2
inspected vaccination work in some of the villages of this district in the
neighbourhood of Bankipore in November 1913, and reported that he found
a large proportion of the children under six years of age to be unvaccinated.
Other information which has been obtained about the state of vaccination in
this area shows that the villagers are assuming an active opposition to the
operation, and that conditions are springing up which will be a source of
danger in future years to the inhabitants of the Capital unless they are
dealt with and it is possible that the compulsory Vaccination Act may have
to be introduced.
In the Gaya and Shahabad districts also vaccination work is not satis-
factory. The rate of mortality from small-pox in the Gaya district for the
last five years (.62) is higher than that of any other district in the Province
except Patna and the number of operations has decreased by 15,414. In
Shahabad also there was a decrease of 5,323. In both the Gaya and Shaha-
bad districts the Civil Surgeons report great difficulty in getting the higher
castes, especially the Rajputs, to accept vaccination and in Shahabad the
difficulty is increased by having to employ as Vaccinators men of the Mali
caste who in this district are said to be particularly dirty and incompetent, and
it seems that no men of a better class can be found to replace them at present.
Tirhut Division.
Judging by the increase in the number of operations reported and by the
low rate of mortality from small-pox during the last five years (.12), vacci-
nation in the districts of the Tirhut Division appears on the whole to have
made progress.
In Saran, the number of operations increased by 11,342, and this increase
occurred in spite of the heavy annual mortality from plague. In Muzaffarpur,
an increase of 2,859 is reported and in Darbhanga 24,818. On the other hand,
in Champaran the number of vaccinations performed during the last three
years fell short of the number performed in the previous period by 3,200,
but the Civil Surgeon reports that the work improved very much during the
last year and that the staff performed 7,766 operations in excess of the number
recorded in 1912-13.
Bhagalpur Division.
The rate of mortality from small-pox in all the districts of the Bhagal-
pur Division is rather high (.24) and is due to the persistence of the disease
in certain areas which include the diaras of the Ganges and Kosi, in which
it seems difficult to get the people vaccinated.
In Monghyr an increase of 18,000 operations is recorded which is said to
have been due to "the unflinching exertions on the part of the Vaccinators
and to the strict supervisions exercised by the Inspecting staff." In Bhagal-
pur, though there was on the whole an increase of 5,515 operations over
the record of the previous period, vaccination work during the last year
has suffered very severely, especially in Bhagalpur town and the Sadr sub-
division, from the presence of plague and cholera and by high floods in
the Kosi river.
In the Santal Parganas a heavy fall of 13,618 operations is reported.
The Civil Surgoon has not given any explanation of the defect.
Orissa Divisino.
The ratio of mortality from small-pox in this Division (.16) for the last
five years is not high and vaccination work on the whole seems to be making
fair progress.
The number of operations in Cuttack and Balasore have increased
during the last three years by 31,000 and 63,000, respectively, while in
Puri and in Sambalpur the number has decreased. In Puri the fall was
over 11,000 and the Civil Surgeon reports that vaccination in the Khurda
subdivision is unsatisfactory. Vaccination in Sambalpur is carried on with