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101
reasonable to think that improved sanitary conditions would tend
to diminish the fatality of, and so to a corresponding extent the
mortality from, small-pox. And there can be no doubt that the
period with which we are dealing has been characterised by an
improvement of this description. There has been better drainage,
a supply of purer water, and in other respects more wholesome
conditions have prevailed.
We have seen, then, that if some changes have occurred
tending to diminish mortality from Small-Pox, other changes
have been simultaneously in progress tending in the contrary
direction. We do not think it possible to strike the balance
between the two, and assert that it would tell in favour of a
smaller mortality. In saying this, we do not mean to indicate an
opinion that sanitary improvements have been without an effect
on Small-Pox mortality, but only that, when all the changes
which have occurred are considered, it cannot be asserted that
they afford an adequate explanation of the diminished mortality
from Small-Pox.
If, however, improved sanitary conditions were the cause
of the mortality from Small-Pox becoming less, we should expect
to see that they had exercised a similar influence over almost all
other diseases. Why should they not produce the same effect in
the case of Measles, Scarlet Fever, Whooping Cough, and, indeed,
any disease spread by contagion or infection, and from which
recovery was possible ? Why should they not lead to these
diseases also prevailing less, and to those attacked by them being
better able to combat the disease ?
We have had put before us no satisfactory answer to these
questions. It has, indeed, been urged that whilst the diseases
we have just mentioned almost exclusively affect children, SmallPox
largely attacks adults. We cannot feel that this circumstance
is of much weight. It must be remembered that in former days
Small-Pox was more fatal to children than to any other class.
But apart from this, we fail to see why improved sanitary