SONTHAL PERGUNNAHS.
17
the year were carried on partly at Deoghur, under the immediate supervision of the civil
surgeon of the Sonthal Pergunnahs, and partly at Rajmehal under myself.
3. Before taking charge of my present duty there was one vaccinator placed at Raj-
mehal. when I was in medical charge of the sub-division. Immediately on my joining the
new appointment, on the 14th of December last, I reported to the civil surgeon the fact of
the willingness of the Rajmehal Sonthals to receive vaccination, and I requested him either
to send down the vaccinators from Deoghur, or to allow me to go thither with the vaccinator
who was then with me. But unfortunately no reply was received (the civil surgeon being
absent on leave) until the end of the month. Meanwhile reports of outbreak of small-pox
were received from the district of Pakour, but I could do nothing towards checking its pro-
gress for want of vaccinators. At last the civil surgeon, after much consideration, sent down
four vaccinators, three of whom reached me about the middle of January (one having absconded
in the way), and when I reached the infected villages I was too late to introduce vaccination.
The people took to inoculation; persuasions to receive vaccination were of no avail. On my
return I had another outbreak of small-pox in the district of Rajmehal to contend with;
the disease was very severe and malignant in its nature: almost all the unprotected people
affected with it died. The people knew me before, and they were very glad to receive vacci-
nation ; but some difficulty was experienced in re-vaccinating those who were operated on
two years previously. The vaccinators who then worked there rather over-estimated the value
of their operations, inasmuch as they promised them that those who were once vaccinated
would never catch small-pox during their life. I took hold of some old men who were then
under the influence of small-pox, although previously protected by inoculation, and convinced
the manjdees, the heads of villages, that both inoculation and vaccination do not afford pro-
tection from small-pox for life-time. The repetition of the former is very troublesome and
not out of danger, whilst that of the latter is very easy. and without any ill consequences.
They at last yielded, and their children who were once vaccinated were allowed to be stamped.
Out of thirty-five children seven had well-marked scars, they were therefore placed under the
head of re-vaccination; the rest I supposed as unsuccessful cases at first, were entered in the
column of primary vaccination. All the infected villages were within a few days vaccinated,
and although many of them were ill with small-pox during the course of our operation, only
two deaths were recorded. The progress of spontaneous small-pox ceased shortly.
4. Several other outbreaks of small-pox were made known to me in the district of
Rajmehal, and the progress of all of them was cut short within as little a time as practicable.
A few of these outbreaks were about the neighbourhood of Rajmehal, on the western side of
the rail line that runs through the district, others were far away from it, whilst a third set
were found in the most inaccessible parts of the Sonthal hills. My vaccinators were there-
fore not stationed with a view convenient for inspection, but to check the isolated outbreaks
of small-pox wherever it occurred.
5. The four vaccinators before mentioned, and another who was sent from Deoghur
about the end of February, were all unskilled in their work, and although two of them were
old and experienced, I had to teach every one of them more or less. Their mode of operating
was very peculiar: a single deep puncture, freely bleeding, was made in two points on the
upper arm, in which virus was inserted with the point of a lancet, thrusting again and again
into the wound at first made. The vaccine matter was taken indiscriminately from all
crusts, and the character of a good crust was not known to them. If vaccination was performed
from arm to arm, the lymph was taken from vesicles whether they were entire or broken.
The consequence of all this was, that they never could vaccinate successfully by the first
attempt; and I am sorry to say that most of them (although taught previously to my
receiving them) could hardly obtain five successful cases in 100. They had therefore to
vaccinate over and over to the highest dissatisfaction of the heads of villages, who could
hardly be persuaded that their children were protected, and the time occupied in vaccinating a
single village was more than that required for four.
6. I first attempted to teach them the proper mode of vaccinating. I showed them with
my own hand that no bleeding should occur during vaccination. I then impressed on them
that a good crust (obtained from a native) is known by its being of a deep brown colour,
having a convex superior surface with a well-marked depression in the centre and concave at
its attached side; that a crust that has any concretions on it, or in any way broken during
maturation, should never be used for operation. That arm-to-arm vaccination is more prefer-
able, and for this I cautioned them not to use virus from any unhealthy children, or from
adult men or women; not to use virus from broken vesicles, or from those that have thick
purulent matter; not to break vesicles too early, on the fifth day, or too late, on or after the tenth;
and no virus should be taken from a round convex vesicle without any depression in the
centre.
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