( 4 )
and lead to the inference that the outturn of work tends to be in inverse ratio
to the relative number of operators.
Cost of vaccination.
Assam
... ... ...
Punjab
...
...
...
Central Provinces... ...
North-Western Provinces
Bombay
...
...
...
Burma
...
...
...
A.
1
1
2
2
3
4
P.
6½
9
0
7
0
2
11. The average cost of each successful operation during the three years
amounted to 1 anna 6 pies, which apparently
compares well with the cost in the other Provinces
in India, as shown in the margin; but it is to be
feared that the comparison is illusory, since a large
number of the vaccinators in Bengal, viz., no less
than 1,756 out of 3,039, are licensed vaccinators,
who are paid by fees taken from the people, while 878 others were unpaid
apprentices, whose operations swell the total without any cost to the State:
apprentices seem to be unknown in other provinces.
Comparison between the death¬
rate from small-pox in each district
and the proportion of protection.
12. Four diagrams are given in the report to illustrate the death-rate from
small pox in each district as compared with the
proportion of the population protected by vaccina-
tion during the last seven years. They lead to no
very convincing deductions, probably because the phenomena recorded do not
extend over a sufficiently long period. Puri and Cuttack, which in each year
are well in the forefront of the list showing deaths from small-pox, are re-
spectively eleventh and eighth from the bottom as regards protection : in these
districts, however, all statistics are obscured by the annual concourse of pilgrims
at Puri. Darjeeling, on the other hand, which is best protected, in no year
shows a death-rate of more than 13 per mille of the population. It would be
advisable in future to show the proportion of protection and the number of
deaths from small-pox in one and the same diagram. In the present instance,
moreover, the usefulness of the diagrams is much impaired by the fact that the
districts are not shown in the same order in each.
Vaccination operations in Dacca
Jail.
13. The Officiating Sanitary Commissioner, as requested by Government,
comments at some length on the result of certain
vaccination operations in Dacca Jail. It appears
that 3,465 prisoners were vaccinated, of whom 1,667 had been previously
inoculated, 1,445 had been previously vaccinated, 197 had had small-pox, and
156 were unprotected. At first 2,719 operations were successful, and as an
experiment 2,032 prisoners were again vaccinated, with the result that 1,303
cases took. Vaccination was also performed on 14 prisoners one month after
their recovery from small-pox, with the result that six cases were successful.
The Civil Surgeon of Dacca, in view of these results, suggests the necessity of
frequent re-vaccination until susceptibility is stamped out. The gist of Dr.
Dyson's reply is that if one attack of small-pox does not necessarily confer
immunity from a second attack, it is only reasonable that it should not neces-
sarily render impossible a subsequent successful vaccination: still less will one
successful vaccination necessarily prevent a second successful vaccination. Dr.
Dyson quotes instances and statistics, which show conclusively that re-vaccina-
tion at the age of puberty practically grants complete immunity from small-pox,
and he draws the conclusion that even, if continuous vaccination is theoret-
ically correct, it is neither practicable nor necessary. He finally recommends
that all school children of over ten years of age, and all Government emlpoyés,
should bear the mark of successful re-vaccination. The first suggestion is less
practicable than the -second, which is akin to one which was made by
Dr. Gregg in 1890, and again by Dr. Dyson in 1893, to the effect that, under
the Factories Act (XV of 1881), all persons employed in factories should bear
a similar mark. The proposal was brought to the notice of the Government
of India in the annual report on the working of the Factories Act, and is under
the consideration of Government in the General Department.
Extent of vaccination.
14. Vaccination is now practised throughout the Province: it is com-
pulsory in municipalities, but optional in rural
areas, save in certain portions of Rangpur, Bhagal-
pur, the Sonthal Parganas and Tippera. The Officiating Sanitary Commissioner
recommends that those sections of the Bengal Vaccination Act (V of 1880)
should be introduced which, without rendering vaccination universally com-
pulsory, make it punishable for individuals, who have been duly served with
a notice, to refuse to undergo, or to allow their children to undergo, the
operation. But the Lieutenant-Governor, while he recognises that Bengal is
lamentably backward in this as in other sanitary matters, and that nothing short
of compulsion will bring vaccination up to what it ought to be according to