9

These appointments will undoubtedly, if the Superintendents work properly,
do much to improve the vaccination in the States and Zamindaris : but much
still remains to be effected in the arrangements for carrying on the work.

                 PROVINCIAL DISPENSARY VACCINATION.

31. The following is the work done by the Hospital Assistants in the
Province during the past two years.

32. In letter No. 3163-152 of the 18th August 1885, the Chief Com-
missioner laid down that (1) Hospital Assistants in charge of Dispensaries
might be relieved of the duty of vaccination by the Deputy Surgeon General
acting on a representation of the Dispensary Committee, but that if not so
relieved vaccination is to be regarded as part of their duty; (2) the period
during which and the area within which Hospital Assistants in charge of dis-
pensaries shall vaccinate shall be prescribed by the Dispensary Committee with
the consent of the Civil Surgeon ; (3) Dispensary Vaccination is not to be per-
formed by any officer of lower grade than a Hospital Assistant.

In accordance with these rules 15 Hospital Assistants in charge of dispen-
saries were altogether relieved of vaccination duty, or directed to vaccinate only
such children as are brought to the dispensary.

The work of 30 was confined to the towns in whieh the dispensary is
situated, and in the case of 10 the area out side the towns in which the Hospital
Assistant is to work was reduced.

These changes together with the prohibition of the performance of Vacci-
nation by compounders and others of the Hospital Establishment are sufficient
to account for the decrease in the total number of operations : 3,329 operations
having been performed in the previous year by the 15 Dispensary Medical
Officers who were this year relieved of vaccination duty.

In the districts of Damoh, Mandla, Chhindwara and Balaghat the Hospital
Assistants performed a larger number of operations than in the previous year.

The Civil Surgeon, Jubbulpore, attributes the much smaller number of
operations partly to reduction of the area in which two of the Hospital Assist-
ants worked and partly to the discussion as to whether vaccination properly
formss part of Dispensary Medical Officer's work, but the number of operations
in one of the reduced areas (Murwara) is larger than it was in the previous year,
and the Chief Commissioner's orders lay down most distinctly that vacciation.