AP European History

## Learning Outcomes

- Explain how the decline of plague contributed to **18th-century** demographic growth
- Distinguish clearly between **plague control** and **smallpox prevention**
- Identify the roles of **quarantine**, **variolation**, and **vaccination**
- Recall key evidence including **Marseille 1720**, **Montagu 1721**, and **Jenner 1796**
- Analyse how medical and public-health change fits AP themes such as **individual and society** and **technological and scientific innovation**
- Use this topic in AP-style causation, comparison, and continuity-and-change answers

## AP European History Syllabus

For the AP European History, you are expected to understand changes in disease, mortality, and population in 18th-century Europe, with a focus on the following syllabus points:

- Know that plague largely receded from Europe by the **early to mid-18th century**
- Identify **quarantine** and related public-health controls as important responses to plague
- Understand that **smallpox inoculation** referred first to **variolation**, not vaccination
- Explain how **Lady Mary Wortley Montagu** helped publicize variolation in Britain in **1721–1722**
- Distinguish between **variolation** and **Edward Jenner’s vaccination of 1796**
- Understand how falling mortality contributed to **population growth**
- Explain how this topic shows both **continuity and change**: older quarantine systems continued while newer preventive medicine spread
- Avoid claiming that inoculation ended plague; it targeted **smallpox**

## Test Your Knowledge

_Attempt these questions before reading this article. If you find some difficult or cannot remember the answers, look more closely at that area during your revision._

1. Why did the decline of plague matter for European population growth?
2. What is the difference between **variolation** and **vaccination**?
3. How did **Lady Mary Wortley Montagu** contribute to the spread of inoculation?
4. Why is it wrong to say that inoculation ended plague in Europe?
5. What examples show the late survival of plague in Europe?

## Introduction

In AP European History, disease history matters because it helps explain bigger changes in society. If fewer people died from epidemic disease, more children survived, families became more stable, and Europe’s population could grow. That links this topic to **causation**, **continuity and change**, and the AP themes of **individual and society** and **technological and scientific innovation**.

This subtopic contains a distinction students often miss. The decline of **plague** and the spread of **inoculation** were both important, but they were not the same process. Plague receded mainly through containment and public-health measures such as quarantine. Inoculation, by contrast, was aimed chiefly at **smallpox**.

> **Key Term: mortality decline**
> A reduction in death rates over time, which helped drive European population growth in the 18th century.

### Why the decline of plague mattered

Europe had lived for centuries with recurrent plague outbreaks. These were not minor local illnesses. They could kill rapidly, create panic, disrupt trade, and weaken both towns and countryside. Even after the Black Death, later outbreaks remained a constant threat in European life. That meant plague was not just a medical problem; it was a demographic and social one.

When plague began to retreat from Europe, one result was fewer sudden mortality crises. This mattered because population growth does not require every year to be healthy; it requires fewer catastrophic collapses. If a region avoids major epidemic loss for a generation, more children survive to adulthood, more workers remain productive, and communities recover faster from food shortages or war.

A useful AP causation chain is:

- fewer plague outbreaks
- fewer mass deaths
- more stable communities
- lower mortality overall
- stronger population growth

This does not mean plague was the only reason Europe’s population grew. Better food supply and agricultural change also mattered. But if an exam asks you to rank causes of mortality decline, plague’s retreat was a major one.

> **Key Term: demographic growth**
> An increase in population size caused by factors such as falling death rates and improved survival.

Students also need to avoid overstatement. Historians do not agree on one single reason plague disappeared. Quarantine helped, but it was not a magical total solution. Changes in trade controls, local containment, and disease conditions all played a role. The safe AP answer is that plague declined through a mix of public-health controls and broader changes in Europe’s disease environment.

One important late example was the **Marseille outbreak of 1720–1722**, often treated as plague’s last major appearance in France. Another late example came in **Messina** in the early **1740s**. The exact year is sometimes given differently, but the exam-safe point is that major plague visitations in Europe had become rare by the mid-18th century.

> **Key Term: quarantine**
> The isolation of people, ships, or goods to prevent the spread of infectious disease.

### How quarantine and public health helped contain plague

European authorities had long used quarantine against plague, especially in port cities. The basic idea was simple: if disease entered through trade and travel, officials should delay entry, isolate the sick, and restrict movement. In practice, this meant watching ships, examining goods, shutting houses, and creating zones of separation.

The word **quarantine** itself came from the Italian expression for **forty days**, reflecting the period ships might be held before landing. That detail matters because it shows this was not a new Enlightenment invention. It was an older system that continued into the 18th century. This is a classic **continuity and change** point: old disease controls remained important even while new medical ideas emerged.

Officials also used related methods:

- port inspection
- isolation of infected houses
- limits on movement
- surveillance of suspected cases
- separation of goods thought to carry infection

The **Marseille plague of 1720** is useful here. It shows two things at once. First, plague had not vanished overnight. Second, public-health systems could fail if they were delayed or applied weakly. That makes Marseille a strong AP example because it shows complexity, not a simple triumph story.

Students often write that sanitation or immunity “ended plague.” That is too certain for this topic. The strongest answer is more careful: quarantine and public-health regulation probably reduced spread and helped protect regions, but no single explanation fully accounts for plague’s disappearance.

> **Test Tip:** In an SAQ or LEQ, score higher by making the distinction explicit: plague declined mainly through containment and public-health controls, while inoculation targeted smallpox.

Plague’s decline also had social effects. Fear did not vanish at once, but governments became more used to managing disease through administrative action. That helped prepare the ground for later modern public health. Even if early quarantine was imperfect, it trained states to collect information, regulate movement, and intervene during crises.

### Smallpox, variolation, and the spread of inoculation

Plague’s retreat was only one side of the story. Smallpox remained a major killer in the 18th century, especially among infants and children. Unlike plague, which struck in dramatic outbreaks, smallpox was a regular and widespread threat. It killed many and left survivors scarred or blind.

> **Key Term: smallpox**
> A highly infectious disease that caused high death rates and severe scarring, especially among children.

This is where **inoculation** enters the picture. In the early 18th-century European context, inoculation usually meant **variolation**.

> **Key Term: variolation**
> The deliberate use of material from a smallpox case to produce a usually milder infection and later immunity.

Variolation worked on a risky but rational idea. If a person received a controlled dose from a smallpox sore, they might develop a milder case and then become protected against future infection. Compared with catching natural smallpox, this could be safer. But it was still dangerous because it used actual smallpox matter. A variolated patient might become seriously ill or spread disease to others.

That is the key comparison students must know:

- **Variolation** used smallpox material and could spread smallpox
- **Vaccination** later used cowpox and was safer

The spread of variolation in Britain is closely linked to **Lady Mary Wortley Montagu**. After observing the practice in the **Ottoman Empire**, she helped introduce it into British discussion. In **1718**, she had her son inoculated there. In **1721**, she promoted the method in Britain and had her daughter inoculated in London.

> **Key Term: inoculation**
> The deliberate introduction of infectious material into the body to produce immunity; in the early 18th century, this usually meant variolation against smallpox.

Montagu matters for AP Euro because she represents **cross-cultural transfer of knowledge**. Europe did not invent every useful medical practice from scratch. An important preventive technique moved from Ottoman practice into British elite medicine. That fits broader AP themes about interaction between Europe and the wider world.

The **1721 British trials**, including tests on prisoners, helped increase acceptance among elites. This is also an Enlightenment point: supporters wanted observation and results, not just tradition. If inoculation worked in visible cases, more physicians and families could accept it.

Still, spread was gradual and uneven. It began mainly among elites because they had more access to doctors, money, and controlled settings. Over time, it moved more widely through parishes, local campaigns, and epidemic response, but students should not imagine universal adoption overnight.

> **Test Tip:** If a multiple-choice option says Montagu introduced “vaccination,” reject it. She promoted **variolation**, not Jenner’s later vaccine.

Why did variolation matter demographically? Because smallpox killed many children. If some communities reduced smallpox deaths, they improved survival rates and raised average life expectancy. But again, caution matters. Variolation was one factor among several. It did not single-handedly cause Europe’s population boom.

### From variolation to Jenner’s vaccination

By the late 18th century, a major shift occurred with **Edward Jenner’s** work in **1796**.

> **Key Term: vaccination**
> Protection against smallpox using cowpox rather than smallpox itself; Jenner’s method was first demonstrated in 1796.

Jenner observed that exposure to **cowpox** could protect against smallpox. This was a major improvement because it offered immunity without using live smallpox in the same direct way as variolation. That made the method safer and reduced the risk of causing new outbreaks.

The contrast is essential:

- **Variolation**: older, riskier, uses smallpox
- **Vaccination**: later, safer, uses cowpox
- **Chronology**: variolation spreads in Europe in the early and mid-18th century; vaccination begins in **1796**

Jenner’s breakthrough is highly testable because it sits at the end of the century and connects medicine, science, and population history. But students should avoid saying that Jenner immediately changed all European demography in the 1790s. The wider impact of vaccination came gradually, especially in the 19th century.

This topic therefore works well in a **continuity and change over time** structure:

- continuity: quarantine remained central in plague control
- change: new preventive medicine spread against smallpox
- further change: vaccination began replacing variolation at the century’s end

A strong LEQ sentence might say: the 18th century saw both continuity in older public-health systems such as quarantine and change in the use of preventive inoculation, first through risky variolation and later through Jenner’s safer vaccination.

## Key Point Checklist

_This article has covered the following key knowledge points:_

- Plague decline and smallpox inoculation were related to falling mortality but were not the same process
- Plague largely receded from Europe by the early to mid-18th century
- **Marseille 1720–1722** was a major late plague outbreak in France
- Major plague visitations in Europe had become rare by the **1740s**
- Quarantine was a major plague-control method, especially in ports and trade networks
- Historians do not explain plague’s disappearance with one single cause
- Smallpox remained a major killer in the 18th century, especially among children
- **Variolation** used smallpox material and could produce immunity, but it was risky
- **Lady Mary Wortley Montagu** helped publicize variolation in Britain in **1721–1722** after observing it in the Ottoman Empire
- **Edward Jenner’s vaccination** in **1796** used cowpox and was safer than variolation
- Declining mortality contributed to European population growth
- A key AP distinction is that inoculation targeted **smallpox**, not plague

## Key Terms and Concepts

- mortality decline
- demographic growth
- quarantine
- smallpox
- variolation
- inoculation
- vaccination


18th-Century Society and Demographics - Plague declined and inoculation spread