vi REPORT.
75 per cent. of the instances the disease was due to the practice of inoculation.
The death-rate was 24 per cent., and vaccination appears to have been of
material service in " stamping out" the disease.
Inoculation.
Instructing inocu-
lators.
Conditions under
which they should
be permitted to
practise.
21. It is not to be wondered at that, notwithstanding the prohibition of
inoculation, this time-honored practice is still occasionally resorted to. The syste-
matic spread of vaccination aided by prohibitive law and, perhaps, a few examples,
will no doubt in time procure its complete disappearance. It is satisfactory to
observe that some progress was made in instructing inoculators. Dr. Powell's
proposal to attach these men as apprentices to the circles on a salary of Rs. 5
during the working season has already been sanctioned. I agree with Dr. Powell
in thinking that a strict watch should be kept over these men's proceedings so
as to ensure good work. They should be registered, allowed to select a certain
definite area of operations, engaged to vaccinate there exhaustively, should
deposit a nominal register of work, and their proceedings should be thoroughly
inspected and verified at least once a season by a member of the vaccine estab-
lishment. These obligations would be compensated by the instruction in the art,
and license to practise. Indeed the time may come when a system of licensing
men certified as competent to vaccinate particular areas will supersede the
present plan of State vaccination by wandering gangs receiving high pay from
the public treasury.
Darjeeling circle
additional esta-
blishment.
22. Darjeeling Circle.—The districts of Purneah and Maldah have been
added to this circle, and an increased establishment of 2 head vaccinators and
12 vaccinators sanctioned in consideration of the increased work. Two additional
head vaccinators have also been sanctioned to secure more effective supervision
in Julpigoree and Rajshahye. The establishment as now constituted consists
of 1 superintendent, 1 deputy superintendent, 7 head vaccinators, and 42 vaccin-
ators. The former receive Rs. 20 during the five working months and Rs. 16
during the remaining seven months; 14 of the vaccinators receive an employed
pay of Rs. 12, and an unemployed of Rs. 6, and the remaining 28 are paid Rs. 10
and 6. In addition to this establishment, 2 vaccinators were employed by
the Rungpore municipality and one by the Nattore estate. Seven head vaccin-
ators and 45 vaccinators were thus employed during the past season against
4 and 36 in the previous year.
Contrast with the
Metropolitan cir-
cles.
Establishment un-
equal to the work.
23. In the Metropolitan circles it has been shown that an establishment,
consisting of 1 superintendent, 3 deputy superintendents, 9 head vaccinators,
and 57 vaccinators, has been found by experience insufficient for the thorough
vaccination of five districts, comprising an area of about 10,000 square miles,
inhabited by a population of about 6 millions. It is therefore not to be
expected that the smaller establishment detailed in the previous paragraph can
be equal to the vaccination of 8 districts covering an area of some 24,000
square miles, inhabited by a population of, it is supposed, 9 or 10 millions. The
work done cannot be otherwise than very partial and correspondingly unsatis-
factory. If to the physical impossibility of overtaking anything approaching
to complete and systematic vaccination of the whole area within a reasonable
time, are added the disturbances of regular and exhaustive work caused by the
prevailing practice of inoculation, the opposition, passive and active, of the
people, and frequent outbreaks of small-pox, it becomes still more evident that
vaccine operations in these districts must be weak and desultory. Dr. Lidder-
dale's report, while giving evidence of great vigour, and, for the means at
disposal, remarkable success, entirely sustains this conclusion.
Summary of results.
24. The amount of work done is greatly in excess of that of the previous
seasons, the increase amounting to 32,937 persons operated on and 23,742
successfully vaccinated. The number of operations performed by each vaccinator
amounted to 2,482 against 2,188 in 1870-71, and the cost of each successful case
was only Rs. 0-2-10 against Rs. 0-3-8¾ of the previous season. Thus it is quite
clear that the work done has been materially greater in amount, allowing for
the increase of establishment, than in 1870-71. This is so far satisfactory and
creditable to Dr. Lidderdale.