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the year, but the figures are only approximately correct
because registration is defective and many people from trans-
frontier tracts, when passing through the settled districts,
allow their children to be vaccinated.

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

14. During the past five years the average annual
number of deaths from small-pox was
805 and the mortality per 1,000 of
population was 0.37. During the year
under report there were 118 deaths,
giving a ratio of 0.05 per 1,000 of population. Small-pox
did not occur in epidemic form but there were scattered
cases reported in all districts except in Hazara.

Particulars of lymph

15. Glycerinated chloroform lymph procured from
the Punjab Vaccine Institute was used
throughout the year. Reports from all
Civil Surgeons state that the lymph
was of good quality.

Attitude of the people
towards vaccination.

16. Vaccination is gradually becoming more popular
among the rural population and resist-
ance to primary vaccination is not
offered. In Hazara complaint was,
however, made of want of co-operation with the vaccinators
on the part of certain lambardars and chaukidars.

General remarks.

17. The result of the year's work is, on the whole, very
satisfactory though there is still room
for improvement. Two superintendents
of vaccination had to be relieved of their duties owing to
inefficiency and slackness, and vaccinators need the stimulus
of constant supervision. On the whole the staff worked
well during the year.



Director of Public Heath,
North-West Frontier Province.

The 12th May 1923.

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