15
immediately exposed to infection. The results of the two statements may be
summarised as follows :—
In infected villages
In infected houses
...
...
PERCENTAGE OF POPULA-
TION ATTACKED
Uninoculated.
77
13.4
Inoculated.
1.8
8.7
PERCENTAGE OF POPULA-
TION DIED
Uninoculated.
4.7
7.4
Inoculated.
0.4
3.2
CASE MORTALITY
Uninoculated.
60.1
55.5
Inoculated.
23.9
36.3
From the 1st of October 1902 to the 31st of August 1903 the total number
of cases and deaths reported in the whole of the Punjab among 481,581
persons who were inoculated in the year was 5,293 and 1,337, giving a case
mortality of 25.26 per cent. This is much below the ordinary case mortality
of plague, and the low incidence of plague attacks among the inoculated is
particularly remarkable in that over 75 per cent. of the inoculations were
performed in the case of persons living in actually infected villages. Further
evidence in favour of inoculation is afforded by the figures (which can be
accepted as correct) showing the case mortality of inoculated persons attacked
at different periods after their inoculation. The figures for 1902-03 agree
fairly well with those of previous years, and it is established that inoculation
gives a protection which increases in amount up to the fourth month after the
operation is performed. It has still not been ascertained how long the pro-
tection lasts, but it is clear that it lasts more than four months.
28. The effects of the severe epidemics through which the Punjab has
passed have not been so immediately apparent or disturbing as might have
been expected. But it must not for this reason be supposed that they will
not be very serious. Plague operations involve a large recurring expenditure,
and plague has already led to an increase of crime, while trade, agriculture,
education, recruiting and other interests are bound to suffer in the consider-
able tracts of country which have lately lost a large proportion of their popu-
lation. Large numbers of those who have died have been in the prime of life,
and the proportion of women who have died (1,141 and 1,341 per mille males
in 1901-02 and 1902-03 respectively) is in excess of the proportion which females
bear to males in the population of the Punjab, which according to the last
Census was 852 females to every 1,000 males. No forecast can safely be made of
the future course of plague in the Punjab, but the figures for the outbreak
of 1903-04 are now mounting up and the Lieutenant-Governor is unable to take
a hopeful view of the situation. The probability is that the Province will
continue to suffer severely until the people have made up their minds that it is
time for them to adopt the measures for combating plague, which are well
within their power, and which Government cannot force upon them against
their will, though it is always ready to assist in their enforcement as soon as
the people awake to a sense of their importance and necessity. The Lieutenant-
Governor can only trust that the people will endeavour to secure for themselves
effective evacuation and that they will not neglect the facilities for inoculation
which are now being provided for them. A large quantity of approved fluid is
now in stock and arrangements have been made to enable inoculation to be
performed at all dispensaries in charge of Assistant Surgeons, as well as to
send out special inoculating officers to places where there is a particular
demand.
29. Major Wilkinson, I. M. S., has been in charge of plague operations
during the period now under review, and on the 20th of March 1902 he was
relieved of his other duties and formally appointed to be Chief Plague Medical
Officer. In this position his work has been heavy and responsible, and the
Lieutenant-Governor is pleased to acknowledge the zeal and careful attention