With the close of the 18th Century, Inoculation with smallpox to avert smallpox was accepted as sound practice throughout England. Its safety and efficiency were extolled by medical writers in terms curiously identical with those applied to Vaccination. The objectors were few, and for pious rather than physiological reasons; and the question that exercised practical and benevolent minds was how to universalise the remedy, which, on account of its troublesome accompaniments, was chiefly confined to the upper and middle classes. On this point it may be well to cite the words of Dr. Haygarth of Chester, who, in a letter to the Council of Health of Geneva, dated 10th February, 1792, thus sets forth the position of affairs-- In Chester, and, I believe, in most of the large towns of England, the casual smallpox is almost constantly present. _All the children of the middle and higher ranks of our citizens are inoculated in early infancy._ The populace, very generally regarding the distemper as inevitable, neither fear nor shun it; but much more frequently by voluntary and intentional intercourse, endeavour to catch the casual infection. All the difficulties of our Smallpox Society in Chester proceeded from this strange delusion and perversity of disposition. With us the smallpox is seldom or never heard of except in the Bills of Mortality; but there its devastation appears dreadful indeed. The strong objection to Inoculation was, that it diffused the disease generally which it was supposed to avert individually. Inoculators tried to minimise and deny the danger, but in vain; and nothing so contributed to the supersession of the practice by Vaccination as the expectation of escape from the artificially propagated disease. How extensive was that propagation, we leave the writer in the _Edinburgh Review_ of 1806 to describe-- The inoculated smallpox is an infectious disease, and those who take it naturally from an inoculated patient have it as violently as if they had been infected from a case of spontaneous disease; it is to all intents and purposes the natural smallpox again in them. Now, if it be considered that several hundred thousand persons have been annually inoculated in these Kingdoms for the last fifty years, it will be easy to calculate the immense addition that must have been made in that period to the cases of actual disease, and the increase of natural smallpox that may be supposed to have arisen from this constant multiplication of the sources and centres of infection.