( 3 )
has not been sufficient to justify any definite pronouncement as to its utility.
Inoculation, which from the first has been a purely voluntary measure, was
resorted to in the few districts in which there was a demand for it, but though,
so far as ascertained results show, the immunity which it conferred was unmis-
takable, the demand was very small and was confined to three districts only
8. The death-rate from small-pox in 1902 (.77 per mille) was much higher
than that recorded in any other year during the decade, and this fact is no doubt
largely responsible for the increase in the number of vaccine operations which
is noticed in the Sanitary Commissioner's notes on vaccination for the year
1902-1903. Singhbhum and Midnapore were the districts worst affect ed, the
epidemic having apparently survived in both cases from the previous year,
in which the mortality from small-pox was also unusually high. The
consequent increase in the number of operations during these two years is
noticeable as indicative both of energetic measures of repression on the part
of the authorities, and of a growing belief in the efficacy of vaccination on
the part of the populace. The invariably high death-rate in the three districts
of the Orissa Division, particularly in Cuttack and Puri, has on several
occasions attracted the notice of the Lieutenant-Governor, who has been led
to conclude that it is to an appreciable extent due to their contiguity to Native
States, in many of which the resort to vaccination, even where it has taken
root, is only of comparatively recent growth. Recent enquiries, moreover,
have shown that the old prejudice in favour of inoculation survives with more
vigour in this Division, and in the adjoining Political States, than elsewhere
in Bengal, and His Honour has already taken steps to enlist the assistance of
the executive authorities, both in British and in Independent Territory, in the
suppression of the practice. The rapid advance made in 1902-1903 in the
spread of vaccination in the Political States of Chota Nagpur is peculiarly
gratifying, and the Lieutenant-Governor sees in it the fruits of a measure
recently undertaken with the full co-operation of the Chiefs under which a
system of trained supervision was introduced, the cost being contributed in
proportion to their areas and population by the various States concerned,
with the object of checking and improving the work of the vaccinators. The
introduction of a similar system in the Orissa States is under discussion, and
the useful object-lesson afforded by Chota Nagpur should help to convince the
Orissa Chiefs of its utility.
9. The general results of the year in regard to vaccination are dis-
tinctly satisfactory from a departmental point of view, and they bear out the
conclusion to which the Lieutenant-Governor has independently arrived in
favour of the continuance of the licensed, as opposed to the paid, system of
vaccination. There was a decided increase in the proportion of persons
successfully vaccinated, the total ratio being 34.22 per mille against 32.68 in
1901-1902, and the average number of operations performed by each licensed
vaccinator rose from 944 to 990, while the average cost to Provincial and
Local Funds of each successful case remained unchanged. The Lieutenant-
Governor would, however, be glad if the Sanitary Commissioner could arrange
to adduce some more direct evidence than is at present furnished of the efficacy
of vaccination in warding off the disease or mitigating its severity. It might
be possible to arrange that whenever a death from small-pox is reported,
information should at the same time be obtained from the chaukidar or other
reporting agency, whether the death is that of a vaccinated or of an unvacci-
nated person. If this could be done, a real criterion of the success of
vaccination would be available, which might serve to convince the general
public of the value of this means of prevention; and moreover the continual
enquiry whether the deceased had been vaccinated would direct their attention
to the subject and lead them to note the evidence themselves.
10. The Sanitary Board had under consideration during the year a
number of schemes for the improvement of the water-supply, the drainage
and the conservancy of various localities, but the work actually carried out
was not of importance. A system of cleansing villages and rural towns was,
however, inaugurated by the Patna Sadar Local Board in the previous year, and
was carried on during the year under review. The procedure is for members
of the Board to report the names of villages in the vicinity of their places of
abode which they find to be in an insanitary state; an annual programme is