Variola major, the virus that causes smallpox, circulates continuously from one susceptible human to another. As the variola virus establishes its migratory sphere, a dramatic transmission of the virus occurs. By the eighteenth century, smallpox had become a universal disease that afflicted populations worldwide. This chapter reviews methods of combatting smallpox before 1800, focusing on a technique called variolation, which involves the exposure of an uninfected person to a person with a mild case of smallpox. Because of the great risks involved, this technique failed to gain official support in Japan. Nevertheless, Japanese physicians continued to seek ideas and instruction from foreign physicians who were experimenting with variolation techniques. The discovery of an alternative method by Edward Jenner before the end of the century initiated a revolution in medicine.
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