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Vaccination should always be done by a competent physician, at three points, an inch and a half apart, on a clean arm, thus:

And the person should be seen by him from time to time, that he may know that a perfect result has been secured. Though simple and painless, it is one of the most important operations that one can ever have done, as imperfect and spurious vaccination can only mislead and give rise to a false sense of security. Failure of the vaccination to take only means that the virus was inert, and is no evidence that the person will not take smallpox, as is commonly believed. Varioloid may occur in persons partially vaccinated, but it has been demonstrated by the experience of thousands of observers, under the most di. verse and trying exposures and tests, that a thoroughly vaccinated person will not take smallpox, although living and sleeping in the room with it. It follows that this dreadful scourge would be immediately and permanently stamped out if vaccination should be promptly and universally practiced.

It is unlawful to remain unvaccinated at any time, but, in the face of existing conditions, intelligent people should not wait for the law to force them to an evident duty. Health and school boards, town trustees and fiscal courts, and corporations and business people everywhere, should co-operate systematically and earnestly in providing and requiring vaccination for all within their respective jurisdictions, or in their employ. The business men in many places, especially in the smaller cities and towns, where facilities for caring for cases of this disease are usually inadequate, have suffered, and are continually



Rule 25. Every child shall be vaccinated before it becomes one year old, and this board recommends that all persons be re-vaccinated as often as once in five years.

Rule 26. All incorporated corporations or companies within the jurisdiction of this board shall cause each new employe to be vaccinated on entrance, unless proof is furnished of recent successful vaccination.

Rule 27. No person shall become a member of any public school within the jurisdiction of this board, as teacher or scholar, without furnishing a certificate from some reputable physician that he or she has been successfully vaccinated.

liable to suffer, incalculable loss from outbreaks which paralyze their trade and which can only be certainly prevented by general vaccination. The law is ample to secure this, and the time has come for its uniform enforcement, by persuasion, if possible, but by legal process where persuasion, kind explanations, and pleas for public welfare fail.

Every precaution should be taken to procure fresh, reliable virus, and to see that it is kept in a dry, cool place. All modern vaccine farms are well kept, and the virus on the markets may be relied upon when fresh, but much of it supplied to physicians has lost its value because it is not kept cool in transit, or in storing. It is not impure, but simply inert, or has at least lost much of its protective value. For these and other reasons which will be given, the board prefers and recommends the use of humanized virus, especially in the country districts where the family physician can select it himself from the arms of healthy children and young girls. It is certain to take, causes less local and constitutional disturbance, and is believed to give better and longer protection. If the scabs are wrapped in tissue paper, sealed up and put in a dry, cool place, they can be kept almost indefinitely. By its use physicians in the small towns and county districts can practice vaccination continuously, at little expense, as was done in former days all over this State when everybody was vaccinated, always having a stock of virus on hand. In many sections it is quite impracticable to do this where bovine virus is the sole dependence, under present methods of distribution. It is now believed that the cry against the use of humanized virus is almost entirely commercial. Certainly we had as good results and less opposition to vaccination under its use, and it appears necessary to return to it in order to bring protection within the reach of our people in the country districts.

Next to the difficulty in getting the people vaccinated, the failure of physicians to recognize and report and properly isolate first cases has caused most trouble in management. Ignorant and obstinate of ficials and communities usually get their first bias and inspiration from some equally ignorant or obstinate doctor. This can be accounted for readily when it is remembered that the country was so long free from smallpox that a generation of medical men were in practice, few of whom had ever seen a case, or had ever had any college training on the subject. Then, too, the disease has usually been attended by so little fatality as to subject those who made mistakes in diagnosis to little risk of criticism. For these or other reasons, often under the pressure of short-sighted merchants, many who had no training or experience on the subject were ready to dispute the diagnosis of experts as to typical, confluent cases, and even to encourage their credulous followers to conceal cases or otherwise embarrass and hinder the difficult and often thankless work of stamping out the disease.

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