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Scheme for extending operations with
animal lymph.
19. A scheme is at present under consideration for extending the operations of
the bovine lymph depôt at Lucknow during the
cold season, and for establishing a similar depôt in
the hills from which lymph can be despatched to
applicants during the recess season, and from which also the material necessary for
establishing the vesicle throughout the Provinces in September can be sent. Such an
institution has long been a desideratum in these Provinces. With the exception of the
one at Lucknow, none of the local depôts can be said to have worked altogether satis-
factorily. A certain amount of animal lymph has been cultivated and used in the head-
quarters' station with success, but it has proved of little efficacy if not used immediate-
ly. The fact is that the matter is one requiring the supervision of an expert, with
adequate time and means at his disposal.
Period during which operations are
performed in the plains.
20. For the last three years, efforts Lave been made to carry on vaccination in
the plains throughout the year. The system has
always been unpopular, not only with the people and
the vaccinators, but also with the authorities who had the best opportunity of watch-
ing the results. As a matter of fact not much was ever done, as compulsion was il-
legal in municipalities and vaccination optional in the district. In the Government
review of the Report of last year it was ordered that the matter should be given care-
ful consideration and Civil Surgeons consulted. These officers and the Deputy Sanitary
Commissioners were practically unanimous on the point. They stated that during the
hot weather and rains foul sloughing sores often followed the operations, that the
system was arousing hostility in localities where the people had begun to accept vacci-
nation, and finally, that the lymph when taken from the vesicles was very commonly
either purulent or inactive. It is now ordered that hot weather vaccination operations
shall only be carried on when small-pox is present in any district in an epidemic form.
Small-pox during the past season.
21. After much immunity from small-pox for several years, this disease-
appeared in these provinces in an epidemic form in
the autumn of 1895 and spring of 1896.
There were 53 deaths in October, 114 in November, 312 in December 1895, 710
in January, 1,284 in February and 2,869 in March 1896.
The districts which suffered most severely were Jalaun, Jhánsi, Agra, Unao,
Bareilly, Allahabad, Cawnpore, Benares, Aligarh, Pilibhít, Muttra, Bulandshahr,
Etáwah and Bahraich, all of which showed a death-rate from this cause of over .1 per
mille, ranging from .78 in Jalaun to .10 in Bahraich. This death-rate by no means
represents the actual incidence of the disease, since many cases occurred ending in re-
covery, for one case which terminated fatally. There are no records to show what
numbers were actually attacked and recovered, but from inquiry and investigation,
it appears clear that the epidemic was very widespread. In well vaccinated localities,
numerous cases occurred in protected people who, while a source of danger to others,
passed through the disease with little difficulty or risk. I have examined many of
these cases occurring in adults who had been efficiently vaccinated as children, and the
symptoms were often so slight as to be only recognized on close inspection. They
served, however, just as efficiently as severe cases, to spread the disease—indeed more
so, since they mingled more freely with the general population. Re-vaccination has
never been extensively practised in these Provinces, and indeed is carried on with
difficulty, since the bread winner is seldom willing to partially cripple himself for a
fortnight. The large number of vaccinated adults who suffered from the disease in
a slight and modified form, attracted attention early in the epidemic, and a circular was
issued to all Civil Surgeons inviting attention to the necessity of as far as possible
increasing and extending re-vaccination operations in the provinces. This was in most
cases complied with, and the number of successful re-vaccinations rose from 16,203 in
1894-95, to 36,318 in the year under report—or more than double.
Special steps were taken where necessary, extra men were appointed, and opera-
tions continued later than usual. At Benares, Surgeon-Major Sweeny had notices
posted about the city that disinfectants were available at the thanas, and the relatives