In south-eastern France, small-pox did not become very widespread until after the outbreak of the war; in Lyons, for example, the epidemic began in the second half of October. To be sure, small-pox had appeared in several places in the year 1868, but by the winter of 1868–9 this epidemic was over, although individual cases continued to occur. Regarding the cause of the small-pox epidemic that broke out in Lyons in the autumn of 1870, Fonteret[[260]] gives us the following information: ‘Two causes could not help favouring the outbreak in our city; the movements of the troops that took place at that time, and the emigration of numerous Parisians, who since the beginning of September, that is to say, since the time when the epidemic began to rage furiously in Paris, passed through our city on their way to Switzerland.’ Regarding the course of the epidemic, no statistics covering the entire city are available, but we are able to see from the following table, compiled by Perroud, the number of small-pox patients taken in by the Hôtel-Dieu and the number that died there:

Patients.Deaths.
January-June (1870)1269
July-September10115
October298
November9426
December16037
January (1871)14831
February14737
March13529
April12425
May8412
June457
July385
August-December446

In the other cantons of the Department 935 deaths were officially recorded in the years 1870–1. It was observed in Lyons, as in other places, that not only the number of persons who contracted small-pox, but also the virulence of the disease itself, increased; whereas only 10.6 per cent of 227 sporadic cases resulted fatally between January and September, out of 1,004 persons who contracted the disease between October 1870 and July 1871 no less than 21.7 per cent died.

In the year 1871 small-pox did not spare a single Department in France, although many of them failed to send in reports. Vacher estimates the number of deaths due to the disease in the year 1871 at 58,236, but he adds that the estimate is too small. No report, for example, was sent in by the Department of Sarthe, where in the city of Le Mans alone there were 1,181 deaths, nor by the Department of Haute-Garonne, where there were 1,328 deaths in Toulouse. The total number of unreported deaths, therefore, must have been at least 20,000. It is almost impossible to estimate the number of deaths that occurred in the year 1870. From the available statistics Vacher estimates the number of deaths caused by the disease in the two years 1870–1 at 89,954, a figure, as he himself says, ‘which represents only a part of the reality.’ Another estimate made by Vacher, putting the number of deaths caused by small-pox in the years 1869–70 at 200,000, is in all probability not an exaggeration.

In the year 1872, to be sure, small-pox appeared in the form of epidemics in numerous parts of France, but nowhere did it spread so widely as in the two previous years. According to a report worked out by Delpech for the years 1870–2, no less than 42 Departments failed to make any report at all in the year 1872, while only 18 of the remaining 41 Departments sent in reports regarding epidemic outbreaks of small-pox. The epidemic lasted until 1873, in which year reports regarding small-pox epidemics came in from 10 Departments; but only in the Departments of Morbihan and Pyrénées-Orientales was the epidemic apparently somewhat more intense.[[261]]

2. Small-pox among the French Prisoners

Thanks to the well-vaccinated condition of the German troops, the army suffered comparatively little from small-pox. In the field army 4,385 men (61·3 per 1,000) contracted the disease, and 278 of them (3·5 per cent of those who contracted it) died. Including the officers, physicians, and officials, the number taken sick was 4,991 and the number that died was 297. The number of men in the individual army corps that contracted the disease varied greatly according to the nature and place of their activity; particularly hard hit were the army divisions in the south-western and northern scenes of the war, where the military operations were carried on in fearfully cold weather, and where it was impossible to quarter the infected soldiers in isolated places by themselves. The French army was attacked much more severely by small-pox, although there are no accurate reports available regarding the prevalence of the disease. According to a report found in the Vienna Medical Weekly,[[262]] the total number of French soldiers that succumbed to small-pox was 23,469[[263]]; but the accuracy of this number, to be sure, is questionable, since, assuming that there was a very high mortality, it would mean that some 120,000 troops contracted the disease. At all events, the French army, taken as a whole, was badly infected with small-pox, and it was inevitable that among the French prisoners brought to Germany there should be numerous small-pox patients, some in the incubation stage, and some in the convalescent stage of the disease, and that they should infect other people there.

The number of French prisoners taken to Germany in the first few months of the year 1871 was no less than 372,918; the prisoners who at the very beginning, but especially after the surrender of Metz, were transported in large numbers to Germany, had to be distributed throughout the entire Empire, clear over to the eastern boundary. Owing to the fact that new transports of French prisoners were constantly arriving at the German frontier, which, in consequence of severe hardships and privations, they reached in such a weak physical condition that they could not be taken very far inland, it became necessary to transfer some of the earlier arrivals to other places of detention, and this, of course, favoured the further dissemination of the disease. This transference was rendered particularly necessary by the arrival of large numbers of prisoners after the battle of Sedan (September 1), after the capitulation of Metz (October 27), and after the battles of Orléans and Le Mans (December and January respectively). Small-pox occasionally broke out among these prisoners while they were on their way to Germany, rendering it necessary to leave them behind, or else the disease made its appearance when they reached their destination; as a rule, however, the first cases of the disease were observed a few days after their arrival at their place of detention, where they soon infected the other prisoners. The further dissemination of the disease among them was checked by means of wholesale vaccination.

Of the prisoners, 14,178, all told (38 per cent of the total number taken), contracted small-pox, and of these 1,963 (5·26 per cent) died. The statistics in the German Health Report indicate distinctly the number of prisoners in the various states and provinces that contracted and succumbed to the disease; but the total number of prisoners taken is known only in the case of the larger states in the Confederation, since the statistics in the Report are compiled on the basis of the army-corps districts, which do not coincide with the political divisions. The figures for the larger states are as follows:

Maximum no. prisoners.Patients.Deaths.Patients per 1,000.Deaths per 100 cases.
N. Germany, excluding Kingdom of Saxony283,75010,5471,52737·214·5
Kingdom of Saxony10,2342481824·27·3
Bavaria40,0831,60719640·012·2
Württemberg12,9583902838·17·2
Baden12,0835122142·44·1
Grand Duchy of Hesse13,81087417363·319·8
All Germany372,91814,1781,96338·013·8