By Peter F. Stevens

The thought of it is terrifying. Soaring fever, grotesque pustules lacing the skin, and permanent scarring &emdash; all are the disease's "trademarks." Some victims do not live long enough to see those scars.

The illness is smallpox, and with so much talk of weapons of mass destruction filling television, radio, and newspapers these days, fears of biological and germ warfare have pealed through many Americans' thoughts. And why not? With reports of everything from Osama's alleged "germ cookbook" to Saddam's reported but as yet undiscovered stashes of lethal materials hitting the airwaves and front pages across the globe, terms such as anthrax, botulism, and smallpox have become all too familiar.

The inhabitants of 17th- and 18-century Dorchester would well have understood the current fears of one of those diseases &emdash; smallpox. Throughout the town's first 170 or so years, the malady raged on several occasions, people praying that the illness would either pass them by or that they would be cured, even if that cure meant severely scarred faces and bodies.

In an earlier column, this space briefly related the smallpox outbreak that hit Dorchester in 1690-91. James Blake, the chronicler of early Dorchester, wrote that "thirty-three persons died of small-pox, and twenty-four of fever" in that span. The worst outbreaks, however, were yet to come.

In 1721, smallpox erupted in Boston and soon spread across The Neck to Dorchester. Eighty-two people from Savin (Rocky) Hill to the Neponset came down with the disease; their families desperately tried to tamp down the high fever with cold cloths and even immersion in cold water. Many locals desperately pondered a radical treatment that Boston Dr. Zabdiel Boylston was offering to those brave enough. The procedure was inoculation.

A historian writes: "Dorchester did not escape the small-pox pestilence which visited Boston in 1721....It was during this period that inoculation was introduced in to the vicinity of Boston by Dr. Zabdiel Boylston. The process had not been previously tried in any of the other colonies, and it occasioned great excitement.

"The physicians and most of the clergy were bitterly opposed to the innovation, but, strange to say, Cotton Mather had faith in its efficacy from the start."

Mather's fellow clerics railed against inoculation as an act against God and Nature, some even decrying it as a "tool of the Devil."

An 18th-century woman described the process, which was also called "variolation": The doctor arrives with a vial "full of the matter of the best sort of small pox, and asks what vein you please to have opened. He immediately rips open that you offer...with a large needle (which gives you no more pain than a common scratch), and puts into the vein as much matter as can lie upon the head of the needle, and after that, binds up the little wound."

As the smallpox epidemic spawned at least 5,889 cases throughout the region and the death toll would swell to 844, Mather and others turned to Dr. Boylston. Boylston's experiments had been prompted in large part by Mather, whose slave Onesimus reportedly "described to Mather how African tribesman would develop immunities to smallpox after having been deliberately infected with a dose of the disease. At Mather's urging, Dr. Boylston first inoculated his son Thomas and two slaves."

When all three recovered from the illness, Mather stepped up his appeal for widespread use of the inoculation treatment, and Boylston treated at least 286 with inoculation. His colleague Dr. William Douglas lambasted the inoculations, which, he charged, were responsible for spreading the disease to healthy people opting for the treatment. After only a month of the practice, Boylston was forbidden by the Selectmen of Boston to administer any more inoculations.

Of the 286 cases Boylston treated with the controversial doses, only six people died. The practice had saved a number of lives in Dorchester.

In January 1764, smallpox appeared again in Boston, and this time, many people in Dorchester and environs went to local physicians for the inoculation, which was a personal "choice" by that time. The outbreak was not as severe as that of 1721.

The American Revolution broke out in 1775, and as George Washington's troops gathered and encamped outside British-held Boston, including Dorchester, smallpox raced through the fetid and crowded camps in 1776. By that year, a Dorchester census showed that 291 families and 1550 persons lived "within the limits" of the town. The locals were justifiably worried that the latest appearance of smallpox would spread to their community.

In a step that would have stunned the residents in 1721, Dorchester's Town Meeting ordered that a general inoculation to prevent small-pox: "Certain houses of the inhabitants were selected for hospitals, and all persons who desired to be inoculated were to present themselves at one of the places designated. Dr. Phineas Holden was in charge of the patients. Dr. Holden was a son of Dr. William Holden, who began business in Dorchester soon after the death of Dr. Elijah Dunforth. He continued his practice in the town until his death in 1819."

The mass inoculation helped quell the outbreak, but did not eradicate it. Smallpox was back in May 1778, as evidenced by two journal entries of the day:

* "1778, May 14. Mr. John Minot Enoculated his family with the small pox much against the minds of his neighbours."

* "1778, May 31. There was near a hundred prayed for this day under the operation of the small pox in Dorchester."

Smallpox inoculation remained the most-used treatment in Dorchester and elsewhere until Edward Jenner popularized vaccination in the 1790s.

(Peter F. Stevens's latest book, The Voyage of the Catalpa: A Perilous Journey and Six Irish Rebels' Escape to Freedom, Carroll & Graf Publishing, is available at fine bookstores everywhere and at amazon.com and barnesandnoble.com)