As 1883 powerfully illustrates, smallpox would resurge during the mid-to-late 19th century. But how accurate is the show’s portrayal?
The answer: Very. It even seems a bit mild in comparison to history. Let’s take a look.
What is Smallpox?
Often likened to the Black Plague, smallpox is an ancient, highly infectious virus of the variola family that took a catastrophic toll on humanity for millennia. According to the American Museum of Natural History, smallpox killed more than 300 million people in the 20th century alone. Thankfully, a worldwide global vaccination campaign brought about the end – and total eradication – of the disease by 1977. This was the first-ever vaccine created by man and the first disease to be eradicated completely as a result.
Before and after, however, smallpox would kill untold millions every single year across the globe, stretching as far back as the 7th (or even 4th) century AD. In central, populous areas such as New York and London, large outbreaks would cause mass die-offs. At the least, 3 out of every 10 people with the virus would die on average. The rest would recover, but with life-long severe scarring from the effects of the resulting disease. Many were also blinded by it.
Smallpox starts with a fever, then causes a distinctive skin rash that gets progressively worse as it spreads. Horrid pustules result from the rash, which eventually burst open – spreading the disease to others. These pustules then scab over, causing permanent scarring.
These pustules are what we see on the victims of 1883. The effect is remarkably similar to historical images of outbreaks.
Vaccination Onto the 19th Century
The last natural outbreak of smallpox in America was in 1949. Vaccination was developed well before during the 18th century and was responsible for drastically reducing the number of casualties. We have a British scientist and physician by the name of Edward Jenner (above illustration) to thank for this. His vaccine, created in 1978, saved millions upon millions of lives.
Yet as 1883 illustrates, smallpox was still a prevalent problem in the 19th century. It was one of many diseases plaguing citizens and soldiers alike throughout the American Civil War. But unlike most diseases, vaccination was available.
This led to a drastic reduction of smallpox cases in the early 1800s. But by the mid-1800s, vaccination became neglected. A generation of Americans never exposed to the virus would populate the country through the Westward Expansion, and the disease would rise to prominence once more by the time of the Civil War (and the fictional 1883).
Smallpox by ‘1883’: The Numbers
According to the National Museum of Civil War Medicine, 12,236 cases of smallpox among white Union Army troops occurred between May 1861 and June 1866. This translates to 5.5 per thousand men annually. A total of 6,716 cases were reported among the historically named U.S. Colored Troops, or 36.6 per thousand black men annually.
Resulting death rates from smallpox were approximately 23% for white troops. Black troops saw a 35% mortality rate.
As is prevalent today with the coronavirus variants, quarantine and vaccination were the primary tools in use to prevent its spread. In addition, destruction of infected clothing, bedding, and personal effects were used to control spread, as well. We see this in 1883 as Sam Elliott’s character, Captain Shea Brennan, burns down his family home with his deceased loved ones inside.
All in all, the graphic portrayal of pustules and forced exile of infected individuals in the Yellowstone prequel is spot-on. Many were driven from town immediately after identification (above illustration from the year 1883), especially out West, where healthcare and hospitals were scarce (if available at all).
Indeed, smallpox was a plague to those brave enough to journey America’s Westward Expansion. And if it didn’t kill you, 1883 powerfully illustrates the countless other perils that would.