| 1847-9 | 1850-4 | 1855-9 | 1860-4 | 1865-9 | 1870-4 | 1875-9 | 1880-4 | |||||||||
| London | 460 | 300 | 237 | 281 | 276 | 654 | 292 | 244 | ||||||||
| Provinces | 274 | 271 | 192 | 175 | 172 | 339 | 48 | 34 |
If the table were continued to the very latest date, it would show the provinces recovering their share, but upon a slight prevalence of the epidemic as a whole, the deaths in London having been mere units from 1886 to 1892, while in 1888 there was a severe epidemic in Sheffield and in 1892-93 a good deal of the disease in a few manufacturing towns of the North-western and Midland divisions. It would be a not incorrect summary of the incidence of smallpox in Britain to say, that it first left the richer classes, then it left the villages, then it left the provincial towns to centre itself in the capital; at the same time it was leaving the age of infancy and childhood. Of course it did none of these things absolutely; but the movement in any one of those directions has been as obvious as in any other. Measles and scarlatina have not shown the same tendency to change or limit their incidence. Smallpox may have surprises in store for us; but, as it is an exotic infection, its peculiar behaviour may not unreasonably be taken to mean that it is dying out,—dying, as in the death of some individuals, gradually from the extremities to the heart.
With all those changes, the fatality of smallpox, or the proportion of deaths to attacks, came out in the great epidemic of 1871-72 curiously near that of the 18th century epidemics, namely, one death in about six cases. This rate comes from the hospitals of the Metropolitan Asylums Board according to the following table:
Admissions for Smallpox, with the Deaths, at the hospitals of the Metropolitan Asylums Board, from the opening of the several hospitals to 30 April, 1872.
| Males | Females | Both Sexes | ||||||||||||||||||
| Age-periods | Adm. | Died | Percentage of deaths | Adm. | Died | Percentage of deaths | Adm. | Died | Percentage of deaths | |||||||||||
| Under 5 | 434 | 235 | 54·15 | 469 | 236 | 50·32 | 903 | 471 | 52·15 | |||||||||||
| 5-10 | 851 | 236 | 27·73 | 821 | 196 | 23·87 | 1672 | 432 | 25·83 | |||||||||||
| 10-20 | 2827 | 265 | 9·37 | 2513 | 237 | 9·43 | 5340 | 502 | 9·40 | |||||||||||
| 20-30 | 2561 | 465 | 18·15 | 1922 | 285 | 14·82 | 4483 | 750 | 16·72 | |||||||||||
| 30-40 | 939 | 244 | 26·00 | 665 | 136 | 20·45 | 1604 | 380 | 23·69 | |||||||||||
| 40-50 | 316 | 100 | 31·64 | 242 | 64 | 26·45 | 558 | 164 | 29·39 | |||||||||||
| 50-60 | 85 | 18 | 21·17 | 88 | 31 | 35·22 | 173 | 49 | 28·32 | |||||||||||
| Above 60 | 40 | 8 | 20·00 | 35 | 7 | 20·00 | 75 | 15 | 20·00 | |||||||||||
| 8053 | 1571 | 19·49 | 6755 | 1192 | 17·64 | 14,803 | 2763 | 18·65 | ||||||||||||
These admissions to hospitals included attacks of every degree of severity, the intention of the hospitals being to isolate all cases, mild and severe alike; so that, although these are technically hospital cases, they are not comparable to the select class admitted to the old Smallpox Hospital of London, but to the cases of smallpox in former times in the community at large. Although the general average of deaths in 14,808 cases, namely, 18·65 per cent., is nearly the same as (being slightly higher than) that of the equally comprehensive totals of 18th century cases given at p. 518, yet the average is made up in a different way. In some of the 18th century epidemics, such as that of Chester in 1774, all the deaths were under ten years of age, and yet the average rate of fatality was only 14 or 15 per cent. The much higher rate of fatality from birth to five years and from five years to ten in the London epidemic of 1871-72 (which is confirmed in part by the Berlin statistics of the same years), must have had some special reasons. One reason, doubtless, was that the attack of smallpox in recent times has fallen upon comparatively few children, whereas in former times it fell upon nearly the whole; and it may be inferred that the infants who have been in recent times subject to the attack of smallpox have also been of the class that are most likely to die of it. The high rates of fatality at the ages above thirty in the table agree with the experience of all times.
The percentages of fatalities from smallpox in the hospitals of the Metropolitan Asylums Board have varied as follows from their opening to the present time:
| Cases | Percentage of deaths | |||
| 1 Dec. 1870-3 Feb. 1871 | 582 | 20·81 | ||
| 4 Feb. 1871-31 Jan. 1872 | 13,145 | 18·95 | ||
| 1872-3 | 2362 | 17·84 | ||
| 1873-4 | 191 | } } | 17·02 | |
| 1874 (11 mo.) | 120 | |||
| 1875 | 111 | |||
| 1876 | 2150 | 21·64 | ||
| 1877 | 6620 | 17·92 | ||
| 1878 | 4654 | 17·99 | ||
| 1879 | 1688 | 15·69 | ||
| 1880 | 2032 | 15·95 | ||
| 1881 | 8671 | 16·61 | ||
| 1882 | 1854 | 12·96 | ||
| 1883 | 626 | 16·06 | ||
| 1884 | 6567 | 15·98 | ||
| 1885 | 6344 | 15·8 | ||
| 1886 | 132 | } } } } | 14·28 | |
| 1887 | 59 | |||
| 1888 | 67 | |||
| 1889 | 5 | |||
| 1890 | 27 | |||
| 1891 | 64 | |||
| 1892 | 348 | 11·29 | ||
| 1893 | 2376 | 7·75 |