7

Cicatrices.

15. The cicatrices examined in the course of the inspection tour have generally been
large, round, and foveated, but varying in number
according to the number of original punctures made, and
to the proportion of success attending the vaccinator's labours. Some vaccinators make
from three to six punctures on one arm only, others three on each arm, and so on, according to
their various ideas in the matter. To ensure uniformity, I think the plan would not be a bad
one, to direct all vaccinators to make a certain number of punctures on one or both arms, and,
I think, six punctures ought to be required of them, three on each arm. There is thus allow-
ance made for failures, and, moreover, Superintendents and their Assistants would be able at
once to estimate the average quality of a vaccinator's work. As a result of my inspections,
I am of opinion that not fewer than three good large cicatrices give sufficient and lasting
protection. On one occasion particularly, at the beginning of this season's tour, I was in a
position to satisfy myself on this point. In the village of Kámbargáum 87 cases of recent
small-pox were reported by the First Assistant Collector of Nagar to be borne on the
small-pox register. In going over this register carefully, on the spot, I found that a number
of previously vaccinated children had been attacked by small-pox, and where vaccination
cicatrices, which averaged two in number, could be distinctly seen, the cases had been no
other than very mild ones—no unseemly scarring, no unhealthy ulcerations, no loss of eyesight.
This was worthy of notice as proving the efficacy of even an imperfect protection from
vaccine lymph.

Re-vaccinations.

16. The number of these is 50 per cent. less than was shown in last year's returns.
This is owing directly to a more correct understanding of
the meaning of the term, rather than to any falling off in
his respect. The percentage of success is lower than last year, but calls for no special
remark.

Small-pox.

17. The disease has been very general throughout the Circle during the year, but on
no occasion has it been allowed to exceed manageable limits.
Prompt and active assistance has been rendered in every
quarter where the disease was reported to exist, and with invariable success. It is still to be
regretted that very many people cannot be brought to think that they do incalculable harm
n a neighbourhood by allowing small-pox to run its course in their midst. Their deity so
ordains it, and it would be unwise, say they, to interfere in the matter in any way whatever.
It was recently a question at home whether small-pox could be cured by vaccination. A
Mr. Furley of Edinburgh stated that such a result could be obtained under certain necessary
conditions, while Dr. Grieve of the Hampstead Hospital, London, conducted a series of ex-
periments showing that not only was Mr. Furley's theory fallacious, but that in many cases
local and sometimes general mischief was done to the patient by the practice recommended.
The late Mr. Duff, Collector of Khándesh, forwarded to me an extract from some " home "
paper on this subject, and kindly volunteered to have the extract translated for the use of the
Local Fund Vaccinators in Khándesh, if it could be of any use to them. Meanwhile the
question was being discussed in the medical papers at home, and it was thought advisable
to defer any action in the matter, until the practice had been fairly and thoroughly tested.

Animal Vaccination.

18. On the subject of animal vaccination I need say nothing. Indeed I am not in a
position to say much in the matter. Sub-Assistant Surgeon
Bálkrishna Chintobá has carried on the work in Púná, and
in his report, which is appended, he details in full his experience during the year.

Village Registers.

19. Throughout the Circle these registers are generally carefully kept. During my
tour, where small-pox registers were found wanting, the
village officers were directed to make up such, and to bring