From 1804 to 1818, one in 18.9; that is, 53 in 1000.
Fractions are not noticed in the last column of numbers.
It appears from this statement, that the proportion of deaths from Small Pox to the total mortality, increased in the course of last century; so that Inoculation appears to have added to the mortality. It is but fair to mention, however, that this total mortality is not quite a just scale whereby to measure the relative mortality of Small Pox; for in the course of that century, the general mortality itself was greatly diminished in relation to the population. This diminution of general mortality was chiefly owing to the diminished mortality of children under two years of age, which, at the time when the account began to be kept, 1729, averaged about 9000; but at the end of the century not more than 5000[[1]]; also to the decrease of fevers, and still more of fluxes. The relation of the mortality of Small Pox to the population, would therefore be a more fair criterion of its increase or decrease. In this view it might, at first sight, be thought that it had decreased; for the population of the metropolis nearly doubled in the course of the last century. But it is to be remarked, that there has been little increase of population in that portion of the metropolis which is included in the bills of mortality; the great increase having been in the parishes of Mary-le-bone and St. Pancras, which are not included in these bills. It is computed in the remarks subjoined to the last parliamentary returns of population, that the population of London, within the walls, had decreased more than three-fifths in the course of last century, from the widening of streets, the erection of public buildings and warehouses, and, it might have been added, from the migration of mercantile families to the west end of the town. As a set-off to this, there has certainly been a great addition, in the same time, to those parishes within the bills, which stand on the verge of the metropolis, such as St. George’s Hanover Square, St. George’s Bloomsbury, Poplar, and Stepney. But the addition to the population, if any, within the bills of mortality, does not seem to be so considerable as to affect the computation. And, if this is admitted, the absolute numbers of the deaths from Small Pox, estimated in relation to the population, that is, exactly as they stand on the Tables, afford a fair comparative statement of the mortality in the last century, and seem to prove that Inoculation has not added so much to it as has been alleged. It was in the rural population that the effect of Inoculation in diffusing Small Pox was chiefly felt. In this situation there is much less intercourse of persons with each other than in towns, so that not only many individuals escaped from their not being exposed to infection during their whole lives, but whole districts were known to have been exempt from it for a long series of years, before it was universally diffused by Inoculation.
But the truly important result from these statements consists in the clear, undeniable, and great diminution of it since the introduction of Vaccination. It appears, that in the last fifteen years, the mortality from Small Pox, in the bills of mortality, has not been much more than one-half of what it was in the two like series of years in the middle and latter end of the last century. Nor does this comprise the whole benefit derived from this discovery in the metropolis; for, besides that the sixth part of it lies without the bills, it was found, in levying the tax on burials for the last six months of 1794, that the number of unregistered deaths, chiefly those of dissenters, amounted in that half year to 3148; and the reporter of the parliamentary enumeration thinks that, as besides these there were undiscovered interments, the unregistered deaths may be computed at one-third of the total mortality, that is, about 7000. (See Abstract of the Parish Registers, 1811, printed by authority of Parliament, page 200.)
Assuming, therefore, that Vaccination had not been practised the last fifteen years, and that the mortality from Small Pox, within the bills, had in that time, that is, from 1804 to 1818, been the same as from 1784 to 1798, that is, 27,569 in place of 14,716; and assuming that there has been the same proportional diminution of deaths in the districts without the bills, and among the unregistered subjects, the account of lives saved in this metropolis by Vaccination in the fifteen years, will stand as follows:—
| Within the bills of mortality | 12,853 |
| Without the bills of mortality | 2,570 |
| Unregistered cases | 7,711 |
| ------ | |
| Total | 23,134 |
The first of these numbers is found by subtracting the amount of deaths by Small Pox, in the bills of mortality, during the practice of Vaccination, from the amount of them, during the same number of years, immediately before the discovery of Vaccination.
The second number is found by dividing the first by 5. The population of the metropolis without the bills is stated at one-sixth of the whole, which is evidently one-fifth of that within the bills.
The third number is found by dividing the sum of the two others by 2; the unregistered cases being, as before stated, one-third of the whole.
It appears, therefore, that, even under the very imperfect practice of Vaccination which has taken place in this metropolis, 23,134 lives have been saved in the last fifteen years, according to the best computation that the data afford. It will be seen, by an inspection of the Table, that in that time there have been great fluctuations in the number of deaths. This has been owing partly to the Small Pox Inoculation of out-patients having, by an unaccountable infatuation, been kept up at the Small Pox Hospital for several years after the virtue of Vaccination had been fully confirmed. The greater number of deaths in 1805 may chiefly be referred to this cause. Since the suppression of this practice, the adoption of Vaccination, though in a degree so incomplete, in consequence of public prejudice, created entirely by mischievous publications, has been unable to prevent a considerable, though fluctuating, mortality from Small Pox. The late mortality from Small Pox, though little more than one half of what it was in former times, might have been entirely saved, if Vaccination had been carried to the same extent as in many cities and whole districts on the continent of Europe, in Peru, and Ceylon.