NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
DIAGRAM ILLUSTRATING THE DEATH RATES FROM SMALL-POX DURING EACH OF THE THREE YEARS OF THE TRIENNIEL PERIOD UNDER REVIEW
& THE PROPORTION OF POPULATION PROTECTED BY VACCINATION DURING THE SEVEN YEAR PERIODS TERMINATING WITH EACH OF THESE YEARS.
Annual Notes
on
Vaccination in the Bombay
Presidency
for the Year 1926-27
(with Appendices)
[Price—Rs. 2 As. 9 or 4s. 9d.]
BOMBAY
PRINTED AT THE GOVERNMENT CENTRAL PRESS
1927
Obtainable from the Superintendent of Government Printing and
Stationery, Bombay; from the High Commissioner for India, 42 Grosvenor
Gardens, S.W. 1, London; or through any recognized Bookseller
INDEX
NOTES ON VACCINATION FOR THE YEAR 1926-27
Selected Districts ... ... ... ...
Changes in area and administration ... ... ... ...
Changes in supervising staff ... ... ... ...
Changes in the strength of establishment ... ... ... ...
Primary vaccination—
Number of persons vaccinated ... ... ... ...
Increase or decrease in vaccination work ... ... ...
Results in primary vaccination ... ... ... ...
Age and Sex ... ... ... ...
Re-Vaccination—
Number of persons re-vaccinated ... ... ... ...
Results in re-vaccination ... ... ... ...
Vaccination of Pilgrims at Karachi ... ... ... ...
Primary and re-vaccinations in Native States—
Number of persons vaccinated ... ... ... ...
Results of primary vaccinations ... ... ... ...
Results of re-vaccinations ... ... ... ...
Total number of operations ... ... ... ...
Incidence of small-pox ... ... ... ...
Vaccination campaign ... ... ... ...
Vaccine Institute, Belgaum —
Repairs ... ... ... ...
Drainage ... ... ... ...
Water supply ... ... ... ...
Cattle Disease ... ... ... ...
Lymph supply ... ... ... ...
Tests of potency of lymph before issue ... ... ...
Distribution of lymph ... ... ... ...
Wastage of lymph ... ... ... ...
Chart showing results of monthly Primary Vaccinations ... ...
Expenditure ... ... ... ...
Lymph in use ... ... ... ...
Cost of vaccination ... ... ... ...
Inspection work of Departmental Officers ... ...
Compulsory vaccination ... ... ... ...
Prosecutions ... ... ... ...
Anti-vaccination movements ... ... ... ...
Vaccination of children in Municipal towns ... ... ...
Ill-effects by vaccination
... ... ... ...
The Diagram ... ... ... ...
General Remarks ... ... ... ...
PAGE
1
1
1
2
3
3
3
3
3
3
3
4
4
4
4
4
5
5
6
6
6
6
6
6
6
6
7
7
7
8
8 & 9
9
10
10
10
11
11
P 3
ii
APPENDIX I
Statement No. 1 showing the particulars of vaccination in the Bombay
Presidency during the year 1926-27 ... ... ... ...
Statement No. II showing the cost of the Department during the
year 1926-27 ... ... ... ...
Statement No. III showing Dispensary vaccination during the year 1926-27...
Statement No. IV showing the number of persons primarily vaccinated and
the number of those persons who were successfully vaccinated in each of
the official years ending 31st March 1918 to 1927 (inclusive) ... ...
Statement No. V showing particulars of vaccination verified by Inspecting
Officers ... ... ... ...
APPENDIX II
Statement No. I showing the particulars of vaccination in Native States
during the year 1926-27 ... ... ... ...
Statement No. II showing the cost of the Department in the Native States
during the year 1926-27 ... ... ... ...
Statement No. IV showing the number of persons primarily vaccinated and
the number of those persons who were successfully vaccinated in each of
the official years ending 31st March 1918 to 1927 (inclusive) ... ...
APPENDIX III
Statement showing the number of vaccinations performed in Municipal
towns on children under one year of age ... ... ...
APPENDIX IV
Diagram showing the proportion of population successfully vaccinated
during seven years from 1st April 1920 to 31st March 1927, and the death
rate from small-pox during 1926-27.
PAGE
13-35B
36-39B
40-41B
42-43
44-45
46-48
49-51A
52-55
56-60
NOTES ON VACCINATION IN THE BOMBAY PRESI-
DENCY FOR THE YEAR 1926-1927
1. Selected Districts.—The system introduced in the year 1910
by which the control of vaccination in one district of each Registra-
tion Circle is exercised by the Local Board of that District was
continued throughout the year.
2. Changes in area and administration.—In Sind, 1,973 villages
and in Central Registration District 10 villages are said to have
been depopulated.
In Muscat town vaccination was carried out on a voluntary basis
at the Agency Hospital only when Small-pox was prevailing. Two
hundred and forty-nine persons were vaccinated during the year.
3. Changes in supervising staff.—The following table shows the
various officers who held the appointments of Director and Assistant
Directors of Public Health and the Director, Vaccine Institute,
Belgaum, during the year under report:—
Appointment
Director of Public
Health.
Assistant Director of
Public
Health,
Western
Regis-
tration District.
Assistant Director of
Public
Health,
Central Registra-
tion District
Name
Lt.-Colonel W. O.'s
Murphy, I.M.S.
Lt.-Colonel H. M.
H. Melhuish, D.S.
O., I.M.S.
Dr. J. D. Munsiff,
M.R.C.P., F.R.C.
S., D.P.H.
Dr. J. D. Munsiff,
M.R.C.P., F.R.C
S., D.P.H.
Major B. E. Emin¬
son,
M.B.B.S.,
I.M.S.
Major, W. C. Spack¬
man, M.B.B.S.,
I.M.S.
Dr.
Accacic
da
Gama, D.P.H.
Mr. J. B. Mama,
L.M.S., D.P.H.
Period
1st April 1926 to 31st
October 1926.
1st April 1926 to 11th
February 1927.
12th February to 31st
March 1927.
1st April 1926 to 1st
February 1927.
2nd February to 22nd
March 1927.
23rd February to 31st
March 1927.
1st April to 18th May
1926 and 3rd June
1926 to 31st March
1927.
19th May to 2nd June
1926.
Remarks
On Combined leave.
Services transferred to
the Government of
India
from
1 st
November 1926.
Acting from 1st April
to
31st
October
1926.
Acting.
Acting in addition to
his own duties as
Civil Surgeon, Nasik.
Do.
do.
On leave from 19th
May to 2nd June
1926.
Acting in addition to
his own duties as
officer in charge,
Public Health Labo-
ratory.
P 3—1
2
Appointment
Assistant Director of
Public
Health,
Gujarat Registra-
tion District.
Assistant Director of
Public
Health,
Sind Registration
District.
Assistant Director of
Public
Health,
Southern Regis-
tration District.
Director,
Vaccine
Institute,
Belgaum.
Name
Dr. K. A. Gandhi,
D P.H.
Major W. C. Spack-
man,
M.B.B.S.,
I.M.S.
Dr. R. V. Shivesh¬
warkar, D.P.H.
Dr. J. L. Pinto,
D.P.H.
Dr. J. L. Pinto
D.P.H.
Period
1st April to
14th
October 1926 and
20th November 1926
to 31st March 1927.
15th October to 12th
November 1926.
1st April 1926 to 3lst
March 1927.
1st April 1926 to 31st
March 1927.
1st April 1926 to 31st
March 1927.
Remarks
On
deputation
to
Saharanpur,
15th
October to
19th
November 192G.
Acting in addition to
his own duties as
Civil Surgeon.
Acting in addition to
his own duties.
4. Changes in the strength of establishment.—In consequence of
the entertainment of a full-time vaccinator by the Dhulia Munici-
pality as a result of the introduction of the Bombay District
Vaccination Act, the Shirpur Municipality resolved that a joint post
of vaccinator and Birth and Death Registration Karkun should be
created and the Birth and Death Karkun who had received adequate
training as a vaccinator should be appointed. This arrangement
was sanctioned temporarily as an experimental measure pending the
personal inspection of the working by the Assistant Director of
Public Health.
The Bijapur Municipality appointed a full-time vaccinator
for the City and cancelled the former arrangement by which the
town and the taluka shared the services of one vaccinator between
them.
This necessitated the re-arranging of taluka work. It was done
by dividing Bijapur Taluka excluding Bijapur City into two divi-
sions—Northern and Southern and distributing the work among the
existing staff. No extra vaccinator had to be engaged by the
Bijapur District Local Board.
The Kurundwad Senior State entertained an independent Inspec-
tor of Vaccination, as the experimental arrangement of entrusting
vaccination inspection work to the Medical Officers of the Taluka
Dispensaries did not prove satisfactory.
The Darbar of Bansda State has proposed to make its own
arrangements for vaccination.
In Aden four male and three female vaccinators were engaged
temporarily during an outbreak of Small-pox.
The permanent strength of the Department was the same as in
the previous year.
3
Primary Vaccination (Appendix I, Statements I and III)
5. During the year 1926-27, 663,052 persons were primarily
vaccinated against 673,235 in the previous year. The decrease is
observed in the Southern, Gujarat and Sind Registration Districts.
The main cause of the decrease is the prevalence of cholera towards
the end of vaccination year in the Karnatik. The services of
vaccinators in the badly affected Talukas were utilized for cholera
duty.
In Kanara the decrease is due to the fact that during the previous
year there was Small-pox prevailing in the District and large
numbers of vaccinations had been performed exceeding the total
average fixed.
The work of vaccination in the Selected District of Bijapur was
found on the increase and satisfactory.
The decrease in Sind Registration District occurred after Septem-
ber 1926 owing to heavy rains and floods in almost the whole of
Sind which made travelling difficult for vaccinators and people were
unwilling to get their children vaccinated during such unsettled
conditions and partly to the prevalence of malaria. Some vaccina-
tors could not visit all the villages in their charges owing to the
distances between these being too great to be completed in one year,
and the prevalence of Small-pox necessitating their presence in the
affected parts.
The highest decrease was noticeable in the Sukkur (Selected)
District.
6. Results.—Out of 663,052 vaccinations, 567,670 or 85.61 per
cent. were successful, 1,186 or .18 per cent. were unsuccessful and
the results could not be ascertained in the remaining 14.21 per cent.
of the cases. Owing to failure of the first operation 73 persons were
operated on a second time.
7. Age and Sex.—Of the primary vaccinations, 433,534 or 65 per
cent. were of infants under one year of age and 126,078 or 19 per
cent. of children between the ages of one and six years. By sex,
352,677 were males and 310,375 females equal to a proportion of
113.63 to 100.
Re-vaccination (Appendix I, Statements I and III)
8. During 1926-27, 117,264 persons were re-vaccinated against
135,996 in the last year showing a decrease of 18,732. The per-
centage of successful re-vaccinations was 20.95. The results in 55.05
could not be ascertained.
Vaccination in Indian States (Appendix II, Statement I)
9. Vaccination of pilgrims at Karachi.—Temporary vaccination
establishment consisting of one male and one female vaccinator,
one clerk and one coolie was entertained in Karachi for the vaccina-
tion of pilgrims proceeding to Hedjaz. 11,475 pilgrims were vacci-
nated in Karachi, out of these 9,662 were males and 1,813 females—all
were cases of re-vaccination. The total expenditure incurred on the
4
vaccination of these pilgrims amounted to Rs. 871-9-0. In the
preceding year 2,803 pilgrims were vaccinated and the total expen-
diture amounted to Rs. 621-11-4.
10. In the Native States 75,225 persons were primarily vaccinated
against 74,783 in 1925-26. The number of successful cases was
74,639 or 99.22 per cent. The percentage of success excluding
unknown was 99.85.
Re-vaccinations numbered 4,802 against 6,315 in the previous
year. The success rate excluding unknown cases was 74.87.
11. Total operations.—During the year the total number of
primary vaccinations performed amounted to 738,277 and of re-
vaccinations 122,066 against 748,018 and 142,311 in 1925-26.
12. Incidence of Small-pox.—The heaviest incidence of Small-pox
occurred during the first quarter of the year in Surat and Panch
Mahals Districts. In the second quarter of the year it gradually
went down in Surat, Broach, Panch Mahals and Ahmedabad
Districts but again assumed an epidemic form in the last quarter
in Surat District. Out of 2,137 cases reported from Surat District,
Surat City alone was responsible for 945 cases. This shows the
necessity for the introduction of the Compulsory Vaccination Act.
One extra vaccinator was engaged for two months and house to
house vaccination work was done. Services of the Inspector of
Sanitation and Vaccination of the District were lent to the Medical
Officer of Health, Surat Municipality, from February to April 1927
to help him in organizing and carrying on a systematic vaccination
campaign and checking the further spread of the disease. Small-
pox also prevailed in East Khandesh, Ratnagiri, Karachi and
Larkana Districts.
Towards the end of the year an epidemic of Small-pox broke out
in Poona City. With the object of starting an extensive vaccination
campaign an informal meeting was called at the office of the
Director of Public Health to which the Assistant Director of Public
Health, the Executive Officers of the two Cantonments (Kirkee and
Poona), the President and the Medical Officer of Health, Poona City
Municipality, the President of the Poona Suburban Municipality
and the representative of the District Surgeon, G. I. P. Railway,
Poona, were invited.
It was resolved that the number of vaccinators in the City in the
Suburban area and the Cantonments should be increased; that
special meetings of the Municipalities should be held at which the
Assistant Director of Public Health should explain the benefits of
vaccination and enroll the sympathy of the Councillors in promoting
a vaccination campaign ; if slides could be procured, to hold magic
lantern demonstrations ; and exhibit charts at different vaccination
stations showing the difference in mortality among the vaccinated;
and unvaccinated. An account of the meeting and a note giving
details of the incidence of Small-pox and measures adopted to cope
with the disease were published in several local newspapers in
order to allay the panic among the people. As a result of the
campaign during the two following months (April and May) 1,013
5
vaccinations were performed in Poona City ; 642 in the Suburban
area; and 733 in the two Military Cantonments. Two special
vaccinators were entertained by the Municipalities of Poona City
and Poona Suburban.
In some cases it was noticed that timely intimation of appearance
of Small-pox was not given owing to the ignorance or carelessness
of village officers. Attention of the Revenue Authorities was
frequently drawn to this glaring neglect and it is hoped that such
cases will decrease as the village officials are made to understand
their responsibility in this connection.
13. Vaccination Campaigns.—Special vaccination campaigns
among school children in Municipal towns and Taluka Headquarters
were conducted as usual during the last monsoon by the Inspectors
of Sanitation and Vaccination. These campaigns serve to reduce
the number of unprotected children of school-going age in each town
to a certain extent but owing to the apathy of the parents in some
cases, and oppositions in others, they do not do as much good as
could be expected.
On receipt of information of the occurrence of Small-pox from
Railway Medical Officers the vaccinators are directed to introduce
lymph at the places reported without delay.
Vaccination in Police Lines and out-posts is being carried out
regularly, special visits being paid by the vaccinators every month
for the purpose.
The Vaccinators in charge of big fair centres were directed to
push on primary and re-vaccinations in and around the centres well
in advance with the object of keeping these places immune from the
disease. As a result, all the fair centres were free from Small-pox
during the year under report.
Vaccine Institute, Belgaum
14. Repairs.—Current repairs were done as usual by the Public
Works Department.
Refrigerating plant and machinery.—The working of the refrige-
rating plant and machinery was satisfactory.
The average
maximum and minimum temperature readings have been 15.92°F
and 8.14°F respectively with a mean of 12.03°F. The maximum
temperature recorded during the year was 17.5°F.
During the year under review the replating of the battery was
carried out. All the positive plates and a few nagative plates were
renewed.
The existing engine whose running expenses appear to be
excessive has not yet been replaced by a new one. Expert advice
from the Electrical Engineer is to be sought for on the subject.
Expriments of keeping the lymph in cold storage under these
temperatures for longer time than usual with a view to observing.
the effects of temperature and time on its potency have been carried
out and will be carried out in the next year so as to arrive at a
definite conclusion.
6
Drainage.—The drains have continued to work satisfactorily.
Effluent from the septic tank was utilised on sewage farm for crops
of lucern and banana trees. During the rains about an acre of the
sewage farm was used for crops of bajri and jowari which was used
as fodder for calves.
Water supply.—During the summer months shortage of water was
keenly experienced. Strict economy in the supply was essential.
Well No. 3 which had no masonry lining has been taken in hand by
the Public Works Department since March 1927 and the work is in
progress. It is hoped that when this work has been completed the
water shortage will cease.
Cattle Disease.—An
outbreak of Piroplasmosis occurred
among calves. Out of 106 calves, 13 were affected, out of which
6 died. The first two cases were detected in the waiting stables
on 11th November 1926, after the calves had passed the quaran-
tine period of a fortnight.
The infection was confined to
the waiting stables only. This epidemic terminated on 17th
December 1926. The preventive measures which were adopted
by the Institute during the epidemic were found effective and
the Director of the Imperial Institute of Veterinary Research,
Muktesar, expressed his opinion that the preventive measures
adopted at the Vaccine Institute could not have been improved upon.
One calf was said to have been bitten by a snake on the grazing
ground. The snake was not traced. The calf was treated with
anti-venin and recovered.
Lymph Supply.—Careful selection of vesicles on calves at the
time of collecting the pulp helped to maintain the quality of lymph
at a uniform level.
The potency of seed lymph was maintained by its passage
through rabbits.
Tests of potency of lymph before issue.—The practice of testing
the potency of every lymph manufactured in the Institute before
its issue to vaccinators, etc., was continued during the year.
The Director General of Indian Medical Services, during his last
visit to this Institute, expressed his approval of the above measure.
Distribution of lymph.—1,215,330 doses of lymph were issued
during the year as against 1,215,785 during 1925-26. Besides the
Vaccinators of the Presidency, lymph was supplied to Baroda,
Kotah and Jhalwar. Kathiawar, Palanpur and Mahi Kantha
Agencies and Idar States. Civil Medical Officers and others in
Zanzibar, Aden, Portuguese Territory, Persian Gulf and Arabia
were supplied with 91,395 doses of lymph and Military Medical
Officers with 34,635 doses.
Wastage.—The percentage of doses wasted in Sind Registration
District was high but shows some improvement in common with
other Registration Districts.
The results of primary vaccinations performed by the vaccinators
were carefully inspected. A chart showing the results of monthly
primary vaccinations in the five Registration Districts and in the
Bombay City for three years is attached.
Insertion Success rates of Primary Vaccinations
with glycerinated lymph in the several Registration
Districts of the Presidency & Bombay City
for the years 1924-25,25-26 & 26-27.
7
Expenditure.—The total expenditure for the year amounted to
Rs. 49,218-14-5 excluding expenditure on cold store and annual
repairs to buildings as against Rs. 60,766-11-0 last year. There
is thus a decrease in expenditure of Rs. 11,547-12-7 and it is partly
due to the non-employment of a full-time Director, Vaccine
Institute, and partly to the new recruitment consequent on the
retirement of certain senior members of the staff. The net
expenditure after deducting sale proceeds from non-contributing
constituents was Rs. 22,076-12-2 against Rs. 34,519-15-9 in the
previous year. The cost of lymph per dose manufactured was 10.71
pies and the cost per dose despatched was 13.39 pies.
Mr. M. G. Pandit, L.C.P.S., who has been taken on the supervis-
ing staff was sent to the Sanitary Surveyors' and second Class Health
Officers' Classes, Bombay, as a Government nominee. He passed
both the examinations with distinction.
The construction of a suitable rabbit house in the compound of
the Institute at an estimated cost of Rs. 6,132 has been administra-
tively approved by Government and the work will be commenced
as soon as funds are provided.
The following projects are still under consideration :—
(1) Quarters for the staff.
(2) A new school house.
(3) Lecture hall.
(4) A hostel.
15. Lymph in use.—The quality of lymph supplied from the
Belgaum Vaccine Institute was excellent, no other lymph being used
in the Registration Circles. The following table shows the results
of vaccinations performed in 1926-27 :—
Districts
Western Registra-
tion District.
Bombay City ...
Central Registra-
tion District.
Southern Regis-
tration District.
Gujarat Registra-
tion District.
Bind Registration
District.
Number of operations
Primary
Vaccina-
tion
144,972
20,026
145,402
102,711
123,365
97,738
Re-vacci-
nation
4,769
23,076
10,426
37,888
4,588
18,753
Successful excluding
unknown
Primary
115,142
18,634
129,055
99,404
112,100
91,885
Re-vacci-
nation
1,823
21
1,502
10,687
1,106
1,505
Percentage of success
Primary
99.80
99.63
99.94
99.94
99.68
99.82
Re-vacci-
nation
58.52
95.45
46.65
39 65
31.78
79.96
16. Cost of Vaccination (Appendix I, Statement II).—The cost
of vaccination came to Rs. 6,16,932 against 6,25,016 a decrease of