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190
There was evidently a great improvement in the health of
London, as measured by the fall of the death-rate from all causes,
from its highest point in the Plague period, to a rate of about onehalf
or one-third of what it had been. A great improvement took
place between the middle of last century and the earlier years of
the present. Dr. Farr, remarking on these figures, says:—
"The diseases of London in the 16th century still prevail in
unhealthy climates; not only the diseases and the manner of
death have changed in this metropolis, but the frequency and
fatality of the principal diseases have diminished.
"Small-Pox attained its maximum mortality after inoculation
was introduced. The annual deaths of Small-Pox registered
1760-79 were 2,323; in the next 20 years, 1780-99, they declined
to 1,740; this disease, therefore, began to grow less fatal before
vaccination was discovered; indicating, together with the
diminution of fever, the general improvement of health then
taking place. In 1771-80 not less than 5 in 1,000 died annually
of Small-Pox; in 1801-10 the mortality sank to 2, and in 1831-5
to 0.83.
"Fever, exclusively of the Plague, has progressively subsided
since 1771; Fever has declined nearly in the same ratio as Small-Pox.
In the three latter periods of the table the deaths from fever decreased
as 621 : 264 : 111; from Small-Pox as 502 : 204 : 83."
We think these figures suggest that the fall of the death rates
from Fever and Small-Pox were associated in cause as well as in
time with the improvement in the public health which the fall in
general mortality indicates. It is possible that inoculation as
practised in London in the latter part of last century, prevented
an earlier or greater reduction in Small-Pox than actually took
place. Among the influences at work in the last quarter of the
18th century which would tend to counteract any injurious
influence of inoculation were the progressive rooting out of SmallPox
from our prisons, the sanitary improvements in our towns,