covered up. Opportunities lost, wasted or ignored.

This excellent work will take you through all of these aspects and more as you journey along a very well structured and written work across the journey of humankind confronting on of its most confronting, dangerous and devastating diseases that for hundreds of years blighted and killed millions of people.

[Darryl · Rating 4 out of 5]

Smallpox was successfully eliminated from the human population in 1979, due to — and in spite of — the efforts of physicians, scientists, public officials and private citizens over the past four centuries to rid mankind of one of its greatest killers. The variola virus now exists only in two research centers in the United States and Russia, and it is guarded with the utmost security, as smallpox remains an untreatable and often fatal infection, ready to unleash a reign of terror if it were ever to fall into the wrong hands.

Gareth Williams, a professor of medicine at the University of Bristol, expertly and interestingly describes the history of smallpox from antiquity, when its telltale scars were found on Egyptian mummies, to the present day, where its legacy is most notable for the current anti-vaccination movement, particularly in the UK and United States.

The story of smallpox is intimately linked with the story of Western civilization and medicine. Its introduction to immunologically naïve native civilizations throughout the Americas decimated their populations and destroyed their cultures, permitting their easy conquest by colonialists. The “discovery” of vaccination by Edward Jenner — which is widely attributed to him but was practiced throughout the world for many years — saved millions of lives since its introduction, and led to the development of vaccines against other deadly pathogens. The study of smallpox was instrumental to the future understanding of microbes as the causative factor of many diseases such as tuberculosis, and the manner in which viruses infect human cells and convert them into virus making factories.

Despite his faults, Jenner, a marginally competent clinician and scientist, can rightfully be credited with introducing vaccination to Western medicine. He had many detractors, and fought throughout his life against those who insisted that vaccination was unnatural, ungodly and dangerous. His unyielding insistence that variola vaccination was safe and provided lifetime protection blinded him and his supporters from the cases of smallpox that occurred in previously vaccinated individuals. That, combined with resistance to compulsory vaccination and the draconian measures used to enforce vaccination laws, led to the birth of the anti-vaccination movement, which attracted those with concerns about the safety and efficacy of the smallpox vaccine, along with opportunistic practitioners who sought to make money on unproven methods of prevention and treatment of smallpox, religious conservatives and natural healers who believed that vaccination was immoral and in opposition to God’s laws, and civil libertarians that opposed it as a violation of their freedom and right to choose.

The main effect of the bitter war between the vaccinationists and anti-vaccinationists was opposition to vaccination, which costs the lives of thousands of children in the 19th and 20th centuries, and the perpetuation of the technique of variolation, in which pus from smallpox lesions was introduced into the skin of uninfected individuals to produce a local infection that was often less severe than the usual disease. Unfortunately many individuals did contract full blown smallpox and died as a result, and those who were not variolated and not previously infected often acquired smallpox from those who underwent this treatment. The anti-vaccination movement grew steadily from the time of Jenner, and continues to exist in the present day West, as current believers continue to use arguments from the 19th century to bolster their case.

Angel of Death is an excellent addition to the history of medicine, which is well researched and written, one that would have broad appeal to clinicians, scientists, and anyone else interested in this deadly disease and the birth of the anti-vaccination movement.

[Ioannis Savvas · Rating 4 out of 5]

Ο Gareth Williams, καθηγητής στην Ιατρική Σχολή του Πανεπιστημίου του Bristol, σε αυτό το βιβλίο παρουσιάζει την ιστορία της ευλογιάς, από την αρχαιότητα μέχρι την οριστική (;) εξαφάνισή της από τον πλανήτη, σύμφωνα με τη διακήρυξη του ΠΟΥ το 1980. Σήμερα ο ιός φυλάσσεται σε εγκαταστάσεις υψίστης ασφαλείας -εφάμιλλες πυρηνικών εγκαταστάσεων- σε δύο σημεία: στις ΗΠΑ και στη Ρωσία. Η ευλογιά είναι η πρώτη ασθένεια στην ιστορία της ανθρωπότητας που εξαφανίστηκε με τις προσπάθειες του ανθρώπου (ίσως ένα από τα σπουδαιότερα επιτεύγματα της ανθρωπότητας). Η δεύτερη ασθένεια που εξαλείφθηκε από τον πλανήτη ήταν η πανώλη των βοοειδών, που αν και είχε μόνο οικονομικές επιπτώσεις για τον άνθρωπο, ωστόσο και αυτή ήταν τόσο ισχυρή που κατέστρεφε αυτοκρατορίες.

Η ευλογιά, ο άγγελος του θανάτου, ο μεγάλος δολοφόνος της ανθρωπότητας, κατέτρυχε το ανθρώπινο γένος για χιλιετίες, σκοτώνοντας εκατομμύρια και αφήνοντας ανάπηρους πολύ περισσότερα άτομα. Εξαφάνισε πόλεις και χωριά, αποδεκάτισε στρατούς και εξάλειψε τους Αζτέκους, πολύ περισσότερο από τα όπλα των conquistadores.

Μέσα από αυτή την ιστορία, αναδεικνύεται η διορατικότητα και το θάρρος κάποιων ανθρώπων, το πείσμα και η κουτοπονηριά των αρχών, η σαθρή αυθεντία των «επιστημόνων» και βέβαια η παρατηρητικότητα και η τόλμη κάποιων άλλων. Ο Jenner έμεινε στην ιστορία ως ο άνθρωπος που ουσιαστικά καθιέρωσε τον εμβολιασμό, ως μέσο πρόληψης μιας ασθένειας.

Το τελευταίο κεφάλαιο του βιβλίου είναι αποκαλυπτικό, καθώς σχολιάζει τις πιθανότητες η νόσος να ενσκήψει ξανά σε έναν πληθυσμό ουσιαστικά και πρακτικά ανεμβολίαστο εδώ και δεκαετίες.

Ένα πολύ καλό βιβλίο Ιστορίας της Ιατρικής.

[Candy Wood]

Williams's introduction emphasizes that this is a story of people as well as of disease, and throughout the book, he provides examples of how the smallpox virus brought out the best and worst in human nature, more often the worst. Less than halfway through, the story seems to be over, with variolation (inoculation with smallpox virus) in the 18th century proving effective at protecting subjects from more deadly forms. But failure to prevent the inoculated from infecting others, as well as unsanitary conditions, caused more deaths. Edward Jenner's method of vaccination with less deadly cowpox did lead to eradication, but not without much controversy that still haunts other forms of vaccination today. Williams ends by warning about the possibility that smallpox could reappear through biological warfare. Though it's written for general readers, Williams sometimes assumes knowledge we may not have, especially about Jenner's role in the story, but many illustrations and a lively style make it accessible and even enjoyable.

[Gerald · Rating 3 out of 5]

Three stars but barely. The factual history of smallpox and how people dealt with it, fought it and event times embraced it is interesting; the facts presented in an understandable way but this book could have been edited much better. I often felt it was repetitive rather than what was authors attempt to be reflective or juxtapose the different ways smallpox hand been handled. All that said it was still interesting history of smallpox.

[Mary Leahy · Rating 3 out of 5]

I read most of this book. It is an interesting study about smallpox.