Smallpox, Ṣọ̀pọ̀nnà and Epidemic Disease

This is the strongest specific case in the whole of Yoruba medicine and it is almost always told badly. The good version, in which the Ṣọ̀pọ̀nnà priesthood were secret inoculators whom the British destroyed out of ignorance, and the hostile version, in which they were extortionists deliberately spreading smallpox for profit, are both simplifications of a record that supports neither cleanly.

What the record does establish is worth more than either story. West Africans, including in what is now Nigeria, practised smallpox inoculation before Europeans in the Atlantic world learned it, and taught it to them. That is documented, has been recently strengthened by archival work, and it is a fact about African medical knowledge that carries no exaggeration at all.

The religious and political dimensions of Ṣọ̀pọ̀nnà, the naming taboo, the diaspora forms and the shape of the 1907 ban are treated in 06-orisa/12-sonponna-obaluaye. This file owns the medical and epidemiological content: what inoculation was, what the Yoruba did about epidemic disease, and what the evidence about the priesthood actually amounts to.

Confidence on this file is contested, and specifically on the central question of what the priesthood was doing. The reason is set out below and it is structural rather than a failure of searching.

Smallpox in Yorubaland: the epidemiology

Smallpox, caused by variola major and variola minor, is transmitted person to person through respiratory droplets and through contaminated clothing and bedding. It is a strictly human disease with no animal reservoir, which is why eradication was possible. Survivors carry deep pitted scarring, characteristically on the face, arms and legs, and are immune to further attack 1.

The documented outbreaks in Yorubaland. The first recorded outbreak in the colonial period was at Lagos in 1869, shortly after the city became a British protectorate. A further outbreak at Abẹ́òkúta in 1884 carried a very high mortality rate. By 1891 the epidemic had reached Iperu, Isara and Ìjẹ̀bú communities, and by 1897 Epe in Lagos, described in the literature as a hotbed of smallpox 1. Further outbreaks are documented in 1902, 1911, throughout the 1920s, in 1938 with 53 notified cases and three deaths, in 1945 with 120 cases and 20 deaths, and in a devastating epidemic between 1956 and 1957 1.

A caution about the mortality figures. The 1938 and 1945 numbers are notifications to a colonial health department in a population that actively avoided that department, and the source states plainly that there is no substantive historical record confirming the severity of mortality by country or in Yoruba communities in particular 1. Colonial notification data undercount by an unknown and probably large factor. Treat these as indicating that outbreaks occurred, not as measures of their size.

No animal reservoir plus immunity after infection means smallpox in a given town burns through the susceptible population and then goes quiet until enough non-immune people accumulate. That periodicity is visible in the outbreak record above and it is the reason epidemics recur at roughly generational intervals.

What the Yoruba did about it

Four distinct responses are documented and they should not be run together.

Propitiation. Smallpox was understood as visited by Ṣọ̀pọ̀nnà, and the response included offerings, observances and the naming taboo. Among the Yoruba, in Benin and in Sudan the sickness was viewed as a punishment from a deity, and was treated first as a metaphysical rather than a bodily problem 1. Practically this meant a babaláwo might advise a client or family to hold a feast with animal and other offerings to appease Ṣọ̀pọ̀nnà, and people were free to consult a babaláwo for preventive medicine during a widespread epidemic 1.

Treatment of the sick. Ṣọ̀pọ̀nnà priests and oníṣègùn were the practitioners responsible for treating smallpox victims 1. Albert's account, as reported in the historical literature, is that the cultists had no specific medicine for smallpox: the patient was told not to eat chicken or to smell burning feathers, was constantly rubbed with palm oil, and the house was swept with a broom made from sida stems rather than the ordinary broom, with palm kernel oil and benniseed prohibited in the compound 12. A treatment recorded from Ìbàdàn and elsewhere before vaccination arrived was a mixture of juice from ìjọyún leaves with shea butter rubbed on the patient 1. Ewúro, Vernonia amygdalina, was drunk as an extract, usually with palm oil, in the belief that it prevented spread within the family 1.

None of these is a treatment for smallpox in any effective sense, and none should be presented as one.

A prophylactic practice with no mechanism. Tagìrì, Adenopus breviflorus, the Christmas melon, was positioned around the house to prevent infectious viral disease from spreading, and was placed at strategic points while an infected child was treated 1. There is no plausible mechanism by which a gourd placed around a house affects an airborne virus and no study has evaluated the claim.

The patient was not isolated. This is the striking one and it runs against what a modern reader expects. During the sickness the smallpox patient was not isolated or neglected by relatives; the belief was that the patient should be greeted with the honour due to a king 1. Because the affliction came from a deity, the sufferer was in some sense in the deity's hands and was treated accordingly. Burial of those who died was in the bush, conducted by the cultists 1.

The epidemiological consequence is obvious and should be stated. Honouring rather than isolating a smallpox case, in a compound of shared living space, is a highly efficient transmission arrangement. Whatever else the Yoruba response to smallpox achieved, it did not achieve containment, and the theological framing is the reason.

West African inoculation: what is actually established

Here the evidence is strong and it belongs to Africa without qualification.

The primary scholarship. Eugenia W. Herbert, "Smallpox inoculation in Africa," Journal of African History 16, no. 4 (October 1975), pp. 539-559, remains the standard survey 3. Its findings: the earliest known descriptions of the practice in sub-Saharan Africa come from African slaves in colonial America in the early and mid-eighteenth century; subsequent accounts come from widely scattered parts of the continent; and the practice appears to have been most extensively used in the Western and Central Sudan, Ethiopia and Southern Africa 3. Herbert discusses the infective materials, the techniques and the anatomical sites used, all of which varied between peoples 3. Nineteenth-century travellers including Heinrich Barth recorded it, and P. A. Talbot documented inoculation among the Yoruba of southern Nigeria 3.

What inoculation is. Variolation means transferring material from a person with smallpox to a person without it, in the expectation that the recipient contracts a mild case and acquires immunity 3. The technique documented for West Africa is specific: pricking a smallpox pustule, taking some of the pus, and placing it in an incision made on the recipient's arm or thigh 4. This is a real medical procedure with a real mechanism. Introducing variola through the skin rather than the respiratory route produces a much less severe illness with a case fatality on the order of one to two percent against twenty to thirty percent for naturally acquired smallpox, and confers full lifelong immunity.

The chronology and its significance. Recent archival work by Elise A. Mitchell has found accounts of the practice concentrated in the sub-Saharan regions that today include Senegal, Gambia, Guinea-Bissau, Guinea, Sierra Leone, Liberia, Côte d'Ivoire, Ghana, Togo, Benin and parts of Nigeria, and establishes that enslaved Africans were responsible for introducing inoculation throughout the Americas by the 1700s 4. The best-known instance is Onesimus, an enslaved man in Boston who described the practice to Cotton Mather; Mitchell's contribution is to show that Onesimus was not an isolated informant, since Mather's own writings refer to an "Army of Africans" in Boston who knew the practice 4. That is nearly a century before Jenner's cowpox vaccination of the 1790s 4.

Practitioners themselves claimed the practice predated the introduction of Islam and had been used in West Africa since time immemorial. That is a claim recorded from informants rather than an independently dated fact, and it should be labelled as such.

Stated exactly, then. West African inoculation knowledge is documented, its technique is known, its transmission to colonial America is established, and it predates European vaccination. Yoruba practice specifically is attested by Talbot 3. What is not established is how widespread it was among the Yoruba, when it began there, or who exactly performed it. The strong version of the claim, that the Ṣọ̀pọ̀nnà priesthood operated a systematic inoculation programme, is plausible and is not documented.

The Sapara case

Oguntọla Ṣapara was born Alexander Johnson Williams on 9 June 1861 in Freetown, Sierra Leone, to a liberated formerly enslaved father, and moved to Lagos in 1876 5. He trained in medicine and midwifery, was honoured at King's College London and became a Fellow of the Royal Institute of Public Health, Glasgow, in 1895, was appointed assistant colonial surgeon in 1896, and served 32 years as a colonial medical officer 5. In 1897 he was posted to Epe, a centre of smallpox activity 6.

What he reported. Observing that the usual preventive measures and vaccination were not working and that the Ṣọ̀pọ̀nnà priests were highly influential, Ṣapara joined the cult covertly 56. He reported that the priests were deliberately infecting people, using scrapings from the skin lesions of smallpox cases, or in one account inoculum from the remains of dead victims, to increase their power and income 56. He ran the priests out of Epe under threat of prosecution and reported to the colonial authorities 6.

What followed. Worship of Ṣọ̀pọ̀nnà was banned in 1907 67. Compulsory vaccination had been introduced by the British and French colonial authorities in 1905, and was reinforced in 1907 and 1909 by ordinances against the worship of Ṣọ̀pọ̀nnà and against infectious disease respectively 1. Ṣapara's 1909 report is credited with leading to the Witchcraft and Juju Ordinance, which penalised the rituals 56; sources differ on the date of that ordinance, with 1917 and Governor McCallum given in the microbiology literature 5 and 1907 and 1909 in the historical 1. This compiler has not resolved the discrepancy.

How to weigh the deliberate-spread charge

Six considerations, and they do not point the same way.

The mechanism is real. Applying material from a smallpox lesion to another person's skin is variolation. Ṣapara described a technique that exists, works, and was practised in the region 34. He was not describing something impossible.

But the same act has two descriptions. Scarifying someone with smallpox material is inoculation if the intent is protection and assault if the intent is infection. The physical act is identical. Ṣapara, an outsider trained in a system with no category for African preventive medicine, observed the act and supplied the second description. Whether the priests understood themselves to be protecting, punishing, transmitting the deity, or extorting is exactly what an infiltrator's report cannot establish, and it is the entire question.

The accusation was extremely convenient. A finding that a religious body was deliberately spreading a lethal epidemic supplied precisely the justification a colonial administration needed to criminalise a religion and compel vaccination. It was produced by an officer of that administration. This does not make it false. It does mean it warrants the scepticism due to any state's account of why it suppressed a religious body, and the scholarly literature on Ṣapara that this compiler located contains no revisionist analysis, no competing interpretation and no critical examination of the deliberate-spread narrative, presenting his findings as established fact 5.

There is independent Yoruba testimony to abuse. The historical literature, drawing on Albert, records that Ṣọ̀pọ̀nnà cultists inherited the property of deceased smallpox victims as of right and in some cases extorted further money from relatives under the pretence of cleansing rites 12. That this circulates as a complaint inside the Yoruba record, and not only in colonial sources, is evidence that the priesthood's conduct was regarded as abusive by Yoruba people too. It establishes financial predation on the bereaved. It does not establish deliberate infection.

The same source says they had no medicine. Albert's account, as reported, is that the cultists had no specific medicine for treating smallpox and confined themselves to dietary and household prohibitions and palm oil 1. That sits awkwardly with the picture of a priesthood in command of a sophisticated inoculation technology. Either the source is incomplete, or the priesthood's technical repertoire was smaller than the inoculation hypothesis requires. Both are possible and this compiler cannot choose between them.

The suppression destroyed the evidence. Because the cult was illegal for decades, it went underground and out of the ethnographic record. Anyone writing about Ṣọ̀pọ̀nnà works with a documentary record deliberately impoverished by law, and the material that would settle the question, an account of the priesthood's own practice in its own terms, is precisely the material the ban ensured was never collected.

The honest position. Variolation-like practice is attested in the region and among the Yoruba 3. The specific charge that the Ṣọ̀pọ̀nnà priesthood deliberately spread smallpox rests on one colonial-era report by a single infiltrator whose administration wanted the conclusion, has not been independently corroborated, and is probably now unanswerable. Financial exploitation of smallpox deaths is separately attested including from Yoruba sources. A reader should hold all of that rather than choosing the version that flatters or the version that condemns.

What the suppression cost

The ban's consequences are documented and they are not the ones its architects intended.

It did not stop the worship. Ṣọ̀pọ̀nnà worship continued in Ìjẹ̀bú and across southwestern Nigeria through the 1930s despite severe penalties, alongside 130 smallpox deaths in Ìjẹ̀bú alone between 1933 and 1934 8.

It did not produce acceptance of vaccination, and may have impeded it. This is the substantial finding. Only a few people in Lagos and Abẹ́òkúta showed interest in vaccination; they regarded it as offensive, poisonous and unhygienic and avoided the vaccinators 1. Vaccination was stigmatised as an element of colonial administration and alien rule 1. Men in particular resisted, and a belief spread that vaccination was for women and children 1. Resistance persisted for decades: apathy and hostility became more pronounced in the 1950s, and most people in Ìbàdàn avoided vaccination until a compulsion law was reintroduced in 1957, with some hiding their children 1.

The mechanism is worth naming because it recurs across public health history. Criminalising a religion in order to promote a vaccine attached the vaccine to the coercion. The colonial administration made vaccination a mark of subjugation, and people responded accordingly.

The colonial effort was itself thin. Vaccination was discontinued in 1915, not because of local resistance but because the colonial authorities failed to appoint more than a single doctor for the whole of Ìbàdàn between 1915 and 1924, and outbreaks became severe through the 1920s 1. The first infectious diseases hospital in Ìbàdàn opened in 1929 with capacity for about 30 patients, which was grossly inadequate for a major outbreak 1. A sanitary inspection regime produced its own abuse: patients hid rather than present, which created opportunities for sanitary inspectors to extort money, and attempts to compel patients to the hospital after extortion led to clashes, including an incident at Isale Ijebu in Ìbàdàn in 1949 1.

The concession the record forces. The colonial administration's health provision was not altruistic and the sources say so: medical intervention served the colonial interest because indigenous labour was essential to the colonial project and because Europeans had no immunity to local disease 1. And yet vaccination works and propitiation does not. Both propositions are true at once, and an account that suppresses either is propaganda in one direction or the other.

Eradication. The last naturally occurring case was diagnosed in October 1977 and the World Health Organization certified global eradication in 1980 1. Smallpox killed at least 300 million people in the twentieth century alone 1. The eradication campaign that finished it was built on ring vaccination and surveillance, and it succeeded in Nigeria as elsewhere.

An òrìṣà whose principal domain no longer exists is in an unusual position, and Ọbalúayé's continuing cult, treated in 06-orisa, has moved towards epidemic disease and skin affliction generally.