196 
this disease — the great probability being that it is no worse 
than its neighbours. 
It is most likely owing to this imperfection of nomen- 
clature that changes have taken place in the apparent rates 
of mortality from some of the diseases mentioned by Mr. 
Baxendell. Many of the deaths recorded of late years as 
arising from bronchitis, would probably have been set down 
in former times to pneumonia ; and hence the former dis- 
ease appears to have increased in fatality, the latter to have 
diminished. Hence, also, owing to an improved diagnosis 
the term dropsy will have given place to the name of the 
organ out of whose derangement it has arisen ; and we have 
it less frequently recorded as the cause of death, whilst dis- 
eases of the heart, liver, and kidneys have apparently 
increased in prevalence. 
The vague terms brain disease, cephalitis, and coirvulsions, 
may also have undergone some amount of transposition. 
But Mr. Baxendell points out a very great increase (86 
per cent) in one disease — small-pox — that is not likely to 
have been mistaken for anything else; and he further 
shows that this increase has taken place mainly amongst 
the adult members of the population. 
His remarks on this point are undoubtedly very im- 
portant and will need to be well weighed by those who are 
responsible for the efficient performance of vaccination. 
It is important to observe, however, that the whole of 
this increase occurred in the years 1871 and 1872, when 
over 40,000 deaths took place from this cause. 
The period of ten years chosen by Mr. Baxendell is 
probably not long enough to afford a basis of argument 
respecting epidemic diseases — 40 or 50 years are sometimes 
required to contain the full cycle observed by some of them 
— as may be seen from the diagram showing the variations 
in the prevalence of Scarlet Fever in Sweden. 
