51]
Ill-effects.
90. In addition to the cases of tetanus already mentioned the only ill-effects tollowing
inoculation, which could be directly referred
to the Operation, were certain abscesses.
Besides these, 9 deatbs from plague and 1 from tetanus were reported tohave followed
closely upon the inoculation of the patients. Investigation showed, however, that in no
instance could inoculation be held responsible for the illness and death of these persons. The
cases of plague were without exception found to have contracted the disease before inoculation.
The person who died of tetanus had slight fever at the time of inoculation and lived in a
house in which another person had recently died of this disease. Inoculation had been
carefully performed and none of the number of other persons, who were inoculated at the
same time with the same brew, suffered any ill-effects.
Thirty-seven cases of abscess at the seat of inoculation were reported. Thirty of the
patients had been inoculated with the new fluid and 7 with the old.
Of the former 23 were inoculated in the Hoshiarpur District, 6 on October 21st, 1902,
with fluid of one brew, 3 on October 22nd, with fluid of another brew, and 14 on Nov-
ember 1st, with fluid of a third brew. In no other instance was inoculation with fluid of a
particular brew followed by abscesses in a group of persons.
There is no reason for believing that the other abscesses reported were the direct
result of inoculation : it is at least as likely that they were due to infection of the inoculation
puncture subsequently to the Operation.
Two persons suffering from tuberculosis who were inoculated experienced a tem-
porary exacerbation Symptoms of the disease as the effect of the Operation.
Results of the measure.
91. In considering results of inoculation as indicated by a comparison of the incidence
of plague among inoculated and uninoculated
persons there are two points which must be
borne in mind. The first is that unless the populations under consideration were similarly
circumstanced as regards the exposure to the infection of plague the comparison will be of
little or no value. The second point to be remembered is that in some districts—as for ex-
ample those of Jullundur, Hoshiarpur Gurdaspur, Sialkot, Ludhiina and Ambala,—which have
been previously visited by severe epidemics of plague, the number of persons who have suffered
from plague forms an appreciable portion of the population. Such persons, it may be safely
asserted, were not inoculated, and as they had acquired an immunity from attacks of plague
the inclusion of their number among that of uninoculated persons tends to obscure the
benefits of inoculation as judged by comparison of the incidence of plague upon the inoculated
and uninoculated communities.
In order to eliminate as far as possible the errors arising from the first of the two,
considerations mentioned above the following method has been adopted for comparing the
incidence of plague among inoculated and uninoculated persons.
Village statistics.
92. The statistics of only those villages have been considered in which not less than
10 per cent. of the inhabitants were inoculated
prior to, or during an, outbreak of plague and
in which such outbreaks occurred not later than four months after the Performance of
inoculation.
Statements have been prepared for each vil'age in which these conditions existed,
showing its populations according to the Census of 1901, the dates on which inoculations
were performed, and the number of persons inoculated on each date as well as the
number of attacks and deaths among inoculated and uninoculated persons daily throughout
the epidemic.
The average population of each class present has been calculated from the data thus
afforded, and the incidence of plague attacks and deaths upon this population has been worked
out, as well as the fatality of the attacks among the two classes.
From the village statistics similar statements were prepared for tahsils and these
have been embodied in Table No. 3 below.