The greater number of recipients did not come under the notice of the regular practitioner at all, but were dealt with by the midwife, a canny friend, or the father, or mother, armed with clasp-knife or darning needle. I remember one amateur vaccinator of great local repute, a “surgeon to old shoes,” the weapon of whose anti-varioloid warfare was his awl. Matter belonging to any stage of vaccinia, or even the scrapings from the moistened under-surface of the effete crust, after it had dropped off from the arm, served the purpose; and when the produce of this rude husbandry was a pimple or sore of any description, it sufficed. In not a few cases, protection from small-pox was never involved in any way.