6
The average cost of each successful case rose from As. 7-4 in 1919-20 to
As. 10-8 in the year under report. It varied from As. 6-1 in the North Arcot
district to as high as Rs. 1-2-9 in the Nilgiri district ; whilst in municipalities,
excluding Madras, the variations were from Rs. 1-6-10 in Erode to As. 2-8 in
Calicut. The average cost in the Madras Corporation was Rs. 2-8-0 per case.
The increased cost is attributable to the low percentage of success obtained during
the year and to the grant of temporary increases of pay to Deputy Inspectors of
Vaccination, vaccinators and peons.
10. 153,594 operations were performed in municipalities during the year
against 159,764 in the preceding year, the largest decrease occurring in Madras
(—4,959), Ootacamund (—2,772), Cocanada (—2,276), Vizagapatam (—1,597)
and Ellore ( — 1,152).
As regards the state of vaccination in municipal areas it has been brought
to the notice of this office that vaccination has not improved in spite of compul-
sory powers, the main reasons being—
(1) the employment or retention of untrained and unqualified men as
municipal vaccinators ;
(2) the general lack of supervision of their vaccination departments by
municipal authorities; and
(3) the insufficient control of the medical officers responsible for the
supervision of this branch in spite of repeated Government orders.
11. The percentage of success obtained by the use of different kinds of lymph
in local fund and municipal areas is compared in the following table:—
Number of cases
excluding
unknown.
920,850
190,456
82,460
26,330
Area.
Local Fund ...
Do. ...
Municipalities ...
Do. ...
Kind of lymph.
Lanoline lymph ...
Glycerine do. ...
Lanoline do. ...
Glycerine do. ...
Whence obtained.
The King Institute, Guindy ...
Do. ...
Do. ...
Do. ...
Percentage of
success.
65.5
31.8
77.0
88.2
Lanoline lymph was used in all local fund districts and municipalities
until the end of June 1920, but in the months of July and August of the same
year glycerine lymph was issued under orders of Government as a tentative
measure as the former was not yielding good results. The results with the latter
were also unsatisfactory and lanoline lymph was issued during the remaining
portion of the year. The percentage of success obtained with lanoline lymph in
local fund areas and municipalities was 65.5 and 77.0, respectively, whilst that
obtained with glycerine lymph for the same areas were 31.3 and 88.2, respectively.
12. 12,091 deaths occurred from small-pox against 40,592 in the previous
year. The proportion of the population protected in districts and municipalities
during the year is shown in the annexed diagrams.
13. With reference to paragraph 16 of G.O. No. 80-P.H., dated 26th January
1921, steps have been taken to ascertain, on the occurrence of an epidemic of
small-pox, the number of persons protected by vaccination who have contracted
and succumbed to the disease.
14. Inspection of vaccinated cases by Deputy Inspectors of Vaccination
during the year was on the whole fair. Ninety-four Deputy Inspectors of Vacci-
nation have verified over 75 per cent and 15 below 75 per cent but above the old
minimum of 50 per cent. Suitable notice has been taken of those Deputy Inspec-
tors of Vaccination who failed to reach the minimum percentage of verifications.