The Report of the Newcastle Dispensary illustrates another truth, namely, that the abatement or cessation of smallpox is by no means equivalent to a reduction of death; that evil conditions of life remaining unchanged, a fall in smallpox is compensated for by a rise in some cognate form of zymotic disease. Thus Dr. Monteith remarks:
It is generally said by the opponents of Vaccination that the other exanthemata have increased since its introduction. It must be allowed that our figures (probably unreliable as general data), give some support to this supposition. The proportion of cases of Scarlatina in the five years, 1827-32 was 4·3 per cent. It has never reached that high limit since; but the percentage has never fallen below 2 in the last thirty-five years. Mortality has also increased to an alarming extent. At one time so low as 2·5 per cent., it has amounted to 17 per cent. in the last five years. Scarlatina is now by far the most fatal disease on the list, with the exception of Consumption.
Of Scarlatina, the Dispensary record stands thus—
| Years. | Cases. | Deaths. | Mortality per 100. |
| 1777 to 1802 | 355 | 33 | 9·3 |
| 1803 ” 1827 | 795 | 30 | 3·7 |
| 1828 ” 1852 | 1,856 | 155 | 8·3 |
| 1853 ” 1877 | 3,659 | 567 | 15·5 |
| —— | —– | —— | |
| 6,665 | 785 | 11·7 |
Of Measles it is said, “the disease has somewhat increased in numbers, whilst the proportion of deaths to cases has not varied much.” Thus the record stands—
| Years. | Cases. | Deaths. | Mortality per 100. |
| 1777 to 1802 | 186 | 16 | 8·6 |
| 1803 ” 1827 | 435 | 22 | 5·0 |
| 1828 ” 1852 | 1,572 | 83 | 5·2 |
| 1853 ” 1877 | 2,537 | 123 | 4·8 |
| —— | —– | — | |
| 4,730 | 244 | 5·1 |
Of Whooping Cough it is observed—
The death-rate in former years fluctuated widely. At present it appears to remain stationary at a figure somewhat above the average of the century. There is a common impression that Whooping Cough is a disease of little danger and no importance, but the following table shows that of late years it has been more fatal than Smallpox or Measles.
| Years. | Cases. | Deaths. | Mortality per 100. |
| 1777 to 1802 | 245 | 22 | 9·0 |
| 1803 ” 1827 | 220 | 23 | 10·4 |
| 1828 ” 1852 | 743 | 112 | 15·0 |
| 1853 ” 1877 | 1,716 | 241 | 14·0 |
| —— | —– | —— | |
| 2,924 | 398 | 13·6 |