In the city of Mayence about thirty cases of small-pox were reported in the year 1870 before the war broke out. ‘Shortly after the beginning of the war,’ say Reissner and Neidhart, ‘numerous prisoners were interned in Mayence, and among them cases of small-pox had not infrequently been observed beforehand. Notwithstanding the admonitions of the military physician, a barrack inside the city was set aside as a lazaret for them. At first in the near-by streets, but later on throughout the entire city, an epidemic now began to rage such as Mayence had never before experienced in the memory of man. It lasted throughout the entire year of 1871 and did not come to an end until the middle of the following year.’ The epidemic reached its climax in Mayence in January 1871, abated a little until March, started up again in April, and then slowly decreased in fury until it finally disappeared altogether. In the garrison at Mayence 190 men contracted the disease in the years 1870–2 and nine succumbed to it; of the prisoners of war 934 contracted the disease and seventeen per cent of them died. The pestilence was disseminated in all directions from Mayence, partly by people from the surrounding country who visited the city, and partly by other means. Thus, for example, the disease broke out with unusual severity in Bretzenheim, a village situated a mile or so away from the barracks where the prisoners were confined; the inhabitants of the village in many instances used the contents of the ditches in which the defecations of the prisoners were thrown to fertilize their fields, and they also bought straw and other waste products in the city.
In the city of Giessen no cases of small-pox occurred in the year 1870 prior to the outbreak of the war. The first cases observed there were in September, but the epidemic, which reached its climax in December, did not become very widespread. In Darmstadt 50 cases of small-pox were reported in the year 1870 prior to the outbreak of the war, and after the war began some 50–60 cases were observed before the end of the year. The epidemic, which became only moderately widespread, lasted throughout the entire year of 1871 and did not disappear until the middle of the year 1872.
(g) General Observations regarding the Epidemic of Small-pox in Germany in the Years 1871–2
In connexion with the Franco-German War an epidemic of small-pox raged throughout Germany, the extent and virulence of which exceeded that of any other epidemic that occurred in the entire course of the nineteenth century. Unfortunately, in the case of a number of small States, we have no statistics relating to the number of deaths caused by the disease. The figures which I was able to obtain I have compiled in the following table. In the case of Alsace and Lorraine, as well as of Oldenburg, the two Mecklenburgs, and the other small North German States, absolutely no figures are available; judging by their population and by the prevalence of small-pox in the States surrounding them, we may safely estimate the number of deaths caused by small-pox in them in the years 1871–2 at some 4,000.
| States in the German Confederation. | Population Dec. 1, 1871. | Deaths caused by small-pox. | ||||
|---|---|---|---|---|---|---|
| 1869. | 1870. | 1871. | 1872. | 1873. | ||
| Prussia | 24,691,085 | 4,655 | 4,200 | 59,839 | 66,660 | 8,932 |
| Bavaria | 4,863,450 | 456[[291]] | 516[[292]] | 5,070 | 2,992 | 869 |
| Saxony | 2,556,244 | ? | ? | 9,935 | 5,863 | 1,772 |
| Württemberg | 1,818,539 | 133 | 529 | 2,050 | 1,164 | 55 |
| Baden[[292]] | 1,461,562 | 67 | 343 | 3,176 | 511 | ? |
| Hesse | 852,894 | 20 | 248 | 1,028 | 167 | 3 |
| Brunswick[[291]] | 312,170 | ? | 2 | 269 | 215 | ? |
| Lübeck | 52,158 | 1 | 36 | 15 | ||
| Bremen[[291]] | 122,402 | 54 | 41 | 3 | ||
| Hamburg | 338,974 | 20 | 83 | 3,647 | 323 | 3 |
| Other States | 2,439,576 | ? | ? | 4,000[[292]] | 4,000[[292]] | ? |
| Alsace-Lorraine | 1,549,738 | ? | ? | ? | ? | ? |
| All Germany | 41,058,792 | 89,104 | 81,951 | |||
The above compilation leaves no doubt that the disease was borne into Germany from France. The contagion was conveyed into Germany by prisoners and field-soldiers, some of whom were infected beforehand and were sick when they got there, others of whom were still apparently healthy, and still others of whom had reached the convalescent stage of the disease, and less frequently by civil persons (teamsters and fugitives); but the prisoners were by far the most active influence in spreading the disease. The dissemination usually took place in the following manner; in the dépôts where the prisoners were confined, small-pox epidemics of varying severity broke out; from all sides the people streamed in to see the prisoners, and when they went away they conveyed the infection wherever they went, at first, of course, around in the immediate vicinity. This is most evident in the eastern provinces, where these dépôts soon came to be dangerous seats of small-pox infection; the near-by districts were very severely attacked as early as the year 1871, whereas the more remote districts did not begin to suffer severely until the year 1872.
The development of a small trade between the prisoners and civil inhabitants in articles belonging to dead soldiers, or in personal effects, also helped to spread the disease; moreover, certain unscrupulous sick-attendants, when they were instructed to destroy such articles, frequently disobeyed the order and secretly sold them, thereby giving an additional impetus to the dissemination of the disease.
The fact that a large part of the population was not vaccinated, and that the necessity of revaccination was not properly recognized (only soldiers were revaccinated), also helped to increase the severity of the pestilence. In all the South German States compulsory vaccination had existed for decades, but its strict enforcement was everywhere hindered by the activity of the anti-vaccinationists; Prussia and Saxony did not introduce compulsory vaccination until the year 1874. Revaccination among the civil inhabitants was rarely practised in either North or South Germany. These differences in the vaccination laws account for the fact that small-pox raged more severely in North Germany than in South Germany; this is also distinctly shown by the tables reproduced in the course of this chapter. The fact that the civil inhabitants in general were more thoroughly vaccinated also explains why the percentage of children that succumbed to small-pox was so much smaller in South Germany than in North Germany.
The number of deaths caused by small-pox in the epidemic of the years 1870–2 was greatly increased by the extremely virulent character of the disease. Of course one cannot estimate the number of deaths caused by small-pox among the civil inhabitants from the number of reported cases of the disease, since the reports sent in were always very incomplete. We know that the mortality of small-pox depends very much upon vaccination; vaccinated persons succumb far less frequently to the disease than unvaccinated persons. This fact explains why among the German field-soldiers, who were constantly subjected to hardships and privations of all kinds, only 5·75 per cent of the patients died, whereas of the French prisoners some 13·85 per cent died. The mortality among the civil inhabitants of Germany was also very high; this was chiefly due to the fact that severe forms of the disease, particularly hemorrhagic small-pox, were of frequent occurrence. As authority for this we can only refer to these reports of the hospitals; but since small children, amongst whom the mortality of small-pox is very high, are less represented in them, and, on the other hand, since mild cases among adults can more readily be withdrawn from hospital treatment, one cannot accept without qualification the experience of the hospitals. According to Wunderlich, of 681 patients treated in the Leipzig hospital between the year 1852 and July 1870, only 29 (4·2 per cent) died, whereas in the years 1870–1, of 1,727 patients treated, 253 (14·7 per cent) died. In Breslau, whereas in former epidemics an average of seven per cent of the patients died, in the epidemic of the years 1871–2 no less than 13·4 per cent died. Guttstadt also states that the mortality in the Berlin hospitals was fifteen per cent, whereas the number of deaths caused by the disease in former years was much smaller. We have seen above that 21·7 per cent of the patients taken to the Hôtel-Dieu in Lyons died. It is unnecessary to adduce further statistics; all contemporary observers agreed that the epidemic involved an extremely severe and virulent form of the disease, and that this same virulence characterized the disease wherever it made its appearance.