NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
14
One case of assault was tried in Court, proved and the accused fined, but
such proceedings are very rightly looked upon as quite exceptional.
63. The Commissioner of the Division has recommended " that the more
" important men of position, such as the Honorary Magistrates, should be spoken
" to on the subject by the Deputy Commissioner, and that in future years, before
" commencing operations in any locality, the more influential Malguzars of the
" neighbourhood be called in by the Deputy Commissioner, addressed personally
" on the aim and object of vaccination, and informed that while Government will
" not actually force vaccination on any one, yet that they will be held responsible
" that the Vaccinators shall be free from molestation and shall be allowed a fair
" and free field to do what they can."
64. If in addition to this the plan of segregation alluded to above in para.
16 be strictly carried out in a few instances, 1 am quite sure from my own expe-
rience elsewhere that active opposition will cease.
Small-pox has been epidemic throughout the district and the immunity of
those that have been successfully vaccinated during the past season will be a
powerful argument in favour of the operation.
In Seoni it was objected that persons vaccinated had not been protected,
but on enquiry it was found that only 17 unsuccessfully operated upon had con-
tracted small-pox, and at Hoshangabad 22 similarly operated upon without suc-
cess and not re-vaccinated had suffered from the disease. Dr. Cullen did not
find any small-pox following successful vaccination.
65. The idea of sacrifice of vaccine crusts to the Railway god alluded to
in my remarks on vaccination at Seoni, is again brought to notice as found in the
Hoshangabad district ; and at Harda there is a doggrel chyme current which
may be translated as follows :—
Run, run the Vaccinator has come,
He will cut the children,
He'll take the flesh and put it on the rail,
And when the train whistles the child will die.
66. It has been proved in one case that a Patwari of three villages with non-
resident Malguzars had frightened the villagers and induced some of them to carry
their children across the Narbada, but on the Malguzars being informed they not
only got back all their people but prevailed upon them to have their children
vaccinated.
67. Dr. Cullen had to assume medical charge of the Native Infantry
Regiment at Hoshangabad during November and December and again in
February, he was therefore not able to march about through the district as much
as he had intended, but nevertheless visited 134 of the 725 towns and villages in
which vaccination had been introduced.
In the Seoni Circle one Vaccinator resigned, another had to be appointed,
and there was only three months' actual work performed. At Sohagpur the Vac-
cinator, found negligent and untrustworthy, was dismissed in February ; but with
all the drawbacks the amount of good work done was very fair, and I have no
doubt that there will be improvement from year to year.
15
68. The number of operations was 1,869 more than in 1871-72, and the
ratio of success had increased from 85 82 to 86.42 per cent. About 187 children
under 1 year were operated upon out of every 1,000 living.
69. Nimar.—In this district one Vaccinator was employed at Khandwa
and one at Burhanpur throughout the year. A third Vaccinator was entertained
at Mundi in February and March.
Operations were carried on throughout the hot weather and rains until Sep-
tember, when there was a failure. Fresh lymph, however, was supplied from
Nagpur and operations resumed. Vaccinators went out into the district in the
middle of October and remained at work till the end of March.
70. The Khandwa Vaccinator visited all the villages in his circle except
those reporting to the Desgaon out-post The Mundi man confined his opera-
tions to the principal registration circle of that name, and the Burhanpur Vacci-
nator worked in the City and within a radius of 5 miles. I examined portions of
the work of each and was satisfied with its character.
71. Dr. Fleming personally supervised the operations in Khandwa and
Mundi and gave certificates to those vaccinated or to their parents. Many of
these certificates I saw, there is no objection to them, but I think it would be
better to leave with the Malguzar or headman of each village a list of all those who
have been successfully vaccinated year by year. This will be useful to inspect-
ing Officers and always available for reference.
At Burhanpur the Vaccinator was supervised by the Native Doctor J.
Samuel, and his work inspected as far as possible by the Civil Surgeon on his
periodical visits.
The Vaccinators go to every village in their lists and vaccinate on the spot,
they have been uniformly well received, and as a rule assisted by the village
authorities.
72. The number vaccinated exceeded that of the previous year by 1,953,
but the ratio of success fell from 91.71 to 84.34 per cent. About 454 per mille
of the children under 1 year of age were operated upon.
73. Mandla.—Only Rs. 40 were voted by the Municipality for vaccination
throughout the year. Dr. Kidd, the Civil Surgeon, commenced operations at
the Sadar Dispensary on the 6th December, and a Vaccinator was employed at
and near the station till the middle of March a period of three months and
four days. A second Vaccinator worked at Shahpura for 1½ month. Not much
could be expected from them. Dr. Kidd remarks that the people only require a
little persuasion, and in villages where vaccination had been successful and had
proved protective the children were at once brought forward. He was able to
inspect the work about Mandla four times, and that at Shahpur once during
the season.
74. The number of cases was 282 less than in 1871-72, and the ratio of
success fell from 75.73 to 69.65 per cent.
Only 25 per mille of those under one year of age were operated upon.
16
75. Balaghat.—The services of a Superintendent were dispensed with, and
three Vaccinators only were employed. These performed 174 more operations
than in the preceding season, and the ratio of success rose from 76.56 to 87.54
per cent. About 66 per mille of those under one year of age were operated upon.
The work was inspected by the Medical Officer twice during the year, and
he was able to visit all the villages in which vaccinations had been performed.
76. A few arm to arm operations were carried on in particular villages,
but children were not taken from one village to another, and tube lymph or
crusts had to be depended upon.
A large proportion of the inhabitants still object to vaccination, and in one
village a Vaccinator was threatened, but the opposition will cease under careful
management.
77. Bhandara.—Vaccine operations were continued throughout the hot
and rainy seasons, and Dr. Ffrench was able to transfer good lymph from a child
to a calf and to re-transfer from the latter to human beings without inconveni-
ence Lymph was also received from England and Nagpur, and used with
success.
78. Six Vaccinators and for a time a Hospital Assistant were employed as
in 1871-72.
Two of the vaccinators were retained throughout the year, but the four others
only entertained for the season. These men were not sent all over the district,
but worked at and near Sakoli, Bhandara and Tirora, and the Hospital As-
sistant of Kamtha operated in that town and neighbourhood. The Civil Sur-
geon by frequent tours was able personally to superintend the work and note
the results.
79. The two first Vaccinators sent out early in October along the Eastern
road were both prostrated by fever, and had to return to head-quarters ; and
Dr. Ffrench attributes the falling off in the numbers vaccinated to the sickness
amongst the Vaccinators.
The decrease was 365, but the ratio of success rose from 94.35 to 95.56 per
cent. About 232 per mille of children under 1 year of age were operated upon.
80. Operations in the same village were as much as possible from arm to
arm, the mothers offering no objection either to this proceeding or the collection
of lymph and crusts, but children were not taken from village to village.
The chief difficulties to be overcome were the apathy and carelessness of the
people.
81. Wardha.—Three paid Vaccinators were employed as in the preceding
season, and the Hospital Assistants at the branch dispensaries operated in a
cases besides overlooking the work of the Vaccinators put under their orders.
The number of operations reported were 26 less than in 1871-72, but the
ratio of success, bad in that year, was much worse in this, falling from 79.56
to 69.20 per cent. About 209 per mille of the children 1 year of age were ope-
rated upon.
18
Mr. Craggs, the Medical Officer, examined the work of the Tallodi man and
found it good ; his visit was unexpected, but he found the Vaccinator carefully
working from village to village with good lymph.
On his visiting Warora the Medical Officer found the Vaccinator ill in hospi-
tal ; only a few cases of vaccination were brought before him, and there had been
a failure in the supply of fresh lymph. On a subsequent visit, however, a fair
show of children were brought for examination and the lymph was good.
87. Sironcha.— There has been a considerable increase in the number of
operations recorded, amounting to 558 in excess of those of 1871-72. The ratio
of success has increased from 42.13 to 86.75. About 26 per mille of children
under 1 year of age were operated upon.
88. In the totals shown, however, are 228 cases returned as vaccinated by
Hospital Assistant Anand Ram, attached to the Deputy Commissioner's camp
whilst on tour ; but the Civil Surgeon does not put much faith in his figures, as,
being constantly on the move, he could not examine results, and the villages
where he operated are so far from the Sadar Station that Dr. Gaffney could not
inspect the work.
Vaccination was carried on throughout the year up till September, when
Hospital Assistant Veeranah, who did most of the work, died.
89. The Civil Surgeon attributes the success of vaccination during the hot
weather to a plan he adopted for preserving lymph. To me it is novel, and I
give its description in his own words:—" Where a good healthy vesicle was
" found, this was punctured and blotting paper applied gently till the lymph was
" absorbed to about the size of a 2 anna piece. One vesicle thus yielded about
"10 little discs of vaccine lymph. In using these the part was first scarified with
" a lancet, the blotting paper disc was applied and kept on for a day by sticking¬
" plaster. Not a single case failed that was so vaccinated. Red blotting paper
" was used in preference to white, as the stain left by the lymph was more per¬
" ceptible. This plan was not used when arm to arm vaccination could be re¬
" sorted to."
90. Raipur.— Five Vaccinators were employed during the season, and the
same Hospital Assistant, Abdul Karrim, acted as Superintendent.
The number of operations registered was 12,339, or 906 more than in the
preceding year ; the ratio of success improved from 87.68 to 88.69, but was very
low at Arang, Drug and Simga. About 144 per mille of the children under 1
year of age were operated upon.
According to the report of the Native Superintendent, there was difficulty
in getting fresh lymph, and the Vaccinators in many cases had to depend upon
vaccine crusts for carrying on operations, which is undesirable.
Four of the Vaccinators are said to have done well, but the returns of the
5th were not looked upon as reliable, and he will not be employed again.
91. Small-pox was present as an epidemic throughout the year, and vac-
cine operations were carried on during April, May, and part of June up till the
rains, Vaccinators being sent to scattered spots where their services appeared to
be most urgently required.
19
At the end of October vaccination was recommenced with success at the
Sadar town under the Hospital Assistant of the Sadar branch dispensary. One
Vaccinator was kept to work in and about Raipur, and four others sent into the
district at the end of December.
92. It had been arranged that these should work in a circumscribed area
north-east of Raipur, and to the east of the tract visited last year,—a portion of
the district principally occupied by Satnamis and where inoculation was prac-
tised. Owing to requisitions from Lown and its neighbourhood, and from Dham¬
tari where small-pox was severe, three of the establishment were sent in those
directions, and only one left in the region originally marked off for operations.
All the villages in this area therefore could not be visited and into some the Vac-
cinator was not permitted to enter.
93. Bilaspur.—The number of cases increased by 102, and the percentage
of success improved from 91.66 to 92.12. About 126 per mille of the children
under 1 year of age were operated upon.
94. There were the same number of Vaccinators employed (4) as in pre-
ceding year. Of these one worked at Bilaspur and within a radius of 10 miles ;
and the three others were attached to the dispensary of Mungeli, Seorinarain,
and Ratanpur, placed immediately under the several Hospital Assistants, and
directed to work in these towns and within a radius of 10 miles of each.
On the Hospital Assistant being removed from Ratanpur in January the
Vaccinator attached to that dispensary was re-called to Bilaspur town to work
in its neighbourhood.
95. The work of each Vaccinator was reported favourably upon by the
Hospital Assistants and the Tahsildars, and the Medical Officer, Dr. Ferdinands,
was also satisfied from his own inspections.
Of the 22 villages near the Sadar Station in which operations had been
carried on he personally visited 9 ; of 20 villages near Mungeli, 7 ; of 27 near
Seorinarain, 9 ; and of 22 near Ratunpur, 4.
Arm to arm vaccination was largely carried out, and insisted upon as far as
practicable.
96. Sambalpur.—There was an increase in the number of operations of
1,008 ; the percentage of success increased from 93.72 to 94.80, and a very large
proportion of the children under 1 year of age were operated upon.
The totals given include 2,167 operations performed in Chandarpur by Vac-
cinators paid by the Zamindar, but deducting these the average number operated
upon by each Vaccinator was 3,927, there having been three employed during
the season.
97. The numbers are so high that doubt as to their accuracy may be excusa-
bly entertained by persons who have not personally examined the work, but
Sambalpur in regard to vaccination is quite exceptional in these Provinces.
When visiting the district two years ago, I carefully examined the work
then being carried on ; from my own observation at the time and from the viva
voce reports of the Civil Surgeon and a former Native Superintendent. I am
quite satisfied as to the general truthfulness of the returns.
20
98. The people as a rule eagerly seek the services of the Vaccinator, who
has no difficulty whatever in getting children brought to him. As I halted at
villages for the purpose, children recently vaccinated were brought to me for
inspection literally by scores; it was not unusual for me to see 70 or 80 in one
good-sized village, and on one occasion the parent of a child felt himself aggrieved
because the latter had been operated upon twice without success, and was clam-
orous that it should be vaccinated by myself, mine being the third operation
within two or three weeks. Since the preceding year a Native Doctor employed
by the Zamindar of Patna had been vaccinating in that feudatory State, but
as a still greater proof of the estimation in which vaccination is held by the
people of the neighbourhood, Hurria Sing, Zamindar of Chandarpur, applied
for and obtained the services of two Vaccinators for his own state, meeting all
expenses from his own revenues.
These men worked in 44 villages and successfully vaccinated 1,947 persons.
99. The total number of villages in which operations were performed was
244 ; of these 127 were visited and inspected by Mr. Harrison, the Civil Surgeon,
who reports very favourably of the Vaccinators under him, of the Hospital As-
sistant at Sambalpur, and Native Doctor at Bargarh.
The Hospital Assistant vaccinated 537 persons and kept up the supply of
lymph at Sambalpur.
100. Good as the results have been they would probably have been still
better but for the out-break of cholera following the march of a Native Infantry
Regiment through a portion of the district in February. The villagers were
anxious to have their children vaccinated, but were afraid to admit the vaccina-
tion for the time the disease was in the neighbourhood.
I have the honor to be,
Sir,
Your most obedient Servant,
JOHN BRAKE,
Offg. Sanitary Commissioner,
Central Prvoinces.
3
The total number of children vaccinated during the year amounts to 11,640,
showing an increase of 1,253 over last year, and this is entirely due to the increase
of operations in the Jaghirs.
In the district itself there is a decrease from. 9,272 to 9,160, owing to the
fewer number of births during the year, and the greater number of deaths of chil-
dren under 1 year, as shown in the following table :—
Years.
1871
...
1872
...
Increase. ...
Decrease. ...
Births.
8,970
8,419
...
551
Deaths under 1 year.
1,548
2,504
956
...
Available for vaccination.
7,422
5,915
...
...
Statement No. I shows that 5,788 children under 1 year have been vaccinated,
or 97.85 per cent of the registered births ; and I think this result may fairly
be attributed to the increasing confidence of the people in vaccination.
Those noted as above 1 year, viz. 3,372, comprise all those not vaccinated in
previous year from sickness or other causes, and few of them were over 6 years
of age.
Of the total number vaccinated during the year, viz. 11,640, the results are
as follows :—
Results.
Successful ...
Unsuccessful ...
Doubtful
...
Unknown
...
Total..
Number.
10,851
621
168
11,640
Per cent.
93.22
5.33
1.45
100.00
Of 138 secondary* vaccinations, excluding those unknown from the total, 125
were successful or 90.58 per cent.
The number of children vaccinated during the past 3 years and the effect
of vaccination in diminishing the spread of small-pox in the district may be well
seen in the following Table :—
Year.
1870 ...
1871 ...
1872 ...
Number of cases of
Small-pox.
6,146
360
82
Number of deaths.
511
41
35
No. of persons vaccinated.
18,005
9,272
9,160
* These are cases of failure re-operated upon.
4
But although a decided check seems to have been given to small-pox, cases
still occur, and very recently in the present year a number of children have been
attacked with the disease at Pandurna, and some have died. The first case was
imported into the town from Multai, the disease showing itself 2 or 3 days after
the child with its parents had come to Pandurna. This case was said to have
been vaccinated at Multai, in the Betul district, last year, probably unsuccessfully.
After this case several other children were attacked, and to prevent any
further spread of the disease, and at the recommendation of the Sanitary Com-
missioner, the sick were removed into chapars, the weekly market stopped, and
all the unprotected children were at once vaccinated, or at least as many as could
be got. I myself proceeded to Pandurna in the latter end of March and
examined about 15 children who had recently suffered from the disease; they
were all children from 6 to 14 years of age, and had never been vaccinated.
The following Table shows the number attacked and the number of deaths,
from January to end of April 1873, as received from the Police Office :—
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Names of village.
Pandurna ... ...
Bamni ... ...
Saurgaon ... ...
Deokhapa ... ...
Khirki ... ...
Magorli ... ...
Rajnah ... ...
Gujarkheri
... ...
Umret
...
...
Chikli ... ...
Dantla ... ...
Singhori
... ...
Jainbai ... ...
Bichhowa ... ...
Gondra
... ...
Ghurar
...
...
Khuniarpani ... ...
Total..
Number of cases.
18
2
2
1
3
1
1
1
2
1
2
2
3
1
1
2
1
44
Number of deaths.
9
2
2
...
...
...
...
...
...
...
...
...
...
...
...
...
...
13
In addition to the children attacked in Pandurna, I also saw the children at
Ghurar, Bichhowa, Khumarpani, Gondra, and Singhori; they were all from 8 to
10 years old. One child at Ghurar had good marks of previous vaccination,
which, according to the village return, was performed in 1867 ; the others had no
marks at all, nor were their names in the village lists.
In all these villages no proof of importation could be got, as neither the
children nor their parents had left their house for months, nor had any cases of
small-pox been brought into them, with the exception of the first case at Pan-
durna, and which led me to believe that the cause of the out-break was to be
found in the villages themselves. Every case of small-pox on recovery throws
off a large number of crusts, perhaps thousands, each crust being capable of re-
producing an almost unlimited number of cases of small-pox; these, owing to be
peculiar habits of life of the natives, may and do lie in and near the houses of
the infected, and in course of time become "dust " It can easily be conceived
how readily the contagium of small-pox can be inhaled in this way and thus give
rise to the disease, more especially to those not protected.
5
Believing this, I addressed a letter to the Deputy Commissioner recommend-
ing that in every village where small-pox had occurred the infected children be
removed out into huts, the house thoroughly swept, and the sweepings burnt out-
side the village; and if at the same time the whole village could be similarly
swept and the sweepings burnt, a further check to the spread of the disease would
perhaps be given.
This has been done in many villages.
Taking into consideration the foregoing facts of the great diminution of
small-pox, consequent on vaccination, as a result of the past three years' labours,
I have had a small report printed in the vernaculars of the district, showing the
numbers vaccinated, the numbers of reported cases of small-pox, and the number
of deaths during the last three years; and have recommended to the people what
is required of them to assist the Government in checking the disease.
The Deputy Commissioner has kindly undertaken to have these circulated
to every Malguzar in the district for the information of the ryots.
I send a copy * for your perusal, and perhaps other Medical officers may find
some such report of their labours circulated amongst the people of their district
equally as successful as I am hopeful this will be to those of this.
The cost of the season's operations has been as follows:—
Pay of Native Superintendent ... ...
Pay of 10 Vaccinators
...
...
Travelling allowance to Civil Medical Officer
Carriage of tents
Total ...
Rs.
847
305
153
1305
As.
0
0
1
1
Ps.
0
0
6
6
or 1 anna 10 pie for each successful case.
Primary Vaccinations ... ...
Second
do.
...
...
10,851
125
10,976
The conduct of the Establishment during the season has been very good. Na-
tive Superintendent Chhitu Ram has carried on,
as in former years, his active duties very credi-
tably indeed. During the season he was constantly
on the move from one Circle to another inspecting the work and advising the
people on the subject of vaccination, and I consider him well worthy of favourable
notice and highly deserving of promotion.
Vaccinator Bhowany Pershad 2nd has vaccinated during the season 2,412
cases, viz. 1,114 in the Chhindwara Circle and 1,298 in the Partabgarh Jaghir.
I have myself inspected 782 children from 109 villages in the Chhindwara and
Jhilmilly Circles. He vaccinates well arm to arm, and most of his work has been
by this method; he is zealous, painstaking and trustworthy He has worked
throughout the year.
2nd. Class Vaccinator Mohamed Abbass has done very well indeed. I have
inspected 398 children from 51 villages in his circle and was highly pleased with
what I saw. All his cases were from arm to arm.
Vaccinator Nader Khan is a very efficient Vaccinator, and does his work
carefully and well. I noticed in his Circle that whereas in former years children
were brought up in a filthy neglected state for vaccination, this year they were
* Printed as Appendex 1 A.,—page 7
U. Y.-18—134-285