REPORT
ON THE
NECESSITY FOR REGULATING THE PRACTICE OF SMALL-POX INOCULATION
IN BENGAL, WHERE IT IS NOT PROHIBITED.
CHAPTER I.
General considerations regarding Inoculation and Vaccination.
The mortality resulting from small-pox inoculation,
is of a two-fold nature, direct and indirect.
1. IT is shewn by various reports and public letters in the possession of Government,
that the practice of small-pox inoculation in Bengal
is accompanied by a considerable mortality. Such
mortality may be said to be attributable to a two-fold
cause: on the one hand there is always a certain number of deaths amongst those who are the
subjects of variolation; and on the other, natural small-pox is frequently communicated, from
those who have artificially received the disease, to those around them, and thus epidemics of
small-pox arise, during which great loss of life sometimes occurs.
The per centage of direct mortality.
2. At present there exists no facility for estimating the percentage of the mortality
which occurs amongst inoculated persons. That
it varies however, within very wide limits, is
certain. Instances have been published by Government in which the percentage has reached a
very high figure. Dr. Sheridan, Civil Surgeon of Serampore, reported that one inoculator
admitted that during the season he had operated on 400 individuals, of whom 200 or 50 per
cent. died; in the case reported by Pundit Goury Sunkur Bhuttacharjee of 1000 people who
had been inoculated at Hooghly in 1850, the mortality was 30 per cent. In the same year 66
inoculators reported having inoculated 2,586 persons in the suburbs of Calcutta, of whom they
said only 19 died, the percentage being 0.73. Some doubt, however, was cast at the time,
on the truthfulness of this latter report. One native gentleman alone knew of 14 deaths
from inoculation in the suburbs that year, and the probability therefore of more than 19 deaths
having occurred was very great. It seems also a fair assumption, that the suburbs of the
Metropolis would attract more skilful operators, and if their work was attended with such
a mortality, the less favored districts at a distance from Calcutta, must probably have suffered
in a much higher ratio. At Sankeberriah, in March 1867, out of about 200 persons
inoculated, eight died ; the rate of mortality being about 4 per cent.
It is also certain, however, that the practice of inoculation, if properly conducted, need not
of necessity involve a high rate of mortality. From a recent investigation made by Dr. Wise,
late Civil Surgeon of Chittagong, it appeared that in that district the percentage of mortality
was 0.50 per cent. In the practice of old and experienced inoculators, even this low figure
possibly represents an unusually high death-rate; thus Mr. Bedford, while Civil Surgeon at
Rampore Bauleah, saw 79 persons inoculated, amongst whom not a single death occurred from
the operation, and I have been assured that this is no unusual occurrence.
Danger of indirect mortality.
3. On enquiry, regarding the mortality which results amongst those who are infected
with the disease by inoculated persons, or indirectly
from others who have received the disease in this
way, there appears to be an equally great range in the results. In some cases the most cala-
mitous results are said to follow, whilst in others the evil is apparently reduced to a minimum.
As an individual example, I may take the instance brought forward by Baboo Issur
Chunder Sing, who states that in his own family three persons contracted the disease from a
case of inoculated small-pox, two of whom died. Again, in the report regarding the outbreak
of small-pox at Sankeberriah, which was clearly traced to infection received from those inocu-
lated in March 1867, it is stated that 35 died, out of 149 who were attacked in direct succes-
sion. Just before the season in which we should naturally have expected that this outbreak would
have attained to epidemic proportions, extensive vaccination practised on all sides of those who
were affected with small-pox put an immediate stop to the disease. Otherwise within the next
three months, a very heavy death-rate would most certainly have been recorded. Numerous
documents exist bearing on the almost incalculable mischief which inoculators do by spreading