4
REPORT ON VACCINATION.
6. Great as the increase in vaccine operations was, it would have been still
more satisfactory if the local authorities in Bellary, Kurnool, Nellore, and South
Arcot had taken full advantage of the assemblage of the people on famine relief to
extend vaccination. The best results of all were obtained in the town of Madras,
where no fewer than 116,335 persons were vaccinated by the regular staff and the
temporary establishment entertained for house-to-house visitation. The numbers
vaccinated in Chingleput, Coimbatore, Salem, North Arcot, Cuddapah, and Madura
were very much above the average.
7. Dr. Shortt, the Inspector of Vaccination, at my request devoted much
personal attention to the extension of vaccination in the town and relief camps of
Madras, and to the organization of a temporary establishment to assist in the house¬
to-house visitation sanctioned under G.O., No. 174, of 13th February 1877. In the
course of the year besides this work he inspected the vaccine arrangements in
North Arcot, Cuddapah, Coimbatore, Chingleput, and Malabar.
8. The lymph employed was on the whole of good quality, as I had abundant
means of observing from constant inspection of famine camps ; but in some of the
children who had been subjected to long privation the vesicles did not appear
healthy, and in a few cases the arms ulcerated. This result, commented on by
Dr. Shortt in his inspection of the North Coimbatore Circle, was, I believe, due more
to the low health of the children than to defects in vaccination. Recent inspection
of the work in Bhavani and Erode in healthy and well-nourished children, shows
the lymph to be unexceptionable, and the work satisfactory in every respect.
9. The number of children under one year of age vaccinated was 68,110.
These results in regard to the actual births in the several districts are unsatis-
factory. It is very difficult, however, to persuade the people that vaccination should
be done during the infantile period of life, and the intelligent counsel and aid of
district officers is much needed to impress upon the people that the proper age for
vaccination is that previous to teething. More support is given to vaccinators than
formerly by village and district officials, but there is still much room for improve-
ment in some of the districts.
10. Small-pox was unusually prevalent and fatal in 1877, but in the greater
part of the Presidency it had declined very much before the end of the year. In
the early months of 1878 it continued to be very prevalent and fatal in Godavari,
Tanjore, South Arcot and Salem. In regard to the prevalence of this disease, the
experience of the various famine camps showed that it could be absolutely
controlled by effective vaccination. Measures essential to the safety of the people
in famine centres, however, cannot be applied to scattered populations of rural
districts, without legal powers compelling the people to have their children
vaccinated within the early months of life.
11. The present report, prepared before the issue of G.O., No. 1,116 of 26th
June 1878, includes the vaccinations performed in a few military cantonments
beyond the Presidency limits. The reasons for the inclusion of such operations in
those of the general report were, I imagine, because the Vaccinators are paid by
the Madras Government, and their work principally confined to the floating
populations of camp-followers, who are subjects of, and mainly belong to, the
Presidency. The numbers are separately given, but if Government desire it the
returns of these cantonments can be excluded in future reports.
12. In regard to the operations performed by Medical Subordinates and
private Vaccinators, the instructions of Government have been attended to in
excluding them from the calculations showing the average cost of each operation.
In the year under review Medical Subordinates (chiefly those of jails) vaccinated
28,584 cases, or an increase of 12,831 on the previous year.
13. Only one Civil Dispensary in this Presidency makes any return of vaccin-
ation, i.e., the institution at Cuddalore, where 584 operations were performed.
In my opinion the Medical Officers of the numerous dispensaries established and
paid for out of Local Funds, ought to exert themselves in the extension of vaccina-
tion. As a rule the smaller dispensaries have but few or no in-patients, and the
officers in charge, according to my experience, have abundance of time and oppor¬