condition of the city favoured a spontaneous outbreak of the disease.
Laveran,[249] who was also present in Metz during the siege, disputes
the correctness of Michaux’s diagnosis, as does the German Health
Report, on the ground that the disease attacked children almost
exclusively, that it caused such a high mortality, and that it
disappeared so suddenly. He seems to think that it was some acute
exanthema, probably haemorrhagic measles. This leaves unexplained the
fact that a large number of nurses contracted the disease.

  III. THE GREAT EPIDEMIC OF SMALL-POX CAUSED BY THE FRANCO-GERMAN WAR

But while typhoid fever and dysentery in the Franco-German War attacked
the civil population only in those parts of the country in which the
fighting took place, and nowhere acquired epidemic dimensions, and while
it is probable that typhus fever did not appear at all at that time,
there occurred in connexion with the war a very severe epidemic of
small-pox, which raged more extensively and furiously than any other
epidemic in the course of the entire century, and spread not only
throughout the belligerent countries, but also throughout all Europe.

Everybody knows how severely Europe suffered from epidemics of small-pox
in the last part of the eighteenth and first part of the nineteenth
centuries, and how the ravages of that disease were first checked by
Jenner’s wonderful discovery. Nevertheless, small-pox did not entirely
disappear from Central Europe until the year 1870. The reason for this
is found in the fact that compulsory vaccination was introduced in only
a few states, and even in them was not properly enforced, and also in
the fact that people did not until later begin to realize that
vaccination insures immunity only for a period of 12–15 years at most.
Consequently new recruits, if they had already been vaccinated once,
were not revaccinated when they began to serve. But since sporadic
outbreaks of small-pox continued to occur in the Prussian army, orders
were issued in the year 1834 that all recruits must be vaccinated. The
result was that from that time on, the Prussian troops were very rarely
attacked by the disease. The same measure was adopted in Württemberg in
1833, in Baden in 1840, in Bavaria in 1843, in Brunswick in 1858, in the
Kingdom of Saxony in 1868, and in the Grand Duchy of Hesse in 1869.
Compulsory vaccination did not exist in Prussia or Saxony before the
Imperial Vaccination Law was passed in the year 1874; the result was
that large numbers of children were never vaccinated. The
anti-vaccinationists, especially in the ‘sixties, carried on a vigorous
agitation, and this had the effect of increasing the number of
unvaccinated persons; the number of revaccinated persons had always been
small. In South Germany compulsory vaccination for one-year-old children
was introduced in the first part of the nineteenth century—in Bavaria
and Hesse in 1807, in Baden in 1815, in Württemberg in 1818—but
revaccination was not enforced until 1874, when the Imperial Vaccination
Law was passed.

The small-pox mortality in Prussia prior to the year 1870 is indicated
by the following table, which shows the number of deaths per 10,000
inhabitants:

                              1831–40 2·6
                              1841–50 1·7
                              1851–60 2·1
                              1861–5  3·5
                              1866–7  5·2
                              1867–8  1·8
                              1868–9  1·9
                              1869–70 1·7

In the year 1864 an epidemic of small-pox had broken out, and the war of
1866 had helped it to spread; but in the year 1868 the disease began to
abate, so that by the middle of the year 1870 almost all of Prussia was
free from small-pox, as will be set forth in greater detail later on. In
South Germany the small-pox mortality was even lower; in Bavaria it was
0·85 in the years 1861–70, in Württemberg it was 0·9 in the same years,
and in the Grand Duchy of Hesse it was 1·9 in the years 1866–70.[250]

       1. _The Small-pox Mortality in France in the Years 1870–1_

In the ‘sixties small-pox had not been very common in France, but no
detailed reports regarding its prevalence there are available; the
reports which the prefects were supposed to hand in are either entirely
missing, or else very incomplete. According to the statistics compiled
by Vacher,[251] the death-rate increased a little in the years 1864–5,
then began to decrease, and in 1869 increased again. The figures which
Vacher compiled, and which the Académie de Médecine in Paris has on
file, are:

                               1860 1,662
                               1861 1,740
                               1862 1,813
                               1863 1,440
                               1864 3,290
                               1865 4,166
                               1866   593
                               1867 2,081
                               1868 3,900
                               1869 4,164

Vacher says in regard to these figures: ‘As far as the actual number of
persons who contracted and succumbed to small-pox are concerned, they
express only a small part of the truth. The reports submitted to the
Academy of Medicine are rarely complete; it is even necessary to say
that about one-quarter of the Departments never send in reports on the
epidemics at all, although the ministerial instructions render the
submission of these reports obligatory, and although the Academy never
ceases to protest against the negligence of the prefectoral
administrators.’ Vacher then goes on to say that in the years 1860–9
only 59 out of every 100 infants born were vaccinated, and that at the
outbreak of the war about one-third of the French population was
unvaccinated; in many Departments, indeed, as many as four-fifths
(Aveyron, Corsica, &c.). Small-pox was much more prevalent in the French
army than in the German army; according to the German Health
Report,[252] the number of deaths caused by the disease was:

                PRUSSIAN ARMY.                   FRENCH ARMY.
        _Total No._   _Per 10,000 men._ _Total No._  _Per 10,000 men._
  1866              8              0.30           46              1.37
  1867              2              0.08           70              1.82
  1868              1              0.04          169              4.28
  1869              1              0.04           95              2.27

The reason for this lies in the fact that a larger proportion of the
Prussian soldiers were vaccinated. Since the year 1806 all French
recruits who had never been vaccinated were supposed to submit to the
inoculation when they presented themselves for service, but this
regulation was for years at a time very laxly enforced; consequently in
the year 1857 a new order was issued, introducing compulsory vaccination
for all recruits. But even this order does not seem to have been
everywhere carried out with the necessary strictness, and complaints
regarding the partial success of vaccination were frequently made by
military physicians.

As stated above, there was a noticeable increase in the small-pox
mortality in the year 1869; this increase lasted into the beginning
of the year 1870, but was confined to certain localities.
Chauffard’s[253] report on epidemic diseases in France is more
incomplete for the years 1869–70, on account of the war, than for
previous years; it was supplemented, partially at least, by the
later reports of Vernois[254] for the year 1871, and also by the
comprehensive report of M. Delpech[255] for the years 1870–2.
According to these, epidemics of small-pox occurred in the year 1869
in North-west France (Bretagne), in North-east France (Departments
of Aisne, Pas-de-Calais), and in South-east France (Departments of
Gers, Ariège, and Pyrénées-Orientales.) In the winter of 1869–70 the
epidemic continued to spread, and by the end of the year 1870 it
included almost the whole of France. The incomplete reports give us
no idea as to which Departments were attacked before the outbreak of
the war and which after. According to Vernois, the disease appeared
that year in 42 Departments, including 132 arrondissements and 539
parishes. But, as stated above, the reports are all very incomplete;
a later report submitted by Delpech adds 11 more Departments to the
42. The total number of deaths caused by small-pox in France in the
year 1871 is unknown; Vernois reported 14,425 deaths in 39
Departments, but this does not include the figures for Paris, where
10,539 persons succumbed to the disease, or for the Department of
Finistère, or for the Department of Sarthe (in regard to which it is
merely observed that there were ‘beaucoup de morts’), or for several
other Departments.

It is a fact that small-pox raged severely among the civil inhabitants
of all regions in which the second half of the war was waged (to the
south, east, and north of Paris), and that the war itself helped the
disease to spread in the eastern Departments (Jura, Doubs,
Saône-et-Loire, Haute-Saône). The wide prevalence of the disease among
the soldiers is attributed by many French physicians to the fact that
the army as a whole had been inadequately vaccinated. If this was true
of the regular troops, lack of time made it absolutely impossible to
vaccinate all the men that were afterwards assembled in such a
precipitate manner. The movements of the soldiers in the cold season of
the year (in December there was some bitterly cold weather) made it
necessary for friends and enemies to share whatever shelter they could
find, regardless of whether the house had previously been occupied by
small-pox patients, or whether such patients were actually lying in it
at the time. The result was that the disease became very widespread
throughout all France. Says Laveran:[256] ‘The army, being composed of
men who had been in service for a long time, and who had been vaccinated
and revaccinated, suffered very little, but the events which took place
after the declaration of war altered this state of affairs. The
regiments of the Departments on their way to Paris were quartered in the
homes of civilians, where they contracted small-pox. The disease spread
easily among the young people who, owing to lack of time, had not been
revaccinated, and many of whom had perhaps never been vaccinated at all.
During the first part of the siege of Paris it was these regiments which
suffered the most from small-pox, but later on the epidemic became more
general and spread to all the corps. The number of soldiers infected
with small-pox during the siege was about 6·76 per 100, or 68 per
1,000.’

Small-pox raged very extensively in besieged strongholds. In Paris an
epidemic of small-pox began in November 1869, and the number of deaths
caused by the disease there was:[257]

                          October (1869)    39
                          November          93
                          December         119
                          January          174
                          February         293
                          March            406
                          April            561
                          May              786
                          June             914
                          July           1,072
                          August           713
                          September        700
                          October        1,361
                          November       1,722
                          December       1,837
                          January        1,503
                          February         763
                          March            230

In the middle of the summer the disease was not very prevalent in the
garrison; most of the cases were among the civil inhabitants. This
condition changed in September, however, when the newly-organized mobile
guard arrived in the city, consisting of young men who had not been
revaccinated for lack of time, and many of whom had never been
vaccinated at all. A severe epidemic now began to rage throughout the
garrison; between October 1870 and March 1871 no less than 7,578 men
suffering from small-pox were taken to the Hôpital Bicêtre, where the
majority of the small-pox patients in the garrison were housed, and
where 1,074 (14·17 per cent) of them died. Colin reports that the total
number of small-pox patients taken there from the garrison (the total
number of men in which he estimates at 70,000 regular troops and 100,000
guardsmen)[258] was no less than 11,500, and that the number of deaths
was 1,600. In November, owing to the rapid dissemination of the disease
in the garrison, the number of cases among the civil inhabitants also
began to increase.

Small-pox also raged in Metz, but not so extensively as in Paris; the
following table indicates the number of men in the garrison carried away
by small-pox:

                           August (15–31)   6
                           September       40
                           October         51
                           November        58
                           December        21
                                          ———
                               Total      176

The surrender of the stronghold, on October 27, led to the discovery of
200 small-pox patients in a tobacco factory. The epidemic among the
civil inhabitants came to an end in March 1871.

Belfort, where the garrison consisted mostly of national guards, also
experienced a severe epidemic during the siege; likewise Strassburg,
Nancy, Toul, and Verdun.

In Strassburg, where cases of small-pox had repeatedly been observed,
the disease became more widespread in the summer of 1870, and during the
siege the number of cases increased considerably; not until August 1871
did the epidemic come to an end. According to Kriesche and Krieger,[259]
the number of civilians that succumbed to small-pox in Strassburg, the
population of which in the year 1871 was 77,859, was:

                                1869. 1870. 1871.
                      January       2     4    81
                      February      3     5    52
                      March         3     9    20
                      April        13    14    15
                      May           1    19    14
                      June          2    23     4
                      July          6    22     3
                      August        5    33     1
                      September     2    66
                      October            92
                      November      2    72     1
                      December      3    92
                                   ——   ———   ———
                        Total      42   451   191

Langres was attacked with especial severity. The garrison there was
composed of freshly enlisted troops (mobile and national guards), and
averaged 14,629 men. The epidemic began in September 1870, and was not
yet over by March 1871. The following table gives the number of cases
and deaths according to Claudot.

                            _No. cases._ _No. deaths._
                  September           81            10
                  October            145            12
                  November           301            34
                  December           598            41
                  January            621            91
                  February           402            93
                  March              186            53
                                   —————           ———
                    Total          2,334           334

The disease raged very extensively in the French provincial armies that
were organized to relieve Paris—thus in the south-western, northern, and
south-eastern scenes of the war, small-pox had already made its
appearance among the civil inhabitants of those parts of the country in
consequence of the continual passing through of soldiers, many of whom
had never been vaccinated. Orléans, Chartres, and Le Mans, were the main
centres of the pestilence; in the north Amiens, Bois-Guillaume, Rouen,
and other places; in the south, besides the strongholds of Belfort and
Langres, the cities of Dijon, Besançon, Pontarlier, and several other
places. The disease raged furiously throughout this entire region, but
the exact number of deaths is not known.

In south-eastern France, small-pox did not become very widespread until
after the outbreak of the war; in Lyons, for example, the epidemic began
in the second half of October. To be sure, small-pox had appeared in
several places in the year 1868, but by the winter of 1868–9 this
epidemic was over, although individual cases continued to occur.
Regarding the cause of the small-pox epidemic that broke out in Lyons in
the autumn of 1870, Fonteret[260] gives us the following information:
‘Two causes could not help favouring the outbreak in our city; the
movements of the troops that took place at that time, and the emigration
of numerous Parisians, who since the beginning of September, that is to
say, since the time when the epidemic began to rage furiously in Paris,
passed through our city on their way to Switzerland.’ Regarding the
course of the epidemic, no statistics covering the entire city are
available, but we are able to see from the following table, compiled by
Perroud, the number of small-pox patients taken in by the Hôtel-Dieu and
the number that died there:

                                   _Patients._ _Deaths._
               January-June (1870)         126         9
               July-September              101        15
               October                      29         8
               November                     94        26
               December                    160        37
               January (1871)              148        31
               February                    147        37
               March                       135        29
               April                       124        25
               May                          84        12
               June                         45         7
               July                         38         5
               August-December              44         6

In the other cantons of the Department 935 deaths were officially
recorded in the years 1870–1. It was observed in Lyons, as in other
places, that not only the number of persons who contracted small-pox,
but also the virulence of the disease itself, increased; whereas only
10.6 per cent of 227 sporadic cases resulted fatally between January and
September, out of 1,004 persons who contracted the disease between
October 1870 and July 1871 no less than 21.7 per cent died.

In the year 1871 small-pox did not spare a single Department in France,
although many of them failed to send in reports. Vacher estimates the
number of deaths due to the disease in the year 1871 at 58,236, but he
adds that the estimate is too small. No report, for example, was sent in
by the Department of Sarthe, where in the city of Le Mans alone there
were 1,181 deaths, nor by the Department of Haute-Garonne, where there
were 1,328 deaths in Toulouse. The total number of unreported deaths,
therefore, must have been at least 20,000. It is almost impossible to
estimate the number of deaths that occurred in the year 1870. From the
available statistics Vacher estimates the number of deaths caused by the
disease in the two years 1870–1 at 89,954, a figure, as he himself says,
‘which represents only a part of the reality.’ Another estimate made by
Vacher, putting the number of deaths caused by small-pox in the years
1869–70 at 200,000, is in all probability not an exaggeration.

In the year 1872, to be sure, small-pox appeared in the form of
epidemics in numerous parts of France, but nowhere did it spread so
widely as in the two previous years. According to a report worked out by
Delpech for the years 1870–2, no less than 42 Departments failed to make
any report at all in the year 1872, while only 18 of the remaining 41
Departments sent in reports regarding epidemic outbreaks of small-pox.
The epidemic lasted until 1873, in which year reports regarding
small-pox epidemics came in from 10 Departments; but only in the
Departments of Morbihan and Pyrénées-Orientales was the epidemic
apparently somewhat more intense.[261]

               2. _Small-pox among the French Prisoners_

Thanks to the well-vaccinated condition of the German troops, the army
suffered comparatively little from small-pox. In the field army 4,385
men (61·3 per 1,000) contracted the disease, and 278 of them (3·5 per
cent of those who contracted it) died. Including the officers,
physicians, and officials, the number taken sick was 4,991 and the
number that died was 297. The number of men in the individual army corps
that contracted the disease varied greatly according to the nature and
place of their activity; particularly hard hit were the army divisions
in the south-western and northern scenes of the war, where the military
operations were carried on in fearfully cold weather, and where it was
impossible to quarter the infected soldiers in isolated places by
themselves. The French army was attacked much more severely by
small-pox, although there are no accurate reports available regarding
the prevalence of the disease. According to a report found in the
_Vienna Medical Weekly_,[262] the total number of French soldiers that
succumbed to small-pox was 23,469[263]; but the accuracy of this number,
to be sure, is questionable, since, assuming that there was a very high
mortality, it would mean that some 120,000 troops contracted the
disease. At all events, the French army, taken as a whole, was badly
infected with small-pox, and it was inevitable that among the French
prisoners brought to Germany there should be numerous small-pox
patients, some in the incubation stage, and some in the convalescent
stage of the disease, and that they should infect other people there.

The number of French prisoners taken to Germany in the first few months
of the year 1871 was no less than 372,918; the prisoners who at the very
beginning, but especially after the surrender of Metz, were transported
in large numbers to Germany, had to be distributed throughout the entire
Empire, clear over to the eastern boundary. Owing to the fact that new
transports of French prisoners were constantly arriving at the German
frontier, which, in consequence of severe hardships and privations, they
reached in such a weak physical condition that they could not be taken
very far inland, it became necessary to transfer some of the earlier
arrivals to other places of detention, and this, of course, favoured the
further dissemination of the disease. This transference was rendered
particularly necessary by the arrival of large numbers of prisoners
after the battle of Sedan (September 1), after the capitulation of Metz
(October 27), and after the battles of Orléans and Le Mans (December and
January respectively). Small-pox occasionally broke out among these
prisoners while they were on their way to Germany, rendering it
necessary to leave them behind, or else the disease made its appearance
when they reached their destination; as a rule, however, the first cases
of the disease were observed a few days after their arrival at their
place of detention, where they soon infected the other prisoners. The
further dissemination of the disease among them was checked by means of
wholesale vaccination.

Of the prisoners, 14,178, all told (38 per cent of the total number
taken), contracted small-pox, and of these 1,963 (5·26 per cent) died.
The statistics in the German Health Report indicate distinctly the
number of prisoners in the various states and provinces that contracted
and succumbed to the disease; but the total number of prisoners taken is
known only in the case of the larger states in the Confederation, since
the statistics in the Report are compiled on the basis of the army-corps
districts, which do not coincide with the political divisions. The
figures for the larger states are as follows:

              _Maximum
                 no.                              _Patients  _Deaths per
             prisoners._ _Patients._  _Deaths._  per 1,000._ 100 cases._
 N. Germany,
   excluding
   Kingdom
   of Saxony     283,750      10,547       1,527        37·2        14·5
 Kingdom of
   Saxony         10,234         248          18        24·2         7·3
 Bavaria          40,083       1,607         196        40·0        12·2
 Württemberg      12,958         390          28        38·1         7·2
 Baden            12,083         512          21        42·4         4·1
 Grand Duchy
   of Hesse       13,810         874         173        63·3        19·8
                 ———————      ——————       —————        ————        ————
 All Germany     372,918      14,178       1,963        38·0        13·8

The number of people who contracted the disease varied greatly in the
different territories, depending upon the locality whence the prisoners
came. Accordingly, the figures in the case of the Grand Duchy of Hesse
were rendered large by the fact that a severe epidemic of small-pox
broke out in the stronghold of Mayence on the occasion of the arrival
there of prisoners from Metz. The number of prisoners that contracted
and succumbed to small-pox in the larger military prison-dépôts is shown
by the following table, which covers only those places in Prussia and
the Grand Duchy of Hesse in which the maximum number of prisoners held
in confinement exceeded 5,000:

              _Maximum
                 no.                              _Patients  _Deaths per
             prisoners._ _Patients._  _Deaths._  per 1,000._ 100 cases._
 Spandau           6,856          77          25        11·2        32·5
 Jüterbog          5,002         196          23        39·2        11·7
 Danzig            9,189         188          24        20·5        12·8
 Königsberg        7,324         221          22        30·2         9·9
 Stettin          21,000       1,303         194        62·0        14·9
 Erfurt           12,400         203          28        16·4        13·8
 Magdeburg        25,450       1,902         271        74·7        14·3
 Torgau            9,359         603         128        64·4        21·2
 Wittenberg        9,753          51          10         5·2        19·6
 Posen            10,303         191          29        18·5        15·2
 Glogau           13,621       1,198         170        88·0        14·2
 Neisse           12,801         385         117        30·1        30·4
 Minden            5,071          98          13        19·3        13·3
 Wesel            16,299       1,042         127        63·9        12·2
 Cologne          13,774         175          24        12·7        13·7
 Coblenz          15,011         571         111        38·0        19·4
 Lockstedt         5,000          47           7         9·4        14·9
 Mayence          14,669         759         165        51·7        21·7

In the case of the Kingdom of Saxony and of the South German States no
figures for the individual places are available. We see from the above
table that of the large prison-dépôts, Glogau, Magdeburg, Torgau, Wesel,
Stettin, and Mayence had the most cases of the disease; generally
speaking, the smaller places were less severely attacked, although there
are a few exceptions to this statement; in Stralsund, for example, there
were 78·2 cases of the disease per 1,000 prisoners, in Papenberg and
Hanover 63·4, in Colberg 53·9, and in Münster 52·8.

               3. _Small-pox in the Immobile German Army_

The occurrence of small-pox in the immobile German army was closely
related to its prevalence among the prisoners, and it attacked the
immobile troops much more severely than the field-troops. The latter, to
be sure, were no less exposed to the infection, but the former, taken as
a whole, were not nearly so well vaccinated; for it was impossible in
the short time available to see to it that all the reserves were
vaccinated, since the troops designated for the field were given the
precedence. Thus between conscription and vaccination there was more or
less of an interval, during which a large number of the reserves were
not protected against the disease. The total number of men in the
immobile army that contracted small-pox was 3,472 (excluding Baden and
the Grand Duchy of Hesse, regarding which we have no statistics).
Assuming that the average number of reserves in the immobile army was
300,424, this means that about 11·6 per 1,000 contracted the disease.
The number of cases among the immobile troops in the individual states
of the Confederation varied greatly, as indicated by the following
table:

              _Average
                 no.                              _Patients  _Deaths per
             reserves._  _Patients._  _Deaths._  per 1,000._ 100 cases._
 N. Germany,
   excluding
   Kingdom
   of Saxony     238,040       1,703          92        7·15         5·4
 Kingdom of
   Saxony         17,628         506          30       28·70         5·9
 Bavaria          34,634       1,183          39       34·16         3·3
 Württemberg      10,122          80           1        7·90         1·3

In the larger Prussian garrisons, and in Mayence, the following number
of men contracted and succumbed to small-pox:

              _Average                            _Patients  _Deaths per
              no. men._  _Patients._  _Deaths._  per 1,000._ 100 cases._
 Berlin            9,110          57           4         6·3         7·0
 Danzig            7,376          45           5         6·1        11·1
 Königsberg        6,426         101          11        15·7        10·9
 Stettin           7,000          74           5        10·6         6·8
 Magdeburg        11,296          84           8         7·4         9·5
 Posen             9,482         113           6        11·9         5·3
 Breslau           8,029          20                     2·5
 Wesel             7,284         117           7        16·0         6·0
 Cologne           9,207          19           1         2·1         5·3
 Coblenz           8,710          83           4         9·5         4·8
 Mayence           9,046         122           9        13·5         7·4

Wherever, as in Breslau, there were few prisoners, the small-pox
percentage in the immobile army is low. Regarding the above figures, it
must be remarked that those pertaining to the garrisons were compiled on
the basis of the average number of troops, whereas in the case of the
French prisoners the maximum number was used as a basis. The relative
number of small-pox cases in the latter table, accordingly, is somewhat
too low. Among the prisoners and among the immobile troops, the climax
of the pestilence was in January, as indicated by the following table:

                     _French Prisoners._ _Immobile German troops._
      July (1870)                      2                        16
      August                          27                         9
      September                       85                        47
      October                        273                        49
      November                     1,041                       128
      December                     3,107                       358
      January (1871)               4,139                       802
      February                     3,151                       719
      March                        1,521                       457
      April                          586                       451
      May                            209                       291
      June                            36                       145

The number of French prisoners taken to Germany in the month of July
1870 was small. Of the sixteen immobiles who contracted the disease
during that month, nine belonged to the Ninth Army Corps, most of them
having been infected inland before the outbreak of the war. That the
month of July did not constitute the starting-point of the subsequent
epidemic is evident from the fact that the prevalence of the disease
decreased in August, as well as from countless individual observations.

  4. _The Epidemic of Small-pox in the Civil Population of Germany in
                                1871–2_

In the summer of 1870 Germany was almost free from small-pox. Later on,
thousands of French prisoners, almost all of them hailing from infected
localities, were within a short time scattered throughout the entire
German Empire, and since the inhabitants of many parts of the country,
as stated above, were very insufficiently vaccinated, it was inevitable
that epidemics of small-pox should break out everywhere. The disease was
disseminated in several ways: by prisoners who had contracted it on
their way to Germany, or who had to be transported from an infected to
an uninfected locality, by persons into whose systems the infection had
entered but had not yet revealed its presence, and by uninfected persons
who had come in contact with infected persons; numerous persons,
moreover, contracted the disease by handling the clothing, blankets, and
other effects of small-pox patients.

‘The dissemination of the disease,’ says the German Health Report,[264]
‘which broke out simultaneously in various parts of Germany, was helped
along in numerous ways. From the lazarets and from the prisons it was
communicated by nurses and guards, and by working men and tradesmen, to
the civil population and to the local garrison, and from there it spread
to the surrounding country. It was conveyed from place to place, often
considerable distances, by the moving population itself, not
infrequently by marching troops, and particularly by the removal of
prisoners from one place of detention to another; the latter measure had
to be adopted in order to make room for the fresh transports of
prisoners that were constantly arriving, many of them in such an
exhausted condition that it was necessary to spare them the long and
trying journey to the far East. Thus the prisons at Mayence, Coblenz,
Wesel, Minden, &c. became the foci from which the disease was
transplanted into hitherto uninfected places.’

The result was that there broke out in Germany an epidemic of small-pox
which raged more furiously and extensively than any other epidemic in
the course of the nineteenth century. Whereas among the prisoners-of-war
and among the immobile German troops (who were particularly exposed to
the infection) the disease reached its climax as early as January 1871,
among the civil inhabitants of the country this climax did not come
until later in the year; in the more out-of-the-way regions, moreover,
where there was less intercourse, the height of the epidemic was not
reached until the year 1872.

_(a) The Dissemination of Small-pox in Prussia and in the smaller North
                             German States_

After the prevalence of small-pox in Prussia had again increased
somewhat in the years 1864–7, in the following years the number of cases
of the disease grew steadily smaller, so that around the middle of the
year 1870 the country was practically free from it. Its prevalence again
increased in the first months of the year 1871. The following table
indicates the number of deaths caused by the disease in Prussia in the
course of twelve years:

             _Total no. deaths._ _Deaths per 10,000 inhabitants._
       1862                3,894                              2·1
       1863                6,250                              3·4
       1864                8,904                              4·6
       1865                8,403                              4·4
       1866               11,937                              6·2
       1867                8,500                              4·3
       1868                4,510                              1·8
       1869                4,655                              1·9
       1870                4,200                              1·7
       1871               59,839                             24·3
       1872          66,660[265]                             26·9
       1873                8,932                              3·6

In the year 1874 only one person per 10,000 inhabitants succumbed to the
disease. Among the French prisoners small-pox usually broke out very
soon after their arrival at their place of detention, while among the
inhabitants of the places in which the prisons were located it usually
did not make its appearance until several months later. Guttstadt,[266]
in his excellent work on the _Epidemic of Small-pox in Prussia in the
Years 1870–1_, has compiled a table of statistics indicating in a number
of places when the disease first made its appearance among the prisoners
and among the civil inhabitants. We reproduce this table below, with a
few small alterations. In some of the places mentioned there was no
military prison; only prisoners suffering from small-pox were taken to
them, usually resulting in an epidemic of the disease among the civil
inhabitants. The table clearly indicates the connexion between the
small-pox epidemics among the civil inhabitants and the outbreaks of the
disease among the prisoners; regarding the manner of dissemination in
the case of the individual epidemics we shall have more to say further
on.

   THE APPEARANCE OF SMALL-POX AMONG PRISONERS-OF-WAR AND AMONG THE CIVIL
            INHABITANTS IN THE GERMAN CITIES IN THE YEARS 1870–1

 ────────────────┬─────────────────────────────────┬───────────────────────
    _Cities._    │        FRENCH PRISONERS.        │  CIVIL INHABITANTS.
 ────────────────┼─────────┬──────┬───────┬────────┼───────┬───────┬───────
        〃        │ _First  │      │       │        │       │       │
                 │ arrival │      │       │        │       │       │
                 │   of    │_Max- │       │        │_First │ _No.  │ _No.
                 │infected │ imum │_First │_No. Pa-│ Out-  │Deaths_│Deaths_
                 │persons._│ no._ │Case._ │tients._│break._│(1870).│(1871).
 ────────────────┼─────────┼──────┼───────┼────────┼───────┼───────┼───────
  1. _East       │         │      │       │        │       │       │
       Prussia_  │         │      │       │        │       │       │
     Königsberg  │         │      │       │        │Aug.   │       │
                 │Aug. 15  │ 7,324│Aug. 15│     221│(end)  │     74│    558
  2. _West       │         │      │       │        │       │       │
       Prussia_  │         │      │       │        │       │       │
     Danzig      │Aug. 25  │ 9,189│Aug. 28│     188│Sep. 16│      5│    709
     Graudenz    │Aug. 5   │ 1,437│Aug. 28│       9│Fall   │      0│     11
     Thorn       │Aug. 21  │ 2,001│Aug. 27│      11│Fall   │      8│    147
  3. _Branden-   │         │      │       │        │       │       │
       burg_     │         │      │       │        │       │       │
     Berlin      │         │      │Aug. 20│      24│Nov.   │    170│  5,212
     Frankfurt-  │         │      │       │        │       │       │
       o.-t.-O.  │         │   756│Nov. 12│       8│Jan.   │      3│    117
     Küstrin     │         │      │       │        │End    │       │
                 │Aug. 7   │ 2,204│Aug. 17│       9│(1870) │      1│     32
     Landsberg-  │         │      │       │        │       │       │
       o.-t.-W.  │Nov.     │   133│Nov.   │       1│Nov. 20│      0│     97
  4. _Pomerania_ │         │      │       │        │       │       │
     Colberg     │Nov. 4   │ 3,246│Nov. 14│     175│Jan. 7 │      0│     27
     Greifswald  │         │      │Oct. 18│       3│Dec. 13│      1│    109
     Schivelbein │Jan. 24  │   603│Jan. 26│      24│Feb. 20│      0│     43
     Stettin     │Aug. 12  │21,000│Aug. 22│   1,303│Dec.   │     13│    422
     Stralsund   │Dec. 4   │ 2,991│Dec. 9 │     234│Jan. 7 │      0│    366
     Stolp       │         │      │       │        │Aug.   │       │
                 │Jan.     │ 1,376│Feb. 3 │       5│(1871) │      0│     16
  5. _Posen_     │         │      │       │        │       │       │
     Bromberg    │-        │      │Dec. 15│      14│Feb. 10│      0│    280
     Posen       │Oct. 4   │10,303│Sep.   │     191│Feb.   │     79│    466
     Schneidemühl│Nov.     │   940│Jan.   │       5│Jan.   │      0│     40
  6. _Silesia_   │         │      │       │        │       │       │
     Breslau     │         │      │Nov.   │       4│       │     28│    742
     Glatz       │Oct. 12  │ 2,284│Oct. 6 │      96│Feb.   │      2│     38
     Glogau      │Sep. 1   │13,621│Sep. 16│   1,198│Oct. 7 │     10│    114
     Görlitz     │         │   326│Nov.   │       5│Jan.   │      0│    164
     Oppeln      │Nov. 6   │ 1,027│Jan.   │      23│Jan.   │      0│     38
     Schweidnitz │Jan. 28  │ 1,821│Jan.   │      75│March  │      0│     52
  7. _Saxony_    │         │      │       │        │       │       │
     Aschersleben│Dec. 2   │ 1,618│Jan.   │      12│Dec.   │      0│     53
     Erfurt      │Sep. 12  │12,400│Sep. 14│     203│Dec.   │     18│    235
     Halberstadt │Jan.     │   619│Jan. 28│       6│Feb.   │      0│     29
     Halle-      │         │      │       │        │       │       │
       o.-t.-S.  │         │      │Nov. 1 │      28│March  │      0│    195
     Magdeburg   │Aug. 30  │25,450│Sep. 15│   1,902│Nov. 18│     22│    646
     Mülhausen   │         │      │Dec.   │        │       │       │
                 │Dec.     │ 1,065│(early)│      57│Feb. 1 │      4│     25
     Nordhausen  │         │      │Sep.   │       8│Jan.   │      0│    233
     Quedlinburg │         │   927│Nov. 27│      29│Nov.   │      1│      3
     Torgau      │Sept.    │      │       │        │       │       │
                 │(end)    │ 9,359│Oct. 4 │     603│Nov.   │      0│     67
     Wittenberg  │Aug. 27  │ 9,723│Sep. 5 │      51│Oct. 3 │      5│    100
  8. _Schleswig- │         │      │       │        │       │       │
       Holstein_ │         │      │       │        │       │       │
     Lockstedt   │         │      │       │        │End    │       │
                 │         │ 5,000│Oct.   │      47│1870   │       │
     Rendsburg   │         │      │       │        │End    │       │
                 │Nov.     │ 2,590│Nov. 26│      44│1870   │      0│    114
     Schleswig   │         │      │       │        │End    │       │
                 │Dec. 3   │ 1,570│Dec. 13│      17│1870   │     10│     38
  9. _Hanover_   │         │      │       │        │       │       │
     Stade       │         │ 2,284│Jan. 28│      32│1871   │      0│      3
 10. _Westphalia_│         │      │       │        │       │       │
     Hamm        │         │      │Oct.   │      12│Nov. 22│      9│    114
     Minden      │Sep. 10  │ 5,071│Sep.   │      98│Nov. 2 │      5│    114
     Münster     │Jan.     │      │Jan.   │        │       │       │
                 │(end)    │ 2,709│(end)  │     143│Feb. 12│      2│     67
 11. _Hesse-     │         │      │       │        │       │       │
       Nassau_   │         │      │       │        │       │       │
     Cassel      │         │      │Nov.   │      13│Nov.   │      6│     99
     Frankfurt   │         │      │Dec.   │       8│Jan.   │     23│    125
 12. _Rhine      │         │      │       │        │       │       │
       Province_ │         │      │       │        │       │       │
     Düsseldorf  │         │      │       │        │Oct.   │       │
                 │         │   981│Aug. 15│      13│(1870) │      6│    524
     Coblenz     │Sep. 15  │15,011│Sep. 23│     571│Nov. 2 │      0│     81
     Cologne     │Sep. 1   │13,774│Sep. 1 │     175│Sep. 12│     65│    418
     Wesel       │Sep. 9   │16,299│Sep. 20│   1,042│Nov.   │      9│     84

 The book contains a survey of the small-pox mortality in Prussia in the
 year 1871 according to Governmental Districts and Communities. The figures
 for the year 1872 have not been published; they were placed at my
 disposal, in manuscript form, by the Royal Prussian Bureau of Statistics.
 ──────────────────────────────────────────────────────────────────────────

The small-pox mortality varied greatly in the different Prussian
Governmental Districts; particularly noteworthy is the fact that it
was considerably higher in the eastern provinces, especially in the
year 1872, than in the western provinces, notwithstanding the fact
that the latter were exposed to the infection much sooner and much
more frequently in consequence of the arrival and passing through of
French prisoners. The only plausible explanation of this is the fact
that the inhabitants of eastern Prussia were not so thoroughly
vaccinated as those in the west; this, however, was not because the
anti-vaccinationists were more influential in the east, but because
the eastern provinces had fewer physicians than the western provinces,
where medical advice and help were far more accessible, and where the
population was more enlightened. The effect of vaccination is clearly
revealed in those Governmental Districts in the west which introduced
compulsory vaccination before they were incorporated into Prussia;
Schleswig-Holstein did this in 1811, Hanover in 1821, the Governmental
District of Wiesbaden in 1820, and the Governmental District of Cassel
in 1828. All these parts of the country had fewer cases of small-pox.
The Governmental Districts in which large military prisons were
located, and those in which, owing to a higher industrial development,
there was more intercourse of all kinds, were attacked earlier by
small-pox than the others. Of the western provinces only the two
highly industrial districts of Arnsberg and Düsseldorf, and the
district of Trèves, were very severely attacked. The living conditions
among the working people were not so good at that time as they are
to-day, and the close quarters must necessarily have favoured the
dissemination of small-pox; furthermore, the constant moving about of
the working inhabitants, many of whom did not live where they were
employed, helped to spread it. Thus it was observed in the vicinity of
Leipzig, that the villages inhabited by working people were much more
severely attacked by small-pox than those inhabited by farmers, with
their stationary and settled population. The high figures in the case
of the Governmental District of Trèves may be explained by the fact
that its location made it necessary for a large proportion of the
French prisoners that were taken into Prussia to pass through it. The
number of deaths per 10,000 inhabitants in the various Governmental
Districts of Prussia is indicated by the following table (the
districts which introduced compulsory vaccination in the year 1870 are
designated with an asterisk):

               _Governmental District._ 1870. 1871. 1872.
               Königsberg                 3·5  24·5  37·8
               Gumbinnen                  4·1   9·7  40·0
               Danzig                     2·8  42·4  67·6
               Marienwerder               3·7  17·7  76·2
               Berlin                     2·1  63·1  31·4
               Potsdam                    1·8  25·8  28·7
               Frankfurt                  0·1  18·6  40·0
               Stettin                    1·6  29·9  21·4
               Köslin                     2·2  12·2  36·7
               Stralsund                  0·2  34·0   3·9
               Posen                      6·0  48·3  58·0
               Bromberg                   5·3  24·1  86·6
               Breslau                    3·1  27·5  33·6
               Oppeln                     1·7  22·5  42·1
               Liegnitz                   0·5  11·2  16·8
               Magdeburg                  0·6  27·5  16·3
               Merseburg                  1·0  28·8  20·2
               Erfurt                     1·4  25·3  14·4
               Schleswig-Holstein*        0·2  18·0   5·0
               Hanover*                   0·3   5·3   8·8
               Hildesheim*                0·1  13·8  19·6
               Lüneburg*                  0·2   7·8   6·5
               Stade*                     1·3   5·6   4·9
               Osnabrück*                 0·3   6·0   0·8
               Aurich*                    0·0   5·4   1·1
               Münster                    0·3  11·6  10·8
               Minden                     0·2  13·4   8·9
               Arnsberg                   0·4  39·1  33·8
               Cassel*                    0·5   9·0   6·2
               Wiesbaden*                 1·7   9·7   2·5
               Coblenz                    1·2  22·8   6·6
               Düsseldorf                 0·3  32·9  20·5
               Cologne                    1·4  14·6   2·8
               Trèves                     2·5  34·0   3·1
               Aix-la-Chapelle            0·8  14·5   7·8
               Hohenzollern               1·7  19·9

In East Prussia small-pox broke out very frequently in the city and
vicinity of Königsberg. According to Guttstadt, small-pox patients, in
consequence of the proximity of the Russian border, kept coming to the
hospital in Königsberg, into which twelve persons suffering from the
disease were received between January 1 and August 1, 1870. The first
prisoners-of-war arrived at Königsberg on August 15, 1870, and among
them was a small-pox patient. Shortly afterwards two more cases of the
disease occurred among the prisoners. The first case among the civil
population occurred in the hospital on September 2. Owing to the
constant intercourse between the prisoners and the civil inhabitants the
epidemic spread very rapidly. The districts surrounding Königsberg were
very severely attacked in the year 1871, while the more remote
districts, especially those along the boundary of West Prussia, were not
attacked until the year 1872. In the districts around Königsberg the
mortality per 10,000 inhabitants was as follows:

                                         1871. 1872.
                   Königsberg (city)      49·8   3·6
                   Königsberg (vicinity)  78·4  13·3
                   Labiau                 42·4  30·6
                   Wehlau                103·1   8·9
                   Insterburg             32·2  47·3
                   Fischhausen            38·7  17·9

In the districts of East Prussia more remote from Königsberg the
following number of deaths per 10,000 inhabitants were reported:

                                     1871. 1872.
                       Memel           5·5  37·0
                       Gerdauen       18·9  53·1
                       Rastenburg     65·9  26·8
                       Friedland      13·7  35·5
                       Eylau          15·2  29·7
                       Heiligenbeil   19·7   8·1
                       Braunsberg      2·9  10·1
                       Heilsberg       6·3  27·2
                       Rössel         25·7  52·2
                       Allenstein      7·4 108·5
                       Ortelsburg     20·6 124·4
                       Neidenburg      1·7  45·6
                       Osterode        4·7  76·5
                       Mohrungen       2·1  36·2
                       Prus. Holland   1·1   8·3
                       Heydekrug            43·3
                       Niederung      23·7  84·6
                       Tilsit          5·4  46·3
                       Ragnit          4·6  51·7
                       Pillkallen      0·7  17·4
                       Stallupönen     0·7  14·0
                       Gumbinnen      17·1  35·8
                       Darkehmen       3·8  25·3
                       Angerburg      10·9  81·0
                       Goldap          2·3  41·2
                       Oletzko         1·0  24·7
                       Lyk             2·4  17·8
                       Lötzen          5·1  28·3
                       Sensburg       13·3  52·1
                       Johannisburg   15·8  12·4

Several of the last fifteen districts (Heydekrug to Johannisburg in the
above table) had relatively few cases of small-pox; the reason for this
was that the governmental district of Gumbinnen had but little
intercourse, that few prisoners were taken there at all, and that there
were no cases of small-pox among the few that were taken there.

Danzig was the chief seat of the pestilence in West Prussia, since large
numbers of prisoners were confined there; per 10,000 inhabitants 79·6
succumbed to small-pox in the year 1871, and 35·9 in the year 1872. Says
Liévin:[267] ‘For a considerable length of time no cases of small-pox
occurred in Danzig, but in the month of September 1870 the beginnings of
an epidemic were observed. Although this happened shortly after the
arrival of the first prisoners, nevertheless the beginning of the
epidemic was probably not connected in any causal way with this
circumstance. For, in the first place, the prisoners were French
soldiers captured in the battles of Weissenburg and Wörth, and were in
all probability healthy men, judging from the fact that not a single
case of the disease occurred among them in the first few months; in the
second place, the disease broke out very sporadically in the first three
or four months, individual outbreaks occurring here and there in the
city, just as has been the case in Danzig almost every year. But during
this indigenous pestilence a large number of badly infected prisoners
arrived from the Metz garrison; this gave rise to an epidemic which, had
the prisoners not arrived, would probably have progressed in the usual,
scarcely noticeable manner; as it was, however, the epidemic attained to
the largest dimensions known to the memory of man.’

According to Liévin, the total number of small-pox cases in Danzig and
its suburbs (including the garrison and the prisoners-of-war) was:

                   1870.                 1871.                 1872.
           _Patients._ _Deaths._ _Patients._ _Deaths._ _Patients._ _Deaths._
 January                                 123        24         245        77
 February                                129        28         222        77
 March                                   201        51         153        75
 April                                   365        70          89        33
 May                                     459       109          34        17
 June                                    442       123          19        12
 July                                    182        71          13         3
 August                                  130        49           8         7
 September           2                   111        37           5         2
 October             4         2         124        57           2
 November           13         2         136        42
 December           34         3         135        39

Of the 9,189 prisoners in Danzig, 188 contracted the disease, and 24
died; the largest number of cases was reported in the month of January.
Of the garrison, which consisted of 7,376 men, only 45 contracted the
disease,[268] and 5 died.

As in East Prussia, so also in West Prussia, only those districts
suffered severely from small-pox in which large military prisons were
located; in the remaining districts the pestilence did not acquire much
severity until the following year. Of the three strongholds, Danzig,
Thorn, and Graudenz, the last two had but few cases of small-pox among
the prisoners; in the districts surrounding them the following number of
deaths per 1,000 inhabitants were reported:

                                       1871. 1872.
                     Danzig (city)      79·6  35·9
                     Danzig (district)  91·2  59·2
                     Prussian Stargard  55·5 105·0
                     Rosenberg          40·5  66·5
                     Thorn              46·0  41·7

In the remaining districts of West Prussia the mortality due to
small-pox was as follows:

                                     1871. 1872.
                       Elbing         18·7  71·8
                       Marienburg     16·0  68·6
                       Berent          6·6  47·7
                       Karthaus        7·7  67·9
                       Neustadt       22·9  89·0
                       Stuhm          21·4  97·8
                       Marienwerder   21·3  62·3
                       Löbau           4·9  88·0
                       Strassburg      6·1  80·7
                       Kulm           25·9  65·5
                       Graudenz        5·4  55·9
                       Schwetz        11·0 118·6
                       Konitz          9·7  79·7
                       Schlochau       6·9  69·5
                       Flatow         23·4  74·1
                       Deutsch-Krone  10·2  92·1

All these districts, especially Prussian-Stargard and Schwetz, which lay
side by side along the Vistula, had an unusually high mortality in the
year 1872.

The Governmental District of Posen, in the Province of Posen, was much
more severely attacked by small-pox in the year 1871 than the
Governmental District of Bromberg, whereas in the year 1872 the
condition was reversed. In the former district cases of small-pox had
occurred even before a transport of French prisoners arrived there in
the middle of September; in that month two of the prisoners contracted
the disease, and these two cases constituted the beginning of a large
epidemic among the prisoners. According to Guttstadt, the epidemic among
the civil inhabitants did not commence until February 1872, and it
lasted until the middle of that year. The districts along the boundary
of Posen (Schroda, Wreschen, Schrimm, Kosten, and Samter) had the
largest number of cases and deaths in the year 1871, whereas in the
remaining, more distant, districts the figures for the year 1871 are for
the most part small, and do not begin to grow large until the year 1872.
The following table indicates the number of deaths per 10,000
inhabitants in the districts mentioned:

                                       1871. 1872.
                      Posen (city)      82·5   4·4
                      Posen (district) 103·2  53·0
                      Schroda          105·6  61·3
                      Wreschen         116·5  63·1
                      Schrimm           61·5  88·4
                      Kosten            75·9  72·4
                      Samter            66·9  83·4
                      Pleschen          17·9  56·7
                      Buk               38·2  42·2
                      Obornik           22·2  76·3
                      Birnbaum          15·4  63·6
                      Meseritz          13·0  53·3
                      Bomst             20·5  34·1
                      Fraustadt         21·5  26·0
                      Gröben            55·8  79·5
                      Krotoschin        22·1  62·0
                      Adelnau           26·3  29·4
                      Schildberg        14·6  91·6

The first prisoners that contracted small-pox in the city of Bromberg
were committed to the lazaret on December 15; the epidemic among the
civil inhabitants began there on February 10, 1871. The figures for 1871
were higher than those for 1872 in only three districts—Bromberg itself,
the adjacent Schubin, and Czarnikau; the last-named district lies in the
west and borders on Samter in the Governmental District of Posen. All
the other districts that are not mentioned had higher figures in the
year 1872. The following table indicates the number of deaths per 10,000
inhabitants in the districts named:

                                    1871. 1872.
                        Czarnikau    47·0  69·8
                        Wirsitz      14·7  65·4
                        Bromberg     89·7  72·3
                        Schubin      59·4  96·5
                        Inowrazlaw   20·4 102·5
                        Mogilno      22·6  96·5
                        Chlodziesen  24·7  79·7
                        Wongrowitz   26·3 153·1
                        Gnesen       32·9  56·0

Of the prisoners in the Governmental District of Liegnitz, those in the
stronghold of Glogau were the most severely attacked. In the garrison,
too, the number of small-pox patients was quite large. The first
prisoners arrived on September 1, and the first cases of small-pox among
them appeared on September 16; the maximum number of prisoners there was
13,621, and of these 1,198 contracted the disease. The first case among
the civil inhabitants was reported on October 7; in December the disease
was conveyed to the surrounding villages, especially by tradespeople who
had visited the markets in Glogau. The adjacent districts suffered
relatively little in the year 1871. In the governmental district of
Liegnitz, with the exception of Glogau, where there were 31·2 deaths per
10,000 inhabitants, only Görlitz and Liegnitz had high figures in the
year 1871. In the city of Görlitz a prisoner was committed to the
lazaret in November 1870, and in December, when a transport of prisoners
passed through the city, one of them was left behind there; the epidemic
among the civil inhabitants began in January 1871. Again in the year
1872 small-pox did not become very widespread except in the districts of
Liegnitz, Jauer, Hirschberg, and Görlitz; Liegnitz, with a mortality of
35·2 per 10,000 inhabitants, had the highest figures.

In the Governmental District of Breslau cases of small-pox were
frequently reported. In the city of Breslau the first case among the
prisoners occurred on November 11, the second on January 27, the third
and fourth in April and May, 1871; the first cases in the garrison
likewise occurred in November; from January on, the number of cases grew
steadily larger. The number of reported cases in the city was:[269]

                            January      33
                            February     68
                            March        90
                            April        68
                            May         134
                            June        235
                            July        287
                            August      271
                            September   361
                            October     699
                            November  1,026
                            December  1,229
                            January   1,311
                            February    790
                            March       462
                            April       242

The epidemic was very severe. Whereas during the previous epidemics
(1856–7, 1863–4, and 1868–9) only about seven per cent of the patients
treated in the hospital died, in 1871–2 no less than 322 out of 2,416
patients (13·4 per cent) taken there were carried away by the disease.
Of the 322 patients, moreover, 182 had hemorrhagic small-pox, and of
these 166 died.

The immediate vicinity of Breslau was very severely attacked; in the
districts lying to the south of the Oder small-pox raged extensively in
the year 1871, whereas those districts on the north side of the river
did not suffer very severely until the year 1872. This may be explained
by the fact that the extensive industrial activity of the districts
south-west of the Oder rendered considerable intercourse with Breslau
necessary. The following table indicates the number of deaths per 10,000
inhabitants in the districts north-east of the Oder:

                                    1871. 1872.
                         Namslau      4·0  48·5
                         Wartenberg  14·0  55·4
                         Oels        22·3  71·0
                         Trebnitz     8·6  27·8
                         Militsch    10·0  37·2
                         Gurau       15·5  20·2
                         Steinau     12·1  34·2
                         Wohlau      41·1  38·4

and in the districts south-west of the Oder:

                                        1871. 1872.
                     Neumarkt            13·5  61·5
                     Breslau (city)      35·7  27·3
                     Breslau (district)  57·3  74·9
                     Ohlau               12·2  23·3
                     Brieg                5·2  17·2
                     Strehlau            30·3  33·8
                     Nimptsch            23·5  37·4
                     Münsterberg         53·0  29·0
                     Frankenstein        34·3  14·3
                     Reichenbach         32·0  19·8
                     Schweidnitz         26·3  13·4
                     Striegau            16·9  48·2
                     Waldenburg          57·7  36·2
                     Glatz               39·1  13·4
                     Neurode             20·2  35·6
                     Habelschwerdt        8·2   7·3

In Upper Silesia the stronghold of Neisse had a maximum number of 12,801
prisoners, among whom there were 385 cases of small-pox and 117 deaths;
in the garrison, which averaged 4,452 men, there were 39 cases and 1
death. The first cases among the prisoners were reported on September
25, and in the garrison in November. The civil inhabitants suffered very
little in the year 1871, and the number of deaths among them did not
begin to grow large until 1872. Only in the district of Neisse and in
the neighbouring district of Grottkau was the number of deaths larger in
1871 than in 1872; in all the other districts there were more deaths in
1872. The districts which were most severely attacked in the year 1872
were—Kreuzburg (78·2 deaths per 10,000 inhabitants), Posenberg (58·6),
Gross-Strelitz (60·0), Beuthen (56·5), and Kosel (62·4).

In the Province of Pomerania the city of Stettin came to be a general
rendezvous for prisoners of war; the maximum number of them, owing to
the continual arrival of new transports, was no less than 21,000. The
first transport arrived on August 12, and the first small-pox patient
among them was committed to the hospital on August 28. Of the prisoners,
1,303 contracted the disease and 194 succumbed to it. The climax of the
epidemic came in January, when there were 462 cases reported. The first
cases in the garrison, which averaged 7,000 men, occurred in October,
the first man to contract the disease being a sick-attendant, and the
second an artilleryman; after that, all the branches of service were
attacked. The epidemic in the garrison, however, was confined to 74 men,
only 5 of whom died. In December the disease spread to the civil
population; the number of cases (including the garrison) was 422 (55·5
per 10,000) in the year 1871, and 113 (14·8 per 10,000) in the following
year. In the Governmental District of Stettin only the communities
surrounding the city of Stettin had high small-pox figures in the year
1871, and these communities were also more severely attacked in the year
1872. The following table indicates the number of deaths per 10,000
inhabitants in the communities mentioned:

                                     1871. 1872.
                       Demmin          1·1   2·6
                       Anklam          4·3  15·8
                       Usedom-Wollin  16·4  16·2
                       Uckermünde     24·7  26·4
                       Randow         70·4  29·3
                       Greifenhagen   37·8  26·3
                       Pyritz         15·3  23·1
                       Saazig         27·8  27·4
                       Naugard        32·4  32·6
                       Kammin         10·3  13·3
                       Greifenberg     4·3  10·4
                       Regenwalde     16·4  27·5

At the stronghold of Kolberg (Governmental District of Köslin) 3,500
prisoners arrived on November 4, and in December and January they were
followed by the arrival of more transports. The first cases among these
prisoners were reported on November 14; all told, 175 of them contracted
small-pox and 24 succumbed to it. On January 7 the disease spread to the
civil population, but did not rage very extensively in the city; 127
civilians contracted it and 24 succumbed to it, and in August 1871 it
disappeared; only two men in the garrison were taken sick. Many of the
prisoners in Kolberg were transported to Stettin, Köslin, and Stolp, and
in all three of these places the disease broke out among the civil
inhabitants. In Schivelbein an infected soldier was found among the
prisoners who arrived on January 24, 1871, and on January 26 he was
committed to the lazaret; in February a working-man contracted the
disease in the same lazaret, and after that the epidemic spread
throughout the city and did not disappear until October 1872; it carried
away a relatively large number of people and spread to two neighbouring
villages. But taking the Governmental District of Köslin as a whole, it
may be said that the dissemination of small-pox was moderate; the
district of Schlawe had the largest number of deaths (22·7 per 10,000
inhabitants). On the other hand, in the year 1872 small-pox caused a
very large number of deaths in the districts of Neustettin, Dramburg,
Schlawe, Rummelsburg, and Stolp.

The number of cases of the disease in the Governmental District of
Stralsund was very large. Small-pox broke out very severely among the
French prisoners in the city of Stralsund, the maximum number of whom
was 2,991; of these 234 contracted the disease and 35 succumbed to it.
The prisoners arrived on December 4, and among them was a small-pox
patient; he was committed to the lazaret on December 9. In the garrison,
which averaged 3,700 men, there were only thirty-one cases of the
disease and one death. The first case among the civil inhabitants
occurred on January 7; the patient was a clerk who lived near the
lazaret and had had more or less intercourse with the prisoners. Of
twenty-three more cases that occurred before January 15, at least six
were shown to be directly attributable to the epidemic among the
prisoners; one of the six was a sick-attendant, two were working-men in
the military lazaret, and the other three were members of the families
of attendants. The epidemic then became very widespread; to the end of
the year 1871 the number of deaths was 366, and the number of reported
cases was 1,807. In Greifswald a French prisoner contracted small-pox on
October 18, 1870, in the military reserve lazaret, another on November
1, and a third on November 16. The first civilian, an attendant,
contracted the disease on December 13, and on January 6, 1871, a
working-man, who had transported the attendant from the military lazaret
to the town small-pox hospital, was taken sick. Until February 14, ten
more cases were reported, and then the epidemic began. Up to the end of
the year 1871 no less than 578 cases of the disease and 111 deaths
caused by it were reported to the authorities. In the year 1872 there
were only a few deaths caused by small-pox throughout the entire
Governmental District of Stralsund.

In the case of the two adjacent confederate states of
Mecklenburg-Schwerin and Mecklenburg-Strelitz no small-pox mortality
statistics are available. On September 20, prisoners from Metz were
taken to the reserve lazaret in Schwerin, and among them was a small-pox
patient who died eight days later. In the same month an assistant in the
lazaret was taken sick, and in October and December two more members of
the lazaret staff contracted the disease. The pestilence spread to the
civil population because the attendants who were commissioned to dispose
of the effects of the dead, instead of destroying them, sold or gave
them to the inhabitants. The epidemic, which spread rapidly throughout
the surrounding country, was quite severe and lasted until March 1871.
In Wismar two cases of small-pox were reported among the prisoners in
December, and these were followed by six more cases in January and
February; in the garrison, which averaged 1,219 men, there were 48 cases
of the disease (5 in January, 32 in February, 9 in March, and 2 in
April); 3 of the 48 were fatal. At Rostock 649 prisoners arrived on
November 11, and these were followed by 544 more on December 14; among
the latter there were two small-pox patients, and in the course of the
next few months forty-one more cases of the disease and six deaths were
reported.

Berlin suffered severely from an epidemic of small-pox in the years
1871–2. The last large epidemic there had occurred in the year 1801, and
had carried away 1,626 out of 176,700 inhabitants. In the year 1864
another rather mild epidemic had broken out, but had quickly
disappeared. In the year 1870 the number of small-pox patients in Berlin
was small; an average of nine persons per month succumbed to the disease
between the first part of August and the last part of November. In the
month of December 1870 the death-rate began to increase, at first rather
slowly; the number of deaths in that month was 22, and in March 1872 it
was 176. The epidemic now began to spread rapidly, and in June it
reached its climax with 648 deaths; during the summer it abated a
little, but in the fall it began to rage more and more furiously until
December, when it reached a second climax with 671 deaths. The progress
of the epidemic is shown by the following table, taken from Guttstadt’s
excellent book. The number of deaths caused by small-pox in Berlin was:

                          November (1870)   9
                          December         22
                          January (1871)   48
                          February         80
                          March           176
                          April           349
                          May             430
                          June            648
                          July            532
                          August          528
                          September       490
                          October         600
                          November        660
                          December        671
                          January (1872)  445
                          February        256
                          March           151
                          April           117
                          May              76
                          June             33
                          July             18
                          August           10

The disease was unusually severe and virulent; fifteen per cent of the
patients died in the hospitals. The total number of deaths[270] in the
year 1871, when the population of the city was 826,341, was 5,212, or
63·1 per 10,000 inhabitants; thus the total mortality, which in the
years 1867–70 had been 31·8 per cent (including the still-births),
reached the prodigious height of 40·4 per cent. The cause of the wide
dissemination of small-pox in Berlin was the fact that large numbers of
people, including children, had never been vaccinated, and only a few
had ever been revaccinated. According to a rough estimate made by
Guttstadt, of Berlin’s total population in the year 1871 some 20,000
people had never been vaccinated, 530,000 had been vaccinated only once,
and only 270,000 had been revaccinated; fourteen per cent of those who
had never been vaccinated, two per cent of those who had been vaccinated
once, and O·5 per cent of those who had been revaccinated, contracted
the disease. In the garrison, which averaged 9,110 men, only 57 cases of
the disease and 4 deaths were reported between July 1, 1870, and June
30, 1871. But few prisoners were taken to Berlin; only 24 prisoners
suffering from small-pox were committed to the lazarets, and of these
only 4 died; the first two cases were in August and September.

In the Governmental District of Potsdam only those districts which
bordered directly on Berlin were severely attacked by small-pox in the
year 1871, e.g. the districts of Niederbarnim, Teltow, Jüterbog,
Luckenwalde, and East and West Havelland; in the following years those
districts bordering on Niederbarnim (as Oberbarnim, Angermünde, and
Templin) also suffered severely. In the city of Potsdam two Frenchmen
contracted the disease on February 6, shortly after their arrival there,
and on February 19 a soldier who had accompanied them was taken sick. In
April an epidemic of rather wide extent was raging in the city; the
number of deaths caused by small-pox in April 1871 was 157 (34·5 per
10,000 inhabitants), and in April 1872 it was 71 (16·2 per 10,000). In
the city of Brandenburg-on-the-Havel an infected French soldier arrived
in February 1871; he communicated the disease to his attendant, and in
that very month cases of small-pox were reported among the civil
inhabitants of the city, although it was impossible to prove a connexion
between them and that of the French soldier. The number of deaths, all
told, was 59. The number of deaths per 10,000 inhabitants in the
Governmental District of Potsdam was:

                                         1871. 1872.
                    Prenzlau               7·5  11·1
                    Templin               17·5  28·4
                    Angermünde            15·0  53·4
                    Oberbarnim            18·2  33·8
                    Niederbarnim          36·5  27·1
                    Teltow                46·4  40·4
                    Beeskow-Storkow       20·6  39·8
                    Jüterbog-Luckenwalde  43·4  38·7
                    Zauch-Belzig          14·6  38·1
                    East Havelland        37·7  14·7
                    West Havelland        32·3  33·4
                    Ruppin                26·8  13·3
                    East Priegnitz        14·9  12·6
                    West Priegnitz        16·8  23·3

In the Governmental District of Frankfurt small-pox raged only to a
moderate extent in the year 1871. In Frankfurt-on-the-Oder itself there
were sporadic outbreaks of the disease every year. On November 12 two
infected prisoners from Metz were committed to the hospital, and before
the end of that month two attendants contracted the disease; a few cases
also occurred in the garrison in the month of November. Of the French
prisoners, whose maximum number was 756, eight contracted the disease
and two succumbed to it; in the garrison, which averaged 1,881 men,
there were 21 cases of the disease and no deaths. Among the civil
inhabitants, on the other hand, a somewhat more severe epidemic raged;
whereas in the year 1870 only 21 cases of the disease were reported, in
the year 1871 there were 19 cases in the month of January alone; until
May some 196 persons contracted the disease, which after that began to
abate. The number of deaths, all told, in the year 1871 was 117, and in
1872 it was 70. In Landsberg-on-the-Warthe small-pox broke out in the
middle of November in consequence of the arrival of an infected
prisoner; the first case among the civil inhabitants was reported on
November 20. The total number of deaths in the year 1871 was 97. At
Kottbus an infected French prisoner arrived on October 1, resulting in a
rather severe epidemic among the civil inhabitants (114 deaths in the
year 1871). Not until the year 1872 did the disease become very
widespread in the Governmental District of Frankfurt; with the exception
of the city of Frankfurt there was no district which suffered more
severely in the year 1871 than in 1872. In most of the districts
small-pox broke out very virulently, the only exceptions being the
districts of Lübben and Spremberg.

Regarding the dissemination of small-pox in the Province of Saxony
Guttstadt gives us very detailed information. In the years 1871–2 the
disease was equally prevalent in all three governmental districts in the
Province. In the city of Magdeburg the last case was reported on May 24,
1870, and from then until November there was not a single case among the
civil inhabitants. The first prisoners arrived at Magdeburg in the
latter part of August, and on September 14 a case of small-pox was
observed among them; this was followed by ten more cases in that month.
Of the prisoners brought to Magdeburg, the maximum number of whom was no
less than 25,450, some 1,092 contracted the disease, and of these 271
died. The largest number of cases was reported in the month of February
1871. Of the garrison, which averaged 11,296 men, there were only 84
cases of the disease (7·4 per cent), and of these 8 died. The first case
among the civil inhabitants was reported on November 18, 1870, and this
was followed by seven more cases in that month, occurring in various
parts of the city. The number of deaths in the year 1871 was 646 (56·4
per 10,000 inhabitants), and in the year 1872 only 45 deaths were
reported. From the city of Magdeburg small-pox spread to the surrounding
country.

On November 25 a transport of prisoners from Metz, after having been
detained for two or three weeks in the badly infected city of Minden,
arrived at Quedlinburg; two days later the first case of small-pox
occurred among them. A second transport, which arrived on January 31,
1871, likewise brought infected men with it. Among the civil inhabitants
small-pox did not become very widespread, and only three civilians
succumbed to the disease in the year 1871. In Aschersleben small-pox
broke out among the prisoners in January 1871, a few days after their
arrival from Mayence, and the number of cases reported in the months of
January and February was only twelve. According to Guttstadt, small-pox
was already prevalent in the civil population in December, when the
disease was given an opportunity to spread to the surrounding country.
According to the German Health Report, on the other hand, small-pox did
not appear in the city until February, when the proprietor of an inn,
which had been converted into a small-pox hospital, contracted it. The
total number of deaths in the year 1871 amounted to 53 (31·6 per 10,000
inhabitants). On January 26 and 27, 1871, some 360 prisoners, four of
them infected with small-pox, arrived at Halberstadt, having come from
Mayence. The number of deaths in the city of Halberstadt in the year
1871 was 29 (11·4 per 10,000 inhabitants). Only those districts in the
Governmental District of Magdeburg which bordered on the city of
Magdeburg were more severely attacked; Kalbe (43·1 deaths per 10,000
inhabitants), Wanzleben (37·7), and Wollmirstedt (29·2). In addition to
these the district of Wernigerode also had a very high small-pox
mortality in the year 1871 (70·5 per 10,000). In those districts further
away from Magdeburg—Osterburg, Salzwedel, Aschersleben, and
Halberstadt—the climax of the small-pox mortality was not reached until
the year 1872, whereas in the other districts it was reached in 1871.

In the Governmental District of Merseburg small-pox broke out very
severely in the stronghold of Torgau, where in the last part of
September and in the first part of December prisoners arrived from
Strassburg and Metz, respectively; in both transports, but especially in
the second, there were infected men. The first cases of the disease were
reported on October 4. Of the prisoners, the maximum number of whom was
9,359, some 603 (64·4 per 1,000) contracted the disease and 128 (21·2
per cent of those who contracted it) died. The epidemic, accordingly,
was unusually severe among the prisoners, and it reached its climax in
January. In the German garrison, which averaged 3,943 men, there were,
all told, 75 cases of the disease (19·0 per 1,000) and five deaths.
Among the civil inhabitants the first persons to contract the disease in
the last part of November and first part of December were a woman, who
was employed as a laundress in the garrison lazaret, her sons, and a
woman who had visited the place where the prisoners were confined. The
epidemic did not break out until December 22, on which day a single case
was reported; on the following day twelve more cases were reported. The
total number of deaths was 67 (61·7 per 10,000). Very soon the infection
spread throughout the entire vicinity of Torgau, which in the year 1871
had a very high small-pox mortality; by 1872 the disease had almost
disappeared from the city.

In Wittenberg, which before the arrival of the prisoners was absolutely
free from small-pox, a transport arrived on August 27, and on September
5 the first small-pox patients were taken to the lazaret. Among the
Frenchmen the disease did not rage very extensively; of a maximum number
of 9,753, only fifty-one (5·2 per cent) contracted the disease and ten
succumbed to it. Of the garrison, which averaged 2,845 men, seventeen
contracted the disease and two died. Among the civil inhabitants the
first case of small-pox was reported on October 3; it was that of a
pastor who had been serving as curate among the prisoners. This case was
followed by several others, most of the victims being persons who lived
in the vicinity of the pastor’s dwelling-place. The pestilence then
began to spread rapidly among the civil inhabitants, finally developing
into a severe epidemic. There were 768 cases reported, distributed as
indicated by the following table:

                           October (1870)  26
                           November        66
                           December       102
                           January (1871) 107
                           February        97
                           March          113
                           April           76
                           May             83
                           June            61
                           July            27
                           August           8
                           September        1

Of those who contracted the disease five died in the year 1870 and 100
died in the following year (86·5 per 10,000 inhabitants). Likewise in
the country surrounding Wittenberg small-pox was very widespread in the
year 1871.

Among the French prisoners in Halle-on-the-Saale there were twenty-eight
cases of small-pox in January and February, and at the same time a few
cases of the disease were reported in the regiment that was transferred
from Halle to Mülhausen. In the first part of March 1871, cases were
reported among the civil inhabitants, and they constituted the beginning
of a large epidemic. In the year 1871 there were 195 deaths due to the
disease (37·0 per 10,000 inhabitants) and in the year 1872 there were
forty-one more deaths.

Generally speaking, small-pox was rather uniformly spread throughout the
Governmental District of Merseburg in the year 1871; the districts of
Torgau and Wittenberg were the only ones that were attacked with
particular severity. In the western part of the governmental district
small-pox raged more furiously in 1872 than in 1871.

The city of Erfurt (Governmental District of Erfurt) in the year 1869
had been the scene of a small-pox epidemic, which lasted well into the
following year. The last cases of the disease occurring in connexion
with this epidemic were reported on August 13, 1870. To be sure, the
disease revealed its presence on September 27 and 30 among the French
prisoners, who had arrived on August 21, and these cases were followed
by many more when a new transport of prisoners arrived from Metz; but of
all the prisoners in Erfurt, the maximum number of whom was no less than
12,400, only 203 men (16·4 per cent), all told, contracted the disease,
and of these only 28 died. In the garrison, which averaged 4,627 men,
there were 25 cases of small-pox and no deaths. On the other hand, in
December there began among the civil inhabitants an epidemic which
spread rapidly and reached its climax in April 1871, with 244 cases.
According to Guttstadt, the number of deaths due to small-pox was 253
(53·9 per 10,000 inhabitants) in the year 1871, and 33 in the year 1872.
The epidemic did not come to an end until June 1872.[271] In Mülhausen,
prisoners from Mayence, where small-pox was prevalent, arrived in the
first part of December, and some of them were already infected with the
disease. On February 1 the pestilence spread to the civil population,
and carried away twenty-five persons in the course of the entire year.
Nordhausen was free from small-pox in the summer of 1870; but the
disease was twice borne into the city, in October 1870 and in January
1871, by prisoners. The first cases among the civil inhabitants were
reported in the latter month, after which they increased rapidly in
number. In the year 1870 there were 233 deaths (109·5 per 10,000
inhabitants) due to the pestilence. Except in these two cities of Erfurt
and Nordhausen the disease did not become very widespread in the year
1871 in any part of the Governmental District of Erfurt.

Regarding the appearance of small-pox in Brunswick, the Thuringian
States, and Anhalt, only a small amount of information is available. In
the city of Brunswick a German soldier, who had come from Carignan,
contracted the disease in September, and in November and January six
Frenchmen were taken sick; two of the latter died. In the garrison,
which averaged 1,389 men, there were four cases of small-pox in March
and June. According to a manuscript report of the Brunswick Bureau of
Statistics, the number of deaths due to small-pox throughout the entire
Duchy was 2 in the year 1870, 269 in the year 1871, and 215 in the year
1872. At Gotha a French prisoner suffering from small-pox was left
behind in January, and another prisoner in the same transport contracted
the disease a few days later; in February there were a few isolated
cases in the garrison. At Weimar a German field-soldier suffering from
small-pox arrived in February; he infected the woman who took care of
him, and presently the disease broke out in the city. In Altenburg two
infected sub-officers of the field-army and two Frenchmen, likewise
suffering from the disease, were committed to the reserve-lazaret, and
shortly afterwards a small epidemic broke out in the garrison. There
were ten cases of the disease and no deaths among the Frenchmen, and in
the garrison, which averaged 1,178 men, there were eleven cases and one
death. Among the civil inhabitants the first to be attacked were a
sick-attendant and a journeyman mason; the latter had removed the soot
from a stove in a room occupied by small-pox patients.

In the Duchy of Saxe-Meiningen, according to a manuscript report of the
local Bureau of Statistics, the number of deaths due to small-pox in the
years 1860–71 was 133, in the year 1872 it was 37, and in the year 1873
it was 47. The figures for the several years before 1871 are not
available. Every transport of sick soldiers from France brought
small-pox patients to the city of Meiningen; five cases, the first in
January, were reported in the garrison, which consisted of 1,663 men,
and in the same month there were cases among the civil inhabitants. It
was impossible, however, to establish a connexion between those in the
garrison and those in the city.

In Dessau, one French prisoner in October and two in November contracted
the disease, which in January appeared throughout the city and became
epidemic. In the garrison, which consisted of 1,228 men, there were ten
cases of the disease, none of which terminated fatally.

Hamburg,[272] after the by no means mild epidemic that raged there in
the year 1864 (19·7 deaths per 10,000 inhabitants) suffered very little
from the disease in the following years; in 1868 there were five deaths
reported, and in 1869 the number increased to twenty. After the
Franco-German War an epidemic of small-pox raged in Hamburg, which was
more extensive and more furious than almost any other epidemic that
Germany had ever experienced. In the years 1870–2 no less than 4,053
persons succumbed to small-pox in Hamburg. Among the French prisoners
there were twenty-two cases of the disease and one death, and among the
German troops there were twelve cases and no deaths. The disease first
made its appearance in the summer of 1870, when there were a few cases
in the city; but in October they began to increase in number, and by the
first of the year the disease was spreading rapidly. The number of
deaths in Hamburg was:

                                       1870. 1871. 1872.
                January                         69   158
                February                       107    74
                March                          163    47
                April                          226    16
                May                            364    17
                June                       2   503     4
                July                       2   554     2
                August                     6   578     2
                September                  5   373     1
                October                   10   311     1
                November                  24   229
                December                  34   170     1
                                         ——— —————   ———
                Entire year               83 3,647   323
                Per 10,000 inhabitants   3·6 154·4   9·5

The figures for 1870 and 1871 include the city and suburbs, and those
for 1872 the entire State—a fact, however, which makes but little
difference. This severe epidemic gave rise to the passing of a law on
January 30, 1872, rendering vaccination compulsory; the enforcement of
this law was greatly facilitated in the following years by the fact that
everybody very soon came to recognize the superiority of animal lymph.

In Schleswig-Holstein the city of Altona, which bordered on Hamburg, was
very severely attacked by small-pox. No detailed information regarding
the epidemic there is available; the population of the city in the year
1871 was 83,177, and in the same year 965 persons (116·0 per 10,000
inhabitants) succumbed to small-pox; in the following year there were
only two deaths. In the year 1871 only three districts were more
severely attacked by the disease than Altona—Rendsburg, Steinburg, and
Stollmarn. The city of Rendsburg was an important seat of the disease,
which broke out there on November 16 among the prisoners, shortly after
their arrival; the epidemic, however, was rather mild, since of 2,590
prisoners only forty-four contracted the disease and only three died.
The garrison, which averaged 2,876 men, was somewhat more severely
attacked; 109 men contracted the disease (37·9 per 1,000), and four
succumbed to it. The epidemic became unusually widespread in the city;
114 inhabitants (98·8 per 10,000) succumbed to small-pox there in the
year 1871.

Of 5,000 prisoners confined in Lockstedt, 47 contracted small-pox, the
first in October, and the rest in February; only a few men in the German
garrison were attacked by the disease. From Lockstedt the disease spread
to the surrounding country, including Itzehoe, where it caused 102
deaths (110·6 per 10,000 inhabitants) in the year 1871. From there
small-pox spread in all directions; it was conveyed to Stollmarn chiefly
by working-men from Hamburg and Altona who lived in the country.

In the city of Lübeck, the population of which in the year 1871 was
52,158, the following number of people, according to the report of the
local Bureau of Statistics, contracted and succumbed to small-pox:

                            _Patients._ _Deaths._
                       1870          24         1
                       1871         315        36
                       1872          99        15

Judging from this table, the city was not very severely attacked by the
disease.

In the province of Hanover, small-pox did not become very widespread in
the years 1871 and 1872, thanks to the introduction of compulsory
vaccination; this is evident from one of the tables reproduced above. In
the year 1871 the districts of Osterode and Harburg had the highest
figures, 32·4 and 18·7 deaths respectively per 10,000 inhabitants, and
in the following year Osterode had 47·4 and Einbeck was second with
24·6. In the city of Hanover the cases of the disease in the garrison
were few and far between; the first cases among the prisoners were
reported in August; their maximum number was 2,299, and fifty-six of
them contracted the disease and three died. In the city seventy-one
persons succumbed to the disease in the year 1871, and eighty-nine
persons in the year 1872 (8·1 and 10·2, respectively, per 10,000
inhabitants). In Hildesheim, cases of the disease, which had been
brought there from France, were reported in March 1871; seven soldiers
in the garrison were taken sick. In Göttingen (Governmental District of
Hildesheim) persons who had contracted the disease in France were taken
to the lazaret in March 1871; whether or not this was responsible for
the communication of the disease to the civil inhabitants, among whom a
severe epidemic had never before raged, cannot be ascertained. At
Einbeck (Governmental District of Hildesheim) several small-pox
convalescents belonging to the field-army arrived in February 1871. In
Osnabrück a soldier belonging to the field-army contracted the disease
in December. In Papenburg (Governmental District of Osnabrück) the dépôt
where the prisoners were confined was very severely attacked; of 993
prisoners, sixty-three contracted the disease and two died. In Lingen
(Governmental District of Osnabrück) there was a rather large number of
Frenchmen suffering from small-pox—fifty-three, all told, of whom three
died. In Stade thirty-two out of 2,284 prisoners contracted the disease
in January and February, and five of them died.

In Bremen the epidemic of small-pox did not become very widespread.
According to a report issued by the local Bureau of Statistics, there
were only twenty-six cases of the disease there in the year 1870 and no
deaths; in the following years the number of deaths was as follows:[273]

                       _Bremen—City._ _Rest of State._
                  1871             45                9
                  1872             20               21
                  1873              3

In the case of the Grand Duchy of Oldenburg the number of deaths due to
small-pox is unknown. In the city of Oldenburg three French prisoners
(two in October and one in November) contracted small-pox, and one case
of the disease was reported in the garrison in March. Regarding the
appearance of small-pox among the civil inhabitants no information is
available.

The governmental districts of Münster and Minden (Province of
Westphalia) were only moderately afflicted by small-pox in the years
1870–2. According to Guttstadt, a few cases of the disease were reported
in the city of Münster in May 1869, and these were followed by seven
more in July 1870. After that no cases were reported until November 9,
1870, when a pastor, who had been ministering to the prisoners in
Lingen, contracted the disease; another pastor fared in the same way.
These were followed by eight more cases in two buildings in Münster
itself, and another two in the community of Überwasser, which bordered
on the city of Münster. In the latter part of the year 1870 no cases
were reported in the garrison. In the latter part of January 1871 some
3,000 prisoners were brought from Wesel, which was badly infected with
the disease, to Münster, and there four of them were immediately taken
sick. This was the beginning of a rather extensive epidemic among the
prisoners, 143 of whom contracted the disease and thirteen died; the
maximum number of cases (107) was reported in February. In the garrison,
which numbered 3,910 men, a small number of cases was reported from
February on; of twenty-one cases reported, one resulted fatally. In the
same month a small epidemic raged among the civil inhabitants, reaching
its climax in May. The following table indicates the number of people
who contracted the disease:

                           November (1870)  2
                           December         8
                           January (1871)   0
                           February        13
                           March           30
                           April           48
                           May             91
                           June            84
                           July            43
                           August           9
                           September        5
                           October          1

The number of deaths in the year 1871 was sixty-seven (26·9 per 10,000
inhabitants), and in the year 1872 it was twenty-two; most of the cases
occurred in the quarters of the city known as Jüdefeld and Lamberti, on
account of the proximity of the prison along the Buddenturm. In the
surrounding communities the epidemic reached its climax in July, and
after that began to abate rapidly. The only other region in the
Governmental District of Münster in which small-pox made its appearance
was Recklinghausen, which borders on the Rhenish-Westphalian
coal-fields, whence the infection doubtless came; in Recklinghausen
there were 28·8 deaths per 10,000 inhabitants in the year 1871, and 46·4
per 10,000 in the year 1872.

In the Governmental District of Minden only the city and vicinity of
Minden were severely attacked; before the war began they were free from
small-pox. On September 10 the first prisoners arrived, and among them
cases of small-pox had already been observed in the first part of that
month; in the course of the next eight days more cases were reported,
and of a total number of 5,071 prisoners 98 contracted the disease and
13 succumbed to it. In the garrison, which numbered 5,071 men, one case
was reported in October, four in December, and fifty-two in the
following months; only two cases terminated fatally. The first case
among the civil inhabitants was reported on November 5; the victim was a
laundress who had done washing for the prisoners. This constituted the
beginning of an epidemic in which 651 persons contracted the disease and
114 succumbed to it; the population of the city was 16,862. The epidemic
spread to the surrounding localities, presumably because the woollen
blankets which the patients had used were sold there. Throughout the
entire district of Minden 391 persons (51·0 per 10,000 inhabitants)
succumbed to small-pox in the year 1871, whereas in the following year
only 34 deaths were reported, all told.

In the Governmental District of Arnsberg the districts of Dortmund and
Bochum, which belonged to the Rhenish-Westphalian coal region, and were
even at that time densely populated, were severely attacked by
small-pox; the districts of Hamm and Hagen, which bordered on the
latter, were likewise very hard hit. The following table indicates the
number of persons per 10,000 inhabitants that succumbed to small-pox in
the districts mentioned:

                                     1871. 1872.
                        Arnsberg      12·7  11·4
                        Meschede       6·5   4·3
                        Brilon        10·0  23·1
                        Lippstadt      2·9   9·8
                        Soest          9·6  26·0
                        Hamm          38·1  30·0
                        Dortmund      55·3  38·4
                        Bochum       123·1  71·8
                        Hagen         13·7  54·2
                        Iserlohn       4·3  16·7
                        Altena        18·5  12·7
                        Olpe          18·8   9·4
                        Siegen         9·2   7·4
                        Wittgenstein  10·1  11·6

In the city of Bochum alone 698 persons (329·0 per 10,000 inhabitants)
succumbed to small-pox in the year 1871; almost one-half of the deaths
that year were caused by small-pox. The city of Dortmund itself was less
severely attacked in the year 1871 than the country surrounding it; in
the city alone 96 persons (21·5 per 10,000) died of the disease, whereas
in the district of Dortmund, excluding the city, there were 661 deaths
(71·4 per 10,000). The near-by city of Hamm was very severely attacked;
114 persons (67·3 per 10,000) succumbed there in the year 1871, whereas
the total number of deaths in the rest of the district amounted to 113
(26·5 per 10,000). According to Guttstadt, a prisoner contracted the
disease there on November 2 and subsequently died. The first cases among
the civil inhabitants were reported on November 22; the victims were an
occupant of a public-house situated near the lazaret, and a Catholic
priest who had visited the patients.

In the Rhine Province the districts of the Rhenish-Westphalian
industrial centre belonging to the Governmental District of Düsseldorf
also suffered severely from small-pox: e.g. the districts of Crefeld,
Duisburg, Düsseldorf, Essen, Mettmann, Elberfeld, and Barmen; later on,
in the year 1872, the districts of Lennep and Solingen were also
severely attacked. The districts in the Governmental District of
Düsseldorf lying on the left side of the Rhine were all, with the
exception of Crefeld, mildly attacked. The following table indicates the
number of deaths per 10,000 inhabitants in the various districts
mentioned:

The districts on the left side of the Rhine:

                                     1871. 1872.
                        Cleve          4·8   1·5
                        Geldern        7·8   0·8
                        Mörs           8·4   8·8
                        Kempen         7·3  13·3
                        Gladbach       1·6   5·5
                        Grevenbroich   1·8   2·3
                        Neuss          9·3   4·3
                        Crefeld       54·7  33·7

The districts on the right side of the Rhine:

                                       1871. 1872.
                      Rees              23·5   4·6
                      Duisburg         100·7  10·2
                      Essen             52·9  37·0
                      Düsseldorf        56·2   3·5
                      Elberfeld (city)  47·5  44·0
                      Barmen            24·8  49·1
                      Mettmann          31·3  36·7
                      Lennep             3·3  31·4
                      Solingen           5·1  36·3

On August 17 and 18, seven infected Frenchmen arrived at the city of
Düsseldorf and were at once isolated in a house outside the city limits;
in November a few more infected prisoners arrived. In the small German
garrison (523 men) no cases were observed until later (April and May).
In December 1870, 20 cases among the civil inhabitants were reported;
they constituted the beginning of an epidemic which developed rapidly,
reached its climax in July with 648 cases, and then quickly disappeared.
In the following year, 524 small-pox patients (75·0 per 10,000
inhabitants) died in the city of Düsseldorf.

In the district of Duisburg eleven cases of small-pox were reported in
December 1870, and here again the epidemic developed rapidly, reaching
its climax (1,549 cases) in May 1871. The city of Duisburg was most
severely attacked; 529 persons (173·2 per 10,000 inhabitants) died there
of small-pox in the year 1871.

In the stronghold of Wesel (district of Rees), where the prisoners were
confined in the stronghold itself on Buderich Island and Spellmer Heath,
persons suffering from small-pox arrived in August and September; and
still more arrived in November with a transport of prisoners from Metz.
Of the 16,299 prisoners, 1,042 (63·9 per 1,000) contracted small-pox,
and 127 (12·2 per cent of those taken sick) died; the largest number of
cases was reported in January. In the garrison, which numbered 7,284
men, there were 117 cases of the disease and seven deaths. Since the
inhabitants of the city of Wesel and of the surrounding country had
continual intercourse with the prisoners, the dissemination of the
disease was inevitable; the epidemic among the civil inhabitants began
in November and carried away nine persons in 1870 and eighty-four
persons in 1871.

In Elberfeld the epidemic did not become very widespread until December
1871. The first fatal case in the city of Essen was reported in January
1871; the epidemic then increased in fury until June 1871 (48 deaths),
when it began to abate. In the following year it revived a little in
May, when 26 cases were reported. All told, 272 persons (53·0 per 10,000
inhabitants) died of small-pox in Essen in the year 1871, and 112
persons (21·0 per 10,000) in the year 1872.[274]

In the Governmental District of Cologne small-pox became more or less
widespread in the years 1871–2 in the city and immediate vicinity of
Cologne; in the few years preceding the war Cologne had had numerous
cases of the disease, and in the year 1866 a small epidemic (223 cases)
had occurred there; in the year 1869 some forty cases were officially
reported. According to Guttstadt, the first transport of prisoners,
among them a small-pox patient, passed through Cologne early in
September. Of the gradually increasing number of prisoners (the maximum
number, including Deutz, was 13,774) 175, all told, contracted the
disease and twenty-four succumbed to it. In the garrison, which numbered
9,207 men, there were only nineteen cases of the disease and one death.
Among the civil inhabitants an epidemic broke out as early as September
12; it reached its climax in April 1871, abated somewhat during the
summer, and in October and November started up again. The following
table indicates the number of people that contracted and succumbed to
the disease in the months mentioned (the population of the city at that
time was 129,000):

                                  _Patients._ _Deaths._
                 September (1870)          24         3
                 October                   65        18
                 November                  80        15
                 December                  97        27
                 January (1871)           194        53
                 February                 336        79
                 March                    434        87
                 April                    510        71
                 May                      318        50
                 June                     159        34
                 July                      75        13
                 August                    35        10
                 September                 16         3
                 October                   66         5
                 November                  34         9
                 December                   7         2

According to this table, 63 persons (4·9 per 10,000 inhabitants) died in
the months September-December 1870, and 416 persons (32·2 per 10,000)
died in the year 1871; in the following year 25 more deaths (1·9 per
10,000) were reported. In the district of Cologne (excluding the city)
212 persons (24·3 per 10,000 inhabitants) succumbed to small-pox in the
year 1871; in all the other districts the number of deaths caused by the
disease was small.

In the Governmental District of Coblenz the city of Coblenz and the
adjacent districts of Neuwied and Mayen, as well as the district of
Kreuznach, which lay in the extreme south and very near the scene of the
war, were most severely attacked in the year 1871. In the stronghold of
Coblenz, according to Guttstadt, a locksmith contracted the disease in
the latter part of August; he had become infected while sitting beside
the body of his brother, who had succumbed to the disease in Casbach, a
village near Lingen, in Hanover. The first prisoners arrived in Coblenz
on September 15, and on September 23 one of them was found to be
suffering from small-pox and was taken to the lazaret; new transports of
prisoners kept bringing more cases of the disease. Of the 15,011 French
prisoners that arrived there, a large number contracted the disease; the
maximum number was in January, when 571 (38·0 per 1,000) were taken
sick, and 111 died (19·4 per cent of the patients). In the garrison,
which consisted of 8,710 men, there were 83 cases of the disease and
four deaths in the month of November. Among the civil inhabitants of
Coblenz 81 persons (24·2 per 10,000) died of small-pox in the year 1871;
in the rest of the district of Coblenz 277 persons (67·1 per 10,000)
died; in the district of Mayen there were 234 deaths (43·9 per 10,000),
in the district of Neuwied 220 deaths (32·3), and in the district of
Kreuznach 129 deaths (21·2). In the year 1872 the epidemic was not at
all widespread in any of the districts.

In the Governmental District of Aix-la-Chapelle only the district of
Malmedy suffered severely in the year 1871; being in the south-western
part of the governmental district it was, like the border districts in
the Governmental District of Trèves mentioned below, exposed to the
first onrush of the transports of prisoners. The number of deaths there
in the year 1871 was 333 (111·0 per 10,000), whereas in the following
year not a single death due to small-pox was reported in the district.
At Jülich a Frenchman suffering from small-pox arrived in July, and in
November an epidemic broke out among the prisoners; 188 cases of
small-pox were reported, and of these only three terminated fatally. In
the garrison only one man contracted the disease.

The governmental district of Trèves had a very large number of small-pox
cases in the year 1871, since a large part of it bordered directly on
the enemy’s country, so that large numbers of sick and convalescent
prisoners passed through it. In the year 1872 only a few cases of
small-pox were reported, except in the immediate vicinity of Trèves,
where the pestilence became quite widespread. The following table
indicates the number of deaths per 10,000 inhabitants in the districts
mentioned:

                                       1871. 1872.
                     Daun                3·0   1·9
                     Wittlich           18·7   1·3
                     Bernkastel          6·1   0·5
                     St. Wendel         20·0
                     Ottweiler          36·2   0·4
                     Trèves (city)      12·6   4·1
                     Trèves (district)  17·2  20·6
                     Prüm               33·2   0·9
                     Bitburg            23·6   1·4
                     Saarburg           60·9   1·0
                     Merzig             51·5   2·8
                     Saarlouis          80·0   0·2
                     Saarbrücken        49·5   0·3

The province of Hesse-Nassau suffered very little from small-pox in the
years 1871–2, since a compulsory vaccination law had long been in force
there. Large epidemics did not occur anywhere. In Cassel a case of
small-pox had occurred in the summer of 1870, and after that there were
no more cases until November 9; on that day a man was taken sick who had
been acting as a sutler among the German troops before Paris and had
there been infected. On November 18 a nurse employed in a house in which
a field-soldier was quartered contracted the disease, and this case was
followed by six more cases among the civil inhabitants; all told, six
persons succumbed to small-pox in the city of Cassel in the year 1870,
ninety-nine persons (21·4 per 10,000 inhabitants) in the year 1871, and
four persons in the year 1872.

In Frankfurt-on-the-Main a few cases of small-pox were reported in the
course of the year 1870; the disease was perhaps conveyed thither from
Stuttgart. After the commencement of the war it was borne into the city
by numerous transports of soldiers and prisoners, and a widespread
epidemic soon developed. In the garrison thirty-two cases of the disease
were reported. After the Rochus Hospital was opened to small-pox
patients, in April, the epidemic reached its climax; the following
table, found in the German Health Report, indicates the number of
patients received into the above-mentioned hospital and the number that
died there:

                          _No. patients._ _No. deaths._
                 January               81            13
                 February             148            16
                 March                168            17
                 April                177            25
                 May
                 June                  36            12

In August the epidemic came to an end. All told, there were 23 deaths
due to small-pox in Frankfurt-on-the-Main in 1870, 125 deaths (13·7 per
10,000 inhabitants) in 1871, and 25 deaths in 1872.

In Wiesbaden an epidemic began in December 1870, and reached its climax
in February. The population of the city was 35,463, and of these 6
succumbed to small-pox in 1870, 71 in 1871, and two in 1872. Regarding
the origin of this small epidemic no information is available.

   _(b) The Dissemination of Small-pox in Saxony in the Years 1870–2_

The kingdom of Saxony experienced a very severe epidemic of small-pox in
consequence of the Franco-German War. The wide dissemination of the
disease is attributed by Wunderlich to the fact that vaccination, in
consequence of the wild agitation of the anti-vaccinationists, was
insufficiently practised; prior to the year 1874 vaccination was not
compulsory in Saxony. Even before the war broke out small-pox had
appeared in Saxony in the form of epidemics, e.g. in Chemnitz and
Freiberg. The following table indicates the number of persons, all told,
that succumbed to small-pox in Saxony:[275]

           1871 9,935 (estimate) 38·8 per 10,000 inhabitants.
           1872 5,863            22·8 per 10,000 inhabitants.
           1873 1,772             6·9 per 10,000 inhabitants.

Of the immobile troops stationed in Saxony, the total number of whom was
17,628, some 506, all told, contracted the disease and 30 succumbed to
it.

Regarding the dissemination of small-pox in Leipzig and vicinity we have
accurate information.[276] In Leipzig itself small-pox patients were
housed only in the city hospital. A small epidemic of the disease had
raged there in the years 1868–9. In the year 1870, eighteen patients
were committed to the hospital in the months of January-July, after
which there were no more cases until October; on the 22nd, 23rd, and
31st of that month a single patient, each time a French prisoner, was
taken to the hospital. On November 7 a laundress employed in the
hospital contracted the disease; the first case among the civil
inhabitants was reported on November 10. In December an epidemic began
which spread rapidly and reached its climax in April. The following
table indicates the number of patients committed to the hospital in the
months mentioned:

                            March (1871) 384
                            April        388
                            May          361
                            June         231
                            July          73

The epidemic lasted until the year 1872, and the highest mortality was
in the month of May 1871; the number of deaths caused by the disease in
the various months was as follows:

                          October (1870)    1
                          November          2
                          December          9
                          January (1871)   20
                          February         47
                          March           117
                          April           233
                          May             246
                          June            205
                          July             91
                          August           32
                          September        24
                          October          14
                          November         13
                          December         10
                          January (1872)    4
                          February          5
                          March and April   4

Among these 1,077 victims of the disease were 21 soldiers and 27
outsiders from the surrounding villages. The disease was very virulent.
Of the 1,727 patients treated in the hospital 253 died (14·7 per cent).
The population of Leipzig in the year 1871 was 106,922, so that the
1,052 deaths of the year 1871 correspond to a mortality of 98·4 per
10,000 inhabitants. Of 3,726 prisoners, 98 (76·3 per 10,000) contracted
the disease and 9 died.

In the district of Leipzig no case of small-pox was officially reported
between the months of May and October. When the disease broke out in the
city of Leipzig it was of course inevitable, in view of the constant
intercourse between the city and the surrounding country, that it should
spread rapidly among the working people who were employed in the city
and lived in the country, first to the immediate vicinity, and then,
following the chief lines of traffic, to the more remote
localities.[277] Of 113 places 106 were attacked; only two
peasant-villages and five isolated farm-estates were spared. The
villages inhabited by working people were much more severely attacked
than those inhabited by farmers and peasants. The progress of the
epidemic is indicated by the following figures, which Siegel says are
incomplete, since not all the cases were reported, and which correspond
at best to only one-half of the actual number of cases and deaths:

                                  _Cases._ _Deaths._
                   October (1870)        2
                   November              9         3
                   December             22         5
                   January (1871)      107        16
                   February            216        42
                   March               398       103
                   April               816       255
                   May                 944       367
                   June                732       311
                   July                288       161
                   August               94        68
                   September            45        35
                   October              38        16
                   November             41        25
                   December             44        18
                   January (1872)       26        12
                   February             28        20
                   March                18        11
                   April                 6        10
                   May                   5         6
                   June                  2         1
                   July                  —         —

According to this table the number of deaths in the district of Leipzig,
the population of which was 97,100, was eight in the year 1870, 1,417
(145·9 per 10,000 inhabitants) in the year 1871, and 60 in the year
1872. Accurate figures regarding the ratio of deaths to total cases
cannot be computed; at all events small-pox raged very severely, owing
partly to insufficient vaccination, and partly to the wretched
conditions in which the working people lived.

In Dresden, mild epidemics of small-pox had raged in the year 1864 and
again in the years 1867–8; between the months of January and August 1870
not a single small-pox patient was taken to the city hospital; the first
case was committed to the hospital on September 27 of that year, and
after that two more persons contracted the disease in a barrack. The
disease spread from there, at first along the streets in the vicinity of
the barrack, and then throughout the Antonstadt, Neustadt, and finally
the Altstadt. The epidemic reached its climax among the civil
inhabitants in April 1871, in the garrison in January. The following
table indicates the number of patients committed to the city hospital in
the months mentioned:[278]

                          September (1870)   2
                          October           12
                          November          22
                          December          31
                          January (1871)    60
                          February          82
                          March             95
                          April            186
                          May              173
                          June             148
                          July              78
                          August            38
                          September         18
                          October           32
                          November          40
                          December          62
                          January (1872)    59
                          February          57
                          March             30
                          April             40
                          May               13
                          June              13

All told, there were fifteen deaths due to the disease in Dresden in the
year 1870, 570 deaths (32·7 per 10,000 inhabitants) in the year 1871,
and 151 deaths (8·4 per 10,000) in the year 1872. Among the prisoners
there were 150 cases of the disease, and of these nine were fatal; in
the garrison there were 413 cases and twenty-one deaths.

The epidemic of small-pox in Chemnitz, at least the beginning of it, was
in no way connected with the war. An exhaustive report made out by
Flinzer,[279] who carefully investigated the conditions relative to
vaccination in the year 1871, furnishes us the following figures; of
64,255 inhabitants 53,891 were vaccinated, 5,712 were unvaccinated,
4,652 had survived a previous attack of small-pox, and only 1,928
persons had been vaccinated more than once. The epidemic of small-pox
began in January 1870, and reached its climax in December of that year.
From March 1871 to September 1872, only a few cases of the disease were
observed, but after September the number of cases suddenly began to grow
larger, resulting in a second severe epidemic, which continued to
increase in severity until March 1873. The mortality statistics found in
Flinzer’s report are reproduced below; they go only as far as April
1873, but after that the epidemic abated considerably:

                             1870. 1871. 1872. 1873.
                   January       1    25     3    43
                   February      3    15     1    68
                   March         5     4     5    74
                   April         8     3     4    37
                   May           8     3     6
                   June          8     1    10
                   July         19          14
                   August       27           6
                   September    20     1     6
                   October      28     1    12
                   November     28     1    27
                   December     38     2    32
                               ———    ——   ———   ———
                     Total     193    56   126   222

A particularly good idea of the protection against small-pox afforded by
vaccination is given in the Chemnitz statistics for the years 1870–1. Of
53,891 vaccinated persons 953 (1·8 per cent) contracted the disease in
those two years and seven succumbed to it, all of whom were more than
ten years of age; of 5,712 unvaccinated persons, almost one-half
contracted the disease (2,643 or 46·3 per cent, to be precise), and of
these 243 (9·16 of those taken sick) died. Of those who died, 102 were
less than one year old, 51 were less than two years old, 47 were in
their fourth or fifth year, and 20 were from five to ten years of age.

How dangerous small-pox showed itself to be after the Franco-German War
is indicated by a report of Geissler[280] regarding the epidemic in
Meerane, a manufacturing town of some 20,000 inhabitants. There, between
October 1871 and May 1872, no less than 460 persons (434 children and 26
adults) succumbed to small-pox, i.e. 230 per 10,000 inhabitants. Of the
children 80·3, and of the adults 26·3, succumbed to the disease in the
course of the epidemic.

             _(c) Small-pox in Bavaria in the Years 1871–2_

In the year 1866 Bavaria had an epidemic of small-pox, which, although
it abated considerably in the following years, did not leave the country