( 14A )
that the annual return (No. III) of " Dispensary Vaccination " in the North-Western
Provinces and Oudh is invariably blank: the Government has no information as to the
extent to which dispensaries have been selected as vaccination offices under rule 2 of
the rules for the enforcement of the Vaccination Act; but His Honor considers that the
operation should be performed at all dispensaries throughout the Provinces, either by
the officers in charge, or, if there is a large attendance of children, by the regular vac-
cinators at stated hours. The subordinates of Civil Surgeons, the Assitsant Surgeons,
and Hospital Assistants, should not hold themselves aloof from the work of vaccination,
as is at present the case in many places, but should be considered ex-officio officers of the
Vaccination Department, and should be called upon to assist in every way in their power.
3. As regards district vaccination, the case is different. As Health Officer of the
district and as an inspecting officer representing the general administration of the
district in the Medical and Sanitation Departments, the duties of the Civil Surgeon
might be held to cover a general superintendence of the work of district vaccination;
but this function has not hitherto been specially assigned to him in these Provinces.
The system of control of vaccination by Civil Surgeons under the supervision of the
Sanitary Commissioner has been adopted by other Governments and Administrations,
such as Bengal, the Punjab, and the Central Povinces, and has worked well as the
published figures show.
In the Central Provinces, where the system of control by district medical
officers has been in force since 1874, Civil Surgeons were on tour during the past
year examining cases of vaccination for periods ranging from 26 to 64 days and inspect-
ed in all 70,960 cases; in these Provinces the inspections by the three Deputy Com-
missioners extended to 33,785 cases only, while the inspections by Deputy Superinten-
dents and Native Superintendents fell far short proportionately of those undertaken
by Native Superintendents in the Central Provinces. Excluding Deputy Sanitary
Commissioners, the supervising staff in the North-Western Provinces and Oudh con-
sists of one Native Superintendent to each district and one Deputy Superintendent to each
division except Kumaun. The report on vaccination in these Provinces for the year
1892-93 shows that in some instances the Deputy Superintendents and Native Superin-
tendents of the Vaccination Department have not co-operated with the district officials,
who have been frequently directed to exercise all proper influence in the extension of
vaccination, and without whose active assistance vaccination cannot be a success in back-
ward tracts. For many reasons a change in the system in force in these Provinces is
advisable. After consulting the Inspector-General of Civil Hospitals and the Sanitary
Commissioner, the Lieutenant-Governor and Chief Commissioner has decided to appoint,
and hereby appionts, all officers in civil medical charge of districts to be ex-officio Su-
perintendents of Vaccination within their respective districts in subordination to the
Superintendent-General of Vaccination; His Honor is pleased to place under the control
and orders of the Superintendents all vaccinators and other officials of the Department
employed within such limits. The powers at present exercised by Deputy Sanitary
Commissioners with reference to the appointment and punishment of these officers are
transferred to medical officers in charge of districts. With the exception of the medical
officers of the following districts—Almora, Garhwál, Allahabad, Benares, Lucknow,
Agra, Bareilly, Cawnpore, Gorakhpur and Muttra—medical officers in charge of districts
will be required to make short tours at frequent intervals into the interior of their dis-
tricts to inspect the work of vaccination and to test the genuineness of the returns.
Though the medical officers in charge of the ten districts enumerated above are not re-
quired to undertake such tours, there is no objection to their doing so, should opportunity
occur except in the case of Almora and Garhwál, where inspection work will be under-
taken by the Deputy Sanitary Commissioners. In the case of Naini Tal it will be
sufficient for the Civil Surgeon to make short tours in the cold weather in the sub-
montane tracts. The tours in each district should extend in all to a period of one or
two months during each year ; the exact period, which must vary with the circum-
stances of each district, cannot be prescribed. In the course of these tours medical