4

From the report of the present Civil Surgeon of Nimar it appears that, owing
to the continued efforts of the late Civil Surgeon, Dr. Cullen (now on leave), vacci-
nation has become so wide-spread and is so generally accepted by the people of
Nimar as a good thing, that " small-pox has ceased to be an important factor in
the mortality of the district". Reference is made in your Report (paragraph
57) to an apparently very useful system introduced by Dr. Cullen in Nimar of
making a vaccination census in each village. The Officiating Chief Commissioner
would be glad to have some further particulars regarding that system and to
know whether its working is confined to Nimar, &c.

Inspection.

7. The results are not satisfactory. Civil Surgeons inspected a smaller
number of villages and a smaller number of cases than in the
previous year ; Native Superintendents spent fewer days on
tour and inspected fewer cases and fewer villages. The Civil Surgeons of Chhind-
wara and Balaghat inspected the largest number of villages, while the Civil
Surgeons of Nimar, Mandla and Damoh saw the largest percentage of cases. You
were on tour in Chhindwara and Balaghat (among other districts) and report that
the work you saw was with few exceptions good, which is satisfactory. Good
work is pretty certain to be found where the Civil Surgeons have taken an active
part in supervising their subordinates.

In Sambalpur, where there was little or no inspection work done, grave irre-
gularities, which have been separately brought to the Chief Commissioner's notice,
were discovered. The Civil Surgeon was tied down to head-quarters for a portion
of the season by having medical charge of the Wing of the Regiment at Sambal-
pur ; the inconvenience thus caused has, as you are aware, been referred to in
recent correspondence with the Government of India.

The unequal amount of work done by the Native Superintendents in the
several districts is very striking, and the Officiating Chief Commissioner trusts
that efforts will be made to bring them all up to a higher level of general efficiency,
some standard of work being set, below which they must on no account be allowed
to fall.

Quality of work.

8. In paragraph 51 of the Report you notice that you saw enough on tour
to convince you that vaccinators are not sufficiently careful
in the selection of the lymph they use on the children they
vaccinate. The Officiating Chief Commissioner would be glad to have some
further explanation of your meaning.

Attitude of the people
towards vaccination.

9. The attitude of the people towards vaccination is chiefly one of indif-
ference, but it would seem that, as a rule, there is no great
difficulty in persuading them to let their children be vacci-
nated. There are, moreover, certain exclusive classes, who
do all they can to avoid having their children vaccinated, and with these classes
time and patience are necessary. Here and there persons are met who have
learned to appreciate the immunity from small-pox which is afforded by success-
ful vaccination, and who willingly assist the authorities. The Civil Surgeon of
Nimar names three malguzars who have rendered him such assistance, and the