This little girl was also in perfect health and unusually well developed for age, both physically and mentally. She complained of feeling ill on Aug. 7 with symptoms indicating a digestive disturbance. The local physician called it acute indigestion. She soon lapsed into unconsciousness and never rallied. Expert counsel was called and case pronounced cerebro-spinal meningitis. A lumbar puncture disclosed in spinal column a clear fluid under normal pressure. Cultures were sterile; intra-spinous injection of the Flexner serum without beneficial effects. Paralysis was extensive, involving the throat; breathing labored and death due to respiratory insufficiency. Temperature elevated during entire illness. All symptoms were so exactly parallel to those of Cases 24 and 25 as to warrant the suspicion that this, too, was infantile paralysis. CASE No. 20 [Illustration: JAMES C. CHURCHILL] JAMES C. CHURCHILL, son of Carl F. Churchill, Dolgeville, N. Y. Age 5 years 9 months. Vaccinated about Feb. 12, vaccine “H.” Commenced to complain in a few days. Died July 23. Diagnosed “Cerebro-spinal Meningitis.” This boy had good health until he was vaccinated. He commenced to complain in a few days and was never well afterwards. He was unconscious for 10 days before death. Right side paralyzed. Compare with Cases 19, 24, 25. CASE No. 24 [Illustration: WILBUR DOYLE] WILBUR DOYLE, son of Ivan Doyle, New Woodstock, Madison County, N. Y. Age 8. Vaccinated Aug. 28, vaccine “E.” Commenced to complain Sept. 9,--11 days from vaccination. Died Sept. 14. Diagnosis, “Infantile Paralysis.” This boy became unconscious Sept. 9. Temperature nearly 106. Kidneys involved; necessary to use catheter. Temperature dropped to about normal for few hours. General paralysis appeared. Throat paralyzed Sept. 13. Could not swallow. Temperature again became extremely high, reaching 107.4 rectal at 3 A.M. on the 13th. Remained unconscious until death, which occurred at 10:35 P.M. Sept. 14. _Note._ The make of vaccine virus used in the different fatal cases shown herein is indicated by the Code letters “E” and “H.” E indicates the virus made by the Mulford Company of Philadelphia, and H the virus made by Parke Davis & Company of Detroit. These were the two manufacturers whose virus is officially alleged to have caused the epidemic of Foot and Mouth Disease in 1908. See page 99.--C. M. H. CASE No. 25 [Illustration: LEWIS FREEBORN LOYSTER] LEWIS FREEBORN LOYSTER, son of James A. Loyster, Cazenovia, N. Y. Age 11. Vaccinated Aug. 29, vaccine “E.” Commenced to complain Sept. 10,--11 days from vaccination. Died Sept. 21. Diagnosed “Infantile Paralysis.”