2
the efficacy of vaccination, but rather that, while they realise the
advantages of vaccination and have recourse thereto in the presence of
danger, the natural tendency of the inhabitants of remote areas is to neglect
precautions until the danger becomes very obvious. Government, how-
ever, are of opinion that the work of the special staff in the Hill States is
of extreme importance and should be continued, as one of the lessons
learned from the epidemic of cholera in Kulu in 1928 was the menace to
British territory from epidemics spreading from territories over which
Government have no control, and the experience of Kulu last year and of
the hills generally in the influenza epidemic of 1918 was that an epidemic
can spread with amazing rapidity in the apparently healthy mountain
valleys.
6. Government agree with you that the figures for successful
vaccination and re-vaccination show that the vaccine lymph supplied was
of a high standard, and congratulate the officers of the Public Health
Department who are responsible for this result.
7. The fact that a large number of the towns which have intro¬
duced the compulsory provisions of the Vaccination Act have so far failed
to draw up suitable rules to carry out the purposes of the Act is unsatis-
factory, and the Ministry proposes to take steps to bring this important
matter to the notice of local bodies.
8. Since the close of the year under report an Act has been passed
by the Legislative Council which will enable district boards as well as
municipal committees to extend the benefits of compulsory vaccination
to areas under their control.
9. Government view with satisfaction the fact that a start has
been made in employing female vaccinators and health visitors for
vaccinating purdah ladies and trust that this useful system will be
extended.
10. The practice of small-pox inoculation referred to in the report
as having been carried out by certain persons unknown in a village in
the Mianwali district, and the possibility of the practice being carried
on in remote villages elsewhere are matters which require careful watching.
A report should be submitted to Government if further information
comes to light.
11. The diagram attached to the report is an interesting exposi-
tion of cause and effect. Although there are exceptions and variations,
it shows clearly that the higher the number of successful vaccinations
the lower is the incidence of small-pox. The district of Montgomery
should take to heart the lesson to be deduced from the fact that with
the lowest record of vaccination in the past five years it has the highest
small-pox record for that period and, with one exception, the highest
record of small-pox also in the year under report. It is observed that
the table is drawn up in order of merit based on the number of vaccina-
tions per 10,000 of the population during the five years preceding the
year under report and it is noteworthy that out of nine districts where
the death rate per 10,000 was 5 or more during the year in question
no less than seven are in the second half of the table.
12. In conclusion I am desired to congratulate you and your
officers on a satisfactory year's work, and in particular to request that
the appreciation of Government may be conveyed to the officers whose
services you have brought to the notice of Government in paragraph 19 of
your letter under reply.
I have, etc.,
ALAN MITCHELL,
Offg. Secretary to Government, Punjab,
Transferred Departments.
76 CS—436—22-4-29—SGPP Lahore