xx
GENERAL REPORT.
"6. The principle of concentrated and exhaustive work being accepted,
the next question is,—how can it best be realized ?
Concentrated vacci-
nation by circles.
" (1.) When " circles " of vaccination exist, I am decidedly of opinion that
this principle should govern their operations. " Vaccinate one area thoroughly
and completely before proceeding to another" should be a standing rule of the
proceedings of vaccine circles. This rule is already scrupulously observed in
the metropolitan circles. The work of the Ranchee circle was, during the season
1871-72, conducted on this principle; the deputy superintendent of the Son-
thal Pergunnahs circle tried to act upon it, but his staff is a very weak one in
relation to the area. The work of the Darjeeling circle was still scattered and
unsatisfactory. I am in entire accord with the Commissioner of Rajshahye
and the superintendent of this circle in their suggestions, and I am decidedly
of opinion that it is necessary to concentrate the work and limit the operations
of the circle to a more reasonable area. It is quite impossible for the establish-
ment sanctioned for the area of these circles, to overtake the work of vaccina-
ting them, and the pretence of doing so should be abandoned. Mr. Cockerell
states the system and aims on which circles should be worked very concisely
and truly.* His observations are in accord with the principles laid down in para-
graph 27 of my report for the year 1871-72. The operations of the Dacca
circle, which has recently been established, are conducted on the principle of
exhaustive and systematic vaccination.
Concentrated vacci-
nation where cir-
cles have not been
established.
" (2.) When circles have not been organised, the sudder station should
be the centre of exhaustive vaccination. The Commissioner of Patna, in
whose division no circle has been as yet established, has recognised the
advantage of confining vaccination in the first instance to municipal towns,
and extending them subsequently to the surrounding country. Colonel
Hopkinson also supports this view as very sensibly put by Mr. Mookerjea,
the Civil Surgeon of Seebsaugor.
Utilizing ex-inocu-
lators.
" (3.) In utilizing the services of inoculators a similar principle must be
borne in mind. They must work within manageable and adjoining areas, and
be closely supervised. I beg to refer to the remarks recorded on this subject
in Paragraph 31 of my report for 1871-72. Colonel Dalton, in whose division
vaccination by this agency is most promising and necessary, insists on the
necessity of supervision. There are two sets of circumstances in which
inoculators may be settled as vaccinators :—
" (a) After a locality has been thoroughly vaccinated by a circle establish-
ment for the purpose of maintaining vaccination ; and
"(b) When inoculators can be induced to exchange the practice of inocu-
lation for vaccination and continue to work in their former fields of labor.
" The first of these objects has not been as yet realized any where; but
after the people have been once rendered familiar with vaccination and
thoroughly vaccinated, I am of opinion that endeavours ought to be made to
settle vaccinators among them under proper arrangements and strict supervision.
* "2. I fully concur in the remarks made as to the inutility of endeavours to extend
vaccination in a desultory fashion throughout half a dozen districts. Except within towns
and municipalities where the men are paid from local funds, I would not introduce vacci-
nation into any district unless the departmental authorities were prepared to work the
entire district or certain definite portions, of it on a regular systematized plan.
3. With the exception of a few vaccinators, who should be kept in each district at
the immediate disposal of the local authorities to meet any sudden outbreaks, I would
concentrate the entire staff of the circle in one district and make them work thannah by
thannah until the entire district was completed ; a sufficient number of vaccinators should
be then organized and left in the district to meet all fresh requirements and inoculation
then forbidden through the vaccinated tracts.
4 If the plan was carried out continuously, a sound system would be introduced and
we should have, I believe, the satisfaction of seeing some definite results from the very
considerable expenditure that is incurred in this department."