REPORT.                                           vii

Difficulties en-
countered.

25. It is not necessary to follow Dr. Lidderdale through the detail of
work in each district of his large circle. His proceedings, always characterized
by energy, vary considerably in success according to the degree of opposition
which he encountered, the existence of small-pox in the district, or the practice
of inoculation and efforts of inoculators. Many special circumstances were against
him,—districts fever-stricken, an inexperienced deputy, disappointments in his
selections of head vaccinators, and misconduct of subordinates. The establish-
ment in these circles is so disproportioned to the work it has to do, that
the illness or misconduct of a single vaccinator makes a material difference
in the outturn of work. The work in the Bograh district was very satisfac-
tory, and it is seldom that so high a figure as 4,086, which represents the work
of each vaccinator for the season, is obtained. In all the other districts results,
from some cause or other, fell short of anticipation.

Employment of in-
oculators to vac-
cinate in Dinage-
pore.

Similar efforts
worthy of encour-
agement.

The employment of inoculators to vaccinate on the estates of the Dinage-
pore Ranee is a most satisfactory circumstance, and I am of opinion that the
thanks of Government are due to Baboo Khetro Mohun Sing, the manager of
these estates, for his commendable endeavours. It is to be hoped that Dr.
Lidderdale's promise to assign to these practitioners definite and manageable
areas, and carefully to supervise their work, will be realized. I consider it of far
greater importance to direct and render efficient local efforts of this kind, which
contain the elements of the exhaustive and perennial vaccination of a particular
tract of country without cost to Government, than to spread protection in an
indefinite manner over a wide expanse by a Government agency. A skilled
vaccinator should be appointed to assist, direct, and watch the proceedings of
these men, and the manager of these estates will, no doubt, accept the superin-
tendent's advice regarding the best system of applying the agency he is willing
to employ to best advantage.

Ratio of success.

26. The superintendent's explanation of the decrease in the ratio of success
is satisfactory. I am not in accord with him regarding his system of inspection.
There is much force in the considerations which he urges, looking to the
present scattered and diffused character of the work, and the overwhelming
amount of vaccination which has to be overtaken, in order to make an approach
to an impression on the large field embraced in this circle, but I still think that
the superintendent should here and there inspect one village on the thorough
plan pursued in the Metropolitan circles and tabulate the results. There is
force also in Dr. Lidderdale's objection to a duplicate register, but I consider
that it is a great advantage to deposit a local register of the work done, and
that the sacrifice of a few vaccinations would be well counterbalanced by the
advantage of this system.

Considerations re-
garding future
work in this cir-
cle.

Present position
unsatisfactory.

Suggestions for im-
provement.

27. It has been shown that in the Metropolitan circles a much stronger
establishment in relation to area and population has, as a matter of experience,
been found unequal to the object in view, namely, the regular and exhaustive
vaccination of the area quinquennially. The obstacles depending on fever,
small-pox, and floods, must be taken into account and provided for, though those
depending on inoculation and opposition are more under control and likely
to disappear in time. The matter is still more or loss in an experimental stage,
and in after years the experience of the Metropolitan circles will be a most
valuable guide in considering the proper performance of vaccination throughout
the province. It is quite clear, however, judging by the experience already
obtained, that the work of the Darjeeling circle is most unsatisfactory. Work-
ing even up to the Bograh standard, the establishment will take many years to
cover the area once with efficient protection, and it is hard to say how often the
protection can be renewed—perhaps not oftener than once in a generation.
This cannot be accepted as a result with which to rest satisfied. Two
alternatives remain—first, to increase the establishment so as to possess a
proper relation to area and population; or second, to contract the area.
If the great increase of expense which the former alternative must
necessitate is a fatal obstacle to its adoption, the latter alternative also
offers two expedients,—(a) to concentrate the existing establishment in