Smallpox Measles Scarlet Fever Diphtheria
1837 (½) 5811 4732 2550 —
1838 16268 6514 5862 —
1839 9131 10937 10325 —
1840 10434 9326 19816 —
1841 6368 6894 14161 —
1842 2715 8742 12807 —
1847 4227 8690 14697 —
1848 6903 6867 20501 —
1849 4644 5458 13123 —
1850 4665 7082 13371 —
1851 6997 9370 13634 —
1852 7320 5846 18887 —
1853 3151 4895 15699 —
1854 2868 9277 18528 —
1855 2523 7354 16929 385
1856 2277 7124 13557 603
1857 3236 5969 12646 1583
1858 6460 9271 23711 6606
1859 3848 9548 19310 10184
1860 2749 9557 9681 5212
1861 1320 9055 9077 4517
1862 1638 9860 14834 4903
1863 5964 11340 30473 6507
1864 7684 8322 29700 5464
1865 6411 8562 7700 4145
1866 3029 10940 11683 3000
1867 2513 6588 12380 2600
1868 2052 11630 21912 3013
1869 1565 10309 27641 2606
1870 2620 7543 32543 2699
1871 23062 9293 18567 2525
1872 19022 8530 11922 2152
1873 2308 7403 13144 2531
1874 2084 12235 24922 3560
1875 849 6173 20469 3415
1876 2468 9971 16893 3151
1877 4278 9045 14456 2731
1878 1856 9765 18842 3498
1879 536 9185 17613 3053
1880 648 12328 17404 2810
1881 3698 7300 14275 3153
1882 1317 12711 13732 3992
1883 957 9329 12645 4218
1884 2216 11324 11143 5020
1885 2827 14495 6355 4471
1886 275 12013 5986 4098
1887 506 16765 7859 4443
1888 1026[1173] 9784 6378 4815
1889 23 14732 6698 5368
1890 16 12614 6974 5150
1891 49 12673 4959 5036
1892 431 13553 5618 6552
1893 1455 10764 6869 8918

The great epidemic of 1837-40 was the last in England which showed smallpox in its old colours. The disease returned once more as a great epidemic in 1871-72, after an interval of a whole generation (in which there had been, of course, a good deal of smallpox); but the epidemic of 1871-72 was different in several important respects from that of 1837-40. It was a more sudden explosion, destroying about the same number in two years (in a population increased between a third and a half) that the epidemic a generation earlier did in four years. It was an epidemic of the towns and the industrial counties, more than of the villages and the agricultural counties; it was an epidemic of London more than of the provinces; and it was an epidemic of young persons and adults more than of infants and children. The great epidemic of 1871-72 brought out clearly for the first time all those changes in the incidence of smallpox; but things had been moving slowly that way in the whole generation between 1840 and 1871. Experience subsequent to 1871-72 has shown the same tendency at work.

To begin with the changed incidence upon rural and urban populations, a glance down the following Table, will show that the counties marked *, with a smaller share in 1871-72, in a total of deaths in all England and Wales which was nearly the same as in the great epidemic a generation before, are nearly all those with a population more purely rural[1174]:

Incidence of the Smallpox Epidemics of 1837-40 (four years) and 1871-72 (two years) respectively upon the Counties of England and Wales.

1837-40 1871-72
England and Wales 41,253 42,084
Metropolis 6421 9698
*Surrey (extra-metr.) 383 231
*Kent (extra-metr.) 817 537
*Sussex 161 126
Hampshire 348 1103
*Berkshire 450 46
*Middlesex (extra-metr.) 418 306
*Hertfordshire 260 157
*Buckinghamshire 268 53
*Oxfordshire 199 109
Northamptonshire 399 563
*Huntingdonshire 65 14
Bedfordshire 125 128
*Cambridgeshire 400 175
*Essex 773 583
*Suffolk 506 348
*Norfolk 1038 895
*Wiltshire 548 85
*Dorsetshire 329 163
*Devonshire 1097 838
*Cornwall 767 531
*Somersetshire 1466 412
*Gloucestershire 1072 323
*Herefordshire 191 34
*Shropshire 345 161
*Worcestershire 1002 529
Staffordshire 1328 3050
*Warwickshire 957 785
Leicestershire 528 622
Rutlandshire 8 7
Lincolnshire 482 498
Nottinghamshire 562 983
*Derbyshire 329 297
*Cheshire 1141 310
†Lancashire 7105 4151
†Yorkshire W. Riding 2858 2609
"E. Riding 480 452
"N. Riding 236 405
Durham 798 4767
Northumberland 569 1512
*Cumberland 549 366
*Westmoreland 98 41
Monmouthshire 672 904
*Wales 2699 2314

The counties which were most lightly visited in 1871-72, as compared with 1837-40, were the agricultural and pastoral. In the outbreaks subsequent to 1871-72, smallpox has almost ceased to be a rural infection in Scotland and Ireland as well as in England. The great change that has come over it in that respect is shown in the following table, in which the annual death-rates from smallpox per 100,000 living are contrasted, for children under five, in each of several agricultural counties, with the mean of all England and of London, 1871-80, and with the corresponding scarlatinal death-rates in the right-hand column:

Annual Death-rates of Children under five, per 100,000 living, 1871-80.

Smallpox Scarlatina
All England 53 349
London 113 307
Sussex 9 100
Berkshire 4 141
Bucks 4 160
Oxfordshire 9 167
Huntingdonshire 3 205
Bedfordshire 11 242
Cambridgeshire 18 112
Suffolk 12 136
Wiltshire 5 210
Dorsetshire 15 152
Herefordshire 5 166
Shropshire 12 247

But the history of smallpox since the great epidemic of 1871-72 has brought out still another tendency in the same direction, namely, the increasing share of London in the whole smallpox of England. In the epidemic of 1837-40, which reached to almost every parish of England and Wales, London had 6449 deaths in a total of 41,644, or between a sixth and a seventh part, having rather less than an eighth part of the population. In the epidemic of 1871-72, London had between a fourth and a fifth part of the deaths (9698 in a total of 42,084), having then about a seventh part of the population. In 1877, more than half of all the smallpox deaths were in London, and in the year after as many as 1417 in a total of 1856. In 1881, London had about two-thirds of the deaths from smallpox in all England and Wales; but in the epidemic of 1884-85, it had only over a third part (1812 in a total of 5043). This excess of London’s share over that of the provinces is expressed in the following table, showing the respective rates of smallpox mortality per million of the population:

Smallpox Deaths in London and the Provinces, per million of population.