NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( xi )
Vaccination by Muni-
cipalities.
29. Municipal vaccination, which was introduced in 1863, is gradually
making progress. The plan was suggested by me
as being calculated to identify local municipal bodies
with efforts to render the protective system of vac-
cination more extended, efficient, and complete. It was first brought into
operation by Dr. Plumptre in the Sattara districts, and has been extended by
him to Gudduk and Bettigherry in the Dharwar, and to Gokak in the Bel-
gaum collectorate. The number of vaccinators supported at the expense of
municipalities in these places, and in the Sattara districts, has increased to
eight, and the number of operations to upwards of 5,000. The plan has
succeeded better there than in other parts of the Presidency, a circumstance
which is mainly attributable to the judicious and active interest taken in the
subject by the Superintendent.
30. It has recently been adopted in Gujerat, where the municipality of
Ahmedabad now employs two vaccinators and two peons, and that of Dakore,
in the Kaira collectorate, one vaccinator. The arrangement was made in the
former town by the influence of Dr. Wyllie, the Civil Surgeon, and in the
latter by that of Dr. Dick, the Superintendent. The other municipalities
in the Kaira collectorate are said to be " far too poor and pressed for
funds" to enable them to contribute to expenses of this kind. It is reported,
however, that there is a probability of arrangements being made for the
engagement of a vaccinator by the municipalities of some of the principal
towns in the Ahmedabad collectorate, and also of Sholapoor and Beejapoor.
Municipal vaccination has now been introduced, not only into the Sattara
districts, but also at Hooblee, Gudduk, Bettigherry, Belgaum, Gokak, Tanna,
Poona, Kotree, Ahmedabad, and Dakore.
Character of the vaccine
lymph.
31. Except in Canara and at Aden, the vaccine lymph was well reported
on throughout the Presidency, the resulting vesicles
being generally well-developed and well-marked.
In one or two instances, in which there appeared to be slight tendency to
deterioration, fresh lymph was immediately procured and introduced. The
Superintendent in Sind reports that only on one occasion had he reason to
find fault with it. In 1864 he received a supply from England in capillary
tubes, and the result was so satisfactory that he caused it to be spread over
the province, so that with one or two exceptions all his men are now working
with it. In Canara, however, the Superintendent found the lymph so much
deteriorated that he was compelled to suspend work, until a fresh supply had
been obtained from Belgaum and Hooblee.
( xii )
Want of sufficient lymph,
32. Complaints have been received, as in former years, of the difficulty,
in a few places, of keeping up a sufficient supply of
lymph so as to be always ready for use. In Bombay
itself this want was recently reported to be felt with increasing pressure,
owing mainly to the strong repugnance felt by the parents of vaccinated
children to allow lymph to be taken from their arms for the purpose of vac-
cinating other children,—a repugnance which appears to be felt as strongly
by the educated classes, as by the uneducated.
33. As an illustration of this feeling, it may be mentioned that the Su-
perintendent at the Presidency, a Sub-Assistant Surgeon, recently mentioned
that during last year nearly a thousand children belonging to the educated
and upper classes were vaccinated, but that only three of their parents would
allow lymph to be taken from their arms. He stated at the same time that,
in his opinion, " nothing short of legislative interference would be able to
meet the exigency, and that there need be no fear of complaints being made
of interference with religious prejudices." There are many considerations
which would probably disincline Government to move in this direction at
present, but it seems nevertheless desirable to record the opinion thus ex-
pressed by a very intelligent Native, who has for several years been Superin-
tendent at the Presidency, and who is intimately acquainted with the feelings
of his fellow-countrymen of all castes on the subject.
Application to Secretary
of State for India for
lymph, and result.
34. Partly for the purpose of diminishing the difficulty on this point, it
was suggested in the last report that the Secretary
of State for India might be requested to communi-
cate with the National Vaccine Establishment in
London, with the view of procuring and of forwarding an annual supply of
lymph. Moreover, as the experience of India showed that lymph, transmitted
on ivory points, almost invariably proved useless, it was particularly pointed
out that it ought to be forwarded solely in " vaccination tubes," a very small
number being sent to Aden, and a larger supply to Bombay. Government
were pleased to approve of these suggestions, and to communicate with the
Secretary of State for the purpose of having them carried into effect.
35. About the close of the year, a small packet of lymph was received
from the India Office, but I regret to say it consisted solely of ivory points,
there not being a single tube. These points were immediately distributed to
the Civil Surgeon at Aden, and to the Superintendents of the Sind, Northern,
Central, Southern, and Presidency Circles, with instructions to adhere
rigidly to the directions for using the lymph, which were enclosed in the
( xiii )
packet, and to report the result. Replies have already been received
from four of these officers, and I much regret to state that, although the
lymph appears to have been used in the most careful manner in
vaccinating both Native and European children, failure was the result in
each case. So anxious was one of the Superintendents to meet with
success, that in addition to making the most careful selection of healthy
children, and to taking the usual precautions, he actually promised a sum
of money to each of the parents of those children, on whose arms a true
vesicle should appear. I would therefore again very earnestly request that
the next supply may be forwarded solely in tubes.
Vaccination at the Presi-
dency.
36. In the Resolution passed by Government on the last report, some re-
marks were made on the small number of vaccina-
tors in the Presidency town, and I was requested to
make inquiry on the point, and to suggest how the want might be supplied.
In accordance with these instructions, I communicated with Dr. Giraud, then
Honorary Inspector of Vaccination at the Presidency, and having ascertained
his views, I reported on the subject to Government, the result being that, on
the recommendation of His Excellency in Council, the Government of India,
towards the close of the year, sanctioned an increase from three to six.
37. It may perhaps be well to place on record, in this place, a few
circumstances connected with vaccination at the Presidency, which led to
this result.
38. At the close of 1858 the number of vaccinators was ten, but at that
period there was no paid Superintendent, and consequently not that active
supervision of operations and of their results, which was requisite. In
January 1859, however, a new scheme was introduced, with the sanction of
Government, which originated with Dr. Peet, who at that time was the Hono-
rary Inspector of Vaccination. The establishment of vaccinators was reduced
from ten to six, and a Sub-Assistant Surgeon was appointed to perform the
duties of Superintendent. Domiciliary vaccination was put a stop to, and
vaccination at stations, under the direct supervision of the Superintendent,
was introduced. The island was divided into six districts, to each of which
a vaccinator was appointed. The result of the plan was to be reported on
after three years.
39. In August 1859, however, eight months after its commencement, the
number of vaccinators, at the recommendation of the local Superintendent,
(which was approved of by the Honorary Inspector) was reduced to three, as
" the experience of the past six months has fully shown that the number of
( xiv )
vaccinators now attached to the establishment is greater than what is actually
required, seeing that all the vaccine operations are performed by the Super-
intendent."
40. In January 1862 the operation of the new system of vaccination was
reported on by Dr. Peet, who stated that " the increase in the numbers vac-
cinated during the three years, now reported on, as compared with the two
immediately preceding periods of the same length, is about 2,000. If this
had been the sole result of the reorganization, it might perhaps be viewed as
meagre and unsatisfactory. The main object was a trustworthy system, but
it was hoped that this would not be incompatible with the extension of the
benefits of vaccination to a larger number of persons." Dr. Peet then added,
"there is, I think, conclusive evidence that an honest and trustworthy
system of vaccination has been substituted for one that was unsatisfactory
and delusive. It cannot, however, be denied that the increase in the num-
ber vaccinated has fallen short of what was anticipated."
41. This was written in 1862, since which time vaccination in Bombay
has not materially increased in numbers. Though there is, no doubt, a bet-
ter feeling than formerly towards vaccination, it has not yet reached that
point at which the majority of parents will, unasked, bring their children to
be vaccinated, and there is in consequence required from the native vacci-
nators a large amount of work in finding out children, and inducing their
parents to bring them to the stations.
42. Dr. Giraud, who succeeded Dr. Peet, stated his opinion that three vac-
cinators were inadequate to perform the duties required of them, and which,
according to existing rules, are to visit as many as possible of the houses in
which children, who have been vaccinated, live; to bring to the notice of the
Superintendent every instance of failure, or of irregularity of the vesicle;
and to make himself acquainted, as far as may be practicable, with the num-
ber and residences of the children in his division who have not been vaccin-
ated. He therefore recommended that as Bombay is divided into six districts,
each with its vaccinating station, there should be six vaccinators, one for
each station and district. This modification was adopted, and has recently
been carried into effect.
Assistance from Civil and
Political authorities.
43. It gives me much pleasure to state that the Superintendents, gener-
ally, express their acknowledgments for the cordial
support they received from the Civil and Political
authorities. Dr. Butler also pointedly mentions
that the Native Chiefs in Kattiawar gave him more assistance than during
any previous year.
( xv )
Services of Superin-
tendents.
44. It likewise affords me great satisfaction to report that the Superin-
tendents, without a single exception, worked
throughout the year with a diligence and earnestness
which could not be surpassed, and which well en-
title them to the favourable notice of Government.
Conduct of Vaccinators.
45. In justice to the body of vaccinators, it must also be mentioned
that, with a few exceptions, their conduct during the
year has been highly spoken of by the Superin-
tendents and Civil Surgeons.
Reorganization of the
department.
46. Having now concluded my statement of the working of the depart-
ment during the year, it becomes necessary, previous
to closing the report, to place on record certain
changes recently made in its organization.
47. It will be recollected that in 1861 the department was modified to
the extent of reducing the number of vaccination " Divisions,"into which
this Presidency was at that time mapped out, from eight to six, and of
introducing Native Sub-Assistant Surgeons as Deputy Superintendents
a post which had not previously existed. Two divisions were in con-
sequence absorbed into others, and the services of the two Assistant
Surgeons, who were the Superintendents, were placed at the disposal
of Army head quarters. Thus the Concan division was broken up and
added to the Central and Southern districts, while the two divisions in
Gujerat were united into one. The term "Division" was at the same time
changed into that of "Circle."
48. With the view of compensating for this loss of European supervision,
it was intended by Government that each of the three most extensive
Circles should be provided with two Deputy Superintendents. Their chief
duties were to assist the Superintendent in the inspection of the vaccinators,
to explain to the people of the districts, in which they might be employed,
the objects and benefits of vaccination, and to encourage its diffusion by
persuasion and by all other legitimate means.
49. This arrangement was made by Government during the time of my
predecessor, but not on his recommendation. On the contrary, Dr. Rooke
maintained that to diminish the amount of European agency was to impair
the efficiency of the department.
50. As mentioned in previous reports, the new system worked badly. The
Sub-Assistant Surgeons disliked the nature of their new appointments,
even though carrying with them increased emoluments. The main objection on
( xvi )
the part of some was the necessity of the almost constant travelling which
was involved, while to others the duty was distasteful as estranging them
from the practice of the profession for which they had been educated.
51. On one occasion, in particular, very convincing proof was given of
this strong dislike. With the view of filling up some vacancies in the post of
Deputy Superintendent, I found it necessary to ascertain how many
Sub-Assistant Surgeons, then employed by Government in different parts of
the mofussil in charge of Dispensaries, would voluntarily enter the depart-
ment. The result showed that ten out of twelve declined, while before long
the two, who did enter, begged to be allowed to resign.
52. The scheme thus proving an entire failure, it became necessary to
lay the subject before Government. The result was the abolition of these
appointments, and a modified return to the system which was in operation
before they were made. Some of the Circles were accordingly re-arranged,
and the amount of European agency was increased to the extent to be now
stated.
53. It was mentioned, in paragraph 47, that the two divisions, formerly
existing in Gujerat, had been united into one. I did not propose to disturb
that arrangement by dividing the province again into two, because in the
meantime a Medical Officer had been sanctioned for the Gujerat Bheel Corps
at Dohud, and as he was nominated at the same time Superintendent of Vacci-
nation in the Rewa Kanta and Punch Mahals, the former of which had
previously formed part of the united Gujerat Division, its extent had in
consequence been considerably reduced. It was therefore not considered
too great for efficient supervision by one Superintendent, particularly at a
time when the number of medical officers was, and still is, insufficient to
meet, adequately, even the ordinary requirements of the Civil and Military
departments.
54. It was different, however, with the Central and Southern Circles,
which embraced the whole of the Deccan, Southern Maratha Country, and
Concan. The great extent of each of these Circles rendered it impossible for
a Superintendent, however zealous and energetic, to effect that thorough
supervision over the vaccinators, or to exercise that strict personal insight
into the working of the department, which is so essentially necessary.
55. I therefore suggested that these two Circles should be divided into
three, by separating from them the collectorates of Tanna and Rutnagherry
( xvii )
and the Sawunt Waree State, and by forming these into a third. Circum-
stances did not at that time, nor do they now, admit of more being done in
the way of sub-division. I trust, however, that, at some future time, means
may be found for still further reducing the extent of all the larger Circles,
for it is obvious that the smaller the district in charge of a Superintendent,
the greater would be his opportunities for more closely and repeatedly
inspecting the work of each of his vaccinators,—a subject of the utmost
importance, inasmuch as the value of the department greatly depends on
unceasing personal inspection.
56. Government were pleased to sanction the arrangements proposed. The
Bombay Presidency is therefore now divided into the following eight Circles,
each being in charge of an Assistant Surgeon, except at the Presidency,
where the Superintendent is a Sub-Assistant Surgeon :—
I.—The NORTHERN CIRCLE, consisting of the Collectorates of Ahmeda¬
bad, Kaira, and Surat, the Sub-Collectorate of Broach, and
the territories of the Chiefs in the Mahee Kanta, and of
Rajpeepla and Pahlunpoor.
II.—The CENTRAL CIRCLE, consisting of the Collectorates of Khandeish,
Poona, Ahmednuggur, and Kulladghee, the Sub-Collectorate
of Sholapore, and the Peint State.
III.—The SOUTHERN CIRCLE, consisting of the Collectorates of Sattara,
Belgaum, Dharwar, and Canara, the Kolapoor State, and the
territories of the Jagheerdars in the Southern Maratha
Country.
IV.—The WESTERN CIRCLE, consisting of the Collectorates of Tanna
and Rutnagherry, and the Sawunt Waree State.
V.—The SIND CIRCLE, consisting of the province of Sind.
VI.—The KATTIAWAR CIRCLE, do.
do.
of Kattiawar.
VII.—The REWA KANTA CIRCLE, consisting of the territories of the
Chiefs in the Rewa Kanta, and of the British territory of the
Punch Mahals.
VIII.—The PRESIDENCY CIRCLE, consisting of the island of Bombay.
57. In addition to this arrangement, each zilla town is provided with a
vaccinator, who works under the eye of the Civil Surgeon.
3 vac
( xviii )
58. Assistant Surgeon Blanc has been appointed Superintendent of the
new Western Circle, but as he is detained on special duty under the orders
of the Political Resident at Aden, and as the Medical Department is at pre-
sent too weak in numbers to admit of an Assistant Surgeon being spared to
officiate, the new arrangements are in abeyance pending Dr. Blanc's arrival.
I have the honour to be,
Sir,
Your most obedient Servant,
M. STOVELL, M.D.,
Principal Inspector General, Medical Department.
Bombay, 31st March, 1866.
( xix )
INDEX TO THE FOLLOWING REPORTS.
VACCINATION UNDER SUPERINTENDENTS—
Central
Circle.. .. .. .. .. .. .. ..
Southern
do. .. .. .. .. .. .. .. ..
Northern
do. .. .. .. .. .. .. .. ..
Sind
do. .. .. .. .. .. .. .. .. .. .. ..
Kattiawar
do. .. .. .. .. .. .. .. ..
Rewa Kanta do. .. .. .. .. .. .. .. ..
Presidency
do. .. .. .. .. .. .. .. ..
PAGE
1
4
8
9
14
15
16
VACCINATION UNDER CIVIL SURGEONS—
Tanna .. .. ..
Poona .. .. ..
Ahmednuggur .. ..
Sattara .. .. ..
Sholapoor .. ..
Dhoolia .. .. ..
Nassick .. .. ..
Belgaum.. .. ..
Dharwar .. .. ..
Kolapoor.. .. ..
Rutnagherry .. ..
Vingorla.. .. ..
PAGE
17
17
18
19
19
20
21
21
22
22
23
23
Honore .. .. ..
Ahmedabad
Kaira .. .. ..
Surat .. .. ..
Broach .. .. ..
Rajcote .. .. ..
Kurrachee .. .. ..
Hydrabad
..
.. ..
Shikarpoor .. .. ..
Kotree .. .. ..
Kutch
..
..
..
Aden .. .. ..
PAGE
24
24
25
26
26
27
27
28
29
29
30
30
APPENDIX—
Vaccination under Superintendents in British Territory ..
Vaccination under
ditto
in Native ditto .. ..
Vaccination under Civil Surgeons .. .. .. .. ..
General Abstract of Vaccination .. .. .. .. ..
Table of Ages
..
..
..
..
..
..
Employment Returns of Superintendents of Vaccination ..
Table No. 1
No. 2
No. 3
No. 4
No. 5
No. 6
VACCINATION UNDER SUPERINTENDENTS.
CENTRAL CIRCLE.
Superintendent.—Assistant
Surgeon P. S. TURNBULL, M.D.
Establishment.—Thirty-six
Vaccinators (Government).
Two Vaccinators (Native Chiefs).
ESTABLISHMENT.
Government ....
Native Chiefs ..
YEARS.
1864
1865
1864
1865
Total
Vaccinated.
69,299
63,251
2,550
1,915
Compared with the
preceding year.
Increase.
....
....
....
....
Decrease.
....
6,048
....
635
Success-
fully
Vaccinated.
66,141
59,350
2,334
1,763
Per-centage
of
Success.
95.4
93.8
91.5
92.1
Of the total number 33,526 were males and 29,725 were females, or respectively 53.0 and
47.0 per cent. This shows that the males still preponderate, and also that there is a fraction-
al falling off in the number of females, as compared with males, vaccinated during the past
year.
In the 8th paragraph of my report on vaccination for the year 1864, I expressed my regret
at the yearly decrease in the number of infants or children under one year of age, operated
upon, or rather of the number of them shown in the Returns; but at the same time I remark-
ed that the age of the child was, in my opinion, incorrectly given, and that I hoped to be
able to show an increase in the Returns for 1865; such has been the case, 14,958 persons have
been operated upon under, and 48,293 above, one year of age, thus giving respectively 23.6
and 76.4 per cent. the total number, and showing an increase in the former of 12.2 per cent. a
very satisfactory increase. I think a proceeding which I adopted in the end of 1864, and
carried out during the past year, has had some effect in increasing the number of infantile
vaccinations. It is this : I called for names of all children under one year of age, from the
Koolkurnees of villages I visited, and also those within a reasonable distance of them. These
yads I forwarded, along with others, to the vaccinators.
The lymph has generally been good throughout the Central Circle, and the vesicles normal.
Husband's tubes have been very largely used during the year, and the lymph sent in them to
numerous applicants, such as medical officers, both in and out of the Presidency, Apothecaries,
Missionaries, and other private persons, has, except in one or two instances, been invariably
successful.
v I
4
SOUTHERN CIRCLE.
Superintendent.—Assistant
Surgeon F. H. PLUMPTRE.
Establishment.—Twenty-nine
(Government).
Twenty-three (Native Chiefs).
Eight (Municipal).
ESTABLISHMENT.
Government ....
Native Chiefs ..
Municipal ......
YEARS.
1864
1865
1864
1865
1864
1865
Total
Vaccinated.
34,708
41,986
18,816
17,142
2,834
5,049
Compared with the
preceding year.
Increase.
....
7,278
....
....
....
2,215
Decrease.
....
....
....
1,674
....
....
Success-
fully
Vaccinated.
32,767
39,779
17,345
15,912
....
4,524
Per-centnge
of
Success.
94.4
94.7
92.3
92.8
....
89.6
This Return shows a satisfactory increase of the progress of vaccination in the Southern
Circle. This increase is not so much marked if compared only with the year immediately
preceding, as it would be were it contrasted with former years. It is not necessary to go
back many years to show this contrast. I will only take the year 1862, the one during which
Dr. Asher held the office of Superintendent of this Circle, under whose control a higher
number of operations was performed than had ever been previously recorded, the total
number then shown of the Government and Jaghecrdar establishments combined being
47.139. The past year gives the total number as 64.177, an increase of no less than 170.38.
A considerable share of this increase has been contributed by the operations performed by
the vaccinators employed and paid for by some eight of the Municipalities in this Circle
Putting the operations of this class aside, the Returns still show that, so far as the Govern-
ment establishment is concerned, although its strength has been slightly increased, compared
with 1862, the working of the whole shows a fairly progressive increase.
As this is the fifth Annual Report on vaccination that I have had occasion to prepare, I
feel that so far as suggestions are concerned for the improvement of the department, that the
subject is nearly exhausted, the more especially as so many of these suggestions have been
carried out in practice, and almost the only remaining one I would wish to see as likely to
increase the efficiency of the department, is one which at present I know, is impossible. It
is that the size of the Circle should be so reduced as to permit of the Superintendent being
able to visit every vaccinator under his charge, once at least, during the annual tour of inspec-
tion. Until such is the case, there will be always some doubt as to the quality of the lymph
in use. The formation of the new or Western Circle is a step in this direction, relieving