ula,
consumption, or any similar disease can be transmitted by vaccination.
In some infants, whose skin is very delicate, and especially in those,
some members of whose family have been liable to eruptions on the skin,
vaccination has seemed to act as an irritant, and to give occasion to an
eruption, or aggravate an eruption already existing. Such cases,
however, are not frequent, and the eruption is not more troublesome than
those which often appear in teething children. The occurrence of actual
erysipelas around the puncture, while very dangerous, is, as I have
already stated, of excessive rarity.

A thoroughly dispassionate review of the whole subject appears to me to
warrant the following conclusions:--

1st. That vaccination, though not a perfect guarantee against small-pox,
diminishes immensely the risk of its occurrence; and that by periodical
revaccination, this guarantee is rendered all but absolute.

2nd. That a very large proportion of the failures of vaccination are due
to its careless and imperfect performance.

3rd. That to such careless performance and to the introduction of the
blood and not of the vaccine matter alone, from one child to another are
due the extremely rare instances in which one special disease has been
transmitted by vaccination.

4th. That there is absolutely no evidence of the transmission of
scrofula, consumption, or any similar disease by vaccination.

5th. That vaccination direct from the calf appears to present some
decided advantages; but it has not yet been practised for a sufficient
time to admit of a comparison between its preservative power and that of
vaccination from one child to another.

6th. That in either case it is expedient that vaccination be performed
within the first three months after birth, so as to avoid the irritation
of teething which is unfavourable to successful vaccination, and also
because the disposition to those skin diseases which vaccination tends
to aggravate is never so considerable before the age of three months as
it becomes subsequently.

Even when vaccination fails to protect against small-pox it tends to
produce a modified and so much milder form of the disease, that while
one patient died out of every two in the Homerton Small Pox Hospital who
had the disease naturally, the deaths were only one in four of those who
had been imperfectly vaccinated, and one in forty-three of those whose
arms bore evidence of perfectly good and successful