FOR THE YEAR 1878-79.
7
Circle the paid and licensed vaccinators worked close together, in order to secure
the proper amount of the supervision as the staff of inspecting vaccinators was
not sufficient for requirements. This is anything but a desirable practice, and
it seems to me that paid and licensed vaccinators should work entirely separate
and should be superintended by a separate staff. In fact, the proper plan is
first of all thoroughly to protect a part of the country by means of circle
operators and then permit the licensed vaccinators to carry on all future opera-
tions. Nothing should be so steadily kept in view as this, that licensed vaccina-
tors or ex-inoculators are a source of danger and difficulty, unless their work is
very closely supervised seeing that they are very apt to revert to inoculation
under such circumstances, it being much more easily carried on. I doubt if the
supervision of paid vaccination has been sufficient in any of the circles; and beg
to call attention to what Dr. Lawrie has written of the mode in which some 298
ex-inoculators in the Monghyr district carried on inoculation under cloak of
being vaccinators working under a Government license. It will further be
observed that in the Chumparun district six ex-inoculators refused to work as
vaccinators according to the English method, saying that they preferred being
independent. It was found that they practised inoculation instead of vacci-
nation. Small-pox has been very prevalent in that district since, and vaccinators
had to be deputed to it from Patna in consequence.
20. Small-pox after inoculation.—Both Dr. Charles and Dr. Lidderdale
have observed that during the past season numbers of persons who had been
inoculated have been attacked with small-pox, which no doubt is an indication
either that inoculation had been very carelessly performed or that its effect had
worn out.
21. Diffusion of small-pox.—I beg to call attention to an extract from the
report of Dr. Charles, which I have quoted, in the abstract which follows
regarding the diffusion of small-pox, and I agree with him that there is urgent
necessity for legislation with regard to giving notice to the police whenever a case
occurs. Dr. Lidderdale informs me that the disease existed for two months in
Rungpore district without ever being reported. No isolation is ever enforced,
and people covered with scabs mix freely with others in bazars, towns, and
villages, while polluted clothing is never destroyed or even boiled or fumigated.
So long as this is the case small-pox must prevail extensively. I commend the
remarks of Dr. Charles to the attention of His Honor the Lieutenant-Governor.
22. Self-supporting vaccination.—Vaccination, in order to be carried on by
Government in the most desirable mode, should be self-supporting, and this
as yet has not been done except to a very small extent, and it is to be feared
that the supervision has not been all that it should be. Vaccination carried
on by ex-inoculators under the supervision of Civil Surgeons I believe to be of
little use. Civil Surgeons have not time to look after the work as it requires
to be done. A district or other part of the country should be thoroughly
protected by means of Government vaccinators working under their Superintend-
ent, and when all the inhabitants have been protected, ex-inoculators, after
thorough training in the system to be followed, should obtain licenses from
the Superintendent of Vaccination and be provided with lymph and lancets
with orders to work in a defined area. Arm-to-arm vaccination should alone
be allowed, and any man who does not follow it should be deprived of his
licence. Supervision by paid Government officers is most necessary, this
supervision being the only expense which Government will have to bear.
Only in this manner can Government hope to introduce and maintain vaccin-
ation in Bengal at moderate expense.
I have the honor to be,
SIR,
Your most obedient servant,
JAS. IRVING, M.D.,
Surgeon-General for Bengal.