The Epidemiology continued to the end of the 17th century.

What little remains to be said of smallpox in England to the end of the seventeenth century may be introduced by the following table of the deaths in London.

Smallpox Deaths in London 1661 to 1700.

Year Total
deaths
Smallpox
deaths
1661 16,665 1246
1662 13,664 768
1663 12,741 411
1664 15,453 1233
1665 97,306 655
1666 12,738 38
1667 15,842 1196
1668 17,278 1987
1669 19,432 951
1670 20,198 1465
1671 15,729 696
1672 18,230 1116
1673 17,504 853
1674 21,201 2507
1675 17,244 997
1676 18,732 359
1677 19,067 1678
1678 20,678 1798
1679 21,730 1967
1680 21,053 689
1681 23,951 2982
1682 20,691 1408
1683 20,587 2096
1684 23,202 1560
1685 23,222 2496
1686 22,609 1062
1687 21,460 1551
1688 22,921 1318
1689 23,502 1389
1690 21,461 778
1691 22,691 1241
1692 20,874 1592
1693 20,959 1164
1694 24,100 1683
1695 19,047 784
1696 18,638 196
1697 20,972 634
1698 20,183 1813
1699 20,795 890
1700 19,443 1031

Sydenham’s remarks throw some light on the smallpox of the several years. While the epidemic of 1667-68 was of a regular and mild type, that of 1670-72, which has fewer deaths in the bills, was of the type of black smallpox complicated with flux. The year 1674 has the highest figures yet reached; the type of the disease was confluent, and so severe that it “almost equalled the plague”; while the smallpox of the year 1681, with a still higher total, was “confluent of the worst kind.”

It is not easy to make out what the differences of “type” described by Sydenham depended on; but it may be hazarded that those who fell into smallpox in an otherwise unhealthy season would die in larger numbers, being weakened by antecedent disease, such as measles or epidemic diarrhoea, influenza or typhus fever. An epidemic of measles in the first six months of 1674 was most probably the reason of the great fatality of smallpox in the second half of that year (see the chapter on Measles). The high figures of smallpox mortality in 1681 followed two hot summers, unhealthy with infantile diarrhoea, and coincided with a third season unhealthy in the same way. The deaths by smallpox in the last week of August, 1681, reached the very high figure of 168, the next highest cause of death that week, and the highest the week after, being “griping in the guts,” or infantile diarrhoea. The smallpox of 1685 was more uniformly distributed over the months of the year, which was one of malignant typhus, the worst week for fever having 114 deaths (ending 29 Sept.), and the worst week for smallpox 99 deaths (ending 18 Aug.).

The deaths by smallpox in the London bills are the only 17th century figures of the disease. According to later experience, a high mortality in London in a certain year meant an epidemic general in England in that or the following year; and the same appears to have held good for the period following the Restoration. In the parish register of Taunton, a weaving town, the smallpox deaths are many in 1658 (“all the year,” which was one of agues and influenza), in 1670, 1677, and 1684 (“very mortal,” the year being noted for a very hot summer and for fevers and dysenteries[853]). The highest total of deaths in London to the end of the 17th century fell in 1681, which is known to have been a year of very fatal smallpox at Norwich[854] and at Halifax. Thoresby’s friend Heywood lost three children by it at the latter town in the epidemic of 1681, which does not appear to have visited Leeds. In 1689 Thoresby himself lost his two children at Leeds within a few days. In 1699 the epidemic returned, and he again lost two of the four children that had been born to him in the interval[855]. Similar calamities befell country houses, of which the following from the correspondence of a titled family in Cumberland is an instance:

“17th April, 1688,—Captaine Kirkby came hither, and told me that Mrs Skelton, my god-daughter, of Braithwaite, dyed the last week, and her two children, of the smallpockes[856].”

Rumours of “smallpox and other infectious disease” at Cambridge in the summer of 1674[857], and at Bath in the summer of 1675[858], threatened to interfere with the studies of the one place and the gaieties of the other.