155 
five years, when vaccination had been strictly carried out 
for twenty years, and the number of vaccinated persons was 
95 per cent of the population, the rate was *679, thus showing 
the extraordinary increase of 132-5 per cent. 
For the reasons given above I have very little confidence 
in the great hulk of the returns of the numbers of vaccinated 
and unvaccinated cases of small-pox, but for my present 
purpose I will take the numbers given in the official report 
of the cases treated in the London hospitals during the great 
epidemic of 1871. Out of a total of 14,808 cases treated 
2,763 died. 11,174 cases occurred in persons vaccinated, 
of whom 1,135 died; and 3,634 in persons unvaccinated, of 
whom 1,628 died. The total deaths from small-pox in 
London during the five years 1869-73 yv-ere 11,059, and 
taking the above proportion the number of deaths of vacci- 
nated persons was 4,542, and the death rate -293, or fully 
equal to the total death-rate of unvaccinated and vaccinated 
before a compulsory law was passed. The number of un- 
vaccinated in 1869-73 was 6,517, and the death-rate no less 
than 8-009, or 27*4 times greater than the small-pox death- 
rate in 1849-53, and considerably above the highest rate 
ever experienced in this country before inoculation or 
vaccination were known. But unvaccinated persons like 
the vaccinated die from other causes besides small-pox, and 
it follows, therefore, if the returns of unvaccinated 
cases which I have used in my calculations can be 
relied upon, that the number of unvaccinated persons now- 
living in London must be excessively small and utterly 
inadequate to account for the present epidemic. The truth, 
however, no doubt is, that a large proportion of the cases 
returned as unvaccinated were really vaccinated, and that 
the true death-rate of the vaccinated was greater than that 
given above, whilst that of the unvaccinated was much less 
than the calculated rate. 
