Reports of the immensity of the horror on the Upper Missouri soon began to trickle eastward. William Fulkerson, who oversaw local Indian affairs from his base at Fort Clark, wrote to the explorer William Clark, at the time Indian superintendent in St. Louis, that “the small pox has broke out in this country and is sweeping all before it—unless it be checked in its mad career I would not be surprised if it wiped the Mandans and Rickaree [Arikara] tribes clean from the face of the earth.”
Clark forwarded Fulkerson’s letter to his superiors at the War Department back in Washington, D.C. But most of the federal government appeared to shrug off the impending disaster, following a familiar pattern: five years earlier, Secretary of War Lewis Cass had cut off funding of a vaccination program for the Indians in the Upper Missouri, apparently not wishing the doctors to proceed as far upriver as the pro-British Blackfeet. The powerful Chouteau family, which controlled fur trade on the Missouri, had likewise blocked a vaccination program because it would have delayed Indian hunting parties from leaving for their profitable trips to the high plains.
But this time, in the face of widespread administrative indifference, one U.S. official finally decided to take action. Joshua Pilcher, a 47-year-old Virginian, had just been appointed to take charge of the Sioux Agency at Fort Kiowa, north of today’s Chamberlain, South Dakota. Traveling to his new post on board the St. Petersduring its fateful trip, Pilcher had observed the disease spreading among passengers on the ship before he disembarked at his post, downriver from FortClark. Quickly realizing the nature of the unfolding calamity, Pilcher sent out messengers from FortKiowa to warn the nomadic Lakota and Nakota Sioux still hunting on the plains to stay away from the river in order to avoid contagion.
By the time he returned to St. Louis that winter, Pilcher had pieced together the first overall estimate of the extent of the tragedy. In just seven months since the first death, the Mandan had been reduced from 1,600 people “to thirty-one persons,” he wrote to Clark in February 1838. (Scholars now believe that there were 100 to 200 actual survivors.) Half of the Hidatsa had died, as had half of the Arikara. “The great band of [Assiniboine], say ten thousand strong, and the Crees numbering about three thousand have been almost annihilated. . . . The disease had reached the Blackfeet of the Rocky Mountains. . . . All the Indians on the Columbia River as far as the Pacific Ocean will share the fate of those before alluded to.” In short, Pilcher told Clark, the Great Plains were being “literally depopulated and converted into one great grave yard.”
But what to do? Pilcher reasoned that it was not too late to save the bands of nomadic Sioux whom he had warned away from “the fatal destroyer” over the summer—and were still on the plains. He proposed going upriver with a doctor and $2,000 in presents. They would try to locate the Sioux and persuade them to accept vaccination with the milder form of variola called cowpox. This vaccine, developed by the Englishman Edward Jenner in the 1790s, had proved so effective that Jefferson had urged Lewis and Clark to carry it with them on their historic expedition. (Their supply was damaged in transit and never used.)
As Pilcher observed, “It is a very delicate experiment among those wild Indians, because death from any other cause, while under the influence of vaccination, would be attributed to that and no other cause.” Nevertheless, he wrote to Clark, “If furnished with the means, I will cheerfully risk an experiment which may preserve the lives of fifteen or twenty thousand Indians.”
It was a bold and seemingly quixotic undertaking. The Indians were profoundly embittered toward the white traders who had inflicted the malady upon them, and some sought revenge. Chardon himself received several death threats and narrowly escaped an assassination attempt at FortClark. In a speech found among Chardon’s papers— the authenticity of which is doubted by some scholars—the dying Mandan chief Four Bears denounced the whites as “a set of Black harted Dogs, they have deceived Me, them that I always considered as Brothers, has turned Out to be My Worst enemies.” Four Bears allegedly went on to say that “my face is so rotten” that “even the Wolves will shrink in horror at seeing me,” and urged his warriors to “rise all together and Not leave one of them alive.”
The War Department, feeling pressure from church groups to take action to relieve the Indians’ suffering, approved Pilcher’s plan. But the agent needed to locate a doctor willing to enter the dangerous borderlands on the Middle and Upper Missouri, at a wage of $6 a day, to vaccinate the Indians. Who would risk such a perilous trip?
Pilcher would find his man in an unlikely spot: the roughhouse streets and saloons of St. Louis. Dr. Joseph DePrefontaine, who was apparently having little success in medicine, had started a new career in theatrical management—and had become notorious for his barroom carousing. In March 1838, DePrefontaine had been ordered out of his employer’s theater for rolling on the floor and singing during a performance of Hamlet. Undeterred, DePrefontaine took his revenge by writing newspaper articles attacking the theater.
Swallowing whatever doubts he may have harbored, and with no other applicants breaking down his door, Pilcher hired DePrefontaine. By April 1838, ten months after smallpox first hit the Mandan, the two men were ready to head up the Missouri to look for Sioux. At the St. Louis levee, they boarded the steamboat Antelope and proceeded upriver, making the usual stops at FortLeavenworth and the Black Snake Hills near present-day St. Joseph, Missouri.