Smallpox sounded variations on the epidemiological themes first heralded with cholera. More endemic than the classic contagious diseases, smallpox was commonly regarded as among the worst of humanity's travails, an ailment that struck with blind disregard for sex or mode of life, favoring the young especially with its ravages, adding the humiliation of disfigurement for survivors of its other symptoms. That no one is spared either love or smallpox was the early modern version of our own, rather gloomier and mundane belief in the inevitability of the fiscus and the reaper. It was considered the most painful and debilitating of diseases, most lethal and costliest in its economic ravages. Even the plague would seem less destructive, was the grim calculation from early in the nineteenth century, were it not that we normally count children's lives only once they have survived smallpox.

While one of fate's hardest blows, however, smallpox was also the first contagious disease for which an effective, preventive medical intervention was developed and the first finally to be eradicated, a date set officially at 1979. Smallpox was thus an illness that allowed humanity to test its prophylactic prowess, the only shameful illness, as Lorain put it, because the one that could best be avoided. Inoculation, or variolation, and then vaccination equipped humans with preventive powers beyond the traditional techniques of breaking chains of transmission.