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31
of the operations of this new Act, but there can be no doubt that
taking England and Wales as a whole, the number of children vaccinated
this year under the new conditions, is largely in excess of that
which obtained during either 1898 or even 1897. It remains to be
seen to what extent the provision for the "conscientious objector"
will be used in the future; but one thing is certain, namely, that a
scare of smallpox will always ensure the vaccination of most infants,
but unfortunately this result is often only obtained after the sacrifice
of many lives.
Ee-vaccination is the most potent means of combating small-pox
when the disease threatens a district, and the isolation of infectious
persons, important as it is as a preventive measure, must rank second
to re-vaccination, for it cannot always be guaranteed (1), that every
case could be and would be efficiently isolated before there was any
possibility of the disease being transmitted to others; (2), that in
every case skilled advice would be sought at the commencement of
the attack; (3), that in every case the early symptons would be such
as to cause the nature of the illness to be easily and readily recognised;
(4), that every district possessed, or would at once provide, isolation
accomodation, and would isolate every case; (5), that in every
instance those living in the same house as the patient, and those who
had been in contact with him at or after the commencement of his
illness, would go into quarantine for fourteen days; (6), that every
person in attendance upon a patient was insusceptible (is anyone
naturally insusceptible?), or has been rendered so by a previous
attack of the disease.
DIPHTHERIA.
The 31 cases of Diphtheria occurred in 30 different houses; and
in only three instances were sanitary defects of a grave nature found
to exist in the home of the patient. Slight sanitary defects were
found in three other cases.
School attendance is either alleged by the parents or surmised
by myself, on good grounds, to be the cause of 3 attacks during the
year, and to be responsible for 9.7 per cent. of the cases as against
5.7 per cent. in the preceding year.
One case of the infection was imported into the Parish. In one
case it was very clear that a preceding tonsilitis of several weeks'