Smallpox is one of the most dangerous and contagious diseases that have killed many people throughout history. Attempts to prevent and treat the disease have always been a concern of physicians and some government officials. In the Qajar era, attempts were made for a modern-style inoculation, but it failed because of its incompatibility with the culture and beliefs of the community and the fundamentals of traditional medicine. In the first Pahlavi period, despite the adoption of laws on free, public and compulsory inoculation, there were no desired results due to some problems. The present study seeks to study the obstacles and problems of inoculation in Iran during the first Pahlavi era and the government's actions with a focus on Isfahan city and its functions using descriptive-analytical method. It also seeks to answer the question of what caused failure of the government to cope with smallpox despite considerable efforts? The results of this study show that although the government's measures to enact free and compulsory public inoculation laws, employing inoculation doctors and threatening and penalizing offenders reduced the number of smallpox patients in Isfahan, however, there were problems such as the unawareness of the people and their refusal to inoculate, the lack of cooperation of several villages’ headman with the inoculation officers, the violation and negligence of some inoculation, and the lack of sufficient funds and health facilities. These problems made smallpox disease still prevalent and caused children’s mortality.
