2
The percentage of successful cases was thus somewhat lower in primary
cases and in re-vaccinations at dispensaries; and you are inclined to believe that
the percentage of successful re-vaccination operations performed by the Vaccine
Department has been over-stated. Possibly the decreased percentage of success
is only nominal, and is due to more careful checking of the entries made by vac-
cinators under the instructions conveyed in last year's review.
5. There were, however, certain special causes which interfered in some
degree with the results of vaccine work. Some bovine lymph which was used
in the Nagpur district and sent to Saugor, Narsinghpur and elsewhere did not
prove so efficient in the establishing of vesicles as English lymph. Similarly in
the Betul district no good results were obtained till English lymph was obtained
from your office. Arrangements should be made to ensure the timely distribu-
tion of good lymph to all districts. In the opinion of the Chief Commissioner
the manner in which vaccination is performed and the material employed should
receive equal, if not greater attention, than the number of operations recorded.
There can be no doubt that the indifference or dislike to vaccination which is
exhibited in many places is due partly to the fact that persons who have not
been properly protected by efficient vaccination often succumb to small-pox, and
partly to the fact that suffering is occasionally caused by use of impure lymph
or by the hasty and perfunctory way in which the vaccinating needle is used.
The encouragement of arm to arm vaccination, which was more extensively
carried out during the year, will no doubt produce satisfactory results; but
so long as it is possible for vaccinators to work clumsily and roughly, as did
the men to whom Dr. Mayne refers in his report, without incurring the penalty
of suspension or dismissal, it is unlikely that the prejudices against vaccination
will be removed. Dr. Mayne's account of what he saw when following in the
track of vaccinators is painful and shocking, and the Chief Commissioner will
be glad to learn what steps have been taken to teach these men their duty
and to prevent them and others from doing such disastrous work in future. In
places where the people have objections to arm to arm vaccination, such as are
described in the Wardha report, and on the other hand, look upon lymph taken
from tubes " as medicine," efforts should be made to humour the preference.
When it is not possible to do so, the operations of the vaccinators should be
closely supervised.
6. The necessity for supervision is shown not only by the facts recorded
by the Civil Surgeons of Bhandara and Balaghat, but by the fact that the
returns prepared by vaccinators, both of the number of operations and of the
number of successful cases, stand in need of careful check. In the Seoni district
a vaccinator was dismissed during the year for sending in false returns. The
return of 2,955 operations as the average number performed by each vaccinator
in the Balaghat district, seems also open to suspicion. Now that the popula-
tion returns furnished by the new Census are to hand, the area of each vacci-
nator's operations should be mapped out as nearly as possible according to the
scale accepted by the Chief Commissioner in 1874, viz: from 130 to 180 villages,
and population of from 30,000 to 60,000; and the necessity for careful inspec-
tion of the work done, should be impressed upon all Civil Surgeons.
7. The birth-rate for this Province is given at page 89 of the Census
Report for 1881 at 42.8. It is true, as you observe in paragraph 5 of your report,
that at least 25 per cent of the children who can be vaccinated in any year are
more than a year old: and that 25 per cent of the newly born are too young to be
vaccinated. This leaves the annual total at the same figure, while it allows
time for the average mortality among children of less than one year of age
(given at 25 per cent in the table in page 88 of the Census Report) to work
its effect upon the number of subjects for vaccination. According to page 97
of the same report, the mean annual birth-rate of this Province (excluding Feuda-
tories) is (in round numbers) 420,000 infants of both sexes, and the annual deaths
of children under one year of age number 35,700 (paragraph 94). The num-
ber of newly born children to be vaccinated in any one year, should therefore
be about 384,000. The number actually vaccinated in 1832-83 in this Prov-
ince (excluding Feudatory States) was 363,781.