( 13 )
Remarkable results of vaccina¬
tion and small-pox in the Dacca
Jail.
12. In connection with the prevalence of small-pox in the town and
district of Dacca during the year 1892-93, some
remarkable results of vaccination were brought to
light in connection with the protection of the pri-
soners in the Dacca jail, which the Government asked me specially to notice
and explain in the Annual Vaccination Report. It appears that 3,465 prisoners
were vaccinated in the jail during the year in question. Of these—
1,667 had previously been... ...
1,445 had previously been... ...
197 had had... ...
156
were...
...
Total 3,465
Inoculated.
Vaccinated.
Small-pox.
Unprotected.
At first 2,719 operations were successful, and as an experiment 2,032 prison-
ers were again vaccinated, with the result that 1,303 cases took. Vaccination
was also performed on 14 prisoners a month after their recovery from small-pox,
and the result was that in 6 cases the operations were quite successful, the
vesicles being normal in every respect. The Civil Surgeon, in drawing attention
to these results, as showing how large a proportion of the people think them-
selves quite safe from small-pox when they are really not so, suggests frequent
re-vaccination until susceptibility is stamped out.
It may at first sight appear surprising that people who have been recently
vaccinated can be again successfully vaccinated, but in my experience as a
Deputy Sanitary Commissioner in the Punjab I have frequently found this to be
the case. There is nothing extraordinary about it, and it does not prove
that vaccination must be repeated again and again until susceptibility is
stamped out. Such a proceeding, even if necessary, would be impracticable.
The practice in small-pox hospitals in England is simply to re-vaccinate
all attendants and nurses, and the results are striking. Dr. Edwardes, in his
work on vaccination and small-pox, states, page 30: " The experience of the
epidemic 1876-77 was of the same kind; all re-vaccinated attendants have
escaped, whilst the only one who had not been re-vaccinated took small-pox
and died of it."
Again, page 31 : " The Committee reported that out of
1,500 such attendants, 43 contracted small-pox, and not one of these 43 had
been re-vaccinated."
It is clear here that re-vaccination afforded complete protection to the
people who, owing to the nature of their duties, were brought in constant
contact with small-pox patients, and the test was a very severe and complete
one. If it were really necessary, in order to protect completely against
small-pox, to vaccinate repeatedly, these nurses and attendants must
necessarily have fallen victims to small-pox. I could multiply examples,
but it is scarcely necessary to do so. I will, however, quote one more statement
bearing on the case.
In Prussia vaccination was compulsory only in the army from 1834. In
the year 1874, however, an Act was passed ordering compulsory vaccination of
every child at the age of 12 years. The statistics are interesting. They are
taken from Dr. Edwardes' book, page 36.
"Prussia—Before and after the Vaccination Law of 1874:—
The deaths from, small-pox per 100,000 living each year for the period 1816-82 were:—
1816-30 ...
1831-50 ...
1851-70 ...
1871-72 ...
1874
1875-82 ...
1884-86 ...
45, 27, 29, 20, 10, 17, 20, 19, 14, 15, 14, 25, 19, 19, 24.
11, 30, 60, 48, 27, 18,15, 16, 14,16,14, 22, 28, 27, 15, 15, 9, 13,
10, 15.
12, 18, 39, 43, 9, 7,13, 26, 19, 18, 30, 21, 33, 46, 43, 62, 43,18,
19,17.
243, 262 (the great epidemic); 1873-74—35, 9.
(Re-vaccination of general population in school age made com-
pulsory.)
3.6, 3.1, 0.3,0.7, 1.2, 2.9, 3.6, 3.6.
4.00,1.5, 1.4, 0.5."
Thus it will be seen that re-vaccination at the age of puberty practically
has the effect of abolishing small-pox; and such results as the above justify
the conclusion that, even if continuous vaccination is theoretically correct, it is
neither practicable nor necessary.