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occurred in any person under 16 years of age who showed two
good cicatrices of vaccination, and after 16, only three such persons
died."
Dr. Fox, the Medical Superintendent of the Fulham Smallpox
Hospital, writes as follows :—" Firstly, not a single patient died out
of 51 admitted, who had four or more marks of whatever quality
they were: further, they were all mild cases, and with one or two
exceptions, all above puberty, i.e., the effect of vaccination was
wearing out. Secondly, whereas the unvaccinated died at the rate
of 43.54 per cent., the vaccinated (and many had the merest
apology for vaccination marks) died at the rate of 7.6 per cent.
Thirdly, that as the number of marks increase, especially if they
be of good quality, so the protection increases, as shown by lessened
per centage of deaths, and number of admissions." These remarks,
based not upon theory, but the outcome of extensive practice and
acute observation, should carry conviction to every unbiassed mind.
For a list of the infected localities in your District, I beg to
refer you to Table 6 in the Appendix.
Sanitary Work.
For a detailed account of the Sanitary work performed in the
District during the year by the Inspectors, I beg to refer you to
Table 7 in the Appendix.
Many questions of Sanitary importance presented themselves
to me for solution, and among them I may mention more particularly