NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
13
The Civil Surgeon considers that the quality of the work has deteriorated in
several of the circles.
The Civil Surgeon was in camp 47 days,inspected the work in all the circles,
and saw 5,825 vaccinated persons.
The Native Superintendent is favorably reported of; he visited each circle
2 or 3 times, and inspected 6,885 vaccinated persons. He gives the average
ratio of success as 93, while the vaccinators return it as 98, and he explains the
difference as due to the fact that in his inspections he saw a number of recent
unsuccessful cases before the vaccinators had had time to repeat the operation.
2 vaccinators are badly reported of.
The attitude of the people has undergone little if any change.
Of small-pox 290 cases were reported by the police. Of the 103 cases
seen by the Vaccination staff 40 were found not to be really that disease; and in
none of the 63 cases of small-pox had the children been vaccinated.
During his inspections the Civil Surgeon found that in several villages the
village forms were not forthcoming, and that in these forms there were frequent
inaccuracies.
The Civil Surgeon is of opinion that the system of employing Hospital
Assistants on vaccination work is objectionable, as it affects their professional
work, and causes much inconvenience to the people, while he believes that the
duty is disliked by the Hospital Assistants themselves. In place of the Hospital
Assistants in charge of the Sadr, the Gadarwara, and the Chhindwara out-station
dispensaries, he would employ one Municipal vaccinator for the work of the 3
towns.
48. Hoshangabad.—The Civil Surgeon, Dr. Henderson, did not take charge
till the vaccinating season had commenced.
The lymph supply was kept up at the 4 dispensary towns by the Hospital
Assistants; the vaccinators all remained at head-quarters during the non-work-
ing season, but did not do any work. Vaccination is chiefly arm to arm.
There is a decrease of 2,816 in the number of operations, but the returns
do not show all the operations ; as those for February and March could not be
obtained from the vaccinator who was under suspension.
There is a decrease in primary operations of 2,967, but an increase in
re-vaccination. The vaccinators do not try and induce people to be re-vaccinated.
All the children available were not vaccinated.
Two improvements have been introduced in connection with vaccination in
towns ; one is that each child vaccinated is furnished with a ticket on which is its
register number : this very much facilitates comparison of the register on inspec-
tion of the children; the other is, that a register of all births reported by the
Police is kept up: this makes it easy to see what children have and what have
not been vaccinated.
At Hoshangabad the rich people are said to object to the vaccination of
their children.
The Civil Surgeon was 36 days in came: he only took charge in December,
and was unable to leave the station for some time after his arrival in consequence
of a case of serious illness at head-quarters: he saw 2,078 persons in 160 vil-
lages.
14
The Native Superintendent was 113 days on tour, visited 468 villages, and
inspected 5,544 vaccinated persons : he is well reported of.
The Civil Surgeon found the registers fairly correct, except in the case of
one vaccinator, whose returns were in many instances unmistakeably false.
Two vaccinators are badly reported of. Most of the vaccinators complain
of the little help they get from the malguzars.
The attitude of the people is much as it was : while in some parts they are
quite ready to have their children vaccinated, in others they resist it : the well-
to-do classes being the most opposed to vaccination.
Of small-pox 560 cases were reported, and of these 258 are said to have
been vaccinated : 112 cases were reported in the town of Hoshangabad.
49. Nimar.— The number of operations is 1,010 more than in 1883-84,
but the Civil Surgeon does not consider this what it should have been, and
would have been, had not most of the vaccinators showed a want of energy, fre-
quently leaving half the children in a village unvaccinated, so that they had to
return to it.
The custom of women returning to their parents house shortly before the birth
of their children, which is very common in this district, makes it more difficult to
thoroughly protect a village, as children born in other villages who are away at
the time of the vaccinator's visit are afterwards brought with their mothers. This
custom also renders the birth return of any village very inaccurate. The Civil
Surgeon has therefore for the past two years followed out the plan of directing
the vaccinators to collect all the children up to 10 years of age, and vaccinate
any unprotected.
More children under one year were actually vaccinated than were alive
according to the Police reports.
The Civil Surgeon thinks that in former years cases of secondary vaccina-
tion were wrongly recorded as those of re-vaccination.
Dispensary vaccination is considered a failure by the Civil Surgeon, the
cause being, that the Hospital Assistant's duties frequently prevent his being
able to take the lymph on the proper day.
The Civil Surgeon was 79 days in camp, visited 379 villages, and inspected
7,283 vaccinated persons.
The Native Superintendent is very favourably reported of Although he
had an unusually large amount of inspection work he did a fair number of opera-
tions himself.
The work of the vaccination staff was fair.
The Civil Surgeon thanks Mr. Bhagwant Rai, Tahsildar of Burhanpur, and
Messrs. Ramchurn Lal and Khandey Rao, Tahsildars of Khandwa, for help: also
the following:—
(1.) Pithoo, Patel of Haraswara.
(2.) Jewan Ram, Patwari of Diplan.
(3.) Babu Rao, Patel of Kurawani.
(4.) Jaloo of Dhamatakee.
(5.) Jugganun, Patwari of Barur.
(6.) Narain, Patwari of Chemati.
(7.) Vital, Patel of Abodh.
15
Of small-pox, 4 cases were reported in April: all proved to be chicken-pox.
At the end of April (1884), the disease were brought to a village by a family
who returned from Khandeish; 7 persons were attacked, of whom 5 were
unvaccinated, and 2 bore doubtful marks : the disease did not spread. In July 4
cases in persons unvaccinated occurred in the house of a Malguzar; they had
just returned from Holkar's territory: the disease did not spread. In March
1885 the disease appeared among the children of the labourers on the railway,
introduced by a child who had come from Holkar's territory with the disease on
it; means were taken to check it, and there was not any extension of the dis-
ease.
50. Betul. — The number of primary operations is larger than that of last
season, by 1,114, and of re-vaccination less by 430. The cost of vaccination is
less, because the Native Superintendent was of a lower grade than last year, and
very little travelling was done by the Civil Surgeon. The Native Superin-
tendent was changed, and the new officer took charge of his duties on the 2nd
December; he inspected 6,380 children, and is well reported of.
Only 509 persons were inspected by the Civil Surgeon, and they were seen
by Doctor Henderson.
51. Chhindwara.—The lymph supply was kept up by the Hospital Assist-
ant of the Sadr and Lodikhera dispensaries. The English lymph proved good.
The number of operations increased by 5,934.
Of the children under 1 year available for vaccination in the Khalsa, 387
are supposed to have been left unprotected.
The number of operations in the Jaghirs is more than it was last season,
but less than in 1882-83.
Of small-pox 235 cases were reported, but as the result of frequent inquiries
from natives of all classes in villages, the Civil Surgeon thinks that many of
these were cases of chicken-pox and other diseases, and that there is very little
real small-pox ; in one village where 12 cases were reported to have occurred,
all were found to be chicken-pox.
The Native Superintendent is well reported of.
In one circle, the Civil Surgeon found marked want of success, due to the
vaccinator having got ill, and kept his lymph till it had become inactive.
52. Seoni.—Vaccination was kept up, except in the months of May and
July.
The English lymph gave successful results in 3 cases out of 5 vaccinated,
and the lymph thus obtained was used throughout the rest of the season.
The number of operations was greater than that of last season by 2,811,
viz. 2,550 by vaccinators, and 261 by Hospital Assistants.
The Civil Surgeon found the work better than usual, except in the Kurai
circle, where, in many of the cases, there was only one vesicle or two : in such
cases he saw marks of scratches showing that the persons had been vaccinated in
more places, but unsuccessfully.
The number of operations performed is larger than that of the births by
4,724.
The Native Superintendent is well reported of.
53. Mandla.—The supply of lymph was kept up all through the year.
The English lymph failed entirely.
16
All the vaccinators except one are well spoken of.
The number of operations is 2,239 less than it was in 1883-84, the falling
off being, the Civil Surgeon thinks, due to the non-vaccination of adults..
The Civil Surgeon was 35 days on tour and inspected 7,203 vaccinated
persons: the Native Superintendent was 124 days on tour, and saw 11,909
operations.
The Native Superintendent is well reported of.
Only half of each circle can be worked over in one season in consequence of
their size.
The Civil Surgeon thinks that the practice of the people offering money to
the vaccinators " has now ceased."
Dispensary vaccination is good.
From small-pox 44 deaths were reported : the deaths took place chiefly
in the parts of the district bordering on Rewah.
The Civil Surgeon is of opinion that by next year all the children under
one year who have not had small-pox will have been vaccinated.
54. Balaghat.—The lymph supply failed, and had to be renewed by a sup-
ply from Nagpur.
The English lymph gave very successful results, and from it alone was the
vaccination carried on.
Vaccination is carried on from arm to arm.
The Malguzars gave assistance.
The Civil Surgeon was in camp 47 days, and the Native Superintendent 152
days.
There is a difference of 20 per cent between the ratio of success returned by
the Native Superintendent (76 ) and that given by vaccinators and the Civil
Surgeon whose ratios are the same (96 ), the difference being explained as
due to persons unsuccessfully vaccinated at the time of the Native Superintend-
ent's inspection having been successfully operated on the second time before the
Civil Surgeon's inspection without the re-entry of their names in the register.
The number of operations is 4,743 more than 1883-84, of which 2,793 are
primary. This large increase is said to be due to many children having remained
unvaccinated last year; but it is calculated that there are still 6,000 children
under one year old unprotected.
Re-vaccinations are 1,950 more than in 1883-84.
The people are favorably disposed towards vaccination.
Dispensary vaccination.—At Waraseoni and Behir all the available children
are vaccinated ; but not at Balaghat. The Civil Surgeon remarks that it should
be remembered the Hospital Assistant at head-quarters had, in addition to his
own work to do that of the Civil Surgeon while that officer was on tour, and
says, that the people at Burha are more opposed to vaccination than they are in
the villages.
From small-pox only 23 deaths were reported.
The Native Superintendent is well reported of.
55. Bhandara.—The lymph supply was kept up all the year round.
The number of operations was 1,853 less than last season : this falling off is
attributed by the Civil Surgeon partly to the non-receipt of vaccinating needles
having delayed the departure of the vaccinators to their circles for some days,
but chiefly to the illness of one of the vaccinators.
17
The Civil Surgeon was 44 days in camp, and saw 4,229 vaccinated persons.
The Native Superintendent was 137 days on tour, and inspected 10,117 persons.
Dispensary vaccination.—At Bhandara, Tirrora, and Pauni, the work was
found good ; and the number of operations increased : at Tumsar and Sakoli the
number of operations is small, though at the latter there is a slight increase. The
small number of operations at Sakoli is attributed to there not being children
available, while the cause at Tumsar is said to be the want of energy of the
Municipal Committee, and the dislike of the upper classes to vaccination.
The Native Superintendent is well reported of, as are also the vaccinators
with the exception of two.
Small-pox.—There were 28 cases and 24 deaths reported in the town of
Bhandara, and 3,253 cases with 519 deaths in the district: in the few cases seen
by the Civil Surgeon the disease was mostly in unvaccinated people, and in
those cases where the patients had been vaccinated the attack was slight.
56. Nagpur.—The report is written by the Native Superintendent, the
Civil Surgeon merely adding his comments.
(As already said the Civil Surgeon did not inspect the work except that of
the Hospital Assistants at the dispensaries).
The lymph supply was maintained at Nagpur and Kamptee.
The English lymph proved very successful.
Two additional vaccinators were employed.
The former Native Superintendent took leave, and the Native Superintendent
from the Betul district was transferred and took charge of the duties on 2nd
January; he inspected 4,134 cases of vaccination, and complains of the difficul-
ties put in his way by the Kotwars and Malguzars of several villages.
Dispensary vaccination.-—The number of operations is less, because the
work has been confined to the towns in which the dispensaries are situated.
Small-pox caused 1,016 deaths according to the reports.
The Native Superintendent says that he found in his inspection that the
disease was very mild in the cases of vaccinated children, and that in one house
the vaccinated children escaped, while those unprotected were attacked.
Yet the people object to vaccination, and in many villages they will not
allow any child to be vaccinated while the small-pox is in their midst, a remark
which is confirmed by Dr. Barter.
The Native Superintendent notices that in the interior of the district, he
found only one or two vesicles.
57. Wardha.—The lymph supply was kept up.
The English lymph proved successful, and took the place of the other.
The vaccinators were directed to follow the plan introduced with success by
Dr. Evers of vaccinating the high caste children first, and use lymph in tubes
or points if necessary, in operating on high caste children, as the parents of such
object to a vaccinator touching them after he has been handling low caste
people.
The Civil Surgeon took over charge of his duties in the end of January
and could not go into camp till 24th Februry on account of professional work a
head quarters, and having to give evidence in Court.
18
He gives instances of the difficulty that is experienced in getting parents
to allow the vaccination of their children, but shows how much may be done by
tact and patience.
The vaccination work is considered satisfactory.
Dispensary vaccination is good, except that of Hospital Assistant Sheoper-
shad at Deoli.
The Civil Surgeon recommends that the vaccination work of Hospital Assis-
tants should be confined to the towns in which the dispensray is situated.
Small-pox caused 878 deaths. In all the cases of the disease in young child-
ren seen by the Civil Surgeon, vaccination had not been performed as also in
many of those in children over 12 years of age.
58. Chanda.—The supply of lymph was kept up till August, when it
became deteriorated, and fresh lymph had to be obtained from Nagpur,
The English lymph failed to give any success.
There was an increase of 610 in the number of operations. The average
of the work in two circles is very low, owing in one to many of the people being
Marias, among whom the work is very difficult in consequence of their timidity,
and in the other to the vaccinator being a new man. The term re-vaccination is
applied to cases in which the operation having, in the first instance, proved
doubtful or unsuccessful, it was repeated.
In the two circles already alluded to the percentage of success is low.
Dispensary vaccination.—All the Hospital Assistants carried on vaccination
except the Hospital Assistant in charge of the Main dispensary who was
exempted, as he had not leisure to do it in addition to his' regular work, which
included the current duties of the Civil Surgeon while on tour.
There was a decrease of 262 in the number of operations performed by
Hospital Assistants ; the decrease was at all the dispensaries except that of
Armori, where the work is very good.
The Civil Surgeon would restrict the work of Hospital Assistants to the
towns in which the dispensary is situated.
Small-pox prevailed more or less all through the year; 3,512 cases with 219
deaths were reported.
The Civil Surgeon's observation lead him to the following conclusions :—
1st.—That small-pox prevailed mostly among adults and older children, and
that infants escaped while older children were attacked.
2nd.—A severe form of the disease was rarely seen in persons who had
good marks of successful vaccination.
3rd.—A mild form of the disease is common after recent successful vaccina-
tion; the type being more severe the longer the interval after vac-
cination at time of attack.
There is still much prejudice against vaccination, but it is gradually getting
less, and the more enlightened of the people have learned from what they have
seen in the late epidemic that if the small-pox attacks a person who has been
successfully vaccinated, the disease runs a short mild course.
Re-vaccination is very much objected to ; arm to arm operations are also
disliked.
Owing to sickness and urgent professional work the Civil Surgeon was
only 37 days in camp.
19
The Native Superintendent was 151 days in camp, and saw 5,484 vaccinated
persons.
The Civil Surgeon considers the returns correct.
59. Raipur.—The Deputy Commissioner in forwarding the Civil Surgeon's
report remarks on the improvement in the relations between the people and the
Vaccination staff compared with what it was in 1883.
The lymph supply was kept up, but towards the end of June it became
inactive, and lymph had to be procured from Nagpur.
The English lymph gave successful results, and the season's work was
carried on mostly with this.
As regards the Provincial department work there is an increase of 1,793
in the number of operations.
The number of children under one year vaccinated is very small: the vac-
cinators allege that the parents will not allow the operations at that age; but
the Civil Surgeon thinks that more should have been done.
The vaccinators were specially asked to pay attention to re-vaccination, but
they did very few such operations, nor did they repeat the vaccination in the
cases of children in which it had proved unsuccessful.
The Civil Surgeon was in camp 37 days, indisposition preventing his staying
out longer ; he returns the percentage of success at 88.69 or 6 per cent less than
last year ; the difference being due to more careful scrutiny, and elimination of
doubtful cases.
The Native Superintendent was 142 days on tour, and saw 16,958 vacci-
nated persons ; he also returned the percentage of success at 3 (per cent) less
than last year from more careful examination of the results.
The vaccinators are not sufficiently careful in recording results, and they
also vaccinate too many children from one vesicle.
Dispensary vaccination. The number of operations is about the same as
last year.
The people of Raipur are backward in availing themselves of the benefits
of vaccination.
Feudatory State vaccination. One Superintendent was employed in the past
season for Chhuikhadan and 6 minor Zamindaris with a population of 180,652.
The work here is fairly good, and the Native Superintendent reports that
the minor States except Chhuikhadan are fairly well protected.
In the work in Raj-Nandgaon State there is an increase of 2,891 operations,
and the prejudice of the people is becoming less. Inoculation is said to have
been carried out in some parts.
In Khairagarh the inspection is still performed by the Hospital Assistants
of Khairagarh and Dongargarh, and they did more of it this season.
The people are beginning to appreciate vaccination.
A man was prosecuted for practising inoculation, but the prosecution failed,
as it could not be proved that he had really used small-pox virus.
60. Bilaspur.—Owing to the extension of vaccination to 4 Zamindaris, it
was necessary to make some alteration in the work allotted to each vaccinator.
20
The Civil Surgeon thinks that 4 additional vaccinators are required in con-
sequence of the extension of the work.
The lymph supply was kept up, and the English lymph gave good results.
The Civil Surgeon was 40, and the Native Superintendent 130 days in
camp.
The Native Superintendent is well reported of.
There is a decrease in the number of operations. due, the Civil Surgeon
thinks, to the absence of 3 vaccinators on cholera duty for a short part of the
working season.
Dispensary vaccination. The Hospital Assistant at the Main dispensary
did little, partly because children were not available in the town for him after
the vaccinators had worked all the non-working season, and partly because he
has little time for the work.
Feudatory State and Zamindari Vaccination: —
In Kawardha the work is very good.
In Pandaria the vaccinators worked with old lymph.
In Sakti the work is good.
In Pendra it is doubtful.
Vaccination is making steady progress in the States, but more vaccinators
are required for those of Kawardha and Pandaria.
In the khalsa the people except Brahmins, Kayets and Banniahs accept
vaccination ; in the Zamindaris there is very decided prejudice against it; and
in the Kurba Zamindari the Zamindar prohibited it, saying that he had a
vaccinator of his own. It was, however, clearly proved, that the man was
really an inoculator.
From small-pox 269 deaths were reported, but the Civil Surgeon thinks it
very doubtful if all cases reported as the disease are really so, as in 4 cases of
so-called small-pox seen by him, not one was really that disease.
61. Sambalpur.—The lymph supply was kept up all the year, and the.
English lymph succeeded in 5 out of 8 operations.
The number of operations is less by 7,105 ; the falling off being due to no
cause in particular.
In the Bamra State the decrease is very large.
The Native Superintendent was 124 days in camp, and saw 18,350 children :
he is reported as intelligent and hardworking.
The Civil Surgeon joined the district in the vaccinating season, and could
make only one short tour: he found the work very good.
The people appear to appreciate the benefits of vaccination.
JAMES H. LOCH, M. D.,
Deputy Surgeon General,
Sanitary Commissioner,
NAGPUR,
The 21st August 1885.
and Supdt. of Vaccination,
Central Provinces.