contagious disorders have become endemic because of the noxious substances conveyed from the City Hall, and the possibility that an outbreak of a general epidemic might originate under these conditions need only be mentioned. To take care of these cases there was appointed, at the request of the ASSISTANT COMMISSIONER, a staff of vaccinators, interpreters, quarantine officers and competent assistants, whose work proved the soundness of your judgment, and who rendered most valuable service in connection with sanitary science. Such a staff had always been required, and the fruits of their labors demonstrated their need. This last year the emergency staff has been reinforced and the work extended, being now merged into the public vaccinating corps and sustained by the vaccinating fund. The duties of the members of this corps consist of attention to vaccination. There are in our city upward of 230 public schools, attended by about 208 000 children, and the economical administration of this work may be appreciated when it is noted that this large number of children has been attended to, and also, all vaccinations outside of the public schools have been performed, including parochial schools, lodging houses, police stations, the County Agent's office, etc., the total sum expended being within $25 000. These vaccinators are obliged to dive into the lowest strata of the city; they have to invade the underground hovels of uneducated people living in filth, and perhaps too often opposed to vaccination and all sanitary aids; they must visit the lodging houses and police stations, and come in direct contact with the great army of tramps and criminals that infest a city like Chicago, and fully eight-tenths of their work must be accomplished by means of diplomacy, suavity and tact. We have been particularly fortunate as to the membership of this corps of vaccinators. Taking into account the variety of the work, and its magnitude, we are surprised at finding the complaints that have reached us can be counted on the fingers of one hand. I feel perfectly safe in saying that the protection afforded by this corps is absolute, the vaccinations being performed with the greatest care, and special observation being given to results. Today our public school children are perfectly immunized as far as smallpox is concerned, and an unvaccinated tramp or criminal cannot be longer than a few days in either lodging house, station or jail before he is discovered and operated upon until a successful result has been attained. An unprotected stranger, or a newly arrived family reaching the poorer districts, cannot remain long undiscovered, as house-to-house canvasses are being continually made. The lodging-house districts have always been troublesome and dangerous battle grounds during an epidemic of smallpox. I am pleased to say that with the assistance of the proprietors, as they aid us at present, we will have no trouble in successfully combating the foe. Most important is the work of this kind that has been done through the County Agent's office. Applicants for relief are closely examined as to their individual condition with relation to vaccination; the number of persons in each family is looked into, how many children, their ages, the schools they attend, and the addresses of all concerned. Each case is thoroughly investigated, vaccinations are performed at once, in the office when necessary, and the localities from whence these applicants come are visited by members of the vaccinating corps, and the individuals found therein are given care. Some of the men connected with this vaccinating corps attend only to primary vaccinations— that is, children before school age, or between three months and six years of age. This part of the work is really very much more important than at first sight appears. Our children are not eligible for admission into the public schools until they are six years old. In a very large number of children the first six years of life would be a dangerous period as far as smallpox is concerned, as during this time the young ones would be unprotected. By our present system, however, this danger period is circumvented, and a large number of children in the future, on presenting themselves for school enrollment, will be found to possess typical vaccine scars. Continuous vaccination from year to year, in a great city, is an absolute necessity and will be the means of not only preventing enormous loss of life, but also of saving millions of dollars. In former times attention to vaccination was confined to the public-school children only, and no care was given to the very large numbers of people constituting the rest of the population. Suddenly an epidemic of smallpox would appear and at once attempts at general vaccination would be made; perhaps only to be met with determined opposition by those who disregarded the danger or denied the efficacy of the procedure. A large number of unprotected persons thus would exist, constituting excellent ground for the growth and propagation of the scourge, and the loss of life and property would be fearful. By, however, constantly maintaining immunization there is no ground left for the seed to grow, and the people are daily educated to correctly understand the value of the method. So soon as this view of the subject was laid before the members of the Finance Committee of the City Council they realized the urgent responsibility placed upon them and granted the necessary appropriation. It is with pleasure that I call attention to our particularly good fortune in obtaining the purest and most efficient vaccine ever used by the DEPARTMENT. It was not until an urgent protest was made by your ASSISTANT COMMISSIONER OF HEALTH against the exposed ivory-point method of vaccination, that the liquid vaccine in hermetically sealed tubes |