Smallpox was highly contagious and often fatal. Survivors often suffered grotesquely pitted skin with severe scarring, blindness leading to horrible disfigurement. Fear of contracting this ubiquitous disease led to social and political attempts at preventing its spread during the seventeenth and eighteenth centuries in America. Colonists relied upon methods of containment and avoidance to prevent recurring outbreaks of smallpox, but were reluctant to use the more reliable yet risky method of inoculation.
As its benefits became clear and incidences of smallpox increased, inoculation gained popularity in the colonies. Statistical proof that inoculation provided protection against smallpox with less severe symptoms and significantly fewer fatalities could not be denied, and with epidemics occurring regularly during the Revolutionary War, colonists began to accept the need for inoculation. The Continental Army started using the procedure to protect the troops early in the war, with significant success. From a public health perspective, compulsory army inoculations helped encourage the civilian population to use this preventive procedure.
The positive effects of Washington’s use of inoculation were recognized even before the end of the war. In 1781 Dr. Benjamin Rush noted, “It must afford no small pleasure to a benevolent mind… to reflect, that the small-pox which once proved equally fatal to thousands, has been checked in its career, and in a great degree subdued by the practice of inoculation.”