corded, and the numbers published by the Local Government Board. My third diagram is for the purpose of showing graphically the relation of smallpox to other zymotic diseases, and to vaccination, for England and Wales. The lower line shows small-pox, the middle one zymotic diseases, and the upper the total death-rates. The relations of the three are much the same as in the London diagram, the beginning of the great decline of zymotics being in 1871, and that of small-pox in 1872, but the line of small-pox is much lower, and zymotics somewhat lower than in London, due to a larger proportion of the inhabitants living under comparatively healthy rural conditions.
But if the amount of vaccination were the main and almost exclusive factor in determining the amount of small-pox, there ought to be little or no difference between London and the country. But here, as in all other cases, the great factor of comparative density of population in compared areas is seen to have its full effect on small-pox mortality as in that of all other zymotic diseases.
This non-relation between vaccination and smallpox mortality is further proved by the thick dotted line showing the vaccinations per cent, of births for the last 22 years, as given in the "Final Report"
(p. 34). The diminution of vaccination in various parts of the country began about 1884, and from 1886 has been continuous and rapid, and it is during this very period that small-pox has been continuously less in amount than has ever been known before. Both in the relation of London small-pox to that of the whole country, and in the relation of small-pox to vaccination, we find proof of the total inefficacy of that operation.
Small-pox in Scotland and in Ireland
In their Final Report the Commissioners give us Tables of the death-rates from small-pox, measles, and scarlet-fever in Scotland and Ireland; and from these
