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was only one fourth of that in 1872. The number of cases in
the fifth month was also little more than one third of that in the
second, whilst in 1872 it was much larger. As, however, the
disease returned in October, 1872, and caused a mortality of 111
in 1873, we must not feel by any means certain that its worst
effects are over; at the same time, the deaths in London during
the corresponding period of four weeks have remained so
singularly even in this epidemic, since the third mortality period,
as to lead us to suppose that although it will probably last as
long as usual, viz., about twelve months, more or less, yet that
it will not increase in severity,
In my report for 1871 I gave some tables showing the
total number of deaths from small pox in all London since 1839,
and the mortality in different groups of years. The latter also
contained the percentage of the deaths in the first year of each of
the four-yearly periods (which is the one in which the disease has
generally been epidemic) and showed that 43.9 per cent.
occurred in the 8 first, 23.9 in the 8 last years of each period,
20.3 in the second, and only 11.9 in the third. Now according
to this table the year for small pox to have assumed an epidemic
form was 1875, but the large number of attacks in 1871-2
appear to have reduced the number of those who were susceptible
to it in an unusual ratio, so that the disease did not become
epidemic until 1876. As, however, the death rate per 10,000
population, since 1872, from small pox has been exceedingly
small, we can scarcely expect the epidemic to subside without
causing a larger number of deaths than usual, unless vaccination
of adults has been better carried out than in previous years.
The ordinary death rate per 100,000 inhabitants from small pox,
in London, is about 41.0; but it was only 3.4 in 1873, 1.6 in
1874, 2.2 in 1875, 21.1 in 1876, and at the annual rate of 136.2
in the first quarter of 1877; so that if the number of deaths
should continue the same in London for the remainder of this
year (1877) there would not be a larger number than usual for