Before vaccines, smallpox management relied mainly on isolation, herbal remedies, and supportive care. Patients were quarantined to prevent spread, while healers used cooling herbs, milk baths, or rosewater to ease fever and skin irritation. In some regions, methods like “variolation” — deliberately infecting a person with a mild form of the virus — were practiced to build immunity, though it carried serious risks. Most remedies offered only limited relief, as the disease’s viral nature was not understood. While these early measures slightly reduced transmission, they were largely ineffective in preventing deaths until vaccination emerged in the late 18th century.