10
REPORT ON VACCINATION IN BENGAL
by means of inoculation. This took place many years ago, and two of the persons thus
inoculated elsewhere, after the practice was illegal in Calcutta, came under the care of Baboo
Callachund Dey. Both of these persons have had small-pox this year, and the belief in the
superior protection afforded by inoculation has been cruelly shaken in the minds of all those
acquainted with the special pains taken to insure protection to these two individuals.
" In connection with these two instances of small-pox attacking after previous inoculation,
I may state as another incident that many examples have this year been brought to my
notice not only of inoculated persons having been attacked, but of many deaths having taken
place among such previously protected persons. I myself have been familiar with such
occurrences since 1864, but I have a very decided impression on my mind that during this
epidemic more inoculated persons have died in proportion to those attacked than I have
ever previously seen. Be this as it may, of another fact there can be no doubt, that the
number of medical men who have this year voluntarily told me of instances of small-pox
taking place in those protected by inoculation has exceeded in great measure the numbers
who used previously to tell me of the same occurrences. Not only was such information
not often voluntarily conveyed to me, but on my raising the question all the medical men
educated at the Medical College quietly expressed their belief in the superior protective
efficacy of inoculation; they either did not know of or had overlooked the fact that large
numbers of people who have been inoculated in childhood, during every epidemic of small-
pox, get the disease, not a few dying from it. Two factors seem to have acted in fostering
a belief among them of the superior protection effected by inoculation. The one was that
they inherited a belief in the absolute protection afforded by inoculation as hundreds of
medical men in Europe have inherited a belief likewise false, that one attack of small-pox
affords absolute protection from another. The other depended on their having seen or heard
of persons having undergone an operation at the hands of a vaccinator, which had been
improperly represented as a protective vaccination. The large amount of unsupervised
vaccination conducted in India only gave them too frequent opportunities of hearing of
small-pox seizing on those imperfectly vaccinated. For many years vaccination has been
most carefully supervised in Calcutta, such cases as above alluded to can only now take place
purely exceptionally, and when the protection given by vaccination has worn out and small-
pox seizes on such persons before the protection has been renewed by re-vaccination, the
nature of the occurrence is estimated at its true value."
Dr. Charles is of opinion from what he has heard and been told that among educated
Bengalis in Calcutta, faith in vaccination as a prophylactic has of late greatly increased, and
goes so far as to express his belief that were inoculation now permitted in Calcutta, " not a
dozen households among the upper and middle classes would allow an inoculator to practise
his calling among them." The experience of the epidemic has shown in a wavering manner
the efficacy of small-pox, as in an example such as the following, where one or two unpro-
tected individuals are living among a number of vaccinated persons, and where the former are
attacked by the disease and the latter entirely escaped.
In Calcutta there is virus from two distinct sources which are kept up entirely apart
and in different parts of the town. The one is from Jenner's lymph which has been
humanised for over 80 years, and the other is some which Dr. Charles humanised in 1871,
and he found during the epidemic of small-pox that the protection by means of the old was
just as good as that afforded by the new lymph.
Dr. Charles favours the idea that vaccination should be made compulsory in Calcutta,
though he is given to understand that Government is opposed to a law compelling it. He
dwells on the fact that in Calcutta during the epidemic of last year, 1,923 persons died, and
the disease was still going on when he wrote. He thinks that such a terrible death-rate
calls for special action of some sort, seeing that, though the vaccination department works
vigorously, small-pox still prevails in Calcutta. Allusion is made to a report which he
wrote in 1868 on the stamping out of small-pox in Calcutta in which he showed how
necessary it was that the department should have immediate notice when a case of small-
pox occurred in order that by means of vaccination a zone should be formed round the
infected house and thus prevent the patient becoming a focus of contagion. Dr. Charles
thus concludes his report—"I beg again to press this point on the notice of Government,
and urge for an enactment to be passed making it obligatory on those in the house to give
immediate notice at the nearest police-station when a case of small-pox appears. Such
a provision should be enforced by heavy penalties. In 1868 exception was taken to my
views on the score that they were very advanced. As the world has progressed since then,
and even in unimportant parts of England such a law is in operation, possibly now it may
be not thought too soon to enforce so necessary a provision of medical police in the
metropolis of the empire where its want, owing to the special habits and customs of the
people, is felt of such pressing importance. The people would soon learn to report small-pox
cases to the police, and I am convinced that a law of this nature would not press with
grevious force on any large numbers. During an epidemy of small-pox it would effect
very large interests to make these reports compulsory, but it must be kept steadily in view that
it is to prevent the possibility of a serious epidemy that such a law is so urgently
demanded. If the knowledge of the first case of small-pox is secured, the precautions that
can be taken by a thoroughly organized vaccine establishment render it quite impossible for an
epidemic to take place. I have again and again recorded, for the information of Government,
how completely and certainly small-pox can be stamped out in this way, and detailed