Once past Council Bluffs, in what is now Iowa, Pilcher and DePrefontaine prepared to face tribes angry at whites and suspicious of vaccinations. Instead, they were astonished to find that the Indians had not only lost their fear of vaccinations but were eagerly seeking them. The two men stopped to vaccinate the Oto, Omaha and Santee Sioux. Just below the Sioux Agency at the mouth of the White River, they found “three or four thousand” Sioux who had gathered for the annual distribution of presents and annuities mandated by the Indians’ treaties with the U.S. government. “Having explained to the Indians the object of the physician, he commenced vaccinating,” Pilcher reported later in a letter to Clark. DePrefontaine soon found himself so inundated by “the mass of men, women and children that crowded around me” that he gave up any effort “to keep an account of ages, sexes, etc.” Working rapidly, he ran out of the vaccine supplied by the War Department and was forced to acquire more on his own, presumably from traders.
After the food and supplies were distributed to the hungry tribes, the Indians quickly departed, Pilcher wrote, like “a flock of Crows rising from a dead carcass—they are suddenly gone, and in a few hours are spread over the Country in every direction, in numerous small bands.” The two men continued upriver, vaccinating isolated bands of Yankton, Oglala and Saone. By the time the Antelope reached FortPierre, 1,500 miles above St. Louis, DePrefontaine estimated he had given 3,000 vaccinations, though Pilcher believed the actual total was far larger.
But DePrefontaine had not yet located several large bands of nomadic Lakota still hunting somewhere in the vast plains between the Missouri River and Rocky Mountains. Pilcher furnished him with more vaccine and sent him overland on horseback. His instructions were to find the Sioux, or to return to FortPierre in three weeks.
Unfortunately, the mission was only a partial success. De- Prefontaine himself fell ill from an unnamed malady “in the Prairies and was not so successful in finding the Indians as I anticipated,” Pilcher reported. Still, DePrefontaine located “several small bands, and operated on all that he found.”
A few months later, Pilcher was able to tell his superiors that the epidemic had finally subsided. He returned to St. Louis and eventually went on to serve as Clark’s replacement as superintendent of Indians. DePrefontaine continued to vaccinate tribes on the Missouri for at least two more years. But as often on the frontier, there was a fine line between humanitarian and rogue. In the 1840s, the mercurial doctor was identified as a member of a gang that robbed and murdered a Spanish merchant on the Santa Fe Trail. He later was reported to have been involved in an attempt to assassinate Frank P. Blair Jr., a prominent antislavery activist and future U.S. senator.
Pilcher and DePrefontaine may well have felt that their efforts did not make much difference in the end. The vaccination campaign saved thousands of lives—but as many as 20,000 Indians had perished across the high plains. Ninety percent of the Mandan died. “In human terms, their culture was massively impoverished,” says anthropologist W. Raymond Wood. “The epidemic ravaged their economy, their arts, their social systems and their kinship systems.” And the epidemic had a monumental effect on the destiny of the West: “By reducing the number of Native Americans,” Wood says, “it made settlement simpler for whites.”
While many Native Americans today are descended in part from the Mandan, there are no full-blooded Mandan left. Only a handful of teachers still know the Mandan language. “When those people leave us, they are going to take the language with them,” says Amy Mossett, a Mandan-Hidatsa educator and interpreter of the life of Sacagawea, the famed Indian woman who helped guide Lewis and Clark. Mossett lives in North Dakota, not far from the site of the old FortClark and Four Bears’ village. “I go out to that site every now and then,” she says. “It’s usually real quiet, and I remember one July walking through the depressions left by earth lodges that stood there. It was searing hot, and I could see the heat waves dancing on the prairie. I remember wondering if our ancestors saw those heat waves before they slipped into delirium, then death.” Now, she says, “for our people this is hallowed ground, a sacred spot. We must treat it with reverence.”
This month marks the 25th anniversary of the World Health Organization’s official declaration of the elimination of smallpox from the earth. It’s been even longer, since 1949, that a single case was reported in the United States. But the variola virus itself still exists in the form of samples retained for research in Siberia and at the Centers for Disease Control and Prevention in Atlanta—leading scientists and homeland security officials to raise the specter of other samples potentially finding their way into the hands of bioterrorists. If that were to happen, the human population would be susceptible to a resurgence of smallpox. Without acquired immunities or widespread vaccinations, “to some extent we’re in the same boat Native Americans were in before 1492,” points out DukeUniversity professor Elizabeth Fenn, author of Pox Americana, a history of the disease. “We’re approaching 100 percent vulnerability.”