NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
3
year. This is not strictly correct, for practically vaccination is only done during
6 months of the year, and a vaccinator cannot vaccinate children under 3 months
and has to go round a large circle visiting a new place every day. It follows
from this that when a vaccinator arrives at any given place on any given
day, say the 1st November, he cannot vaccinate the children born in August,
September and October. On the other hand, he has to vaccinate all the
children still alive who were born in August, September and October of the
previous-year.
The same is true of every day and every village. Consequently wherever
he goes a vaccinator is unable to vaccinate 25 per cent of the children under one
year, and has to vaccinate, as primary cases, 25 per cent of cases over one year.
This is on the supposition that when he left the village a year ago he left no
arrears of work.
6. Statement II. gives the cost of the Vaccine department calculated for
each district. The cost varies from 11½ pies per successful case in Jubbulpore,
to 2 annas 5¼ pies in Betul.
7. Statement III. shows the amount of Dispensary vaccination done in
each district.
The following table gives the amount done at each dispensary :—
District.
Saugor ...
Damoh
...
Jubbulpore
...
Narsinghpur
...
Hoshangabad
...
Nimar
...
Name of Dispensary.
Saugor ...
Sadar Bazar ...
Deori
...
Khurai ...
Banda ...
Shagarh
...
Rehli ...
Garhakota ...
Police
...
Damoh ...
Hatta
...
Pathuria ...
Jabera
...
Jubbulpore...
...
City
Branch...
...
Thaggi...
...
...
Murwara... ...
Sehora
...
Bijeragogarh ...
Gadarwara ...
Narsinghpur ...
Chhindwara
...
Jail and Police
...
Hoshangabad ...
Kothi Bazar ...
Harda ...
Seoni
...
Sohagpur
...
Pachmarhi
...
Khandwa
...
Burhanpur ...
Mandhatta
...
Pandhana
...
Civil Station
...
No. of vaccinations
at each dispensary
in 1882-83.
110
248
301
582
142
97
293
405
...
408
269
258
204
365
2,835
420
1,008
1,063
656
323
498
132
55
591
237
720
972
972
25
318
92
59
90
76
Total.
2,178
1,139
6,347
1,008
3,517
635
No. of vaccinations
at each dispensary
in 1881-82.
60
87
280
487
201
85
256
347
15
248
301
284
199
165
1,760
349
1,565
1,307
802
364
231
242
45
720
158
783
413
918
56
209
114
39
20
...
1,818
1,032
5,948
882
3,048
382
4
District.
Mandla...
...
Betul...
...
...
Chhindwara...
...
...
Seoni...
...
Balaghat...
...
Bhandara...
...
Nagpur...
...
Wardha...
...
Chanda...
...
Raipur
Bilaspur...
...
Sambalpur...
...
Name of Dispensary.
Mandla... ...
Ramgarh...
...
Mandla Road P. W. D. ... ...
Police... ...
Badnur... ...
Multai... ...
Chhindwara... ...
Lodhikhera...
...
...
Seoni...
...
Lakhnadon... ...
Balaghat... ...
Hatta...
...
Wara-Seoni... ...
Behir...
...
...
Bhandara...
...
Tirrora... ...
Sakoli... ...
Pauni...
...
Itwari... ...
Rai Bahadur... ...
Heude... ...
Umrer...
...
Khapa...
...
Mowar...
...
Katol... ...
Ramtek...
...
Wardha...
...
Hinganghat... ...
Arvi...
...
Sindhi...
...
Deoli...
...
Jail and
Police...
...
Chanda...
...
Sironcha... ...
Brahmapuri... ...
Armori...
...
Mul... ...
Warora... ...
Jail...
...
Raipur...
...
Sadar Bazar... ...
Arung... ...
Drug...
...
Dhamtari... ...
Jail...
...
Police...
...
Bilaspur...
...
Seorinarian...
...
Mungeli...
...
Sukti State... ...
Pandhana
State...
...
Police... ...
Kawardha...
...
Pandaria... ...
Sambalpur...
...
Bargarh...
...
Police...
...
Sarangarh State... ... ...
Jail...
...
Total... ...
Number of vaccina-
tions at each dis-
pensary in 1882-83.
145
383
...
3
265
269
1,574
386
540
94
322
*
168
57
289
217
140
105
559
671
62
912
725
599
425
562
285
282
408
211
251
68
...
347
613
428
307
314
27
110
212
169
484
858
50
7
202
264
214
226
91
58
160
35
168
507
76
149
131
...
Total.
531
534
1,960
634
547
751
4,515
1,505
2,036
1,890
1,250
1,031
32,008
Number of vaccina-
tions at each dis-
pensary in 1881-82.
120
132
60
3
27
104
1,332
205
658
103
88
5
242
16
252
157
97
...
702
750
71
920
775
629
708
502
224
259
373
231
111
121
155
188
121
372
279
202
...
186
83
85
102
1,350
1,350
...
106
73
187
122
153
...
...
...
...
13
18
226
...
...
315
131
1,537
761
351
506
5,066
1,319
1,317
1,806
641
271
27,131
* Closed.
7
He is intelligent and energetic, and his character and conduct good. He himself
vaccinated 131 cases, of which 122 or 96.12 per cent were successful. Many of
these operations, as well as those performed by the Assistaut Surgeon, were on
children of well-to-do people."
The following table is submitted by the Officiating Civil Surgeon :—
Work of vaccinators compared with last year.
Name of vaccinators.
Behari Lall ... ...
Doole Khan ... ...
Nandkeshore Brahmin
... ...
Oomaid Prashad
... ...
Mahomad Hussain
... ...
Sheoram ...
...
Hur Prashad ... ...
Khajanchee ... ...
Nandkeshore Lala ... ...
Kamchand Rao ...
Kashi Prashad
... ...
Shaik Hussain ... ...
Total
Their work.
1881-82.
1,681
2,828
2,877
2,025
1,603
1,176
2,452
1,685
1,473
1,830
1,187
2,186
23,003
1882-83.
1,807
2,506
2,929
2,220
2,077
1,847
1,504
2,010
1,350
1,809
1,623
2,333
24,015
Increase
or
Decrease.
+ 126
— 322
+ 52
+ 195
+ 474
+ 671
— 948
+ 325
— 123
— 21
+ 436
+ 147
+ 1,012
Eight Hospital Assistants have vaccinated 2,178 children, including 312
cases of re-vaccination.
Small-pox of a mild type was prevalent in the district. In most instances
the disease came from the adjoining Native States, where vaccination is neglected
and small-pox makes fearful ravages every year.
The Officiating Civil Surgeon states, that the following gentlemen have
given him valuable aid during the year under report :—
1.
2.
3.
4.
5.
6.
7.
Molvi Moohfoozool Bari, Tahsildar Banda.
Pundit Bulwant Rao, Naib Tahsildar Rehli.
Mr. Wali Mahomad, City Inspector of Police, Saugor.
Chief Constable Gunnesh Doobe Soorkhi.
do.
Jagmohan Singh Gopalgunge.
do.
Turubudin, Rahatgarh
Zulenar Khan, Lumbardar of Herunkhera, Rahatgarh Circle, Saugor
tahsil.
Staff—
1 Native Superintendent, 12 vaccinators:
Total number of primary operations ...
Of these successful ... ...
Total number of primary last year ...
Of these successful
...
...
21,576
20,924
22,291
21,713
13. Damoh.—Owing to the illness of 4 vaccinators the work was less than
usual.
The work done by the Hospital Assistants was rather greater than last
year. Lymph was kept up during the hot weather.
The Civil Surgeon inspected work in 294 places and found it gene¬
rally excellent. He found that there is still a great deal of passive dislike to
9
The Civil Surgeon saw many cases of small-pox in adults who had had
small-pox in infancy.
" This points to the necessity of re-vaccination, which will be attended to in future. Till
now the vaccination staff was small and untrained, and it was as much as they
could do to overtake the work most urgently called for, vaccinating children."
I entirely concur with Dr. Rice in his views in this point, and think that
till the vaccine staff can do an amount of primary vaccination equal to the
birth increment they ought not to attempt secondary vaccination. After that
the more secondary vaccination they do the better. The reason of course is that
lymph used in secondary vaccination yields no return. A child successfully vacci-
nated gives lymph with which to vaccinate other children, an adult, however well
vaccinated, gives none.
Dispensary vaccination improved from 5,948 to 6,288. Dr. Rice concludes
his report by writing—
" As usual Hospital Assistant Chooni Lal, of the City branch dispensary, has done
excellent service not only in protecting the City but also in supervising the arrange-
ments generally."
I do not exactly understand why the general supervision is not done by the
Assistant Surgeon or the Native Superintendent of Vaccination.
Staff—
Native Superintendent
Vaccinators
1.
13.
Primary this year ...
Successful ...
Primary last year ...
Successful ...
28,064
26,867
20,890
19,906
15. Narsinghpur.—Vaccination was carried on during the hot weather, and
there was a sufficient supply of lymph of a fair quality to commence operations
on a larger scale on the 1st November.
Ten English tubes and six tubes of Bovine lymph were received from
Nagpur. The vaccinators were sent to their posts in the middle of October.
The Gadarwara vaccinator was supplied with 10 points. The Chhindwara
vaccinator 1 English tube, The Birman vaccinator 7 points English lymph.
Karabgaon vaccinator 2 English tubes and a few points. Narsinghpur vaccinator
had 18 points of Bovine lymph. All these men were able to establish the vesicle.
The total number of vaccinations during the season amounted to 14,161, includ-
ing Dispensary vaccination, showing a decrease of 1,972.
The Civil Surgeon says, that this is not owing to any want of zeal and
energy; but to the limited number of subjects available for operation.
From the monthly vital statistics it will be seen that the total births from
1st November 1881 to 31st October 1882 was only 15,646 and the deaths under
one year 3,892, leaving 11,754 infants available for vaccination.
Of 13,153 vaccinations performed by the vaccinating staff, 12,840 were
successful, 83 unsuccessful, and 230 result not known. The percentage of success
was thus 99.34.
Of 1,008 vaccine operations performed by Hospital Assistants 498 were by
the Hospital Assistant main dispensary, 55 by Hospital Assistant Police dis-
pensary, 323 by Hospital Assistant Gadarwara, and 132 by Hospital Assistant
Chhindwara. The percentage of success in Dispensary vaccination was 95.42.
11
Time will no doubt do much, but I fear it will be many years before vac-
cination is popular to the degree that inoculation was formerly popular in
Bengal and in the Himalayahs.
There are two reasons for this :—
In the first place the protective power of vaccination is slightly less than
that of inoculation, The difference is not great, but such as it is, it is in favour
of inoculation.
In the second place inoculation was under the patronage of the goddess of
small-pox. Prayers and sacrifices were offered to her before and after the
operation, and she was believed to look on it with a favourable eye. If it is
desired to banish small-pox from India, during the life-time of the present
generation, inoculation should be encouraged in Native States instead of being
discouraged. The stock objection to inoculation is that it spreads small-pox
all over the country, causing disease to those unprotected. This is of course
true, but when small-pox is already epidemic, it is not a valid objection.
Even in British territory, except in places where vaccination has been made
compulsory, I would not interfere with an inoculator; —
Staff—
1 Native Superintendent.
9 Vaccinators.
Total primary cases ... ...
Of these successful ... ...
Total primary last year ... ...
Of these successful ... ...
15,305
14,386
17,949
16,779
17. Nimar.—A vaccinator who was sent to study Hygiene at Nagpur
refused to return in November, and an untrained boy had to be entertained
in his place. Another vaccinator had to be dismissed in December, and a
suitable man could not be got so late in the season to replace him.
Small-pox was introduced from Holkar's territory and spread westward and
southwards all over the district. The Civil Surgeon suggested to the Deputy
Commissioner, that the Governor General's Agent for Central India should be
asked to obtain permission to vaccination being performed in all Holkar's vil-
lages south of the Nerbudda; but the Deputy Commissioner did not think it
advisable to move in the matter,
Permission would be a difficult thing to obtain, but if no vaccination is
done in these villages, Nimar will always be liable to epidemics of small-pox.
Altogether 6,389 cases of small-pox were reported in 1882-83, with a mortality of
697.
The Civil Surgeon spent much time in visiting villages where small-pox was
reported.
He inspected 230 villages, and the Native Superintendent saw 2,775 cases of
reported small-pox; but of these, 593 cases or nearly ¼ were not really small-pox.
The reporting Moharrirs were not in any way to blame, small-pox was so
prevalent that when any child had a feverish attack the parents concluded it was
sickening for small-pox and reported it accordingly. In some cases their real
motive was to have their child registered as having had small-pox, so that the
vaccinator might have no pretext for coming to vaccinate it.
Dr. Cullen thinks that the natives know perfectly well the distinction
between small-pox, chicken-pox and measles, which are all diseases of the
Country.
13
It was formerly the practice in this district to vaccinate from points, crusts,
or tubes, not from arm to arm ; but this year strict orders were given to vacci-
nate invariably from arm to arm. The Civil Surgeon doubts, however, whether
his order was always obeyed. He says that the registered births for the year
was 10,506, and the deaths under one year 2,925. The number actually vacci-
nated under one year was 7,831. The number of cases which were reported
unknown is in the Civil Surgeon's opinion far too high.
The number of re-vaccinations was 3,575, including persons in jail and Govern-
ment officials as well as the free population. The Civil Surgeon was much
surprised to see typical vaccine vesicles appear on the arms of a man 30 years
of age and well pitted with small pox.
Great difficulty was sometimes experienced in finding the village registers.
When asked for, the reply often was that it was lost. The want of these lists
was much felt during the recent epidemic of small-pox. When the Civil Sur-
geon inquired whether a certain child had been vaccinated in infancy or not,
it was impossible to verify the answer given as the old lists could seldom be
found. Dr. Price proposes that in future the vaccine registers should form part
of the Kotwar's books, and the Deputy Commissioner writes that he has issued
orders on the point.
There were in the district 1,230 reported cases of small-pox, with 269 deaths;
but the Civil Surgeon believes that many of the cases were measles, not small-
pox. He himself saw this to be the case in many instances. During the epi-
demic, the rules laid down in Nicholl's Digest, page 570, were brought to the notice
of the district authorities, but judging from the disbelief in the protective power
of vaccination which still exists among the people, he fears that the orders
remained unattended to, especially in regard to segregating the affected and
treating them outside the village.
Dr. Price believes that much of this disbelief in vaccination is owing to the
vaccinators having been allowed to vaccinate from crusts, points or tubes.
At dispensaries there were—
Primary vaccination... ...
Successful... ...
Secondary vaccination... ...
Successful... ...
336
275
198
132
Owing to severe and long continued illness among some of the residents of
Betul, the Civil Surgeon was not able to make a thorough inspection of the work
of all the vaccinators—
Staff—
1 Native Superintendent.
8 Vaccinators.
Primary cases... ...
Successful... ...
Primary last year... ...
Successful... ...
9,156
8,588
10,299
9,761
19. Chhindwara.—In this district vaccination was carried on during the
summer at the dispensary of Chhindwara and Lodikhera, and the Officiating
Civil Surgeon thinks the Hospital Assistants of these places deserve credit for
the good work they have done during the year.
At Chhindwara there were 997 primary successful cases, and 457 secondary
successful.
At Lodhikhera 373 primary and 13 secondary.
At the commencement of the working season a few tubes of English lymph
were received from the Sanitary Commissioner, and this was found to be better
than the district lymph.
14
The Officiating Civil Surgeon inspected the work of each of the vaccinators
at least once during the year, in some cases he inspected two or even three
times.
There is no Native Superintendent in Chhindwara, which appears to me to
be a great mistake.
The following table gives the amount of work by each vaccinator and the
amount inspected by the Officiating Civil Surgeon:—
Bhowani
Pershad...
...
...
...
Goolam
Hussein...
...
...
...
Ahmed Beg... ... ... ...
Mohiudin Khan... ... ... ...
Shaik Hoossein... ... ... ...
Mahur Ali... ... ... ...
Zainul
Abdeen...
...
...
...
Janoji...
...
...
...
2,843
2,186
2,159
2,148
2,350
1,710
1,428
1,638
598
794
711
849
746
220
912
...
The Officiating Civil Surgeon praises all the vaccinators except Mahur Ali,
who is very quarrelsome and unpopular. He recommends his transfer to another
district, and this is also recommended by the Deputy Commissioner and the
Commissioner.
The Deputy Commissioner in forwarding the report says, that he has found
the conduct of the vaccinators generally good and their manners conciliatory,
chiefly owing no doubt to the careful supervision of the former and present Civil
Surgeons.
Staff
Vaccinators ... ...
Primary vaccinations this year ...
Of these successful ... ...
Primary last year ... ...
Of these successful
...
...
8
11,829
11,791
10,426
10,400
20. Seoni.—Vaccination was not carried on during the hot weather, owing
to all the vaccinators being required for cholera duty. Twelve children were
vaccinated in September and 60 in October, and from them a sufficient supply of
lymph was procured for the working season. In October 10 tubes of English
lymph were sent by the Sanitary Commissioner. With this lymph 12 children
were vaccinated, 10 being successful.
There was a considerable falling off in the numbers vaccinated, which the
Civil Surgeon attributes to the re-appearance of cholera in January. Of the
eight vaccinators five did over 2,000 cases each, one man did 1,960, one 1,416,
and the worst man did 864, and was eventually turned out for sending in a
false return.
From the monthly vital statistics it appears that 12,667 children were born
in the district. As 15,660 were primarily vaccinated the whole population will
soon be completely protected, if this number, or anything like it, is kept up.
During his tour the Civil Surgeon was chiefly occupied in inspecting vil-
lages where cholera had occurred and he was only able to see 679 children. His
inspection was prematurely brought to a close by illness.
The vaccinators worked very well, all but one. During the cholera epi-
demic they were most willing. One vaccinator took cholera but recovered. His
servant also took it and died.
Staff-
1 Native Superintendent.
8 Vaccinators.
15
Primary cases... ... ...
Of these successful... ...
Last year
primary...
...
Of these
successful...
...
...
15,026
14,335
16,704
16,067
It is to be hoped that the Civil Surgeon will be able to inspect the vaccina-
tion thoroughly next year as illness prevented him this year.
21. Mandla.—In this district there was an epidemic of small-pox, chiefly
in the circles of Narainpur and Pendrai. The Civil Surgeon explains the
occurrence of this by saying that for two years previous no vaccination was
done in these circles, the vaccinators having been aggregated in the Ramgarh
tahsil where small-pox was raging.
There were 65 deaths in Pendrai circle, 165 in Narainganj circle during the
year.
The Native Superintendent and all spare vaccinators have been sent to
Pendrai and Narainganj. In several cases the Civil Surgeon found that money
had been offered to vaccinators and he invariably ordered this money to be
returned. This occurred in the Shahpura circle, the Dindori circle and the
Newar-Singarpur circle.
The Deputy Commissioner writes that should this practice be repeated next
year he is prepared to endorse any recommendation for punishment which the
Civil Surgeon may be disposed to make.
The Civil Surgeon of Mandla has done a great deal of inspection, visiting
381 villages. He saw 5,897 cases, of which 5,785 were successful.
The Native Superintendent visited 538 villages. He saw 11,352 cases, of
which 10,907 were successful.
Staff-
1 Native Superintendent.
7 Vaccinators.
Total primary cases this year... ... ...
Of these total successful... ... ...
Total primary last year...
...
...
Of these total successful... ... ...
15,947
15,700
10,358
10,177
22. Balaghat.—Dr. Mayne reports that when he took charge he found
vaccination in a very bad way. In spite of the repeated orders of the Sanitary
Commissioner arm to arm vaccination was rarely practised and vaccination was
done from vaccine points. The vesicles were also generally too large, though
making large vesicles had been forbidden by Deputy Surgeon General Hutchinson
when he inspected the Balaghat vaccination.
In the Wara-Seoni circle Dr. Mayne inspected the work in 35 villages and
found the average percentage of success was only 74.95. In one place, Ugassi,
there were no successful cases at all.
Altogether Dr. Manye examined the work in 415 villages and sums up this
part of his report as follows :—
" The mothers of the Balaghat children have begun to dread vaccination as other
mothers did' Herod of old. One of the children had an arm so bad that a little
more would make one fear the loss of the child's arm; there was so much inflam-
mation and suppuration, and it would be well could a Hospital Assistant follow
on the trail of these vaccinators, in so many cases a salve is wanted. 1 have
seen scores of aggravated cases."
"I consider Rahimet Khan who has been newly employed was not properly instructed
by the Native Superintendent beforehand.
He operated very roughly and I1 was
17
Two vaccinators fell ill at the beginning of the working season, one of fever,
the other was bitten by a snake and afterwards became deranged in mind.
This caused the amount of work done to be less than it otherwise would.
The Civil Surgeon also states that his predecessor by mistake brought all
the vaccinators into Bhandara at the end of March 1882 for the purpose of
compiling their returns. Owing to this no work was done in April. But for
this mistake of his predecessor, the Civil Surgeon estimates that 1,680 more cases
would have been done.
During his tour the Civil Surgeon found that the cicatrices were often
elongated, not round, owing to the vaccinators using flat vaccinating needles
instead of circular Cooper Rose's needles. He has prohibited for the future the
use of flat needles.
He considers that the work of the Bhandara vaccinators is not altogether
satisfactory or creditable to them.
Staff—
1 Native Superintendent.
10 Vaccinators.
Number of primary cases
Of these successful
Number of primary cases, 1881,
Of these successful
17,885
17,501
18,206
17,781
24. Nagpur.-—The duties of the Civil Surgeon at Nagpur do not allow of
his leaving the station on tours of vaccine inspection, but last year tours were
made by one of the Assistant Surgeons attached to the Medical school.
Lymph was kept up in Nagpur all summer, and on the 25th September a
vaccinated calf was brought to Nagpur from Berar.
From this animal 3
other calves were vaccinated, and from these a large number of children, Euro-
pean, Eurasian and Native were successfully vaccinated.
Doctor Brake states that there is not much opposition to vaccination,
and what there is is rather passive than active.
Parents desire to put off the operation, without considering that a vacci-
nator having a large number of villages to visit cannot return over and over
again to the same place.
The Native Superintendent attributes the falling off in numbers to the large
percentage of unsuccessful cases which occurred in November, but he gives no
clear explanation why this occurred more this year than in former years.
I presume it was owing to calf lymph being used instead of humanised
lymph, for, as Dr. Seaton says in his handbook of vaccination, " The transfer-
" ence of humanised lymph to the cow causes it to lose a certain amount of its
''potency, so that it requires to be transmitted through 3 or 4 generations of
" human subjects in order to have the same activity as it had before it was trans-
" ferred."
My own experience in this respect is exactly the same as that of Dr. Seaton.
I have always found that lymph passed through a calf remains troublesome and
unsatisfactory until by repeated transmissions through human beings it again
becomes humanised.
The explanation of the Native Superintendent is submitted.