PRACTICE OF MEDICINE AND HYGIENE 



small-pox. Then vaccination came into use. 

 From 1801 to 1810 the number of deaths per 

 million of population had dropped from 5020 

 to 2040. From 1831 to 1835 it was 830. 

 From 1854 to 1871 it was 388. From 1883 to 

 1892 it was 73. During these 121 years the 

 total death rate from small-pox diminished 60 

 per cent. In England in 1838 the death rate 

 from small-pox was 1064 (per million) ; in 

 1884 it was 27; in 1889 it was 1; and in 1890 

 it was nothing. In Iceland in 1807, 18,000 

 deaths from small-pox were reported in a pop- 

 ulation of 50,000. The history of other coun- 

 tries has been similar to these : there have been 

 the endemic presence of the disease, with its 

 high mortality, and occasional epidemics, es- 

 pecially fatal among primitive unvaccinated 

 people. The perfect success of vaccination has 

 blinded people to its importance. In the coun- 

 tries compelling vaccination there are so few 

 cases that the disease is little thought of. 

 This is a disease with which cleanliness and 

 hygiene cut no figure. It attacks the clean 

 and healthy as well as the dirty if they have 

 not been rendered immune by vaccination or 

 by an attack of the disease. 



The Royal Commission on Vaccination 



95 



