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attendant on the practice of inoculation, where all the necessary rules of quaran-
tine were neglected, and the extensive and fatal outbreak of small-pox, which re-
sulted from the inoculation under notice, fully confirms all that I then stated, viz.,
that if inoculation is permitted in the plains, some measure should be taken to enforce
quarantine, and I have very little doubt that inoculation, carried on as it alone should
be, if permitted at all, viz., with a large preventive staff, so to speak, would, with its
necessary derangement of trade and intercourse, be found to be far more expensive
than any system of vaccination at present practised in India, as far as I am aware; and
to permit inoculation to be practised, as it was during this hot season in the district of
Teraie Ghurwal is to allow a few interested men to earn a livelihood on the misery and
horrors attendant on a severe outbreak of small-pox of a fatal type, where their supposed
specifics and ceremonies are purchased by the ignorant and naturally terror-stricken
villagers on terms which enable these inoculators to live in comfort for months, it may
be years, to come; and I most earnestly hope that, through the kind assistance of Colo-
nel Ramsay, C.B., the Agent for the Government, and the support which the present
Rajah of Terree seems inclined to extend towards vaccination, as a substitute for ino-
culation, that the scenes witnessed- during the past hot season may never re-occur in any
portion of my division. I have myself seen a complete gap in the population of a very
large village in Terree Ghurwal produced by an outbreak of small pox, which originated,
I have little doubt, in much the same way as that described above; and when it is
borne in mind how completely vaccination can stamp out even such an extensive out-
break as was met with this year, coupled with the many obstacles which the disease has to
overcome to enter these hills, as compared with the plains, I have no hesitation in stating
that, if small pox were to enter my Himalayan District, it is impossible for it to spread
unless assisted by inoculation. I may here mention what may not be generally known,
viz, that the simple operation of inoculation does not invariably impart that immunity
which it has the credit of doing ; an attack of spontaneous small-pox subsequently is far
from uncommon among these cases ; nor need this be wondered at, since I have known
of several cases where the operation has been performed with a preparation of powdered
small-pox crusts, which, from age and minuteness of division, must have been almost
inert, and all that consequently resulted was the irritation and subsequent ulcerating
surface, where the crust preparation was applied. Many of these cases on going to the
plains, as for instance selling Ganges water, as was the case last year, contract small-
pox, and bring it to their village, whence inoculation spreads it far and near. In short,
though inoculation when skilfully practised, is undoubtedly far superior to no preventive
measures at all against small-pox, yet the necessary enforcement of quarantine, and its
attendant drawbacks make it infinitely inferior to systematic vaccination; while the
former, if properly carried out, should, as stated before, involve far greater outlay than
any system of vaccination which has come under my notice in this country.
Vaccine returns for the hot and
rainy seasons.
4. As these have not yet been received in full, I cannot allude to them in detail,
but I trust that what has been accomplished, not-
withstanding the interested opposition of these here-
ditary inoculators, will meet with the approval of the Government, and I cannot speak
in too high terms of the Native Superintendent and his vaccinators, who have so gained
the respect of the headmen of many of the villages in which they have worked that in
some instances, in addition to the ordinary gratuities of food, &c., often willingly given to
a native of their own country, as these men are, they have received pecuniary rewards from
the headmen of the villages, small in amount no doubt, viz., ranging from three annas to
a rupee, yet representing an amount of support to the present scheme of vaccination far
beyond the pecuniary value of the gift; and were it not for these interested inoculators,
the practice of inoculation I doubt not would soon die out; but, for some time to come,
these inoculators will have to be watched, otherwise they will practise their profession
secretely, and, from no quarantine being kept up, will perhaps be the originators of an out-
break of small-pox similar to that under report. In conclusion, I have to offer my thanks
v
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