National Library of  Medicine
National Library of Medicine
Variolation was successfully used in Charleston during the 1738 smallpox outbreak by Dr. James Kilpatrick. Of 441 persons inoculated, 15 died. The death toll was much heavier among those who were naturally infected, so the results of variolation were seen as encouraging.  In September, 1738, the general assembly was called into session to deal with the outbreak. By the end of September, the death toll was 295 of 1,675 reported cases.  Charleston had fewer than 5,000 residents.
The disease had a devastating impact on Indian communities, as it spread rapidly in a population with no immunity.  The Cherokees lost half their numbers during the 1738 epidemic.
John Duffy. (1953) Epidemics in Colonial America.  Louisiana State University Press