NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
40
A—VACCINE DEPARTMENT.
Statement No. II showing the Cost of the Department in the Madras Presidency for the official year 1915-16—continued.
Number.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
Municipalities.
Adōni
...
...
...
...
...
...
Anantapur ... ... ... ... ... ...
Anakāpalle ... ... ... ... ... ...
Bellary
...
...
...
...
...
...
Berhampur
...
...
...
...
...
...
...
Bezwada ... ... ... ... ... ...
Bimlipatam
...
...
...
...
...
...
...
Calicut
...
...
...
...
...
...
...
Cannanore
...
...
...
...
...
...
...
Chicacole
...
...
...
...
...
...
...
Chidambaram ... ... ... ... ... ... ...
Chingleput
...
...
...
...
...
...
...
Cochin
...
...
...
...
...
...
...
Cocanada
...
...
...
...
...
...
...
Coimbatore
...
...
...
...
...
...
...
Conjeeveram ... ... ... ... ... ... ...
Coonoor
...
...
...
...
...
...
...
Cuddalore
...
...
...
...
...
...
...
Cuddapah
...
...
...
...
...
...
...
Dindigul
...
...
...
...
...
...
Ellore
...
...
...
...
...
...
...
Erode
...
...
...
...
...
...
...
Gudiyāttam ... ... ... ... ... ... ...
Guntūr ... ... ... ... ... ... ...
Hospet
...
...
...
...
...
...
...
Karūr ... ... ... ... ... ... ...
Expenditure—cont.
Travelling allowauce.
16
RS. A. P.
...
...
...
...
...
3 12 6
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Contingencies.
17
RS.
143
18
67
80
56
42
36
276
92
28
42
47
45
175
90
117
42
142
37
65
154
43
39
92
40
23
A.
2
15
2
0
7
10
10
2
2
14
14
10
2
14
11
9
11
8
7
3
0
10
6
1
15
14
P.
8
2
8
3
11
5
5
4
8
9
1
1
7
3
4
9
11
1
1
10
5
8
8
9
1
7
Total cost.
18
RS.
490
146
222
744
296
420
192
823
332
373
253
191
267
637
679
419
345
562
1,93
241
598
271
173
609
160
318
A.
2
2
4
12
7
10
7
12
2
9
6
10
10
6
3
9
5
0
7
15
5
10
11
13
15
14
P.
8
7
8
9
11
5
9
3
8
1
1
1
4
3
4
9
9
1
1
11
8
8
2
2
1
7
Paid from
Imperial funds.
19
RS. A. P.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Provincial funds.
20
RS. A. P.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Local funds.
21
RS. A. P.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Municipal funds.
22
RS.
490
146
222
744
296
420
192
823
332
373
253
191
267
637
679
419
345
562
193
241
598
271
173
609
160
318
A.
2
2
4
12
7
10
7
12
2
9
6
10
10
6
3
9
5
0
7
15
5
10
11
13
15
14
P.
8
7
8
9
11
5
9
3
8
1
1
1
4
3
4
9
9
1
1
11
8
8
2
2
1
7
Total.
23
RS.
490
146
222
744
296
420
192
823
332
373
253
191
267
637
679
419
345
562
193
241
598
271
173
609
160
318
A.
2
2
4
12
7
10
7
12
2
9
6
10
10
6
3
9
5
0
7
15
5
10
11
13
15
14
P.
8
7
8
9
11
5
9
3
8
1
1
1
4
3
4
9
9
1
1
11
8
8
2
2
1
14
Number of all successful
primary
vaccination
and
re-vaccination.
24
1,225
209
630
3,004
1,655
1,410
566
5,939
1,579
666
825
795
1,241
1,698
1,968
1,726
574
2,482
531
971
2,741
880
751
2,262
882
508
Average cost of each suc-
cessful case.
25
RS
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
A.
6
11
5
4
2
4
5
2
8
9
4
3
3
6
5
3
9
3
5
4
3
4
3
4
2
10
P.
5
2
8
0
10
9
5
3
4
0
11
10
5
0
6
11
7
7
10
0
6
11
8
4
11
1
42
B—DISPENSARY VACCINATION.
STATEMENT No. III showing Dispensary Vaccination in the Madras Presidency for the official
year 1915-16.
Districts.
1
Anantapur ... ...
Bellary
...
...
...
Chingleput ... ... ...
Chittoor
...
...
...
Coimbatore ... ...
Cuddapah
...
...
Ganjām
...
...
Gōdāvari (L.F. Amala¬
pur hospital).
Guntūr
...
...
...
Kistna ... ... ...
Kurnool ...
...
...
Madras ... ... ...
Madura (Municipal hos
pital, Kodaikānal).
Malabar ... ... ...
Nellore ... ... ...
Nilgiris ... ... ...
North Arcot ... ...
Rāmnād
...
...
Salem ... ... ...
South Arcot ... ...
South Canara ... ...
Tanjore
...
...
...
Tinnevelly ... ...
Trichinopoly ... ...
Vizagapatam ... ...
Koraput ... ...
Total ...
Number of dispensaries in
each district to which a
vaccinator is attached.
2
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Average number of vacci
nators attached to dis
pensaries during the year.
3
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Total number of persons
vaccinated.
4
...
...
...
...
...
...
...
10
...
...
...
...
130
...
...
...
...
...
...
...
...
...
...
...
...
...
*140
Average number of per
sons vaccinated by each
vaccinator.
5
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Primary vaccination.
Total number of
operations.
6
...
...
...
...
...
...
...
...
...
...
...
...
99
...
...
...
...
...
...
...
...
...
...
...
...
...
*99
Successful.
Under one year.
7
...
...
...
...
...
...
...
...
...
...
...
...
59
...
...
...
...
...
...
...
...
...
...
...
...
...
59
Over one and
under
six
years.
8
...
...
...
...
...
...
...
...
...
...
...
...
35
...
...
...
...
...
...
...
...
...
...
...
...
...
35
Total of all
ages.
9
...
...
...
...
...
...
...
...
...
...
...
...
96
...
...
...
... ...
...
...
...
...
...
...
...
...
96
Unknown.
10
...
...
...
...
...
...
...
...
...
...
...
...
1
...
...
...
...
...
...
...
...
...
...
...
...
...
1
Re-
vaccination.
Total number of
operations.
11
...
...
...
...
...
...
...
11
...
...
...
...
31
...
...
...
...
...
...
...
...
...
...
...
...
...
*42
Successful.
12
...
...
...
...
...
...
...
9
...
...
...
...
24
...
...
...
...
...
...
...
...
...
...
...
...
...
33
Unknown.
13
...
...
...
...
...
...
...
2
...
...
...
...
1
...
...
...
...
...
...
...
...
...
...
...
...
...
3
Percentage of
successful cases
in which the
results were
known.
Primary vaccina
tion.
14
...
...
...
...
...
...
...
...
...
...
...
...
97.9
...
...
...
...
...
...
...
...
...
...
...
...
...
97.9
Re-vaccination.
15
...
...
...
...
...
...
...
100.0
...
...
...
...
80.0
...
...
...
...
...
...
...
...
...
...
...
...
...
84.6
Percentage of
unknown cases to
total operations.
Primary
vaccina
tion.
16
...
...
...
...
...
...
...
...
...
...
...
...
1.0
...
...
...
...
...
...
...
...
...
...
...
...
...
1.0
Re-vaccination.
17
...
...
...
...
...
...
...
18.1
...
...
...
...
3.2
...
...
...
...
...
...
...
...
...
...
...
...
...
7.1
* Difference between number of operations and number of persons vaccinated equals 1. This shows secondary operations.
43
STATEMENT No. IV showing the number of persons primarily vaccinated and the number of those persons who were successfully vaccinated in the Madras Presidency
in each of the undermentioned years.
—
Government vaccinators ...
Local Fund
do. ...
Cantonment
do.
...
Zamindari
do. ...
Municipal
do. ...
Dispensaries
do. ...
Medical Subordinates ...
Total ...
Persons primarily vaccinated.
Total number.
Number success-
fully vaccinated.
1906-1907.
19,958
1,207,394
5,041
4,356
116,654
1,304
3,038
1,357,745
18,054
1,081,374
4,892
8,989
110,989
1,024
2,280
1,222,602
Total number.
Number success-
fully vaccinated.
1907-1908.
12,918
1,309,814
4,687
...
108,261
93
2,121
1,437,924
11,557
1,176,323
4,542
...
102,615
78
1,558
1,296,673
Total number.
Number success-
fully vaccinated.
1908-1909.
12,478
1,373,883
5,164
...
110,669
129
1,045
1,503,368
11,319
1,265,809
5,072
...
106,433
120
758
1,389,571
Total number.
Number success-
fully vaccinated.
1909-1910.
12,448
1,319,314
4,134
...
111,045
18
369
1,447,328
11,758
l,163,628
4,023
...
105,198
18
214
1,284,839
Total number.
Number
success-
fully vaccinated.
1910-1911.
11,214
1,240,602
4,187
...
111,754
5
411
1,368,173
10,270
1,027,398
3,963
...
102,748
5
229
1,144,613
Total number.
Number success-
fully vaccinated.
1911-1912.
11,897
1,328,350
3,606
...
111,070
65
497
1,455,485
10,545
1,133,157
3,421
...
103,028
60
322
1,260,527
Total number.
Number success-
fully vaccinated.
1912-1913.
15,646
1,277,687
4,821
...
103,170
17
206
1,401,547
13,254
1,118,513
4,681
...
99,018
11
118
1,235,625
* Total number.
Number success-
fully vaccinated.
1913-1914.
17,492
1,335,023
5,021
...
110,076
6
139
1,467,757
17,015
1,223,086
4,916
...
106,611
6
114
1,351,748
* Total number.
Number success-
fully vaccinated.
1914-1915.
19,843
1,333,727
4,282
...
113,408
1
131
1,471,392
17,892
1,186,576
3,949
...
108,742
...
117
1,317,277
* Total number.
Number success-
fully vaccinated.
1915-1916.
16,052
1,332,471
4,354
...
112,146
99
1,681
1,466,803
14,283
1,155,851
4,152
...
106,830
96
1,464
1,282,676
* As per G.O. No. 1158 L., Mis., dated 4th September 1911.
48
Statement No. VII showing Inspection Work done by the Deputy Inspectors during the year 1915-16—continued.
District.
1
Tanjore
...
Tinnevelly ...
Trichinopoly.
Vizagapatam.
Koraput ...
Circle.
2
Tanjore ... ... ...
Negapatam
...
...
Pattukkōttai
...
...
Kumbakōnam ...
...
Shermadevi
...
...
Srivaikuntam ... ...
Koilpatti
...
...
...
Trichinopoly
...
...
Ariyalūr
...
...
...
Nāmakkal ... ...
Vizagapatam
...
...
Vizianagram
...
...
Pārvatīpuram
...
...
Gunupur
...
...
...
Jeypore ... ...
...
Koraput
...
Total ...
Number of inspect
ing officers.
First-grade Deputy
Inspectors.
3
...
1
...
...
...
1
...
1
...
...
...
...
...
...
...
...
18
Second-grade Deputy
Inspectors.
4
1
...
...
...
1
...
1
...
...
...
1
...
...
...
1
1
25
Third-grade Deputy
Inspectors.
5
...
...
1
1
...
...
...
...
1
1
...
1
1
1
...
...
37
Number of villages visited.
First-grade Deputy
Inspectors.
6
...
311
...
...
...
1,085
...
883
...
...
...
...
...
...
...
...
8,929
Second-grade Deputy
Inspectors.
7
276
...
...
...
268
...
298
...
...
...
445
...
...
...
820
955
12,904
Third-grade Deputy
Inspectors.
8
...
...
507
417
...
...
...
...
204
676
...
360
409
365
...
...
14,119
Total number of cases
vaccinated.
9
12,844
17,349
19,558
18,415
22,563
26,298
21,513
24,238
16,604
20,052
52,619
44,952
26,500
10,970
17,602
10,380
1,577,460
Number of days spent on
Inspection duty.
10
235
254
272
270
241
252
262
221
208
247
234
246
211
238
200
314
19,025
Number of cases verified.
First-grade Deputy
Inspectors.
11
...
12,014
...
...
...
18,332
...
15,174
...
...
...
...
...
...
...
...
241,173
Second-grade Deputy
Inspectors.
12
9,013
...
...
...
15,521
...
13,208
...
...
...
29,839
...
...
...
10,067
8,082
336,184
Third-grade Deputy
Inspectors.
13
...
...
13,464
11,319
...
...
...
...
14,131
16,890
...
19,106
15,365
6,877
...
...
464,865
Total number of cases in
spected by Deputy Inspec
tors of all sorts.
14
9,013
12,014
13,464
11,319
15,521
18,332
13,208
15,174
14,131
16,890
29,839
19,106
15,365
6,877
10,067
8,082
1,042,222
Total number of successful
cases as reported by
Deputy Inspectors.
15
7,975
10,996
12,935
8,686
13,062
13,069
10,620
13,687
11,674
14,404
22,731
12,726
10,464
5,394
7,625
6,862
818,262
Percentage
of successful
cases to the total number
inspected as reported by
Deputy Inspectors.
16
85.5
91.5
96.1
76.7
84.2
71.3
80.4
90.2
82.6
85.3
74.9
66.6
68.1
78.4
75.7
84.9
78.5
Proportion per cent of in
spection to total number
vaccinated.
First-grade Deputy
Inspectors.
17
...
69.2
...
...
...
69.7
...
62.6
...
...
...
...
...
...
...
...
69.6
Second-grade Deputy
Inspectors.
18
70.2
...
...
...
68.8
...
61.4
...
...
...
56.7
...
...
...
57.1
77.8
68.8
Third-grade Deputy
Inspectors.
19
...
...
68.8
61.5
...
...
...
...
85.1
84.2
...
42.5
57.9
62.6
...
...
62.6
Government of Madras.
LOCAL AND MUNICIPAL DEPARTMENT.
G.O. No. 1299 L., 22nd September 1916
Vaccination
Report on the working of the — department in the Madras Presidency during the year
1915-16 reviewed.
No. 1299 L., 22ND SEPTEMBER 1916
3
6. The average cost of each successful operation in the case of local fund vacci
nators was the same as in the last year, viz., As. 3-8. In the case of the municipal
vaccinators it fell from As. 4-11 to As. 4-4, in spite of a slight increase in the cost of
establishment. There appears to be room for further reduction since it should be
cheaper to carry out these operations within the limits of a single town than it is when
the vaccinators have to cover the whole area of a district. The cost was in excess of
As. 5 in the districts of Chingleput, Koraput, Gōdāvari and Cuddapah and in
excess of As. 8 in the municipalities of Anantapur, Karur, Coonoor, Chicacole
and Peddapuram. The local authorities concerned should analyse these high figures
and see whether a reduction is not feasible.
7. The number of children under one year of age successfully vaccinated fell by
27,867. The districts in which a large decrease was noticeable were Gōdāvari,
Kurnool, Ganjām and Vizagapatam. Similar decreases occurred in Madras and in the
Calicut, Salem and Trichinopoly municipalities. The Government note with regret
that in Nellore and Palni less than one-half of the children available for vaccination
according to the registers of births were protected against small-pox, which is one of
the common causes of infant mortality.
8. The Deputy Inspectors of Vaccination showed 68.1 per cent of the total
number of primary and secondary vaccinations in all areas except the cantonments as
having been verified by them, and 32.7 per cent of the number of cases re-vaccinated.
The District Medical and Sanitary Officers verified a small percentage of primary and
secondary operations. In Bellary, Coimbatore, Guntūr, Madura and Rāmnād the
total number of cases verified by them was less than 1 per cent of the total number of
operations. The verification work done by the Sanitary Assistants to the District
Medical and Sanitary Officers was less than 2 per cent in Gōdāvari and Guntūr and
less than 1 per cent in North Arcot, Kistna and Tanjore. The attention of the
President, District Board, Gōdavari, will be called to the coincidence of neglect of
control by the Sanitary Assistant with the extraordinarily bad results above
commented on.
9. The proposals of the district boards for the re-organization of the vaccination
staff continued to be received throughout the year, those from Guntūr being still due.
The scrutiny of the remainder is in progress and it is hoped that it will be possible to
issue orders at an early date.
(True Extract.)
C. G. TODHUNTER,
Acting Secretary to Government.
To the Sanitary Commissioner.
„ the Sanitary Engineer.
„ the Surgeon-General.
„ Medical Section.
„ Home Department (Judicial).
„ Revenue Department.
„ Assistant Quartermaster-General, 9th (Secunderabad)
Division (with C.L.).
„ Director of Public Instruction.
„ Accountant-General.
„ President, Corporation of Madras.
„ all Collectors.
„ all Presidents of District Boards.
„ all Chairmen of Municipal Councils.
Editors' Table.
AGENTS FOR THE SALE OF MADRAS GOVERNMENT
PUBLICATIONS.
IN INDIA.
A. C. BARRAUD & Co. (Late A. J. COMBRIDGE & Co.), Madras.
R. CAMBRAY & Co., Calcutta.
E. M. GOPALAKRISHNA KONE, Pudumantapam, Madura.
HIGGINBOTHAMS (Ltd.), Mount Road, Madras.
V. KALYANARAMA IYER & Co., Esplanade, Madras.
G. C. LOGANADHAM BROTHERS, Madras.
S. MURTHY & Co., Madras.
G. A. NATESAN & Co., Madras.
The Superintendent, NAZAIR KANUN HIND PRESS, Allahabad.
P. R. RAMA IYAR & Co., Madras.
D. B. TARAPOREVALA SONS & Co., Bombay.
THACKER & Co. (Ltd.), Bombay.
THACKER, SPINK & Co., Calcutta.
S. VAS & Co., Madras.
S.P.C.K. PRESS, Madras.
IN THE UNITED KINGDOM.
B. H. BLACKWELL, 50 and 51, Broad Street, Oxford.
CONSTABLE & Co., 10, Orange Street, Leicester Square, London, W.C.
DEIGHTON, BELL & Co. (Ltd.), Cambridge.
T. FISHER UNWIN (Ltd.), 1, Adelphi Terrace, London, W.C.
GRINDLAY & Co., 54, Parliament Street, London, S.W.
KEGAN PAUL, TRENCH, TRÜBNER & Co. (Ltd.), 68—74, Carter Lane, London,
E.C., and 25, Museum Street, London, W.C.
HENRY S. KING & Co., 65, Cornhill, London, E.C.
P. S. KING & SON, 2 and 4, Great Smith Street, Westminster, London, S.W.
LUZAC & Co., 46, Great Russell Street, London, W.C.
B. QUARITCH, 11, Grafton Street, New Bond Street, London, W.
W. THACKER & Co., 2, Creed Lane, London, E.C.
OLIVER AND BOYD, Tweeddale Court, Edinburgh.
E. PONSONBY (Ltd.), 116, Grafton Street, Dublin.
ON THE CONTINENT.
ERNEST LEROUX, 28, Rue Bonaparte, Paris.
MARTINUS NIJHOFF, The Hague, Holland.
ANNUAL REPORT
ON
VACCINATION IN THE MADRAS
PRESIDENCY
AND ON THE WORK OF THE
VACCINE SECTION OF THE KING INSTITUTE
OF PREVENTIVE MEDICINE, MADRAS
FOR THE YEAR
1916-17.
MADRAS:
PRINTED BY THE SUPERINTENDENT, GOVERNMENT PRESS.
PRICE, 10 annas.]
1917.
[1 shilling.
D. No. 548/V.
OFFICE OF THE SANITARY COMMISSIONER,
MADRAS, 31st July 1917.
From
MAJOR W. A. JUSTICE, M.B., C.M., D.P.H., I.M.S.,
Sanitary Commissioner for Madras,
To
THE SECRETARY TO GOVERNMENT,
LOCAL AND MUNICIPAL DEPARTMENT.
SIR,
I have the honour to forward herewith the report of the Director, King
Institute, Guindy, on the working of the Vaccine Section of the Institute and
that of the Deputy Sanitary Commissioner, Madras, on the progress of Vaccination
in the Madras Presidency during the official year 1916-17.
VACCINE SECTION OF THE KING INSTITUTE, GUINDY.
2. (i) General.—The work of the section was uniformly satisfactory. Credit
is due to Dr. Gibson and his Assistants for the continued efficiency and
usefulness of the Institute.
(ii) Vaccine.—The experiment of storing vaccine lymph in the raw
condition and grinding and mixing it with lanoline as required for issue was
discontinued. The vaccine was prepared throughout the year on the old method
and the bulk of the lymph supplied was lanolinated vaccine. Glycerinated
vaccine also was supplied to Madras and to Colombo for seed lymph.
Supplies to local bodies of lanolinated vaccine were made fortnightly as
usual. In a few selected towns, however, tri-monthly supplies were ordered as an
experimental measure to see whether such frequent supplies would effect any
improvement in the local success rates. The result of the experiment is under
observation. Its extension to other tracts will depend upon whether reports are
favourable or not.
The total average success rate of the year was 86.81 per cent of cases
vaccinated against 87.70 per cent in 1915-16. The highest rate (90.03 per cent)
was recorded in October and the lowest (82.55 per cent) in June. Judged with
reference to districts, Kurnool (96.85 per cent) takes the first place and Gōdāvari
(68.34 per cent) the last. The success rate was also bad in several other districts,
Coimbatore and Gōdāvari are conspicuous in returning lowest success rates year
after year. Chingleput, their companion in previous years, shows some improve
ment during the year under review. The local bodies of all these three districts
are fully aware of the uniform backward condition of vaccination in their
jurisdictions. The reports received from them on this feature with reference to
paragraph 5 of G.O. No. 1299 L., dated 22nd September 1916, were duly forwarded
to Government. Proposals to improve the present conditions in their districts
have been framed and revised instructions issued defining clearly the period within
which the vaccine despatched from the Institute should be used by the vaccina
tors. The putting in operation of these remedial measures is now in the hands of
the local bodies and the necessity of seeing that the revised regulations are
properly enforced should be impressed upon them.
(iii) There was a further fall in the cost of the Vaccine Section of the
Institute from Rs. 41,814 in 1915-16 to Rs. 38,962 during the year under review.
The principal budget head which showed decreased expenditure was "contingen-
cies ." This saving has resulted in a slight reduction (0.08 pies) in the price of
each vaccine case manufactured at the Institute.
2
VACCINATION DEPARTMENT.
3. (i) Deputy Sanitary Commissioner and his inspections.—There was only one
Deputy Sanitary Commissioner on duty during the year against the sanctioned
strength of three. His work was satisfactory as can be judged from the several
inspections he has made and the pains he has taken to enquire into several cases
of Deputy Inspectors' misconduct for which they have been suitably admonished
or punished.
(ii) Vaccination staffs.—The discipline of the subordinate staffs of the
department was satisfactorily maintained during the year. A grievance, however,
exists on account of the delay in giving effect to the new scale of pay, etc. The
present class of man employed as vaccinators is quite unsatisfactory and the
sooner steps are taken to replace them by a better class on enhanced rates of pay
the better. Nearly 70 per cent of our present day vaccinators get pay varying
from Rs. 5 to Rs. 12 per mensem and it is not difficult to imagine what type of
man will accept this. To continue this rate of pay which would bring in only
very inferior men is, in my opinion, false economy and no delay should take place
in bringing the new scheme into force.
(iii) Results of vaccination, etc.—The total number of cases vaccinated both
under " Primary" and " Re-vaccination" showed a decline from 1,801,170 in
1915-16 to 1,699,926 during the year under report, in spite of the greater preva-
lence of small-pox in the Presidency. Primary vaccination is compulsory in only
municipal areas and in a few selected tracts within District Board areas, while
re-vaccination is optional throughout the Presidency. The protective value of
vaccination would become better appreciated should primary vaccination be made
compulsory throughout the Presidency and re-vaccination at least in tracts imme-
diately threatened with small-pox epidemics. The question of conferring on
District Board Presidents the power to extend compulsory provisions of vaccina-
tion to re-vaccination in areas where small-pox assumes epidemic proportions
may be considered in connection with the proposed amendment of the Local
Boards Act.
The average success rate, both under primary and re-vaccination, fell from
86.0 per cent of cases vaccinated in 1915-16 to 85.0 per cent in 1916-17. The
decrease is mostly attributable to the causes enumerated by the Deputy Sanitary
Commissioner in paragraph 5 (iii) of his report. The employment of better
qualified vaccinators for actual vaccination work and a close adherence to the
regulations issued by this office for the correct method of vaccinating cases are
the only remedies to bring about a better state of things. These matters should
receive the earnest attention of all local bodies.
I have the honour to be,
Sir,
Your most obedient servant,
W. A. JUSTICE, MAJOR, I.M.S.,
Sanitary Commissioner for Madras.