The lesions from these two specimens are from an early stage of smallpox in 1776. The disease is likely to have been contracted in utero. From the Hunterian Collection, Royal College of Surgeons, London.

DEFINITION: Smallpox is an acute contagious disease caused by variola virus, a member of the orthopoxvirus family. Smallpox, which is believed to have originated over 3,000 years ago in India or Egypt, is one of the most devastating diseases known to humanity.

For centuries, repeated epidemics swept across continents, decimating populations and changing the course of history. In some ancient cultures, smallpox was such a major killer of infants that custom forbade the naming of a newborn until the infant had caught the disease and proved it would survive…

Smallpox had two main forms: variola major and variola minor. The two forms showed similar lesions. The disease followed a milder course in variola minor, which had a case-fatality rate of less than 1 per cent. The fatality rate of variola major was around 30%. There are two rare forms of smallpox: haemorrhagic and malignant. In the former, invariably fatal, the rash was accompanied by haemorrhage into the mucous membranes and the skin. Malignant smallpox was characterized by lesions that did not develop to the pustular stage but remained soft and flat. It was almost invariably fatal. [World Health Organization]

DESCRIPTION: ‘December 30, 1776, I was sent for to Mrs. FORD, a healthy woman, about twenty-two years of age, who was pregnant with her first child. She had come out of the country about three months before. Soon after her arrival in town she was seized with the small pox, and had been under the care of Messieurs HAWKINS and GRANT, who have favoured me with the particulars here annexed.

I called upon her in the afternoon; she complained of violent griping pains in her bowels, darting down to the pubes. On examining I found os tinsae a little dilated, with other symptoms of approaching labour. I sent her an anodyne spermaceti emulsion, and desired to be called if her pains increased. I was sent for. The labour advanced very slowly; her pains were long and severe; she was delivered of a dead child, with some difficulty.’ [John Hunter, ‘Account of a Woman who Had the Small Pox during Pregnancy…’, Philosophical Transactions of the Royal Society 70 (1780): pp. 129-130.]