54 ABSTRACTS OF REPORTS OF CIVIL SURGEONS.
Domiciliary vac-
cination intro-
duced in 1853
Vaccination during
1853.
" It was the practice until 1853 to have children vaccinated at the hospital; after that
date the vaccinators sought for and operated on the children at their own homes.
" During 1853 the total number vaccinated was only 1,559, but as many as 1,532, or 98.2
per cent., are returned as successful. This reduction was referred to the introduction of the
new vaccine establishment. The people are pronounced to be ' too indifferent about vaccin-
ation, and not so fully convinced of the protection it affords as to be induced to bring their
children to the vaccinators.'
" In July 1854 Dr. Green examined the prisoners then in jail, and found that 31 were
vaccinated, 644, or 82.3 per cent., were inoculated, 16 were unprotected, and 91 had marks of
natural small-pox.
Failure in 1855.
Dr Simpson's tes-
timony.
" In 1855 vaccination was almost entirely suspended. ' The vesicle was very imperfect,
coming up and going through its stages prematurely, and often degenerating into sores diffi-
cult to heal.' From this year until 1860 I find nothing recorded regarding the obstacles met
with in spreading vaccination. In January 1861, however, Dr. Simpson, in his half-yearly
report of the Mitford Hospital, writes : ' The diligence of the three vaccinators cannot be
correctly ascertained. Their returns are not trustworthy. They cannot show all the children
they vaccinate, and I have no means of checking their returns.' They bring some children
occasionally to show that the virus is effective, and they manage to keep up a supply. The
prejudices of the people generally are against vaccination. This is the confession of no
ordinary observer. During the last half century no Civil Surgeon of Dacca has had as much
influence with the inhabitants and been as respected as the late Dr Alexander Simpson;
yet, with all his command over the people, even he was obliged to confess that his endeavours
to overcome their prejudices had failed. In July 1862 he again dwells on the ineffectual
attempts to propagate vaccination, and he refers the failure to the want of zeal and diligence
on the part of the vaccinators, and to the difficulty of testing the accuracy of their returns.
Vaccination during
1858-71.
" I append a list of the total number of persons vaccinated between 1858 and 1871, and
the percentage of successful cases of each year. The most striking thing about this list is the
small proportion returned as successful as compared with the returns from other districts.
" It is difficult to offer any explanation of this shortcoming, as it is unlikely that the
Civil Surgeons of Dacca have been stricter than their neighbours, or that the vaccinators
have been so blind to their own interests as to register without reason so low a percentage of
success.
Obstacles and
failures.
Vaccine census in
1871.
" Of the obstacles to the spread of vaccination in Dacca, and of the signal failure that
has resulted from past endeavours, many letters and reports have been written by me. In
none of them has the present state of vaccination in Dacca been more clearly shown than in
my report to the Commissioner of Dacca, No. 597, dated 14th September 1871, a copy of
which was delivered to you last year. The chief point in that letter was, that of 950 residents
of Dacca, three-fourths of whom were under 15 years of age, only 18.3 per cent. were found
to be vaccinated, 48.6 inoculated, 19.7 had marks of natural small-pox, and 13.2 were
unprotected. Of 2,889 residents outside the city, 79.5 were inoculated, 3.2 were vaccinated,
14.1 were unprotected, and only 3.2 had marks of small-pox.
Influences brought
to bear on the
people and mis-
conceptions fos-
tered by the ino-
culators.
" It will have been observed that in the extracts from the records in my office, allusion is
rarely made to the religious prejudices of the natives. When the great small-pox epidemic of
1850 appeared in Dacca, the inoculators appear to have seized the opportunity of extolling
the advantages of inoculation and of decrying the benefits of vaccination. The same tactics
have been practised ever since the introduction of the Inoculation Act into the city. The
people have had pointed out to them the occasional occurrence of small-pox after vaccination
and the necessity of having revaccination performed after a certain number of years. As
natives always do, the mass accept what is told them without question or doubt. The
advantages on the side of vaccination being carefully kept back, and the accuracy of what the
inoculators tell them being past dispute, a large proportion of the residents of Dacca prefer
sending their children beyond the five-miles prohibition limit, and having them protected once
and for ever, instead of submitting them to an operation which requires to be renewed, and
which, it is generally allowed, does not provide such a well-founded immunity as their own
method does.
Caste prejudices.
" I have ascertained that the children belonging to the Bysak and Tanti castes are
invariably sent out of Dacca to be inoculated. They are not brought back until they have
completely recovered. The poorer members, who cannot afford to act thus, keep their children
unprotected at home..
Illustrative return.
" To test the effects of caste prejudices in opposing the spread of vaccination in Dacca,
I insisted this year on the vaccinators keeping a careful register of the caste of every child
vaccinated. The result is shown in a table herewith appended. Of the total number vaccinated,
1,925, 55 were Christian children, 793, or 41.1 per cent. were Mahomedans, and the remaining
1 ,077 were Hindus. It is not possible to ascertain what particular religious belief the parents
of the Mahomedan children entertain, but with the Hindoos it is easy.
The higher and
middle classes
most obstructive
" In glancing over the castes of the Hindus, it is at once apparent that the lowest in the
social scale form the largest proportion. The Kumhars, or potters, of whom there are no