FOR THE YEAR 1874-75.
19
Exemption of
vaccinated
districts.
State of habitually
inoculated districts.
Transition districts.
" Stamping out"
outbreaks of small-
pox.
in this province. As the prevalence of small-pox in the province has been very fully
and instructively described in the report of the Sanitary Commissioner (page 24), which has
already come under the notice of Government, I need not repeat the information here.
Dr. Coates has drawn pointed attention to the exemption of vaccinated districts. It is also
fair to state that districts which are habitually inoculated showed also a low small-pox
mortality. In such districts small-pox deaths must be very nearly a constant quantity. The
districts which suffered most are those in which a struggle between inoculation and vaccination
is going on (Bankoora and Sonthal Pergunnahs for example). Dallying with vaccination is a
dangerous practice in this country, and if the mortality which is annually due directly and
indirectly to inoculation is to be reduced or abolished, arrangements must be made for complete
and exhaustive vaccination of all the unprotected. The reports show that excellent results
followed upon the practice of stamping out outbreaks of small-pox, i.e., vaccinating every-
body in and around the contaminated locality when the system was properly practised.
Prevalence of the
practice of
inoculation.
Necessity of
decided measures.
75. Inoculation is still very extensively practised in the province, more particularly in
Eastern Bengal, Orissa, and Behar. That the people can be easily weaned from the per-
nicious practice, the experience of the circles of vaccination fully proves. There can be no
question that a large and unnecessary mortality is being caused by the practice, and that its
prohibition, when efficient vaccination is substituted, is an unmixed good. These two things
must always go together, but the more quickly and extensively they are spread over the pro-
vince the better. A transition state when vaccination is desultory and partial, and inoculation
stealthily performed here and there, is fraught with very great danger, and this is the predica-
ment into which many districts are now drifting. It is very doubtful if any district is so
completely inoculated as to reduce the inevitable mortality consequent on the practice to the
minimum; and the progress of vaccination, if it is not, so to speak, driven home at once, is up
to a certain point one of increasing hazard. On these grounds I would very strongly press the
need of largely extending systematic and exhaustive vaccination in Bengal, inoculation
being simultaneously prohibited and resolutely suppressed.
Vaccine census.
76. Medical officers have forwarded " vaccine census," which have been compiled into
a table which appears in the appendix. I have already remarked on the importance of infor-
mation of this description being beyond doubt, and trust that officers will not in future
entrust the collection of such data to their subordinates. As a test of how the inhabitants
of particular localities are protected from small-pox, such statements are very valuable, and
their record in these reports will constitute a most important material for comparison, and
a good means of estimating the progress of vaccination.
General conclusion.
77. The history of vaccination in Bengal during 1874-75, which I have set forth in
detail in the preceding paragraphs, contains a large element of progress, and is suggestive of
satisfaction and hope; but very much more than has been accomplished still remains to be done
ere the province can be pronounced to be as safe from small-pox as vaccination can render it,
and this, I would submit, is the end which must be steadily held in view until it has been
entirely compassed.
I have the honor to be,
SIR,
Your most obedient servant,
K. McLEOD, A.M., M.D.,
J. FULLARTON BEATSON, M.D.,
Secretary.
Offg. Surgeon-General, Indian Medical Department.