Usage Instructions

To play Pox in the City, please download the file by clicking 'download' in the upper right. Supporting information about the project is shown below.

Creative Commons License

Creative Commons Attribution 3.0 License
This work is licensed under a Creative Commons Attribution 3.0 License.

Document Type

Multimedia Submission

Multimedia Category

Games & Other Interactive Multimedia


Pox in the City is a prototype of a social history game that focuses on the medical profession circa 1800 in Edinburgh. The prototype was research, designed and developed on a small budget (about $17,000) and in a short time frame (20 weeks). The experimental design goal was to create a narrative driven educational game that was engaging and delivered some basic educational goals to be used in the high school and college level classrooms. To experiment with writing historic game narrative and to stay within budget, the design was built around a point and click adventure framework. Narrative was expressed through character dialogue, quest and journal text, graphic elements and additional text elements like notes, menus, etc. Activities consist of environmental puzzles and minigames. Players have some agency as their actions in the game will lead to one of three final outcomes. Player freedom was limited, as the quests were chained with only one active quest available at a time.

Writing engaging historic game narratives and balancing educational goals is difficult. Preliminary results from classroom testing indicate that the game is engaging within this context. [1] The effectiveness at reaching educational goals has not as yet been assessed.

Walk through initial quests:

Begin the game and play through until you arrive in your office.

First Quest: Clean your office (paper goes in the fire, book in the bookcase, read the letter)

Next, click on the map and travel to the Grassmarket. You must recreate Jenner’s initial experiment:

  • Talk to the farmer.
  • You must convince him to give you cowpox material by first buying some cheese from him.
  • Remember to click Robertson at the end to finish the conversation
  • This has now unlocked the laborer conversation.
  • Convince the laborer to let his son be your text subject.
  • When successful, the lad will be in your office when you return.
  • Remember to check journal for current and past quests!

Multimedia Information:


RIT: Elizabeth Goins, Lisa Hermsen, Dave Simkins, Jason Ferraira, Graham Berger, Jon Dymock.

NEH project: Lisa Rosner, Laura Zucconi, Ethan Watrall

Media format: Flash

Development level: Prototype

Educational goals/outcomes:

Educational Goal: Communicating the three body problem in the history of medicine: interactions between the patient, healer and disease.

Educational Outcomes:

Comprehension (see Appendix 1 for details):

Players will be able to summarize the early history of smallpox inoculation.

  1. Players will be able to explain the response of the medical community to Jenner’s methods.

Players will be able to summarize a range of patients’ responses to the new vaccine, and explain its connection to social/economic/geographic.

  1. Players will be able to explain Jenner’s innovation.
  2. Players will be able to describe/summarize/explain the reasons why a doctor would want to establish a vaccine dispensary in 19th century Edinburgh, and the steps he might take, from a social/economic/geographic perspective
  3. Players will be able to explain the variables involved in the patients’ perspective towards medicine and their impact on the decision to seek treatment in the 19th century Edinburgh. See Appendix 2


  1. Players will be able to apply three body interactions to a 19th century case study of smallpox vaccination.
  2. Players will learn how to apply historic information from primary sources.


  1. Players will be able to examine and compare in order to successfully complete the game:
    • opportunities afforded early 19th doctors by the new vaccine
    • Variables influencing patients’ perspectives toward medicine.
      • Social
      • economic
      • educational


  1. Players will be able to assess and choose conditions/variables of the three body problem in order to make successful game strategy/decisions.

Target Demographic

  • Formal education: High school and post-secondary school students
  • Informal education: General public/outreach

Experimental Goals and Outcomes

Narrative driven educational history game

  1. Can we make an engaging narrative driven game?
  2. How effective is branching narrative with multiple outcomes?
  3. How do we integrate game mechanics, primary source documents and dialogue centered narrative to express the interaction between doctor-patient-disease.


Pox and the City lets players step into the role of a young medical doctor circa 1800 Edinburgh, Scotland. Players engage in quests that guide them through the growth of a practice and the establishment of a dispensary. Different paths open up to players based on the decisions made during the game resulting in different quest lines and social interactions depending on the player’s choices. Actions also build philanthropy or entrepreneurial points which will affect the type of doctor the player turns out to be in the end.

Original artifacts included in the game are medical text excerpts and synopses, Jenner’s notes on his original experiments, and a map of Edinburgh from about 1820. This prototype was designed and developed in 20 weeks over the fall and winter quarter at the Rochester Institute of Technology by undergraduate students and faculty. The game takes most players about an hour to complete.

Initial testing has shown that the gameplay is engaging to most players, in an educational setting. Current work needs to assess the effectiveness of the game at achieving educational outcomes and ways to improve game narrative, dialogue and mechanics.

Copyright Information: NEH funded project, in the public domain


[1] L. Rosner, “A Digital Role-Playing Game for the History of Medicine,” ODH, Final Performance Report, Sept. 2013.