NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
TRIENNIAL REPORT ON VACCINATION IN THE BOMBAY
PRESIDENCY FOR THE YEARS 1923-24,
1924-25,1925-26
1. Selected Districts.—The system introduced in the year 1910 by
which the control of vaccination in one district of each Registration
circle is exercised by the Local Board of that District was continued
throughout the triennium.
2. Changes in area and administration.—Vaccination of the civil popu-
lation in the Belgaum Cantonment was handed over by that Committee
to the Public Health Department on 1st June 1923. The Municipality of
Karachi took over control of vaccination in Karachi town from the Assis-
tant Director of Public Health, Sind Registration District, from 1st April
1923. The control and supervision of vaccination in Sachin State was
withdrawn as per Government Resolution, General Department, No. 2125,
dated 18th July 1924. The Administrator, Chhota Udepur State, expressed
his desire to separate Chhota Udepur Head Quarter station of the State
from the charge of the Chhota Udepur North Divisional Vaccinator and
place it in charge of a qualified vaccinator under the direct supervision of
the Chief Medical Officer of the State. Nagothna in Kolaba District
ceased to exist as a separate Mahal. The villages in the Nagothna Mahal
have been included in the Pen and Roha Talukas. The States of Western
India—Kathiawar, Cutch and Palanpur are now in direct relations with
the Government of India. In the year 1925-26, 1,985 villages are said
to have been depopulated in Sind. The number of villages depopulated
in 1923-24 and 1924-25 was 1,866 and 2,077 respectively. The reporting
of vaccination results in Bushire has been discontinued at the request
of the Residency Surgeon there for the reason that " Bushire is a purely
Persian town administered by Persian officials who keep no records of
any kind and the preparation of a return worth anything is impossible".
Similarly it is difficult to follow the results of vaccination work in Muskat,
an Arab State, in which there are no rules for the vaccination of the
people. The Agency Surgeon, Muskat, reports that "whenever there
is an epidemic of small-pox, His Highness the Sultan 's Government
make their own arrangements for vaccination of the people in the interior
of the country the records for which are not kept. In the case of the
town of Muskat the vaccinations are arranged for by the Agency Surgeon
but since most of the people continue shifting either to the interior of
the country or to other places it becomes very difficult to follow the
results. Two hundred persons were vaccinated in the Agency Hospital,
Muskat, during the year 1925-26. People as a rule do not come for
revaccinations and hence all the vaccinations may be considered
primary."
3. Changes in supervising staff.—The following table shows the
various officers who held the appointments of Director and Assistant
P 4—1
2
Directors of Public Health and the Director, Vaccine Institute, Belgaum,
during the triennium:—
Appointment.
Director, Public Health
Assistant Director of Public Health,
Western Registration District.
Assistant Director of Public Health,
Central Registration District.
Assistant Director of Public Health,
Guzerat Registration District.
Assistant Director of Public Health,
Sind Registration District.
Assistant Director of Public Health,
Southern Registration District.
Director, Vaccine Institute, Bel-
gaum.
Name.
Lieut.-Colonel W. O'S.
Murphy, I.M.S.
Lieut.-Colonel H. M. H.
Melhuish, D.S.O.,I.M.S.
Dr. J. D. Munsiff, D.P.H.
Dr. Accacio da Gama,
D.P.H.
Dr. J. L.Pinto, D.P.H...
Dr.R. V. Shiveshwarkar,
D.P.H.
Dr. J. L.Pinto, D.P.H...
Dr. K. A. Gandhi, D.P.H.
Dr. F. Barretto, D.P.H..
Dr. R. V. Shiveshwarkar,
D.P.H.
Dr. R. D. Dalai, D.P.H..
Dr.K.A.Gandhi.D.P.H.
Lieut.-Colonel H. M. H
Melhuish, D.S.O., I.M.S
Dr. J. L.Pinto, D.P.H...
Dr. R. W. Fisher, D.P.H
Dr. R. D. Dalai, D.P.H
Lieut.-Colonel H. M. H
Melhuish, D.S.O.,I.M.S
Dr. J.L.Pinto, D.P.H..
Period.
30th March 1924 to
10th February 1926.
1st April 1923 to 29th
March 1924 an
11th February 1926
to 31st March 1926.
1st April 1923 to 31st
March 1926.
3rd April 1923 to 31st
March 1926.
1st and 2nd April
1923.
1st to 6th April 1923.
7th April 1923 to 18th
June 1925.
19th June 1925 to
31st March 1926.
1st April 1923 to 15th
April 1923 and 18th
September to 17th
November 1925.
16th April 1923 to
17th
September
1925
and
18th
November 1925 to
31st March 1926.
1st April 1923 to 0th
April 1924.
7th April 1924 to
13th June 1925.
14th to 23rd June
1925.
24th June 1925 to
31st March 1926.
1st April 1923 to 25th
October 1923.
26th October 1923 to
5th April 1925.
6th April 1925 to
3rd February 1926.
4th February to 31st
March 1926.
Remarks.
Acting.
Acting.
In addition to
his
own
duties.
In addition to
his own duties
from
26th
October 1923.
In
addition
to his own
duties.
In
addition
to his own
duties.
The death of Dr. Fisher in October 1923 was a grievous loss to the
Institute and to vaccination in general. He was the first Director
of the Institute and devoted his untiring energy and many talents
to the very special work of his appointment. His conduct of the
Institute and his technical work drew expressions of appreciation
from officials, medical scientists and many others.
4. Changes in the strength of establishment.—The combined post of
Inspector of Kurundwad Junior and Senior States was done away with
4
average annual number of vaccinations performed together with the
average annual success rate for the last three triennial periods are shown
below :—
Periods.
1917—1920
1920—1923
1923—1926
Average annual
number.
639,034
601,881
628,969
Average annual
success rate.
99.59
99.64
99.67
The percentage of unknown cases for the Presidency excluding Aden
during the year 1925-26 was 10.07 against 9.53 in the previous year
while for Aden it was 91.50 against 92.75. The average annual per-
centage for the triennium being 12.39 against 11.53 in the previous
triennium.
Re- Vaccination (Appendix I, Statements I and III)
6. During 1925-26, 135,996 persons were re-vaccinated against
114,231 in the previous year and 112,268 in 1923-24. The annual average
number of persons re-vaccinated during the triennium was 120,832
against 102,421 in the preceding triennium, showing an increase of
18,411. The number of successful re-vaccinations was 30,680 during
1925-26 against 26,114 in 1924-25 and 25,906 in 1923-24. The average
number of successful re-vaccinations was 27,566 during the triennium
against 24,762 in the preceding triennial period. By Registration Circles
the decrease is noticeable in Gujarat and Central Registration Districts
and it is attributable to the apathy of the public towards re-vaccination.
In Karachi District the decrease is attributed to fewer pilgrims being
re-vaccinated during the year under report.
7. Vaccination of Pilgrims at Karachi.—A temporary vaccination
establishment consisting of one male and one female vaccinator, one
clerk and a coolie was entertained in Karachi town for the vaccination
of pilgrims proceeding to Hedjaz, by whom 2,803 pilgrims were re-vacci-
nated, the total expenditure being Rs. 621-11-4 against Rs. 708 in the
previous year.
Vaccination in Indian States (Appendix II, Statement I)
8. In the Indian States shown in Appendix II, there were 74,783
persons primarily vaccinated against 75,577 in the previous year and
72,291 in 1923-24. The average number of successful cases was 73,542
against 53,320 in the preceding triennium. Considering only those cases in
which the results were definitely ascertained the percentage of success was
99.77 against 99.74 in 1924-25 and 99.40 in 1923-24.
Re-vaccinations numbered '6,315 against 4,966 in the previous year
and 3,536 in 1923-24. The success rate excluding unknown cases was
65.35 against 64.81 in the previous year. The rate of unknown results
was 10.70 per cent.
9. Total operations.—During the year the total number of primary
vaccinations performed amounted to 748,018 and of re-vaccinations
142,311 against 698,786 and 119,217 in 1924-25.
5
Incidence of Small-pox
10. Small-pox prevailed in a severe form during the first quarter of
the year in Surat, Broach and Ahmedabad districts. This infection in
Guzerat continued over from last year. It gradually died out in Broach
and Kaira Districts but elsewhere it lurked on in a mild form during the
second and third quarters of the year and again assumed an epidemic form
in Surat District. It also appeared in Bijapur, East Khandesh, Thana,
Sholapur, Larkana, Sukkur and Aden. In Aden extensive house to
house inspection and vaccination work was carried out vigorously with
the assistance of an additional temporary establishment engaged for the
purpose.
Failure to notify the appearance of infection until the epidemic was
well established and beyond control occurred as usual in a number of
places.
11. Vaccination Campaigns.—Vaccination campaigns were conducted
in mills and schools and it is hoped that the number of unprotected children
of school going age will be reduced to a minimum. The scheme drawn
up during the year 1924-25 for the periodical inspection of Police Lines
and out posts and vaccination of all children was carried out by vaccina-
tors in all Registration Circles. At big fairs vaccinators were directed
to push on primary and re-vaccination in and around the fair centres
well in advance of the festivals with a view to keep these places free from
small-pox; as a result, all fair centres excaped infection.
VACCINE INSTITUTE, BELGAUM
12. Repairs.—No new buildings were constructed—A verandah was
added to the power house on the eastern side and a platform was
constructed in well No. 1 to facilitate repairs to the pumping machinery
being carried out.
Refrigerating plant and machinery.—A breakdown which occurred in
the previous year necessitated a new cylinder and connecting rod. These
were received from England and fitted up bringing the engine again
into commission.
A serious breakdown in the Gardener engine occurred which was
attended to by the Electrician in charge as promptly as possible. The
three engines are old, noisy and liable to break down and it is time that
they were replaced by up-to-date engines. A proposal is, however,
under consideration to obtain current from the military power station
in Belgaum Cantonment.
The repairs carried out to the cold storage with a view to improving
insulation, etc., have proved very satisfactory. The average morning
and evening temperature readings have been 14.69°F. and 11.70°F.
respectively. The maximum temperature reached during the year was
18°F. while a daily minimum of 10°F. was always obtained.
The experiment of keeping the lymph in cold storage under these
temperatures for much longer periods than formerly is being carried
out.
6
Drainage.—The drainage system has continued to work satisfactorily.
Care is exercised to maintain the efficiency of the drains. The land
used as a sewage farm was under the management of the Institute staff.
Crops of lucern were grown and used for feeding the calves and rabbits.
Banana trees served to absorb the surplus effluent during the summer
months. Jwari and bajree were also grown for fodder during the rains.
It may be noted that during this summer the effluent was considerably
reduced owing to some scarcity in water which necessitated curtailing the
supply generally.
Water-supply.—By observing strict economy in the consumption of
water and by curtailing the supply, the scarcity referred to above was
just got over. No water carts were engaged to supplement the ordinary
supply, as has been necessary on previous occasions.
This question of water-supply is one of the most important points
requiring consideration. The supply from the two pucca wells is
undoubtedly insufficient to meet.all the demands of the Institute. The
new well does not seem to have answered expectations and the yield from
both shows a gradual tendency to decrease. This is probably due to a
rapid extension of Belgaum Town towards the Institute where an exten-
sive area at a somewhat lower level than the Institute is being built over
and a large number of wells have been sunk. These are probably
affecting the supply of the present Institute wells. The best means of
supplementing the existing supply is under consideration.
Supply of calves.—The practice of obtaining calves on hire from local
butchers was continued. This system is not without its drawbacks as
the Institute is dependent on the caprice of these " contractors ". There
being no actual contract if it does not suit them to buy calves for any
reason, no calves are forthcoming. A crisis of this nature occurred
during the year and the Institute authorities were compelled to buy 52
calves themselves in the open market which put them to a deal of
unnecessary troubles there being no staff for this purpose. With the
help of the Cantonment Magistrate, however, the difficulty was overcome,
and by November a large supply of calves was obtained from the
contractors.
Cattle Disease.—No epizootic occurred during the year 1923-24. In
1924-25 an outbreak of Rinderpest caused heavy loss to the Institute
with 47 cases and 34 deaths. During the year under report a second
small outbreak of Rinderpest occurred among the calves in the month
of May. The exact source of infection could not be definitely traced. In
all 6 cases and 3 deaths occurred before the outbreak was brought under
control.
A system of notification of infectious cattle diseases by the Civil
Veterinary Department was observed during the year. On receipt of
the notification the calf contractors are informed in order that they may
not buy animals from infected villages.
Three calves were bitten by snakes. They were immediately treated
with Anti-Venin inoculations. Two were saved and one died.
Insertion success rates of Primary Vaccinations with giycerinated
lymph in the Several Registration Districts of the Presidency and
Bombay city for the years 1923-24, 24-25 & 25-26.
7
Lymph-supply.—Strict and careful selection of vesicles on calves at
the time of collection of pulp helped to maintain the quality of lymph
at a uniform level.
The potency of seed lymph was maintained at a high level by passage
through rabbits. Alternate passage of a strain from calf to rabbit and
rabbit to calf without waiting for deterioration of lymph was found to
be effective. The quality of lymph continued as usual to be satisfactory
giving case success rates of over 99 per cent.
Tests of potency of lymph before issue.—The practice of testing the
potency of every lymph manufactured in the Institute before issue
was continued during the year.
Distribution of lymph.—1,215,785 doses of lymph were issued during
the year as against 1,177,570 and 1,184,957 during 1924-25 and 1923-24
respectively. Besides the vaccinators of the Presidency, lymph was
supplied to Paroda, Kotah, Jhalwar, Kathiawar, Palanpur, Mahikantha
Agencies and Idar States. Civil Medical Officers and others in Zanzibar,
Aden, Portuguese Territory, Persian Gulf and Arabia—were supplied with
106,735 doses of lymph; and Military Medical Officers with 30,790
doses.
The results of primary vaccinations performed by the vaccinators
were very thoroughly inspected. A chart showing the results of monthly
primary vaccinations in the five Registration Districts for 3 years and in
the Bombay City for two years is attached.
Expenditure.—The total expenditure for the year amounted to
Rs. 60,766-11-0 excluding expenditure on cold store and annual repairs
to buildings as against Rs. 60,647-12-2 last year. This shows an increase
of expenditure (Rs. 118-14-10) over the previous year. It is to be noted,
however, that the amount of lymph manufactured was far in excess of
previous years, a balance of 468,590 doses of lymph being carried over
to next year. The net expenditure after deducting sale proceeds
from non-contributing constituents was Rs. 34,519,-15-9 against
Rs. 40,129-3-10 in the previous year. The cost of lymph per dose
manufactured was 11.14 pies and the cost per dose despatched
15.50 pies.
The work of the Vaccine Institute, Belgaum, during the year under
report was, therefore, very satisfactory.
The following are the requirements of the Institute and they are
mentioned below in order of their urgency :—
(1) Utilizing the existing kutcha well on the premises as
a supplemental source of water-supply, since the present
source is becoming inadequate. It is proposed to have this
well masonry built and provided with a motor pump, pipe
connections, etc.
(2) A suitable and sanitary rabbit house.
8
(3) Additional quarters for the staff.
(4) A new school house with accommodation for 50 boys.
(5) Lecture Hall.
(6) Hostel for vaccinators and graduates attending the special
training classes held at the Vaccine Institute, Belgaum.
On April 6th, 1925, Dr. R. D. Dalal went on six months' leave prepara-
tory to retirement after over 27 years' valuable service of which the last
1 year, 5 months and 11 days were spent as Director of the Vaccine
Institute.
Lymph in Use
13. The quality of lymph supplied from the Belgaum Vaccine Insti-
tute was excellent, no other lymph being used in the Registration
Circles. The following table shows the results of vaccinations performed
in 1925-1926.
Districts.
Western Registration District .. .. ..
Bombay City .. .. .. .. ..
Central Registration District .. .. ..
Southern Registration District .. ..
Guzerat Registration District .. ..
Sind Registration District .. .. ..
Number of operations.
Primary.
142,367
18,866
142,688
103,088
125,229
90,138
Re-vaccination.
5,470
8,878
4,858
49,760
5,786
11,736
Successful
excluding
unknown.
Primary.
114,999
17,600
126,061
100,856
113,649
93,438
District.
Western Registration District .. .. ..
Bombay City .. .. .. .. ..
Central Registration District .. .. ..
Southern Registration District .. ..
Guzerat Registration District .. ..
Sind Registration District .. .. ..
Successful
excluding
unknown.
Re-vaccination.
1,128
1
1,852
15,020
1,440
1,961
Percentage of success.
Primary.
99.70
99.18
99.95
99.94
99.61
99.85
Re-vaccination.
27.12
100.00
54.07
42.12
34.39
33.47
14. Cost of Vaccination.—The cost of vaccination came to Rs. 6,25,016
against Rs. 6,15,187 and Rs. 6,18,353 in the years 1924-25 and in 1923-24
respectively. The rise is due to increased rate of Government subsidy
on account of the time-scale pay of vaccinators and paid candidates,
to pony allowance, and to the maintenance of a temporary establishment
in the Thar Parkar District.
9
The average cost of each successful case of vaccination was
Rs. 1-0-10 against Rs. 1-1-2 in the previous year and Rs. 1-1-1 in
1923-24.
The average annual expenditure for the triennium amounted to
Rs. 6,19,519 against Rs. 6,09,892 in the preceding triennium, whilst the
average number of successful primary and re-vaccinations (excluding
vaccinations at dispensaries) came to 581,657 against 550,735, the average
cost per each successful case during the triennium being Rs. 1-1-0
against Rs. 1-1-9 in the last triennium.
15. Inspection work of the Assistant Directors of Public Health and
Inspectors of Sanitation and Vaccination.—The Assistant Directors of
Public Health inspected 23,813 vaccinated persons or 4.01 per cent. of
the total in 1925-26 against 27,749 in the previous year; of these 309
were re-vaccinations. The success rates observed by these inspections
worked out at 94.86. The annual average number of inspections
for the triennial period was 24,009 against 20,147 in the previous
triennium.
The Assistant Directors visited 538 towns and villages and travelled
23,813 miles during the year 1925-26.
The Inspectors of Sanitation and Vaccination inspected 207,326
vaccinated persons in 9,140 towns and villages and travelled 73,580 miles
in 1925-26.
Thus the results of 231,139 vaccinations or 40.62 per cent. were
checked by examination. The success rate of primary vaccinations as
ascertained by the Assistant Directors of Public Health was 94.86 and by
Inspectors 96.11 as against 97.94 and 98.93 respectively, in the previous
year.
COMPULSORY VACCINATION
16. The Compulsory Vaccination Act has been newly introduced
in the Ahmednagar and Belgaum Cantonments and in Dhulia
Town.
By proclamation of the Rajpipla State authorities in 1925 vaccination
was made compulsory as a temporary measure in Avidha village of
Jhagadia Taluka where a severe form of small-pox had become
prevalent. A special vaccinator was also requisitioned. The proclama-
tion was extended to three other villages and to Rajpipla and Bhalod
towns and was in force throughout the year.
The compulsory Vaccination Act is in force in the following towns.—
Bombay, Bandra, Kurla, Ahmedabad, Karachi, Hyderabad, Sukkur,
Rohri, Larkana, Deolali Cantonment, Ahmednagar Cantonment,
Belgaum Cantonment, Dhulia town and Aden.
Bombay.—In Bombay City the Act has been in force for the last 48
years. The following table shows the progress made in the protection
of infants during the last eight years and the annual average number of
P4—2
10
vaccinations performed during the two years preceding and the four
decennial periods succeeding the introduction of the Act.:—
Years.
1
Average 1876-77 and 1877-78 .. ..
Average from 1878-79 to 1887-88 ..
Average from 1888-89 to 1897-98 ..
Average from 1898-99 to 1907-08 ..
Average from 1908-09 to 1917-18 ..
1918-19 .. ..
1919-20 .. ..
1920-21 .. ..
1921-22 .. ..
1922-23 .. ..
1923-24 .. ..
1924-25 .. ..
1925-26 .. ..
Births
returned as
having
been re-
gistered.
2
13,593
15,054
14,947
16,059
20,432
21,098
19,875
19,731
19,125
20,452
20,995
21,838
20,268
Deaths
registered
among
children
under one
year.
3
6,980
6,072
6,654
9,319
8,132
13,268
12,504
10,896
12,751
8,236
8,632
0,156
7,212
Children available
for vaccination.
Births
minus
deaths.
4
6,613
8,982
8,293
6,740
12,201
8,230
7,371
8,835
6,374
12,216
12,363
12,682
13,056
At the rate
of 31 per
1,000 of
population.
5
19,977
22,771
25,023
25,733
30,347
30,362
30,362
30,362
36,453
36,453
36,453
36,453
36,453
Years.
1
Average 1876-77 and 1877-78 ..
Average from 1878-79 to 1887-88 ..
Average from 1888-89 to 1897-98 ..
Average from 1898-99 to 1907-08 ..
Average from 1908-09 to 1917-18 ..
1918-19 .. ..
1919-20 .. ..
1920-21 .. ..
1921-22 .. ..
1922-23 .. ..
1923-24 .. ..
1924-25 .. ..
1925-26 .. ..
Children under one year successfully vaccinated.
Number.
6
8,526
11,894
13,879
11,494
14,348
11,373
9,809
11,227
12,856
11,829
12,034
12,826
12,025
Ratio per 100
on those in
column 4.
7
128.93
132.42
167.36
170.54
117.57
138.19
133.03
127.07
201.69
96.83
97.34
101.14
92.10
Ratio per 100
on those in
column 5.
8
42.68
52.53
55.46
44.67
47.28
37.45
32.31
36.98
35.27
32.45
33.01
35.18
32.99
ii
Karachi.—In Karachi City, the Compulsory Vaccination Act has
been in force for 46 years and the following table shows the average
number of vaccinations performed for the four decennial periods together
with details for the last six years :—
Years.
1
Average from 1880-81 to 1880-90 ..
Average from 1890-01 to 1899-1900 ..
Average from 1900-01 to 1009-10 ..
Average from 1910-11 to 1919-20 ..
1920-21 .. ..
1921-22 .. ..
1922-23 .. ..
1923-24 .. ..
1924-25 .. ..
1925-20 .. ..
Births
returned
as having
been re-
gistered.
2
3,134
4,180
5,515
6,535
7,465
8,076
7,194
8,841
8,534
9,366
Deaths
registered
among
children
under one
year.
3
720
1,254
1,554
1,708
1,818
2,137
1,768
1,904
2,146
2,082
Children available
for vaccination.
Births
minus
deaths.
4
2,414
2,926
3,961
4,826
5,647
5,939
5,426
6,937
6,388
7,284
At the rate
of 31 per
1,000 of
population.
5
2,118
3,261
3,476
3,605
4,681
6,696
6,696
6,961
6,961
6,961
Years.
1
Average from 1880-81 to 1889-90 ..
Average from 1890-91 to 1890-1900 ..
Average from 1900-01 to 1919-10 ..
Average from 1910-11 to 1919-20 ..
1020-21 .. ..
1921-22
..
..
1922-23 .. ..
1923-24 .. ..
1924-25 .. ..
1925-26 .. ..
Children under one year
successfully vaccinated.
Number.
6
2,912
3,061
3,704
4,282
4,645
4,712
4,311
5,437
5,214
5,487
Ratio per 100
on those in
column 4.
7
120.63
104.61
93.51
88.73
82.26
79.34
79.46
78.38
81.62
75.03
Ratio per 100
on those in
column 5.
8
137.49
93.87
106.56
118.77
99.23
70.37
64.39
78.10
74.90
78.82