18
I also received a supply of English lymph from you in October, and of 7 cases vac-
cinated only 1 proved successful.
From these sources of supply I was enabled to provide the Vaccinators with a few tubes
each, and to send them to the same Circles in which they worked last year, between the 11th
and 15th November.
The results of " arm to arm" vaccination was so encouraging last year that I deter-
mined even at the risk of doing less work, to direct that no other source of supply should be
used unless circumstances prevented the Vaccinators from obtaining fresh lymph, and each
man was supplied with spare tubes in which to keep up a supply in case of need.
From the operations of last year it was expected that the people were fairly acquainted
with the benefits of vaccination and that much unwillingness to bring up their children would
not be shown by them this year, and the Vaccinators were directed to collect the children from
a few villages at a time only, and from very short distances.
In the Chhindwara Circle I worked at two opposite directions.
In this way the fresh cases were brought from some distance on the first day, but on
the eighth day had a very short distance to go.
In many instances where the villages were far apart and the distance too great for chil-
dren to be brought up for inspection, the Vaccinator after vaccinating a few children at a cen-
tral village proceeded on the eighth day to these villages and there vaccinated all the others.
This plan succeeded very well in the Chhindwara Circle, for although only a few opera-
tions were performed each time the people had very short distances to go. It was also very gene-
rally carried out in all the circles above the Ghats. Below the Ghats, however, much difficulty
was experienced in collecting the children in the manner above described, and the Vaccinators
received but little assistance of any kind from the Tahsildar ; the little that was given was un-
productive of results.
There can be no doubt that " arm to arm" vaccination is superior to that from any
other method, either from crusts or points, and a glance at the village Statements, showing the
work of each Vaccinator in every village, will show that in nearly all success was obtained in
the first instance, and that only in a few (comparatively) were the results doubtful or unsuc-
cessful ; and this point ought always to be borne in mind, viz, success with the first operation,
for any one who does not know the difference between successful and unsuccessful vaccination,
loses confidence in the operation if his child be subsequently attacked by small-pox after
having been vaccinated unsuccessfully.
During my inspections I had many opportunities of proving this point in several villages
where, although the children had been vaccinated (unsuccessfully), for no mark of vaccination
was perceptible on the arm, they suffered from small-pox and were brought forward as a proof
of the inefficacy of vaccination to confer immunity from the disease. It is better therefore to
endeavour to vaccinate well " arm to arm" and a few only, than to look for numbers, and this
end has been steadily pointed out to the Vaccinators.
Again I have used my utmost endeavours to impress on the Malgozars and village
notables to have every child vaccinated in their villages if possible, for it is well known that
vaccination will not confer entire immunity from small-pox if one-half of the inhabitants are
unprotected. These do suffer from small-pox and a quantity of infecting matter during the
disquamatory process is thrown off the patients, quite sufficient to create an epidemic when
favouring circumstances arise, and it is perhaps in this way more than from any other that
small pox is propagated.
The amount of accumulated filth and excreta of all kinds in and around every village
is well known, and in these are also the germs of small-pox.
Owing to the large number of children vaccinated last year, there were not so many
to operate upon this year, and the number vaccinated comprises only those born during the
year and those who from sickness or other causes were not vaccinated lastyear ; and the work
having been completed in many circles some time before the season for closing operations, I,
in communication with yourself and the concurrence of the Deputy Commissioner, proposed