Frederick Ayer and the Suppression of the 1871 Smallpox Epidemic in Lowell, Massachusetts

Frederick Ayer — born on December 8, 1822, in Ledyard, Connecticut — was a man of character, honesty and hard work. He possessed a “quick vision and keen judgement,” but the one characteristic which defined him above all else was his firm belief in progress. His “extraordinary youthfulness of mind” allowed him to discuss “all manner of subjects, however foreign to the interests which had always crowded his life.” In 1917, at ninety-five, Frederick advised his son-in-law, Captain George S. Patton Jr., to be open to “new means to win the Great War, particularly the adoption and development of the tank.”

“Unostentatious, modest, unassuming,” Frederick Ayer “never paraded his achievements nor permitted others to do so.” It took his daughter Beatrice years to convince him to tell her his life’s story, from his humble beginnings on his grandparents’ farm where he began to work at the age of three gathering sticks, to a titan of business at the head of the J. C. Ayer & Company and the American Woolen Company. However, of all the countless achievements throughout his illustrious life, Frederick always said he took most “pride in suppressing the small-pox epidemic in Lowell in 1871.”

Lowell, located along the Merrimack River about thirty miles NW of Boston, was the cradle of the American Industrial Revolution. Chimneys dotted the cityscape and thousands of residents of every age and nationality trotted to work every morning at one of the textile mills the town was famous for. According to a report by the Board of Consulting Physicians, the smallpox epidemic began in January 1871 at the home of the Kennedys on Mill Street, not long after the family returned from Liverpool. There was some “uncertainty about the origin,” but the Kennedy children likely contracted the variola virus one of two ways: either from a recently purchased secondhand mattress or from the Atlantic crossing. After all, Europe was in the midst of a smallpox outbreak, triggered by the Franco-Prussian War, which would last four years and claim five hundred thousand lives.

View of Lowell, Massachusetts at the confluence of the Merrimack and Concord rivers, with a row of textile mills or factories mainly along the Merrimack River. – Lowell New Hampshire Massachusetts Merrimack River, None. [Place not identified: publisher not identified, between 1840 and 1860] Photograph. https://www.loc.gov/item/94515606/.

Unlike the Prussian army where vaccination was mandatory, the French army was largely unprotected against smallpox. Even though a safe and effective vaccine was invented in 1796 by the British Edward Jenner and could be administered up to seven days after exposure to prevent severe illness, many still regarded vaccination “with great suspicion.” In Lowell, it had been six or seven years since the last mandatory smallpox vaccination and the high population turnover made it very difficult to keep track of who had been vaccinated. Since the virus easily spread through face-to-face contact and could survive for weeks on items such as clothing and bedding, vaccination and revaccination with a booster shot every three to five years was of the utmost importance.

Highly contagious and with a mortality rate of 30 percent, by the time Lowell’s Board of Health started keeping track, there were twenty-one confirmed cases of smallpox and twenty-seven people had died. The first signs of illness appeared ten to fourteen days after exposure, but patients weren’t contagious until sores appeared in their mouths and their bodies were covered in a rash. Isolation was paramount at this point but many of the sick refused to leave their homes as “neither was there a suitable hospital nor a sufficient supply of nurses.” Reluctant to enforce the law, the Board of Health merely resorted to flying a red flag from the homes where cases were present, but they did manage to get nine thousand people vaccinated (only a minor fraction of the total population though).

Cases kept rising — 32 in June, 61 in July, and 93 in August — but the public was told that the number “in the city was very limited, and the expectation was held out that the epidemic would soon come to an end.” In an effort to stave off a panic and prevent the mills from shutting down, the Board of Health claimed the smallpox numbers were based on “exaggerated and unauthorized reports.” The inadequate response of the Board — which had the same members for years, none of whom were physicians — tragically and unnecessarily prolonged the epidemic with devastating effects. “Many left the city; people from surrounding towns were deterred from coming here with their products and for business purposes, and the commercial and other business enterprises of our city became almost paralyzed.”

When the North Middlesex District Medical Society met in July, they agreed “that by proper measures this epidemic could be suppressed in a short time” and recommended the creation of a commission “whose exclusive duty it should be, so long as may be necessary, to do all in their power, by proper and legal means, to get rid of the disease now existing in our midst.” These recommendations languished with the City Council for six weeks during which time “the epidemic was raging to an alarming extent, and many lives were being sacrificed.” When more than one hundred cases were recorded in the first half of September alone, the citizens of Lowell finally had enough of “the political smallpox.”

A prominent resident of Lowell since 1855 when he joined his brother in the patent medicine business and an alderman for many years, Frederick was described as “a leader because others were proud to follow” and “powerful because he was kind and just.” On September 15 he arrived at a special meeting convened by the City Council carrying a petition signed by hundreds of Lowell residents protesting the efficiency of the Board of Health and urging “prompt and efficient action” against the smallpox epidemic. A hefty debate with a “political tone” ensued, which resulted in Frederick Ayer and four other aldermen being “declared the [new] Board of Health, — thus having imposed upon us onerous duties and a grave responsibility, against our will and most earnest protest.”

The new Board of Health was organized “on September 18, and at once appointed a Board of Consulting Physicians, seven in number, to take charge of the medical situation.” Despite his initial reluctance at being elected chairman, Frederick immediately “acted with vigor” and did what the old Board was unwilling to do. “In handling the legal situation my father had the able and whole-hearted co-operation of his attorney, Mr. A. P. Bonney,” Frederick Ayer Jr. later wrote. “They conferred with the Governor and decided that (with the situation as critical as it was, and with the Governor’s promise to support them in so far as he was able) they would take such measures as were called for, regardless of legal authority, and trusting in popular sentiment to back them up.”

Rules and Regulations pertaining to the 1871 smallpox epidemic in Lowell, Massachusetts
Lowell Daily Citizen and News – September 23, 1871

Within days, a temporary hospital with an adjacent smoke-house was built, ready to fumigate every doctor, patient, and resident who came in contact with the sick. Patients were taken to the hospital (this time without reluctance because of the good care provided by the temporary doctors and nurses from neighboring towns), or were made to quarantine at home under the watchful eye of a newly sworn in volunteer police force. Fresh cases were immediately reported to the Board of Health, and a team was sent to fumigate the patients’ homes and burn their linens. The wagons used for transportation were fumigated after each trip and the Fire Department washed down the streets every night. The Board prosecuted and fined two cases “for concealment, and four cases for refusing to be vaccinated,” but an additional fifteen thousand mill workers, about a third of the city’s population, were quickly vaccinated.

The Board “proceeded vigorously to exterminate the disease, which they effectually accomplished in about six weeks.” The Complete Report Of The Board Of Health, and Board of Consulting Physicians, As Presented To The City Council, December 12th, 1871, concluded this sudden turnaround was due “to the prompt report of cases and suspected cases to the Board; to the removal and isolation of all cases as soon as reported; to the immediate destruction or thorough fumigation of all infected material and… all infected persons and premises; to every precautionary measure, to prevent spread of the disease, that could be devised; and to vaccination.”

Lowell’s smallpox epidemic lasted eight months, sickened 570, and killed 172. If “duty to the public and the cause of humanity” had been as important to the old Board as economical and political issues were, far fewer lives would have been “sacrificed.” When the City Council received The Complete Report of the Board of Health and Board of Consulting Physicians, they wanted certain parts critical of their conduct amended or deleted. After “candid consideration,” Frederick Ayer and his four colleagues “respectfully [declined] to accede to this request, or make any change in their Report, and herewith return the same as original presented.”

Fully invested with “ample powers under the law,” the new Board of Health brought the number of cases down from 212 in September to just 6 in November. The Board of Consulting Physicians concluded that this “demonstrates what skill and science can do, sustained by wise management and efficient action.” They ended their report with a scathing rebuke of the City Council and the old Board of Health: “How frequently, of late, has the whole community been shocked by the loss of life, in the fall of some building, some railroad disaster, explosion, or by the wreck of some vessel at sea, but here in our midst, this very year, have the lives of one hundred and seven-five individuals been quietly sacrificed, which, apparently, might and ought to have been saved!”

The World Health Organization declared the world free of smallpox on May 8, 1980, but we once again find ourselves in a similar situation with Covid-19. Unfortunately, it appears that not much has changed in the last one hundred and fifty years and the lessons learned from Lowell’s smallpox epidemic, and other such similar cases, have been lost to history.


Sources:

  • The Complete Report Of The Board Of Health And Board Of Consulting Physicians, As Presented To The City Council, December 12th, 1871. United States: Stone & Huse, book & job printers, 1871.
  • Ayer, Frederick. The Reminiscences of Frederick Ayer. United States: Priv. print., 1923.
  • “Small-pox.: How The Disease Was Exterminated In Lowell, Mass.” New York Times (1857-1922), Dec 25, 1872.
  • “Smallpox in Lowell.” Boston Daily Evening Transcript, 16 Sept. 1871. 
  • “Frederick Ayer, Winter Resident, Died Yesterday.” Daily Times Enterprise, Mar 15, 1918.
  • “Frederick Ayer Dead In Georgia.” The Boston Daily Globe, 15 Mar. 1918. 
  • “Libguides: The Town & The City: Lowell before the Civil War: The 1871 Smallpox Epidemic.” The 1871 Smallpox Epidemic – The Town & the City: Lowell Before The Civil War – LibGuides at University of Massachusetts Lowell, https://libguides.uml.edu/early_lowell/smallpox_1871. 
  • “History of Smallpox.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 20 Feb. 2021, https://www.cdc.gov/smallpox/history/history.html. 

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