NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
No. 3037/131
FROM
LINDSAY NEILL, ESQUIRE;
OFFG. ASST. SECRETARY TO THE CHIEF COMMISSIONER,
Central Provinces,
To
THE SANITARY COMMISSIONER,
Central Provinces.
Dated Nagpur, the 17th September 1873.
SIR,
I am directed to acknowledge the receipt of the Vaccination Returns
for the year ending March 31st 1873, and of your report thereon.
2. Paragraphs 2—5 explain that the orders of Government on your report of
last year reached you after the end of the year when the vaccination season, had
closed, and that you are therefore unable to give all the information asked for.
You have, however, arranged that in the present year Vaccinators shall be sent
to work in certain fixed registration circles, and it will then be possible to exhi-
bit the number of operations performed, the number of births and deaths, and
the approximate number of available infants in each circle. Beyond brief allu-
sion to it in one or two places, no mention is made as to whether children who
had been successfully vaccinated in former year had been attacked with small-
pox subsequently. At Chhindwara one such case did actually occur, a child
vaccinated in 1867 being attacked during the year. The point is one of great
practical importance and one that should not be overlooked in next year's
report. One such case readily gets known and does much to destroy a belief in
the efficacy of vaccination which it has taken us years to create.
3. The Chief Commissioner is unable to see that any advantage would result
from placing the locally entertained Superintendents and Vaccinators more directly
under your control All our success depends, as you rightly remark in paragraph
13, on the interest taken in the work by the Civil Medical Officer, and were all
the work placed under your control, the responsibility of each Medical Officer
would seem to be diminished and his interest and zeal would proportionately
decline, while no additional supervision or control could be looked for from
you.
4. In paragraph 6 et seq. you explain the present constitution of the depart¬
ment in these Provinces. It is the same as in the previous year. In the Sat¬
pura districts, i. e. in Chhindwara, Seoni and Betul, there is a Provincial estab-
lishment consisting of 3 Native Superintendents and 30 Vaccinators. In all the
other districts, with the exception of Nagpur, the establishments are paid either
from local and Municipal contributions or from private subscriptions, and the strength
of establishment varies, being regulated by the sums voted for vaccination purr¬
poses by Committees and by the liberality of private individuals. In Nagpur
the arrangement is an intermediate one. The. Native Superintendent receives
from Government the pay of his rank as a 2nd Class Hospital Assistant and
an equal sum from Municipal sources. The establishment is directly under your
control, and the returns are submitted to you direct.
D-17—123—285.
2
5. In the present report you have included the Nagpur operations in those
performed by what may be called the Special Department, and in order to admit
of comparison have made the corresponding necessary additions to the figures
of 1871-72.
6. The mortality from small-pox in 1872 was more than double that of
1871, the figures being 5,237 and 2,383 respectively. Sagar was the only dis-
trict which had complete immunity from the disease. Jabalpur, Narsinghpur,
Chhindwara, Seoni and the Upper Godavari District suffered but little, the
deaths in each district being less than twenty.
In Raipur and Nimar the mortality was very great, and in all the remaining
districts, with the exception of Mandla, deaths were very much more numerous
than in the previous year. In Betul, where no deaths were registered in 1871,
111 were recorded in 1872.
7. It is satisfactory to find that there has been an increase as compared
with 1871, in the number of vaccinations performed and also in the ratio of
success.
Paragraphs 27 and 28 of your report give the following Tables, viz. for the
four districts, Chhindwara, Seoni, Betul and Nagpur.: —
Years.
1871-72
1872-73
Increase
Operations,
41,644
52,871
11,227
Successful.
35,404
47,257
11,853
Percentage of success.
89.25
91.71
2.46
For the remaining districts the figures are :—
Years.
1871-72 ...
1872-73 ...
Increase ...
Operations.
67,236
71,378
4,142
Successful.
55,784
60,308
4,524
Percentage of success.
85.69
87.36
1.67
Statements A. No. 1, and B. No. 5 give details for each circle. The Special
Department shows better results in all 3 districts, the increase in operations in
5
19. Upper Godavari District —There has been considerable increase in the
number of operations attended with a great improvement in the ratio of success.
The success during the hot weather, the Civil Surgeon attributes to a plan
which he adopted for preserving lymph. The Chief Commissioner is unable to
offer any opinion on the merits of the plan ; it is one solely for the consideration
of Medical men.
20. Sambalpur.—It is with much satisfaction that the Chief Commissioner
learns that vaccination has been extended to the Chanderpur Zamindari.
21. The number of vaccinations in the district is so large, and the percentage
of success so very high, that Mr. Morris confesses to feeling some doubt as to the
correctness of the returns. He is pleased to learn that you are satisfied as to
their truthfulness, and that your observations when in Sambalpur two years ago
convinced you of the great eagerness with which the people welcomed vaccina-
tion.
22. Statement A. No. 3 exhibits the expenditure by Government, Local
Funds and Municipalities, the total number of persons vaccinated, the percentage
of successful cases, and the cost of each successful case.
23. The Table may be briefly summed up thus : Rs. 12,187 were expended;
124,249 persons were vaccinated, of whom 89 per cent successfully; and the cost of
each successful cases was 1 anna 9¾ pies ; in other words this year's results com-
pare in every way favourably with these of 1871-72, more persons were vacci-
nated, the ratio of success was greater, and the cost of each successful operation
considerably less, and the total expenditure also slightly less.
24. It only remains for the Chief Commissioner to express his satisfaction
at the success which the labours of the Department have met with in 1872-73.
I have the honor to be,
Sir,
Your most obedient Servant,
LINDSAY NEILL,
Offg. Asst. Secretary.
D—18—137—285.
No. 244.
FROM
SURGEON MAJOR JOHN BRAKE,
OFFICIATING SANITARY COMMISSIONER,
Central Provinces,
To
THE SECRETARY TO THE CHIEF COMMISSIONER,
Central Provinces.
Dated Nagpur, the 7th August 1873.
SIR,
I have the honour to forward for the information of the Chief Com-
missioner the Vaccination Returns for the year ending March 1873.
2. When reviewing my report for 1871-72, the Secretary to the Govern-
ment of India suggested the entering more fully into the subject of births and
deaths in each mortuary registration circle, and their relation to the number
of persons annually vaccinated in each, and also questioned whether it might
not be better to place all the Native Superintendents and their subordinate
Vaccinators more directly under the Vaccine Department as in the North West
Provinces.
3. The letter of the Secretary to Government of India only reached me
on May 1st last, a month after the regular vaccinating season had closed. As
the Vaccinators had not been generally restricted to defined limits, it has been
found impossible in this report to give the population of the ground covered
with sufficient accuracy for the comparison to be of much value, but further on
will be found a Table relating to whole districts. I have, however, issued a
Circular to the Civil Medical Officers in the terms of the Secretary's letter, and
have requested them to send Vaccinators during the ensuing season to work
in certain fixed Registration Circles, and there should be no difficulty therefore
in giving the proportion of cases operated upon to the number of births or
approximate number of available infants in each sub-division of a district.
4. On the question of bringing the Native Superintendents and their sub-
ordinate Vaccinators directly under the Vaccine Department as in the North
West Provinces, there are difficulties, 1st, as to payment ; 2nd (and more
specially) as to superintendence.
5. As I understand, there are in the North West Provinces large establish-
ments of Vaccinators working under European Superintendents, whose sole
duty it is to supervise the work in certain divisions. From my own experience
I can speak of the advantage of such an arrangement, but there is the drawback
of expense. In these Provinces the duties of Superintendent General of
Vaccination have been superadded to those of Sanitary Commissioner and
Meteorological Registrar, and however zealous he may be, he can do little more
in the way of inspection than examine cases and compare them with the village
lists and Vaccinators' registers along the lines of his periodical routes.
6. At present the division in the Central Provinces is into a small regular
Establishmant of 3 Native Superintendents and 30 Vaccinators paid from Pro-
vincial revenues, and into strictly local establishments supported from Local and
Municipal Funds.
7. The Provincial Establishment is specially under the supervision of the
Medical Officers of Seoni, Chhindwara and Betul, the districts in which it has
been working for some years.
F N—11—85—281
5
23. At Damoh, Hoshangabad, Wardha and Betul, old crusts kept from
the preceding season were tried, but with only partial success at Betul. As
long as arm to arm vaccination can be carried on throughout the year in any
station it is undesirable to try doubtful lymph or crusts, as the parents of
children very naturally object to experimental operations and it is desirable to
guard as much as possible against any possible failure, especially at the com-
mencement of the season.
24. According to the returns received the following Table gives the
number of children under one year of age operated upon during the season, and
an approximate proportion to the number under one year available
I have taken the difference between the number of births and the deaths
under one year to represent the number of children under one year available for
vaccination; this formula of course is not quite accurate, but I think is sufficiently
so for comparison. Corrections have been made in the Chhindwara and Sambalpur
returns, where the number of infants operated upon at first sight appear to have
exceeded the number living ; but in the first named district 456 operations in the
Jaghirs of Harrai, Sonepur and Partabgarh have been deducted, since the birth and
death rates are not excluded in the District returns. In Sambalpur 2,167 operations
performed in the Zamindari State of Chandapur have been deducted, but those
in Singabaga, Rampur and Bharun, not having been particularized, have been
allowed to remain, and so slightly increased the percentage.
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
DISTRICTS.
Chhindwara ..
Sambalpur ..
Betul ..
Nimar
..
Seoni
Jabalpur
..
Bhandara ...
Wardha ..
Hoshangabad ...
Nagpur ...
Sagar ..
Raipur ..
Bilaspur ..
Balaghat ..
Damoh ..
Upper Godavari ..
Mandla ...
Chanda ..
Narsinghpur ..
Number of births from April
1872 to March 31st 1873.
8,128
7,255
7,606
6,160
9,903
16,023
10,588
6,062
13,520
14,881
15,628
22,824
12,244
3,668
9,708
1,152
4,053
11,086
11,654
Number of deaths of child¬
ren under one year of age
from April 1872 to March
1873.
2,284
1,644
1,763
2,424
2,801
3,265
2,219
1,637
3,200
3,268
3,748
4,896
2,931
830
2,114
150
622
2,649
3,275
Difference, being an
approximation to the num-
ber available for vaccina-
tion.
5,844
5,611
5,843
3,736
7,102
12,758
8,369
4,425
10,326
11,613
11,880
17,928
9,313
2,838
7,594
1,002
3,431
8,437
8,379
Actual number under one
year operated upon.
5,788
*5,548
4,024
1,695
3,000
3,580
1,942
924
1,933
1,761
1,726
2,582
1,173
187
448
26
62
206
198
Ratio per mille of children un-
der one year operated upon
to approximated number
under one year available.
990
*989
689
454
422
281
232
209
187
152
145
144
126
66
59
26
25
25
24
* The number operated upon in the Chandapur Zamindari are deducted, but an unknown
number of cases in the Singabaga, Rampur and Bharun Zamindaris are included which would
reduce the percentage.
D F—13— 95—385
6
25. The returns for Chhindwara and Sambalpur are as favourable as they
well can be, and the numbers high enough to excite suspicion in persons who
have not inspected the work, but I accept them without hesitation from my own
observation. The reasons will be best given with my remarks upon the work
in the several districts.
26. Small-pox has raged as an epidemic in several districts of the Pro-
vince and has been present more or less in all but Sagar It has shown itself
in the best protected districts of Chhindwara, Betul, Seoni, Sambalpur and
Jabalpur; in each there were found some special circumstances favouring its
presence; but I don't think that it is asking too much to ascribe some of the
immunity from the disease in those particular districts to the vaccine operations
carried on in this and preceding years. This may be said more especially of
the Satpura districts, as the hill tribes have hitherto as a rule suffered so
exceptionally from the ravages of small-pox.
DISTRICTS.
Sagar ..
Damoh
. .
Murwara ...
Jabalpur ...
Narsinghpur ...
Hoshangabad ...
Nimar ...
Burhaupur
Mandla ...
Betul ...
Chhindwara ...
Seoni ...
Balaghat ...
Bhaudara
...
Nagpur ...
Wardha
...
Chanda ...
Sironcha
...
Raipur ...
Bilaspur ...
Sambalpur ...
Grand Total ...
April 1872
..
36
1
...
1
5
164
45
14
...
1
6
9
39
70
56
9
...
196
26
1
679
May.
...
36
2
2
2
6
183
25
5
2
...
7
16
24
51
45
...
..
177
37
2
622
June.
..
32
..
7
6
3
123
30
5
12
...
1
9
36
10
71
7
1
177
26
1
562
July.
..
13
1
2
1
2
42
11
12
12
2
...
13
16
15
24
10
...
115
46
1
338
August.
...
16
...
...
6
3
62
3
8
19
1
2
7
3
2
13
3
...
92
15
3
258
September.
...
1
...
...
...
9
8
6
1
5
1
...
14
3
...
19
...
...
68
23
4
162
October.
...
3
...
...
1
3
2
3
7
2
...
...
1
1
...
3
14
...
26
4
1
71
November.
...
2
...
...
...
9
12
2
4
7
...
...
7
1
1
...
1
...
70
15
3
134
December.
...
...
...
...
1
22
21
...
5
12
...
...
4
8
2
12
12
...
75
2
3
179
January 1873.
...
...
...
...
...
52
13
...
2
10
...
1
2
22
16
58
23
..
192
24
2
417
February.
...
...
...
...
1
61
8
...
8
10
3
...
19
56
44
62
55
2
259
23
1
612
March.
...
1
...
1
1
111
29
1
6
20
5
...
13
106
172
66
103
1
487
78
2
1,203
Total.
...
140
4
12
20
286
672
126
77
111
13
17
114
315
383
429
237
4
1,934
319
24
5,237
27. There has been an increase over the preceding year, both in the
number of vaccinations performed and the ratio of success. Taking in the first
place the four districts of Betul, Chhindwara, Seoni and Nagpur, the numbers
are—
1871-72 ...
1872-73 ...
Increase.
..
Operations successful.
41,644
52,871
11,227
35,404
47,257
11,853
Percentage of success.
89.25
91.71
2.46
7
In the remaining districts, the numbers are,—
1871-72 ...
1872-73 ...
Increase.
...
Operations successful.
67,236
71,378
4,142
55,784
60,308
4,524
Percentage of success.
85.69
87.36
1.67
Taken together, the numbers are,—
1871-72 ...
1872-73 ...
Increase
..
108,880
124,249
15,369
91,188
107,565
16,377
85.19
89.22
4.03
28. The cost of operations has been,—
By Department ...
Municipal Vaccination ...
Paid from Local Funds...
1870-71.
Rs.
0
0
0
0
a.
1
0
3
1
p.
8½
10½
1½
11
1871-72.
Rs.
0
0
0
0
a.
2
1
1
2
p.
2¼
11½
4½
1¾
1872-73.
Rs.
0
0
0
0
a.
1
2
1
1
p.
6¾
0¼
5¾
9¾
29. The cases of true re-vaccination have been very few, and from miscon-
ception of the meaning of the term, many of the returns have contained errors
under that head, which have now been corrected.
Cases of failure followed by a second operation after a few days had been
given as re-vaccinations. The Sub-Assistant Surgeon in charge at Sagar, in
answer to my inquiry informs me that all cases so returned by him were true
re-vaccinations and the Medical Officers at Wardha and Chanda reply in similar
terms. At Jabalpur all policemen, prisoners, lunatics and candidates for Gov-
ernment employment are vaccinated irrespective of their having had small-pox
and of these as many as had unmistakeable marks of small-pox or vaccination
have been returned as re-vaccinated,
30. Betul.—There has been much improvement in this district under the
zealous management of Dr. Hall, but he has been unfortunate in his Native
Superintendent, who not only neglected his supervision and otherwise miscon-
ducted himself, but was also I believe the cause of the gross misconduct of his
Mujid or disciple Shaik Myboob. These two have been treated departmentally
and will not give further trouble, but from the failure in his duties of the Native
Superintendent, the returns are not quite as favourable as they might otherwise
have been expected to have been. During the year there were vaccinated 2,385
more than in 1871-72, the successful cases were more by 3,581 and percentage
of success of primary vaccination 92.25 against 85.35.
From the Table in a preceding page it will be seen that about 689 per mille
of the available children under one year of age were operated upon, against 371
in 1871-72.
31. In his report for the preceding year Dr. Hall drew attention to oppo-
sition or at least want of co-operation of the Malguzar of Betul, Taji Patel,
11
didates available to take their places, but as soon as their services could be
spared four good vaccinators were sent from Chhindwara to assist their fellows
at Nagpur.
Up to March 31st 1,784 had been vaccinated in the city and suburbs, with
a percentage of 94.8 of success ; and operations were actively carried on after
that date, the result of which will be shown in the next season's returns.
47. The Superintendent saw some persons who had been vaccinated suffer-
ing from small-pox, but also others with the same disease who had on their
persons undoubted marks of a previous attack. He gives no particulars as to
numbers, ages or other conditions.
48. The assistance given by Sivraj Singh, Tahsildar of Katol, and Gan¬
put Rao, Tahsildar of Umrer, has been favourably brought to notice. During the
year there was somewhat troublesome opposition exhibited at Bela, and the
vaccinators' instruments were lost, and a single case in the Nagpur Tahsil has
been mentioned.
49. Sagar. —The returns show a falling of 2,037 operations, and except
at the Sadar station the average of success is low. The number of available
children under 1 year vaccinated was about 145 per 1,000.
In the present season only two paid vaccinators were employed and their
operations confined to Sagar and Kurai with the villages in the immediate
neighbourhoods. The Hospital Assistants at the branch dispensaries vaccinated
a few only.
In the season 1871-72, in addition to the two paid Vaccinators a Native
Doctor and two Native Medical pupils were employed in operating in the district,
and the Sub-Assistant Surgeon ascribes the falling off in numbers to the loss
of their services.
The English lymph supplied was used successfully at Sagar, Kurai and
Shahgarh on or about October 28th, whilst the Nagpur lymph failed in two out
of the three places, and the result of its use at Sagar was not ascertained.
Arm to arm vaccination is said to have been extensively practised, but if
this were so the ratio of success should have been much higher except under
very unskilful hands.
50. Damoh —After failures from the use of old crusts and recently received
English lymph, the first successful case was obtained from Nagpur lymph on
November 1st ; two Vaccinators were employed, one being a new man, a Brahmin
Pandit. The work done was very little, there was a trifing increase of 56 in
the number of operations, but only 4 in that of successes, and the percentage of
the latter is very low, 72.71. Very little arm to arm vaccination was performed,
which may perhaps in a great measure account for the numerous failures.
51. The operations were chiefly carried on at Damoh and Hatta, but in
the former circle there were 123 successful cases in 22 outlying towns and
villages, and in the latter circle 44 successes in 11 villages,—not sufficient to have
any appreciable effect in moderating an epidemic of small-pox should one occur.
Mr. King, the Civil Surgeon, states that he has observed that the prejudice
against vaccination is gradually wearing away, and that some who obstinately
refused in former years now bring their children forward with apparent wil-
lingness.
13
The vaccine operations in the district cannot be considered very satisfactory,
and only about 24 per mille of children under 1 year have been operated upon.
58. Hoshangabad.—Increased efforts were made to more effectually pro
tect the people of this district. A Vaccinator was employed on increased pay in
each of six large circles. Two new men were appointed on the nomination of
the Municipal Committees of Babye and Sohagpur, a Brahmin sent out on
requisition from Hoshangabad to Seoni, two Mohammadans entertained for Hos¬
hangabad and Duluriya, and the old Vaccinator retained at Harda.
The new men were instructed in their work under Dr. Cullen at Hoshanga-
bad, and a seventh man had to be similarly taught to relieve one who resigned in
November.
Operations were commenced with success on October 4th with lymph re-
ceived from Nagpur and Puna.
59. Dr. Cullen, who entered into the work with his usual zeal, was consider-
ably disheartened by the numerous frivolous objections and excuses, as well as the
passive opposition met with, His experiences generally tally with those of
others who have been similarly employed, and he has been able in very many
cases to overcome opposition by personal explanations and demonstrations. In
the Duluriya circle, however, he met with determined opposition, led chiefly by
four brothers, the owners of 11 villages. The influence of the Tahsildar proving
unavailing, Dr. Cullen himself visited the villages, where he was treated with
great discourtesy and actually hooted from the one in which the brothers were
assembled, on his going there in the hope of being able to persuade them to
forego their opposition.
60. Of more importance was the opposition given by two Honorary Magis-
trates of Harda, Tulsi Ram Sookul and Vynek Rao, and the Honorary Magis-
trate of Seopur in the Seoni Tahsil, men of considerable local importance whose
conduct greatly influenced that of others.
61. As a counterpoise, Dr. Cullen brings to notice the valuable assistance
received from Ramdyal, Tahsildar of Seoni, and Mahomed Ali, Inspector of
Police, then of the same place, but now at Damoh, amongst the officials ; and the
following amongst the Malguzars and leading men of the towns and villages :—
1, Khool Chund, Malguzar of Magrole ; 2 and 3, Ruttee Ram of Cheelachawn
and his brother of Kurliza ; 4, Khaim Chund of Barondia ; 5, Jagat Kissore
of Mala Kheiree ; 6, Pragchand Chowdry of Russulpur ; 7, Anundajee of
Sonasawrie; 8, Ram Kissu of Mohari ; 9, Gopal of Chandwar ; 10, Kawall Ram of
Dunasa, a jungle village, the pattern of cleanliness; 11, Bala Ram of Kuparia,who
accompanied him for 3 days, giving great assistance ; and 12, Gundasha Cazi of
Babye, the only one of the Municipal Committee who took any interest in the
work of the Vaccinator nominated by itself.
62. The opposition in some instances appears to have taken an active form
and Vaccinators were threatened and assaulted. The Civil Surgeon attributes
the large number of results recorded under the heads " doubtful and unknown "
to this circumstance, the Vaccinators fearing to return to the villages to examine
the results of their operations.
D P Z-15-109-385