56
5. I have not had any reports made to me of small-pox epidemics in any of
the surrounding villages during the year under notice.
KARWAR CIVIL HOSPITAL.
Surgeon S. J. Goldsmith, Civil Surgeon (acting).
Population 13,263.
The number of vaccinations performed at the civil, police, and jail hospitals
and by the dispensary officer in the municipal towns is as follows :— Civil hospi-
tal 46, police hospital 127, jail hospital 98, and in the municipal towns 524. This
includes both primary and re vaccinations. The 113 vaccinated at the charitable
dispensary are not included in this return, but will be shown in a separate one.
2. The number of cases of primary vaccination was 558; of these 2S8 were
males and 240 females ; there being an excess of 30 operations over the number of
persons vaccinated ; the percentage of successful cases excluding those " unknown"
from the total, are 82.0, out of these 114 were christians or 21.6 per cent., 390
were hindus or 74 per cent, and 24 were musalmans or 4.5 per cent.
3. The number of revaccinations was 237, of these 83 were successful or 35
per cent, and 154 unsuccessful.
4. In most of these cases arm-to-arm vaccination was practised; in only a
few was tube lymph used, but this method was employed almost entirely in the jail,
as the mothers have a slight objection to take their children there, which would
however I think be easily got over by giving them a small remuneration.
Quality of lymph.
5. The quality of lymph from what 1 have seen
was good and the vesicles were large and well deve-
loped.
Small-pox.
G. During the twelve months under record parts of two epidemics have pre-
vailed. The former of these was going on when last
year's report was sent in ; 183 cases and 23 deaths
have been reported as occurring between the beginning of April and the 10th June
1873 : and not a single case occurred between the latter date and the end of Decem-
ber of the same year ; but then the disease broke out again and from that date up
to 31 st March 1874, 57 cases and 13 deaths are reported, making a total during the
12 months of 240 cases and 30 deaths. Of the cases occurring during the part of
the epidemic mentioned in 1873, 12.6 per cent, died, while of those attacked during
the tirst three months of this year 22.6 percent died : this seems to show that the
protection of the people by vaccination has not increased progressively during the
year, as apparently there is still a large proportion of the people liable to fatal at-
tacks of small-pox ; but it is encouraging to observe that in the last epidemic there
has not been a single case among the vaccinated which proved fatal.
Measures taken to prevent
spread of small-pox.
7. During the last few weeks all that could be done to try and arrest the
disease has, I think, been done. At first an attempt
was made to isolate the cases in a separate building,
but the patients could not be induced to leave their
houses : as soon as a case occurs, the friends, as many as will submit to the
operation, are vaccinated, whether previously protected or not : and intercourse
between the sick and their neighbours is prevented as far as possible ; as soon as
the patient is convalescent or dead, the house, if a cheap temporary one, is burnt
down, If of a more expensive kind, it is disinfected with chlorine, the walls scrub-
bed and whitewashed and the earth of the floor taken up, buried and fresh earth put