5
preceding years. The epidemic signal-
led its advent by a distinct rise in the
mortality from small-pox especially
in Calcutta
when
small
explosive
outbreaks occurred in November and
December, 1924, and the Public Health
Department lost no time in giving time-
ly warnings to the local bodies. They
were urged in the Public Health Depart-
ment circular letter No. 48-E., of 1924,
to push forward vaccination and re-vac-
cination as widely as possible and it was
pointed out to them that Calcutta was
likely to serve as the distributing centre
from which the infection of small-pox
would disseminate throughout the Presi-
dency. The various Railway Compan-
ies and the Inland Steam Vessel Ser-
vices were also advised to take such
steps as will prevent the spread of the
disease. In Calcutta the number of at-
tacks and deaths rapidly went up week
by week, until it attained the maximum
in March. Since then the epidemic
tended to decline and during the latter
part of June, 1915, it practically sub-
sided. A total of 2,708 deaths from
small-pox occurred in the City during
the year under report. Next in order
of the severity of the epidemic came the
district of the 24-Parganas with 1,727
deaths, Burdwan with 752, Mymen-
sing with 714, Howrah with 636, Dacca
with 531, Midnapur with 469, Chit-
tagong with 440, Bogra with 433,
Hooghly with 425, Jalpaiguri with 271.
Malda with 185, Bankura with 184 and
Rangpur with 125 deaths. In other
districts it was below 100. It will ap-
pear from the Statement No. VI at-
tached to this report that the epidemic
of small-pox of 1925 was neither so
severe as regards its total mortality nor
so widely spread as that of 1919-20, be-
ing specially confined to Calcutta and
its neighbouring districts, the outlying
districts being comparatively lightly
affected. The actual mortality in Cal-
cutta was distinctly higher than in the
previous epidemic.
14. Admissions to the Campbell
Hospital, Calcutta, from small-pox.—
An analysis of the admissions from
small-pox to the Campbell Medical Hos-
pital shows that out of 1,196 cases ad-
mitted from 1st October 1924 to 31st
March 1925, 380 or 31.8 per cent. were
unvaccinated. Of the remaining, 179
or 21.9 per cent. of the vaccinated cases
showed no marks and 637 or 78.1 had
one or more cicatrices. Of these that
bore evidence of vaccination on their
arms, 78 had 1 cicatrix, 222 two cicat-
rices, 46 three, 271 four, 2 five and 18
six cicatrices. With the exception of
16, all the primarily vaccination cases
were reported to have been operated up-
on in childhood. Of the 816 vaccina-
ted cases, only 52 were said to have been
re-vaccinated; of these 17 were operated
upon during the incubation period of
small-pox. The records being incom-
plete, it is difficult to say how many of
the vaccinated cases were successful and
how many unsuccessful. Classified ac-
cording to the type of the disease 62 had
modified, 391 discrete, 436 semi-conflu-
ent, 242 confluent and 65 hœmorrhagic
small-pox. As regards age 4 were un-
der one year, 34 between 1 and below 10
years, 200 between 10 and below 20 and
the remaining 958 above 20, which
shows that vaccination has had a dis-
tinct effect on transferring the age inci-
dence of small-pox from infancy
and
childhood to adolescence. Of the 4 in-
fants none was vaccinated; of the child-
ren between the ages of 1 year and be-
low 10 years, 23 were unvaccinated, 3
had no marks, 8 were successfully vacci-
nated and bore one or more cicatrices.
Out of 1,196 persons 354 or 29.6 per
cent. died in hospital during the same
period. Of these 184 or a little above
50 per cent. were unvaccinated, 51 were
said to have been vaccinated but bore no
evidence of having been operated upon
as such; while only 119 had one or more
cicatrices on their arms, 7 were re-vac-
cinated, 5 being operated upon within
the incubation period of small-pox.
Classified according to age 2 deaths oc-
curred among infants, 10 between 1 and
under 10 years of age, 23 between
10 years and below 20 years of
age, 145 between 20 years and below 30
years of age and the rest above 30. As
regards the type of disease no death oc-
curred in cases having modified form of
disease, 7 among those having discrete
small-pox, 107 among semi-confluent, 181
among confluent and 59 among hœmorr-
hagic cases. Compared with admis-
sions all the 62 modified cases survived
while 1.8 per cent. of the discrete cases,
24.5 per cent. of the semi-confluent, 74.8
per cent. of the confluent, 90.8 per cent.
of the hœmorrhagic cases died.
15. Different methods of vaccina-
tion.—The following table shows the
number of primary and re-vaccination