This thesis explores eighteenth-century smallpox to investigate the course, management and control
of the disease by communities, families and individuals. It focusses first on the prevalence of smallpox
in Oxfordshire demonstrating that smallpox mortality in the county reduced during the century
because, even before inoculation was practised, the disease was clearly being controlled through
community and familial responsibility; containment and isolation practices were successful in
impeding the disease.
Secondly, the thesis uses the combination of parish register data and family reconstitution to
reconstruct three catastrophic outbreaks in the county. It ascertains a causal relationship between
adult and child deaths and presents new knowledge on pathways of smallpox transmission and the
nature of familial proximity. Moreover it establishes a direct relationship between changes in
behavioural patterns and adult smallpox deaths. Drawing from a national body of life-writings the
roles of smallpox carers are also scrutinised, revealing their high levels of stress but also their resilience
thanks to integrated and reciprocal support. Spousal, parental and kinship networks were vital
components of this care.
Thirdly, the thesis explores how inoculation was practised in Oxfordshire from the 1760s onwards.
Despite the difficulties and conflicts encountered by practitioners, it is clear that local provision was
characterised by demand-led and well-organised programmes, conclusions that help to explain the
high levels of local immunity. It also argues that inoculation was a likely factor in the rise in smallpox
mortality in the late 1760s and early 1770s, although the absence of major outbreaks of smallpox in
Oxfordshire after the 1770s and the high level of inoculation activity in the county and its regions
indicate that the practice was reducing smallpox mortality by that time. The procedure was generally
more accepted by the younger generation despite the sometimes irreconcilable family differences.
This helps explain reduced infant mortality in the later eighteenth century since it is shown that infants
were most at risk of smallpox from the home environment and thus the immunity of parents to
smallpox through inoculation was a key factor in reducing overall infant mortality.
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