1. The Small-pox Mortality in France in the Years 1870–1
In the ‘sixties small-pox had not been very common in France, but no detailed reports regarding its prevalence there are available; the reports which the prefects were supposed to hand in are either entirely missing, or else very incomplete. According to the statistics compiled by Vacher,[[251]] the death-rate increased a little in the years 1864–5, then began to decrease, and in 1869 increased again. The figures which Vacher compiled, and which the Académie de Médecine in Paris has on file, are:
| 1860 | 1,662 |
| 1861 | 1,740 |
| 1862 | 1,813 |
| 1863 | 1,440 |
| 1864 | 3,290 |
| 1865 | 4,166 |
| 1866 | 593 |
| 1867 | 2,081 |
| 1868 | 3,900 |
| 1869 | 4,164 |
Vacher says in regard to these figures: ‘As far as the actual number of persons who contracted and succumbed to small-pox are concerned, they express only a small part of the truth. The reports submitted to the Academy of Medicine are rarely complete; it is even necessary to say that about one-quarter of the Departments never send in reports on the epidemics at all, although the ministerial instructions render the submission of these reports obligatory, and although the Academy never ceases to protest against the negligence of the prefectoral administrators.’ Vacher then goes on to say that in the years 1860–9 only 59 out of every 100 infants born were vaccinated, and that at the outbreak of the war about one-third of the French population was unvaccinated; in many Departments, indeed, as many as four-fifths (Aveyron, Corsica, &c.). Small-pox was much more prevalent in the French army than in the German army; according to the German Health Report,[[252]] the number of deaths caused by the disease was:
| Prussian Army. | French Army. | |||
|---|---|---|---|---|
| Total No. | Per 10,000 men. | Total No. | Per 10,000 men. | |
| 1866 | 8 | 0.30 | 46 | 1.37 |
| 1867 | 2 | 0.08 | 70 | 1.82 |
| 1868 | 1 | 0.04 | 169 | 4.28 |
| 1869 | 1 | 0.04 | 95 | 2.27 |
The reason for this lies in the fact that a larger proportion of the Prussian soldiers were vaccinated. Since the year 1806 all French recruits who had never been vaccinated were supposed to submit to the inoculation when they presented themselves for service, but this regulation was for years at a time very laxly enforced; consequently in the year 1857 a new order was issued, introducing compulsory vaccination for all recruits. But even this order does not seem to have been everywhere carried out with the necessary strictness, and complaints regarding the partial success of vaccination were frequently made by military physicians.
As stated above, there was a noticeable increase in the small-pox mortality in the year 1869; this increase lasted into the beginning of the year 1870, but was confined to certain localities. Chauffard’s[[253]] report on epidemic diseases in France is more incomplete for the years 1869–70, on account of the war, than for previous years; it was supplemented, partially at least, by the later reports of Vernois[[254]] for the year 1871, and also by the comprehensive report of M. Delpech[[255]] for the years 1870–2. According to these, epidemics of small-pox occurred in the year 1869 in North-west France (Bretagne), in North-east France (Departments of Aisne, Pas-de-Calais), and in South-east France (Departments of Gers, Ariège, and Pyrénées-Orientales.) In the winter of 1869–70 the epidemic continued to spread, and by the end of the year 1870 it included almost the whole of France. The incomplete reports give us no idea as to which Departments were attacked before the outbreak of the war and which after. According to Vernois, the disease appeared that year in 42 Departments, including 132 arrondissements and 539 parishes. But, as stated above, the reports are all very incomplete; a later report submitted by Delpech adds 11 more Departments to the 42. The total number of deaths caused by small-pox in France in the year 1871 is unknown; Vernois reported 14,425 deaths in 39 Departments, but this does not include the figures for Paris, where 10,539 persons succumbed to the disease, or for the Department of Finistère, or for the Department of Sarthe (in regard to which it is merely observed that there were ‘beaucoup de morts’), or for several other Departments.
It is a fact that small-pox raged severely among the civil inhabitants of all regions in which the second half of the war was waged (to the south, east, and north of Paris), and that the war itself helped the disease to spread in the eastern Departments (Jura, Doubs, Saône-et-Loire, Haute-Saône). The wide prevalence of the disease among the soldiers is attributed by many French physicians to the fact that the army as a whole had been inadequately vaccinated. If this was true of the regular troops, lack of time made it absolutely impossible to vaccinate all the men that were afterwards assembled in such a precipitate manner. The movements of the soldiers in the cold season of the year (in December there was some bitterly cold weather) made it necessary for friends and enemies to share whatever shelter they could find, regardless of whether the house had previously been occupied by small-pox patients, or whether such patients were actually lying in it at the time. The result was that the disease became very widespread throughout all France. Says Laveran:[[256]] ‘The army, being composed of men who had been in service for a long time, and who had been vaccinated and revaccinated, suffered very little, but the events which took place after the declaration of war altered this state of affairs. The regiments of the Departments on their way to Paris were quartered in the homes of civilians, where they contracted small-pox. The disease spread easily among the young people who, owing to lack of time, had not been revaccinated, and many of whom had perhaps never been vaccinated at all. During the first part of the siege of Paris it was these regiments which suffered the most from small-pox, but later on the epidemic became more general and spread to all the corps. The number of soldiers infected with small-pox during the siege was about 6·76 per 100, or 68 per 1,000.’
Small-pox raged very extensively in besieged strongholds. In Paris an epidemic of small-pox began in November 1869, and the number of deaths caused by the disease there was:[[257]]
| October (1869) | 39 |
| November | 93 |
| December | 119 |
| January | 174 |
| February | 293 |
| March | 406 |
| April | 561 |
| May | 786 |
| June | 914 |
| July | 1,072 |
| August | 713 |
| September | 700 |
| October | 1,361 |
| November | 1,722 |
| December | 1,837 |
| January | 1,503 |
| February | 763 |
| March | 230 |