Nos. 715, 716 L., 25TH JULY 1902.                                  3

of persons successfully vaccinated in that district during the past five years is only
17.5 per mille of the population.

For municipal towns the ratio was 52.9 per mille, and the towns in which it
was lowest are Kumbakonam (29.3), Cuddapah (30.0), Nellore (30.8), Masulipatam
(31.6), Tanjore (31.8), Chidambaram (32.2), Salem (32.6), Mannargudi (32.9),
Gudiyattam (33.6), and Erode (33.7). The figure given for Calicut is 124.9,
which is much higher than that for any other town.

The quality of the work done is not so good as it was ten years ago, and the
actual decline in this respect is measured by the fall in the percentage of success
from 95 in 1892-93 to 92 in 1901-02. In towns, however, there was an
improvement, the percentage having advanced from 94.6 to 96.7. The quality of
the work was particularly bad in the districts of Godavari, Kistna, Chingleput and
Malabar, parts of the hill tracts of Vizagapatam and the towns of Chicacole, Palni,
Salem, Chingleput, Cochin and Berhampur.

Infant vaccination.

4. Excluding the figures for the cantonments which are situated beyond the
limits of this presidency, the number of children under
one year of age who were successfully vaccinated in
above, about 1,275,000. In 1892-93 the number of infants successfully vaccinated
was only 257,000, but though steady progress has been made in this respect, it
is obvious that very much still remains to be done. The population of the 60
towns given in statement 1901-02 was 354,000 while the number available for vaccination was as explainedNo. VI is 1,913,000 and with a birth-rate of even 40 per
mille the number of births should be 76,500 as compared with the 63,500 actually
registered. The number of deaths among these infants is approximately 19,000
as against 12,000 registered and the number of infants remaining for vaccination
would thus be 57,500 instead of 51,677. The number actually vaccinated was only
34,373 and even assuming that this figure includes none of the infants who died
during their first year the result is extremely unsatisfactory. The remedy rests
with the municipal councils, who must insist on better registration and on more
work being done by the vaccinators. The latter are for the most part under the
control of the local medical officer and the Surgeon-General should direct all such
officers to give more personal attention to the work of vaccination. The towns in
which this branch of vaccination was particularly backward are Bellary, Cuddapah,
Ellore, Kumbakonam, Nellore and Tanjore.

Bellary is the only district in which infant vaccination was at all satisfactory,
. the proportion of successful cases being 21.9 per mille of the total population. In
Malabar the ratio was so low as 0.9 per mille and the President of the District
Board should explain the grave neglect which this figure discloses. Other districts
with very low ratios are Godavari (4.5), Nilgiris (4.6), Ganjam(5.3), Nellore (5.5),
South Canara (5.5) and Cuddapah (5.9). Heads of villages are required to keep
lists of unprotected children and the Revenue officers must see that the standing
orders on this subject are obeyed. The districts in which there has been most
neglect are Coimbatore, Cuddapah, Madura, Nellore and Trichinopoly and the
matter should receive special attention there without delay
Lymph.

5. The marked fall in the measure of success obtained with glycerinated
lymph is a matter of serious importance which has
not received, adequate notice from either the Inspector
of Vaccination or the Sanitary Commissioner, but the Government trust that the
opening of the Vaccine Institute will result in the supply of a lymph of uniform
and reliable quality.

Cost.

6. There was a small but satisfactory decline throughout the three years
1899:—1902 in the average cost of each successful case,
but the figure is still slightly above that of 1892-93.
With the supply of a more trustworthy quality of lymph and a consequent
improvement in the degree of success, there should be a decrease in the average
cost of a successful case.