In 1803, the Spanish government began a campaign to vaccinate everyone in all its Spanish territories. The story of the Royal Philanthropic Vaccine Expedition (the so-called Balmis Expedition), is well known as one the first large-scale international public health initiatives. By 1806, many hundreds of thousands had been vaccinated, from the Viceroyalty of Peru to China and the Philippines. The epidemic resurged in Spain over the next decade, and fresh mandates were issued, including ours, in 1818, ordering all children three months of age or older to be vaccinated. The preamble to the mandate suggests that the lower classes are inherently less caring for their children and therefore bear more responsibility for the spread of the disease. The mandate comprises seven articles; we summarize below.
1. All children of both sexes are to be vaccinated at three months of age. The parents or guardians of children whose constitutions are too weak to receive a vaccine must provide evidence to this effect from their doctors and submit it to the Board of Health.
2. Those who do not vaccinate their children or wards as per the first article are subject to fines.
3. Any child who contracts smallpox shall be quarantined in a room in their own home and cared for by someone who has been vaccinated or has already had the disease. If the child should die, the room will be chemically fumigated and sealed off. Those who contravene this article shall be fined.
4. Anyone twelve or older who contracts smallpox and cannot be cared for at home shall be transferred to a lazaretto (smallpox hospital) until they recover, and may not leave until a doctor permits it. When transfer to a lazaretto is not possible, Article 3 will be in force. When quarantine at home is not possible, quarantine at an available (general) hospital will be enforced. Those who contravene this article shall be fined.
5. Fines collected will be used to defray public health costs related to smallpox, to promote the vaccine, to pay for the cost incurred by members of the indigent population who contract smallpox, and to reward whistleblowers who reveal persons who are concealing the infected.
6. If doctors or those in the medical establishment conceal or do not report instances of the illness, they will be subject to higher fines.
7. The mandate does not supersede or abrogate laws already in place.
The mandate (legally an edict) was signed by Francisco Javier Castaños Aragorri Urioste y Olavide, the 1st Duke of Bailén. Castaños, who later distinguished himself in the Napoleanic campaigns and then served as the first president of the House of Peers in Spain. Castaños is adamant in his goal of exterminating smallpox, and is clear that he will punish those who stand in the way:
Cometo al zelo de las Juntas de Sanidad y Justicias el exacto cumplimiento de cuanto contienen los articulos que anteceden esperando que lo desplegaran ahora y en lo sucesivo, hasta conseguir el total exterminio de las viruelas, que por necesidad debe ser infalible, si el escarmiento reprime á los preocupados, y la persuasion convence a los que miran con indiferencia sus mismos hijos y el interes general de sus conciudadanos. Y para que llegue noticia y nadie pueda escusarse con la ignorancia , he mandado expedir el presente Edicto firmado de mi mano y refrendado por el Secretario de S. M. y de esta Capitania General. Barcelona 23 de Mayo de 1818.
A most forceful document, written with direct plainness for the benefit of the populace, and intended to be posted in public places in Spain and the colonies.
Broadside, 425 x 294 mm. Central vertical and horizontal creases from having been folded in quarters and stored. Small hole, affecting a letter but not sense or legibility; four other small holes, all marginal, not touching text. A well preserved copy.
One copy listed in OCLC, but no associated library listed. Not in BNE. No digitized or microform surrogate known. Full text of mandate available upon request.