No. 700S.

FROM

              COLONEL C. W. CARR-CALTHROP, M.D., Ch.D., I.M.S.,

                            Principal Medical Officer and Sanitary Commissioner, Assam,

To

       THE SECRETARY TO THE CHIEF COMMISSIONER OF ASSAM.

                                                                        Shillong, the 26th May 1899.

SIR,

Late submission of returns.

I HAVE the honor to submit the prescribed Vaccination Statements for the
year 1898-99, with certain remarks. This report was due
to you on May 15th, but as the last statement required was
not received from the Sibsagar district until May 13th, instead of reaching me, as it
should have done, on April 15th, the delay has been unavoidable. The returns from seven
other districts were received after May 1st.

Number         of vaccinators
employed.

2. Annual Statement No. I shows the average number of vaccinators employed in
each district, as well as details of work done by paid and
licensed vaccinators. The vaccinating staff was practically
of the same strength and constitution as in 1897-98, con-
sisting of 18 inspectors, 183 paid and 29 licensed vaccinators with 7 apprentices,
a total of 237 individuals ; against 18 inspectors, 182 paid and 30 licensed vaccinators
with 10 apprentices, or a total of 240 individuals, in the previous year. No changes
of importance were made in the distribution of this staff, except that 3 paid vaccina-
tors were appointed to the Lushai Hills for the first time.

Amount of work done by paid
and licensed vaccinators.

3. During the working season 1898-99, 127,075 males and 105,344 females, or a
total of 232,419 persons were vaccinated by the paid and
licensed staff, against 255,583 in 1897-98 ; that is, there
was a falling off of no less than 23,164. Of these 232,419
operations, 210,986 were primary vaccinations, 21,433 were re-vaccinations, against
245,381 primary and 10,202 secondary ones in 1897-98. The number of re-vaccina-
tions is thus shown to be more than double of what were done in the previous year ; but
the number of primary operations, which are the more important, fell from 245,381 to
210,986, a very serious decrease indeed. Of those successfully vaccinated, 47,317
were infants under one year of age, as against 55,574 in 1897-98, and 44,472 in 1896-
97.

Percentage of operations report-
ed as successful.

4. The paid and licensed vaccinators reported that out of their 210,986 primary
operations, 208,542, or a percentage of 98.84, were suc-
cessful ; and that out of their 21,433 re-vaccinations, 20,113,
or a percentage of 93.84, were successful. I personally
inspected a very large number of cases during my tours, especially in the Nowgong
district, and I am of opinion that the number of cases reported as successful is too
high. Vaccinators seem to report, as successful, cases in which the smallest vesicle
follows the operation, notwithstanding that no trace may be visible three months after-
wards. From my personal inspections I should think the primary operations were prob-
ably satisfactory in 95 per cent., partially successful in 3 per cent., and failures in about
2 per cent. The percentage reported of successful re-vaccinations, viz., 93.84, is
suspiciously high, and is to my mind inconsistent with a very high percentage of
thoroughly successful primary vaccinations; at the same time I would add that the
lymph supplied by the Vaccine Depôt in Shillong is so good and uniform in quality
that the percentage of successful cases in the hands of a skilful operator might
approach the possible. It is known that Lieutenant-Colonel R. Neil Campbell has done
over 800 operations with his own hands, without a single failure ; but we cannot expect
the whole of the vaccinating staff to be equally expert.

                                                                                                                B