49
Between June and September 1903, only 451 inoculations were performed in the
Punjab, the total number of inoculations performed during the year under report thus
amounting to 481,581. It has been seen that the number of inoculations which it was ex-
pected that each full-time operator would perform daily was 700, but though this figure was
occasionally exceeded by individual operators, in no case did the daily average number of
persons inoculated by any one officer exceed 232. The highest number of inoculations per-
formed by any officer in one week was 3,733, which number was attained by Dr. Michell
in the Hoshiárpur District in April. The highest number of inoculations performed by all
operators in any one week was 37,977- This figure was reached in the week ending
October 25th. It was in the following week that orders were first issued restricting in-
oculation operations and in the next succeeding week that the entire cessation of these
operations was directed. In no week after orders were issued restricting operations did
the number of persons inoculated reached to within 10,000 of the figure just mentioned.
After the recommencement of operations the highest number of persons inoculated in any
one week was 27,455 : this was during the week ending February 28th.
As has been seen, the monthly total of inoculations was largest in October 1902, when
it reached 111,337- In only one other month, namely, February 1903, did the monthly total
reached a lakh ; during this month the number of persons inoculated was 103,283.
In seven of the thirteen districts included in the scheme the highest monthly totals
were reached in October, and in only two districts, namely, Hoshiárpur and Amritsar, were the
•totals for this month largely exceeded. In the Amritsar District the number of persons
inoculated in October was only 2,106, this being chiefly due to the circumstances previously
mentioned that the available supply of prophylactic was chiefly reserved for those districts
in which the demand for inoculation was expected to be greatest, and Amritsar was not one
of these. The highest monthly total of the district was only 14,862, this figure having been
reached in February, In this month 44,931 inoculations were performed in the Hoshiárpur
District, this being the highest monthly total of any district. The district in which the
largest number of inoculations was performed was Hoshiárpur where 158,550 persons were
inoculated, next came Jullundur with 82,097 inoculations, then Amritsar and Ambala with
62,775 and 60,716 inoculations, respectively. In only two other districts, namely, Gurdáspur
and Ferozepore, did the number of inoculations performed exceed 20,000, and in but four
others were more than 10,000 persons inoculated. Particulars will be found in Statement
No. 2 in which are shewn the numbers of plague cases and deaths and inoculations in each
district monthly throughout the year under report.
Effects.
Results.
88. It remains to consider the immediate effects of inoculation, that is, the reaction of
the operation and any injury apparently due to it,
and the result of measure as shewn by a com-
parison of plague cases and deaths occurring among inoculated and uninoculated persons.
It should be premised that all inoculating officers were instructed to observe and
record the reaction following inoculation in as large a number of persons as possible and were
.enjoined to report particulars of all cases in which any injury was observed to follow the
operation. The results of inoculation in protecting from attacks of, and deaths from, plague
have been ascertained from the records of plague occurrences and inoculations maintained in
accordance with the instructions in the Plague Manual and from special enquiries.
Effects of the operation.
Temperature.
89. Whenever possible the effects and results of the old and new prophylactic have-
been shewn separately. In Table No. 2 below
are shewn the body temperature observed at
various periods after inoculation, with the old and new fluid respectively. All inoculating
officers were provided with reliable minute or half-minute clinical thermometers and the
axillary temperature was observed in almost all instances. It will be noticed that
subnormal temperatures were recorded at all periods of inoculations both with the old and
the new fluid. It was first thought that such observations were erroneous, but the enquiries
which were made which showed that although this might be the case in some instances, most
were correct.
If the temperature reaction is any indication of the efficacy of inoculation, it would
appear from effects recorded in this table that while neither the old nor the new fluid
reached the desired standard, activity of the latter was much less than that of the former
as judged by its failure to produce either any reaction or a rise of temperature to 101 0 . The
failure to produce this temperature was more marked in the case of new than of the old fluid
at all periods after inoculations.