REPORT ON VACCINATION IN ASSAM.
11
Evil consequences of spurious vaccination.
small-pox was lately prevalent in their villages, and that its attacks were confined to
those who had been vaccinated. Mr. McNaught would be doing a public service if he
would take pains to ascertain what degree of truth there is in such a report and in tracing
it to its source. Spurious vaccination is no protection, but is
under all conditions an active injury to the cause. More-
over, even good lymph may be an imperfect protection, if enough has not been absorbed,
or if maturation has been interrupted. Inspecting officers should see not only the cases
of the week, but also some who were vaccinated the year before; for from these genuine
vaccination, and enough of it, as evidenced by a typical, depressed, and foveated scar,
can be much more thoroughly diagnosed. The ex-inoculator is not to be employed again.
Sources of lymph supply for the year.
44. The Tura lymph was obtained from three sources, viz., locally raised, fresh
lymph from Dacca, lymph in tubes from Darjiling twice,
and 10 tubes of English lymph from Shillong. The Dacca
supply was excellent, and practically supplied the district. The two from Darjiling and
England were not successful.
45. Nagá Hills.—There is not much vaccination work done among the hill
tribes. The Civil Surgeon at Kohima has a permanent paid vaccinator under his
orders, and has also trained the Hospital-Assistant and the dispensary compounder to
assist.
46. The result of their efforts has been 473 operations, and 459 successful. This
gives an average of 97 per cent., which reads too plausible. The climate and the people
are, however, favourable. Last year, there were 327 successful cases, and the year before,
which was the first to introduce the prophylactic, 178 cases.
47. Out of 473 cases, 29 were operated on at Kohima, 413 at Kaliani and
adjacent Mikir villages, and 31 at Wokha and Themokodima, and of the people 7 were
Angami Nágas, 212 Lhota Nágas, 214 Mikirs, and 40 other castes. The Civil Surgeon
notes that the Náigas still strongly object to vaccination. In fact, sweetmeats and
small coin appear necessary to secure their consent and the children's presence.
48. There is no sort of protection used by the Nágas; when small-pox breaks out
in a village, the sick are segregated in temporary huts in the fields, and the healthy
encamp outside the village till the epidemic has ceased, a primitive and rational sani-
tary arrangement.
49. The lymph used was obtained from the Sanitary Commissioners of Assam and
Bengal, and was of good quality. The bovine supply failed. A store of crusts for the
next season was secured.
50. Dr. Borah's attention is requested to the remarks made elsewhere as to the
necessity of practising a vigilant inspection of the subordinates' operations. The Nága
Hills may be considered a virgin ground for the introduction of this specific protection;
and its success will greatly depend on the value of these initial operations.
Reformed staff during the year.
51. Goálpára.—The establishment in this district has been completely reformed
since 1882-83. A Vaccination Superintendent on Rs. 25
a month has been allowed, and was effective for five months;
eight vaccinators worked under him. There were also nine ex-inoculators instead of 16
last year. The Civil Surgeon, the Assistant-Surgeon of the Immigration Depôt, and four
Hospital-Assistants of dispensaries added their quota. In this way the recommendations
of the Sanitary Commissioner given in the report of 1882-83 have gone far to be realised.
But the ex-inoculators must now be dismissed.
Results are highly satisfactory.
52. The results may fairly be claimed as satisfactory in a high degree. The area
of work was carefully mapped out from the beginning, and
the operators prohibited from " vague wanderings in search
of outside villages." Except in the Goálpára sub-division and its surrounding hamlets,
there was no real opposition on the part of the people, although nowhere was a cordial
attendance met with.
Statistics.
53. The total number of persons who were primarily vaccinated was 14,474, and of
these 13,094 are reported successful, being a ratio of 90.4
per cent. The figures for 1882-83 were 6,922 and 6,794
respectively. The nine ex-inoculators are credited with 6,319 cases, of which 5,830 were
successful. The inspections, however, were not very thorough; and the high ratio of suc-
cess achieved, especially by the latter class, who are paid by results, is open to doubt.
In Goálpára, as in all the other districts, I strongly advise the inspecting officers to