Vaccinations can be a wonderful form of preventive medicine. We generally tend to think of vaccinations as a modern medical development, but this is not necessarily the case. Vaccinations are largely responsible for the eradication of smallpox and the decline in reported cases of polio, measles and tetanus.

Did you realize that Benjamin Franklin the oldest delegate to sign the Declaration of Independence in 1776 was recommending smallpox inoculation way back in 1730?

In those days this meant that a lancing wound was created and pus or dry scabs from an active lesion were introduced into the wound of the recipient. This caused a milder form of the variola or smallpox disease but subsequently imparted immunity for life.

This form of inoculation may have been first practiced in China before the 16th century.

Franklin reported in 1730 that only two out of 72 people inoculated died, but one in four died if they contracted smallpox the natural way.

John Adams was similarly inoculated in 1764, as were Thomas Jefferson and some of his family in 1782.

George Washington ordered his troops to be vaccinated in 1777 as more troops were dying from smallpox than in combat with the British.

Edward Jenner, the now famous British physician, noted that milk maids who had cowpox did not develop smallpox. His findings led to the medical term vaccination because material derived from a virus affecting cows (Latin: vacca-cow) was used.

In general vaccinations use intact but inactivated viral material for the vaccine. Inoculations use live viral material and are therefore more risky.

So, it is now generally understood that smallpox was the first infectious disease prevented through inoculation and many people inoculate themselves and their family and friends.

Routine smallpox vaccinations ended in the U.S. in 1972, but also in that year a single “pilgrim” from the middle east started a chain reaction from Kosovo to Belgrade, Yugoslavia, with a virulent strain of smallpox.

All of the country was placed on quarantine, and 20 million vaccinations were administered.

As you can see a single case can affect an entire country. This is a highly infectious disease that kills up to 30 percent of those infected.

The World Health Organization reported in 1967 that smallpox was affecting 10 to 20 million people per year. Fortunately smallpox was declared eradicated worldwide in 1977.

Ben Franklin, the most eloquent advocate of smallpox inoculation, was concerned that not everyone in his day could afford inoculation and he took measures to make it available to those who could not pay.

As I write these words I have in my hand a small cylindrical container of my grandfather’s dated Jan. 28, 1942.

The label reads as follows: “Ten Tubes, Smallpox Vaccine, Keep in a cold place, Not to be sold, For Free Distribution by the South Carolina State Board of Health.”

As you can see efforts like these helped to eradicate smallpox worldwide. Let’s hope it stays that way. Long live eradication.

David Keisler is a gastroenterologist and internist in Aiken.