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border on foreign territory, it is always liable to invasion from outside. In
the north-west corner Holkar and Government villages are a good deal mixed
together, and small-pox is almost always prevalent in the former, owing doubtless
to the fact that no vaccination is done there. His villages afford shelter to the
more timid women of ours, who carry their children there to escape vaccination.
Out of 28 villages in which 299 cases of small-pox occurred, 14 villages and 156
cases occurred there, i. e. more than half the entire number.
The next most exposed locality is Chandgarh, which on 2 of its 3 sides is
bounded by foreign territory, and was on 3 occasions infected from Holkar's vil-
lages. On enquiry being made as to the cause of the outbreak the almost,
invariable answer has been that it happened in this way. In Burhanpur and
Khandwa there were slight outbreaks, but a peculiar feature of the attacks was
that the majority of people who suffered were adults; in one case only was a
child with successful marks of vaccination affected : a fact which points pretty
clearly to the importance of revaccination.
30. Hoshangabad.—Towards the commencement of the present year, cases
became pretty frequent in the Harda tahsil, and in March the disease assumed
the dimensions of an epidemic, affecting this and the Seoni tahsil almost exclu-
sively. 1,178 cases were reported during the first three months of the year.
Thinking it possible that the outbreak might be in some measure dependent on
neglect on the vaccinators' part, I desired the Civil Surgeon to make a personal
inspection, the result of which is given in full as an appendix to this report.
At the same time, I issued a Circular instructing all Civil Surgeons, on the
occurrence of an epidemic of small-pox in their districts to withhold the pay of
the vaccinators in whose circles the disease was prevalent, pending an enquiry
as to whether they had properly performed their duties. The result in the
instance in question proved the correctness of my conjectures, and each of the
vaccinators concerned was fined a month's pay. When this is thoroughly under-
stood, I trust it will be productive of good. Dr. Browne's notes are especially
valuable just now in view of the controversy which is taking place in England
as regards the value of vaccination as a protection against small-pox, I have
therefore deemed it right to publish them in full. His remarks concerning
revaccination are doubtless in a great measure correct; but, as the people become
more alive to the benefits of primary vaccination, it is reasonable to expect that
the difficulties described by him and others will vanish. The returns from the
Chhindwara district show a large number of cases of revaccination, and prove
that with care and tact much may be ultimately achieved if the Civil Surgeons
will devote their energies to so desirable a work.
Vaccination in Feudatory States.
31. In the Feudatory State of Bamra in the Chhattisgarh Division, whilst
the Rajah was absent on a trip to Benares, two inoculators from Bengal enticed
the Malguzars of some villages to allow them to practise inoculation. Several
people were operated on in 8 or 10 villages, the result being about 40 deaths.
The people becoming alarmed complained to the Rajah, who at once wrote to the
Civil Surgeon to send vaccinators. Two were accordingly despatched to the
affected locality and checked the spread of the disease by vaccinating freely in
this and the surrounding villages; the people at once realized the benefit derived
from it and accepted vaccination eagerly. The Civil Surgeon visited Bamra later
on. The Rajah availed himself of this opportunity to get himself and all the
members of his household vaccinated ; it was in a great measure owing to this
that adult vaccination in these parts was very large.
The Civil Surgeon reports a most pernicious practice as prevailing in the
Feudatory States of Sonpur, Phuljhar, Rehrakole, Borasambur and Raigarh.
Inoculation is not only practised here, but the right to do so farmed out to
inoculators on a certain payment to the States. The Deputy Commissioner has
promised to take steps to stop the practice. It is proposed to send "vaccinators
there next season.