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is necessary to review in some detail the history of Small-Pox and
the various preventive measures which have at different times
been in vogue, and to scrutinise the grounds on which one alone
of these preventive measures has been relied upon to the exclusion
of others. We desire also to give reasons for thinking that other
more effective and practicable (as well as less objectionable) modes
of stamping out Small-Pox, or protecting communities from its
introduction, are available. We venture to think that the report
of our colleagues, in the preparation of many portions of which
we have borne our part, has approached the consideration of the
behaviour of Small-Pox, and the means of preventing it, too
exclusively from the standpoint of vaccination, and that too little
attention has consequently been accorded to sanitary organisation,
prompt notification and isolation, measures of disinfection and
cleanliness, and healthy conditions of living, whjch we believe to
be of the first importance in preventing and controlling outbreaks
of Small-Pox.
In 1710, for the first time since the Bills of Mortality had
been compiled, more than 3,000 deaths were ascribed to SmallPox
in London, or 127 per 1,000 deaths from all causes. The
prevalence of the disease led to many speculations as to possible
means of deliverance from it. The orthodox teaching of propagation
by "epidemic constitution of the atmosphere" was not
calculated to inspire sanitary precautions, or the separation of the
sick from the whole. Mead's work on the prevention of contagions,
primarily directed against a threatened invasion of plague, was
not written until 1720. On the other hand there were reports
from the Levant, where Small-Pox had been long endemic, that
by a method of "engrafting" the disease artificially it might be
robbed of its terrors. As far as the epidemiological history of
Small-Pox can be followed back in Asia and Africa, we find
records of the popular practice, in some form or other, and often
with religious associations, of the artificial induction of the disease.
Even in Wales and Scotland, and in Western Europe, some kind
of popular tradition of a similar practice has been traced by some
authorities.