NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
21
APPENDIX A.—Statement showing the number of vaccinations performed
in municipal towns on children under one year of age in 1922-23.—(Contd.)
Towns.
1
Chanda
District.
Chanda...
Warora...
Total...
Balaghat
District.
Balaghat...
Jubbulpore
District.
Jubbulpore...
Do.
Cantonment ...
Sehora...
Murwara...
Total...
Saugor
District.
Saugor...
Do. Cantonment...
Khurai...
Deori...
Etawa...
Bamora...
Total...
Damoh
District.
Damoh..
Seoni
District.
Seoni...
Mandla
District.
Mandla...
Number
of
births
during the
year.
2
762
370
1,132
207
3,457
455
210
767
4,889
1,520
333
240
216
164
61
2,534
796
566
412
Number
of
deaths
among children
under one
year during
the year.
3
163
106
269
38
681
104
42
164
991
409
64
64
37
24
18
616
190
84
64
Number of
successful
vaccinations
on children
under one
year during
the year
ending the
31st March
1923.
4
347
172
519
127
1,129
271
91
456
1,947
914
158
110
150
106
26
1,464
517
234
171
Date of extension of
Vaccination Act
to town.
5
18th March 1909.
13th July 1903.
27th July 1897.
15th February 1890.
8th December 1898
28th December 1898.
5th September 1894.
22nd May 1895.
9th October 1899.
28th April 1916.
6th May 1920.
22nd December 1892.
1st March 1903.
20th April 1898.
22
APPENDIX A.—Statement showing the number of vaccinations per-
formed in municipal towns on children under one year of age in
1922-23.—(Contd.)
Towns.
1
Hoshangabad District.
Hoshangabad...
Harda..
Seoni-Malwa...
Itarsi...
Sohagpur
Piparia...
Panhmarhi...
Total...
Nimar District.
Khandwa...
Burhanpur...
Total...
Narsinghpur District.
Narsinghpur...
Gadarwara...
Chhindwara...
Total...
Betul District.
Betul...
Betul-Bazar...
Multai...
Total...
Chhindwara District.
Chhindwara...
Pandhurna...
Sausar...
Total...
Number
of
births
during the
year.
2
490
699
245
373
342
120
150
2,419
1,050
1,783
2,833
436
406
151
993
258
241
234
733
585
316
221
1,122
Number of
of
deaths
among children
under one
year during
the year.
3
152
198
63
84
S3
20
31
601
300
467
767
100
75
46
221
50
88
58
196
150
74
60
284
Number of
successful
vaccinations
on children
under one
year during
the year
ending the
31st March
1923.
4
346
377
137
196
169
102
21
1,348
592
1,248
1,840
147
205
134
486
174
131
52
357
423
54
3
480
Date of extension of
Vaccination Act
to town.
5
5th April 1894.
24th September 1892.
19th February 1901.
8th March 1916.
1st May 1920.
8th August 1906.
28th August 1894.
6th September 1893.
29th September 1892.
16th September 1892.
13th May 1896.
6th September 1916.
6th September 1893.
5th January 1914.
6th March 1914.
23
APPENDIX A.—Statement showing the number of vaccinations per
formed in municipal towns on children under one year of age in
1922-23.—(Concld.)
Towns.
1
Raipur District.
Raipur...
Dhamtari...
Bhatapara...
Total...
Bilaspur District.
Bilaspur...
Drug District.
Drug...
Amraoti District.
Amraoti...
Amraoti Camp..
Elhchpur...
Ellichpur Camp..
Total ...
Yeotmal District.
Yeotmal...
Akola District.
Akola...
Akot...
Basim...
Karanja...
Murtizapur...
Total...
Buldana District.
Buldana...
Khamgaon...
Shegaon...
Malkapur...
Total...
GRAND
TOTAL...
Number
of
births
during the
year.
2
1,163
376
160
1,699
840
330
1,801
283
1,088
303
3,675
729
1,467
668
452
6l5
401
3,603
194
720
597
630
2,141
45,961
Number
of
deaths
among children
under one
year during
the year.
3
312
89
52
453
230
111
437
55
244
57
793
150
380
147
117
168
124
1,036
31
184
163
124
502
10,964
Number of
successful
vaccinations
on children
under one
year during
the year
ending the
31st March
1923.
4
580
220
56
856
490
122
909
161
627
181
1,878
485
856
490
291
419
186
2,242
181
521
396
483
1,581
26,8l6
Date of extension of
Vaccination Act
to town.
5
25th October 1888.
18th September 1903.
15th February 1916.
30th May 1894.
10th February 1916.
8th August 1894.
18th March 1893.
8th August 1894.
22nd December 1893.
1st April 1894.
18th March 1893.
1st April 1897.
11th May 1917.
22nd December 1893.
18th March 1893.
8th August 1894.
2nd February 1911.
24
APPENDIX B.—Statement showing the annual mortality from small-pox for
during each of
Year.
1
1916-17...
1917-18...
1918-19...
1919-20...
1920-21...
1921-22...
1922-23...
—
2
Annual mortality from small-pox...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from
small-pox...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from
small-pox...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from
small-pox...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Nagpur.
3
10
32.82
3
34.44
125
40.66
303
27.11
63
32.17
109
32.62
33
32.14
Bhandara.
4
4
44.70
4
48.31
7
37.90
52
29.44
96
26.80
130
24.80
26
30.59
Wardha.
5
4
33.43
4
35.70
66
34.65
218
31.76
80
35.84
43
35.33
6
34.89
25
seven years and the annual proportion of persons protected by Vaccination
the seven years.
Chanda.
6
8
36.72
3
38.16
156
28.32
428
23.20
221
20.67
56
20.39
...
20.61
Balaghat.
7
1
31.09
20
43.30
...
34.74
1
28.91
21
27.78
58
23.68
...
25.86
Jubbulpore.
8
...
37.74
...
47.32
3
33.50
6
26.50
16
34.21
98
21.24
5
29.08
Saugor.
9
...
38.68
...
46.83
1
36.13
66
27.07
6
29.31
...
28.55
1
25.08
Damoh.
10
8
33.51
29
36.76
9
26.51
21
32.89
80
31.28
61
31.95
9
35.46
Seoni.
11
2
33.39
3
40.57
3
37.05
73
27.34
335
16.68
69
16.01
9
23.81
Mandla.
12
4
39.39
5
39.13
5
23.23
13
26.69
208
25.40
244
22.64
4
30.34
Ho-
shang-
abad.
13
4
35.86
3
35.63
21
32.39
134
27.69
5
29.34
6
30.50
2
27.53
26
APPENDIX B.—Statement showing the annual mortality from small
Vaccination during each of
Year.
1
1916-17 ...
1917-18 ...
1918-19...
1919-20 ...
1920-21...
1921-22...
1922-23...
—
2
Annual mortality from small-pox...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from
small-pox...
...
Annual proportion of persons protected by vaccinator
per 1,000 of population.
Annual mortality from small-pox
...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Annual mortality from small-pox...
Annual proportion of persons protected by vaccination
per 1,000 of population.
Nimar.
14
2
31.09
44
40.05
69
37.26
93
32.24
1
33.43
6
34.33
14
35.17
Nar-
singh-
pur.
15
...
35.02
...
36.38
18
30.21
83
26.77
35
26.05
17
21.8l
34
32.75
Betul.
16
4
36.35
8
36.06
3
23.63
129
20.38
55
22.72
3
27.56
...
26.10
27
pox for seven years and the annual proportion of persons protected by
the seven years.—(Concld.)
Chhind-
wara.
17
...
47.57
...
40.83
4
40.80
43
29.13
15
28.21
4
29.05
1
28.07
Rai-
pur.
18
62
37.80
136
37.04
344
32.95
708
29.60
143
27.72
120
26.93
25
26.06
Bilas-
pur.
19
48
35.35
134
38.91
972
40.68
1,409
36.04
412
26.07
70
25.76
48
29.58
Drug.
20
28
38.02
3
40.60
6
35.64
270
32.39
251
32.85
40
22.77
4
27.27
Amraoti.
21
23
32.50
25
33.19
473
29.27
372
23.57
16
25.26
12
26.47
58
30.81
Yeotmal.
22
57
30.26
43
37.20
280
23.01
294
22.70
179
25.09
41
26.11
11
29.60
Akola.
23
31
31.52
133
31.04
991
29.21
443
23.47
21
28.18
15
26.84
58
23.79
Buldana.
24
2
35.78
381
40.70
699
33.68
113
32.39
4
28.36
14
28.49
35
27.32
Govt, Press, Nagpur:—No. 982, Dir. of P. H.—29-9-23—284.
NOTES
ON
VACCINATION
IN THE
CENTRAL PROVINCES AND BERAR
DURING THE YEAR
1923-24
NAGPUR
PRINTED AT THE GOVERNMENT PRESS
1924
[PRICE—ONE RUPEE]
NOTES
ON
VACCINATION
IN THE
CENTRAL PROVINCES AND BERAR
DURING THE YEAR
1923-24
Agents for the sale of Books published by the Central Provinces
Government.
IN ENGLAND.
CONSTABLE & Co., 10, Orange Street, Leicester Square, London, W. C.
P. S. KING & SON, 9, Bridge Street, Westminster, London, S. W.
KEGAN PAUL, TRENCH, TRUBNER & Co., 68/74, Carter Lane, London, E. C., and
39, New oxford Street, London, W. C.
E. QUARITCH, 11, Grafton Street, New Bond Street, London, W.
GRINDLAY & Co., 54, Parliament Street, London, S. W.
DEIGHTON BELL & Co., LD., Cambridge.
B. H. BLACKWELL, 50 & 51, Broad Street, Oxford.
LUZAC & Co., 46, Great Russell Street, London, W. C.
W. THACKER & Co., 2, Creed Lane, London, E. C.
MESSRS. EAST & WEST, LTD., 3, Victoria Street, London, S. W. 1.
OLIVER & BOYD, Tweeddale Court, Edinburgh.
E. PONSONBY, LTD., 116, Grafton Street, Dublin.
T. FISHER UNWIN, LTD., 1, Adelphi Terrace, London, W. C.
MESSRS. WHELDON AND WESLEY, LTD., 2, 3 & 4, Arthur Street, New Oxford Street
London,W.C.2.
ON THE CONTINENT.
ERNEST LEROUX, 28, Rue Bonaparte, Paris.
MARTINUS NIJHOFF, The Hague.
OTTO HARRASSOWITZ, Leipzig.
FRIENDLANDER& SOHN, Berlin.
IN INDIA AND THE COLONIES.
THACKER, SPINK & Co., Calcutta and Simla.
NEWMAN & Co., Calcutta.
R. CAMBRAY & Co, Calcutta.
S. K. LAHIRI & Co., Calcutta.
BUTTERWORTH & Co., (INDIA), LTD., 8-2, Hastings Street, Calcutta.
CALCUTTA SCHOOL BOOK AND USEFUL LITERATURE SOCIETY, Calcutta,.
THE WELDON LIBRARY, 18/5, Chowringhee Road, Calcutta.
M. C. SIRCAR & SONS, 75, Harrison Road, Calcutta.
THE ASSOCIATION PRESS, Calcutta.
THE PROPRIETOR, INTERNATIONAL BUDDHIST BOOK DEPÔT, 4, Chandney Chowk,
1st Lane, Calcutta.
A. J. COMBRIDGE & Co., Bombay.
THACKER & Co., LTD., Bombay.
RADHABAI ATMARAM SAGOON, Bombay.
SUNDER PANDURANG, 25, Kalbadevi Road, Bombay.
RAMCHANDRA GOVIND & SON, Booksellers, Kalbadevi, Bombay
A. J. COMBRIDGE & Co., Madras.
HIGGINBOTHAM & Co., Madras.
V. KALYANARAM IYER &CO., Madras.
G. A. NATESAN & Co. Madras.
S. MURTHY & Co., Madras.
THOMPSON & Co., Madras.
TEMPLE & Co., Madras.
RAI SAHIB M. GULAB SINGH & SONS, Lahore.
THE PROPRIETOR, NEWAL KISHORE PRESS,Lucknow.
N. B. MATHUR, SUPERINTENDENT, NAZAIR KANUN HIND PRESS, Allahabad
A. H. WHEELER & Co., Allahabad, Calcutta and Bombay.
SUPERINTENDENT, AMERICAN BAPTIST MISSION PRESS, Rangoon.
MANAGER, GENERAL BOOK DEPÔT, Nagpur and Jubbulpore
AIDAN BINZANI, PROPRIETORS, KARMVIR BOOK DEPÔT, Mahal, Nagpur.
THE MANAGRS, " The Hitawad," Nagpur.
A. M. & J. FERGUSON, Booksellers, Ceylon.
BABU S. C. TALUQDAR, Proprietor, Students & Co., Cooch Behar.
THE STANDARD BOOKSTALL, Karachi.
KARSANDAS NARANDAS & SONS, Surat.
MUNSHI SEETA RAM, Managing Proprietor, Indian Army Book Depôt
Juhi, Cawnpore.
THE PROPRIETORS, New Kitabkhana, Poona.
THE OXFORD BOOK AND STATIONERY CO., Delhi.
THE PATNA LAW PRESS CO., Patna.
THE UPPER INDIA PUBLISHING HOUSE LTD., Booksellers and Publishers
41, Amdnabad Park, Lucknow.
TABLE OF CONTENTS.
Introductory...
...
Administration...
...
Establishment... ...
Total vaccinations... ...
Vaccination by Special Staff... ...
Dispensary vaccination and vaccination by other agencies... ...
Cost of Department... ...
Supply of lymph... ...
Inspection of vaccination... ...
Percentage of success in primary and re-vaccination... ...
Vaccination in municipal towns... ...
Deaths from small-pox... ...
General... ...
Cause of delay... ...
PARAS
1
2
3
4&5
6 to 8
9
10
11 & 12
13
14
15
16
17 to 19
20
NOTES ON VACCINATION
IN THE
Central Provinces and Berar during the year 1923-24.
Introductory.—As a detailed report for the triennial period
ending 1922-23 was submitted last year, this report deals briefly
with the vaccination performed in 1923-24 as compared with
1922-23.
2 Administration-—I was in charge of the Department
throughout the year.
3. Establishment—The number of Assistant Superin-
tendents of Vaccination was increased from 36 to 37 as the Dis-
trict Council, Mandla, appointed a second man for inspection work.
The number of vaccinators was reduced by one, 302 to 301. The
District Councils of Chanda, Saugor, Hoshangabad and Betul,
curtailed their staff by one each, while Narsinghpur and Buldana
raised theirs by one. The Itarsi Notified Area Committee also
entertained a temporary vaccinator to work solely in the town
4. Total number of vaccinations performed.—The
total number of vaccinations performed in the Province during the
season was 501,398 against 429,291 or an increase of 72,107 over
the previous year.
All the districts, except Jubbulpore and Bilas-
pur, show an increase, the largest being in Raipur, Drug, Mandla,
Akola, Chhindwara, Hoshangabad, Saugor and Buldana districts.
The Commissioner, Nagpur division, commenting on the increase
remarks that the progressive decrease that has been going on for
a number of years has been arrested, but this is only partially true.
The increased out-put is due to the high birth-rate of the year
which gave an excess of 136,845 births over the former year and
does not indicate completeness of work. This is evidenced by
(1) the large number of unprotected children to be found both in
municipal towns and in villages, and (2) the average number of
operations performed by individual vaccinators which except for a
few instances is still far below the standard.
5. It is to be noted that the balance of unvaccinated children
has actually increased in spite of the higher figure of work. Now
that the District Councils and Local Boards have shouldered the
responsibility for this work and have, with the exception of four
2
districts, delegated definite powers to the Civil Surgeons, there
is promise of improvement.
Plague, as usual, retarded the work
in Jubbulpore, but there is no excuse for the fall in Bilaspur district.
Some drastic measures combined with skillful handling of the staff
seem necessary in this district.
6. Vaccinations by the special staff.—Of the total
number of 501,398 operations performed during the season,
506,806 (458,019 primary and 42,787 re-vaccinations) were done
by the vaccination staff. Primary vaccinations show an increase
of 70,941 over the previous year, but re-vaccination showing an
increase of only 1,991 over the preceding year, at a season when
small-pox is prevalent in many districts, is highly unsatisfactory
A press communiqué was recently issued by Government urging
the necessity for vaccination in consequence of the prevalence of
small-pox, but neither this nor the instructions issued by Deputy
Commissioners seem yet to have produced much effect.
7. Recently two vaccinators were assaulted in Akola district.
The Civil Surgeon reports that a villager of Takli-Khojbod kicked
the vaccinator and that two patels and a patwari saw this and wrote
notes to this effect. A first class magistrate tried the case but,
in spite of the written statements, the offender was acquitted.
The Deputy Commissioner remarks that the case failed
principally because vaccination is not compulsory under the law.
If a clear case like this fails then apparently a vaccinator
can be obstructed with impunity in the performance of his duties
and moreover he cannot even claim the protection from assault
which is the right of all under the law.
The second case, where stones were thrown and equipment
damaged, has not yet been decided.
The Civil Surgeon, Amraoti, reports that' in the village of
Sirasgaon (Station House) not one child was vaccinated. He
gives no details. Such cases have to be reported to the District
Council which is the responsible authority under the Local Self-
Government Act, but it is desirable for the Civil Surgeon to see that
action follows.
Some of the patels and patwaris have not been doing their
duty in helping the vaccinators.
8. The introduction of compulsory vaccination is advocated
in many of the reports. Some District Councils such as Wardha
and Betul are in favour of compulsory vaccination being introduced
into their districts, while the Deputy Commissioners of Seoni and
Akola remark that " the time is ripe for such an introduction " and
that '' it can no more be delayed with impunity". Proposals for
3
making vaccination compulsory in rural areas have been submitted
and are under the consideration of Government.
9. Dispensary vaccination and vaccination by other
agencies.—During the season, the Medical Officer in charge of
the Jail Hospital at Nagpur and the Assistant Medical Officer in
charge of the Cantonment Hospital, Pachmarhi, performed 110
vaccinations, 103 primary and 7 re-vaccinations. The Railway
Medical Officers at Nagpur, Chanda, Bina and Nagbhir (Chanda
district) did 126 primary and 144 re-vaccinations. At the Coal
Mines, Chhindwara, 194 primary operations were performed and
10 primary and 8 re-vaccinations at the Mission Hospital, Raipur.
10. Cost of Department.—The total expenditure on
vaccination fell from Rs 2,02,015- 2-10 to Rs. 1,96,210-3-6 during
the year, the chief decrease being under the heading " pay of
the establishment ". Arrears of pay on account of the introduction
of a time-scale of pay had swelled the expenditure in 1922-23.
In consequence of the fall in expenditure and also on account of
the larger number of successful vaccinations done during the season,
the average cost per successful case decreased from Re. 0-8-3 in
the past year to Re. 0-5-10 Excluding the expenditure incurred
in connection with the Vaccine Institute, Nagpur, the cost per
successful case stands at Re. 0-5-11 against Re 0-7-3 in the
preceding year.
11. Supply of lymph.—Only glycerinated calf lymph
prepared at the Vaccine . Institute was used. The supply is
reported to be satisfactory and the lymph good.
12. The following is a report on the working of the Institute
as submitted by the Superintendent in charge Major F. G. H.
Deeks, I.M.D. : —
"185 calves were successfully operated on yielding a total
of 6450.23 grammes of lymph equivalent to 560,480 doses, and the
cost per dose was 7 pies. The average purchase price per calf
was Rs. 13 and the average sale price Rs. 10.
" The whole province of 22 districts and the States of Raigarh,
Sirguja and Bhopal were regularly supplied with lymph on indents.
Occasional supplies according to requirements were made to all
other Feudatory States, the Railways, Jails, Military and Mission
hospitals. 529,135 doses were supplied to vaccinators and 57,280
doses to the States of Raigarh, Sirguja, Bhopal and others, making
the total of 586,415 doses. Results: primary vaccination, case
success 99per cent; insertion success 92 per cent; re-vaccination
case success 63 per cent; insertion success 48 per cent.
4
" Total expenditure incurred was Rs. 25,299-1-11 of which
Rs. 12,968-8-0 were spent on salaries and travelling allowances
and the remainder on contingencies.
Total receipts were
Rs. 20,749-9-9, made up as follows:—
Sale of lymph Rs. 18,595-10-6; miscellaneous Rs. 352-9-3
and sale of calves Rs. 1,801-6-0.
" The Assistant Superintendent conducted two training classes
for 4th grade vaccinators in vaccination, hygiene and epidemiology ;
27 vaccinators were trained and given certificates of efficiency
by the Director of Public Health.
" One Assistant Superintendent of Vaccination, Bilaspur
district, and the Sanitary Inspector, Ellichpur City, also attended
a course of instruction, and passed the necessary examination.
" A hostel for vaccinators under training was completed and
occupied in October 1923. The vaccinators are now properly
housed on the institute premises".
13. Inspection of vaccination.—Most of the Civil
Surgeons have during the season devoted more time to this im-
portant part of their duties. They inspected 7.28 per cent of
the primary and 7.21 of the re-vaccinations against 5.68 and 6.87,
respectively, in the previous season. In Saugor, Hoshangabad,
Amraoti and Akola the inspections are very limited and the recent
rules allotting six weeks for touring by Civil Surgeon in the
cold weather appear to have been overlooked.
The Assistant Superintendents and others such as the Assist
ants to Civil Surgeons, Epidemic Dispensary Assistant Medical
Officers and Sanitary Inspectors in municipal towns who have
been nominated additional Superintendents, inspected 49.43 per
cent of the primary and 21.09 of the re-vaccinations. The work
of the Assistant Superintendents of Vaccination is not satisfactory.
In Nagpur one of the Assistant Superintendents spent most of his
time in headquarters. He was out on tour for only 96 days
during the year. The work of the Second Superintendent also
is below the standard prescribed. Wardha, Jubbulpore, Saugor,
Damoh, Seoni, Hoshangabad and Chhindwara are other instances
where the number of these inspections is very low. The attention
of the Civil Surgeons is being drawn to this.
14. Percentage of success in primary and re-vaccina-
tion.—The percentage of success recorded by vaccinators was
98.85 for primary and 58.96 for re-vaccinations. The Civil
Surgeons and Assistant Superintendents during their inspections
found 98.70 and 97.85 success for primary and 42.33 and 49.53
for re-vaccinations.
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15 Vaccination performed in municipal towns.—
During the season 30,254 vaccinations were performed on infants
under one year of age in municipal towns. This number works
out at about 76 per cent of the infants available for vaccination
which is a very low figure, lower in fact than in any of the previous
years. The percentage last year was 77 and in the two preceding
seasons 90 and 84. It is urgently necessary that municipal
authorities should set this matter right otherwise the results will be
disastrous. In Jubbulpore there are over 5,000 unprotected
children. Small-pox is already gaining ground in many places and
several towns such as Akola, Balapur, Harda, Khandwa, etc., are
now paying the penalty for their apathy and indifference towards
vaccination and other towns will follow suit.
16. Deaths from small-pox.—There were 420 deaths
from small-pox recorded against 373 in the previous year. I do
not think this number represents the true state of affairs since the
epidemic reports and others show that the disease has committed
serious havoc in many places.
17. General.—From the above notes it will be seen that
vaccination work is being neglected both in municipal towns and
rural areas, mainly owing to the apathy and indifference of the
local bodies. As this is the fifth year since the last big epidemic
of small-pox and there is every likelihood of the disease assuming
serious proportions, I would very strongly urge these bodies to
adopt drastic measures to work off the arrears accumulating during
the past few years.
18. Under the Local Self-Government Act, 1920, sec-
tion 21 (d), the local bodies are responsible for vaccination. In
all but four districts—Jubbulpore, Seoni, Damoh and Balaghat—
the District Council has delegated definite powers to the Civil
Surgeon and work has been going on harmoniously. In the above
four districts the position is not clear although the Civil Surgeon
does the work and efforts are being made to arrive at a settlement.
19. Some suggestions are now being made by local bodies
to train school masters as vaccinators and also hand over work to
dispensary Assistant Medical Officers. I fail to see any advan-
tage—the ordinary duties of these men will be interfered with while
checking of results and discipline will be made more difficult.
The need for compulsory vaccination in rural areas is more
in evidence. The case has been represented to Government.
Work in municipal towns requires close supervision and the
bylaws on the subject rigid enforcement.
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20. Cause of delay in the submission of the report—
The cause of delay in the submission of this report is as usual the
late receipt of reports and statements from many districts. Seoni
sent its report in June. The report from Chanda that has to come
through the Commissioner has not yet reached this office.
T. G. N. STOKES, M.B., LT.-COL., I.M.S.,
NAGPUR:
The 10th July 1924.
Director of Public Health,
Central Provinces.