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This fact was an argument in favour of vaccination, that none of the villagers
(chiefly cowherds) could set aside or deny ; the Vaccinator therefore who was
deputed to Turia on the occasion of the outbreak, was allowed to do his work
without the slightest opposition.
From Turia the disease spread to the neighbouring village of Amajbiri ;
there were eleven cases of small-pox here. The Patel pointed out to me a child,
who, notwithstanding that he was vaccinated, it is said, was attacked by the
disease. I carefully examined the child's arms, but could not detect any trace
of a vaccine cicatrice. The Patel had lost the village form, so it was impossible
to ascertain the truth or otherwise of his statement. I pointed out to him, how-
ever, that none of the children with marks of successful vaccination were
sufferers.
This immunity from the disease by " protected " persons, I again noticed in
the slight outbreaks of small-pox in the villages of Pipurwani and Goruck-
pur. In both these villages I learned that the disease was introduced from
Turia. In the north of the district, small-pox appeared in Lakhnadon in the
month of June. Only 7 cases were reported ; and they all made good recoveries.
Three or four of these children had been vaccinated, it is said, during the season
of 1872-73. The disease was mild in typo.
In March this year (1874) 4 cases of small-pox occurred in Chapara. I
learnt on enquiry that none of these children had been vaccinated. The Patel
of Chapara is an active supporter of vaccination.
7. The Sanitary Commissioner's Circular No. 186 of 1st May 1874, raises
the question of payment to mothers " as a recompense for the trouble of taking
their children to a neighbouring village ." the object of the measure is to pro-
mote arm-to-arm vaccination. The work is more satisfactorily done, and the
payment system, in my opinion, is therefore unnecessary. At present the people
believe that they are under obligations to the " Sirkar" as their " Ma-Bap,"
for instituting vaccination,—'introduce the payment system, however, and you will
not find it easy to convince them that the " Sirkar's." object is a disinterested one.
Again, what is to deter a dishonest parent from arresting, or altogether prevent-
ing, the formation of the vesicle, by vigorously washing the child's arm (the.
Vaccinator prohibits washing or bathing the arm for seven days) immediately after
it is vaccinated, so that a second or even a third gratuity may be earned under the
plea that the operation was not in the first instance successful.
Besides, what proof have we that arm-to-arm vaccination affords more effec-
tive protection or, as one writer states, "ensures better and more permanent results,"
than vaccination by means of lymph contained in tubes, by crusts, &c. It is
simply an assumption to state that a child vaccinated by, let me call it, the me-
diate method (in contradistinction to immediate vaccination from the arm.) will
" in a year or two, or longer still" (!) be attacked by small pox. I am not
aware that proof has yet been produced to show that the period of protection
in immediate vaccination, is greater than in mediate vaccination. Until facts
and figures can be produced therefore, I am compelled, like ' Hudusi.' to " very
much doubt the fact." In immediate vaccination, the lymph it is said is trans-
ferred in " a living state, and is at once taken up by the circulation." How is
this proved ? Does the fact that the lymph was transferred in " a living state"
shorten the period of incubation ; or cause any increase in the constitutional distur-
bance that accompanies successful vaccination ? Are the stages of papule, vesicle,
and pustule attained more rapidly, than in mediate vaccination ? Is the vesicle
more typical, and does the resulting cicatrice differ in appearance from one
produced by successful mediate vaccination ? I fear these questions cannot be