( 3 )
returns of villages visited and cases inspected really represent a careful examina-
tion of the work done by the licensed or salaried vaccinators, and not merely
a hurried compliance with an arbitrary departmental standard of supervision.
7. Some interesting results may be arrived at by comparing the regis-
tered deaths from small-pox as shown for each district in Bengal in Statement V
(b) with the diagram given on page 11, to illustrate the proportion of the
population protected by vaccination during the last seven years. If the returns
of successful vaccinations and the mortuary statistics were both accurate, it
might be expected, as a general rule, that districts with the highest proportion of
persons protected by vaccination would have the lowest death-rates from small-
pox, and conversely that districts, where only a small proportion of the population
is protected, would show a comparatively high small-pox mortality. Notwith-
standing the admitted imperfection of both sets of figures, a distinct tendency
towards some such correspondence between increased protection and reduced
death-rate may be traced on the diagram referred to. The following districts
returning a high vaccination rate show, with the single exception of Chittagong,
a low death-rate from small-pox, thus—
Darjeeling ... ... ...
Chittagong ... ... ...
Backergunge ... ... ...
Singbhoom ... ... ...
Tipperah ... ... ...
Maldah ... ... ...
Protected
per 1,000
for 1884—91.
680
460
325
280
278
268
Death¬
rate per 1,000
for 1890-91.
.01
.32
.03
.18
.02
.02
while the following districts, with a low ratio of protected population, have
a comparatively high death-rate from small-pox:—
Mozufferpore ... ... ...
Durbhunga ... ... ...
Sarun ... ... ...
Chumparun
...
...
...
Gya ... ... ...
Puri
...
...
...
Midnapore ... ... ...
Protected
per 1,000
for 1884—91.
97
10
60
79
89
127
160
Death-
rate per 1,000
for 1890-91.
.20
.10
.27
.87
.40
.84
.98
It should be added that in Chittagong, the one district where the statistics
appear to conflict with the tendency noticed above, recent inquiries have shown
that the work of vaccination was very indifferently done during the last three
years, and that the protection afforded was little better than nominal. On the
whole, therefore, there seem to be statistical grounds for the conclusion that some
real progress is being made, and that vaccination in Bengal, in spite of bad
lymph and careless operators, does afford substantial protection from small-pox.
In order to make the protection more effective and to extend its range, it seems
to the Lieutenant- Governor that considerable changes must be introduced into
the internal organization of the Department. Closer local supervision, and more
intimate relations with the district executive, seem to be needed in order to
induce the people to take more freely to vaccination; and Sir Charles Elliott
doubts whether this object can be attained under a system which has all the
defects of centralisation, and few, if any, of its advantages.
8. The total cost of vaccination was Rs. 1,82,400-4-3 against Rs. 1,72,696-5-9
in 1889-90, showing an increase of Rs. 9,703-14-6. The average cost of each
successful case has also increased from one anna six pie in 1889-90 to one anna
and seven pie in 1890-91. It was as usual highest in Calcutta, where each
operation cost Re. 1-3-4, and lowest in Eastern Bengal, where the cost was only
ten pie.
9. Dr. Gregg again speaks very unfavourably of the working of the
animal vaccination depôt in Calcutta. The lymph supplied in tubes has
frequently failed even when used immediately on receipt from the depôt, and its
failure is ascribed by Dr. Gregg to carelessness in extraction and storage.
This is the third time that the working of the depôt has been reported as un-
satisfactory, and the Superintendent of the Metropolitan circle, who was in
charge of it, has since been transferred to another appointment. The establish-
ment of an animal vaccination depôt at Darjeeling has been under consideration