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APPENDIX C.
Annual Report on Vaccination in the 3rd Circle by SURGEON MAJOR G. M. J. GILES,
Deputy Sanitary Commissioner.
In submitting the subjoined remarks on the vaccine operations for the present
year, it will be noted that the general system of organization has undergone very
radical modifications during the period in question. In the first place the duration of
the working season has been increased by continuing operations until the 15th of April.
In the second place the direct control of the District staffs has been handed over to
their respective Civil Surgeons, the Deputy Sanitary Commissioner being left with
only a sort of auditing control. These changes are, however, too recent to exert any
marked effect on the work of the individual vaccinator at present, and their full effect,
whether for efficiency or the reverse, can only be judged in future years.
Another new departure was that an attempt was instituted to keep up in each
district, a supply of lymph throughout the hot weather. There is no doubt, that, if
practicable, this plan would form a most valuable insurance against the chance of the
supply of lymph cultivated in the hills breaking down, and I spared no efforts by
means of repeated circulars and admonition to secure the success of the experiment.
In spite of this however, I was constantly getting reports from one or the other
districts of the supply having broken down, owing to the impossibility of keeping the
vesicle intact till maturity.
Whenever this took place fresh lymph was supplied, either from a neighbouring
district, or by means of lanoline paste, and, as the weather grew cooler during the
late rains that marked last autumn, I received assurances of the lymph being alive
from most districts. In spite of this however, the spell of hot, dry weather that
immediately preceded the commencement of work proved fatal to the vesicle in most
districts, and went far to demonstrate the impracticability of the scheme in ordinary
seasons,—so that, on close enquiry, I found that the only district which was in a
position to have done without the supply from Garhwal was the district of Ballia to
which I had sent, for experiment, a supply of lanoline paste which as it chanced tided
them over the hot dry portion of the autumn. The fact is that, even among Indians,
the skin is so irritable duriug the hot weather, that there is little chance of the vesicle
remaining intact to maturity at that season, and I fear that more harm than good is
likely to be done to the cause of vaccination by the attempt to extend operations into
the hot season.
My reason for this is that the Indian parent takes but little pains in dressing
the sore resulting from vaccination, and that hence very ugly ulcers are extremely
common as soon as the weather becomes at all hot and eczema cellulitis, and other
results of neglect, become so frequent as to cause an amount of needless suffering to the
children that may easily convert the present reluctant acquiescence of the parent to an
active opposition. Vaccination is steadily gaining ground and will doubtless continue to
do so but the amount of work done by the vaccinator is limited not by the time at his
disposal for work, but by the objection of the parents to accept vaccination.
If this latter obstacle were non-existent, the duration of the working season might
be diminshed by half without the vaccinators being in any way at a loss to compass
a far larger amount of work than they do at present.
The supply of lymph from Garhwél, as usual, proved excellent and it was only in
one or two districts that a second supply was required, so that the vesicle was every-
where thoroughly established by the 2nd or 3rd week of October.
Taking the circle as a whole, I am glad to be able to report most satisfactory
progress, the total increase in operations performed being 43,375. The progress of
vaccination is however curiously intermittent, and the improvement was very much larger
in the year 1890-91, in which the increase attained the even larger figure of 51,520.
Considerable as it is therefore, the increase cannot be fairly attributed to the prolongation
of the working season, as it was surpassed in a year when no such change had taken place.