Extract from the Proceedings of the Resident at Hyderabad, No. 2195, dated
Hyderabad Residency, the 29th June 1898.
READ—
Notes on the Annual Returns of Vaccination in the Hyderabad Assigned Districts for the year 1897-98.
ORDER.
Brigade- Surgeon-Lieutenant- Colonel Little's Notes on the Annual
Vaccination Statements of the Hyderabad Assigned Districts for 1897-98 were
received on the 16th May 1898, or one day after the prescribed date, while
the Commissioner's remarks were received on the 18th June.
2. The total number of operations (primary and secondary) rose to
125,289 in the year under review from 120,311 (and not 120,111 as stated in
paragraph 4 of the notes) in 1896-97, an increase of 4,978, which in the cir-
cumstances of the past year must be regarded as eminently satisfactory. It
is true that the number of primary vaccinations showed a decrease (from
98,594 to 95,048) as compared with 1896-97, but the explanation offered, viz.,
the high mortality among children owing to the prevailing scarcity, is fully
adequate. Though the increase in the number of re-vaccinations (from 21,717
to 30,241) is in the circumstances mainly indicative of the energy of the
vaccinators, it is not to be supposed that an increase of operations due entirely
to secondary at the expense of primary vaccinations would in a normal year
be regarded as satisfactory, and the Resident agrees generally with the Com-
missioner's comments on the subject. The work performed by each vaccina-
tor averaged 2,160 primary and 687 re-vaccinations, and the percentage of
success averaged in primary operations 96.4 as compared with 96.8 in the pre-
vious year, and in re-vaccinations 30 as against 20.5.
Sir T. Chichele-Plowden
agrees generally that ratios of success in re-vaccination such as are shown for
Ellichpur (45.9) and Buldana (36.9) cannot be regarded as altogether reliable,
but at the same time he is informed that, even when the visible effects of a re-
vaccination may be merely a papule as compared with the well-marked vesicles
of a successful primary operation, its success may really be as great; and it
appears not improbable that the converse to that apprehended by the Sanitary
Commissioner may sometimes happen, and that inspecting officers return as
unsuccessful many re-vaccinations on account of the greatly modified appear-
ance of the vaccinia.
3. The diagram given in paragraph 9 of Dr. Little's notes and table
No. 3 show in a very remarkable way the efficacy of vaccination in prevent-
ing small-pox in the Hyderabad Assigned Districts. There have, of course,
been years in which an exceptionally severe outbreak of the disease has
raised the death-rate for that year, but taking the quinquennial periods
from 1868 down to the year under review, and without taking into account
the much higher perfection attained in the system of registering deaths
and their causes obtaining now, the average rate of deaths due to small-pox
has shown a continuous decline, and now stands at the very low average
(for the period from 1893-94 to 1897-98) of .19 per mille.
4. Inspection work declined somewhat, owing, it is reported, to the diffi-
culty of obtaining children for inspection in parts where famine pressed heavily
on the people.
5. In paragraph 4 of last year's review the question of introducing the
use of lanoline paste lymph in municipalities was discussed, and the Resident
desired that the matter should be further considered before any steps were
taken. No reference has been made to the subject in the Sanitary Commis-
B-117—[G.C.F.]