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also remarks in his report for 1871, that nothing has occurred to
shake his confidence in vaccination when properly performed,
hut that almost all cases of failure of vaccination have occurred
in consequence of the careless and imperfect manner in which it
has been practised. Dr. Monk further considers that the adult
population of the country should he re-vaccinated, except when
the person has had Small Pox, or unless he have four good
marks as evidence of the goodness of the primary vaccination.
It is useless to vaccinate persons who have undoubted symptoms
of the disease, as experience shows that re-vaccination either
does not then succeed, or does not modify its course. There is
one other point which is very important in connection with
vaccination, viz: not only that the mortality is very much less,
but that the patient suffers very much less, as the fever and
general discomfort in a non-protected case usually increase until
the ninth or tenth day, whilst in protected cases they generally
diminish soon after the eruption comes out.
The rate of death amongst those attacked was unusually high
in this epidemic, having been 18.5 per cent. for all London;
18.6 per cent. at the Small Pox Hospital in this district; 18.2
per cent. at Stockwell, and 19 per cent. at Upper Holloway.
This per-centage at the Homerton Small Pox Hospitals is a
little greater than that obtained by calculating the number of
admissions and deaths furnished to me by Drs. Gayton and
Collie. According to their returns, the admissions in the Small
Pox Hospital were 1955 and the deaths 387; in the Fever
Hospital the admissions were 1194 and the deaths 180, making
a total of 3149 admissions and 367 deaths, being a mortality of
18 per cent. We make 19 deaths more, viz., 586, but have included
some deaths returned as being from other causes, which
they have excluded, although the persons were admitted for