Smallpox attained its maximum mortality after Inoculation was introduced. The annual deaths from smallpox from 1760 to 1779 were on an average 2323. In the next twenty years, 1780 to 1799 they declined to 1740. The disease, therefore, began to grow less fatal before Vaccination was discovered; indicating, together with the diminution of fevers, the general improvement of health then taking place.[82] The decrease of smallpox towards the close of the century, says Dr. Farr, was due to “the general improvement of health then taking place;” but to what was that improvement due? No marked improvement had been effected in the sanitary arrangements of London--why then this change for the better? My answer is, that a great alteration was in progress in the popular diet. Dr. George Cheyne, in his famous _Essay of Health and Long Life_, published in 1724, says-- There is no chronical distemper whatsoever more universal, more obstinate, and more fatal in Britain, than the Scurvy taken in its general extent. And more than fifty years afterwards, in 1783, we have Dr. Buchan bearing similar testimony-- The disease most common to this country is the Scurvy. One finds a dash of it in almost every family, and in some the taint is very deep. It is scarcely necessary to cite authority for what was so generally known and confessed; but in this question of smallpox and its prevention we have to deal with many who appear to be destitute of any historic sense; who argue as if what Englishmen are to-day, they always were; and who contend that as there was more smallpox in London before Jenner than since Jenner, therefore Jenner must be the cause of the diminution. It is necessary to condescend to such feeble folk. The cause of the general scorbutic habit of the people was widely recognised by medical men, and Buchan merely repeated their common opinion in saying-- A disease so general must have a general cause, and there is none so obvious as the great quantity of animal food devoured by the natives of this island. As a proof that Scurvy arises from this cause, we are in possession of no remedy for that disease equal to the free use of vegetables.[83] Cheyne said much the same at the earlier date. He complained that the upper classes gorged themselves with animal food, and slaked their thirst with wine, “which is now [1724] become common as water, and the better sort scarce ever dilute their food with any other liquor.” Beer had the place of wine among the middle and lower orders. In the words of Buchan-- The English labourer lives chiefly on bread, which being accompanied with other dry, and often salt food, fires his blood and excites an unquenchable thirst, so that his perpetual cry is for drink. He adds--