Small-Pox and Vaccination in Bhurtpoor

The State of Bhurtpoor, in common with, the surrounding districts, had been free from small-pox for nearly four years, when the present outbreak began. Having no data to go upon, I shall not speculate on the origin of the epidemic. Some of the first cases were in famine-stricken refugees from Bikanir and Marwar, and the disease had appeared in Agra a full month before these were noted; but its almost simultaneous appearance throughout the North-West Provinces and Bajpootana causes some doubts as to its introduction by special contagion, and suggests the possibility of the sudden vivification of dormant germs under some unknown circumstances favourable to their development. I was absent on tour when the first cases occurred, and was unable to trace them with certainty on my return ; but howsoever originated, the disease appeared about the end of November or beginning of December, and once established, spread with great rapidity to every quarter of the city. The first death was registered on the 14th of December, and for the next two months the disease raged with great violence, carrying off many victims. The space at my disposal being limited, I shall confine myself to a detail of the leading features of the epidemic, and the results deduced from the observed cases. One of the first points which struck me was the entire similarity of the cases, in type, symptoms, and results to those which I had seen in Dudley during the English epidemic of 1863-64. There were no signs of that peculiar virulence, which, according to Copland, Marson, and most modern writers, characterizes the invasion of small-pox in the dark skinned races; and after a few days' observation it was evident that the number of comparatively slight cases (variola discretaj was far more than in ordinary epidemics in England, or in the experience of the small-pox hospital of London for a long series of years, thus reducing the total mortality much below the English average. The following table shews the relative proportion of the different forms of small-pox in 728 cases in unvaccinated children in Bhurtpoor, and in the small-pox hospital for fifteen years