3
ledge the protective powers of the operation, it is not as popular as could be
wished. He is, however, of opinion that the dislike to the operation is fast disap-
pearing, and that the results of the season's work were very satisfactory.
9. Dr. Evers also gives a good account of the working of the system
in the Seoni district. During the season he made five tours, and thus was able
to inspect the work of each Vaccinator more than once, and he considers that
the work was generally well and honestly performed. In the course of his
tours Dr. Evers visited upwards of two hundred villages. He gives several
instances in which the protective power of vaccination was plainly exhibited to,
and acknowledged by the people. Dr. Barter also, who, while officiating as
Sanitary Commissioner inspected the vaccination in these districts, bears testi-
mony to the changed feeling of the people of Seoni in respect of vaccination.
10. Dr. Evers is certainly heterodox in his opinion with regard to opera-
tions with points and crusts ; as, however, he acknowledges that working from
"arm to arm" is preferable where it can be done, I trust he will in future seasons
see his way to adopting the system more generally. The only obstacle to it is the
assembling the children of several villages together at one central place, but it
has been found very easy to overcome this difficulty in the districts of Chhind-
wara and Betul. He will also by this method be able to confer protection
against small-pox on a larger number of infants, for in this respect the work of
the Seoni district is not so good as that of the districts of Chhindwara and
Betul.
11. Dr. Barter after inspecting the work in these districts reported very
favourably of all. Mr. Price's work he considers as good as can be done. He
inspected 683 children belonging to 39 villages, and found that the operations
had been uusuccessful in 30 cases only. In Betul he happened to light on the
work of a Vaccinator who had been reduced for bad work, and finding it again
unsatisfactory, the man was dismissed. The work of three other Vaccinators
inspected by Dr. Barter, yielded a percentage of 93.3 successful cases.
In Seoni district Dr. Barter inspected some of the work of three Vaccina-
tors, which yielded 88 per cent of successful cases.
12. The amount of protection conferred on the people of these districts by
the year's work may be estimated by the number of infants vaccinated under one
year of age, or by the number of persons vaccinated per mille of the population.
13. In countries as in England, where it is compulsory for all infants to be
vaccinated within 3 months after birth, the number of vaccinations per cent
of births affords the best estimate of the extent to which the population is pro-
tected. In England for some years prior to 1871, the number of vaccinations
did not exceed 65 per cent of the number of births, and in that year a violent
epidemic of small-pox carried off nearly 23,000 persons. Measures were then
taken to ensure better enforcement of the law, and the rate of vaccination has
since risen considerably.
14. In this country we cannot as yet adopt this mode of estimating the effi-
ciency of vaccination work, for in the first place our registration of births is still
very imperfect, and secondly parents are generally much averse to having very
young children operated on, and everywhere a large proportion of those vaccina-
ted are above 1 year old. As however young children are more readily brought
for operation in proportion as the protection it confers becomes known and ap-
preciated by the people, the proportion of children under 1 year operated on
becomes a good test of the progress that has been made in overcoming the
prejudices of the people.