NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( vi )
STATEMENT
No. III.—Showing Dispensary Vaccination in the North- Western Provinces and Oudh, during the year.
1
Number.
2
District.
3
Number of Dispensaries in
each district to which a
Vaccinator is attached.
4
Average number of Vacci-
nators attached to Dis-
pensaries during the sea-
son.
5
Total number of persons
vaccinated.
6
Average number of persons
vaccinated by each Vacci -
nator
7
8
9
10
Primary Vaccination.
Total.
Successful.
Under one
year.
Nil.
Over one and
under six
years.
Total of all
ages.
11
12
Re-Vaccination.
Total.
Successful.
13
14
Percentage of success-
ful cases.
Primary.
Re-Vaccination.
NOTE.—No special Vaccinators are attached to dispensaries in the North-Western Provinces and Oudh ; and the few operations performed by Civil and Assistant Surgeons and the dispensary
staff are not included in the returns.
( viii )
VACCINATION
COMPARATIVE STATEMENT NO. IV.—Showing the number of persons primarily vaccinated, and the number
the undermentioned
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
27
28
29
30
31
32
33
34
35
36
37
37
38
Circle.
First
Circle.
Second Circle.
Third Circle.
Establishment.
Meerut Division.
Government ... ... ...
Municipal ... ... ...
Local Funds... ... ...
Native States or(Tehri-Garhwál)
Agra Division.
Government... ... ...
Municipal ...
...
...
Local Funds ... ... ...
Native States ... ...
Total of First Circle ...
Kumaun Division.
Government ...
...
...
Municipal
...
Local Funds ...
... ...
Natives States ... ...
Rohilkhand Division.
Government ...
Municipal ... ... ...
Local Funds... ... ...
Native States ... ...
Oudh Division.
Government... ... ...
Municipal ... ... ...
Local Funds ... ... ...
Native States... ... ...
Total of Second Circle ...
Allahabad Division. ...
Government ... ... ...
Municipal
...
... ...
Local Funds ...
... ...
Native States ... ...
Benares Division.
Government... ... ...
Municipal ... ... ...
Local Funds ... ... ...
Native States ... ...
Jhánsi Division.
Government ... ... ...
Municipal ...
...
...
Local Funds... ... ...
Native States ... ...
Gorakhpur Division.
Government... ... ...
Municipal
...
...
...
Local Funds ... ... ...
Native States ... ...
Garhwál District.
Government ... ... ...
Local Funds ...
... ...
Total of Third Circle ...
Grand Total
1885-86.
Total number
66,497
32,262
34,545
7,096
55,317
16,762
8,044
...
220,523
15,772
990
9,423
...
71,929
21,189
12,646
...
22,885
8,643
6,177
5,427
175,081
88,206
7,585
5,053
...
98,693
11,084
14,670
7,233
20,133
5,380
2,798
2,976
...
...
...
...
11,120
1,181
276,112
671,716
Number successful vaccina-
ted.
61,014
29,479
31,831
6,684
51,644
15,453
7,434
...
203,539
13,973
850
8,410
...
61,413
17,478
10,678
16,831
6,553
4,348
4,073
144,607
76,213
5,792
4,257
...
88,145
9,289
12,737
6,472
17,308
4,607
2,473
2,309
...
...
...
...
10,225
1,045
240,872
589,018
1886-87
Total number
65,998
32,931
33,015
6,074
63,120
18,220
8,726
...
228,084
14,989
1,033
9,604
...
75,224
20,979
11,624
...
25,727
9,635
4,253
9,085
182,153
89,025
7,446
4,456
...
103,380
12,043
13,731
7,293
21,694
4,908
1,665
2,075
...
...
...
...
10,790
1,170
279,676
689,913
Number successful vaccina-
ted.
60,379
30,047
30,417
5,798
59,172
17,065
8,052
...
210,930
13,370
865
8,577
...
64,472
17,270
9,506
...
19,659
7,914
3,167
6,704
151,504
79,713
5,999
3,846
...
93,095
10,650
11,778
6,744
19,428
4,598
1,547
1,959
...
...
...
...
10,152
1,075
250,584
613,018
Persons primarily
1887-88.
Total number.
70,591
34,884
35,650
9,239
69,966
22,285
11,618
...
254,233
16,009
1,309
9,545
...
79,499
20,509
13,257
...
27,446
10,887
7,124
7,816
193,401
87,597
7,920
5,370
...
104,454
11,560
13,223
7,716
20,530
5,538
2,713
1,984
...
...
...
...
11,812
1,699
282,116
729,750
Number successful vacc
ted.
64,096
31,605
32,462
8,599
65,378
20,548
10,882
...
233,520
14,344
1,114
8,191
...
69,091
16,669
11,196
...
21,591
8,822
5,469
5,998
162,485
79,863
6,724
4,721
...
95,556
10,735
11,966
7,105
18,323
4,846
2,441
1,809
...
...
...
...
11,033
1,441
256,563
652,568
( ix )
DEPARTMENT.
of those persons who were successfully vaccinated in the North-Western Provinces and Oudh, in each of
official years—(concluded).
vaccinatcd-(concluded).
1888-89.
Total number.
69,907
35,716
37,110
11,181
63,906
21,568
11,048
250,436
17,218
1,198
10,249
80,478
22,376
12,484
...
36,914
12,918
5,430
9,756
209,021
87,971
8,268
5,029
...
108,106
9,627
13,404
8,085
19,253
5,672
2,653
1,964
...
...
...
...
11,454
2,197
283,683
743,140
Number success-
fully vaccina-
ted.
63,847
32,621
34,391
10,587
56,539
18,597
9,688
226,270
15,686
1,042
9,148
69,091
18,547
10,441
...
28,702
9,993
4,092
7,145
173,887
80,012
6,840
4,429
...
100,128
8,907
11,864
7,427
17,327
5,113
2,393
1,856
...
...
...
...
10,859
1,879
259,034
659,191
1889-90.
Total number.
65,214
35,504
37,094
8,122
71,365
22,137
9,862
249,298
16,346
1,210
10,400
82,527
22,866
12,026
...
45,032
20,374
11,375
21,297
243,453
88,862
8,164
4,999
...
116,584
11,045
14,487
7,847
18,782
5,227
2,513
1,953
...
...
...
...
10,725
2,018
293,206
785,957
Number success-
fully vaccina-
ted.
59,893
32,799
34,525
7,486
62,020
18,763
8,630
224,116
15,179
1,090
9,575
74,891
20,186
10,424
...
35,545
16,539
8,626
15,784
207,839
80,346
6,712
4,351
...
108,746
10,079
13,414
7,269
16,994
4,606
2,282
1,806
...
...
...
...
10,285
1,584
268,474
700,429
1890-91.
Total number.
71,641
38,283
40,762
9,796
82,508
23,337
12,895
279,222
15,528
1,782
9,313
82,576
26,726
13,859
...
64,000
26,497
11,775
73,796
325,852
90,782
10,408
4,733
...
155,626
12,184
16,793
9,951
18,838
5,768
2,476
2,139
...
...
...
...
11,785
2,069
343,552
948,626
Number success-
fully vaccina-
ted.
64,614
34,551
37,293
9,347
71,203
20,374
10,659
248,041
14,647
1,648
8,732
75,372
23,347
12,126
...
50,263
21,781
9,331
57,728
274,975
81,293
8,934
4,051
...
143,844
10,800
16,013
9,310
17,228
5,252
2,326
1,955
...
...
...
...
11,485
1,871
314,362
837,378
1891-92.
Total number.
65,708
41,608
41,353
6,569
84,873
27,188
12,542
279,841
15,397
1,724
9,330
88,406
30,295
12,877
...
97,711
33,846
26,721
83,421
399,728
99,969
14,356
7,028
2,249
69,283
10,896
9,303
8,728
...
...
...
...
90,878
3,007
7,146
1,672
11,077
2,105
337,697
1,017,266
Number success-
fully vaccina-
ted.
60,071
38,199
37,748
6,083
69,964
23,186
10,495
245,746
14,519
1,601
8,927
79,990
26,399
11,467
...
76,687
27,933
21,004
60,357
328,884
89,269
12,588
6,136
2,066
63,725
9,549
8,652
8,177
...
...
...
...
80,013
2,476
6,024
1,400
10,706
1,940
302,721
877,351
1892-93.
Total number.
67,663
40,857
44,668
6,760
92,752
25,633
10,138
288,471
14,413
2,127
9,489
92,125
28,238
13,719
...
110,363
32,874
33,613
107,806
444,767
107,403
20,418
7,541
2,471
77,105
12,354
6,347
9,637
...
...
...
...
89,167
3,770
7,140
802
8,787
1,575
354,517
1,087,755
Number success-
fully vaccina-
ted.
62,059
37,742
41,154
6,180
78,051
22,015
8,525
255,726
13,607
1,985
9,197
83,045
24,654
12,216
...
88,781
26,916
26,031
80,827
367,259
97,890
17,656
6,532
2,343
71,338
11,368
5,921
9,129
...
...
...
...
80,352
3,162
6,142
615
8,474
1,457
322,379
945,364
ORDERS OF GOVERNMENT.
No.374/V—231B/1-3 OF 1893
FROM
THE SECRETARY TO GOVERNMENT,
N.-W. PROVINCES AND OUDH,
To
THE SANITARY COMMISSIONER,
N.-W. PROVINCES AND OUDH.
DATED NAINI TAL, THE 2ND SEPTEMBER 1893.
SIR,
ITATION DEPT.
I AM directed to acknowledge the receipt on 10th August 1893
of your triennial report on vaccination, dated 17th June 1893, due on
1st July, which appears to have been unnecessarily delayed in the
Press. The report, though it relates more particularly to the year
ending on 31st March 1893, covers the years 1890-91, 1891-92 and
1892-93. The period has been one of considerable activity, marked by
substantial progress. The number of persons primarily vaccinated
has risen from 785,957 in 1889-90 to 1,087,755 in 1892-93 and
the number successfully vaccinated from 700,429 to 945,364, a rise of
38.3 per cent. in the former case and 34.9 in the latter. The number of
vaccinators, the number of operations performed by each vaccinator, the
ratio per mille of successful operations and the expenditure on vaccina-
tion have all largely increased, from 700 to 824, 1,143 to 1,349, 16.09
to 20.34 and Rs. 1,30,672 to Rs. 1,54,485 respectively.
2. Notwithstanding this advance, it is somewhat disappointing
to note that, owing no doubt to the continued backwardness of Oudh
in the matter of vaccination in spite of the unusual exertions that have
been made at the instance of the Government in that Province, the
ratio of deaths from small-pox in the United Provinces has not decreased,
being 1.98 per mille for the years 1890, 1891 and 1892 and 1.84 per
mille for the previous three years. If however individual districts be
examined, the influence of vaccination in checking the ravages of
small-pox is apparent: it will be seen from the statistics of the last
five years relating to the six districts in which vaccination has been
most and least successful, that a high ratio of protection coincides with
a low ratio of mortality and vice versa :—
District.
Garhwál ...
Almora ...
Naini Tal ...
Saháranpur ...
Muttra ...
Dehra Dún ...
Average annual
number of
persons success-
fully vaccinated
per mille.
47.5
35.6
33.2
28.0
27.0
26.8
Average annual
number of deaths
from small-pox
per mille.
.02
.12
.23
.05
.09
.03
District.
Partábgarh ...
Gonda ...
Kheri ...
Unao ...
Fyzabad ...
Rae Bareli ...
Average annual
number of
persons success-
fully vaccinated
per mille.
3.4
5.6
5.8
6.9
7.8
8.0
Average annual
number of deaths
from small-pox
per mille.
1.0
.97
1.6
2.4
1.0
6.1
( 2 )
The number of persons successfully vaccinated in the North-Western
Provinces and Oudh. has reached 20.34 per 1,000 of the population,
which is still considerably below that of other Provinces : the advan-
tages of vaccination are now far more widely appreciated by the people,
and it is hoped that on an outbreak of small-pox the mortality will
not again reach the high figures of 3.14 and 4.59 per mille as in the
epidemics of 1883 and 1884. The ratio of deaths from this disease in
1892, .16 per 1,000 of the population, is the lowest on record: in the
large towns there were 428 deaths only in all, and many of them,
including Lucknow and Cawnpore, were entirely free from the disease.
It is an encouraging sign that in towns where the proportion of persons
successfully vaccinated nearly doubles that in districts, the death rate
from small-pox in 1892 was .13 per mille as compared with .17 in the
rural tracts.
3. The more important statistics of the year reported on are com-
pared below with those of the previous year :—
1891-92 ...
1892-93 ...
Average
number of
vaccinators
employed.
770
824
Total
number of
persons
vaccinated.
1,059,981
1,112,117
Average
number
vaccinated
by each
vaccinator.
1,376.60
1,349.65
Persons
successfully
vaccinated
per mille.
19.10
20.34
Average
cost of each
successful
case.
A.
2
2
p.
3
7
In the 102 municipalities of the Provinces the number of persons
successfully vaccinated per 1,000 of the population rose to 36.89 and
in the 19 cantonments to 54.42, although, as you point out, the Vaccina-
tion Act, 1880, had not been carried into effect fully in municipalities and
cantonments before the close of the year. Action was taken during
the year for the further extension of the Act and for the making of
rules under the Act, with the result that only seventeen municipalities,
of which eleven are in the Meerut Division, have not as yet adopted
compulsory vaccination for children. Among these the most important
are Háthras, Lalitpur, the headquarters of a subdivision, Deoband,
Kairána, Hápur, Sikandrabad, Khurja and Káshipur: the Municipal
Boards concerned will be again addressed on the subject. In municipali-
ties at headquarters of districts and in most cantonments the Civil Sur-
geon, who has undertaken under the orders of the Government the duties
of superintendence for many years past, has been appointed Superin-
tendent of Vaccination under the Act. I am to point out that the town
of Bhinga has been omitted from the list of municipalities in Appendix
A to your report. You remark in paragraph 36 that there has been no
desire or necessity to enforce the penal sections of the Vaccination
Act, from which it is concluded that no punishments have been inflicted
under section 22 for offences committed. It appears from the returns
attached to the Police Report for 1892 that 249 cases under the Act
were instituted during that year, and that 78 persons appeared before the
Courts, but were all discharged or acquitted. Apart from punishments
however, the Act and the rules made thereunder have imposed duties
on municipal and cantonment authorities and on Superintendents of
( 5 )
Inspections in the 2nd Circle have improved, but the percentage
of inspections to total number vaccinated is still low in some of the
Oudh districts, and the backward district of Basti in the 3rd Circle
did not receive sufficient attention from inspecting officers.
6. The question of the extension, so far as the law permits, of
the vaccination season in municipalities, to which you refer in paragraph
39, will be separately considered. You advocate the performance of
operations at any period and season of the year during the occurrence
of epidemic small-pox. I am to enquire if the practice still prevails
in Oudh of forbidding vaccinators to operate in villages in which small-
pox is prevalent. The Lieutenant-Governor and Chief Commissioner
observes with satisfaction the commendations you bestow on Maulvi
Wazir Ali, Deputy Superintendent of the Agra Division, who is shortly
to retire. I am to remind you of the standing orders which require
that the names of district officials and others who specially exert
themselves in carrying out the wishes of the Government in the
matter of vaccination should be reported.
I have the honor to be,
SIR,
Your most obedient servant,
W. H. L. IMPEY,
Secy. to Govt., N.- W. P. and Oudh.
ANNUAL REPORT
ON
VACCINATION
IN THE
NORTH-WESTERN PROVINCES AND OUDH,
FOR THE YEAR 1893-94.
ALLAHABAD:
NORTH-WESTERN PROVINCES AND OUDH GOVERNMENT PRESS.
1894.
Price Rs 1-4-0.
ANNUAL REPORT
ON
VACCINATION
IN THE
NORTH-WESTERN PROVINCES AND OUDH,
FOR THE YEAR 1893-94.
ALLAHABAD:
NORTH-WESTERN PROVINCES AND OUDH GOVERNMENT PRESS.
1894.
( 2 )
Summary of Allahabad report ... ... ...
Do.
of Hamirpar
do.
...
...
...
Do.
of Jaunpur
do.
...
...
...
Do.
of Gorakhpur do.
...
...
...
Do.
of Basti
do. ... ... ...
Do.
of Azamgarh
do.
...
...
...
Do.
of Mirzapur
do.
...
...
...
Do.
of Benares
do.
...
...
...
Do.
of Ghazipur
do.
...
...
...
Do.
of Ballia
do.
...
...
...
Do.
of Jhansi
do.
...
...
...
Do.
of Jalaun
do. ... ... ...
General results of the operations in the 3 Circles compared ...
Vaccination according to age ... ... ...
Do.
in proportion to births ... ... ...
Re-vaccination
...
...
...
The supply of humanised lymph
...
...
...
List of applicants supplied with lymph, during season 1893-94
Inspection of operations
...
...
...
Great increase in the number of cases inspected
...
General results of inspection
...
...
...
Animal lymph
...
...
...
...
Vaccination and small-pox
...
...
...
Localities in which the Vaccination Act is in force
...
Reports of Deputy Sanitary Commissioners
...
...
Progress in vaccination
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
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...
...
...
...
...
...
...
...
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PAGES.
20
ib.
ib.
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21
ib.
ib.
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ib.
22
ib.
ib.
23
ib.
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ib.
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24
ib.
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25
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27
ib.
ib.
APPENDICES.
Appendix A.—Annual Report on Vaccination in the 1st Circle, by Brigade-Surgeon-Lieutenant-
Colonel R. Jameson, M. D., Deputy Sanitary Commissioner
...
... 2A to 4A
Do.
B.—Annual Report on Vaccination in the 2nd Circle, by Surgeon-Captain W. G.
Thorold, Deputy Sanitary Commissioner
...
...
...
...
5A to 9A
Do.
C.—Annual Report on Vaccination in the3rd Circle, by Surgeon-Major G. M. J.
Giles, Deputy Sanitary Commissioner
...
...
...
...10A to 12A
Do.
D.—Resolution No. 412/V. 267B-12, dated 23rd September 1893 of Government, N.-W.
P. and Oudh, in the Sanitation Department
...
...
...13A
to 17A
ANNUAL REPORT
ON
VACCINATION
IN THE
NORTH-WESTERN PROVINCES AND OUDH,
For the year 1893-94.
Activity and marked progress in vac-
cination.
1. The activity and progress which have characterized vaccine operations in the
North-Western Provinces and Oudh, during the
past few years, are still the leading features of the
annual report on vaccination.
Great increase in the number prima-
rily vaccinated.
2. The total number of persons primarily vaccinated in 1888-89, was 743,140,
and since then the number has risen to 1,839,711.
Besides, there has been substantial progress in
extending operations in every direction where pre-
judice and hostility to the operation were at one
time rampant.
The number of operations exceeds
the number of infants living at the end
of the year.
3. It is a satisfactory feature also of the operations that, in a province with a
population of 47,146,327, the total number pri-
marily vaccinated, now exceeds the average num-
ber representing the infantile community.
It
was stated in last year's report that in a few years
hence, it will be practicable by careful and conciliatory methods, to vaccinate in the
United Provinces up to the Standard of the United Kingdom ; and this hope is becoming
rapidly realized.
Area of administration and operation.
4. The area of administration and operation remained the same as in previous
years, and comprises the whole of the North-
Western Provinces and Oudh and the Native State
of Tehri Garhwál, but excludes the Native State of
Rampur and the Kapurthala estate in Bahraich, where operations are carried on and
controlled by native agency.
Re-organisation of the Department by
which Civil Surgeons are placed in Exe-
cutive control of districts.
5. In accordance with the suggestions of the Government of India, the Vaccina-
tion Department of the United Provinces was re-or-
ganised with effect from the 1st October last, and
Civil Surgeons were placed in executive control
of operations within the limits of their respective
districts. The new arrangement undoubtedly tends to secure adequate supervision
of operations in the rural as well as the urban areas ; and it will be possible now to
rigidly control the work of subordinates in every portion of the province. It is too
early to estimate the effect of the changes in the department on the nature and quality
of the work generally; but it has been noted by the Civil Surgeon of Saháranpur,
that the work of the district had been previously carried on with such zeal and effici-
ency that his inspections were all but a waste of time, and involved a serious absence
from legitimate Medical, Surgical and other work at Headquarters. The change in
executive control, however, as indicated in the Government Resolution, which forms
Appendix D, will undoubtedly strengthen the hands of the department, and add greatly
to efficiency in carrying on extending and controlling operations.
1
( 2 )
The vaccination establishment.
6. The vaccination establishment is under the administration of the Sanitary
Commissioner acting as Superintendent-General, and
consists of 3 Deputy Sanitary Commissioners or
Superintendents of Circles, of 48 Civil Surgeons
and Civil Medical Officers as District Superintendents, of 49 district Assistant Super-
intendents of different grades, and 848 Vaccinators of all classes. There are besides
44 paid Apprentice Vaccinators.
Distribution of the establishment.
7. The distribution of the establishment
during 1893-94, was as follows :—
Circle.
First circle, comprising the Meerut and Agra
Divisions and Native State Tehri Garhwál.
Second circle, comprising the Rohilkhand Divi-
sion, the Province of Oudh and the districts
of Almora and Naini Tal.
Third circle, comprising the Allahabad, Benares
and Gorakhpur Divisions, and British Garhwál.
Total ...
Superintendents of Circles
(Deputy Sanitary Com-
missioners).
1
1
1
3
District Superintendents
(Civil Surgeons).
12
20
16
48
Assistant Superinten-
dents.
First grade.
1
2
4
7
Second grade.
5
6
6
17
Third grade.
7
12
6
25
Vaccinators.
197
364
287
848
Apprentices.
12
14
18
44
Expenditure on vaccination.
8. The total expenditure on vaccination in 1893-94 was Rs. 1,58,996-9-10, as
compared with Rs. 154,484-11-7 in the previous
year, and the slight increase in cost is more than
accounted for by the travelling allowances and contingencies incurred by Civil Surgeons
under the scheme of re-organisation.
Sources of disbursement and heads
of expenditure.
9. The sources of disbursement, and heads of
expenditure, for 1892-93 and 1893-94, are com-
pared as follows:—
Sources of disbursement.
Year.
1892-93
...
1893-94
...
Provincial funds.
Rs.
1,16,306
,15,928
a.
2
9
p.
5
4
Local funds.
Rs.
9,764
11,831
a.
7
10
p.
9
5
Municipalities.
Rs.
20,395
22,908
a.
4
3
p.
1
9
Other sources.
Rs.
8,018
8,328
a.
13
2
p.
4
4
Total.
Rs.
1,54,484
1,58,996
a.
11
9
p.
7
10
Heads of expenditure.
Year.
1892-93
...
...
1893-94
...
...
Pay of establish-
ment.
Rs.
1,42,146
1,35,266
a.
10
0
p.
3
10
Travelling allow-
ance.
Rs.
5,999
11,653
a.
1
15
p.
10
11
Contingencies.
Rs.
6,338
12,076
a.
15
9
p.
6
1
Total.
Rs.
1,54,484
1,58,996
a.
11
9
p.
7
10
The increase and decrease in expenditure under the different heads are indicated
as follows :—
Increase in expenditure.
Travelling allowance ... ...
Contingencies ... ...
5,654
5,737
14
9
1
7
Decrease in expenditure.
Pay of establishment 6,880 9 5
...
Total increase.
4,511 14 3
...
gram illustrating the death-rate from small-pox in the city of Lucknow, as compared with the death-
rate from small-pox in London.
black lines and figures indicate the death-rate from small-pox in the city of Lucknow, and the red lines and figures indicate the death-rate from
small-pox in London.
Diagram illustrating the death-rate from small-pox in the North-Western Provinces and Oudh, from
1876 to 1893.
Diagram showing the relation between the death-rate from small-pox, and the proportion of population protected by Vaccination, in each district of the North-Western Provinces and Oudh for 1893-94.
The black lines and figures indicate proportion protected per 10,000 of population during the season 1893-94.
The red lines and figures indicate death-rate from small-pox per 10,000 of population during the same period.
( 28 )
complete, implies the successful vaccination of at least 1,330,000 children annually, and
against that number 1,181,600 successful vaccinations were recorded as stated during the
past season. A little more effort and exactness in system and method by District Super-
intendents, aided as hitherto by district authorities, and the work will soon be fully
accomplished.
LUCKNOW :
Dated the 23rd July 1894.
G. HUTCHESON, M. D.,
Sanitary Commissioner,
N.-WP. and Oudh.
( 4A )
I know of no instance in which parents were punished for not having their
children vaccinated, even though summoned, and the Civil Surgeon of Saháranpur
pronounces the Vaccination Act to be a dead letter in that city.
In conclusion I have to add that most of the vaccinators worked well. Non-success-
ful cases are occasionally found entered as successful, the vaccinators not having person-
ally inspected these, and too frequently indifferent lymph is used. Ulcerated arms are
not uncommon, but for these it is the filth applied to the vesicle by the mothers to
keep off flies that is principally to blame. Two or three cases of erysipelas following
vaccination, are usually seen annually, and sometimes an abscess in the armpit.
Considering the grossly insanitary state in which the children are brought up, it is
surprising there is so little erysipelas. Had the quality of the work been equal to
that of 1892-93, I would have been much pleased with the season, 1893-94. As it is
one may express satisfaction with the result.
R. JAMESON, M. D.,
Deputy Sanitary Commissioner, 1st Circle.