In the years after the Civil War, smallpox spread throughout the South, mainly infecting Black people. The story of an outbreak of a disease long since eradicated may seem remote from our own times. But the smallpox epidemic of the 1860s offers us a valuable, if disconcerting, clue about how epidemics end.
Terms such as pandemic and epidemic are biomedical explanations designed to define suffering and inordinate mortality, but they also have a narrative element embedded within them. They offer a beginning and an ending, characters and settings, rising action and falling action, conflicts and themes. As the Harvard historian of science Charles Rosenberg puts it, an epidemic is “an event” that has a “dramaturgic form.”
Epidemics, according to Rosenberg, “proceed on a stage limited in space and duration, follow a plot line of increasing and revelatory tension, move to a crisis of individual and collective character, then drift toward closure.” Statistical evidence suggesting that cases are declining gives way to a narrative that an epidemic is ending. But a focus on the overall number of cases may fail to attend to the fact that those who are continuing to get infected are typically the most marginalized.
The smallpox outbreak in the 1860s had an unequal impact. White people had the support of religious communities, municipal relief organizations, charities, friends, and families to protect them from the virus, so their rate of infection was lower. The federal government, focused on the smallpox epidemic’s denouement, neglected to address a series of outbreaks mostly among poor Black people that lasted for decades.
From the point when smallpox first appeared among formerly enslaved people in an abandoned lot in Washington, D.C., in 1862, not far from where President Abraham Lincoln drafted the Emancipation Proclamation, the course of the outbreak depended on how those in power decided to narrate it. The refusal of the federal government to acknowledge the smallpox epidemic rendered it virtually nonexistent. The Medical Society of the District of Columbia condemned the government’s neglect. “It is generally admitted that small-pox is one of the diseases due to domiciliary circumstances, and is at all times a preventable disease,” the physicians argued. “It has been stated over and over again by eminent authorities, that there need not be a single case of small-pox in any city; if the authorities will but take the proper steps to check it.”
As more formerly enslaved people liberated themselves from farms, homes, and plantations in Maryland and Virginia and sought refuge in the nation’s capital, the infection rate increased.