( 3 )

Percentage of success recorded by Civil Surgeons was 92.47 for primary
and 54.21 for re-vaccination. Divisional Inspectors and Superintendents
record a success of 98.05 and 98.24 for primary and 83.75 and 93.40 for re-
vaccination respectively. The Deputy Sanitary Commissioner doubts the
accuracy of the latter figures, especially as the Superintendents in inspecting
report a higher percentage of success in re-vaccination than the Vaccinators
themselves, viz. 93.40 against 91.22. I entirely agree with this criticism.

Appendix A.—Vaccination in Municipal Towns.

15. In Peshawar City 2,190 births were registered during the year and
5,452 children under 1 year of age were
vaccinated. The discrepancy in the
number is due to the following causes:—

(1) Vaccination in Peshawar itself of children domiciled outside.

(2) The exceedingly unsatisfactory way in which birth registration
is carried out in certain wards.

Major Stiles Webb. Deputy Sanitary Commissioner, considers that the
introduction of the Vaccination Act is both feasible and necessary, but that
more accurate registration of births must first be assured.

Nowshera Kalan, Kohat and Bannu all show an excess of primary
vaccinations over births registered; the first factor mentioned above is the
probable cause of this.

Appendix B— Case-success and annual ratio of deaths
from small-pox.

16. In Appendix B are shown the number of successful vaccinations
and the mortality from small-pox per
1,000 of population for the past five
years; the latter will be seen to have
decreased in all six districts, and may be considered to represent the normal
state of affairs.

Particulars of lymph used.

17. Throughout the year chloroformed glycerinated lymph obtained
from the Punjab Vaccine Institute,
Lahore, has been used.

The results have been very good and compare favourably with those of
other provinces. The percentage (recorded by the Vaccinators) of case-success
being 99.01 for primary and 91.22 for secondary operations, the accuracy of
the latter figure is open to doubt.

Attitude of the people towards vaccination.

18. From the reports of the various Civil and Agency Surgeons it
would appear that the people are not
hostile to primary vaccination, but
regard secondary vaccination as unnecessary and irksome. The protection
conferred is understood. This is shown by the increase in the demand for
both vaccination and re-vaccination when small-pox tends to become epidemic.

                                                                        I have the honour to be,

                                                                                    SIR,

                                                                  Your most obedient Servant,

                                                      T. W. IRVINE, LIEUT.-COLONEL, I. M. S.,

                                          Sanitary Commissioner, North-West Frontier Province.

      N.-W. F. P. Govt. Press. Peshawar—13 C. M. O —28-5-14—180.