( 2 )

exceptional nature, there is reason for believing that the check to the progress of operations will prove
but of short duration. These causes may be enumerated as follows:—

1st.—As above mentioned, the office of Superintendent of Vaccination remained vacant through-
out the year ; and a considerable portion of the establishment was less efficiently supervised, and there-
fore less energetic, than in former years.

2nd.—The excessive sickness and mortality of infants and children from zymotic diseases (chiefly
miasmatic fevers and small-pox) which during the last two years prevailed throughout the greater
part of the Province. In the Sanitary Commissioner's Report for 1878 it is shown that, out of a total
of 628,771 deaths registered during that year, as many as 245,154, or rather more than a third of the
whole number, occurred among children under six years of age ; and of these nearly 45 per cent. were
infants, i. e., under one year of age. Again, the number of subjects for vaccination was found to have
been considerably diminished by the excessive small-pox prevalence which had obtained during the
previous two years, and which had caused no small amount of the general mortality just mentioned.

3rd.—The diminished birth-rate said to have resulted from the long prevalence of sickness, and
the enfeebled state of health of the population arising therefrom. Enquiries as to this point, as a rule,
elicited the reply that of late the number of births had greatly decreased ; and on consulting the birth
registers both in the towns and rural circles, it appeared that the statement was in the main correct.

4th.—Operations, during the year under review, were confined to old vaccinated districts, whereas
during the two preceding years 8 new districts had been added to the vaccine circle.

6. In 2,816 primary cases in which the results were noted by me, only 24 failures were found,
the ratio of success being 99.15 per cent. Many more cases were inspected, but having been at stages of
development, when the results—successful or otherwise—could not with any degree of accuracy be pronoun-
ced upon, they were not recorded further than to check the figures given in the weekly registers submitted
by the vaccinators. The standard of success above recorded seems suspiciously high ; but with a moderate
amount of care, skill, and a judicious selection of vaccinators, it can easily be attained by vaccinating
direct from the arm—the method which for years has been adhered to by the vaccinators of the Provin-
cial Establishment. The system of checking the returns by "village registers" (instituted in the
season of 1871-72, and described in the Vaccination Report for that year) is still in force ; and the
returns of that portion of the establishment which worked under my own supervision may be received
as fairly correct. The total cost of the operations was Rs. 47,731-14-5, as compared with Rs. 58,406-5-4
expended during the previous year,—a decrease of Rs. 10,674-6-11 ; but, owing to the great falling off in
the numbers vaccinated above referred to, the cost of each successful case is almost the same for the two
years in question, being annas 2 and pies 7.43 and annas 2 and pies 6.74 respectively.

7. Sex and Age of the vaccinated.

                              Statement No. II.

(a) Sex.—In 311,123 cases in
which the sex was noted, 164,297, or 52.8
per cent., were males, and 146,826, or 47.2
per cent., were females,—a difference of
5.6 in favour of the former. These pro-
portions closely approximate those ob-
tained in 1878-79, while they very nearly
coincide with those shown in 1877-78.

(b). Age.—Of the 288,141 successful primary vaccinations, in which alone the age was noted,
157,813, or 54.77 per cent., were under a year, and 130,328, or 45.23 per cent., were above a year, show-
ing again of 9.26 per cent. in infant vaccinations, as compared with the proportion of previous year.
This increase is due to the fact that, as above mentioned, operations were in the year under review
confined to old vaccinated districts ; whereas, in the preceding year, four new districts, in which the
unprotected children had been accumulating from year to year in times when small-pox was not pre-
valent, had been overtaken. From the same cause, and notwithstanding the great falling off in the
out-turn of work as a whole, the proportion of infants successfully vaccinated to the assumed annual
birth-rate, taking the number of successful operations under one year, performed by all establishments,
at 194,985, and the assumed number of births in the Province during the year at 704,160, fell little
short of that obtaining in 1878-79, the ratios of the two years being 29.3 and 27.6 per cent., respectively.
In the Hill States the prejudice against infant vaccination remains undiminished : the proportion of
infants to those above a year was 22.76 per cent., showing but little difference from that recorded in
the preceding year.

                                                      KANGRA DISTRICT.

8. Vaccination work was continued here throughout the greater portion of the hot season.
The remarks made in the Vaccination Report for the previous year regarding the frequent occurrence
of local outbreaks of small-pox, coincident with the practice of inoculation, if not resulting from it
have this year to be repeated. In the spring months, the inoculators, the majority of whom are natives
of this district, as usual, began operations, and, a short time afterwards, it was found that small-pox was