cinations not considered perfect, even though they had to a certain extent "taken," were either immediately revaccinated or the parents informed that the protection was not perfect; and advised to have the operation repeated at an early date. This work was also reported to the inspector, and the revaccinated cases again visited on the eighth day.
Between the twentieth and thirtieth days each case of primary vaccination was visited a second time to make sure that all was right, and deliver certificates of vaccination. If any unusual symptoms had occurred or the sore was tardy in healing, the case was taken in charge and treated until well. But even here the care did not cease. In each family where vaccination was performed a circular was left, printed in English and German, giving directions for the care of the vesicle, and directing parents to bring their children to the inspector's office at any time afterward, should any unpleasant effects appear which they might attribute to the vaccination—a privilege which they were not backward in claiming.
All the schools, institutions, asylums, workshops and factories were visited and vaccination offered. Two physicians were assigned specially to the public schools and the same care regarding reports, records, and revisiting was observed. Certificates were also given to those thoroughly protected in order to avoid the annoyance and labor of unnecessary examinations.
Thus the work of vaccination was for the first time carried on in a thorough and systematic manner, and thus it has been kept up ever since. Twice a year the tour of inspection and vaccination is made throughout the tenement-house region, factories, and all places where people are habitually brought together in large numbers in a more or less confined atmosphere. The schools are thoroughly canvassed about once in three years. Five years of such extensive, systematic and thoroughly studied work could scarcely fail of results of some kind either for good or for evil. During that time 270,970 vaccinations were performed by the Vaccinating Corps alone, independent of the great number performed at the dispensaries, and by physicians in their private practice. It remains to examine these results as regards the protection which vaccination affords against small-pox, and as regards the transmission of disease, which has constituted the great ground of prejudice against the practice of vaccination. Regarding the advantages or disadvantages of vaccination two main points present themselves:
1. Is vaccination a protection against small-pox?
2. Is it a vehicle for the communication of other diseases? Let the facts themselves speak; and the facts here presented, all of which occurred during the epidemic of 1874-'75, are drawn from the published reports of the Board of Health and from personal conversations with Dr. Taylor, the very efficient Inspector of Vaccination, whose excel-
