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Tuesday, October 18, 2016

Book Review: Pox Americana by Elizabeth Fenn

pox americana

Pox Americana by Elizabeth Fenn
e-book, 384 pages
Hill and Wang
October 2, 2002

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Genre: History, Non-Fiction

Source: Personal purchase for my Masters class

The astonishing, hitherto unknown truths about a disease that transformed the United States at its birth

A horrifying epidemic of smallpox was sweeping across the Americas when the American Revolution began, and yet we know almost nothing about it. Elizabeth A. Fenn is the first historian to reveal how deeply variola affected the outcome of the war in every colony and the lives of everyone in North America.

By 1776, when military action and political ferment increased the movement of people and microbes, the epidemic worsened. Fenn's remarkable research shows us how smallpox devastated the American troops at Qu├ębec and kept them at bay during the British occupation of Boston. Soon the disease affected the war in Virginia, where it ravaged slaves who had escaped to join the British forces. During the terrible winter at Valley Forge, General Washington had to decide if and when to attempt the risky inoculation of his troops. In 1779, while Creeks and Cherokees were dying in Georgia, smallpox broke out in Mexico City, whence it followed travelers going north, striking Santa Fe and outlying pueblos in January 1781. Simultaneously it moved up the Pacific coast and east across the plains as far as Hudson's Bay.
The destructive, desolating power of smallpox made for a cascade of public-health crises and heartbreaking human drama. Fenn's innovative work shows how this mega-tragedy was met and what its consequences were for America.

This originated as an opinion essay for class and I have adapted it for a review, but because of this it is a little different in tone than my regular reviews.

The experience of reading Pox Americana was a very different one for me as I was not all that sure how this epidemic would relate to American history during the Revolution. I soon found myself thoroughly engrossed in the material and actually interested in learning more. Disease is always a common factor in war, but for me, the association of smallpox with history had always been regarding the indigenous peoples of the Americas and the effect of its arrival on their way of life; I had not previously considered how it might have affected the colonists and almost changed the outcome of history as we know it.

I have never read a microhistory on disease, or for that matter any type of book on disease. That has always been my husband’s area of interest and I was happy to leave that study to him; so I was more than a little hesitant about approaching a history on smallpox (remember that this wasn’t originally by choice). One thing that I appreciated early on, rather surprisingly, was the author’s fairly detailed discussion of the effects of smallpox. While disturbing, especially when reading these passages while eating lunch, it gave me a much deeper understanding of just how devastating the disease would have been to those suffering from its effects during any time period. I have never even had the chicken pox and therefore did not even have that terrible comparison to draw upon when considering smallpox previously in the limited experience I have had with the subject. It also is not a disease that exists in nature today, only in a secured laboratory, which means that I have not heard anything about the disease even in passing. While that portion of the book might have been a little bit gruesome, I found it necessary to my understanding of how devastating the disease would have been to an already hard-pressed army.

I can understand why a subject like the smallpox epidemic might not be covered in American history survey classes in high school or college. In their grand scheme of imparting the most important information on the American Revolution, it is not absolutely necessary to understand the effects of this disease on the troops. At that stage, the big names and events will serve their purpose and there is usually some general discussion of camp diseases that will vaguely touch on the effects of health on army readiness. However, for a Masters level class or for those who are deeply interested in American history, where we should already have a solid understanding of the basic points of the history, I think that Pox Americana provided another level of valuable analysis to dig deeper into why events transpired how they did and allow us to consider, even tangentially, how history might have been different if not for General Washington’s decision to inoculate the troops at Valley Forge. That decision is just as significant a turning point in the American Revolution as the outcome of the Battle of Saratoga. The rate at which smallpox was devastating the American army was placing it in a dire situation, especially when compared to the relative health of the British regulars; you could almost see the crush of the American troops coming. Knowing this, my opinion of General Washington has thus improved after having considered just how difficult of a decision it was to decide to take the chance with inoculation when so many at the time were against it and his troops so badly needed it. It is a great leader who can justify taking an immense risk as that given all the marks against it. If his great leap of faith had gone wrong, the Americans might have lost the war, but they might have lost even if he did not.

We were only required to read a couple of chapters of this book for class, but I was interested enough to pick it back up and finish the book. It explored all areas of the North American continent and it was interesting to see how the disease effected the regions differently; although I will admit that the chapters assigned were the most interesting.  Some of the later chapters became much more dry resulting in the lower rating. 

While this book was a history of a devastating disease in a localized area, it served an even greater purpose: to bring to light a chronically overlooked, but critical element in the history of the Revolutionary War. The author tells us in her introduction to the book that the outbreak of smallpox killed more people during the war years than resulted from combat with the enemy and that just as much as the war, this epidemic was a defining characteristic for many who lived through that time. Phrases like this do not suggest that the effect of smallpox on the history of the United States should be taken lightly. Disease often kills more people during wartime than the battles do, but it is often the result of many different camp diseases, not just one disease, showing just how powerful smallpox was. Additionally, for something to be a defining characteristic in someone’s life, especially during a time when there was so much change happening in the country to begin with, that means it was perceived to be of vital importance. For these reasons I am grateful to have had the opportunity to explore the topic and further my understanding of the myriad of elements that comprised the American Revolution years. For me, the most eye-opening aspect was the discussion on the differences between how smallpox effected the British troops versus the American troops. Not only did it help me to understand to a greater extent the uphill battle that Washington and his men were facing, but it also helped draw another distinction showing how far the Americans had come from the way of life of the Old World. Other texts have illustrated how their manner of speech had changed and customs began to differ, but nothing is as striking as their susceptibility to a common disease in their former motherland. It is even more interesting when you consider that so many of the indigenous peoples of the Americas died after first contact because of the introduction of this disease by explorers who were not affected by it and that not so many years later, the descendants of these settlers were now being attacked by that very same disease, while again the “invaders” were immune. It makes a very interesting point for further consideration.

Reviews of this book by other bloggers:

Buy the Book: Amazon | Barnes & Noble | RJ Julia

You can check out more from this author about this book on this Book TV segment.

Also by Elizabeth Fenn:

Encounters at the Heart of the World: A History of the Mandan People

natives and newcomers
Natives & Newcomers: The Way We Lived in North Carolina before 1770




  1. "I can understand why a subject like the smallpox epidemic might not be covered in American history survey classes in high school or college."

    Homer covered the plague among the Greeks.

    We are not spared the medical horrors about WW-I trenches or Stalingrad battle.

    1. I wasn't suggesting directly or indirectly that the effects of disease itself on history isn't covered in classes, but rather specifically smallpox on the events of the Revolution and its time period beyond just the battlefield, since that is what this book was about. I too learned about diseases and history, but it was usually within the context of a war and battlefield - as you said WWI, or the Civil War. While covering the war element here too, it explored a lot more outside of the battlefield: natives in the west, the fur trappers and traders of the North, etc and dug in deep. But I can assuredly say that we didn't cover anything about smallpox in school beyond the basic: it came over with the early explorers and decimated the native population on first contact. Additionally, as I stated, I can see why in a survey class on the Revolution the issue of smallpox might be skipped or glossed over as there is only so much time and they want to cover the "big" events, figures, etc, not because it's too gruesome to discuss disease.

    2. I could also identify with "smallpox is too humdrum", and War of Independence is Our Glorious War. Such thinking. Or if not identify with, strictly, at least consider it a possibility.

    3. That is certainly a possibility. What is likely to keep attention more is another possiblexample consideration for skipping it.


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