No. 6650-V.

FROM

                        LIEUTENANT-COLONEL, G. TATE, M. B., I. M. S.,

                                                            Sanitary Commissioner,

                                                                  North-West Frontier Province.
To

                        THE HON'BLE MR. P. J. G. PIPON, C. I. E., M. C., I. C. S.,

                                          Secretary to the Hon'ble the Chief Commissioner,

                                                      North-West Frontier Province.

                                                      Dated Peshawar, the 17th September 1920.

SIR,

I HAVE the honour to submit herewith, for the information of the
Hon'ble the Chief Commissioner, the Annual Vaccination Report for the
year 1919-20, and to offer the following remarks on the working of the
Department.

2. Before proceeding to give the Statistical details about vaccination
as carried out in the North-West Frontier Province for the year 1919-20,
it may not be out of place to prefix a few general considerations,
concerning Small-pox, the disease for the prophylaxis of which,
Vaccination is carried out.

Definition.

Variola or Small-pox is an acute specific fever characterised by a
more or less general eruption passing through the
stages of the papule, vesicle, pustule, and often scar.

History.

Small-pox was prevalent in India and China before Christian Era
and the practice of inoculation against it was
started in China as far back as A.D. 590. Whether
it arose de novo in India and Africa we cannot say, but there are possibly
two varieties of the disease, viz., the ordinary Small-pox which eventually
spread to Europe, and so to America; and an African type known as
Amaas, or milk-pox.

In India there was a special worship defined in the Atharvaveda,
and there were special prayers to be said by the Brahmins when practising
inoculation.

In Africa Ruffer and Ferguson found an eruption on the skin of a
Mummy belonging to the period of the 28th dynasty (1100-1200 B.C.)
which they believed to be Small-pox; so that it is quite possible that there
has been from immemorial an endemic focus in the heart of Africa.

From these two endemic foci of the disease, Asia and Africa, it
undoubtedly spread all over the world.

An Arabian Physician Rhazes, whose full name was Abu Bakr
Muhammad Ben Zakriya'-r-Razi, wrote a work on medicine about A.D. 900
called Kitab-ul-Mansuri which was divided into ten Chapters, in one of
which he gives the earliest accounts on record of Small-pox and Measles.
He died in A. D. 923.

In Europe, in the middle ages, records of its prevalence were kept
up in the monasteries.

Vaccination was first introduced by a general practitioner Dr.
Jenner in 1798.

Vaccination was made compulsory in England in 1854; but under
the Act of 1898 the "Conscientious objector" has been allowed latitude.

The last pandemic of the disease occurred in 1871-72.