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no evidence to show that any marked decline in the practice took
place during the remainder of the century. But the distribution
of the practice was very unequal. It was much more common
among the rich, or at least, among the well.to.do, than among
the poor, though many benevolent efforts were made ' to extend
its advantages' to the latter. Again, in some districts, as in
Essex and Herts, the home of Sutton and Dimsdale, and in
Yorkshire, the practice was very widespread. On the other
hand, parts of Kent and Sussex are quoted by Haygarth in 1793
as having been practically free from inoculation, and similar
statements as to the paucity of inoculation in this or that district
are made by other writers of about the same period.
There are no records giving exact information as to the
amount of inoculation practised in London, but, seeing that it
was favoured by the rich, and that on the other hand opportunities
for the poor were afforded by the Inoculation Hospital, we may,
perhaps, conclude that the practice was at least very general.
What influence, then, had the practice on the prevalence of,
and on the mortality from, small.pox, during the latter half, and
especially during the latter quarter, of the eighteenth century ?
Since an inoculated person was infectious, each inoculation
was a source of danger to those, not protected by a previous
attack, who came into the company of, or even near, the inoculated
person during the attack; and this danger was increased by
the fact that the mild character of the inoculated disease permitted,
in many cases at least, the patient to move about among his
fellows. Moreover, as Haygarth, himself a zealous advocate of
inoculation in a systematic regulated manner, points out, the
beneficial results of inoculation had robbed the disease of its
terrors to so great an extent that the rich and powerful no longer
made the efforts which they formerly did to prevent its entrance
into, or its spread in, their neighbourhood, and thus favoured its
spread among the unprotected poor ; so that inoculation,' though
eminently useful to the rich appeared to be injurious to the poor.'