( 4 )

Here is a total of 193,053 deaths in five years, from a preventible disease. This, too,
does not shew the mortality among those who, reduced in health and strength by it, became
afterwards easy victims to other diseases. Many also undoubtedly suffer throughout their
lives from its effects, having become blind or otherwise maimed.

Deaths from Cholera in the Punjab.—During the same five years, Cholera, that so much,
and so justly dreaded disease, caused 53,651 deaths, which, when compared with those from
small pox, appears quite insignificant,

Impossibility of checking small pox without strict quarantine laws, and compulsory vaccina-
tion.—Special quarantine laws are always insisted on when cholera is present, and I cannot
see how small pox is to be stopped or checked, until quarantine laws and compulsory vacci-
nation are strictly enforced. In every village I visit where this disease is, I see children
covered with the eruption playing with others, the clothes of those attacked, whether they
die or not, are neither destroyed nor fumigated ; that the lives of many are saved under
the present system is true, and here and there the people are fully aware of it, but even
should vaccination become generally popular eventually, many years must elapse before such
a happy result could take place, and, in the meantime-, many thousands of lives will have
been lost.

10. Work in the hot season.—During the hot weather part of the Establishment was
employed in the hills, and the rest were distributed over some Districts in the plains, being
placed under the orders of Civil Surgeons. The Civil Surgeons state that the services of
the Native Superintendents and Vaccinators were useful, especially during the cholera
epidemic. Native Superintendent Nyaz. Ali Shah was employed in the City of Lahore in
the house to house visitation of cholera cases, under the Civil Surgeon and the Principal
Lahore Medical College, who both expressed themselves perfectly satisfied with him. This
was an onerous, and somewhat difficult duty, and I trust he may receive some reward—say
one month's pay ; as a Native Superintendent of vaccination Nyaz Ali Shah bears an excellent
character.

11. Small pox in Simla.—There were a few cases of small pox in Simla, but none
in the country about. The cases that occurred were among people from the plains.

Among sheep.—Small pox also appeared among a flock of sheep belonging to His
Excellency the Viceroy, which were at once destroyed.

12.    Vaccinations continued in Lahoul.—Vaccinations were carried on in Lahoul; and
one of the Missionary gentlemen located there informed me that the people were exceedingly
thankful for it.

13.   Ladâk.—Dr. Cayley also continued vaccinations with much success in Ladak.

14.    Difficulty of vaccinating in the Simla Bazars. Special measures required for its
enforcement.—Vaccination is always carried on with much difficulty in the Simla bazars. As
small pox invariably appears there yearly among the people who come from the plains, some
special measures are required for its enforcement.

15.    Vaccine from England.—Several supplies of vaccine were received from England,
and all proved successful in my hands, though parts of them transmitted to other stations
failed.

16.    Attempt to procure vaccine from heijers.—An attempt is being made to procure
supplies of vaccine from heifers in the Government Cattle Farm at Hissar. The Civil