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
entirely free from the disease; it was, however, confined to a very few
localities in the year 1870. In Upper Bavaria cases were reported in
that year only in Altötting and Friedberg; in Lower Bavaria absolutely
no cases were reported; in Upper Franconia a small epidemic raged in
August 1870, in the district of Forchheim; in Central Franconia, where
in the year 1868 a rather severe epidemic had raged, the disease had
almost entirely disappeared by 1870; Lower Franconia and Swabia,
finally, had only sporadic cases of the disease. French prisoners and
homeward-bound soldiers, away on furlough, caused the pestilence, as was
reported from all sides, to break out anew; the rapid dissemination of
the disease, according to these reports, was helped by persons coming in
direct contact with French prisoners in crowded places, by teamsters
returning from France, by German fugitives from France, by persons
handling the linen and clothes of patients, and by the sale of woollen
blankets and other things which the French prisoners brought with them.
The following table indicates the number of people who succumbed to
small-pox in Bavaria:[281]
_Total._ _Per 10,000 inhabitants._
Oct. 1, 1865–Oct. 1, 1866 577 1·2
Oct. 1, 1866–Oct. 1, 1867 1,210 2·5
Oct. 1, 1867–Oct. 1, 1868 917 1·9
Oct. 1, 1868–Oct. 1, 1869 487 1·0
Oct. 1, 1869–Oct. 1, 1870 363 0·8
Oct. 1, 1870–Dec. 31, 1870 224
1871 5,070 10·4
1872 2,992 6·1
1873 869 1·8
1874 263 0·5
1875 87 0·2
Munich fared pretty well, and the civil population suffered less than
the soldiers.[282] Not a single case of small-pox occurred there during
the entire year of 1870. In November an officer suffering from dysentery
returned home from France, and shortly after his arrival he was taken
sick with small-pox, which later attacked two members of his family. In
the first part of the year 1871 small-pox became more and more
widespread, and reached its climax in June. The total number of deaths
in the year 1870 was 7, in the year 1871 it was 150 (8·9 per 10,000
inhabitants), and in the year 1872 it was 108 (6·4 per 10,000
inhabitants). The following table indicates the number of deaths that
occurred in the months mentioned:
November (1870) 2
December 5
January (1871) 18
February 17
March 15
April 17
May 20
June 22
July 7
August 4
September 6
October 7
November 10
December 7
January (1872) 10
February 21
March 20
April 20
May 21
June 11
July-December 5
In Nuremberg[283] sixteen isolated cases of small-pox were observed up
to the end of September in the year 1870, and twenty cases from October
to December (five in October, four in November, and eleven in December);
not a single patient succumbed to the disease in the course of that
year. In January the number of people to contract the disease increased
rapidly, and the climax of the epidemic was reached in April. The
following table indicates the number of deaths caused by the disease in
the months mentioned:
January (1871) 1
February 3
March 10
April 18
May 13
June 11
July 6
August 0
September 3
October 1
November 2
December 5
January (1872) 7
February 13
March 6
April 9
May 2
June 2
In the second half of the year 1872 there were two more deaths due to
small-pox. The total number of deaths caused by the disease was 73 (8·8
per 10,000 inhabitants) in the year 1871, and 40 (4·8 per 10,000) in the
year 1872.
Augsburg was very severely attacked. A Bavarian soldier and two French
prisoners succumbed there to small-pox in December 1870. In January the
disease spread to the civil population, increased rapidly in severity,
and reached its climax in May. After abating a little in September, the
epidemic started up anew and did not disappear entirely until May 1872.
The number of deaths is indicated by the monthly reports found in the
Bavarian _Ärztliches Intelligenzblatt_, a few of which we reproduce:
January (1871) 8
February 14
March 24
April 35
May 42
June 34
July 17
August 14
September 2
October 9
November 14
December
January (1872) 17
February 18
March 11
April 8
May 6
June and July 5
The total number of deaths, some of which are not included in the
monthly lists, was 234 (45·7 per 10,000 inhabitants) in the year 1871,
and 71 (13·8 per 10,000) in the year 1872.
In Regensburg sixteen persons (eleven prisoners, three soldiers, and two
civilians) contracted the disease in the latter part of 1870; in 1871 as
many as 123 persons contracted the disease, and of these thirty-three
died. In Bamberg the first two cases were reported in December 1870, the
disease having been brought there from Würzburg; up to August 1871 some
ninety persons contracted the disease, among them twenty-three prisoners
and five soldiers; of these, eight died. After a short lull, new cases
were reported (between December 1, 1871, and August 1872); there were
thirty-one cases, all told (seventeen of the patients being soldiers),
and only one death.[284]
_(d) Small-pox in Württemberg in the Years 1871–2_
In Württemberg, where vaccination had been compulsory since 1818, but
had been frequently evaded in the ‘sixties in consequence of the
agitation of the anti-vaccinationists, an epidemic of small-pox raged in
the years 1863–7, causing, all told, 804 deaths. In the latter part of
the year 1869 a new epidemic began and carried away many people,
particularly in Stuttgart, but also in the rest of the Neckar district.
With the arrival of the French prisoners the number of cases increased
rapidly, and the disease appeared in many places which had never before
been attacked. The following table indicates the number of reported
cases and deaths:[285]
_Year._ _Cases._ _Deaths._ _Deaths per 10,000 inhabitants._
1868 559 34 0.2
1869 1,488 133 0.7
1870 5,208 529 2.9
1871 10,848 2,050 11.3
1872 ? 1,164 6.4
But the reports were not always complete, for the reason that many cases
were kept secret. The following table indicates the number of deaths
caused by small-pox in the various districts:
_Neckar _Schwarzwald _Jagst _Donau
district._ district._ district._ district._
1868 1 19 3 11
1869 77 5 40 11
1870 381 71 40 37
1871 883 570 173 424
In the years 1869–70 Stuttgart[286] was the principal seat of the
epidemic; sixty-six cases were reported there in 1866, fifteen cases in
1867, and seventeen cases in 1868; only one case terminated fatally in
the year 1868. In the year 1869, after an average of twenty cases per
month had been officially reported up to August, the disease raged more
and more furiously, so that the total number of cases for the entire
year was no less than 744. In the following year the disease continued
to increase in severity until February, when it began to abate somewhat,
so that in October 1870 only thirteen cases were reported. Then the
number of cases steadily increased again until June 1871, when the
epidemic once more subsided a little, only to reach another moderate
climax in November. In the middle of the year 1872 the epidemic suddenly
came to an end. The following table indicates the number of deaths
caused by small-pox in the Stuttgart epidemic:
1869. 1870. 1871. 1872.
January 1 21 7 17
February 19 8 14
March 20 10 12
April 2 22 25 6
May 21 22 3
June 1 14 23 3
July 3 2 12 4
August 2 5 15
September 2 2 6
October 5 1 21
November 13 2 19
December 21 5 19
—— ——— ——— ——
Entire year 50 134 187 59
It is impossible to prove that the recrudescence of the disease in
Stuttgart in the latter part of 1870 was in any way connected with the
arrival of infected persons from France. In the garrison, which numbered
some 3,000 men, only four mild cases occurred, inasmuch as all recruits
had been vaccinated in Württemberg since the year 1833. But in the
latter part of the year 1870 there arrived a battalion of the Landwehr,
a third of whom had never done active service, and had therefore never
been revaccinated in accordance with the military regulation; after
this, numerous cases were reported in the garrison (October 1870 to
April 1871), although none of them resulted fatally.
The connexion between the epidemic in the stronghold of Ulm and the war
was very obvious. Says Volz:[287] ‘After the summer of 1870 had produced
only a few cases of small-pox, and a long pause (August to the beginning
of November) had intervened, during which we saw absolutely no traces of
the disease, the arrival of French prisoners caused the disease to
spread far and wide, constituting a part of the epidemic which raged
throughout almost all of Europe. In the latter part of September the
first cases of small-pox were observed among the prisoners. But a month
and a half elapsed before the disease made its appearance among the
civil inhabitants; one of the first cases was traced to the beds in the
barracks. In January 1871 the disease was conveyed to Söflingen by a
woman from that place who had been employed as a nurse in the military
hospital at New Ulm. The constant intercourse between Söflingen and Ulm
soon asserted itself through the infection of working-men who were
employed in the latter place and lived in the former. At the same time
the disease frequently appeared among the laundry-owners, washerwomen,
scrubwomen, innkeepers, sutler-women, and generally among persons who
were employed in any capacity in the field-hospitals and forts. Then,
too, patients kept arriving who had been infected in Baden, Switzerland,
Bavaria, North Germany, and in regions which, like ours, had been
infected by prisoners and fugitives arriving from France. In the
district of Beimerstetten the disease also made its appearance, having
been brought there in a carpet which a woman purchased from a Bavarian
soldier who had accompanied a transport of prisoners. In addition to
this woman, sixteen more persons contracted the disease, and three of
them died.’
In the city of Ulm thirty-six civilians (13·7 per 10,000 inhabitants)
succumbed to the disease, while in the district of Ulm forty-six persons
(21·2 per 10,000) died. The climax of the epidemic was reached in May;
after a short lull in August and September it started up again and
lasted until the autumn of 1872. The garrison at Ulm was also attacked,
but not very severely.
Of the immobile troops in Württemberg, who averaged 10,122 men, 7·9 per
1,000 contracted the disease. Of the French prisoners that were held in
Württemberg, 390 contracted the disease (the climax, 199 cases, was
reached in December). The maximum number of prisoners was 12,958, and
30·1 per 1,000 contracted the disease and twenty-eight died (7·2 per
cent of those taken sick).
In Heilbronn,[288] as in Stuttgart, a small epidemic had raged before
the war broke out; from February to July 1870 some forty persons had
contracted the disease. From August to October no more cases were
reported, but in November a new epidemic began and spread with great
rapidity. The following table indicates the number of cases and deaths
in the small-pox hospital at Heilbronn:
_Patients._ _Deaths._
November (1870) 2
December 19 2
January (1871) 51 3
February 66 9
March 95 13
April 83 14
May 95 17
June 47 11
July 18 2
In addition to these, twenty-seven cases of the disease were reported in
the city, so that the total number of patients was perhaps as large as
1,000. All told, seventy-one persons died in Heilbronn in the course of
the epidemic.
_(e) Small-pox in Baden in the Years 1871–2_
In Baden a great many cases of small-pox were reported among the French
prisoners; their maximum number was 12,083, and of these 512 (42·4 per
1,000) contracted the disease, and 21 (4·1 per cent of those taken sick)
succumbed to it. The largest number of cases (133) was observed in
January. Regarding the distribution of the French prisoners among the
various dépôts no information is available, while regarding the immobile
German troops we know absolutely nothing. Among the civil inhabitants a
small epidemic raged as early as the year 1869, particularly in the
district of Mannheim. In the latter part of the year 1870 a considerable
number of cases was reported, and a rather severe epidemic rapidly
developed. According to a written report of the Baden Bureau of
Statistics, the number of deaths due to small-pox per 10,000 inhabitants
was as follows:
_District._ 1870. 1871. 1872.
Constance 0·6 18·8 3·2
Freiburg im Breisgau 3·5 27·5 2·3
Karlsruhe 3·7 33·1 5·2
Mannheim 1·0 6·5 3·4
——— ———— ———
All Baden 2·4 21·7 3·5
Of those cities which at that time had more than 10,000 inhabitants,
Mannheim and Karlsruhe suffered very little; Rastatt, Freiburg, and
Constance were the most severely attacked. The number of deaths caused
by small-pox was:
_Population._ 1870. 1871. 1872.
Mannheim 39,606 3 33 4
Karlsruhe 36,582 4 25 9
Freiburg im Breisgau 24,668 10 138 17
Heidelberg 19,983 2 37 2
Pforzheim 19,803 2 34 2
Rastatt 11,560 10 99 1
Baden 10,080 4 9 4
Constance 10,061 2 39 2
_(f) Small-pox in Hesse in the Years 1871–2_
Regarding the epidemics of small-pox that raged in the Grand Duchy of
Hesse in the course of the nineteenth century, Reissner and
Neidhart[289] have published an excellent book. Vaccination, at least
once, was made compulsory in Hesse in the year 1807. According to the
above-mentioned book, small-pox was prevalent in Hesse all the time; the
average number of deaths per annum in the years 1863–8 was O·47 per
10,000 inhabitants. After the year 1868 the statistics read as follows:
_Deaths—Total._ _Per 10,000 inhabitants._
1869 20 0·24
1870 248 2·95
1871 1,028 12·08
1872 167 1·95
1873 3 0·03
The increased prevalence of the disease began in September; the
following table indicates the number of deaths in the several months:
1870. 1871. 1872.
January 163 27
February 3 148 30
March 3 136 33
April 9 163 35
May 9 143 22
June 10 105 17
July 5 73 2
August 5 30 1
September 13 21
October 30 15
November 45 15
December 116 14
——— ————— ———
Entire year 248 1,026[290] 167
While small-pox made its appearance here and there in the first half of
the year 1870, it did not acquire epidemic dimensions until after the
outbreak of the war. In many places, to be sure, it was impossible to
prove that the disease was directly connected with the war. Reissner and
Neidhart mention numerous cases in which the disease was communicated by
field-soldiers who were sent from France to Hessian reserve-lazarets
(Pfungstadt, Lampertheim, Crumstadt, and others), by furloughed
field-soldiers (Lauterbach, Lorsch, Eschollbrücken, and others), by
fugitives from Paris at the beginning of the war (Giessen,
Gross-Eichen), by French prisoners who had contracted the disease in
camp or during transport, by teamsters returning home from France
(Worms, Grossgerau), by military effects—such as carpets, clothing,
tent-canvas (three places in the district of Grossgerau), and especially
by people who had visited the prisons where the French soldiers were
confined (Mayence, Darmstadt, &c.).
Not a single district in Hesse was spared during the epidemic of the
years 1870–2. The district of Mayence suffered worst of all; then came
Giessen, Offenbach, and Darmstadt, all districts in which moderately
large cities were located. The following table indicates the number of
deaths per 10,000 inhabitants in the various cities and districts:
1870. 1871. 1872.
Mayence (city) 13·5 37·4 3·2
Mayence (district) 3·2 33·3 0·3
Darmstadt (city) 3·5 12·9 0·8
Darmstadt (district) 2·9 21·7 1·8
Giessen (city) 7·4 9·0
Giessen (district) 11·8 9·6 1·0
Offenbach (city) 0·4 15·9 6·6
Offenbach (district) 0·7 12·7 4·7
In the city of Mayence about thirty cases of small-pox were reported in
the year 1870 before the war broke out. ‘Shortly after the beginning of
the war,’ say Reissner and Neidhart, ‘numerous prisoners were interned
in Mayence, and among them cases of small-pox had not infrequently been
observed beforehand. Notwithstanding the admonitions of the military
physician, a barrack inside the city was set aside as a lazaret for
them. At first in the near-by streets, but later on throughout the
entire city, an epidemic now began to rage such as Mayence had never
before experienced in the memory of man. It lasted throughout the entire
year of 1871 and did not come to an end until the middle of the
following year.’ The epidemic reached its climax in Mayence in January
1871, abated a little until March, started up again in April, and then
slowly decreased in fury until it finally disappeared altogether. In the
garrison at Mayence 190 men contracted the disease in the years 1870–2
and nine succumbed to it; of the prisoners of war 934 contracted the
disease and seventeen per cent of them died. The pestilence was
disseminated in all directions from Mayence, partly by people from the
surrounding country who visited the city, and partly by other means.
Thus, for example, the disease broke out with unusual severity in
Bretzenheim, a village situated a mile or so away from the barracks
where the prisoners were confined; the inhabitants of the village in
many instances used the contents of the ditches in which the defecations
of the prisoners were thrown to fertilize their fields, and they also
bought straw and other waste products in the city.
In the city of Giessen no cases of small-pox occurred in the year 1870
prior to the outbreak of the war. The first cases observed there were in
September, but the epidemic, which reached its climax in December, did
not become very widespread. In Darmstadt 50 cases of small-pox were
reported in the year 1870 prior to the outbreak of the war, and after
the war began some 50–60 cases were observed before the end of the year.
The epidemic, which became only moderately widespread, lasted throughout
the entire year of 1871 and did not disappear until the middle of the
year 1872.
_(g) General Observations regarding the Epidemic of Small-pox in Germany
in the Years 1871–2_
In connexion with the Franco-German War an epidemic of small-pox raged
throughout Germany, the extent and virulence of which exceeded that of
any other epidemic that occurred in the entire course of the nineteenth
century. Unfortunately, in the case of a number of small States, we have
no statistics relating to the number of deaths caused by the disease.
The figures which I was able to obtain I have compiled in the following
table. In the case of Alsace and Lorraine, as well as of Oldenburg, the
two Mecklenburgs, and the other small North German States, absolutely no
figures are available; judging by their population and by the prevalence
of small-pox in the States surrounding them, we may safely estimate the
number of deaths caused by small-pox in them in the years 1871–2 at some
4,000.
───────────────┬───────────┬─────────────────────────────────────────────
_States in the │_Population│
German │ Dec. 1, │
Confederation._│ 1871._ │ _Deaths caused by small-pox._
───────────────┼───────────┼────────┬────────┬──────────┬──────────┬─────
〃 │ 〃 │ 1869. │ 1870. │ 1871. │ 1872. │1873.
───────────────┼───────────┼────────┼────────┼──────────┼──────────┼─────
Prussia │ 24,691,085│ 4,655│ 4,200│ 59,839│ 66,660│8,932
Bavaria │ 4,863,450│456[291]│516[292]│ 5,070│ 2,992│ 869
Saxony │ 2,556,244│ ? │ ? │ 9,935│ 5,863│1,772
Württemberg │ 1,818,539│ 133│ 529│ 2,050│ 1,164│ 55
Baden[292] │ 1,461,562│ 67│ 343│ 3,176│ 511│ ?
Hesse │ 852,894│ 20│ 248│ 1,028│ 167│ 3
Brunswick[291] │ 312,170│ ? │ 2│ 269│ 215│ ?
Lübeck │ 52,158│ │ 1│ 36│ 15│
Bremen[291] │ 122,402│ │ │ 54│ 41│ 3
Hamburg │ 338,974│ 20│ 83│ 3,647│ 323│ 3
Other States │ 2,439,576│ ? │ ? │4,000[292]│4,000[292]│ ?
Alsace-Lorraine│ 1,549,738│ ? │ ? │ ? │ ? │ ?
───────────────┼───────────┼────────┼────────┼──────────┼──────────┼─────
All Germany │ 41,058,792│ │ │ 89,104│ 81,951│
───────────────┴───────────┴────────┴────────┴──────────┴──────────┴─────
The above compilation leaves no doubt that the disease was borne into
Germany from France. The contagion was conveyed into Germany by
prisoners and field-soldiers, some of whom were infected beforehand and
were sick when they got there, others of whom were still apparently
healthy, and still others of whom had reached the convalescent stage of
the disease, and less frequently by civil persons (teamsters and
fugitives); but the prisoners were by far the most active influence in
spreading the disease. The dissemination usually took place in the
following manner; in the dépôts where the prisoners were confined,
small-pox epidemics of varying severity broke out; from all sides the
people streamed in to see the prisoners, and when they went away they
conveyed the infection wherever they went, at first, of course, around
in the immediate vicinity. This is most evident in the eastern
provinces, where these dépôts soon came to be dangerous seats of
small-pox infection; the near-by districts were very severely attacked
as early as the year 1871, whereas the more remote districts did not
begin to suffer severely until the year 1872.
The development of a small trade between the prisoners and civil
inhabitants in articles belonging to dead soldiers, or in personal
effects, also helped to spread the disease; moreover, certain
unscrupulous sick-attendants, when they were instructed to destroy such
articles, frequently disobeyed the order and secretly sold them, thereby
giving an additional impetus to the dissemination of the disease.
The fact that a large part of the population was not vaccinated, and
that the necessity of revaccination was not properly recognized (only
soldiers were revaccinated), also helped to increase the severity of the
pestilence. In all the South German States compulsory vaccination had
existed for decades, but its strict enforcement was everywhere hindered
by the activity of the anti-vaccinationists; Prussia and Saxony did not
introduce compulsory vaccination until the year 1874. Revaccination
among the civil inhabitants was rarely practised in either North or
South Germany. These differences in the vaccination laws account for the
fact that small-pox raged more severely in North Germany than in South
Germany; this is also distinctly shown by the tables reproduced in the
course of this chapter. The fact that the civil inhabitants in general
were more thoroughly vaccinated also explains why the percentage of
children that succumbed to small-pox was so much smaller in South
Germany than in North Germany.
The number of deaths caused by small-pox in the epidemic of the years
1870–2 was greatly increased by the extremely virulent character of the
disease. Of course one cannot estimate the number of deaths caused by
small-pox among the civil inhabitants from the number of reported cases
of the disease, since the reports sent in were always very incomplete.
We know that the mortality of small-pox depends very much upon
vaccination; vaccinated persons succumb far less frequently to the
disease than unvaccinated persons. This fact explains why among the
German field-soldiers, who were constantly subjected to hardships and
privations of all kinds, only 5·75 per cent of the patients died,
whereas of the French prisoners some 13·85 per cent died. The mortality
among the civil inhabitants of Germany was also very high; this was
chiefly due to the fact that severe forms of the disease, particularly
hemorrhagic small-pox, were of frequent occurrence. As authority for
this we can only refer to these reports of the hospitals; but since
small children, amongst whom the mortality of small-pox is very high,
are less represented in them, and, on the other hand, since mild cases
among adults can more readily be withdrawn from hospital treatment, one
cannot accept without qualification the experience of the hospitals.
According to Wunderlich, of 681 patients treated in the Leipzig hospital
between the year 1852 and July 1870, only 29 (4·2 per cent) died,
whereas in the years 1870–1, of 1,727 patients treated, 253 (14·7 per
cent) died. In Breslau, whereas in former epidemics an average of seven
per cent of the patients died, in the epidemic of the years 1871–2 no
less than 13·4 per cent died. Guttstadt also states that the mortality
in the Berlin hospitals was fifteen per cent, whereas the number of
deaths caused by the disease in former years was much smaller. We have
seen above that 21·7 per cent of the patients taken to the Hôtel-Dieu in
Lyons died. It is unnecessary to adduce further statistics; all
contemporary observers agreed that the epidemic involved an extremely
severe and virulent form of the disease, and that this same virulence
characterized the disease wherever it made its appearance.
5. _The Epidemics of Small-pox that raged in the European, and in a few
of the non-European States in connexion with the Franco-German War of
1870–1_
_(a) Switzerland_
Switzerland was exposed to great danger in consequence of the passage of
General Bourbaki’s army, which consisted partly of very young soldiers
who had suffered great hardships, including cold and hunger, and which
contained large numbers of men who were suffering from small-pox. The
little country was called upon to take in some 85,000 men; when the
latter were examined on the frontier a large number of them were found
to be infected with small-pox and were held at Verrière in France. But
this did not prevent the disease from being conveyed across the border.
Of the French prisoners confined there, 137, all told, succumbed to
small-pox.
Unfortunately no mortality statistics giving the cause of death were
compiled in Switzerland until the year 1876, so that we have no figures
indicating the prevalence of small-pox. The western cantons were most
exposed to the infection. In Berne, which at that time had a population
of 506,511, no less than 2,637 persons, excluding the French prisoners
interned there, contracted the disease between October 1870 and
September 1872; in the year 1871 there were 9·6 deaths per 10,000
inhabitants.[293] In the city of Basel, which was attacked as early as
November 1870, the epidemic reached its climax in February; the number
of deaths there was as follows:[294]
_Total no._ _Per 10,000 inhabitants._
1870 7 1·6
1871 64 14·0
1872 13 2·7
The Canton of Basel (Land) was attacked somewhat less severely; in the
year 1871 only 59 persons (10·9 per 10,000 inhabitants) succumbed there
to small-pox. In the Canton of Solothurn, which was infected from Olten,
a railway junction, 13·9 persons per 10,000 inhabitants died in the year
1871. In the Canton of Waadt small-pox broke out, according to Vogt, in
the district of Vivis in November 1870, and 200 persons contracted the
disease in the course of that month. In the two small-pox hospitals at
Lausanne, 351 patients were treated between November 20, 1870, and the
end of 1871, and 62 of them died.
The small-pox epidemic spread very rapidly from the West throughout all
the rest of Switzerland, partly in consequence of the distribution of
the French prisoners among the other cantons, and partly in consequence
of inland intercourse. Of the French prisoners interned in the Canton of
Zurich 180, according to A. Brunner,[295] contracted the disease and 31
died of it. The patients were sheltered in the small-pox camp at
Winterthur, whence the infection spread to many places. In February 1871
there was a rapid increase in the number of cases; the epidemic reached
its climax in March and April, and then steadily abated until June. The
statistics for the Canton of Zurich, which had a population of 285,915,
were as follows:
_Patients._ _Deaths._
1870 85 6
1871 1,068 137
1872 200 18
1873 22 —
In the Canton of Thurgau, according to Vogt, there were 9·2 deaths per
10,000 inhabitants in the year 1871, in the Canton of Schaffhausen 4·0,
and in the Canton of St. Gall 3·3. During the small-pox epidemic that
raged in the Canton of Schwyz in the year 1871 the communities of Gersau
and Küssnacht were severely attacked; throughout the entire canton 56
persons (11·7 per 10,000 inhabitants) succumbed to the disease. The
Cantons of Glarus, Unterwalden, Zug, and Graubünden were also rather
severely attacked. In the Canton of Tessin, whither the disease, which
first appeared in Locarno, had been conveyed by travellers from Paris,
and where 62 cases of it and 6 deaths had been reported up to June, a
new epidemic broke out in Personico, resulting in 15 deaths; in the year
1871 there were 11 deaths reported throughout the entire canton. In the
Canton of Willis small-pox broke out only sporadically.
_(b) Belgium_
In numerous places throughout Belgium small-pox had appeared in the
first part of the year 1870 in the form of widespread epidemics, a fact
which we can readily explain when we consider the country’s proximity to
France, which was everywhere infected with the disease. Thus, according
to Larondelle, a severe epidemic of small-pox broke out in February
1870, in the city of Verviers, which at that time had some 33,000
inhabitants, and lasted until January 1871; in the year 1870 no less
than 428 deaths were reported there, and 185 of them occurred in the
month of December alone. When the war began French fugitives kept
bringing the disease into the country, especially after the battle of
Sedan, when more than 10,000 French soldiers were interned on Belgian
soil, some in Beverloo and others in the citadel of Antwerp. From these
places the epidemic spread throughout all Belgium. In Brussels, for
example, no cases of small-pox were reported in July 1870, in August
there were two cases, in September two, in October twenty-two, in
November sixty-nine, and in December 101. In all Belgium the number of
deaths caused by small-pox was:[296]
_Total no. deaths._ _Per 10,000 inhabitants._
1868 843 1·7
1869 1,651 3·3
1870 4,163 8·2
1871 21,315 41·7
1872 8,704 16·8
1873 1,749 3·3
_(c) Netherlands_
In the Netherlands an epidemic of small-pox had raged in the year 1866;
in the following year it had rapidly abated, and in the year 1869 had
caused only fifty deaths in the three provinces of North Holland,
Utrecht, and Limburg combined. In the year 1870 the number of deaths
increased considerably, and in the following year reached an appalling
height.[297] The following table indicates the annual mortality of the
disease:
_Total no. deaths._ _Per 10,000 inhabitants._
1869 50 0·14
1870 706 1·96
1871 15,787 43·55
1872 3,731 10·21
1873 351 0·95
Thus both Belgium and the Netherlands had a very high small-pox
mortality in the year 1871; as elsewhere, the cause is traceable to
repeated transplantations of the disease, and to the fact that
vaccination was insufficiently practised.
_(d) Austria_
In the years 1872–4 Austria suffered severely from small-pox; the total
number of deaths per annum caused by the disease is indicated by the
following table:[298]
_Total no. deaths._ _Per 10,000 inhabitants._
1870 6,177 3·0
1871 8,074 3·9
1872 39,368 19·0
1873 65,274 31·2
1874 36,442 17·3
1875 12,151 5·7
Although small-pox was usually conveyed into Austria from the East and
South (Italy), nevertheless the connexion between the epidemic in
Austria of the years 1872–4, and the great German epidemic is too
obvious to be overlooked. This is clearly shown by the successive
appearances of the disease in the various crown-lands, the number of
deaths per 10,000 inhabitants in which is indicated by the following
table:
1870. 1871. 1872. 1873. 1874. 1875.
Lower Austria 2·6 5·1 37·0 28·8 15·1 10·6
Upper Austria 1·4 2·5 12·6 19·8 7·4 3·1
Salzburg 4·1 9·8 20·4 18·6 3·1 0·7
Styria 1·3 1·7 7·0 15·1 22·4 8·0
Carinthia 2·6 1·9 2·7 18·3 27·8 5·6
Carniola 1·2 1·2 4·0 21·2 51·1 4·3
Triest 3·2 2·1 72·2 4·1 5·9 2·7
Görz and Gradiska 〃 1·1 5·5 7·6 5·2 1·4
Istria 〃 0·6 18·3 9·5 8·9 3·0
Tyrol 0·9 1·1 1·0 3·3 11·0 14·4
Vorarlberg 〃 1·7 7·2 12·9 3·2 0·7
Bohemia 1·1 1·8 15·7 29·0 4·0 1·0
Moravia 1·8 3·8 21·0 47·0 6·6 2·4
Silesia 0·2 3·6 57·7 25·2 4·7 1·3
Galicia 6·4 6·4 20·9 46·5 33·5 7·3
Bukowina 6·6 12·0 9·0 9·7 44·3 29·2
Dalmatia 4·4 3·6 3·0 9·4 5·8 3·5
These relative percentages were based upon a mean population computed
from two censuses, one taken in 1869 and the other in 1880.
We see how the epidemic gradually penetrated into Austria, and how
Triest at a very early date became a second focus of the dissemination.
In the year 1870 the small-pox mortality was generally low in Austria.
The small epidemic in Bukowina in the year 1871 had no causal connexion
with the Franco-German War; it was an epidemic such as had often broken
out in former years in the countries of eastern Austria, and such as
still break out occasionally nowadays. On the other hand, a considerable
increase in the number of deaths caused by small-pox is observed in the
year 1871 in Lower Austria and Salzburg, and to a certain extent in East
Austria, Moravia, Silesia, and Bohemia; in Lower Austria, Salzburg, and
Silesia the epidemic reached its climax in the year 1872, whereas in
Upper Austria, Bohemia, and Moravia this climax did not come until the
year 1873. The same is true of Vorarlberg, while the crown-lands of
Styria, Carinthia, Carniola, and Tyrol were most severely attacked by
the disease in 1874. In Triest and Istria the climax of the epidemic was
reached in 1872, in Görz and Gradiska in 1873. In Galicia, which had
always had a high small-pox mortality, the epidemic did not begin until
the year 1872; it reached its climax in the following year. In Bukowina
the climax did not come until the year 1874.
‘To follow the progress of the disease according to political
districts,’ says Daimer, ‘is instructive for the reason that, as was
clearly shown at that time, it always spread slowly—a fact which was
also repeatedly observed in the case of other epidemics; thus, there was
always time enough to adopt appropriate measures aiming to check its
progress.’ There is a very marked difference between the epidemic of
small-pox in East Austria and the one in Germany; the latter attacked
all Germany within a short time, since the war had developed there a
very extensive intercourse. And even in Germany it was observed that the
disease was a long time in reaching those regions that were less
affected by this intercourse.
Vienna was attacked with great severity by small-pox; so also was
Prague, though to a lesser extent. The following table indicates the
number of deaths caused by the disease per 10,000 inhabitants:
_Vienna._ _Prague._
1869 5·4 1·9
1870 4·8 2·6
1871 7·6 1·5
1872 52·7 39·7
1873 22·0 28·2
1874 14·3 3·0
1875 18·0 1·1
But in these cities the epidemic did not come to an end; epidemic
outbreaks of small-pox continued to occur in Vienna until 1885, in
Prague until 1893, and in a number of years (for example, 1877, 1880,
1883, 1884, and 1888) the disease underwent some very important
exacerbations.
_(e) Italy_
Small-pox is supposed to have been conveyed into Italy by the volunteers
who had fought under Garibaldi; they became infected with the disease in
the Department of Côte d’Or, where it had raged extensively, and then
brought it back with them when they returned home. In Milan 200–300
cases per annum were usually reported prior to the year 1870. In the
summer of that year the number of cases greatly increased, terminating
in the following year in a severe epidemic which reached its climax in
September and October. According to Felice del Agua,[299] there were
1,287 cases and 152 deaths in the year 1870, and 4,467 cases and 866
deaths in the year 1871. In Rome small-pox made its appearance in
October 1871, causing 335 deaths between October 10 and December 31,
1871, and 727 deaths in the entire year of 1872. In the case of a large
number of individual places we have reports regarding epidemics of
small-pox, but I was unable to find a comprehensive account of the
epidemic that raged at that time in Italy.
_(f) Great Britain and Ireland_
Owing to the constant intercourse between England and France it was
inevitable that small-pox should very soon be conveyed into England; the
persons who conveyed it were probably French refugees. As on the
continent, so also in England, small-pox was always prevalent; in the
years 1869 and 1870, however, it was not very widespread, and it did not
begin to gain much headway until the autumn of 1870. The number of
deaths caused by small-pox in England was:
_All told._ _Per 10,000 inhabitants._
1868 2,052 0·9
1869 1,565 0·7
1870 2,620 1·2
1871 23,126 10·1
1872 19,094 8·3
1873 2,264 1·0
In the first nine months of the year 1870 there was no increase in the
small-pox mortality, but in the last three months, and from January 1871
on, the increase was very marked. The number of deaths caused by the
disease was:
1870. 1871.
First 405 4,903
Second quarter 446 7,012
Third quarter 500 4,612
Fourth quarter 1,229 6,380
These figures do not agree with the figures for the years 1870–1 given
in the previous table, and the reason for this is not explained in the
report. The places where the disease first entered England were London,
Liverpool, and the mining districts of Durham and South Wales
(Monmouth). The compiler of the reports regarding the movement of the
population in England in the year 1871 says:[300] ‘Nearly all the
smaller outbreaks may be more or less directly traced to one of these
centres; Brighton, for instance, doubtless suffered from its intimate
communication with London. There is distinct evidence in many cases of
the introduction of the disease into sea-side towns by sailors, and
considering its fatal prevalence in Holland, Belgium, and many parts of
France, it is not a matter for great surprise that Southampton, Great
Grimsby, and one or two other ports suffered from the epidemic. It is
indeed very probable that the epidemic in London was due to the large
arrivals of French refugees during the latter part of the previous
autumn. That the epidemic may to a great extent be traced to our foreign
communications is beyond doubt, and it is to be regretted that the
steady decline of deaths from small-pox in the six years 1864–9 had
induced a certain apathy in the matter of vaccination, and thus left a
large portion of the population unprotected from the disease. In times
of severe epidemics large numbers of the vaccinated in some way or other
also suffer for the neglect which has left so many unvaccinated.’
The number of deaths caused by small-pox in London was:
_All told._ _Per 10,000 inhabitants._
1868 597 1·9
1869 275 0·9
1870 973 3·0
1871 7,912 24·2
1872 1,786 5·4
1873 113 0·3
In the first quarter of the year 1871 some 2,400 persons succumbed to
small-pox in London, in the second quarter 3,241, in the third quarter
1,255, and in the fourth quarter 980. The epidemic broke out in the East
End of London in the fortieth week of the year 1870, i.e. in the first
part of October; the number of deaths caused by it there was 40, and by
the end of the year this number had increased to 110.
Of the English counties, those along the north-east coast were most
severely attacked; for example, Durham and Northumberland, where the
number of deaths caused by the disease was 45·0 and 29·8, respectively,
per 10,000 inhabitants. In the cities of Sunderland and
Newcastle-on-Tyne, located in these counties, the number of deaths per
10,000 inhabitants in the year 1871 was 86·0 and 54·1 respectively.
There was a very large number of deaths in London (24·2 per 10,000
inhabitants), and the counties bordering on London (Middlesex and Essex)
also suffered severely (9·3 and 8·0 respectively); next in order come
the counties of Monmouthshire and Lancashire with 14·8 and 11·9
respectively. The high mortality in Lancashire was due only to the city
of Lancaster, where there were no less than 38·8 deaths per 10,000
inhabitants; in the rest of the county the number of deaths per 10,000
inhabitants was only 6·3.
In Scotland and Ireland the number of deaths caused by small-pox was:
_All told._ _Per 10,000 inhabitants._
_Scotland._ _Ireland._ _Scotland._ _Ireland._
1869 64 20 0·2 0·04
1870 114 32 0·3 0·1
1871 1,442 665 4·3 1·2
1872 2,448 3,248 7·2 6·2
1873 1,126 504 3·3 0·9
1874 1,246 569 3·6 1·1
1875 76 535 0·2 1·0
Small-pox spread very slowly to Scotland and Ireland; whereas in England
the maximum number of persons died in the year 1871, in Scotland and
Ireland the maximum number of deaths occurred in the year 1872. Both
countries, moreover, were less severely attacked than England.
_(g) Denmark, Norway, Sweden, Finland, and Russia_
Small-pox was a long time in spreading to the Scandinavian countries. In
Denmark an epidemic had raged in the year 1869, but did not become very
widespread until the year 1872. In Copenhagen it began in the year 1871
and reached its climax in February 1872; between January and April 1,220
cases of the disease and 86 deaths were reported there. Regarding Norway
we have no statistical information. In Sweden small-pox raged in the
years 1865–9, abated a little in the years 1871–2, and started up again
with considerable severity in the year 1873. Stockholm was severely
attacked; in the year 1873 there were 13·0 deaths per 10,000
inhabitants, and in the following year 79·2. In Finland, where an
epidemic had raged in the year 1868, the number of deaths caused by the
disease began to increase in the year 1872, and in the two following
years the epidemic acquired enormous dimensions. The number of deaths
per 10,000 inhabitants was:
_Denmark._[301] _Sweden._[296] _Finland._[296]
1870 1·0 1·8 1·3
1871 0·6 0·8 1·0
1872 2·2 0·8 3·4
1873 0·3 2·6 45·6
1874 0·4 9·4 50·1
1875 2·1 4·6 8·6
1876 0·1 1·4 3·6
L. Colin reports that the pestilence spread to Russia in the year 1872,
when it attacked St. Petersburg very severely. More detailed information
I was unable to find.
_(h) Non-European Countries_
Constant emigration to America caused the disease to make its appearance
there, and it gradually spread over the entire continent. The following
table indicates the number of deaths caused by it in the states of
Michigan and Massachusetts:[296]
_Massachusetts._ _Michigan._
1870 131 11
1871 294 75
1872 1,029 304
1873 668 93
1874 26 19
In New York 109 persons succumbed to small-pox in the year 1869, 293 in
1870, and 805 in 1871.
The disease was also conveyed to the West Indies and to Chile.
Lersch,[302] moreover, reports that severe epidemics of small-pox
occurred in the Sandwich Islands and in Borneo, and that 500,000 persons
succumbed to it in the years 1873–5 in British India. But inasmuch as
small-pox frequently breaks out there in the form of large epidemics, it
cannot be assumed that the epidemic in Europe exerted any influence upon
this outbreak.
6. _The Age of the Small-pox Patients. The Connexion between the
Epidemic and the War. The German Imperial Vaccination Law_
Thus far very little attention has been called to the fact that the age
of the persons who succumbed to small-pox varied greatly in the
different countries. This depends upon how well vaccinated the
population of the country or countries was. Formerly, when nobody was
ever vaccinated, the first year of life and the following years were by
far the most seriously threatened; after the first few years the
mortality of small-pox gradually decreased as the age of the patients
increased. This also applies to-day to those countries in which
vaccination is neglected. On the other hand, in those countries in which
children are vaccinated in the first year of their lives, the infant
mortality is low, although the same children lose their immunity to the
disease when they grow older. To illuminate these facts let us adduce a
few figures. In estimating the number of deaths, however, we cannot use
the number of the living as a relative basis to work on, since the
prevalence of small-pox varied greatly in the different countries;
consequently we must take the total number of deaths and estimate the
mortality on the basis of age from that alone. But in doing this we can
compare with one another only entire countries in which the various ages
are all about equally represented; if we were to take smaller units, for
example, city and country, or agrarian and industrial districts, and use
them for a basis of comparison, more detailed computations would be
necessary. Of the four states included in the table below, Bavaria and
Hesse introduced compulsory vaccination (the law required everybody to
be vaccinated at least once) in the year 1807; Saxony and the
Netherlands, on the other hand, did not have compulsory vaccination. Of
every 100 persons who died of small-pox the following table indicates
the relative proportion on the basis of age:
_Vaccination not
_Vaccination compulsory._ compulsory._
_Bavaria._ _Hesse._ _Saxony._ _Netherlands._
(1870–5). (1870–2). (1872). (1870–3).
0–20 years old 22·4 21·8 76·3 68·3
20–60 years old 59·0 65·4 21·9 29·6
Over 60 years old 18·6 12·8 1·8 2·1
This table clearly shows that vaccination protects a person against
contracting small-pox for a number of years, or at least against
succumbing to it, but that this immunity lasts only for a certain length
of time and should be prolonged by revaccination—a fact which the
Prussian military authorities recognized and took into practical
consideration for many decades prior to the year 1870.
Many have contended that the epidemic of small-pox which ravaged a large
part of Europe, from the year 1870 on, was not a consequence of the
Franco-German War, but an independent outcome of unknown conditions that
were particularly favourable to the dissemination of the disease. The
main argument used to uphold this contention is that epidemics of
small-pox had occurred in all the states in the years before the war,
without having gained such irresistible headway, and that the disease
had broken out in the form of epidemics in many parts of Germany and the
neighbouring countries even in the first half of the year 1870. But to
refute this argument it can be clearly shown through Guttstadt’s
instructive compilation of data that the German epidemic was in
countless instances, in the case of Prussia as well as in that of other
states in the German Confederation, brought about by the transplantation
of the disease from France. Whenever small-pox broke out anywhere in
times of peace, it was possible to keep the disease localized, through
isolation of patients and the vaccination of the inhabitants of all
regions in which fugitives from pestilence took refuge. In the year
1870, on the other hand, the contagion of small-pox was spread
throughout all Germany in a few months; the increased intercourse caused
by the war, together with the habit the Germans had of visiting the
prisons where the French soldiers were confined, also helped to spread
the disease in all directions.
For Germany this disastrous epidemic, which throughout the German
Empire, including the Imperial Provinces, carried away upwards of
170,000 persons, had just one good result—it led to the passing of a law
in the year 1874 which rendered vaccination compulsory. ‘Besides taking
thousands of human lives the epidemic also caused considerable economic
loss; the care of the sick and the measures adopted to prevent the
disease from spreading necessitated large expenditures of money, while
large numbers of working-men contracted the disease and were thus
incapacitated for a long time; furthermore, the disease left unnumerable
sickly people, who had to be further supported, and at the same time the
fear of infection interfered with commercial intercourse. Those who
managed to escape infection, or to recover from an attack of the
disease, naturally wished to run no more risks in the future, or to
expose the welfare of their families to danger or destruction.’[303]
In consequence of all this grave suffering, the representatives of the
people petitioned the Imperial Government to provide as soon as possible
for a uniform legislative regulation, making universal vaccination
compulsory. The desire expressed in this petition was soon fulfilled by
the submission of a bill on February 5, 1874; the bill was passed by the
Reichstag on March 14, and received the signature of the Kaiser on April
8, 1874. This law required all persons to be vaccinated in the first
year of their lives, and to be revaccinated in their twelfth year; it
applied generally to all Germany.
The beneficial result of the passing of this law was clearly
demonstrated in the course of the following decades. Notwithstanding the
fact that Germany is almost entirely surrounded by states in which
epidemics of small-pox, in consequence of insufficient vaccination, are
of frequent occurrence, since the passing of the Imperial Vaccination
Law the disease has not once made its appearance on German soil in the
form of a widespread epidemic. Despite the fact that small-pox is
frequently conveyed into the country, especially by foreign working-men,
the efforts to keep it confined within narrow limits have always been
successful. The measures which are so effective in the case of other
diseases—isolation of the patients and of suspected persons living in
the vicinity, disinfection of the room and effects which have been used
by patients—in an insufficiently vaccinated community do not have the
desired rapid success, since the contagion of small-pox clings with
extraordinary tenacity to clothes and articles of general use. This fact
has been abundantly proved in the epidemics of small-pox that have
occurred in Europe in the course of the last few decades.