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Smallpox made no distinctions. It affected all ages and socioeconomic classes. It killed Marcus Aurelius in AD 180; the first Abbasid caliph, Abbul al-Abbas al-Saffah (“the blood shedder”), in 754; King Thadominbya of Burma in 1368; the Aztec emperor Ciutlahuac in 1520; King Boramaraja IV of Siam in 1534; the King and Queen of Ceylon and all of their sons in 1582; Prince Baltasar Carlos, heir to the Spanish throne, in 1646; William II of Orange and his wife, Henrietta, in 1650; Emperor Ferdinand IV of Austria in 1654; Emperor Gokomyo of Japan in 1654; Emperor Fu-lin of China in 1661; Queen Mary II of England in 1694; King Nagassi of Ethiopia in 1700; Emperor Higashiyama of Japan in 1709; Emperor Joseph I of Austria in 1711; King Louis I
of Spain in 1724; Tsar Peter II of Russia in 1730; Ulrika Eleanora, Queen of Sweden, in 1741; and King Louis XV of France in 1774. During the 18th century, four reigning European monarchs died of the disease, and the Habsburg line of succession to the throne changed four times in four generations because of the deaths of heirs .

Citizens were equally at the mercy of the illness. In the late 18th century in Europe, 400 000 people died of smallpox each year and one third of the survivors went blind .

The word variola (smallpox) was used for the first time by Bishop Marius of Avenches (near Lausanne, Switzerland) in AD 570. It came from the Latin word varius, meaning “stained,” or from varus, meaning “mark on the skin”. In England, the term small pockes (pocke meaning sac) was first used at the end of the 15th century to distinguish the illness from syphilis, which was then known as great pockes. The dread that smallpox inspired is graphically described by Macaulay: “that disease … was the most terrible of all the ministers of death.”

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