( 4A )

I know of no instance in which parents were punished for not having their
children vaccinated, even though summoned, and the Civil Surgeon of Saháranpur
pronounces the Vaccination Act to be a dead letter in that city.

In conclusion I have to add that most of the vaccinators worked well. Non-success-
ful cases are occasionally found entered as successful, the vaccinators not having person-
ally inspected these, and too frequently indifferent lymph is used. Ulcerated arms are
not uncommon, but for these it is the filth applied to the vesicle by the mothers to
keep off flies that is principally to blame. Two or three cases of erysipelas following
vaccination, are usually seen annually, and sometimes an abscess in the armpit.
Considering the grossly insanitary state in which the children are brought up, it is
surprising there is so little erysipelas. Had the quality of the work been equal to
that of 1892-93, I would have been much pleased with the season, 1893-94. As it is
one may express satisfaction with the result.

R. JAMESON, M. D.,
Deputy Sanitary Commissioner, 1st Circle.