Pursuing protection from disease: the making of smallpox prophylactic practice in colonial Punjab.

SUMMARY: Focusing on colonial Punjab, this article explores how agrarian lower-class families' pursuit of safe and effective protection from smallpox shaped the region's prophylactic practices during the late nineteenth and early twentieth centuries. Specifically, the article explains shifts from variolation in conjunction with Sitala (smallpox goddess) worship to vaccination in conjunction with Sitala worship; from vaccination with crusts to vaccination with human and animal lymph; and from vaccination with fresh lymph to vaccination with tubed lymph. The article also illustrates how, regardless of the particular technologies employed at any given point in time, the demand for, and efficacy of, vaccination varied with seasonal fluctuations in labor and disease. More broadly, this article challenges the assumptions of elite agency and linear cultural change that animate national and global histories of vaccination by demonstrating the importance of regional socio-environmental factors and the creative, productive agency of the agrarian lower classes.