NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( 15 )
Small-pox.
23. Small-pox was more prevalent throughout the province during 1889
than in either of: the two previous years. Like
cholera, it shows a tendency to recur in an epide-
mic form during certain years. This epidemic periodicity or fluctuating explosion
of disease cannot be explained on any mere biological basis. We know that
these epidemic visitations recur in a way which mere contagiousness cannot
explain, and we further know that although their advent cannot be controlled,
yet timely sanitary measures can mitigate their ravages.
The efficacy of vaccination in diminishing small-pox mortality is proved by
the statistics of every country in Europe, and the following table will show how
small-pox has decreased in this province, as the ratio of successful vaccinations
has increased:—
STATEMENT No. 19.—Showing efficacy of vaccination in diminishing small-pox mortality.
Year.
1868-69 ...
1869-70 ...
1870-71 ...
1871-72 ...
1872-73 ...
Mean ...
1873-74 ...
1874-75 ...
1875-76 ...
1876-77 ...
1877-78 ...
Mean ...
Ratio per 1,000
successfully
vaccinated.
4.3
3.2
7.9
13.0
16.2
8.92
14.5
21.
24.
31.1
38.
25.72
Death-
rate per
1,000
from
small-pox.
1.9
3.6
.6
.2
3.8
2.02
3.8
.5
.4
.2
2.9
1.56
Year.
1878-79 ...
1879-80 ...
1880-81 ...
1881-82 ...
1882-83 ...
Mean...
1883-84 ...
1884-85 ...
1885-86 ...
1886-87 ...
1887-88 ...
Mean ...
Ratio per 1,000
successfully
vaccinated.
22.3
29.3
33.9
32.5
38.
31.2
30.3
37.
35.3
35.6
35.2
34.68
Death-
rate per
1,000
from
small-pox.
2.7
.03
.02
.08
.10
.58
1.50
.20
.09
.04
.10
.38
The death-rates are for calendar years.
In the first five years of the series 1868—1872 the mean ratio of successful
vaccination was 8.92 per 1,000 of population as compared with a death-rate
from small-pox of 2.02 per 1,000. In the next five years 1873—1877, the vacci-
nation rate rose to 25.72, the small-pox mortality falling to 1.56. In the third
period 1879—1883 the vaccination rate increased to 31.2, with a corresponding
decrease in the death-rate from small-pox to .58 ; and in the last quinquennial
period the proportion of the population protected was 34.6, and the mortality
from small-pox .38.
This diminishing mortality from small-pox in the light of the above figures
must be accepted as due to the beneficial results of vaccination, and is practical
evidence of the protective powers of vaccination against small-pox.
The above table also shows how three years of comparative immunity from
small-pox are usually followed by two years of greater prevalence of the
disease.
The next table exhibits the deaths from small-pox, as well as the ages of
the diseased and the number of persons successfully operated upon in each dis-
trict for the past three years :—
( 16 )
TABLE No. 20.—Showing deaths from small-pox according to age and number successfully
vaccinated for three years compared.
District.
Amraoti
...
...
Ellichpur
...
...
Wun ...
...
...
Basim ...
...
...
Akola ...
...
...
Buldana
...
...
Years.
1887-88
1888-89
1889-90
1887-88
1888-89
1889-90
1887-88
1888-89
1889-90
1887-88
1888-89
1889-90
1887-88
1888-89
1889-90
1887-88
1888-89
1889-90
Deaths from small-pox.
Total
deaths.
33
163
426
1
7
21
27
58
265
10
148
483
208
78
330
32
363
212
Under 1
year.
10
50
120
...
2
4
6
14
48
3
53
162
76
27
88
22
122
161
Under 12
years.
20
94
235
1
1
2
16
42
134
7
85
234
101
48
208
9
235
103
No. of suc-
cessful opera-
tions (special
and dispen-
sary).
21,143
22,944
20,900
9,327
10,299
9,847
14,258
15,023
14,985
13,617
13,503
14,626
16,938
19,759
17,148
15,947
17,341
15,967
Proportion
of popula-
tion per
1,000 pro-
tected.
36.8
39.9
36.3
34.5
37.9
36.3
36.4
38.3
38.2
37.9
37.6
39.1
28.4
33.2
28.8
36.5
39.6
36.5
It will be observed that only 29 deaths from small-pox occurred in the
Ellichpur District during the last three years.
Attitude of the people.
24. Very little difficulty is experienced in carrying on vaccination through-
out rural Berar. The lower classes give no trouble
and readily produce their children for operation
at the instigation of the local officials. The well-to-do and educated classes
also, though with certain exceptions, generally accept vaccination, but like to
have the operation performed when it suits their own convenience.
The class of people who generally give trouble are Marwaris, Banias,
Muhammadans and Brahmins. On the whole, however, the benefits of vaccina-
tion are recognised and generally accepted.
It is in the municipal and larger towns that difficulty is met with, where
Marwaris and Banias mostly congregate. In the city of Amraoti the depart-
ment signally failed to carry on vaccination amongst these classes, though
assisted by the Tahsildar and secretaries of the municipality.
To meet such cases it would be advisable to apply the Compulsory Vacci-
nation Act to municipalities. Indeed, the general feeling is gaining ground
that the time is fast approaching when it will be desirable to make vaccination
compulsory throughout the province.
* Secretary's letter No. 1837. dated
30th of August 1880, received under
Commissioner's endorsement No. 4587
of the 16th September.
† Sanitary Commissioner's No. 183,
dated 11th November 1880, to Com¬
missioner.
In 1880 the Sanitary Commissioner was asked * to report if there was any
objection to the extension of the Compulsory Vac-
cination Act to Berar, who, in reply, gave † it as his
opinion that the people of the province would
not raise any great objection to vaccination being
made compulsory, and that as regards municipali-
ties the Act might be introduced with great ad-
vantage. District officers, however, were evidently averse to the proposed
( 17 )
measure, for the local Administration, as conveyed in Secretary's letter No. 924
of May 1881, " accepted the opinion of the local officers that it would be very
inexpedient to introduce the Vaccination Act into Berar at present."
Nearly a decade has passed since the above remarks were expressed, during
which the people have become more familiarized with vaccination, which, together
with the spread of education and the general growth of knowledge during the past
ten years, have greatly weakened, if they have not altogether removed, the
popular prejudices and apprehension which led to opposition in the past. The
mass of the people are fully alive to the fact that the object of vaccination is
to control a deadly and mutilative disease, and there are few who do not admit
its efficacy to this end.
Vaccination might therefore be made compulsory without much opposition.
and in the case of the small minority who would object, it is but right that the
law should interefere, as in the case of the man who deliberately acts to the
detriment and danger of his neighbour, for, by refusing to accept vaccination,
he not only exposes his own unconscious infant to become the prey of a fatal
and mutilating disease, but he does so to the detriment of his neighbour's children
under three months old, too young to be vaccinated. It is this privilege of unre-
stricted small-pox—this " liberty of omissional infanticide " as it has been termed
by a high sanitary authority—which the law must sooner or later step in to
prevent.
Vaccinators employed on cholera
duty.
25. Eighteen vaccinators were employed on
cholera duty during the season as shown in the
subjoined statement:—
TABLE No. 21.—Showing the number of vaccinators and the period employed on
cholera duty.
Districts.
Amraoti ... ... ...
Akola ... ... ...
Buldana ... ... ...
Basim ... ... ...
Ellichpur ... ... ...
Wun ... ... ...
No. of vacciuators em¬
ployed on cholera
duty.
2
4
6
6
...
...
Total No. of days em¬
ployed on cholera
duty.
96
97
217
*328
...
...
* Particulars regarding the two vaccinators so employed not available,
C. LITTLE, M.D.,
Sanitary Commissioner,
Hyderabad Assigned Districts.
APPENDICES.
( 2 )
A.—VACCINE DEPARTMENT.
STATEMENT NO. I.—Showing particulars of Vaccination in the Hyderabad Assigned Districts during the year 1889-90.
Number.
1
1
2
3
4
5
6
Districts.
2
Amraoti ... ... ...
Ellichpur ... ... ...
Wun ... ... ...
Basim ... ... ...
Akola ... ... ...
Buldana ... ... ...
Total for the Province ...
Melghat ...
Grand Total ...
Population of district according to
census of 1881.
3
531,783
242,088
374,428
338,713
530,912
397,770
2,415,694
42,655
* 2,458,349
Average population per square
mile.
4
208
278
100
121
223
157
164
2,586
...
Average number of vaccinators em-
ployed throughout the season.
5
9
4
7
6
9
7
42
2
44
Total number of persons
vaccinated.
Male.
Female.
Total.
6
10,772
5,970
7,955
7504
9,268
7,781
49,250
725
49,975
9,817
4,551
7,544
6,959
8,026
7,704
44,601
750
45,351
20,589
10,521
15,499
14,463
17,294
15,485
93,851
1,475
95,326
Average number of persons vacci-
nated by each vaccinator.
7
2,288
2,630
2,214
2,410
1922
2,212
2,234
737
2,166
Primary vaccination.
Total.
8
19,326
8 443
14,607
13,866
16,169
15,088
87,499
1,475
88,974
Successful
Under 1 year.
9
15,098
7,606
11,674
10,126
12,780
11,982
69,266
806
70,072
Over 1 and under
0 years.
10
3,596
550
2,077
3,015
2,170
2,174
13,582
575
14,157
Total of all ages.
11
18,856
8,218
14,033
13,294
15,064
14,352
83,817
1,392
85,209
Re-vaccination.
Total.
12
1,263
2,078
892
597
1,125
397
6,352
....
6,352
Successful.
13
305
733
70
211
169
217
1,705
...
1,705
Percentage of
successful cases.
Primary.
14
97.57
97.33
96.07
95.88
93.16
95.12
95.79
94.37
95.76
Re-vaccination.
15
24.15
35.27
7.84
35.34
15.02
54.66
26.84
26.84
Persons successfully vaccinated per
1,000 of population.
16
36.03
36.97
37.66
39.87
28.69
36.62
35.40
32.63
35.68
Average annual
number of per-
sons successfully
vaccinated dur-
ing' previous
five years.
Number.†
17
21,082
9,642
14,663
13,493
18,422
16,552
93,854
...
...
Ratio per 1,000.
18
36.6
35.6
37.4
37.3
31.0
37.8
...
...
35.7
Average annual
number of. deaths
from small-pox
during previous
five years.
Number.‡
19
92
6
95
101
115
129
538
...
...
Ratio per 1,000.
20
.16
.02
.24
.28
.19
.29
.20
...
...
* Excluding population of dispensary towns.
† Include dispensary vaccination.
‡ Include deaths in dispensary towns.
( 3 )
A.—VACCINE DEPARTMENT.
STATEMENT No. 2.—Showing the cost of the Department in the Hyderabad Assigned Districts during the year 1889-90.
Number.
1
1
2
3
4
5
6
7
Circles and Districts.
2
Amraoti ...
Ellichpur ...
Wun ...
Basim
Akola
Buldana
Establishment
with
Sanitary
Commissioner...
Total
...
Melghat
...
Grand Total ...
Establishment.
Superintendent General.
3
...
...
...
...
...
...
1
...
1
Superintendents of Circles.
4
...
...
...
...
...
...
...
...
...
Deputy Superintendents.
5
...
...
...
...
...
...
...
...
...
Native Superintendents.
6
1
1
1
1
1
1
1
7
...
7
Vaccinators.
Head Vaccinators.
7
2
...
2
...
...
...
1
5
...
5
1st Class Vaccinators.
8
1
1
2
...
...
1
...
5
*2
7
2nd Class Vaccinator.
9
4
...
...
3
4
1
...
12
...
12
3rd Class Vaccinators.
10
2
3
3
3
5
5
...
21
...
21
Apprentices.
11
1
1
1
1
1
1
...
6
...
6
Chaprasees and other servants.
12
1
1
1
1
1
1
1
7
...
7
Expenditure.
Pay of Establishment.
13
Rs.
3,158
1,836
2,586
1,819
2,925
2,351
1,602
16,279
188
16,467
a.
8
1
11
0
6
8
0
7
4
11
p.
10
11
7
0
10
1
0
3
0
3
Travelling allowance.
14
RS.
3
0
a.
15
8
p.
0
9
...
...
12 8 0
...
37
54
9
9
6
3
54 9 3
Contingencies.
15
RS.
60
60
60
60
60
60
a.
4
4
4
4
4
4
p.
1
0
0
0
1
1
...
361 8 3
361 8 3
Total cost.
16
Rs.
3,222
1,896
2,646
1,879
2,998
2,411
1, 639
16,695
188
16,883
a.
11
14
15
6
2
12
9
8
4
12
p.
11
8
7
0
11
2
6
9
0
9
Paid from
Imperial Funds.
17
...
...
...
...
...
...
...
...
...
...
Provincial Funds.
18
Rs.
3,222
1,896
2,646
1,879
2,998
2,411
1,639
166,95
l88
16,883
a.
11
14
15
6
2
12
9
8
4
12
p.
11
8
7
0
11
2
6
9
0
9
Local Funds.
19
...
...
...
...
...
...
...
...
...
...
Municipalities.
20
...
...
...
...
...
...
...
...
...
...
Native States.
21
...
...
...
...
...
...
...
...
...
...
Total.
22
Rs.
3,222
1,896
2,646
1,879
2,998
2,411
1,639
16,695
188
16,883
a.
11
14
15
6
2
12
9
8
4
12
p.
11
8
7
0
11
2
6
9
0
9
Number of all successful vaccination
and revaccination.
23
19,161
8,951
14,103
13,505
15,233
14,569
...
85,522
1,392
86,914
Average cost of each successful case.
24
Rs.
0
0
0
0
0
0
a.
2
3
3
2
3
2
p.
8
4
0
2
1
7
...
0
0
0
3
2
3
1
2
1
* Temporary establishment sanctioned for 5 months.
( 4 )
B.—DISPENSARY VACCINATION.
STATEMENT No. III.—Showing Dispensary Vaccination in the Hyderabad Assigned Districts during the year 1889-90.
Districts.
1
Amraoti ... ...
Ellichpur ... ...
Wun ... ...
Basim ... ...
Akola ... ...
Buldana ... ...
Total ...
Number of dis¬
pensaries in
each district to
which a vacci¬
nator is attach-
ed.
2
7
7
6
5
7
8
40
Average number
of vaccinators
attached to
dispensaries
during the
season.
3
No vaccinators attached to a dispensary.
Total num-
ber of per-
sons vacci-
nated.
4
1,854
1,031
905
950
2,161
1,445
8,346
Average num-
ber of persons
vaccinated by
each vaccina¬
tor.
5
265
147
134
190
309
181
208
Primary vaccination.
Total.
6
1,793
875
866
768
2,039
1,430
7,771
Successful.
Under 1
year.
7
1,472
808
685
662
1,611
1,149
6,387
1 and
under 6.
8
243
31
172
92
265
242
1,045
Total of
all ages.
9
1,720
839
862
754
1,876
1,391
7,442
Re-vaccination.
Total.
10
61
156
39
182
122
15
575
Successful
11
19
57
20
67
39
7
209
Percentage of suc¬
cessful cases.
Primary
12
95.93
95.9
99.5
98.2
92.
97.27
95.7
Re-vacci-
nation.
13
31.15
36.5
51.3
36.8
31.9
46.66
36.3
Column 2 shows the number of dispensaries and hospitals in each district where vaccination was performed.
Column 5 shows the number of persons vaccinated by each Hospital Assistant.
( 5 )
COMPARATIVE STATEMENT No. IV.—Showing the number of persons primarily vaccinated and the number of those persons who were successfully vaccinated in the
Hyderabad Assigned Districts in each of the undermentioned official years.
Establishments.
Government...
Dispensaries...
Municipalities.
Melghat ...
Total ...
Persons primarily vaccinated.
Total No.
No.
success¬
fully
vacci-
nated.
1878-79.
54,118
3,801
...
...
57,919
45,453
3,311
...
...
48,764
Total
No.
No.
success-
fully
vacci-
nated.
1879-80.
69,731
2,307
...
...
72,038
62,009
1,951
...
...
63,960
Total
No.
No.
success¬
fully
vacci-
nated.
1880-81.
80,083
5,592
...
...
85,675
69,406
4,897
...
...
74,303
Total
No.
No.
success-
fully
vacci-
nated.
1881-82.
90,058
5,211
...
...
95,269
80,930
4,624
...
...
85,554
Total
No.
No.
success-
fully
vacci-
nated.
1882-83.
103,517
6,492
...
...
110,009
95,080
5,685
...
...
100,765
Total No.
No.
successfully
vaccinated.
1883-84.
78,994
6,984
94
...
86,072
73,453
6,258
82
...
79,793
Total
No.
No.
success-
fully
vacci-
nated.
1884-85.
92,920
7,535
515
...
100,970
88,615
6,781
409
...
95,805
Total No.
No.
success-
fully
vacci-
nated.
1883-86.
91,056
6,483
...
...
97,539
87,105
5,922
...
...
93,027
Total
No.
No.
success-
fully
vacci-
nated.
1886-87.
86,898
7,226
...
...
94,124
83,554
6,672
...
...
90,226
Total
No.
No.
success-
fully
vacci-
nated.
1887-88.
87,658
6,749
...
2,318
96,725
84,702
6,294
...
2,122
93,118
Total
No.
No.
success
fully
vacci-
nated.
1888-89.
92,140
8,727
...
358
101.225
88,833
8,389
...
340
97,512
Total No.
No.
success-
fully
vacci-
nated.
1889-90.
87,499
7,771
...
1,475
96,745
83,817
7,442
...
1,392
92,651
NOTES
ON THE
ANNUAL
RETURNS
OF
VACCINATION
IN THE
HYDERABAD ASSIGNED DISTRICTS
FOR
THE YEAR 1890-91.
BY
SURGEON-MAJOR CHARLES LITTLE, M.D.
HYDERABAD:
PRINTED AT THE RESIDENCY GOVERNMENT PRESS.
1891.
Price one rupee per copy.
( 2 )
animal lymph now in general use in the province. The people are satisfied
with the existing system of using animal lymph direct from the calf, and the
vaccinators experience no difficulty in obtaining as many calves as are needed.
5. Dr. Little brings to notice the assistance afforded by his Head Clerk,.
Mr. George, in carrying out the experiment with lanoline, and I think that he
himself merits the commendation of the local administration for the interest he
has taken in this important matter, and the success which has attended his-
efforts.
I have the honour to be,
Sir,
Your most obedient servant,
T. CHICHELE PLOWDEN,
Commissioner, Hyderabad Assigned Districts.
TABLE OF CONTENTS.
Brief notes on vaccination statistical returns ... ... ... ...
Statement No. I.—Particulars of vaccination during the year 1890-91 ... ...
District work ... ... ... ... ... ...
Inspection work of District Superintendents of Vaccination ... ...
Statement No. II.—Strength and cost of the Vaccination Department ... ...
Statement No. III.—Dispensary Vaccination ... ... ... ...
Dispensary vaccination work inspected by Civil Surgeons ... ... ...
Statement No. IV.—Primary vaccination for a series of years ... ...
Lymph supply ... ... ... ... ... ...
Experiments for preserving animal lymph ... ... ... ...
Para.
1
2
3
4
5
6
7
8
9
10
B-116
FROM
SURGEON-MAJOR C. LITTLE, M.D.,
Sanitary Commissioner, Hyderabad Assigned Districts,
To
T. CHICHELE PLOWDEN, ESQ., C.S.,
Commissioner, Hyderabad Assigned Districts.
Dated Amraoti, the23rd May 1891.
SIR,
In accordance with the orders of Government of India, No. 28—1579-95,
dated the 15th July 1887, I have the honour to submit the statistical returns of
the vaccination department for the year 1890-91 with brief notes thereon.
Statement No. I.—Particulars of
vaccination during 1890-91.
2. The total number of persons vaccinated during the year was 103,796, of
whom 57,595 were males and 46,201 females as
compared with 95,326 in 1889-90.
Each vaccinator performed on an average 2,471 operations in comparison
with 2,166 in the previous year.
The number of primary operations was 89,473 and re-vaccinations 14,323,
against 88,974 and 6,352 respectively in 1889-90.
In primary vaccination the percentage of success was 95.1, and in re-vac-
cination 29.5. For the previous year the ratios of success were 95.7 for primary
and 26.8 for re-vaccination.
In all 89,351 successful operations were performed against 86,914 in the
previous year, or an increase of 2,437 operations, notwithstanding that in
1889-90 two additional vaccinators were temporarily engaged in the Melghat,
where 1,392 cases were successfully operated on.
The percentage of the population successfully vaccinated was 36.8 per 1,000
as compared with35.4 for the previous year and 35.6, the average of the previous
five years.
There has thus been a satisfactory increase in the number of successful
operations, also in the average number of operations performed by each vacci-
nator and in the number of persons protected per 1,000 of population.
The slight fall in the percentage of success in primary vaccination may pos-
sibly be connected with the substitution of animal lymph direct from the cow
for arm-to-arm vaccination, as all the vaccinators were not equally expert in
animal vaccination.
Of the total number of successful primary operations, 73,059 were performed
on infants under one year of age; 11,028 on children over one and under six
years old; and 1,032 on persons over six years and adults.
Thus, out of every 100 persons successfully vaccinated, there were 85.8 in-
fants; 12.9 children between one and six; and 1.2 of other ages.
The percentage of the estimated births protected was 75.7 against 71.9
in the preceding year. Calculated on the total births registered during 1890, the
percentage of births successfully vaccinated was 71.5.
B-116—I
( 2 )
District work.
3. There has been an increase in each district in the total. outturn of work
as compared with the previous year, but the Am-
raoti district shows a falling-off in primary vac-
cination of 74 cases. This faliing-off is attributed to sickness amongst vaccina-
tors and to Head Vaccinator Ismail Khan having been deputed to take charge
of the Akola district on the death of Superintendent Trimbak Rao.
The ratio of success attained in the several districts in primary vaccination
ranged from 97.6 in the Ellichpur district to 91.4 in the Akola district, and in
re-vaccination from 55.7 in Buldana to 18.8 in Akola.
This discrepancy in the ratio of success in re-vaccination is unsatisfactory.
In the Buldana district, not only is the rate too high, but the number of re-vac-
cinations is too few, only 474 operations having been performed. The Superin-
tendent will be required to give more attention to this duty.
Inspection work by District Super-
intendents of Vaccination.
4. Of the total 103,796 operations, 56,888 or
54.8 per cent. were verified by Superintendents as
shown below:—
District.
Amraoti ... ... ...
Ellichpur
...
...
...
Wun ... ... ...
Basim ... ... ...
Akola ... ... ...
Buldana
...
...
...
Percentage of
work verified.
51.2
73.4
66.5
65.8
12.7
74.6
The low rate of inspection work in the Akola district was due to the illness
and death of one Superintendent and to his successor being attacked with inflam-
mation of the lungs shortly after joining the district.
Statement II.—Strength and cost
of the Vaccination Department.
5. Statement No. II shows the strength and
cost of the department during the year.
The establishment remained the same as last year, i.e., 7 Superintendents and
48 Vaccinators.
The conduct of the staff throughout the year was on the whole satisfactory
It is usual to recommend for reward the three vaccinators who have done
the best work during the season. The men who this year head the list are—
1. Habeeb Ally,
2. Shaik Curreem,
3. Mahabeer Pershad,
and the sanction of the Resident is requested to a reward of Rs. 30 being pre-
sented to each.
The total cost of the department was Rs. 16,900-15-0, or Rs. 17-2-3 in
excess of that of the previous year. The increase is due to the inclusion in the
amounts of a sum of Rs. 275-9-2 expended on a special experiment in connec-
tion with the manufacture of lanoline-vaccine.
The cost of each successful case was 3 annas, as compared with 3 annas
and 1 pie in the preceding year.
Statement III.—Dispensary vac-
cination.
6. The total number of vaccine operations performed at dispensaries was
10,366, or 2,020, more than in the preceding year.
Amraoti is the only district which shows a decrease
in work (301 cases) compared with the previous
year. The principal falling-off was at the Karanja dispensary (211 cases),
which is explained by the fact that the medical officer in charge was on three
months' leave during the cold weather, and the work was not pushed by his
locum tenens.