3
8. It must be borne in mind, however, that the number of primary vacci-
nations does not represent the number of children vaccinated at and between the
ages of three and fifteen months. On the contrary, it appears that the
majority of the operations are performed upon subjects whose ages vary
between one year and six years, and between six years and sixty years.
There are no figures which show this directly; but the inference may, as you
hint in paragraph 5 of your report, be drawn from the fact that out of the
total of 372,462 successful primary vaccinations performed in 1882-83, no
less than 215,734 (or about 58 per cent) dealt with subjects of more than one year
of age. The conclusion to be drawn is, that much of the time spent on vaccination
duty is occupied in making up the arrears of previous seasons. This is the more
certain, because the figures denoting successful primary vaccinations given in
Statement No. IV. leave a considerable margin for arrears. Thus while at the
end of the year 1880-81 the number of children of 4 years of age and under
in the districts of the Central Provinces (excluding Foudatory States) was
1,584,873 (see page 88 of Census Report), the number of persons who were succes-
fully vaccinated in these districts (excluding Feudatory States) during that year
and the three preceding years was 1,014,453 only. To the difference between
these totals must be added about 300,000 to represent the mortality among
children under 5 years of age.
9. Last year, under the Chief Commissioner's orders, an addition of 15
vaccinators was made to the departmental staff. You report that vaccination
is, on the whole, admirably conducted in the Central Provinces; but that more
supervision is required. You state that a Native Superintendent is required for
Chhindwara; and that in Jubbulpore, Betul, Nagpur and Raipur, the inspection
work done by the Civil Surgeon or Assistant Surgeon has been deficient. The
Jubbulpore staff has recently been strengthened by an Assistant Surgeon, part
of whose duties will be the superintendence of vaccination : and it appears that
the Civil Surgeon of Betul was detained in the station during the marching
season by special causes. The Chief Commissioner is prepared to receive any
proposals from you which will promote supervision of vaccination in the other
districts mentioned.
10. In paragraph 19 you quote Dr. Cullen's remarks on the objections to
making vaccinators perform the duty of sanitary inspectors. The subject was
also mentioned in the Sanitary report. I am to ask you to submit a special
report on this matter after due inquiry. Anything that tends to make vacci-
nators unpopular must of course be avoided, but with the development of local
self-government the attitude of the people towards sanitary improvements and
their supporters may perhaps undergo a change.
11. The Commissioner, Chhattisgarh Division, will be asked to consider
your remarks regarding the want of supervision over vaccinators working in
Feudatories and Zamindaris, and in consultation with you to propose some means
by which adequate supervision may be secured. As Dr. Trimnell has been
relieved of the executive charge of the Raipur Jail, it should be possible for him
to make his inspection of the khalsa portion of that district quite thorough.
12. In the 17th paragraph of your report, Dr. Cullen is made to say
that the form of our registers requires that chicken-pox and measles should be
shown as small-pox. It is scarcely necessary for the Chief Commissioner to
point out that they should be shown as " other diseases." The error is a
strange one for an experienced Civil Surgeon to make; and the Chief Commis-
sioner thinks you must have misunderstood him.
The difficulty of teach-
ing the natives to discriminate between these diseases is well-known. But when
chicken-pox or measles is recognized, there should be no doubt as to where the
entry must be made.
13. There remain to be noticed the remarks which you have made on the
subject of inoculation. Your statement that inoculation is a good thing and
that the practice of it should not be interfered with, is opposed to all previous