(2)

and 64.04. Dr. Gregg reports that the percentage of successful secondary
operations in municipalities is much too high to be correct, and that either
many cases returned as secondary were in fact primary, or that the rate of
success was not truly recorded. The question of the accuracy of the reported
rate of success was raised by the Government of India in Mr. Lyall's letter
No. 327, dated 17th October 1889, in which comment was made on the small
proportion of operations checked by inspecting officers. The following table
shows, however, that during each of the three years under report the number
of operations checked by supervising officers of one class or another has always
exceeded 70 per cent. The Lieutenant-Governor attaches much importance to
these inspections, and hopes that future years will show a larger percentage,
especially on the part of Superintendents:—

5. Dr. Gregg dwells at some length on the very important question of
the results of vaccination as shown by the number of deaths from small-pox
in various areas, compared with the proportion of population in those areas
protected by vaccination; and illustrates these results by several useful diagrams.
The following table shows the proportion of deaths from small-pox during the
last seven years in areas under vaccination compared with those not under
vaccination:—

It is noticeable that though the death-rate in protected areas is, as a rule,
much lower than in those which are not under vaccination, the results of the
last two years are far from satisfactory. The table shows, moreover, a marked
increase in the mortality from small-pox in each of the last three years. In
this connection Dr. Gregg remarks that "the protection of rural areas can never
be placed on a proper footing until the Compulsory Vaccination Act in a suitably
modified form be extended to them," and promises a full report on the subject,
which is awaited by Government.

6.    The total cost of vaccination during the three years was
Rs. 4,97,833-0-11, giving a yearly average of Rs. 1,65,944-5-7. The average
cost of each successful operation was one anna six pie against one anna eight
pie in the three years 1884—87. It was highest in Calcutta, where each
successful operation cost 15 annas 7 pie, and lowest in the Eastern Bengal
Circle, where the cost was only 7 pie.

7.    The attitude of the people towards vaccination is, according to
Dr. Gregg, one of passive acceptance tempered apparently by a considerable
but fortunately diminishing amount of passive obstruction. The issue of lymph
in tubes from the Animal Vaccination Depôt in Calcutta to the mofussil has
proved a failure owing, in Dr. Gregg's opinion, rather to carelessness in storing
at the depôt than to any physical causes. Dr. Gregg speaks most unfavourably
of the whole working of the depôt, which is under the supervision of the Super-
intendent, Metropolitan Circle. It is hoped that, when the projected Darjeeling
depôt is in working order, the supply of animal lymph from Darjeeling and
Calcutta will be sufficient to enable the Bengal vaccine establishment to dis-
pense with lymph obtained from the human subject.