CALCUTTA AND THE SUBURBS.
3
the circumstances it was impossible that it should do so. How many of the cases of small-
pox which could not be traced to any source of infection caught the disease in these infected
conveyances it is impossible to say, but the case is a most instructive one, as showing how
easy it is for small-pox to be disseminated without any trace being left of the source of
infection.
6. Deaths from small-pox in Calcutta and Bombay compared.—As considerable sums of
money are annually spent on vaccination both in Bombay and Calcutta, and as in Calcutta
the expenditure is greater than in Bombay, a comparison between the death-rates of the two
cities is not devoid of interest. State vaccination requires to be provided on an extensive
scale before its full benefits can be secured in protecting the population from a high death-rate.
For Calcutta provision to the fullest extent that I considered advisable has been provided,
while the requirements of Bombay, as judged by the same standard, have been only imper-
fectly supplied. The success met with in Calcutta proves most conclusively that the liberal
provision of funds has not been misapplied by the Government, and that an immense saving
of human life has directly resulted. The following table of the death-rate for the last five
years shews at a glance the difference in the death returns in the two capitals :—
Table showing the deaths from small-pox during the last five years.
Bombay ...
Calcutta ...
1866.
1,079
83
1867.
1,055
35
1868.
1,123
43
1869.
1,725
39
1870.
555
151
Total.
5,537
351
The comparison between the two cities in the table is not strictly a fair one, as the
population of the island of Bombay is nearly double that of Calcutta within the municipal
boundaries, for which alone the death returns are available. No death return is available for that
portion of Calcutta under the suburban municipality, and as the establishment under my
control is responsible for the protection both of the town and suburbs, the deaths occurring
under both of these jurisdictions ought to have found a place in the table before the
comparison could be considered a fair one As stated, however, in another part of the report,
the suburbs are better protected than the town, and consequently small-pox in them is not so
prevalent as it is in the town. Besides pointing out this defect in the table, I have to state
that I have no intention to suggest any thing more by bringing forward these figures than
what I have distinctly stated.
Before the remodelling of the establishment, the death-rate from small-pox in Calcutta
was alarmingly high. and by selecting only the last five years for comparison, I have no wish
to keep this fact in the background; as by going back one year more the Superintendent-
General of Vaccination in Bombay could display a rate of death from small-pox in Calcutta
which, when compared with even the very high figures appearing in the table for Bombay,
would make them shrink into comparative insignificance. Without making too much of the
comparison, it may be pardonable to take this opportunity of drawing attention to the fact
that the more liberal provision of a vaccine establishment has enabled Calcutta to take an
easy lead in demonstrating the possibility of combating small-pox in a crowded and populous
Eastern city. The fact that Calcutta is so favorably situated in comparison with Bombay
appears to be more remarkable when the vaccination in the Bengal presidency and Bombay
presidency are compared. For many years the Bombay Government have been most anxious
on the subject of vaccination, and the progress made throughout the whole of the presidency
is very great. The lower provinces of Bengal, on the other hand, are far behind Bombay, as
comparatively little has yet been attempted in vaccinating.
7. Need of restrictive measures.—From the success reported in the previous paragraph,
it might be imagined that as Superintendent-General of Vaccination I am satisfied with the
result arrived at. I therefore take the opportunity of pointing out forcibly that I consider
the fact of 151 persons having died of small-pox in 1870 a most deplorable result. When
compared to the very large numbers who died in previous epidemics, the smallness of the
numbers is most satisfactory; but there is another way to look at it, when it assumes quite
a different aspect. Each of these deaths, in the language of state medicine, is a preventable
one. It would be utopian to believe that in the present state of India every one of these 151
persons might have been saved from death. It is a hard and stern fact, however, that the
great majority of these lives could have been preserved by judicious restrictions having been
placed on the inhabitants of this city, rendering it obligatory on them to report the circum-
stance at once whenever small-pox attacked them. As the Government have so lately
declared that no action can be taken in this matter, I make these observations, not with any
hope of, for the present, having the question opened up again. The observations will serve to
show that I am still fully impressed of the necessity for legislation, which I pointed out in a
separate report, and to explain in a measure how, with an efficient vaccine establishment—
D