2
The Tirhut Division shows small decreases in all the districts except
Champaran which returns a slight increase.
The Bhagalpur Division shows a large decrease in the Purnea district
(8769) and small decreases in the Bhagalpur and Monghyr districts and a
rise of 4594 in the return from the Santal Parganas.
The Chota Nagpur Division returns show small increases in the districts
of Ranchi and Palamau and large decreases in the districts of Manbhum and
Singhbhum amounting to 16352 and 6416, respectively.
Hazaribagh
district shows a small decrease of 1782.
4. Vaccination in towns and compulsory areas.—During the year under
report the Vaccination Acts were extended to the area under the jurisdiction
of the Jharia Mines Board and to the Patna and Phulwari Thanas of Patna
District. Statement VII shows that during the year 25081 children under one
year of age out of an available number of 29178 or 85.95 per cent. were
successfully vaccinated.
The town of Bhagalpur again shows the smallest proportion of work
done and the towns of Darbhanga, Hazaribagh and Chapra have given very
unsatisfactory returns.
5. Protection of Infants.—Out of 1076026, the estimated number of
children under one year available for vaccination, 624193 equal to 580.09
per 1000 were successfully vaccinated as compared with 629670 or 516.21
per 1000 in the previous year. The protection of infants in municipalities is
separately shown in Statement VII and works out at a ratio of 859.59 per
mille of the surviving infant population. The majority of Civil Surgeons
report that there is considerable opposition to the early vaccination of infants
and that there is a strong popular prejudice against the operation being per-
formed on children under one year of age. Many Civil Surgeons and the
Deputy Sanitary Commissioners also report that opposition to vaccination is
chiefly confined to a few castes and sects such as illiterate Brahmins, Marwaris
and a few Muhammadan communities, but that generally speaking vaccination
is not objected to under normal conditions.
6. Incidence and mortality of small-pox.—During the last ten years the
total number of deaths from small-pox in the districts of this Province has
been 117755 from which it may be inferred that over 600000 cases of the
disease occurred in that period.
During the first quinquennium the number of deaths was 83972 and
during the second 33783. In the last quinquennium the mortality has risen
during the five years as follows:—3088, 2741, 4347, 8979 and 14628.
The provincial ratios of the mortality from small-pox per 1,000 of popu-
lation during the last five years have been .08, .06, .11, .22 and .42 respectively.
7. Prevention of small-pox.—The constant and considerable mortality
noted in the preceding paragraph is in my opinion a complete demonstration
both of the insufficiency and of the inefficiency of the existing arrangements
for vaccination.
It is well known—in fact it is an admitted axiom—that thorough vaccina-
tion can and does stamp out small-pox altogether and in the light of that know-
ledge and in face of the above facts there is great necessity for a more definite
vaccination policy.
The inefficiency of the Department is being severely dealt with and action
is being taken against a large number of officers (about 28). The departmental
rules and regulations are being strictly enforced and the staff generally has
been warned against laziness, neglect of duty and breach of rules. I anticipate
that I can establish discipline and efficiency in the cadre within two years and
I am confident that a considerable improvement in the returns will ensue.
At the same time I do not consider that small-pox can be effectively dealt
with and stamped out unless vaccination is made compulsory throughout the
Province and I would recommend that the Vaccination Act should be modified
so as to extend the age within which vaccination is required to one year and