There has been but little difficulty in securing better compliance with the law respecting the vaccination of school children. The near approach of small-pox to the boundaries of Maryland has had a wholesome effect. So far as is known there is but one county in the State where any considerable popular opposition to vaccination exists. That is Garrett County.

Several weeks in advance of the date of the opening of the public schools, all the county school boards were reminded that vaccination should be attended to before the schools opened, and not delayed so long as to become a hindrance to the work of the opening weeks of the school year. On the day previous to the date of opening the public schools of Garrett County, a telegram was received reporting that a large number of children were unvaccinated, and asking whether the schools should be opened. Reply was made that the schools should be opened since even an outbreak of small-pox was not too high a price to pay for public schools, and that if Garrett County should elect to take such a risk, her affairs were in her own hands, so long as her neglect did not endanger the adjacent parts of the State. The School Commissioners were advised, however, to push forward the vaccination of school children as rapidly as possible.

In December a committee of the Garrett County School Board visited Baltimore to consult the State Board of Health concerning the incomplete vaccination of school children in that county. They reported that twenty-five per cent. of the children in the public schools were unvaccinated. The small-pox situation in Pennsylvania and in West Virginia was fairly put before these gentlemen, and they were urged to press the work of vaccination as rapidly as possible to completion.

On the same afternoon notification was received of the occurrence of small-pox at Lonaconing, in Allegany County. The School Board of Garrett County was accordingly notified that this circumstance gave the previous recommendations added urgency. They were instructed to notify all unvaccinated children in the schools that they need not return after the holidays unless they were, in the meantime, vaccinated. The School Board presently began to receive more or less violent protests against this action. The following letters were referred to me by Mr. U. G. Palmer, Secretary of the School Board for Garrett County. The replies of the Executive Officer of the State Board of Health are also reproduced:

PROF. U. G. PALMER:

POCAHONTAS, PA., December 22, 1899.

DEAR SIR-Received your note to-day, will do as requested. Please find enclosed term report. I read notice regarding vaccination to school yesterday, and in consequence the citizens are up in arms. They say they will not have their children vaccinated. If they are determined my

school will have to be closed. There will be about 65 scholars after the holidays, and there isn't any person here to vaccinate them even if the people were willing. There is a practicing physician stationed at Finzel, but he positively refuses to vaccinate the children unless authorized to do so by the proper authorities, and armed with legal power. And, furthermore, he says that if the law is compulsory that the State should pay for the work done in that capacity. If the law is enforced it means that nearly that many children will be deprived of that much schoo ing. Please advise by letter to Pocahontas, Pa.

MR. H. A. L., Pocahontas, Pa.:

H. A. L., Teacher.

December 27th, 1899.

DEAR SIR-Your letter to Mr. Palmer referred to me. Unvaccinated children must not be admitted to your school when it is reopened. If the school must be closed then close it. We did not make the law and we cannot relax it. Parents who do not want their children vaccinated know the law, and make their own choice, either to have the children vaccinated or keep them out of the public schools.

The School Board is responsible to us for the vaccination of the children, and the County Commissioners are responsible for the cost of vaccination. No physician can be expected to do the work unless payment is guaranteed, but a vaccination certificate is a necessary qualification for any child who wishes schooling at public cost.

(Signed)

MR. PALMER:

Yours very truly,

JOHN S. FULTON, Secretary.

WILSON, W. VA., December 25th, 1899.

DEAR SIR-The people up here are not going to have their children vaccinated for they have the mumps and they don't want both. If you could let the school go on this winter, they will have them vaccinated next summer. If they have to be vaccinated the school will close. Please write at once.

MR. W. H. K., Wilson, W. Va.:

W. H. K.

December 28th, 1899.

DEAR SIR-Your letter to Mr. Palmer referred to me. If mumps are so prevalent as to prevent vaccination then the schools should be closed on account of mumps. When the mumps are over you can open the schools, admitting only the children who bring vaccination certificates. The vaccination law was passed long years ago, but the mumps have just arrived. An attack of mumps need not postpone vaccination more than a week, and vaccination need not postpone a child's return to school one day. Yours very truly,

(Signed)

Mr. U. G. PALMER, Secretary,

JOHN S. FULTON, Secretary.

Garrett County School Board, Oakland, Md.

January 12th, 1900.

DEAR SIR-Yours received. The penalties of the vaccination law are upon school teachers who admit unvaccinated children, upon parents who neglect to have their children vaccinated, and upon physicians who refuse or neglect to vaccinate those who apply for that purpose. All the fines are for the use of the local School Board.

We went over this matter yesterday at the meeting of the Board, no other county than Garrett being under consideration. I suggest that you attend the next meeting of the Board on February 8th. We take the

same common sense view of the law that you do. It is intended to prevent small-pox. But we do not think the burden of the safety of schoolgoing children ought to be carried by part of the children, but should rest equally on all. We do think that the exclusion of unvaccinated children from school makes it almost impossible that children shall contract fatal small-pox while in school. Unvaccinated children cannot be kept off the streets nor out of church, but they can and should be kept out of school. If many unvaccinated children are losing their winter schooling, it can be for no reason except that their parents have not had them vaccinated. They are also losing the vaccination which the State provides as free as it does education for those who are unable to pay for it. Education is not compulsory, nor is vaccination compulsory, but the law says that children who want to go to school at public cost must be vaccinated. You, as a School Board, cannot protect the safety of the community at large any further than that the careful defense of the schools is a part of the public defense, but to that extent it does seem to us that the School Commissioners are the guardians of public health.

There may be no small-pox in Garrett County this winter, but if there should be, are you prepared to guarantee that children will not suffer? These are the young citiezns who cannot speak for themselves, but are at the mercy of their parents, of your board and of ours. I confess that I know of no other means of defending them against small-pox as sure as vaccination. It is said, in round numbers, that three thousand schoolgoing children in Garret County are vaccinated, while one thousand are not. This is manifestly unfair. If all your children were unvaccinated, and your community were willing to take the full risk of small-pox. I should say that public education is too valuable to be lost on account of small-pox. But the parents who are keeping one thousand children at home say in that act that education is not worth the cost of vaccination. Yours very truly,

JOHN S. FULTON, Secretary.

FINZEL P. O., GARRETT Co., MD., January 12th, 1900.

DR. JOHN S. FULTON, Baltimore, Md.:

DEAR DOCTOR-I enclose you a letter that I received from the County Commissioners in regard to your letter to Mr. Loraditch, the teacher here, that the county would pay the expenses of vaccination. I have vaccinated 35 children, and have 10 or 15 more to vaccinate. I have received no pay for this, and the parents all say, and justly too, that if there is compulsory vaccination for the children that the county or State ought to pay for it. I have had a good deal of trouble prevailing on the people to have their children vaccinated, but have succeeded in getting some vaccinated in every family around me. I do not know what the price is for vaccination, but I think the county ought to pay for it, especially as it is compulsory and the people have kicked against it so. Hoping to hear from Yours very truly,

you about the matter, I remain,

DR. F. A. M., Finzel, Md.:

F. A. G. M., M. D.

OAKLAND, MD., January 3d, 1900.

DEAR SIR-In reply to yours of the 29th ult. will say that the children's parents will have to pay for the vaccination of their children, as the Commissioners have no power to do so.

DR. F. A. G. M., Finzel, Md.:

January 15th, 1900.

DEAR DOCTOR-If you will read that portion of Article 43 which falls under the title "Vaccine Agency" you will find that the County Commissioners are bound to pay for the vaccination of children whose parents are unable to pay. So far as you can swear to your bill you can collect it. You are quite right that the State ought to pay for vaccination which is compulsory, but there is no compulsory vaccination in Maryland. Vaccination in this State is alternative; vaccinate the children or keep them home from school.

I think if you put the matter squarely and resolutely before the County Commissioners, they will pay your small bill. Fifty cents is the sum named in the act as the fee for a vaccination. I have known other Boards of County Commissioners to refuse payment, but I do not know of any instance in which a bill like yours has been successfully contested by the Commissioners. The only means they have of avoiding such bills is to appoint regular vaccine physicians.

DR. FULTON, Baltimore, Md,:

Yours very truly,

JOHN S. FULTON, Secretary.

GORTNER, MD., January 15th, 1900.

DEAR SIR-The vaccination "question" is on here in this county of Garrett, and being a teacher I desire to be within constitutional law. Has the question of the constitutionality of the vaccination law ever been decided by the Court of Appeals of this State? If so, in what volume of reports may the opinion be found? Also, has it ever been decided by that tribunal whether or not the Legislature has the power to make, or require teachers to make, exclusive, what the constitution says shall be free? Also, is it the object to have the children vaccinated or to drive them out of school? If the former, why not enforce the original act relating to vaccination, which is law just as potential as that relating to or requiring a certificate for entrance to the public schools, and then the trouble about entrance to the schools could not arise.

You speak of your duty under the law. Is it more your duty to attend to the driving of uncertified children upon the street, and the punishment of teachers who will not assist you in the work, than it is to punish the parent who has a child past twelve months old and in good health and not vaccinated upon the street, or within the home and around the family hearth, if you please? Since you seem to be very much interested in the second part of the vaccination law to keep your official skirts clean, will they become more befouled by neglect in the second part than in the first part?

Show the people of your State that you are not hostile to the public schools by laying the enforcement of health laws wherever it can be done in a way, and where they will not operate in a way to drive a single needy child from the benefits of the public schools, and in this case it can be done. Why not do it?

Is there any less danger with the child at home, where it seldom, if ever, gets to town if living in the country, or on the streets, if in town, than if it be in the school under the same circumstances? Is it any more our duty as teachers to send a child home unless it has a certificate of vaccination than it is your duty to see that every child of twelve months or over in this State be vaccinated? That is, provided it is your constitutional and lawful duty to see that we obey the law. I do not believe the law is constitutional, since two States have so decided similar laws, and another one, to my personal knowledge, abandoned its enforcement as a result of those decisions, and I shall act accordingly. Hoping to hear from you relative to the first two questions, and to receive a reply thereto, I am

Your obedient servant,

I. C.

Mr. I. C., Teacher, Gortner, Md.:

January 16th, 1900.

DEAR SIR-Yours of Jan. 15th at hand, and replying have to say that your whole duty as a teacher in relation to the vaccination of school children is found in Section 31 of Article 43, (Sec. 7, Chapter 257, Acts of 1872.) The State Board of Health has not laid these injunctions upon teachers nor upon school boards. The purpose is to protect the children in the public schools from small-pox.

It is not at present the business of teachers or school boards, or health officers, to inquire into the constitutionality of the law. We are all bound to comply with the law so long as its constitutionality, affirmed by the vote of the Legislature and the approval of the Governor, remains unimpaired. I have a letter from a lawyer on the question of constitutionality. Yours very truly,

MR. I. C., Attorney-at-Law, Gortner, Md.:

JOHN S. FULTON, Secretary.

January 16th, 1900.

DEAR SIR-I have yours of 15th inst., and replying have to say that the validity of the several acts making up the law of Maryland relating to vaccination has never been attacked.

To your question-whether the Legislature can make exclusive what the constitution says is free-I reply that education is free in this State to all healthy children above the age of six years, of sound mind, and vaccinated.

To your next "also”—I reply that the laws of Maryland and the Constitution offer to every indigent child both education and vaccination at public cost, and that both are valuable gifts to the citizen, and profitable investments for the State.

The only duty of the State Board of Health involved in the law under consideration is to maintain the immunity of children to small-pox. An unvaccinated child is no safer upon the streets than at school, but the school is safer.

My private opinion is that public education is too valuable to be lost to the youth of our State even if we had to pay the price of many young lives for it. But it is unnecessary to pay such a price and the security against small-pox is very cheap. The question concerns not the value of public schools, but the value of children.

We hold the open and free schools to be worth considerable loss of life from small-pox. You seem to hold the schools of less value than the cost of vaccination. Garrett County governs herself. Get your School Commissioners and your Local Board of Health together. If they agree that children are so cheap the schools can be run on that principle, the State Board of Health will not interfere until the penalty of that view falls in part upon some other portion of the State.

Respectfully yours,

JOHN S. FULTON, Secretary.

SMALL-POX.

Late in December, 1898, cases of variola occurred in Hagerstown. This was the first invasion of the State, and it was well and decisively met by the local Health Officer, Dr. J. McP. Scott, who was able not only to hold the infection fast at one point, but to put it out without disturbing the public mind even in the slightest degree. The brief note upon this outbreak contained in our last report comprised the whole story of this outbreak.