The recent epidemic of smallpox was the severest in the history of the city, and has seldom been equaled in the number of cases and in malignancy in recent times, in civilized countries, as will be seen by the accompanying chart, which shows cases and deaths, prepared by Dr. Probst, secretary of the Ohio State Board of Health. The total number of cases for 1902 was 1,248, with 224 deaths. The death rate was 17.9 per cent., and, as Dr. Probst well said: "This was the genuine old-fashioned smallpox." Many of the cases were of the most malignant character and exceedingly contagious, unlike the mild form of the disease which hitherto prevailed.
The cause of this widespread epidemic is not far to seek. During Dr. G. C. Ashmun's incumbency of the Cleveland health office, from 1880 to 1891, the rule requiring vaccination of all school children was rigidly