A Lesson from the Kangxi Emperor for Robert Kennedy Jr.
In his resignation letter dated March 28, 2025, prior to lambasting FDA director Robert Kennedy Jr. for basing health policy on “misinformation and lies,” Dr. Peter Marks, the top vaccine official at the FDA, notes that in 1777, during the Revolutionary War, George Washington had “the courage and foresight to sign an order requiring inoculation of his troops against smallpox.”
“Subsequently, refinement of the smallpox vaccine combined with a widespread vaccination campaign resulted in the eradication of smallpox from the globe.”
I was struck by this passage, because I recently learned, while making my way through Geoffrey Parker’s magisterial Global Crisis: War, Climate Change & Catastrophe in the Seventeenth Century, that one of the way governments ended up responding to the nonstop turmoil of the 17th century was to institute various public health measures that vastly decreased the incidence of deadly plagues, going forward.
Quite possibly, the most influential and pioneering of such efforts was a smallpox inoculation campaign masterminded by the Qing dynasty’s Kangxi emperor, a figure who has been popping up quite frequently in this newsletter of late.
Smallpox had been endemic in China since ancient times, but the Manchus, descended as they were from nomadic tribes in a region where smallpox did not historically flourish, were particularly susceptible to the disease as they pursued thier conquest of China. Avoiding smallpox was just as crucial to longterm success as the logistics of supply or actual battle strategy, according to Chia-Feng Chang, in her article Disease and Its Impact on Politics, Diplomacy, and the Military: The Case of Smallpox and the Manchus (1613–1795).
Kangxi’s own father, the Shunzhi emperor, died of smallpox at 23, and a key reason Kangxi was chosen to succeed him was because he had already survived a mild case as a small child, and thus was deemed immune.
As emperor, Kangxi took smallpox extremely seriously. In Southern China, for at least 100 years prior to the Manchu invasion, Chinese healers “outside the orthodox tradition” had been experimenting with a technique in which children were purposely exposed to the smallpox virus as a preventative measure. “One favored method,” wrote Chang, “was to take the scabs from a child with a mild case of smallpox, to grind the scabs into powder, to mix the powder with water or wine, to use cotton balls to dip in the wet scabs, and to place cotton balls into the nasal passages.”
In medical history, this technique is known as “variolation,” but its close relationship to vaccination should be obvious. And it was successful enough to attract Kangxi’s attention. In 1681, Kangxi summoned two practitioners of the technique to “variolate” the royal family and the practice was subsequently extended to troops stationed in Manchuria and Mongolia. One group of researchers argues that smallpox variolation was responsible for a huge drop in child mortality among the Manchu nobility over the next century. Even more intriguingly, argues Parker, “from China, the technique spread slowly westwards to both the Ottoman and Mughal empires; and from there favorable reports reached western Europe.”
George Washington followed where Kangxi led. Such is progress.
Of course, right now, it is difficult to peruse news headlines and retain any sense that further “progress” is guaranteed. Instead, we are careening backward with astonishing velocity.
I have spent a lot of intellectual energy over the past six months acquainting myself with the disasters of the 17th century and I have to say, I found the journey oddly comforting. You think shit is bad now, well, just be happy you didn’t have to live through the Thirty Years War. But one of the key parts of Parker’s argument in General Crisis is that the catastrophes that afflicted nearly the entire globe in the 17th century, and which were in part due to circumstances out of human control (global cooling), led, ultimately, to a suite of progressive responses by both governments and individuals. Processes were set in motion that resulted in vast increases in health and prosperity for millions of people.
Today, as I watch stock markets across the world crumble because of the unilateral actions of the Trump administration, and I ponder what the likelihood is that Robert Kennedy Jr.’s FDA could cope with a bird flu epidemic in any kind of coherent or sane fashion, it is impossible to avoid the sense that we are sowing the seeds of our own general crisis, of our own free will.
Future historians will be baffled.