30                                     PRESIDENCY CIRCLE

prevent the spread of the disease, this occupies some time, during which disease is extending
and considerable loss of life taking place.

Instruction of
inoculators

With reference to Mr. Gupta's remarks on the instruction of inoculators, the same
necessity as in all vaccination operations for a really efficient supervising and controlling
agency exists. The protective influence of vaccination depending so completely on the care
with which the operation is performed and the selection of proper lymph, cannot be left to be
carried out by any agency except it is under thorough control, and the work inspected by
competent and trustworthy officers.

If this can be arranged, a system similar to that in practice in the Midnapore district
might probably answer. There the vaccinators are ex-inoculators, and receive a purwanah
from the magistrate granting them permission to vaccinate in the villages named on the
document. The privilege is jealously guarded; all outsiders, both inoculators and vaccinators,
are warned off as interlopers, the men holding the purwanahs looking to remunerate
themselves by fees. In the first instance these men received a retaining fee of a few rupees
monthly from Government; during the last year this has not been given, and the magistrate
doubts if there is any necessity for continuing it. The supervising and controlling agency
rests with the civil surgeon, and depends very much on the time he can personally devote to
the duty, visiting and testing the work of the vaccinators in the district, and the trustworthi-
ness of the more educated vaccinators he entertains for the purpose of inspecting the work of
the men at the different villages.

It seems possible that some system of the kind indicated might be developed, while to
vaccinate the population of a country by establishments maintained for that purpose appears,
after the first opposition to the measure has been overcome, likely to limit the extent to
which vaccination ought to be carried out, and to prevent its becoming at any period either
self-supporting or generally accepted by the community at large.