A Reign of Terror: Smallpox in Imperial China

For modern societies protected by vaccines, smallpox is a forgotten menace. Yet in the Qing Dynasty (1636-1912), this highly contagious disease struck terror into the hearts of emperors and commoners alike. Historical records reveal staggering mortality rates—50-60% of infected individuals succumbed to the virus. Unlike contemporary illnesses treatable with antibiotics, smallpox represented an existential threat that altered dynastic succession, reshaped court politics, and left permanent scars on survivors.

The Imperial Panic: Emperors Fleeing the Invisible Enemy

### Hong Taiji’s Extreme Precautions

The second Qing emperor Hong Taiji (r. 1626-1643) embodied this dread. Having never contracted smallpox—making him vulnerable “unexposed flesh” (生身) unlike immune “ripe flesh” (熟身) survivors—he developed elaborate avoidance strategies:

– Sacred Isolation: During outbreaks, Hong Taiji retreated to Shenyang’s Changning Temple, believing remote Buddhist sanctuaries offered protection
– Hunting as Public Health: His “hunting expeditions” to dense forests were often smallpox avoidance measures with minimal attendants
– Brutal Quarantines: Infected individuals were banished 100 li (31 miles), later reduced to 20 li (6 miles) after public outcry—a policy that frequently exiled misdiagnosed patients with mere rashes or fevers

### The Tragic Case of the Shunzhi Emperor

Hong Taiji’s son, the Shunzhi Emperor (r. 1643-1661), inherited this terror but met a grimmer fate. His extreme measures included:

– Abandoning Governance: During epidemics, he fled to Nanhaizi hunting park, delegating state affairs to ministers
– The “Three Prohibitions” Edict: In his final days infected with smallpox, he issued a desperate decree banning bean frying, lantern lighting, and water splashing—folk beliefs thought to aggravate the disease
– A Dynasty’s Turning Point: His death at 24 in 1661 precipitated the Kangxi Emperor’s succession under regents, altering Qing history

Stolen Futures: Smallpox as Dynastic Disruptor

### Lost Thrones

The virus repeatedly reshaped Qing succession:

– The Doomed Prince Rong (1657-1658): Beloved son of Consort Donggo, declared heir apparent at birth but dead from smallpox after 104 days
– Prince Yongcong (1746-1747): Second son of Empress Xiaoxianchun whose death precipitated her decline and passing

### The Tongzhi Emperor’s Aborted Reign

The 19-year-old Tongzhi Emperor’s (r. 1861-1875) brief personal rule ended abruptly when smallpox allowed his mother Empress Dowager Cixi to resume regency—extending her grip on power that would last decades.

Cultural Trauma and Medical Legacy

### The Psychological Shadow

Even battle-hardened warriors like Dorgon’s brother Dodo (Prince Yu) fell to smallpox at 36, creating pervasive dread. As Prince Haoge lamented before battle: “I’ve never had smallpox—this campaign bodes ill.”

### Empress Dowager Xiaozhuang’s Ordeal

Her 1657 smallpox infection became a political drama:

– Unwanted Caregiver: Her disliked daughter-in-law Consort Donggo nursed her despite mutual animosity
– Missed Reconciliation: The absent empress (Xiaozhuang’s niece) mirrored earlier neglect when she herself had smallpox
– Lifelong Consequences: Post-recovery skin conditions forced repeated hot spring treatments until her 1688 death

From Imperial Curse to Global Victory

The Qing experience mirrors smallpox’s global impact until its 1980 eradication. These stories remind us how disease transcends medicine—shaping politics, culture, and the very course of history. The terror that once emptied palaces now exists only in archives, a testament to one of humanity’s greatest public health triumphs.