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in future be vigorously carried on, and that if more lanoline vaccine was
required at any time, it would be asked for. No more has since been demanded.
General remarks.
17. In conclusion it only remains for me to make a few general remarks
on vaccination in connection with small-pox. This
disease is now, thanks to the prophylactic dis-
covered by Jenner 100 years ago, the least prevalent of all the fatal diseases.
It is sometimes ignorantly urged that this is due not to the use of vaccination,
but to the decrease of variolous inoculation. It is also asserted that the
decline in the small-pox fatality is due to improved sanitation. Doubtless to
some extent personal and municipal cleanliness, good food and pure water,
have beneficial effects on all diseases, and in the benefit small-pox has had its
share, but the lessening of small-pox cannot be set down to improved drainage
and water-supply any more than can the lessening of enteric fever be set down
to vaccination. There is abundant evidence the world over, and a mass of
statistics to prove the influence of vaccination and the remarkable decrease
that has taken place in the small-pox mortality following the introduction of the
prophylactic. There are many people, however, who will not take the trouble
to study figures, and who excuse themselves by the easy statement that statistics
can prove anything. For such people, the following illustrations may be instruc-
tive:— At Terrington in England, the disease of small-pox appeared in a house
occupied by a man and his wife and seven children. According to the statement
of the medical man in attendance, the wife had had small-pox in childhood,
the husband had been vaccinated when an infant, but was an ardent anti-vacci-
nator and had allowed only one of his children to be vaccinated. All the family
were attacked, with the single exception of this child who escaped altogether,
though sleeping in the same room and in the same bed with some of the others.
The wife and two of the children died; the four unvaccinated children had
the confluent form of the disease and were much disfigured; the father had a
very mild attack and was able to nurse the rest. A report (December 1884)
of a Coroner's inquest in Shoreditch shows that small-pox broke out in the house
of a determined anti-vaccinationist, and her three unvaccinated children died.
At Hull in 1883 small-pox broke out in a house where there were 19 lodgers.
Of these, 16 were revaccinated, one refused revaccination, because he had been
vaccinated in his youth, and two others also refused, though they had never
been vaccinated. All these three caught small-pox, and the two who had never
been vaccinated died. At Billericay in 1883 three young men—one unvacci-
nated, the others vaccinated in infancy—left home to look for work. About
11 days after returning, the unvaccinated man fell ill with small-pox which
killed him. All three had occupied the same room the whole time. The
vaccinated men escaped. The father and mother of the unvaccinated man
refused vaccination and both took small-pox, the former slightly, the latter
severely. At Chatham, in a household in 1884 consisting of father, mother
and three children, one child only was unvaccinated. It died of small-pox.
At Claygale, Surrey, in 1885, small-pox broke out in a household consisting of
father, mother, three sons, four daughters and a lodger. The eldest son
and the lodger had been revaccinated, and the second son had been once
vaccinated. These three alone escaped; none of the other seven had been
vaccinated, all took the disease in a severe form, and one of them died.
These remarkable instances are not exceptional, and could easily be multiplied
indefinitely.
In Bengal the people seem to be gradually realizing the benefits of vacci-
nation, but there are still places where vaccination, in common with other
great movements, is sadly opposed—prejudice and the pleasure of opposition
having their influence, and inefficient, careless or injudicious methods helping
both. In this respect, however, a great work has been accomplished in Eastern
Bengal during the last year of the triennial period under report by the Deputy
Sanitary Commissioner, Surgeon-Captain Deare, who, acting under my instruc-
tions, has entirely overcome the almost fanatical opposition hitherto offered by
the Ferazi Muhammadans of Faridpur. I append to this report as an appendix
Dr. Deare's own interesting description of the work he had to do, from which
it will be seen what tact and precaution was necessary in accomplishing the
end which has been gained. If the Vaccination Department had nothing else
to report during the years 1893—96, this work in Eastern Bengal alone is