th smallpox were a common sight. Among the
Indians, whole tribes were wiped out with it. It is computed that in
Europe, during the eighteenth century, 50,000,000 people died of
smallpox. In England, the death-rate was 300 per 100,000. As late as
1800, Boston was visited by severe epidemics of smallpox.

_Value of vaccination._

Owing to vaccination, the extent and intensity of the disease has
continually grown less until to-day attacks of smallpox are not serious
and the results are seldom fatal. For this reason and because of the
chronic objection of uneducated persons to submit to governmental or
outside restrictions, there has been, in recent years, a serious outcry
against vaccination, with the result that in New York State, during the
year 1908, there were in certain parts of the state epidemics of
smallpox with, however, but two deaths. The disease may, however, at any
time become serious, and, because of its virulent contagiousness, no
objection ought to be made to reasonable requirements in the matter of
vaccination.

Vaccination is usually not the cause of any serious inconvenience or
illness, and, while some slight swelling of the arm may result, the
protection afforded is so great in comparison with the temporary
inconvenience that the latter ought not to be even considered. The
protection afforded by a successful vaccination lasts usually from two
to seven years, and it is understood that after ten years the protection
is certainly lost, and in the presence of a smallpox epidemic one ought
to be re-vaccinated after the minimum time named. Whether every person
always ought to be vaccinated at intervals of five years or so is open
to discussion. If one were on a desert island in a large or small
community without intercourse with the outside world, vaccination would
be of no value since smallpox would be impossible. There are communities
where smallpox has been for years unknown, and consequently where the
need for vaccination is not apparent. On the other hand, where smallpox
is prevalent in the vicinity, and the disease is continually recurring,
it is of the greatest importance, in order that it may be promptly
suppressed, that every individual lend himself readily to vaccination.

Whatever harmful results formerly came from vaccination were due to a
lack of cleanliness on the part of the person vaccinated or in the
vaccination material itself. More care is now used in disinfecting the
surface of the arm