Dr. Grieve, Medical Director to the Hampstead Small-pox Hospital, says: "We have sixty officials connected with the Hospital, who are constantly in contact with the sick; and in the three months we have been open not a single case has occurred among them."

In the British Army every recruit is closely examined, and if he has not previously had Cow-pox or Small-pox, he is forthwith vaccinated. And a few extracts from the Government "Statistical Reports of the Sickness, Mortality, and Invaliding among Her Majesty's Troops " for 20 years, viz.: from 1817 to 1836 inclusively, will give a good idea of the real value of vaccination as a protection against Small-pox.

" In Dragoon Regiments and Guards, with an aggregate strength during that period of 44,611 men, and a total mortality of 627, there were but three deaths from Small-pox.

"Among the troops at Gibraltar, one death only from Smallpox occurred, the aggregate strength being 60,269, and the whole mortality 1291.

"In the West Indies, although several epidemics of Small-pox had ravaged the islands within that period, not one person died of the disease among the British or white troops, with an aggregate strength of 86,661, and a total mortality of 6803: while among the black troops on the same station, with an aggregate strength of 40,934, and a mortality of 1645, there was not even one case of Small-pox.

"At Bermuda, Nova Scotia, New Brunswick, Cape of Good Hope, and the Mauritius, not a single death from Small-pox occurred during those 20 years; and even the white troops of Western Africa wholly escaped this disease, which was carrying off hundreds of the black unprotected population. "In Malta, from 1818 to 1836 inclusively (a period of 19 years), the aggregate strength of the British troops was 40,826, the total mortality 665, and the mortality from Small-pox 2. Yet, in the years 1830 and 1831, Small-pox raged there as an epidemic, and destroyed 1169 persons: for in 1830, there died of Small-pox 1048, the total mortality being 3407; and in 1831 there were 121 deaths from Small-pox, out of an aggregate mortality of 2583.

"Again, in Ceylon three epidemics of Small-pox occurred during the 20 years included in the Government reports; namely, in 1819, when of the natives 7874 took the disease, and 2945 died; in 1830, when 806 of the natives took the disease, and 169 died; and in 1834, when 425 of the natives took the disease, and 94 died."

Yet in the same island, during the same period, there were among the white troops, with a total mortality of 3000,4 deaths from Small-pox (out of 8 cases); among the Malay troops, with a total mortality of 858, 9 deaths from Small-pox; among the pioneer corps, with a total mortality of 647,1 death from Small-pox. And in the last of these epidemics, Dr. Kinnis states that not one instance of the disease appeared among the white or the native troops.

Both the profession and the public have been much agitated with the question whether, in the course of time, the protective virtue of the vaccine wears itself out, and re-vaccination becomes necessary or not. Opinions on that point are very much divided; or whether, in the process of transmission from one individual to another since it left the cow, the vaccine lymph has become weakened. Sir Thomas Watson says:-

"For one year I had a seat, as the Senior Censor of the College of Physicians, at the National Vaccine Board, and I then had opportunities of satisfying myself that lymph which had been transmitted without interruption from person to person ever since the time of Jenner, continued to generate what seemed to be a very perfect cow-pox pustule. And it is the expressed opinion of the permanent members of that Board ' that the vaccine lymph does not lose any of its prophylactic power by a continued transit through successive subjects;' and the Registrar General also coincides in that view of the question. Other practitioners, however, hold a different view, and Dr. Grieve, of the Hampstead Small-pox Hospital, thinks that re-vaccination ought to be performed about the age of puberty."

Mr. Marson has considered and -settled a very important question, which sometimes presses for immediate solution. Suppose a person who has neither had Small-pox nor been vaccinated, has been exposed to the contagion of Small-pox; may he escape that disease, or obtain comparative safety, by subsequent vaccination? and if so, within what limits of time?

Mr. Marson declares the following result to be confirmed by his own personal experience. After the reception of the poison of Small-pox, an interval of twelve days elapses before the manifest outbreak of the disease.

The areola in vaccination is not complete till the ninth or tenth day of the vesicle. If this areola be fully formed before the onset of Small-pox, the patient is safe.

He illustrates this rule by an example. Suppose an unvac-cinated person exposed to the contagion on a Monday. If he be vaccinated as late as on the following Wednesday, the vaccination will be in time to prevent the Small-pox from being developed. If it be put off till Thursday, the Small-pox will appear, but will be modified. If the vaccination be delayed till Friday, it will be of no use.

Should the person have been formerly vaccinated, re-vaccination will be effectual two days later than this; because in re-vaccinated persons the stage of areola is reached two or three days sooner than in persons vaccinated for the first time.

Treatment

At the commencement of the disease, as soon as the feverish symptoms begin to show themselves, the patient should take a cooling laxative, Nos. 2, 3, or 4, according to his age; and he may take the Fever Mixture, No. 9. He must be kept cool, and his diet must consist of gruel, sago, arrow root, etc. No stimulants of any kind must be taken. About the eighth or ninth day wakefulness, restlessness, and sometimes tremors are apt to come on, and the Bromide of Potash or the Hydrate of Chloral may then be taken, in doses proportionate to the patient's age.

If the pustules should not fill up properly, nor their contents become purulent at the proper time, then strong broths may be of use, or even wine. But the effects of these must be carefully watched. When the pustules are livid, and intermixed with petechiae, and putrid symptoms occur, the strength of the patient must be kept up by means of stimulants. Quinine and acids are given as well as wine.

Dr. Arthur W. Foot, Physician to the Meath Hospital, has recently published some cases of Small-pox, treated according to what is called the "Antiseptic" method. He says, "I have given the Sulpho-carbolate of Sodium, in thirty-four cases of Small-pox, in doses of from seven grains occasionally, to sixty grains every third hour; it is very soluble, and can be taken in plain water, or it can be given with some infusion of Orange Peel, or Cascarilla. During its administration, Carbolid Acid is eliminated by the lungs, its odour being very perceptible in the breath, and the Sulphuric Acid and the Soda pass off by the kidneys. I have not observed it to cause any sickness of the stomach or unpleasant feeling in the head, even in very large doses: children have no objection to it. Subsequent to its administration the fetor of the evacuations from the bowels is greatly lessened, the urine is unusually slow to decompose, and the flesh resists putrefaction." At the same time he gave them Sulphurous Acid in dram doses. One dram in two wineglassfuls of water several times a day.

Dr. William Stokes, Regius Professor of Physic in the University of Dublin, lately mentioned a bad case of Small-pox, where the patient was delirious from pain, and the fetor was so great that it "seemed to pass through the by-stander like a sword," which was instantly relieved by putting the patient in a warm bath. "The fetor immediately and completely disappeared, so that on entering the ward no one could suppose that there was a case of Small-pox in it." He was kept at least seven hours in the bath, during which time brandy was freely administered. The bath was repeated next day; and the patient gradually recovered.

To prevent pitting, many different plans have been recommended. Dr. Stokes recommends poulticing the face, or covering the face with a mask of lint steeped in glycerine and water, and this covered with another mask of oil silk. Dr. Sansom touches the centre of each pustule on the face with a fine camel's hair pencil, dipped in strong liquid Carbolic Acid, taking care not to allow any to reach the sound skin, and orders a solution of one part of Carbolic Acid in three of Olive Oil to be applied over the individual pustules night and morning. Dr. Foot applies Carbolic Oil to the face, and washes the body with solutions of Sulphurous Acid, or vinegar and water. Mr. J. N. Stephens of Plymouth applies Carbolic Acid and Olive Oil to the pustules; with the internal administration of Bisulphate of Soda every four hours, and gives each patient, on three successive days before leaving the Hospital, a bath containing a pint of chloralum.

It was ascertained about forty years ago, in England, that powdering the face over with flour, from a common "dredger" (the patient closing his eyes during the operation) was complete protection against the pitting. Why the operation has gone out of use, or been forgotten, I do not know, unless that the remedy was too simple.