( 2 )

establishment during the year ; while the average number vaccinated by each vaccinator shows a decrease
of 187.19. This falling off is, in great measure, to be attributed to the great sickness and mortality
from diseases of the zymotic class, which in the antumn and early winter months largely prevailed in
so many districts of the Punjab; the season's work was also impeded by the sickly condition of many
of the vaccinators, not a few of whom from repeated attacks of fever were for a time unable to go on
with their work. But, had it not been for the great opposition met with by the large staff of men
working under my immediate supervision in the districts of Delhi and Karnál, the ground thus lost
would ultimately have been recovered, and the year's record would have shown a much larger out-turn
of work. As in former years, the arm-to-arm method of vaccinating was adhered to, and on this
depends the high standard of success maintained. Of the cases which came under my own personal
observation, the ratio of success in primary operations was found to be 98.3 per cent., or 0.7 per cent.
more than that given in the above statement.

To avoid misunderstanding it is necessary to explain that the apparent discrepancies between
the ratios of successful vaccinations given in the body of the report, and those entered in the appended
statements (Nos. I and III) arise from the fact of their having been calculated from different data : in
calculating the percentages of success embodied in the report, the unknown cases, according to the plan
hitherto followed, have been excluded from the total; while in the calculation of the same ratios
given in the statements, in accordance with the method adopted in para. 12 of Government of India,
Home Department letter No. 136, dated 28th May 1879, the unknown cases have been included, and
classed in the same category with unsuccessful operations.

The total expenditure of the special establishment amounted to Rs. 58,406-5-4, as against
Rs. 59,901-12-8 expended during the previous year, and the cost of each successful case was annas 2
and pies 6.74—a slight decrease from preceding year.

7. Sex and age of the vaccinated—

                                Statement No. II.

(a). Sex.—The proportion of
males to females closely approximates to
that shown in 1877-78. In 391.529 cases,
208,912, or 53.36 per cent. were males,
and 182,617, or 46.64 per cent. were
females, a difference of 6.7 per cent.,
showing a falling off in the proportion
of females as compared with previous
year.

(b). Age.—In 359,893 successful primary vaccinations, 163,814, or 45.51 per cent. were under,
and 196,079, or 54 49 per cent., were above a year, a difference of nearly 9 per cent., showing a
diminution in infant vaccination. The hill states give a still lower ratio in cases under a year than
that noted in preceding year, viz., 22.5 per cent. against 26.8, being 23 per cent. under the general
averagre of the Province. The unpopularity of infant vaccination among hill people generally, as was
remarked in previous year's report, is entirely due to their experience of the risks of inoculation, and
to their apprehending injurious results from vaccination, when performed on children under one or two
years of age.

8. Re-vaccination.—In the month of July, on examining some recent work done by the
vaccinators of the special establishment in the district of Kángra, I found that a considerable number of
adults, male and female, had voluntarily come forward to be vaccinated, and that a large proportion
of them, 71.3 per cent., had been operated on with complete success. Among those who showed no
marks of having been previously protected, whether by small-pox, inoculation, or vaccination, the
proportion of successful cases rose to 98.8 per cent.; while the proportion of successful re-vaccinations
performed on children vaccinated but a few years before, was only 11.5 per cent. The unexpectedly
high percentage of success obtained in the vaccination of adults, strongly indicates the advisability of
carrying out vaccination irrespective of age, as far as practicable, instead of, as hitherto, confining
operations almost entirely to infants, and children under 10 years of age. As is well known, the
protective effects of primary vaccination performed in infancy or childhood frequently diminish, or
wear out, after the age of puberty; and to confer absolute immunity from small-pox, re-vaccination
should be performed after that period of life has been passed. In illustration of the absolute
protection of re-vaccination, I may here cite the authority of Sir Thomas Watson, the eminent London
physician, who, in a recent publication on the subject, mentions that in the London Small-pox and
Vaccination Hospital it has been an imperative rule, for the last forty years, that every employé of the
hospital should, on entering the service, be vaccinated, or, as was more frequently the case, re-vaccinated.
" These nurses," he says, " live in the closest daily and nightly attendance upon small-pox patients,
and the other servants are constantly exposed to the profuse and concentrated contagion, yet in no
single instance during those forty years did any one of these servants and nurses become affected with
small-pox. Surely no stronger proof than this can be imagined that re-vaccination in the adult, rightly
performed, is an absolute protection against small-pox, and need not be repeated. "