Volume 2

Reports of the Royal Commission appointed to inquire into the subject of Vaccination; with minutes of evidence and appendices / Vaccination Commission.

  • Great Britain. Royal Commission on Vaccination.
Date:
1889-1897
Catalogue details

Licence: Public Domain Mark

Credit: Reports of the Royal Commission appointed to inquire into the subject of Vaccination; with minutes of evidence and appendices / Vaccination Commission. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    585/798 (page 13)
    50. In one respect tlie provinces diflfered from the metropolis. In London, as we have seen, small-pox was always present during the eighteenth century ; though in some years the deaths from small-pox were more numerous than in others, a large number died every year; even in the years quoted above as yielding the lowest returns, the yearly number of deaths is still considerable. In the provinces, as is shown by records and numerous incidental statements, the disease had a more distinctly epidemic character, especially in towns other than the great cities and in rural districts. Thus in the small parish of Kilmarnock the records show that the small-pox q_ 24,823 was severe every few years, between which there were no deaths at all from 24,979. small-pox or very few only. Hence we may conclude that though in the districts where for one reason or another epidemics did not make their appearance, as in the Kentish rural parishes, the mortality from small-pox was low, yet where epidemics did make their way the prevalence of small-pox was great and the mortality from it high, comparable indeed with that of London, 51. Records exist of the deaths from small-pox in the times previous to the nineteenth century in countries other than England. Thus, in Sweden records from 6, App. 752 1774 to the end of the century (and beyond) give both the population and the deaths l, App. 112. from small-pox. (The records go back to 1749, but up to 1774 the deaths from small-pox and measles were not distinguished.) These show great variations in the yearly mortality from small-pox. In some (epidemic) years, the mortality was very great, greater even than that of London, as calculated from the Bills of Mortality in the manner described above ; on the other hand in many years the mortality was much lower than that ever reached in London during the same period. In Sweden as a whole, as in the provinces of England, the disease had a very marked epidemic character. Similar records relating to Copenhagen and Greneva, the last reaching back ^ jq^ to 1580, and other places, all confirm the conclusion as to the great prevalence of, and. high mortality from, small-pox in Western Europe during the eighteenth century and earlier. 52. But perhaps the most striking evidence in favour of this conclusion is to be seen in the fact that the chance of taking the disease and of dying from it was made the subject of mathematical treatment by distinguished mathematicians of the time. Thus Daniel Bernouilli, writing in 1760-5, takes as one of the bases of his calculation the datum (arrived at by means of various records in various places) that small-pox carries ofi' the thirteenth or fourteenth part of each generation ; or in other words, that the deaths from small-pox are about one-thirteenth or one-fourteenth of the deaths from all causes. The same author uses another datum obtained in a similar way, namely, that the eighth or the seventh part of those attacked die of it. Erom this, it follows that something like 40 per cent, of those born died without having small-pox. Since of these so dying a large number died at an early age, the number of those dying in adult and in advanced age without ever having had the disease would be much less. And in this sense, probably, must be read the statement of Haygarth, which he gives without supplying the data on which it is based, namely, that some persons are incapable of infection by the small-pox. The proportion of mankind thus exempted has been observed to amount to 1 in 20 ; that is to 5 per cent. The persons here referred to are probably those who lived to an advanced age without taking small-pox, though exposed to infection and possibly (for Haygarth wrote in the inoculation period) subjected to inoculation. That Bernouilli should use data like the above for an elaborate work, ana that a careful observer like Haygarth should make such a statement as that above quoted, emphasizes the conclusion as to the great prevalence of small-pox in the times in question. 53. We may pass no^v from the mere prevalence gf or the mere mortality from small-pox to its fatality in those days. Much contro-versy has arisen on this point, and much has been made of the statistics of Dr. Jurin on this head. The returns furnished to him of the number of cases attacked, and of the number of deaths of those attacked, during epidemics in various places in En;^land and America, showed an average rate of fatality of 16-5 per cent, amongst those attacked. This, which does not differ much from the datum employed by Bernouilli, has been put forward by many as being about the natural fatality of small-pox duirng the 18th century. It has been urged that the deaths of those dying under two years of age were excluded from .Turin's statistics, and that this must have led to the omission of many deaths, as the mortality in that class was high. The evidence relied onto show that cases