( 2 )
It will be seen from the above statement that excepting Gurgaon, Karnál
and Rohtak in the Eastern, and Jhang, Muzaffargarh, Pesháwar and Hazára
in the Western Circle, all other districts show an increase in the number of
vaccinations performed during the year under review, as compared with the
previous year. The increase was most marked in Kángra 13,598, Hoshiárpur
8,228, Amritsar 7,578, Siálkot 7,482, Gurdáspur 6,966, and Jhelum 6,578. In
Pesháwar, Karnál and Muzaffargarh the decrease is very trifling, namely, 83,
123 and 217 respectively. In regard to Gurgaon, Rohtak and Hazára no special
reasons are assigned for the decrease in the number of vaccinations by the Civil
Surgeons of these districts in their annual reports; but it seems to me that the
unpopularity of vaccination is the main cause of the fluctuations from year to
year in the number of vaccination operations. In the Jhang district the Civil
Surgeon attributes the diminution in the number principally to two causes—
first, the absence of the Bár tribes from the district; and secondly, the preva-
lence of measles. Owing to the want of rain the grass in the Bár was a failure,
so that the inhabitants went off to other districts where rain had fallen and
where grass could be had in abundance.
Measles had been very prevalent
throughout the district in the winter months, more especially in the towns.
The increase in the number of operations performed in the several
districts of the Province is a hopeful sign of the growing popularity of the
Reorganized Vaccination Scheme,
Vaccination started in
each district by lymph
supplied by Deputy Sanitary
Commissioners,
4. Vaccination was started in most of the districts of the
Eastern and Western Circles in the beginning of October
1883, with lymph supplied from the offices of the Deputy
Sanitary Commissioners. Dr. Doyle, Deputy Sanitary
Commissioner, Western Circle, has omitted to make any
remarks on this head, but Dr. O'Neill, Deputy Sanitary Commissioner, Eastern
Circle, observes as follows :—
" The first supplies were sent out on September 23rd, and second supplies were
sent before the results of the first were known, so that there might be no delay in commenc-
ing operations. Compared with the preceding year the results were very satisfactory,
the first supply having in every case produced healthy vesicles."
This shows the Civil Surgeons paid special attention to the starting of
lymph, and also that the lymph supplied was active. All the lymph supplied,
except a small quantity, was stored by Surgeon G. W. P. Dennys, Officiating
Deputy Sanitary Commissioner, and to the skill and care he exercised is, in a
great measure, due the early and simultaneous production of vesicles in all the
districts of the Eastern Circle. The small quantity of lymph stored by the
vaccinators of the special staff was also of good quality.
The manner in which the
work of vaccination is
carried out in districts.
5. The manner in which the work of vaccination is carried on in the
several districts varies. In some the Civil Surgeon allows
the native supervisor to allot the work amongst the vaccin-
ators; in others the Civil Surgeon makes all the men
work at the same time in one tahsíl, while again in others the men are working
all over the district throughout its length and breadth simultaneously. Dr.
O'Neill thinks the best method is to have the vaccinators working as far apart as
is consistent with close supervision.
" When they work within too small an area," he observes, " they come frequently in
contact with one another, and are likely to loiter over their work ; while on the other hand
if they are widely separated, the returns are likely to show an increased number of opera-
tions; but supervision must be imperfect, for how can a native supervisor at one end of a
district tell what sort of vesicles are being produced at the other end, or how can he tell
but half of the most distant vaccinators may have taken a week's leave to visit their
kindred, having every reason to believe their trusty comrades left behind will prevent the
lymph dying out in their absence?"
I concur in the main in the above remarks, and agree with Dr. O'Neill in
the following suggestion :—
"That if the vaccinators work in one-third or one-half of the district at a time, they
would be well within reach of the native supervisor, and the Civil Surgeon could, in a short
time, pass over the whole seat of operations."
But at the same time I would remark that the conditions and peculiarities
of each district have to be taken into consideration, and the plan followed in one