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(a). Delhi District.—The city establishment, consisting of one Native Superintendent and five
vaccinators paid from Municipal funds, underwent no change during the past year. The total number
vaccinated was 3,707, a decrease of 388 from previous year. This decrease is attributed to the
prevalence of fever and small-pox during the vaccinating season. The work inspected by me in
January was found to be of good quality, but, as was the case the year before, operations were too
much spread, and carried out in a desultory, indefinite manner. The people of Delhi, however, are so
averse to vaccination, that it would be impossible for vaccinators, working as these men were without
assistance of any kind, to attempt systematic vaccination of the localities visited. The percentage of
success was 92.34, a gain of 1.47 per cent. over that of preceding year, and the ratio successfully
vaccinated per mille of population was 18.2, less than half of the birth-rate. In the town of Sonepat,
Assistant-Surgeon Ram Kishan, in charge of the dispensary, superintended the performance of 362
operations, of which 99.69 per cent. were returned as successful. He is reported to have taken much
pains in making vaccination popular, both in the town and in the adjoining villages.

(b). Umballa District.—In the report for previous year unfavourable remarks were made
on the backward state of vaccination in the town of Umballa; but this year, in consequence of the great
attention paid to the subject by Dr. Bateson, and Assistant-Surgeon Duni Chand in charge of the town
dispensary, a marked improvement in the out-turn and quality of the work has been effected. The
number of operations performed by two Municipal vaccinators was 2,518, an increase of 1,251 over the
number of previous year, and the ratio of successful primary cases was 96.80 per cent. as compared with
66.74, a gain of 30.06 per cent.; ratio successfully vaccinated per mille of population was 86.01, against
34 of the previous year. The operations inspected by me in December were all successful ; the quality
of the lymph was good, and the vesicles presented every appearance of having resulted from arm-to-arm
vaccination. A Municipal vaccinator attached to the Jagádhri dispensary vaccinated 574 persons, of
whom 80.08 per cent. were returned as successful. The character of the work inspected by me about the
end of March was found to be most unsatisfactory : indeed, very few of the cases examined could have
been pronounced successful. Local vaccinators were also employed at the Sohdra, Shahabad and Thánesar
dispensaries, the numbers vaccinated at these places being 539, 160, and 129 respectively.

(c). Rúpar Subdivision.—Operations were carried on by two vaccinators paid from Municipal
funds in the town of Rúpar and in the villages adjoining. The total number vaccinated was 5,565,
showing an increase of 1,876 over the previous year ; and the percentage of success 96.48, again of 1.96
per cent.; arm-to-arm vaccination is said to have been carried out.

(d). Ludkiána District.—No returns for the town of Ludhiána have been received ; the season
was considered too sickly to permit of vaccination work being satisfactorily carried on. In the
town of Jagraon, 627 operations were done by the Hosipital Assistant in charge of the dispensary.

(e). Amritsar City.—The work was inspected by me in January. One permanent and two
temporary vaccinators were employed ; one of the latter being a new hand and quite untrained, acted as
writer. Moti Ram, the head vaccinator on whom I had to comment so unfavourably in the Vaccination
Report for 1877-78, and whose dismissal, recommended by me, on account of malpractices, was sanctioned
by the Hon'ble the Lieutenant-Governor in his remarks on the vaccine operations for that year,
continued to superintend operations. His services, however, would appear to have been dispensed
with about the middle of March, when, at the request of the Secretary of the Municipal Committee, a
vaccinator was sent from the special establishment to fill the vacant post. As was mentioned in last
report, no regular system in carrying on work was observed; the vaccinators, as a rule, perambulated
the streets, and operated on children, on passant, as it were. as they happened to meet them being carried
about in their mothers' arms, the results of the operations being afterwards but rarely examined.
On inspectiog the registers, it appeared that nearly a third of the cases were entered under the heading
" Músáfirs " (travellers), the children of people who had come in from villages in the district; and it
was impossible to find out whether the entries so headed were false or not. Of those residing in the city,
only five recent vaccinations were inspected : all were successful. Total number of operations shown in
the returns is 7,772, a decrease of 2,987 as compared with the preceding year ; and the percentage of
success in primary cases given is 95.64.

(ƒ). Lahore City.—Four vaccinators were employed by the Municipality, and vaccinated 2,357
persons, with a percentage of success in primary cases of 95.06. One hundred and eighty vaccinations
were performed at the Mayo Hospital for the purpose of instructing the students attending the
Medical School in the practice of vaccination. There is a decrease of 586 operations as compared with
1877-78, which is ascribed, partly to the failure of the lymph supplied at the commencement of the
season, and partly also to the unusual prevalence of small-pox, measles, and malarious fever. On
inspecting the work of the vaccinators at the end of December, I found the lymph to be of excellent
quality, but the out-turn was small, the daily average number of cases during the previous two weeks
having been only six. The area of operations, too, was ill-defined; and no efficient assistance was being
received from the members of the Municipal Committee. Dr. Scriven, however, reports that afterwards
many of these gentlemen actively co-operated in inducing the people to come forward, and they gave
much confidence by accompanying the vaccinators while at work. The vaccine arrangements, as in
former years, continued to be under the management of Assistant Surgeon Brij Lál Ghose, Resident
Surgeon of the Mayo Hospital, who, Dr. Scriven states, showed much zeal and tact in carrying them
out. An epidemic of small-pox, commencing in November 1877, continued with full force up to
November 1878, and caused many deaths amongst children. In Kasur a Municipal vaccinator
vaccinated 788 cases.