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they occur. There is reason to believe, however, that the system, in the
course of time, loses some of the protective influence of the original vaccination;
and my own experience of more than 200 re-vaccinations of persons
whose ages ranged from 21 to 60 years, during the present epidemic, has
convinced me that the belief is well founded. The finest pocks—pocks, in
some instances, similar in every respect, form, development, areola, to an
infantine vaccination—I have noticed in persons over fifty years of age. If
susceptibility to the action of the vaccine lymph be an evidence of tho
susceptibility to small-pox, re-vaccination is a necessity, and should be
systematically practised soon after puberty, and once, at least, in later life.
Vaccination in St. Giles. 28. Although the practice of vaccination is
said to have been neglected in some districts of London, I am pleased to be
able to state that in St. Giles it has been carried out by the Public
Vaccinator with much vigour and efficiency. The Parochial Authorities have
appointed a Committee to supervise the work and an Officer to inspect the
infants born in the conjoint parishes, to ascertain the fact of their vaccination,
and to put the law in force against negligent parents. The result was
that, during the year included between October, 1869, and September, 1870,
496 children were vaccinated in the first instance out of 1688 children born;
the operation having been neglected in the large number of 1192. It is now
that the importance of the duty performed by the Inspector of Vaccination
is seen. He calls upon the parents or gives a formal notice requiring tho
infants to be vaccinated, and it appears that, after these measures had been
taken, 770 children were vaccinated; so that of all the children born 1266
were protected, and 422 were omitted.
29. The deaths of children under one year in the same period were 332.
Some of these would have been previously vaccinated; but the large majority
in all probability, would not, having died too early, or having been too
delicate and feeble for the operation. Subtracting this number from the 422
it gives us about 100 children who are unaccounted for. It is probable that
the parents of many of these children moved out of the District; but provision
is made, even for such an event; for, as I am informed, whenever the
address of the parents so removing can be ascertained, it is usual to send a
letter to the authorities of the parish into which the parents have removed
to inform them of the fact, in order that the children may not escape vaccination.
Thus we have a system of vaccination established in this District
which is most creditable to the Authorities and unusually successful in its
results. The success would be greater if all other Parishes carried out the
same plan.

30. The foregoing Table shows that the largest number of attacks
occurred in Bloomsbury, owing, no doubt, to its proximity to the source of
infection, and in the second quarter of the year. It is remarkable that there
was a disproportionate mortality among males.