REPORT.                                          13

Chota Nagpore division has been already described. The amount of inspection accomplished
by Mr. Manook in Manbhoom contrasts favourably with the trifling number in Singbhoom,
and the total absence of it in Lohardugga and Hazareebagh.

Small-pox.

50. The year 1873-74 was remarkable for the great prevalence of small-pox. The
disease was not absent from any district, while it assumed an epidemic form in several localities.
In Calcutta small-pox was present all the year, and caused a total reported, mortality of 67.
There was very little small-pox within the Metropolitan circles. In Bankoora and
Beerbhoom the disease prevailed severely, and caused a large mortality. Small-pox was more
or less severe in Jessore, Moorshedabad, Cuttack, Pooree, Noakholly, Goalpara, Nowgong,
Arrah, Sarun, Chumparun, Monghyr, Hazareebagh, Sonthal Pergunnahs, and other
districts. There is no doubt that 1873-74 was a year of small-pox. The usual cause which
lights up small-pox is always present in Bengal, namely the baneful practice of inoculation
without any rule or restriction. But this alone could not account for the unusual prevalence
of small-pox during the last year. There must have been other causes at work. What those
causes are, have not yet been ascertained. Some atmospheric conditions are believed to exercise
much influence over small-pox. Atmospheric changes are above human control, but we should
endeavour to reduce to a minimum the chances of small-pox spreading. This can be effected
by thorough and systematic vaccination, and by putting a stop to the baneful practice of
inoculation. Dr. Charles has brought out fully the benefits which thorough and systematic
vaccination confers on a community. Though case after case of small-pox was imported
into the city, the spark was soon extinguished. I am indebted to Surgeon-Major J. M. Coates,
M.D., Officiating Sanitary Commissioner for Bengal, for the Table No. VII appended to
this report, showing the number of deaths from small-pox reported monthly from each district
in Bengal during the past year 1873-74.

Inoculation.

51. Inoculation.—The reports of the civil surgeons show that inoculation is still largely
practised all over Lower Bengal. In and around some civil stations it had been discontinued,
but in the interior it is still practised without any check or restraint. But no information
regarding the mortality direct and indirect of the practice has been furnished by any of the
civil surgeons. Inoculation, though prohibited in Calcutta, was practised surreptitiously, but
the inoculator was soon caught and punished. In the 24-Pergunnahs it was extensively
practised, and there too the men were punished. It was practised in three districts where
it was supposed the inoculators had given it up, as in the Sonthal Pergunnahs, the Chota
Nagpore division, Bhagulpore, &c.

Instruction of
inoculators.

52. Instruction of inoculators.—It is satisfactory to find that a greater number of
inoculators were induced in the past year to change their practice and to undergo instruc-
tion in vaccination. This was notably the case in the districts of Bankoora, Midnapore,
Jessore, Gowhatty, Patna, Chumparun, Monghyr, and Bhagulpore, in the Chota Nagpore
division, and Sonthal Pergunnahs. Some allowance ought to be granted to these men while
under instruction.

Vaccine census

53.    Protection from small-pox.—The " Vaccine Census," taken by superintendents of
circles and by civil surgeons, and included in their reports, have been embodied in Table No. VI.
A glance at the figures will show that the proportion of inoculated among the adult popula-
tion varies between 70 and 95, and among the juvenile population from 11 to 50 ; while the
ratio of vaccinated in the former is from two to about 20, and in the latter it varies from 12 to
60. The proportion of unprotected persons is rather considerable, varying from about two in jail
to 30. But as the figures belong to different districts and to different classes of people living
under various circumstances, no general conclusions can at present be drawn from them.

54.     On the whole the past vaccine season has been very successful, and has amply
fulfilled my hope that year by year vaccination will progress until it has eventually entirely
displaced the pernicious practice of inoculation.

                                                   I have the honor to be,

                                                            SIR,

                                                      Your most obedient servant,

                                                                    J. CAMPBELL BROWN,

                                                       Surgeon-General, Indian Medical Department.