While small-pox made its appearance here and there in the first half of the year 1870, it did not acquire epidemic dimensions until after the outbreak of the war. In many places, to be sure, it was impossible to prove that the disease was directly connected with the war. Reissner and Neidhart mention numerous cases in which the disease was communicated by field-soldiers who were sent from France to Hessian reserve-lazarets (Pfungstadt, Lampertheim, Crumstadt, and others), by furloughed field-soldiers (Lauterbach, Lorsch, Eschollbrücken, and others), by fugitives from Paris at the beginning of the war (Giessen, Gross-Eichen), by French prisoners who had contracted the disease in camp or during transport, by teamsters returning home from France (Worms, Grossgerau), by military effects—such as carpets, clothing, tent-canvas (three places in the district of Grossgerau), and especially by people who had visited the prisons where the French soldiers were confined (Mayence, Darmstadt, &c.). Not a single district in Hesse was spared during the epidemic of the years 1870–2. The district of Mayence suffered worst of all; then came Giessen, Offenbach, and Darmstadt, all districts in which moderately large cities were located. The following table indicates the number of deaths per 10,000 inhabitants in the various cities and districts: 1870. 1871. 1872. Mayence (city) 13·5 37·4 3·2 Mayence (district) 3·2 33·3 0·3 Darmstadt (city) 3·5 12·9 0·8 Darmstadt (district) 2·9 21·7 1·8 Giessen (city) 7·4 9·0 Giessen (district) 11·8 9·6 1·0 Offenbach (city) 0·4 15·9 6·6 Offenbach (district) 0·7 12·7 4·7