NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
17
small-pox and the number of successful vaccinations during the 10 years ending 1915-16.
1910-11
Ratio of deaths from small-pox.
10
.30
.07
.04
.07
.02
.03
.07
.11
.26
.39
.07
.007
.41
...
.007
.08
.01
.07
.11
.01
.08
...
.10
Number of successful vaccina-
tions.
11
45665
68104
39890
86741
59887
101395
84025
85497
74438
63167
67446
139487
56052
9353
53738
33399
50075
57541
21059
60086
26593
4956
1288594
1911-12
Ratio of deaths from small-pox.
12
.09
.07
.02
.03
.03
.05
.06
.09
.43
.24
.08
.002
.19
...
.006
...
.006
.02
.008
.0006
.004
...
.08
Number of successful vaccina-
tions.
13
48687
69923
36809
83221
60354
102535
83343
89123
80294
59409
61909
153747
63287
8207
53619
33153
46544
48913
24782
60420
22841
4967
1293587
1912-13
Ratio of deaths from small-pox.
14
.07
.008
.006
.006
.07
.04
.01
.08
.41
.14
.19
.01
.006
...
.02
.04
.02
.004
...
.005
.05
...
.06
Number of successful vaccina-
tions.
15
48768
66965
47086
85339
55486
101405
93546
84475
77274
56956
60236
137175
68271
5906
55642
23955
46150
51096
23683
61191
20254
4581
1275440
1913-14
Ratio of deaths from small-pox.
16
.17
.03
.09
.06
.02
.01
.06
.48
.31
.22
.27
.01
.11
...
.07
.05
.02
.01
.07
.02
.09
...
.11
Number of successful vaccina-
tions.
17
48480
67817
53812
81699
63100
103052
93735
89024
75244
60587
64815
134227
69059
7945
47269
25063
51777
49989
21459
61316
23496
5654
1298619
1914-15
Ratio of deaths from small-pox.
18
.48
.10
.32
.06
.10
.09
.24
.46
.35
.30
.18
.06
.90
...
.02
.02
.03
.03
.10
.43
.45
...
.22
Number of successful vaccina-
tions.
19
57665
65855
62079
80729
64146
105292
97760
89749
75831
58496
53182
113297
53281
7680
33820
27561
48299
50958
28327
73369
25909
6742
280027
1915-16
Ratio of deaths from small-pox
20
.71
.68
.45
.15
.14
.24
.41
.42
.38
.38
.37
.69
.90
.01
.30
.75
.49
.12
.17
.63
.28
...
.42
Number of successful vaccina-
tions.
21
68438
75641
65016
79608
68255
104624
95237
87999
74532
51206
57558
89925
38609
9686
37595
22606
46709
52111
31808
54056
19526
5037
1235782
18
Statement No. VII.—Showing the protection afforded to infants in. each town in the Province
of Bihar and Orissa during the year 1915-16.
District.
1
Patna
...
Gaya
...
Shahabad
...
Saran
...
Chawaparan
...
Towns.
2
Patna ...
Bihar ...
Dinapur ...
Barh ...
Khagole ...
Total ...
Gaya ...
Tikari ... ...
Daudnagar ...
Total ...
Arrah
Buxar
Dumraon ...
Jagadespur ...
Sassaram ...
Bhabhua ...
Total ...
Total of Patna Divi-
sion.
Chapra ...
Revelganj ...
Siwan ...
Total ...
Motihari ...
Bettiah ...
Total ...
Number of
births du-
ring the
year
ending 31st
March 1910.
3
3220
1341
1109
317
225
6212
1916
215
386
2517
1424
434
526
333
891
212
3820
12549
1495
905
57
2927
350
850
1200
Number of deaths
amongst infants
under one year
during the year
ending 31st
March 1916.
4
666
212
231
58
44
1211
763
47
84
894
293
77
114
68
129
31
712
2817
306
146
75
527
92
159
251
Number of successful
vaccinations amongst
infants under one
year during the
year ending 31st
March 1916.
5
2116
935
795
227
149
4222
1088
107
224
1419
1272
386
183
341
818
280
3283
8924
752
269
329
1350
204
518
722
Date of extension of Vacci-
nation Act to town.
6
1st October 1884.
1st April 1887.
28th January 1891.
1st April 1887.
12th July 1910.
1st January 1883.
3rd
„ 1891.
Ditto.
20th July 1885.
1st April 1887.
Do.
20th December 1890.
1st April 1887.
Ditto.
1st April 1887.
12th December 1890.
1st April 1887.
1st April 1887.
Ditto.
19
Statement No. VII.—Showing the protection afforded to infants in each town in the Province
of Bihar and Orissa during the year 1915-16—contd.
District.
1
Muzaffarpur
...
Darbhanga
...
Monghyr
...
Bhagalpur
...
Purnea
...
Towns.
2
Muzaffarpur ...
Sitamarhi ...
Hajipur ...
Lalganj ...
Total ...
Darthanga ...
Roserha ...
Samastipur...
Madhubani ...
Total ...
Total of Tirhut
Division.
Monghyr ...
Jamalpur ...
Total ...
Bhagalpur ...
Colgong ...
Total ...
Purnea ...
Kishanganj ...
Katihar ...
Forbesganj ...
Total ...
Number of
births da-
ring the
year
ending 31st
March 1916.
3
1209
313
706
344
2572
1996
340
282
534
3152
9851
1878
967
2844
1818
204
2022
431
241
328
157
1157
Number of deaths
amongst infants
under one year
daring the year
ending 31st
March 1916.
4
278
61
128
63
530
419
81
51
69
620
1928
364
178
542
307
28
335
68
56
30
24
178
Number of successful
vaccinations axougst
infants under one
year during the
year ending 31st
March 1916.
5
974
265
744
320
2303
1028
204
152
268
1652
6027
1393
737
2130
968
55
1018
240
206
130
132
708
Date of extension of Vacci-
nation Act to town.
6
1st January 1886.
1st April 1887.
1st May 1890.
1st April 1887.
24th May 1884.
3rd January 1891.
25th July 1910.
1st April 1887.
15th November 1882.
Ditto.
15th February 1884
withdrawn on 16th
October 1895 ; re-
extended on 18th
August 1898.
Ditto re-extended on
19th December 1901.
1st July 1887.
12th November 1892.
8th August 1910.
9th August 1912.
20
Statement No. VII.—Showing the protection afforded to infants in each town in the Province of
Bihar and Orissa during the year 1915-16—contd.
District.
1
Santal Parganas ...
Cuttack
...
Balasore ...
Puri ...
Sambalpur ...
Hazaribagh
...
Ranchi
...
Towns.
2
Sahibganj ...
Deoghar ...
Madhupur ...
Dumka ...
Total ...
Total of Bhagal-
pur Division.
Cuttack ...
Kendrapara ...
Jajpur ...
Total ...
Balasore ...
Puri ...
Sambalpur ...
Total
of
Orissa
Division.
Hazaribagh ...
Chatra ...
Giridih ...
Total ...
Ranchi
...
Lohardaga ...
Total
...
Number of
births
during the
year
ending 31st
March 1916.
3
495
284
325
233
1337
7360
1160
457
370
1987
507
679
389
3562
565
277
243
1085
909
213
1122
Number of deaths
amongst infants
under one year
during the year
ending 31st
March 1016.
4
62
46
39
36
183
1238
260
146
118
524
99
421
145
1189
69
42
33
144
112
23
135
Number of successful
vaccinations amongst
infants under one
year during the
year ending 31st
March 1916.
5
351
319
263
195
1128
4984
1235
270
107
1612
353
248
317
2530
291
122
121
534
926
240
1166
Date of extension of
Vaccination Act to
town.
6
1st May 1884.
Ditto.
22nd August 1910.
Notifications dated
the 9th April 1884
and 23rd August
1910.
1st September 1884.
7th February 1888.
Ditto.
7 th February 1888.
Ditto.
7 th March 1895.
1st January 1885.
1st August 1885.
8th September 1910.
1st April 1887.
25th June 1892.
21
Statement No. VII.—Showing the protection afforded to infants in each town in the Province of
Bihar and Orissa during the year 1915-16—concld.
District.
1
Palamau
...
Manbhum
...
Singhbhum ...
Towns.
2
Daltonganj ...
Purulia ...
Raghunathpur ...
Jhalda ...
Total ...
Chaibassa ...
Total of Chota
Nagpur Division.
Total for the Pro-
vince.
Number of
births
during the
year
ending 31st
March 1916.
3
258
354
193
202
749
287
3501
36823
Number of deaths
amongst infants
under one year
during
the year
ending 31st
March 1916.
4
55
45
39
27
111
28
473
7645
Number of successful
vaccinations amongst
infants under one
year during the
year ending 31st
March 1916.
5
190
329
130
56
515
211
2616
25081
Date of extension
Vaccination Act to
town.
6
9th October 1890.
1st January 1887.
9th February 1894.
9th July 1892.
20th June 1892.
24
ANNEXURE
Provincial Statement.—Showing the different kinds of lymph
District.
1
Patna ... ...
Gaya ... ...
Shababad ... ...
Saran ... ...
Champaran ...
Muzaffarpur ... ...
Darbhanga ... ...
Monghyr ... ...
Bhagalpur ... ...
Purnea
...
...
Santal Parganas ... ...
Cuttack ... ...
Balasore ... ...
Angul ... ...
Puri ... ...
Sambalpur ... ...
Hazaribagh ... ...
Ranchi ... ...
Palamau ... ...
Manbhum ... ...
Singhbhum ... ...
Political States of Singhbum
TOTAL ... ...
Primary vaccination.
Direct from the calf.
Total.
2
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
5415
...
3730
...
...
...
...
9145
Successful.
3
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
5889
...
3730
...
...
...
...
9119
Unsuccessful.
4
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
21
...
...
...
...
...
...
21
Unknown.
5
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
5
...
...
...
...
...
...
5
Percentage of successful cases.
6
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
99.09
...
100.00
...
...
...
...
99.71
With lanoline or glycerine lymph.
Total.
7
53390
75110
55777
80701
68186
97082
95252
88008
71358
48116
55845
90556
34503
7007
38606
17647
45806
45668
30553
42864
19025
4851
1165911
Successful.
8
53029
74688
55235
79192
67952
96743
94952
87972
71258
47817
55688
85410
32596
6416
36820
16488
45733
45657
30333
41684
18888
4843
1149094
Unsuccessful.
9
183
301
453
703
100
290
274
26
23
271
94
672
192
362
1056
798
64
3
107
77
80
1
6165
Unknown.
10
178
121
89
806
104
49
26
10
72
28
63
4,474
1715
209
730
361
9
8
113
1103
57
7
10352
Percentage of successful cases.
11
99.32
99.43
99.02
98.13
99.65
99.65
99.68
99.82
99.86
99.37
99.71
94.31
94.49
91.56
95.37
98.43
99.84
99.97
99.27
97.24
99.27
99.83
99.58
Arm-to-arm
Total.
12
15111
...
9708
...
...
6988
...
...
1793
2610
...
...
...
...
...
...
...
...
...
6325
...
...
42535
Successful.
13
15036
...
949
...
...
6951
...
...
1775
2584
...
...
...
...
...
...
...
...
...
6312
...
...
42154
B. &. O. G. P. ( any. Commr.) No. 15—450—18-6- 916.—
25
II.
used and their rates of success during the year 1915-16.
vaccination.
Unsuccessful.
14
32
...
198
...
...
30
...
...
7
16
...
...
...
...
...
...
...
...
...
12
...
...
298
Unknown.
15
43
...
14
...
...
4
...
...
11
10
...
...
...
...
...
...
...
...
...
1
...
...
83
Percentage of successful cases.
16
99.50
...
97.81
...
...
99.47
...
...
98.99
99.00
...
...
...
...
...
...
...
...
...
99.79
...
...
99.10
Revaccination.
Direct from the calf.
Total.
17
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
291
...
2201
...
...
...
...
2562
Successful.
18
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
239
...
1496
...
...
...
...
1735
Unsuccessful.
19
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
44
...
689
...
...
...
...
733
Unknown.
20
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
8
...
86
...
...
...
...
94
Percentage of successful cases.
21
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
82.13
...
65.87
...
...
...
...
67.72
With lanoline or glycerine lymph.
Total.
22
548
1477
1084
810
425
1449
781
74
2085
2398
3178
18311
12722
4379
1098
1143
1224
1040
2075
9510
11.12
200
68113
Successful.
23
373
953
283
416
303
882
285
27
1499
805
1870
4515
6013
3270
775
490
976
1228
1475
6060
638
194
33280
Unsuccessful.
24
159
305
745
307
80
378
285
47
565
1587
1113
4638
2091
747
235
554
246
278
671
3237
378
62
18708
Unknown.
25
16
219
56
87
42
239
211
...
21
6
195
9158
4618
302
88
99
2
134
229
213
126
4
16125
Percentage of successful cases.
26
68.06
64.52
26.10
51.35
71.29
57.41
36.46
36.48
71.89
33.56
58.84
24.65
47.30
74.62
70.58
42.86
79.73
74.87
62.10
63.72
...
74.01
48.85
Arm-to-arm vaccination.
Total.
27
...
...
7
...
...
146
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
153
Successful.
28
...
...
2
...
...
98
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
100
Unsucccssful.
29
...
...
5
...
...
38
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
43
Unknown.
30
...
...
...
...
...
10
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
10
Percentage of succcssful cases.
31
...
...
28.57
...
...
67.12
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
65.35
TRIENNIAL REPORT
ON
VACCINATION
BIHAR AND ORISSA
FOR THE YEARS
1914-15, 1915-16 & 1916-17
PATNA:
PRINTED BY THE SUPERINTENDENT, GOVERNMENT PRINTING, BIHAR AND ORISSA
1917.
[Price—Indian, 6 annas; English, 6d.]
TRIENNIAL REPORT
ON
VACCINATION
BIHAR AND ORISSA
FOR THE YEARS
1914-15, 1915-16 & 1916-17
PATNA :
PRINTED BY THE SUPERINTENDENT, GOVERNMENT PRINTING, BIHAR AND ORISSA
1917.
[Price—Indian, 6 annas ; English, 6d.]
Agents for the Sale of Books published by the Bihar and Orissa Government.
Agents in India :
(1) Messrs. Thacker, Spink & Co., Calcutta.
(2) Messrs. W. Newman & Co., Calcutta.
(8) Messrs. S. K. Lahiri & Co., College Street, Calcutta.
(4) Messrs. A. M. & J. Ferguson, Ceylon.
(5) Messrs. R. Cambray & Co., 6 and 8-2, Hastings Street,
Calcutta.
(6) Messrs. Thompson & Co., Madras.
(7) Messrs. D. B. Taraporevala, Sons & Co., 103, Meadow Street,
Fort, Post Box No. 18, Bombay.
(8) Messrs. M. C. Sircar & Sons, 75, Harrison Road, Calcutta.
(9) Proprietor of the Newal Kishore Press, Lucknow.
(10) Messrs. M. N. Burman & Co., Bankipur.
(11) Babu Ram Dayal Agarwala, 184, Katra Road, Allahabad.
(12) Standard Literature Co., Ltd., 13/1, Old Court House
Street, Calcutta.
(13) Manager of the Indian School Supply Depôt, 309, Bow
Bazar Street, Calcutta.
(14) Messrs. Butterworth & Co., Ld., 6, Hastings Street,Calcutta.
Agents in England :
Messrs. Constable & Co., Ltd., 10, Orange Street, Leicester
Square, London, W. C.
(2) Messrs. Kegan, Paul, Trench, Trubner & Co., 68, Carter
Lane, London, E. C. (Oriental Department) and 25, Museum
Street, London, W. C.
(3) Mr. B. Quaritch, 11, Grafton Street, New Bond Street,
London, W.
(4) Messrs. P. S. King & Son, 2 and 4, Great Smith Street,
Westminster, London, S. W.
(5) Mr. B. H. Blackwell, 50-51, Broad Street, Oxford.
(6) Messrs. Deighton Bell & Co., Ltd., Trinity Street ,Cambridge.
(7) Messrs. Henry S. King & Co., 65, Cornhill, London, E
(8) Messrs. Grindlay & Co., 54, Parliament Street, London, S. W.
(9) Messrs. W.Thacker & Co., 2, Creed Lane, Ludgate Hill,
London, E. C.
(10) Messrs. Luzac & Co., 46, Great Russell Street, London, W. C.
(11) Messrs. Oliver and Boyd, Tweeddale Court, Edinburgh.
(12) Messrs. E. Ponsonby, Ltd., 116, Grafton Street, Dublin.
(13) T. Fisher Unwin, Ltd., 1, Adelphi Terrace, London, W. C.
Agents on the Continent:
(1) M. Ernest Leroux, 28, Rue Bonaparte, Paris, France.
(2) Martinue Nijhoff, The Hagne, Holland.
TRIENNIAL REPORT
ON
VACCINATION,
BIHAR AND ORISSA,
FOR THE YEARS
1914-45, 1915-16 & 1916-17.
1. Staff.—Vaccination work in the Province is chiefly carried out by
a special staff of vaccinators, the majority of whom are licensed, but a few of
whom are paid. In municipalities and in the district of Sambalpur and
largely in Puri the work is done by paid vaccinators and since the end of 1916
paid vaccinators have been temporarily employed in the Singhbhum district
and in Angul. Elsewhere throughout the Province vaccination has been
carried out under the licensing system, except for the employment of paid
vaccinators for short periods to deal with outbreaks of small-pox.
The total number of vaccinators employed in the Province during the last
three years have been as follows :—
Year.
1914-15 ... ... ... ... ...
1915-16
...
...
...
...
...
1916-17 ... ... ... ... ...
Licensed.
995
986
1,086
Paid.
143
184
207
The increase in the number of paid vaccinators is chiefly due to their
temporary employment in Singhbhum and Angul and the increase in the
number of licensed vaccinators in the last year under report is due to the
redistribution of elakas on a population basis which was carried out under
my orders in 1916.
The inspecting staff now consists of 20 District Inspectors of Vaccination
and 65 Sub-Inspectors of Vaccination (including 3 deputed for duty at the
Vaccine Depôt) in addition to the three Sub-Assistant Surgeons combining
vaccination inspection with other duties in Angul. During 1915-16 two
additional appointments were sanctioned in order to provide Sub-Inspectors
for the new Sub-division at Simdega and for the compulsory vaccination area
in Patna, but otherwise the cadre has remained constant during the three years
under report.
2. Operations Performed.—The average number of operations performed
each year between 1915-17 was 1,227,012 as compared with an average of
1,306,556 during the previous three years. Of these operations 95.02 were
primary and 4.97 were revaccinations as compared with 97.48 per cent. and
2.51 per cent., respectively, in the previous three years. The average number
of operations performed annually by each vaccinator was 1,023 as compared
with 1,136 in the previous three years.
2
The total numbers of operations performed during the last three years
have been as follows :—
Year.
1914-15 ... ... ... ...
1915-16 ... ... ... ...
1916-17 ... ... ... ...
Total number of
operations.
1,307,295
1,283,308
1,090,434
Number performed
by Vaccinators.
1,288,432
1,250,599
1,072,081
Of the total number of operations performed the majority have been
primary as is shewn in the following statement :—
Year.
1914-15 ... ... ... ...
1915-16... ... ... ...
1916-17... ... ... ...
Primary.
1,235,571
1,200,351
1,039,575
Secondary.
52,861
50,248
32,506
Both primary operations and revaccinations have fallen off very considera-
bly in numbers during the last two years. It is doubtful whether the statis-
tics of past years can be accepted as accurate as they show a primary vaccina-
tion rate considerably in excess of the birth-rate which is an obvious impossi-
bility over an extended period of years. As it was the custom in Bengal to ex-
pect an increase in the returns every year and to arrange promotions accord-
ingly, I think it probable that the old returns and standards were fictitious.
Nevertheless I am not satisfied with the present state of affairs which now
shews a primary vaccination rate of about 31 per thousand which is well within
the limits of possibility and I have accordingly increased the number of vacci-
nators and brought considerable pressure to bear on the inspecting staff with
a view to improving the quality and increasing the quantity of vaccination
work.
The percentages of successful operations out of the total number of opera-
tions performed during the last three years have been as follows :—
1914-15 ... ...
1915-16 ... ...
1916-17 ... ...
98.12
97.23
97.27
Patna Division.
3. Vaccination in Districts.—The total number of operations performed in
this Division increased by 81,491 in the
three years under report as compared with
the previous period. Patna District showed an increase of 47,082 and Shahabad
an increase of 41,306, but in Gaya there was a decrease of 6,897.
Owing to the high rates of small-pox mortality prevailing in previous
years in the districts of this Division, special efforts were made in the last two
years to improve the works, and new and energetic inspecting officers have
been posted to the districts of Patna and Shahabad. During the period under
report Act V of 1880 and Act II of 1911 making vaccination compulsory were
enforced throughout the Patna and Phulwari thanas of Patna District.
Tirhut Division.
In the two districts of Saran and Muzaffarpur the number of operations
during the three years under report de-
creased by 15,964 and 8,098, respectively.
Whilst in the two districts of Darbhanga and Champaran the numbers in-
creased by 19,392 and 2,995 respectively. The work in this Division meets
4
The following tabulated statement shows the results for the last 12
years:—
Year.
1
1905-06 ... ... ... ...
1906-07 ... ... ... ...
1907-08 ... ... ... ...
1908-09 ... ... ... ...
1909-10 ... ... ... ...
1910-11 ... ... ... ...
1911-12 ... ... ... ...
1912-13 ... ... ... ...
1913-14 ... ... ... ...
1914-15 ... ... ... ...
1915-16 ... ... ... ...
1916-17 ... ... ... ...
Total number of
Vaccinations.
2
117,619
165,967
187,150
226,042
269,728
310,962
341,701
387,190
430,720
419,562
454,699
* 504,948
Total number of
Revaccinations.
3
...
43,498
69,685
97,078
142,911
163,162
179,688
215,438
261,225
260,707
281,913
*311,670
* Excluding the figures of the State of Rairakhol.
The figures above quoted speak for themselves and are a very satisfactory
record of the work done to stamp out and prevent small-pox in these States.
Both vaccination and to a large extent revaccination are practically compul-
sory in the majority of these States and both the record and the results of the
work are eminently satisfactory.
6. Protection of infants.—During last year out of 1,052,193 the estimated
number of children under one year available for vaccination 492,588 equal
to 468 per thousand were successfully vaccinated as compared with 620,702
equal to 576 per thousand in the previous year.
The protection of infants in municipalities is separately shown in
Statement VII and works out a ratio of 681 per mille of the surviving
population. These figures are very unsatisfactory as they show that more
than half the total number of operations are performed on children over
one year of age. Whilst the ratio of protected children under one year of
age has fallen to below 500 per thousand, the total number of operations
performed is still in excess of the total number of infants available as it always
has been. In previous years the excess has been very marked and as there
has been a constant excess it must be inferred that the returns are to that
extent on the average fictitious.
Civil Surgeons and Deputy Sanitary Commissioners are unanimous in
attributing the opposition to vaccination to be concerned more with the age
of the child than with the operation itself and in view of the strong popular
prejudice which exists against vaccination of infants at an early age I consider
that it is desirable that the Vaccination Act should be amended so as to raise
the age for compulsory vaccination to one year instead of six months.
7. Incidence and Mortality of Small-pox.—During the first two years of the
period under report the death-rate from small-pox increased from .11 to .22
and again to .42, but during last year it has fallen to .28,
5
Patna Division.
The Patna Division has always been a hot bed of small-pox, second only
to the Orissa Division in the prevalence
of the disease.
During the last two years efforts have been made to extend and improve
vaccination work in the Patna Division and during the last year of the period
under report there has been a decrease in the death-rate from small-pox in
the Patna Division amounting to over 50 per cent.
Tirhut Division.
In the Tirhut Division the death-rate from small-pox has always been
low and there is no doubt but that this
Division is the best vaccinated Division
in the Province.
Bhagalpur Division.
In the Bhagalpur Division the mortality has always been higher than
in Tirhut but has never recently exceeded
the mortality in the Patna Division.
Orissa Division.
The Orissa Division has the unenviable position of returning the highest
death-rate from small-pox and is headed
by the Sambalpur District with a death-
rate of 1.09 last year which is almost double the death-rate in Puri District
(.52) and Cuttack (.46) which are the districts with the next highest death-
rates in the Province.
Chota Nagpur Division.
In Chota Nagpur small-pox is not very prevalent and this Division shares
with Tirhut the reputation of being well
vaccinated and having a low small-pox
mortality.
8. Prevention of Small-pox.—In last year's Annual Report I recommended
that the Vaccination Act should be modified and generally enforced through-
out the Province. As that proposal has not been accepted I would now suggest
that it should be tried on a small scale in one Division and I would propose
to choose the Orissa Division in which vaccination is in a very backward and
unsatisfactory state and in which small-pox has been unduly prevalent for
many years.
9. Inspeciton of work.—During the three years under report the three
Deputy Sanitary Commissioners inspected a large number of children most
of whom had undergone primary vaccination.
The numbers are as follows:—
1914-15 ... ... ... ...
1915-16 ... ... ... ...
1916-17 ... ... ... ...
8,781
133,895
213,885
The figures for the first year were abnormal as there were only two Deputy
Sanitary Commissioners and both of them were employed on special duty
during most of the inspecting season. The inspection work done during the
last year under report has been very extensive and thorough and has covered
all the districts of the Province except Angul.
The Civil Surgeons of the Province have inspected a considerable number
of operations, the numbers of which are shown in the following statement:—
Year.
1
1914-15 ... ... ...
1915-16 ... ... ...
1916-17 ... ... ...
Primary.
2
78,646
82,485
67,096
Secondary.
3
7,162
10,265
6,263