2
Midnapur (31,358), Dacca (31,060), Pabna (19,436), 24-Parganas (17,572),
Nadia (15,254), Chittagong (13,150), Jalpaiguri (12,826), Rajshahi (12,008),
Murshidabad (11,425), Birbhum (9,850), Noakhali (7,821), Malda (7,208),
Bankura (5,753) and Bakarganj (5,003). While in other two districts (Chitta-
gong Hill Tracts and Jessore) the increase was below 5,000. The largest
decrease (37,647) was reported from Calcutta, the principal reduction
(36,458) being in re-vaccination cases. This may be attributed to the large
number of re-vaccination cases having been performed during the previous
year (1921-22) in anticipation of a small-pox epidemic. The decrease
was marked in Burdwan (16,385), Faridpur (8,569), Bogra (4,300), Howrah
(4,007), Khulna (1,688) and Tippera (1,088). In other three districts,
viz., Darjeeling, Hooghly and Dinajpur, the decrease was insignificant.
Although there was a decrease in the total number of operations and also in
re-vaccinations (41,023) in Tippera, still it stands first as regards increase
(39,935), in the number of primary operations. The District Health Officer
of Tippera attributes the reduction in re-vaccination cases to the absence of
small-pox in epidemic form and to the fact that under the law as it stands at
present the people cannot be compelled to accept re-vaccination in places
where small-pox breaks out. The increase in primary cases in that district
was due to the introduction of free and compulsory vaccination. The flood
of the last year was responsible for the decrease of vaccination work in the
Bogra District. In the list of increase in primary cases next to Tippera
come Rangpur (35,740), Midnapur (29,432), Dacca (29,365), Mymensingh
(24,980), Pabna (21,738), 24-Parganas (16,516), Dinajpur (15,572), Birbhum
(11,151), Malda (9,947), Murshidabad (9,450), Rajshahi (9,122), Nadia (7,893),
Noakhali (7,842) and Chittagong (5,336). In other districts the increase was
below 5,000. In 16 out of 28 districts, there was an increase in re-vaccina-
tion cases. Mymensingh with an increase of 32,593 operations stands first in
the list. Next to this come Rangpur (9,869), Jalpaiguri (8,806), Chittagong
(7,814), Nadia (7,361), Bankura (4,340) and Rajshahi (2,886), while the other
districts show an increase of 1,000 to 2,000. The large increase in both
primary and re-vaccination cases in Mymensingh is attributed to the introduc-
tion of the paid system of vaccination, the close supervision of the inspecting
officers and the prevalence of small-pox in the district. It was reported that
the rate of success higher than 30 per cent. in re-vaccination in Rangpur was
due to the absence of immunity amongst the majority of the people re-vacci-
nated long after primary vaccination. On account of prevalence of small-
pox in the Jalpaiguri district, the medical officers of fourteen dispensaries
were supplied with lymph and lancets. Propaganda work with posters
and pamphlets in hâts and railway stations resulted in the increase
of primary and re-vaccination operations in Jalpaiguri.
It is a matter of satisfaction that the introduction of free and compul-
sory vaccination has been successful everywhere. It is reported that 4,000
people of the Debinagar Panchayat Union in the district of Malda have been
vaccinated for the first time by the enforcement of the law, no vaccination
work, either primary or re-vaccination, was done there within the last 20
years. In places, such as the 24-Parganas, Chittagong and Malda, where
many persons who could not be vaccinated by inducement, had to get them-
selves vaccinated on enforcement of the law. Vaccination in this way is
making steady progress.
5. Protection afforded to infants.—During 1922-23, out of 998,829,
the estimated number of available infants for vaccination, 290,172 or 290.4
per mille were reported to have been successfully vaccinated in the rural
areas of this Presidency as compared with 271,735 or 269.11 during the
previous year. In nine districts including Calcutta the protection was
stated to have been over 500 per mille. The districts in the Dacca Division
were the worst in this respect. The protection reported as having been
afforded to infants in municipalities is shown in Appendix VII attached
to this report. It is stated that 553.3 per mille of the surviving infants in
municipalities were protected during the year as compared with 627.5 per
mille during the previous year.
6. Recess work.—To suppress the outbreaks of small-pox 213,794
vaccinations were performed during the recess or non-working season of