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Government and local Vaccinators, in whose returns there is a percentage of 1.17
unsuccessful. Nothing which I could write in praise of the care with which the
Vaccinators operate could add to this. In no part of the world is it excelled by more
than a fraction of percentage, and in few parts of it equalled. The very high rate of
success which has obtained in Sind for the last ten or eleven years is, I consider, due
to,—1st, the practice of vaccinating from arm to arm ; 2nd, the large number of each
Vaccinator's operations affords great scope for choosing typical vesicles from which to
operate ; and 3rd, the skill of the Vaccinators in no small measure contributes to the
high rate of success.

12. The condition of the lymph, with one or two exceptions, has been good
throughout the year. Two Vaccinators were found working with deteriorated lymph,
—lymph which on the eighth day after vaccination had not developed sufficiently large
vesicles, though their shape was good enough in most cases : on the tenth day, they
obtained the size which good visicles obtain on the eighth. I replaced the deteriorated
lymph by good at once. The cause of the deterioration was the careless manner of
vaccinating practised by Purtab Rai. He said he had been ill of fever and unable to
vaccinate on the eighth day, about a month before my arrival at Nowshera. Sickness
is a good enough excuse for doing no work at all, but unfortunately it is one that can
be given at any time, and almost under and circumstance ; but it is no excuse for working
with deteriorated lymph, and good can always be got for the asking. The other man
was Wuttun Mull, who had just three weeks before my visit got lymph from Purtab
Rai, and taken it across the river Indus from Nowshera Talooka to Dadoo Talooka ; as
a matter of course the lymph was not good, yet it was better than Purtab Rai's. This
illustrates a singular fact which I have frequently observed in the last five years; viz.,
that deteriorated lymph, producing too small but characteristically shaped vesicles,
can, by selecting the most typical from which to vaccinate other children, be improved.
Still, deteriorated lymph ought always to be abandoned at once, because, while im-
proving it by selection, there must be an unusual number of unsuccessful and doubtful
cases such as I observed in the work of Purtab Rai and Wuttun Mull.

13. Capillary tubes have been occasionally used for starting work in the
districts by the Vaccinators when moving from one field to another. Lymph has been
supplied in them to all the Dispensaries in the province, to Surgeon Moore for the use
of the Dispensaries in Rajpootana, to the Deputy Inspector General of Hospitals in this
Division for use in the Abyssinian Force, and to the local Superintendent of Vaccina-
tion in the Bombay Circle. It is very difficult to keep lymph good in tubes, or,
indeed, in any other artificial method, in Sind during the very hot and dry months of
April, May, and June. With regard to this, I may notice a peculiar and inexplicable
incident. Last hot weather I had some tubes charged in Doaba and used next morn-
ing in Kotree, which produced very small and badly formed vesicles, out of the same
lot of tubes ; a few were sent to Dr. Turnbull, Superintendent of Vaccination in the
Central Circle, and were used by him near Ahmednuggur, and proved quite successful.
The difficulty of keeping lymph good here in the hottest months, either in tubes or