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go out until the eruption begins to fade, about the fourteenth or sixteenth day. During
this time the other people belonging to the house in which the inoculated children
reside are allowed to hold communication with, but not to touch any of the other vil-
lagers on pain of being pronounced unclean. Should any one of these not have had
small-pox, either naturally or by inoculation, no further restriction is placed on him,
but he is treated with a little medicated conserve and is directed to breathe over a few
cloves to prevent his catching the infection !
8. Regarding the measures adopted to prevent the spread of the disease, state-
ments vary considerably.
Some Bengalee Inoculators allege that previous to the operation all the infants,
delicate children and unprotected adults are removed to a separate house and are there
secreted until danger is past. This degree of care is, however, in this district excep-
tional ; for the majority affirm that the recently inoculated children are allowed to play
with the others during the greater part of their illness.
The attempts at segregation must, as a rule, be practised in a very loose way; for
all the Inoculators I have asked have admitted that the small-pox is occasionally
spread by the Inoculator, and this is in the opinion of many the reason why small-pox
is in this district more prevalent during the spring and hot months when the Inocu-
lator is at work than at other seasons.
9. The mortality direct from inoculated small-pox depends much on the care
of the operator. On its introduction into England, it was about two per cent. of the
operations performed, and even when done with the greatest care in the small-pox and
inoculation hospital was never less than three per mille. In Bengal, the actual death-
rate from the operation is believed by Dr. Wise to be from a half to one and a half per
cent., which Dr. Charles, after mentioning instances where the mortality was so high as
30 and even 50 per cent. and so low as only 0.73 per cent., states as his belief that with
proper precautions the mortality might here be reduced to the minimum recorded,
i. e., three per mille. From the reports of various Inoculators and from the number
of cases that have come under my own notice, I am inclined to consider the mortality
in this division to be nearly two per cent, of the cases operated on.
10. But the great danger of inoculation does not lie in the mortality direct from
the operation, but, in its spreading the disease it is supposed to remedy, by multiply-
ing the foci of contagion. For, though small-pox thus introduced into the blood
usually produces a mild form of the disease on the individual operated on, still this
mild form is so contagious that it may give rise to virulent small-pox on any unpro-
tected person who comes within the sphere of its contagion. Thus it was found that
during the first thirty years after the practice had become common in England, the
mortality from small-pox in proportion to 1,000 deaths from all causes rose from seventy-
four to ninety-five, and in London alone from fifty-six to ninety-six. Thus, as Dr.
Seaton says, " it was becoming evident that unless inoculation could be made by com-
pulsion universal, it would be better for the community that it should be abandoned
altogether. " This large increase in the mortality was doubtless in a great measure
caused by the very reprehensible way in which inoculation was generally carried on
in England; for the report of the Royal College of Physicians for 1807, after remarking
that " however beneficial the inoculation of the small-pox may have been to indivi-
duals, it appears to have kept up a constant source of contagion which has been the
means of increasing the number of deaths by what is called the natural disease, " goes
on to say—" It cannot be doubted but that the mischief has been extended by the incon-
siderate manner in which great numbers of persons even since the introduction of
vaccination are still every year inoculated with small-pox and afterwards required to
attend two or three times a week at the places of inoculation through every stage of
their illness."