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Not advisable for the present to interfere with the
procedure of the Inoculators. Heavy mortality in-
explicable
30. It will be seen that the subject of interference with the procedure, of inoculation
has been studiously avoided. It is possible that in
some parts of the country it may be found advisable
to furnish the inoculators with short rules, which
they should be invited to follow, with precautions
which they should keep in mind, as well as with hints on the general mode of conducting
their work. For the present, any such measure would be hazardous, and would be much more
efficiently had recourse to, when we are acquainted with special faults or shortcomings, which
it would be desirable to guard them against. The question has been carefully considered of
requiring the inoculators to note by means of witnesses, the source from which their
virus has been derived, whether taken by themselves or bought from a vendor of it,
with the view of punishing them for ill consequences, in the event of their being proved to
have taken it from a case of small-pox known to have been an unfavorable one for the purpose.
It seems, however, for the present, better not to take action in this way, but to wait to see
whether the mere knowledge that their operations are watched by the Government, will not
ensure all the necessary care on their part.
It may be right while on this subject, to point out to Government, that a careful selection
of the small-pox cases from which to inoculate, may influence the result to the extent of a
few individual deaths per cent.; but when the mortality reaches to the heavy ratio of 30 or
50 per cent., as in the cases cited in paragraph 2, the result in the present state of our
knowledge seems quite inexplicable.
The mortality from small-pox among large numbers of persons who have been vaccinated,
is very much the same every where; in the same way, small-pox, among unprotected persons,
has a death-rate, which though influenced by climate and race is surprisingly regular ; inoculated
small-pox also obeys the rule of its death-rate being a fractionally small one. That only a
certain small number of persons out of every thousand should die after being inoculated with
the virus chosen from a slight case of small-pox, is as much a law of nature, as any of which
we have cognisance within the limits of Medical experience. Allowing this to be the case,
it is a matter for very great regret, that at the time when such extravagant and incredible
assertions were made, as that a third or half of those operated on died in any given instances,
a searching enquiry should not have been at once instituted, to verify or disprove alleged
facts, which it is difficult to believe, seeing they are so much at variance with the well
ascertained and carefully matured knowledge on the subject.
Time for commencing such regulation.
31. It is of importance that the results collected, should contain as much information
as possible extending over the whole of the next
inoculating season. In the neighbourhood of Calcutta,
this would be attained, and abundance of time for preparation would be allowed, if the
regulation were to come into operation on the 1st of January 1869.
CHAPTER IV.
Further investigation concerning Inoculation necessary.
Exact information regarding the proportion of pro-
tected persons to the population is necessary.
32. When the scantiness of the available data on which to estimate the degree of pro-
tection which exists in the country against small-pox
is considered, the conviction will doubtless be felt,
that though it is conclusive so far as it goes, it is of
too meagre a description to found very active or sweeping measures on. To remedy the
restricted nature of such data is a desideratum of the first importance.
With exact information regarding the percentage of protection against small-pox which
exists in each particular district, the question of preventing the ravages of small-pox in it
will be much simplified. The enquiry ought to embrace all the three sources of protection,
and include, under distinct headings, the number protected by previous attacks of small-pox,
by inoculation and by vaccination, as well as the numbers devoid of all protection.
Proposal for ascertaining the ratio of protected
persons.
33. For the purpose of ascertaining the amount of protection against small-pox, any
general census must be excluded from the means at
our command, as independently of the magnitude of
the task any agency available for such a purpose
would be quite untrustworthy.