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The average number of operations returned by the vaccinators of this
district during the year is 23,060, being an increase of 2,415 over the number
vaccinated in the previous year. There were 21,257 primary cases returned as
successful against 19,562 in the previous year, and the percentage of success
92.40 as compared with 94.85, being a decrease of 2.45. The number of re-
vaccinations was 66 against 22 of previous year. The number successfully
vaccinated per mille of population was 34.47 against 31.71 in the preceding year ;
increase 2.76. The aggregate cost amounted to Rs. 1,661 as compared with
Rs. 1,763, a decrease of Rs. 102; and each successful case cost Re. 0-1-3, decrease
Re. 0-0-2.
Three thousand nine hundred and eighteen primary vaccinations were
inspected by the Civil Surgeon (Dr. R. J. Quinnell), of which 3,886 were found
to be successful, the ratio of success being 99.18 per cent.
The first supply of lymph was received on the 4th October, when arrange-
ments were immediately made, and operations started on the 6th idem in a village
(Lohiánwála) near the Sadr. Three more supplies arrived at intervals of a few
days later on. In each instance, to remove doubt, the Civil Surgeon, Dr.
Quinnell, tested their quality himself by vaccinating two or three children in
different centres in the neighbourhood; the result having proved to be satis¬
factory, the work was extended at once by arm-to-arm operations, and, in order
that it should be carried on systematically, one tahsíl was done at a time, each
being previously mapped out successively into zails and halkas. By this
method, omission of villages was impossible, and the operations were confined to
areas in turn, which not only allowed of more easy and efficient supervision, but
reduced, in a great degree, the amount of trouble and discomfort the parents
were sometimes put to in having to travel inconvenient distances with their children
for operation or inspection. This plan, moreover, of working near and together,
facilitated the submission of reports and returns from the vaccinators with more
punctuality than had been the case when they worked in a straggling way in
different tahsíls at the same time.
The native supervisor, under instructions from the Civil Surgeon, re-
mained always with the vaccinators during the time they were engaged in oper-
ations, and it is believed that, while his constant presence instilled energy into
the work, it had a salutary effect further in preventing carelessness of a kind
likely to cause serious prejudice against vaccination, and that is, in not properly
examining and excludiug children who, suffering from eruptions and other
diseases, were unfitted at the time for vaccination, or for supplying afterwards
lymph to other children. The manner in which Dr. Quinnell conducted his
own inspections is shown thus in his able and interesting report:—
"The inspection of towns usually required a day's previous notice, but of villages I
never found that any previous intimation was necessary. On proceeding to a village the
lambardár was asked for, and, if he happened to be absent, the chaukídár was found invari-
ably present. More often, than not, both were found present. I then called for the parcha
(or nominal roll) and directed that all the children should be assembled near a well or
under some tree just outside the village, and employed the interval, between the time of my
arrival and the collecting of the children, in riding through and looking into the sanitary
condition of the streets, dwellings, &c. When the children were assembled I examined their
arms, noted down the result in a pocket-book, compared the notes with the figures in the
parcha, and then these figures with entries in the birth and death register, after which
I entered the date of inspection in each, and put my initials below. Should there have been
any doubtful or unsuccessful cases these were noted in the parcha for the information of
the vaccinator, who was sent to do them over again. On finishing the inspection in each
village, I usually spent a few minutes in ascertaining the feeling in regard to vaccination,
and in not a single instance can I remember any exhibition of dislike to the operation,
On the contrary, I believe the mass of the people of this district have come at last to show a
very intelligent belief in the great benefit it has conferred; and often when talking with them
on the subject, they will of themselves compare the time past, when year after year countless
numbers of children were destroyed by small-pox, with the gradually increasing immunity
from the disease since vaccination was introduced, which immunity is now almost complete
in certain places, notably the towns of Rámnagar, Háfizabad, Pindi Bhatián, and other places
where there have not been any deaths from small-pox for six or seven years, and where the
appreciation of vaccination is quite enthusiastic."
It was due to the operations being planned and carried out in a systematic
manner that the work was completed by a little earlier date than last year, that
is, by almost 2½ or 3 weeks. Advantage was taken of this to renew operations