The history and traditional treatment of smallpox in Ethiopia.

SMALLPOX, which has a very long history in Ethiopia, was the most serious of the epidemics from which the country suffered in the past; it was moreover one of the diseases for which society evolved some of its most remarkable traditional cures, as well as being perhaps the first malady to be brought largely under control by the introduction of modern medical practices. Smallpox is thought to have been native to Ethiopia and adjacent countries of the Nile,' and is known to have existed in the area for around a millenium and a half. According to one Arab tradition the disease was first brought to Arabia from Ethiopia by the Aksumite soldiers around 370 A.D.2 while the Koran records that another smallpox epidemic broke out among the Aksumite troops in Arabia two centuries later in 570 or 57i.3 Ethiopian records of the Middle Ages are not sufficiently precise to enable us to trace the various smallpox epidemics which undoubtedly occurred in that period. The royal chronicles mention frequent outbreaks of one kind or another, but seldom indicate the nature of the disease.4 The chronicler of Zara Yaqob (1434-I468), for example, describes the outbreak of an epidemic of some sort which may well have been smallpox though this is not stated. He says that so many people died at the capital, Debra Berhan, that 'no one was left to bury the dead'. The pious king thereupon built a church, Beta Qirqos, as it was said there would be no plague, drought or death near a shrine. The chronicle goes on to claim that the erection of this church drove the disease from the palace. Zara Yaqob then ordered his subjects to assemble with sticks, branches and holy water with which to bury the dead. He called these bands of grave diggers Congregations of the Gospel, and the branches sticks of Moses, and to ensure obedience he ordered his chiefs to pillage the houses and seize the goods of anyone who failed to obey his commands.5 It was in all probability this epidemic which was referred to by the Arab historian Maqzizi who stated that it took place in 1435-6 and left Ethiopia almost empty of inhabitants.6 A later epidemic which broke out in Harar around 1567, killing large numbers of people including the Emir, Nur bin Mujahid, may also have been smallpox, but like so many other outbreaks this cannot be established from the meagre historical records of the time.7 The character of many later epidemics can, however, be clearly established. Bruce, the Scottish traveller and historian, for example, says that a very severe epidemic of smallpox occurred during the reign of Iyasu I (I682-I706) and that it raged among the Gallas 'with such violence that whole provinces . . . became half desert.'8 Later chronicles tell of a violent attack of smallpox in I718 in which many nobles died,9 and another outbreak in 1768 which