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Evidence of frequent
epidemics of small
pox were visible in
this Town.

Vaccination has not been conducted here for the last six years, and
epidemics of small pox, during that period, have been of frequent occurrence.
Ample evidence of this was observed in the large number of children seen,
who were marked and maimed with this disease. A mild epidemic of small
pox was going on at the time the vaccinators were at work here, but a large
number of children having been rapidly brought under the influence of vac-
cination, the disease was not allowed to spread to any considerable extent.

Assistance rendered
by the Municipal
Committee.

The members of the Municipal Committee were very active and gave
the vaccinators excellent assistance.

Operations conducted
with much difficulty
in the Town of
Patti.

Patti.—After seeing the work well started at Khem Kharn, I went on
to Patti a town of considerable pretensions, being in this Tehseel next in
point of size and importance to Kasur. Finding on my arrival, that the
people were ill disposed towards vaccination, and that no assistance was
being given to the vaccinators, I collected the Lumberdars, Chowdries &c.,
and after some delay and difficulty succeeded in getting the work commen-
ced. In the first Mahulla visited everything went on very satisfactorily, a
good many Hindoos having been induced to come forward, but, as on for-
mer occasions, the exertions of the Lumberdars &c. were not of long dura-
tion; the number of children brought very soon diminished and but little
was done. The operations were continued next day with partial success,
but chiefly among the Musalman population.

Number vaccinated
in Town of Patti.

This town contains a population of 6,718 (census 68), with an esti-
mated birth rate during the year at about 290; and there were vaccinated
209 children of whom 87 were under 1 year, and 122 over that age; the
percentage of success was 98.

Epidemics of small
pox prevalent in
this Town.

Epidemics of small pox have also been rife here during the past few
years, and owing to the opposition towards vaccination met with, the town
still remains badly protected from future outbreaks of that disease.

All along this portion of the Tehseel, which lies adjacent to the Um-
ritsur District, the people shewed much unwillingness to receive vaccina-
tion, and, notwithstanding that the Tehseeldar frequently called upon the
Zaildars and others to give assistance, the attempt to carry on operations
in these parts proved a decided failure. Soochet Sing, Zaildar of Maniala,
a man of considerable local influence, evinced the greatest indifference; the
Lumberdars of his own Zail, as well as those of the neighbouring Zails,
followed the bad example set by him, and giving no assistance, hardly any-
thing was done. For example, in Bairkee a village in Jowala Sing's Zail
containing over 150 houses, only 12 vaccinations were done; and in Soor-
Sing, a large village in the same Zail composed of about 1,000 houses only
33 operations were inspected. The Zaildar, Jowala Sing, was anxious to
give all the assistance in his power, but having a refractory set of Lumber-
dars to deal with his efforts made but little impression on them. On ar-
riving at Soor Sing, I made a second attempt to vaccinate the children,
but owing to the obstinacy displayed by the Lumberdars, nothing could
be done.

Inspection of work in
the Umritsur City.

12. City of Umritsur.—On the 16th March I commenced marching
towards Noorpore in the Kangra District, and reaching Umritsur the same
day, I halted two days for the purpose of inspecting the work carried on
there during the past season. I found two vaccinators at work in the Cash-
miri part of the city, but as they were not receiving any assistance what-
ever, hardly anything was being done. The work of the previous day
consisted of 6 cases, and it was with much difficulty that the vaccinators
could shew me as many as 12 recently performed operations. The quality
of the vesicles was fair, considering the vaccination had been done from
crusts.

Vaccination perform-
ed with Crusts—
owing to objections
of the people to
lymph being taken.

The vaccinators informed me that they found it impossible to carry on
arm to arm vaccination, and were obliged to perform all the operations from
crusts as the people strongly objected to lymph being taken from their
children's arms. This is much to be regretted, as the number of unsuccess-
ful cases operated on with crusts or stored lymph, must in the hands of
these men without proper supervision, be very large; and, in this way,
much injury is done to the cause' of vaccination, ignorant people being led
to place little faith in its prophylactic value against small pox.

Inspection of work in
the Umritsur dis-
trict.

13. District of Umritsur. On the following day, I went out with the
local Native Superintendent into the district to inspect his work in the
Ujnala Tehseel.