NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
No. 2924/158
FROM
J. W. CHISHOLM, ESQUIRE,
OFFG. SECRETARY TO THE CHIEF COMMISSIONER,
Central Provinces.
To
THE DEPUTY SURGEON-GENERAL,
Central Provinces.
Dated Nagpur, the 6th August 1880.
SIR,
I am directed to acknowledge your letter No. 49-C., dated 23rd July
last, submitting Surgeon-Major Barter's report on Vaccination in the Central
Provinces during 1879-80, and in reply to make the following remarks on the
general results of the year.
2. The numbers vaccinated by the Vaccine department are returned at
276,657 as against 242,301 in the previous year, or an increase of 34,356 in the
number of persons vaccinated. In addition Hospital Assistants at dispensaries
vaccinated 20,912 persons compared with 19,740 in 1878-79, or an increase of
1,172 persons vaccinated ; altogether therefore 35,528 more persons were vacci-
nated during the past as compared with the previous year.
3. The Chief Commissioner trusts that the returns have been properly
scrutinized, and that the statistics finally furnished may be accepted as fairly
reliable. This was clearly not the case as regards the figures submitted for
1878-79, and accordingly a corrected statement is furnished with the present
report. Dr. Barter explains that " by an oversight the operations performed by
" Hospital Assistants in charge of dispensaries, also those performed in Native
" States, were included in this statement : again, the work returned by eight
" vaccinators in the Saugor district, who, later on in the year, were proved to
" have systematically falsified their returns, was also shown." It was necessary
to eliminate " these two sources of error" to admit of a correct comparison
between the two years. The Chief Commissioner has had the original and the
amended statements compared, and finds that the errors extend far beyond
the "two sources" noted by Dr. Barter. In the original return the num-
bers vaccinated stood at 295,741, and in the amended return these
have been reduced to 242,301, being a difference of 53,440.
Of this
difference 25,202 are persons vaccinated in Native States, and 11,042 are
persons wrongly shown as vaccinated in the Saugor returns. Thus " the
"two sources of error" indicated by Dr. Barter account for only 36,244
out of the difference of 53,440 persons shown in excess of the proper figures, and
the remaining 17,196 persons represent the excess entries relating to other dis-
tricts. As a fact the entries relating to every district appear to have been
wrong in the original statement, at least in no single instance do the figures
recording the simple fact of the actual number of persons vaccinated remain the
same in the two statements, and in some districts the difference is considerable,
thus:—
Jubbulpore
Hoshangabad
Chanda
No. of persons.
By original Statement.
...16,137
...17,430
...21,938
Vaccinated 1878-79.
By amended Statement.
...12,778
...14,951
...19,902
4
tions generally can be placed on a satisfactory footing. Looking at the record
of years contained in Section IV. the progress achieved in actual work done is
considerable, viz. from 17,466 vaccinated in 1867 to 307,212 vaccinated in the
past year. Experience has now been gained, and with continued progress it
remains to ensure that the vaccination undertaken is carried out with care and
efficiency.
9. I am to note that the report omits to mention the extent to which the
Vaccination department assisted in general sanitary work. The point should
not have been overlooked, as the subject was required to be specially dealt with
by paragraph 15 of letter from Home Department, dated 21st August last, for-
warded to you for compliance with this office No. 3668-195, dated 4th Septem-
ber. The Chief Commissioner believes that much good sanitary work is done
by the Vaccination department, especially by Civil Surgeons in the course of
their vaccination inspections. The Sanitary report for 1879, paragraph 86,
shows that a set of men are now being specially trained in sanitary matters, so
that they may advise and instruct the people, among whom their vaccination
work throws them for several months in the year, and, at the same time, it is
stated that " the admission to the department of uneducated men has ceased."
Clearly then, persistent efforts are being made to improve the standard of quali-
fication of the vaccination staff so as to utilize them more fully in the general
purposes of sanitation ; but, in future reports, I am to request that, in accordance
with the orders above referred to, the aid rendered by the Vaccination depart-
ment in sanitary matters may be distinctly recorded.
10. The Chief Commissioner's acknowledgments are due to several Civil
Surgeons who have ably pressed on the work of vaccination, and to Dr. Barter
for his zealous and careful control.
I have the honor to be,
Sir,
Your most obedient Servant,
J. W. CHISHOLM,
Offg. Secretary.
No.49/C.
FROM
J. A. C. HUTCHINSON, M. D.,
DEPUTY SURGEON GENERAL,
Central Provinces,
To
THE OFFG. SECRETARY TO THE CHIEF COMMISSIONER,
Central Provinces.
Dated Mortakka, Nimar, the 23rd July 1880.
SIR,
In forwarding the report on Vaccination in the Central Provinces during the season
1879-80, drawn up by Surgeon Major J. F. Barter, for the consideration of the Chief Com-
missioner, I have the honor to make a few observations, the brevity of which I beg to be
excused for, as I have, as yet, had no practical experience of Vaccination work in these
Provinces.
2. It is satisfactory to know that vaccination was prosecuted with energy during the
above period by the majority of the agents employed. The published results testify to
this:—in a population of 7,409,865, a total of 253,308 primary and successful operations
were secured. These figures represent a gain over the numbers of the preceding season
of 34,356.
3. Still more cheering results could have been obtained had all vaccinators worked
with the same determination and earnestness to secure success, and had all Native Superin-
tendents followed in the track of the workers and convinced them that their work was
neither disregarded nor unwatched.
4. I agree with Surgeon Major Barter that there is a medium to be observed on the
part of Civil Surgeons between a lavish expenditure of time in supervision, and a rapid,
hurried and short passage over the district.
The well laid out expedition, covering a few days at the outside, and directed at hap-
hazard to some few villages, here and there, in the circle, would be more productive of use-
fulness than a prolonged and more systematic inquiry.
A searching and crucially testing inquiry confined to a comparatively few villages
in each circle, would be very unsettling and disquieting to the mind of the careless and faith-
less workman. Under a plan like this the vaccinator could never be certain at which por-
tion of his course he would be subjected to this searching examination and consequently his
earnest desire would be that sincerity and large results were characterstic of the entire
portion of his work.
5. It seems to me open to discussion whether the plan of employing the Hospital
Assistant so extensively in vaccinating work is altogether to be commended. This medical
subordinate's chief aim in his public life is to secure the popularity and success of the
institution with which he is connected, and vaccination, with all its great advantages, should
be altogether secondary to his legitimate work.
Hurried visits to neighbouring villages with the view of securing cases for vaccination
might prejudice the popularity of his dispensary, not only by being absent when required,
but in raising the suspicion of the villagers in the neighbourhood.
If each vaccinator accomplished what he ought to it might be -unnecessary to place
too much pressure on the Hospital Assistant to go beyond the special work he is called
upon to foster.
I have the honor to be,
Sir,
Your most obedient Servant,
J. A. C. HUTCHINSON, M. D,
Deputy Surgeon General,
Central Provinces.
INDEX.
Inefficient men got rid of ... ... ...
Comparison of results of 18,78-79 and 1879-80 arranged for ...
Primary and re-vaccination ... ... ...
Causes of reduced expenditure ... ... ...
Cost of Establishment
...
...
...
Remarks on the season's work ... ... ...
Remarks on the inspections performed by Civil Surgeons and
Native Superintendents of Vaccination ... ...
Work done in each district
...
...
...
Cause of delay in the submission of report
...
...
PARA.
1
2
3
4
5
6&7
8—11
12—34
35
22 7 80 2C 347 260
10
vaccinated, and 20 among unprotected persons: 11.91 per cent was the mortality
In the small-pox hospital London in 20 years among cases showing one indiffer-
ent vaccine cicatrix and 3.83 among those showing one good mark, the mortality
decreasing to 0.55 per cent among those showing four cicatrices : making every
allowance for the difficulty of obtaining correct data in Sambalpur and the
circumstances of a London hospital as compared with an Indian hut, the
conclusion forced on one is that the quality of the work in Sambalpur is not as
good as it might be. If Mr. Harrison and Civil Surgeons generally would carry
out the system insisted on by Dr. Browne in Hoshangabad, that is to insist on
four distinct points of insertion of lymph, they would find mortality among
vaccinated persons reduced to a minimum when an epidemic of small-pox occurs.
The prevalance of small-pox hindered the vaccinators and a lower out-
-turn is reported,—14,422 as against 15,843 or an average of 2,787 per man ; this
however is good work and shows that the people have not lost faith in vacci-
nation.
35. The incorrect manner in which the statements have been submitted
has delayed the submission of this report by not less than one month.
NAGPUR:
The 9th July 1880.
J. F. BARTEK,
Surgeon Major.
20 7 80 8C 312 260
DISPENSARY VACCINATION.
Statement No. III., showing Dispensary Vaccination in the Central Provinces, during the year 1879-80.
Districts.
1
Saugor... ...
Damoh...
Jubbulpore... ...
Narsinghpur... ...
Hoshangabad... ...
Nimar... ...
Mandla... ...
Betul... ...
Chhindwara... ...
Seoni... ...
Balaghat... ...
Bhandara... ...
Nagpur... ...
Wardha... ...
Chanda... ...
Baipur... ...
Bilaspur... ...
Sambalpur... ...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Total...
Number of Dispensaries in each district
to which a vaccinator is attached.
2
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Average number of vaccinators attached
to dispensaries during the season.
3
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Total number of persons vaccinated.
4
1,547
944
5,619
1,480
2,839
381
239
488
902
987
444
453
871
633
1,759
620
367
339
20,912
Average number of persons vaccinated
by each vaccinator.
5
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Primary Vaccinations.
Total.
6
1,534
944
5,478
1,476
2,813
375
239
484
614
974
444
453
871
633
1,737
620
364
333
20,386
Successful.
Under one year.
7
844
415
1,761
709
1,795
294
80
233
535
232
92
224
609
195
998
379
86
20
9,501
One and under six.
8
448
410
2,960
576
646
59
107
183
57
439
252
143
217
173
539
171
153
291
7,824
Total of all ages.
9
1,317
878
5,080
1,338
2,570
354
215
424
603
910
394
368
830
432
1,594
590
258
325
18,480
Re-vaccinations.
Total.
10
13
...
141
4
26
6
...
4
288
13
...
...
...
...
22
...
3
6
526
Successful.
11
7
...
99
3
4
...
...
2
200
13
...
...
...
...
20
...
3
6
357
Percentage of successful cases.
Primary.
12
88.87
94.10
93.83
94.09
92.34
94.44
92.67
87.78
98.21
93.72
89.33
84.02
95.62
72.85
92.30
96.41
79.88
97.60
92.19
Re-vaccination.
13
58.33
...
83.90
75.00
15.39
...
...
50.00
69.69
100.00
...
...
...
...
90.90
...
100.00
100.00
71.26
NOTE—Columns 2, 3, & 5 are left blank, the work having been performed by Hospital Assistants.
Compartive Statement No. IV., showing the number of persons primarily vaccinated and the number of those persons who Were successfully vaccinated in the Central Provinces in each of the undermentioned official years.
Establishment.
Government... ...
Municipal... ...
Local Funds... ...
Native States... ...
Dispensaries... ...
Army—
European...
...
Natives...
...
Persons primarily Vaccinated.
Total number.
Number successfully vaccinated.
Year ending 30th
April 1866.
...
...
...
...
...
...
...
...
...
...
...
...
Total...
...
...
Total number.
Number successfully vaccinated.
Total number.
Number successfully vaccinated.
Total number.
Number successfully vaccinated.
Total number.
Number successfully vaccinated.
Total number.
Number successfully vaccinated.
Total number.
Number successfully vaccinated.
Total number.
Number successfully vaccinated.
Total number.
Number successfully vaccinated.
Total number.
Number successfully vaccinated.
Total number.
Number successfully vaccinated.
Total number.
Number successfully vaccinated.
Total number.
Number successfully vaccinated.
Total number.
Number successfully vaccinated.
Total number.
Number successfully vaccinated.
Year ending 31st March
1867.
17,466
...
...
...
...
...
17,466
15,060
...
...
...
...
...
15,060
1868.
36,927
43,259
...
...
...
...
80,186
31,435
34,417
...
...
...
...
65,852
1869.
55,348
64,827
...
...
...
...
120,175
46,816
52,033
...
...
...
...
98,849
1870.
86,669
12,299
42,258
...
...
...
141,226
77,166
10,037
32,473
...
...
...
119,676
1871.
49,204
48,764
27,173
...
...
...
125,141
40,394
44,606
17,035
...
...
...
102,035
1872.
33,380
21,127
54,373
...
...
...
108,880
28,775
16,440
45,973
...
...
...
91,188
1873.
45,098
25,090
53,327
...
...
...
123,515
40,734
20,455
45,971
...
...
...
107,160
1874.
128,590
...
...
...
...
...
128,590
112,435
...
...
...
...
...
112,435
1875.
176,893
...
...
...
...
...
176,893
158,704
...
...
...
...
...
158,704
1876.
201,636
...
...
...
9,766
...
211,402
188,384
...
...
...
8,574
...
196,958
1877.
245,224
...
...
...
10,184
...
255,408
229,930
...
...
...
8,988
...
238,918
1878.
260,408
...
...
8,976
19,304
...
288,688
241,633
...
...
8,744
16,964
...
267,341
1879.
235,846
...
...
24,015
19,097
...
278,958
223,036
...
...
23,653
17,114
...
263,803
1880.
254,824
5,238
9,535
17,229
20,386
...
307,212
239,497
5,023
8,788
16,579
18,480
...
288,367
21 7 80 1 & 3 C. 333-260
Dispensary Vaccination 1879-80.
Districts.
Saugor
...
Damoh... ... ...
Jubbulpore... ... ...
Narsinghpur... ...
Hoshangabad ... ...
Nimar... ... ...
Mandla... ... ...
Betul...
...
...
Chhindwara... ... ...
Seoni...
...
...
Balaghat... ... ...
Bhandara... ... ...
Nagpur...
...
Name of Dispensary.
Sadar Bazar... ... ...
Rehli...
...
...
...
Deori... ... ...
Garhakota... ... ...
Kurai... ... ...
Shahgarh...
...
...
Banda... ... ...
Jail... ... ...
Police... ... ...
Damoh Town... ... ...
Hatta... ... ...
Jabera...
...
...
Pathuria... ... ...
Jubbulpore Main... ... ...
Cantonment Branch Dis-
pensary... ... ...
Sehora... ... ...
Murwara... ... ...
Bijeragogarh... ... ...
Thaggi and Police... ... ...
Gadarwara... ... ...
Narsinghpur... ...
Chhindwara... ... ...
Jail and Police... ... ...
Hoshangabad... ... ...
Kothi Bazar... ...
Harda... ...
Seoni... ...
Sohagpur... ...
Khandwa... ... ...
Burhanpur... ... ...
Pandhana... ... ...
Mandhatta... ... ...
Mandla...
...
...
Ramgarh... ... ...
Police... ... ...
Budnur... ... ...
Multai... ... ...
Chhindwara... ... ...
Lodhikera... ... ...
Seoni... ...
Lakhnadon... ... ...
Police and Jail... ... ...
Balaghat... ... ...
Waraseoni... ... ...
Hatta... ... ...
Behir... ... ...
Bhandara... ...
Tirrora...
...
...
Sakoli... ... ...
Itwari...
...
...
Heude... ... ...
Rai Bahadur... ... ...
Mowar... ... ...
Khapa... ...
Umrer... ...
Number of vac-
cinations at each
dispensary.
150
250
250
261
294
219
81
26
16
158
417
131
238
324
1,856
1,104
1,087
651
597
614
463
214
189
603
113
680
923
520
81
124
150
26
120
104
15
319
169
720
182
736
237
14
91
73
86
194
337
93
23
361
56
170
104
150
30
Total.
1,547
944
5,619
1,480
2,839
381
239
488
902
987
444
453
871
Remarks.
Districts.
Wardha
...
Chanda
...
Raipur
...
Bilaspur
...
Sambalpur
...
Name of Dispensary.
Wardha Main
...
Hinganghat ...
Sindi ...
Deoli ...
Arvi ...
Jail and Police
...
Warora ...
Brahmapuri
...
Armori ...
Allapilli ...
Sironcha ...
Jail ...
Sadar Branch ...
Drug ...
Dhamteri ...
Arung ...
Police
...
Sadar Dispensary ...
Mungeli ...
Seorinarain ...
Sambalpur
...
Bargarh ...
Total ...
Number of vac-
cinations at each
dispensary.
52
150
78
32
214
107
88
817
470
10
279
95
76
4
501
6
33
158
95
114
315
24
Total.
633
1,759
620
367
339
20,912
Remarks.
21 7 80 2C 335 260
REPORT
ON THE
VACCINE OPERATIONS
IN THE
CENTRAL PROVINCES,
FOR
THE YEAR 1880-81.
NAGPUR:
PRINTED AT THE CHIEF COMMISSIONER'S OFFICE PRESS.
1881.
No. 3204/ 174.
FROM
LINDSAY NEILL, ESQUIRE, C. S.,
OFFG. SECRETARY TO THE CHIEF COMMISSIONER,
Central Provinces.
To
THE SANITARY COMMISSIONER,
Central Provinces.
Dated Nagpur, the 30th August 1881.
SIR,
I am directed to acknowledge your report on Vaccine operations in the
Central Provinces during the year 1880-81, which reached the Chief Commis-
sioner in print on the 19th August.
2. The Chief Commissioner observes with satisfaction that the out-turn
of work was larger than in any previous year.
In all 325,021 vaccine operations were performed, 317,838 of which were
primary and 7,183 secondary.
Of the primary operations 2,944,755 were done by the Vaccine establish-
ment in British and Feudatory territory, and 23,083 by hospital assistants at
dispensaries.
Of the 317,838 cases 301,140 or 94 per cent were successful, viz. :—
280,151 of cases by the Vaccine establishment, and
20,989 at dispensaries.
Of the secondary vaccinations numbering 7,183, 6,195 were done by the
Vaccine establishment and 488 at dispensaries. Of these 7,183 cases 4,775 were
successful at places other than dispensaries and 311 at dispensaries, in all 5,086,
giving a percentage of 70 per cent.
3. The arrangements for the supply of lymph seem generally to have been
suitable, and vaccination was started early in the cold season. In the districts of
Hoshangabad, Seoni and Raipur the arrangements seem however not to have been
effective; in the first named the English lymph supplied had lost its vitality, in
Seoni the supply of vaccine matter was not kept up, and in Raipur the supply
was not successfully preserved. On the good quality of the vaccine used the
protective power of the vesicles depends, and the Government of India, in its
remarks on the report for 1879-80, observed, "that the thoroughly good quality
" of the vaccine used is even more essential than a large number of operations."
4. Turning to Statement A, which it is important to remember takes no
account of operations at dispensaries but includes vaccinations in Feudatory States,
and comparing it with the similar statement for 1879-80, the first striking variation
is the great increase in the number of vaccinators from 160 in 1879-80 to 196. The
increase is thus explained. The table for the present year includes 33 vaccinators
employed in Feudatory States attached to the Chhattisgarh Division; 4 more
vaccinators were entertained in the Raipur district, and 1 less in Chhindwara.
In all other districts vaccinators remained at the same numerical strength.
5. The comparative Statement shows that in eight districts, viz. Damoh,
Jubbulpore, Hoshangabad, Mandla, Bhandara, Nagpur, Wardha and Chanda,
there was a large increase in vaccinations ; in four districts, Narsinghpur, Bala-
ghat, Raipur and Sambalpur, there was a slight increase. On the other hand
there was a slight decrease in the Saugor district, a more marked decrease in
the districts of Nimar and Chhindwara, and very large decreases in Betul, Seoni
and Bilaspur.
4
In conclusion I am to thank you for your report, which gives a clear account
of the work done during the year. Your explanation of the supposed inaccu-
racies in the figures of 1879-80 seems satisfactory. You also appear to have
drawn the attention of Civil Surgeons to several points, such as the desirability
of re-vaccination, which seem to merit their attention.
I have the honor to be,
Sir,
Your most obedient Servant,
LINDSAY NEILL,
Offg. Secretary.
INDEX.
Remarks explanatory of the supposed errors in the statistics of
1879-80 ... ... ...
No. of operations performed during the year ...
Different subjects usually dealt with, placed under different
heads ... ... ...
Work of vaccinator sdone in Native States is recorded as direc-
ted in paragraph 4 of letter No. 388, dated 6th September
1880, from the Secretary to the Government of India,
Home, Revenue, and Agricultural Department (Medical.)
Instructions issued to vaccinators. Dates of commencing work.
Vaccination in districts of the Central Provinces ...
Causes which led to the decrease in the number of cases ...
Dispensary Vaccination
...
...
...
Vaccination in Native States ... ... ...
Re-vaccination
...
...
...
Inspection made by Civil Surgeons ... ... ...
Remarks on the percentage of successful cases ...
Attitude of the people ...
Causes which lead to opposition
...
Suggestions for the better understanding of vaccination ...
Small-pox and inoculation
...
...
Lectures on Hygiene ...
Cost of Vaccination ... ...
PARA
1—5
6—9
10
11
12—15
16—21
22—26
27—33
34—87
38
39—49
50
51
52&53
54
55—57
58
59
2
districts, more especially Jubbulpore and Nagpur, the figures of the past season
would not have borne a favorable comparison with those of the previous one.
The causes of the decrease will be taken into consideration further on, but it may-
be here said that the only serious hindrance to the work is in the indolence and
apathy of the agents employed. This must be overcome, so that every infant born
in these Provinces is efficiently vaccinated. If every vaccinator employed did
as much as 2,000 cases, this desirable result would soon be gained.
7. On this subject the remarks of Surgeon Major Barter are given. He
writes :—
" Vital statistics show that about 11,000 children are born yearly in this district
(Betul), the death rate of children under 1 year is not less than 150 per 1,000
when small-pox does not prevail; taking then those eligible for vaccination, that
is, from 3 to 12 months, perhaps not more than 900 children of those ages out of
each 1,000 born are alive, or say 10,000 out of the 11,000 born ; of these 6,866
were successfully vaccinated during the past season, and over 3,000 remain unpro-
tected."
8. On the same subject the Civil Surgeon of Chhindwara writes :—
" The total number of registered births during the year is 10,114. Number vaccinated
under 1 year 7,198 or 71.16 per cent of the registered births. Every year a con-
siderable proportion of the children escape vaccination either by illness or absence
from the village. "
This number year by year increases and gives an advantage to small-pox
when this disease appears.
9. In connection with this subject the following table is given which
gives the ratio of vaccinated persons to every 1,000 of the population.
District.
Saugor ... ...
Damoh ... ...
Jubbulpore ... ...
Narsinghpur ... ...
Hoshangabad ... ...
Nimar ... ...
Mandla ... ...
Betul ... ...
Chhindwara ... ...
Seoni
...
...
...
Balaghat ... ...
Bhandara ... ...
Nagpur ... ...
Wardha ... ...
Chanda ... ...
Raipur
...
...
Bilaspur ... ...
Sambalpur ... ...
Total ...
Population,
1872.
527,725
269,642
528,859
339,395
449,977
211,224
213,018
278,857
265,191
292,178
280,101
564,813
631,229
356,511
481,215
883,246
516,722
319,962
7,409,865
Ratio per
1,000,
1872.
32.01
40.53
37.48
36.95
42.70
36.94
56.49
35.92
47.98
44.40
33.11
34.13
43.19
44.20
42.94
22.85
48.60
90.47
40.68
10. In the following pages will be found the different subjects usually
dealt with, placed under different heads.
11. Before entering on these it may be here said that the instructions,
conveyed in paragraph 4 of letter No. 388, dated 6th September 1880, from the
Secretary to the Government of India, Home, Revenue and Agricultural Depart-
ment (Medical), have been carried out and that the work of vaccinators done in
Native States is recorded as directed.
Instructions issued to Vaccinators.—Dates of commencing work.
12. At Saugor the supply of lymph was kept up throughout the season.
At one time it degenerated in quality, but again became active later on.