are told in a note to the official tables that the first successful vaccination in Stockholm was at the end of 1810, so that the earlier vaccinations must have been mainly in the rural districts; yet the earlier Stockholm epidemics in 1807, before a single inhabitant was vaccinated, and in 1825, were less severe than the six later ones, when vaccination was far more general.
Bearing these facts in mind, and looking at diagram V., we see that it absolutely negatives the idea of vaccination having had anything to do with the great reduction of small-pox mortality, which was almost all effected before the first successful vaccination in the capital on the 17th December, 1810! And this becomes still more clear when we see that as vaccination increased among a population which, the official Report tells us, had the most "perfect confidence" in it, small-pox epidemics increased in virulence, especially in the capital (shown in the diagram by the dotted peaks) where, in 1874, there was a small-pox mortality of 7,916 per million, reaching 10,290 per million during the whole epidemic, which lasted two years. This was worse than the worst epidemic in London during the eighteenth century.[1]
But although there is no sign of a relation between vaccination and the decrease of small-pox, there is a very clear relation between it and the decrease in the general mortality. This is necessarily shown on a much smaller vertical scale to bring it into the diagram. If it were on the same scale as the small-pox line, its downward slope would be four times as rapid as it is. The decrease in the century is from about 27,000 to 15,000 per million, and, with the exception of the period of the Napoleonic wars, the improvement is nearly continuous throughout. There has evidently been a great and continuous improvement in healthy conditions of life in Sweden, as in our own country
- ↑ The highest small-pox mortality in London was in 1772, when 3,992 deaths were recorded in an estimated population of 727,000, or a death-rate of not quite 5,500 per million. (See Second Report, p. 290.)
