Appendix.
From S. H. Browne, M. D., Civil Surgeon, Hoshangabad, to the Deputy
Surgeon-General, Central Provinces,—No. 436 of 1882, dated
Hoshangabad, the 12th May 1882.
IN continuation of this office No. 372, dated the 21st ultimo, I have the honor to
report that I have made an inspection of some of the villages in this district in which small-
pox has been most prevalent during the past three months.
2. The details of the inquiries I made regarding the type of the disease ; the influence
on it of vaccination ; and the sanitary condition of the villages, are given in the form of daily
notes during my tour, and are hereto attached.
3. From these notes it will be seen that of 286 persons whom I saw who had suffered
from the disease, 46 only or 16.08 per cent had been previously successfully vaccinated, and
of these 8 only suffered severely; whilst amongst those who had not been vaccinated the
great majority of cases had been slight.
4. As regards the work of the vaccinators in the villages inspected I am of opinion
that it has been unsatisfactory; the number of children operated on has been comparatively
very small; indeed the vaccinators seem to have confined their operations to those children
who were born within the year. As it appears to me that the extensive prevalence of the
disease is in some measure due to the shortcomings of the vaccinators in the circles of
Handia, Charwah and Pokheria, I have, under the authority of your Circular No. 1999V.,
dated the 20th ultimo, withheld the pay of vaccinators Syud Ibrahim, Abdul Wahab, and
Amir Khan for the month of April, pending your orders.
5. Re-vaccination has not been practised in the circles named in the preceding para-
graph, but in extenuation of the failure of the vaccinators to practise it, I would mention
that any attempt at re-vaccination is met by much opposition on the part of the people, who
seem to consider that in allowing their children to be vaccinated, they have performed a
duty to Government which they should not be called on to repeat.
6. The three vaccinators already named have done practically no work during the
month of April, notwithstanding repeated orders issued from this office directing them to
work with unusual energy. It is a fact, however, that the people are much opposed to vac-
cination during the hot season, and the difficulties in the way of the vaccinators are therefore
considerable.
7. From my own inspection, and the reports by the Native Superintendent which are
attached in the form of statistics, I think there can be no doubt but that in the great
majority of cases the disease which has been so prevalent is really small-pox; cases of
measles being rare.
8. As regards the sanitary condition of the villages in which the disease has been
most prevalent, although it is in almost every case extremely defective, still it is not more so
than that of the great majority of villages in the district generally where small-pox has not
prevailed. No epidemic of small-pox has occurred in the Harda Tahsil for a number of years,
and it seems evident that the present extensive out-break is in great measure the result of
the presence amongst the people of a large number of susceptible persons, the greater num-
ber of cases having occurred in children from 3 to 5 years of age.
9. I am again addressing the Deputy Commissioner on the subject of vaccination, and
also of sanitation in the infected villages, with a view to assistance being rendered to
vaccinators in their work, and to the removal of prominent sanitary defects.
Inspection Notes on Vaccination and Small-pox tour
commencing 5th May 1882.
May 5th.—Harda to Handia. In Handia, a village of more than 400 houses, small-pox
has been prevalent since January 1882, 104 children having suffered from the disease, of
whom 15 died. I examined 62 children who had been reported to have been attacked, and
found that all except two, in whom the symptoms resembled more those of measles and
chicken-pox respectively, were genuine cases of small-pox. The condition of these cases as
regards vaccination, type of disease, and age, are given below:—
Vaccinated.
Mild.
9
Under
one year.
5
Severe.
3
Unvaccinated.
Mild.
36
One to five years.
36
Severe.
12
Above five years.
19