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Hospital
Rock
By
Charles Leach, M.D.
 This
entry is courtesy of Hog
River Journal , where it originally appeared in the Winter,
2004 issue.
Hidden
deep in the second-growth hardwood forest of Rattlesnake Mountain
is an inconspicuous flat ledge of traprock. On it are carved 66
names of long-ago Farmington residents. This is Farmington 's "Hospital
Rock," and it marks the site of Eli Todd and Theodore Wadsworth's
smallpox inoculation hospital of the 1790s. It is a reminder of
the terrible epidemics of another day, and of the efforts of local
physicians to halt their spread.
In
colonial New England villages like Farmington smallpox epidemics
were infrequent, but the inhabitants were more susceptible than
city dwellers when outbreaks did occur. A rural population would
become immune as the result of infection, and another outbreak would
not occur until five to 20 years later, when a critical mass of
susceptibles was again present. The larger towns and cities, on
the other hand, experienced small outbreaks of the disease with
such frequency that it was almost endemic. Their populations carried
a high level of immunity, and were protected for life after a childhood
infection. The grim folk wisdom was that one's child was not one's
own until it had survived smallpox. Most children did in fact survive,
and their mortality was lower than that of adults, for whom the
death rate was 20 to 30 percent.
The Virus and the Disease
The smallpox
("variola") virus consists only of two twisted strands of DNA. It
is smaller than the smallest bacteria, and unaffected by antibiotics.
It is a member of the Orthopox virus group, which includes several
animal pox viruses. Humans have been its only reservoir; the virus
was neither carried by insects nor did it affect animals. For this
reason quarantine was effective as a preventive measure if instituted
in time. However, because of its long incubation period, a victim
could transmit the virus before its presence was recognized, especially
since it survived for many days on the bedding and clothes of victims.
These "fomites" have been an important means of spread. There are
several strains of the virus, and consequently the severity of the
illness has varied considerably geographically and over time.
John Adams
called smallpox "The King of Terrors," and Thomas McCaulay referred
to it as "The most terrible of the ministers of death." Gurdon Buck's
1858 medical textbook referred to it as "the most loathsome and
fatal disease known to man." The disease was usually acquired by
inhalation of respiratory droplets. After roughly 12 days it would
manifest with high fever, headache, backache and nausea. The characteristic
rash developed over two weeks; small, deep nodules evolved into
pustules in the thickened and inflamed skin. These might be few
in number, or they might cover much of the body. The lesions would
then dry and form scabs over a two- to three-week period. The pustules
might also hemorrhage and merge into a single, malodorous mass.
Rotting sheets of skin might be shed, and stick to bedclothes. Respiratory
tract and eyes could be involved, and blindness could result. In
severe cases, the victim was physically dehumanized and unrecognizable
by loved ones. Transmission can occur until the scabs are shed;
scab-laden bedding and clothing is infectious for days or weeks.
The end result for survivors was disfiguring and often extensive
scarring, but lifelong immunity.
Smallpox arrived
in the New World with the Spanish conquistadors in Central America
in 1519. A great epidemic in London in 1628 was exported to Massachusetts
, where the disease caused havoc from 1628 to 1631. The first terrible
epidemic among New England Indians wiped out more than 90 percent
of the tribes along the coast and in the Connecticut Valley in 1633
and 1634. Subsequent outbreaks occurred in 1638, 1648-49, 1660,
1666, 1677-78 (the worst), 1689-90, and 1702-03. Finally, during
a terrible epidemic in Boston in 1721, immunization was employed
for the first time in America .
Variolation:
"Taking the Pox by Engrafting"
Protection
from smallpox could be achieved by "variolation"-voluntarily receiving
a small inoculum and sustaining localized mild disease. This had
been done in China by inhaling the dried scabs. In Africa, the Near
East and later in Europe , the variolator deposited a small quantity
of pus from the pock of a patient with mild disease into a shallow
cut in the arm or leg. The resulting disease was usually localized,
and the inoculee only mildly ill. The patient was contagious for
several weeks and had to be isolated, as local outbreaks sometimes
followed. Mortality was 1 or 2 percent, and depended on technique
and aftercare.
In 1721, thousands
were dying of the contagion in Boston . The Puritan divine and medical
scientist Cotton Mather convinced physician Zabdiel Boylston to
join him in variolating Bostonians. Boylston was severely criticized
by his colleagues, and Mather himself was threatened and vilified,
and his home was firebombed. Their work continued however. The results
of immunization were carefully recorded, and its success was documented
through one of the earliest applications of the scientific method
to medicine. Mather and Boylston found that protection among 247
inoculees was virtually 100 percent. Thereafter, variolation was
accepted and used in the American colonies to one degree or another.
There were two great ironies in the story: one was that Mather,
spanning from medieval to modern thought, was both a medical innovator
and an advocate of the Salem witch trials. The other was that Mather's
acquaintance with variolation derived not only from English examples
but also from his slave, Onesimus, who told him of its use in Africa
.
Further major
outbreaks in New England were documented in 1730-31, 1735-40, 1750-52,
1760-61, 1764, and 1772. The Revolutionary War years brought repeated
outbreaks, especially among the troops. It was in this setting that
Eli Todd, Theodore Wadsworth, and their contemporaries initiated
the smallpox hospitals of the 1790s.
Smallpox
Immunization in the 1790s
Although
it had been more than a decade since the last great smallpox epidemic
in America (1774-1782), for many reasons, the early 1790s was the
right time for enlightened practitioners to offer immunization to
their communities. Smallpox immunization in the colonies had followed
a pattern of years of neglect interspersed with epidemics, which
triggered urgent variolation programs. When the disease was not
stalking a community, there was little enthusiasm for undergoing
the risk and discomfort of "taking the pox by engrafting." In addition
to the 1 or 2 percent mortality rate, the live variola virus inoculum
could spread to the community. For this reason variolation was outlawed
in New England in 1761, but again permitted in 1777. In New York
and the middle colonies it was more freely practiced, and many Yankees
journeyed there to "receive the pox." From time to time, local Connecticut
governments prohibited the practice. Town selectmen always had the
say as to when and where inoculation could be done and by whom.
One Connecticut practitioner was permitted to variolate, but made
to promise that he would pay a fine of 40 shillings for every case
that occurred secondarily in the town. Another was fined 60 dollars
for doing the procedure without permission.
The
English inoculator Robert Sutton introduced safer preparation and
technique in the 1760s, and the advantages of the "Suttonian Method"
were well known in the colonies. In consequence, more physicians
offered inoculation, and more patients accepted it. The need for
isolation was better recognized and implemented. The beginnings
of more sensible and kindlier treatment of the disease itself were
on the horizon. Patients were no longer starved before inoculation,
and many had begun to doubt the efficacy and safety of vomiting,
sweats, purges, mercurials (toxic mercury salts such as calomel),
and bleeding which had previously weakened both inoculees and those
who "took the pox in the natural way."
In
the early 1790s roads were still very poor and often impassible,
but the needs of commerce required improvements. In consequence,
the era of turnpike-building began in 1792. Since troop movements
during the French and Indian War had brought smallpox to Farmington
in 1760, and probably during the Revolution, residents knew that
contagion would increase with better highways and increased travel.
Socioeconomic factors were also at work, and the earliest signs
of the industrial revolution were evident. The famous Slater cotton
mills began operations in 1790 in Rhode Island , and were soon emulated
in Connecticut . Smallpox-susceptible farm girls and children were
packed into unsanitary workplaces and habitations. And so greater
social organization gave impetus to preventive efforts. Physicians
had begun to form state and local medical societies- Hartford 's
was founded in 1792-which led to greater exchange of information
and awareness of new therapies, preventive and otherwise. Treatment
methods were debated and improved. Often highly motivated toward
the public good, the physician-variolators were also leaders of
the new medical societies. Furthermore, community leaders and physicians
perceived the dangers of crowding and poor sanitation. As a result,
publications on public health began to appear, and communities were
ready to be more proactive in the face of epidemic disease. It was
natural that they should turn to their most trusted physicians for
inoculation by the safer and less distressing Suttonian method.
The
Two Doctors
Eli
Todd (1769-1833) was the well-to-do son of a New Haven merchant.
He was a brilliant honors graduate of Yale who had studied medicine
with Dr. Ebenezer Beardsley of New Haven under the old apprentice
system. He had begun practice in Farmington at the very young age
of 21, and had gained the respect and love of his many patients.
His were gentle treatment methods in an age of harsh remedies. His
skill, kindness, and cultivation made him the favorite practitioner
of the emerging wealthy class in the community. In 1792, when he
joined with Theodore Wadsworth to establish the "hospital" on Rattlesnake
Mountain , Todd was a hard-working 23-year-old bachelor. He had
already participated in the founding of the Hartford County and
Connecticut Medical societies and was active in the community, supporting
the temperance movement and other worthy causes. He was an excellent
musician, and a founder of the Handel Society. Membership in the
local Masonic Lodge conferred status and powerful friends. In later
years, he was a leading figure in the Conversation Club. The crowning
achievement of Todd's career was his role in 1819 in the founding
of the Hartford Retreat for the Insane, of which he was the first
director.
Todd
was the younger of the two Hospital Rock doctors, but probably supplied
the brain power and energy for the enterprise. He was a man of his
times-the heady first years of the Republic when, under the influence
of the Age of Reason, citizens were ready to take action for the
betterment of society. He was also a bit of an entrepreneur: newspaper
advertisements and town records show that he offered variolation
at several other facilities and with various partners, last in 1801.
Todd was highly altruistic, but very willing to engage in a lucrative
business. Medical historian Rufus W. Mathewson commented that in
1792 "the practice of inoculation was at its height.. and a source
of great income to many.... [and] the keeping of 'pock houses' ..
was profitable."
Todd's
partner in the enterprise was Theodore Wadsworth (1753-1808), who
was slightly older, and a veteran of the Continental army. His medical
training was also in the form of an apprenticeship, though we do
not know his teacher's name or whether he had attended university.
In 1792 Wadsworth was 39 years old, and the father of three children.
He had practiced in Southington since 1780. Nothing in the records
suggests Wadsworth matched the brilliance of Todd, but he had the
advantage of having practiced variolation in the army, which he
joined in 1777. His military experience had no doubt taught him
the highly contagious and lethal character of smallpox. Like Todd,
Wadsworth had an entrepreneurial streak and participated in more
than one variolation enterprise. He was also bold and original,
as illustrated by the agreement (1791) documented in the Southington
town records to "cure Mary Evans of her insanity for fifteen dollars
. in six months. otherwise to have nothing." Ironically, Wadsworth
died in the terrible spotted fever epidemic of 1808.
The
Hospital and the Rock
The
hospital building stood on a stony hillside known as the "goat pasture"
on Settlement Road , the old road to New Britain . The land on which
the hospital was situated is believed to have belonged to the Josiah
Kilbourn family, and was purchased in 1798 by Elias Brown.Â
Both families evidently had farm buildings near the site. However
it is unknown at present whether the hospital had been a farmhouse
or outbuilding, or was a specially built structure. It was far from
both town centers, but easily accessible for attendants and visitors
with immunity. Rattlesnake Mountain sheltered the building from
north winds that would otherwise chill the patients during the autumn
months. Our only description of the structure comes at second hand
from a patient's grandchild, who described a long narrow building
standing somewhat off the road near a spring. Inoculations were
done only from about May until October, and there was no need for
fireplaces.
Near
the hospital building was a smooth sunny ledge on which the young
patients could socialize, and where they picked up messages and
packages from home. Of the hundreds who must have stayed at the
hospital in the years 1792, 1793 and 1794, sixty-six have left us
their names or initials cut into the ledge. It is smooth, flat and
slopes down away from the old roadway. Scattered on the rock's surface
in an irregular area about 15 by 20 feet, the names are barely discernible
until a visitor dusts them with flour. Then they emerge, like a
photographic print materializing in a darkroom pan.
The
old Settlement Road is now abandoned, though it can be traced from
the quarry on Route 6 several miles through the forest to where
it is interrupted by Interstate 84. Along it innumerable fragments
of traprock litter the forest floor, and there area a few hints
of stone walls. Near the road and 1,000 feet from the rock itself,
there is a cellar hole lined with mortarless rock and a long-abandoned
well. These are the only remains so far uncovered that accompany
Hospital Rock with its carved names recalling a long ago and very
different time.
The
Patients
When
news of a new smallpox epidemic came from Boston in 1792, Farmington's
best families entrusted their children to the charismatic Todd and
to Wadsworth , his more experienced colleague.
It
is estimated that hundreds of patients were inoculated and spent
their recovery at the Todd-Wadsworth Smallpox Hospital . Fifty-two
of the 66 names carved into the rock include first, and sometimes
middle, initials, and these patients can be further identified with
some confidence. Considerable information is available for 26 of
them. The known ages of the patients ranged from 9 to 33 years.
Twelve family groups appear, and one or two parent-child pairs.
The social position of the inoculees is revealing. Nineteen were
descended from original proprietors of Farmington , and most appeared
to come from homes of at least middling wealth. There were the children
of physicians, future physicians, and future spouses of physicians.
For example, the name " Hull " appears five times and all are descended
(by various lines) from five generations of doctors. Families of
clergy, judiciary, and military officers were also represented.
For example, Mary Pitkin was the daughter of Timothy Pitkin, the
wealthy and liberal minister of the Farmington Congregational church.
Edward, Sally and William Hooker were children of Col. Noadiah Hooker
who had led his troops to the smallpox-threatened siege of Boston
in 1776. They were descended from Hartford founder Thomas Hooker.
Names such as Cowles, Wadsworth , and Whitman abound. These youngsters
were connected by blood or marriage to an extensive network of educated,
wealthy and powerful Yankees.
The
high cost of variolation limited the Hospital's clientele. We do
not know what Todd and Wadsworth charged for variolation, but a
physician in 1764 charged the equivalent of $190 in 2001 currency,
and in 1801 Todd charged a man $83 apiece (in 2001 currency) for
variolating his three daughters. Free care was occasionally offered,
but the uninoculated poor suffered disproportionately during epidemics.
The
length of stay at the smallpox hospital varied, of course, but was
generally three to four weeks. This was approximately the length
of time it took for the last scab to shed. Patients were probably
inoculated in small groups, to avoid the risk of cross-infection.
Males and females were immunized and quarantined separately on the
mountain, and while there were no scandals, lots of visiting and
socializing went on. One young man stated that he was attracted
to the hospital because "the girls are as thick there as toads after
a rain." There were even two marriages that took place after sojourns
at Hospital Rock. One involved Dr. Wadsworth's son, Harry, who wed
Anna Mix, an inoculee, in 1807. The other marriage was of Luther
Seymour and Rebekah Curtis, whose names are carved together on the
rock, with the dates "1792" and "1794," Respectively. Evidently
Luther was immune, having been variolated in 1792, and had gone
up to visit Rebekah in 1794 while she convalesced. They were married
in Middletown in 1797, and Luther became a respected housewright,
furniture maker and town librarian in Farmington.
Postscript
Variolation
passed into history with the 1796 discovery by English physician
Edward Jenner that infection with cowpox, a viral disease of cattle,
protected milkmaids from smallpox. Cowpox, or vaccinia, virus could
be passed from person to person, and resulted in immunity. Jenner's
work was quickly followed by widespread use of "vaccination" in
England and after 1800 in the New World . The new procedure was
much safer than variolation and just as effective. Though a few
physicians continued to use variolation for a time, it was quickly
supplanted. The Todd/Wadsworth hospital was no longer needed, and
faded away into the woods.
There
were no further significant smallpox epidemics for many years in
Connecticut . Evidently because immunity waned and vaccination was
neglected for a few years, an increased number of susceptibles provided
the raw material for a new episode. This came in 1827, when cases
in Farmington alerted the town's officials and doctors. In response,
the town undertook a thorough program of vaccination. Teams of physicians
(including Todd) vaccinated hundreds of citizens at the several
district schoolhouses. The epidemic was effectively stopped. The
carefully-kept records of this program are now in the Farmington
Room at the Town Library. Farmington again acted in response to
the threat of smallpox in 1857. On a motion by Egbert Cowles Esq.,
it was voted that "the Selectmen be . directed to take measures
to have the people of the Town vaccinated by School Districts .
and use their best endeavors to have a general attendance of the
People at the District School Houses to meet the Physicians.." In
later years, vaccination was more routinely done, and the need for
revaccination was recognized. Eventually, smallpox immunization
became a requirement for admission to school and remained so until
the disease was declared eradicated by the World Health Organization
in 1980.
The
last small local outbreak of smallpox occurred in 1918, and was
recalled by Farmington 's revered Dr. Edward Dunn, along with the
influenza epidemic, as his "welcome to town." The last case in the
United States was recorded in 1949, and the last naturally occurring
case in the world was recorded in Somalia in 1977. As the result
of a massive years-long effort by the World Health Organization,
smallpox became the first living species to be deliberately made
"extinct" by man. (At present stocks of the virus are held in freezers
at the Centers for Disease Control and in Moscow .) No vaccinations
had been done since 1980 until fear of terrorism led to resumption
in 2002.
Hospital
Rock has for two centuries rested on the periphery of Farmington
history. Since even local historians have been uncertain of its
location, it has acquired an aura of mystery and romance. Yet it
has remained a very meaningful artifact, speaking to us in a direct
and moving way from the past. In the last few years, however, there
has been renewed and effective interest in its preservation. While
the site is actually in Farmington , the land is owned by Hartford
, which purchased it for its watershed. In 2002 the Connecticut
Historical Commission declared Hospital Rock and the surrounding
forest to be an Historic Archeological Site, and Farmington is collaborating
with Hartford in a move to gain easement protection for the site.
An archeological search for the remains of the hospital itself is
projected for the near future. There remains, however, the intriguing
question of how to preserve the inscribed slab of bedrock out in
the woods.
Dr.
Charles Leach is a retired cardiologist, former director of cardiology
at New Britain General Hospital , and clinical professor of medicine
at UCONN. He is also past president of the Farmington Historical
Society, and a member of the Farmington Historic District Commission.
REFERENCES
Bickford,
Christopher P. Farmington in Connecticut . Phoenix Publishing, Conway
, N.H. , 1982.
Fenn,
Elizabeth A. Pox Americana . The Great Smallpox Epidemic of 1775-82.
Hill and Wang , New York , 2001.
Jensen,
Oliver, ed. The Miracle of Connecticut . 2 nd Edition. Connecticut
Historical Society and Fenwick Productions, Hartford , 1995.
Leach,
Charles N., Jr. "Farmington Physicians and Their Times." The Farmington
Historical Society News. Farmington , Ct. , April 1999.
Leach,
Charles N., Jr. "Hospital Rock Families." The Farmington Historical
Society News. Farmington , Ct. , May 2003.
Mathewson,
Rufus W. The History of Middlesex County 1635 - 1885. J.H. Beers
and Co., New York . 1884.
Porter,
Noah, Sr. "Half-Century Discourse; on Occasion of the Fiftieth Anniversary
of his Ordination." Farmington and Hartford , 1857.
Roop, Jonathan Crane M.D. "Hospital Rock: A New Story."
May 2002.
Shepard, James. "The Small-Pox Hospital Rock at Farmington Conn.
" Connecticut Quarterly, Vol. 1 No. 1, pp. 50-55. January 1895.
Timlow,
Heman R. Ecclesiastical and Other Sketches of Southington, Conn.
Case, Lockwood and Brainard Co., Hartford Ct 1875.Â
Reprinted 1976 under sponsorship of the Southington Bicentennial
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