Between 1775 and 1782 (the years of the American Revolution) a smallpox epidemic spread across North America. By 1782, the disease had reached the villages of the Mandans and Hidatsas. The death rate was very high. The Dakotas attacked the weakened Mandan villages including On-a-slant village (today the villiage is in Fort Lincoln State Park) and Double Ditch village. By 1790, the survivors (of both disease and war) left the Heart River area and moved north to establish villages near Painted Woods Creek and at the mouth of the Knife River. The Mandans who had once occupied six large villages now lived in two small villages. There were only two remaining Hidatsa villages and another village where both Mandans and Hidatsas lived. The populations of the two tribes had been reduced by 75 percent. The Mandans and Hidatsas also suffered cultural losses because of the smallpox outbreaks. The Mandan villages had always shared some common cultural traits, but each village had a slightly different language. As the survivors were forced to move together for security, the differences disappeared. There were similar cultural losses for the Hidatsas. The Arikaras who lived farther south along the Missouri River also experienced the smallpox epidemic. By 1790, the Arikaras had been reduced from a large population living in 32 villages to a group that occupied two villages. Only 500 men of military age remained of the 4,000 Arikara warriors who had protected their villages in previous decades. In 1801, smallpox struck the people of the northern Great Plains again. This time, the epidemic killed fewer people. It is possible that the survivors of the 1782 epidemic were still immune to the virus this time. In 1830, the Army identified smallpox as a dangerous disease at Indian agencies on the lower Missouri River (in modern-day Missouri, Kansas, and Nebraska). The Secretary of War, L. G. Randolph, authorized Indian agents to hire doctors to vaccinate American Indians living at the agencies. However, these agents were not ordered to vaccinate Indians. Many mothers feared the vaccine. They had seen many babies become sick because doctors did not use sterile procedures (which were unknown at the time). Sometimes vaccine was not effective and the children became sick anyway. For a variety of reasons, the Army’s vaccination campaign did little to stop smallpox epidemics among the Indians of the frontier. Indian agents on the frontier were concerned about smallpox. Non-Indian settlers were approaching the lands where the tribes lived. Disease was spreading and the agents begged the Office of Indian Affairs (part of the War Department) to provide vaccine for Indians. Finally, in 1832, Congress passed the Indian Vaccination Act. The bill appropriated $12,000 to purchase vaccine and hire doctors to vaccinate Indians. Exactly which tribes would be vaccinated was not specified in the bill. Secretary of War Lewis Cass, who administered the program, decided that the vaccination program would be extended to tribes that were friendly to the United States, those with important economic roles, and those tribes (Cherokee, Choctaw, Chickasaw, Creek, and Seminole) that were being forced out of southern states to relocation sites in the West. Cass specifically excluded the Mandans, Hidatsas, and Arikaras (along with other tribes living farther up the river) from the vaccination program. Cass believed the fur trade on the Upper Missouri River was no longer economically important. He also stated that the treaties that all three tribes signed in 1825 identified them as hostile towards the U. S. and its citizens. (See Document 1.) Other tribes, including the Teton Sioux (Lakotas) did not have such statements in their treaties. Cass excluded the Upper Missouri tribes from vaccination because he considered them to be far removed (both geographically and socially) from “civilized man.”