y a
dark crust which remains from one to three weeks and then falls off. It
leaves a bluish scar which soon turns white and the part is roughened
and honeycombed. During the period when the vaccination is at its height
the child suffers from fever and irritability and loss of appetite.

If vaccination does not "take" in an infant it should be done two or
three times and if then unsuccessful it should be repeated every year
until it takes. The fact that vaccination does not take does not imply
that the child would not take small-pox but rather that the vaccine used
is not suitable. There are some children, however, who seem to be immune
to vaccination.

Sometimes the symptoms are more severe than those enumerated; this seems
to depend upon the susceptibility of the child. The vesicle may be much
larger and the area of inflammation much more dense and angry. The fever
may be higher and may last longer; there may be a general rash and the
degree of depression more profound. Vesicles may be produced on other
parts of the body as a result of scratching. Mothers must always
remember that vaccination is a surgical wound to begin with and that it
is capable of infection in the same way as are other wounds, and that
any result coming from such an infection is not due to the vaccine or to
the process of vaccination, but to the infection. Many people get unjust
ideas about vaccination from just such cases. If the mother is not
cleanly or neglects the vaccinated area and permits it to become
infected she must not and others should not decry vaccination as a
consequence. Anyone who doubts the virtue of vaccination is condemning
himself; he is simply ignorant of the accumulation of evidence in favor
of it and assumes a position without any possible justification. The
mortality of vaccination is stated by Voigt from statistics to be 35 in
2,275,000 cases. In fact, all the deaths are from causes which are
preventable and no doubt the result of direct carelessness on the part
of the operator or the mother.

TREATMENT.--The mother must understand in what way she may contribute to
the successful termination of a case of vaccination. She should see that
the part upon which the child is to be vaccinated is absolutely clean so
far as she can make it with soap and water. She should see that the part
is allowed to dry thoroughly after vaccination. She should not wash the
part for at least twenty-four hours. If a vaccine shield is put on she