NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( xii )
1862 ....................
1863 ....................
1864 ....................
1865 ....................
1866 ....................
1867 ....................
10.57
11.70
8.60
7.83
7.83
7.10
Accuracy of returns.
31. Superintendents have generally pronounced in a very favourable
manner on the accuracy of the returns of vaccination.
In the Northern Circle and in Sind, where the super-
vision was most perfect, the reports are highly satisfactory. In the former
Circle only one instance of false returns was discovered; in Sind, none. In
Kattiwar a case was found by the Superintendent; none others are men-
tioned.
Capillary tubes.
32. A great aid in favour of the decrease of this crime, of preparing
false returns of vaccination, exists in the use of Hus-
band's capillary tubes by the working Vaccinators,
every one of whom should be most carefully instructed in the correct mode
of charging them. Vaccine lymph can be carried in these tubes with far more
surety than by any other known method, and with these in possession the
Vaccinator can 'go on his way without fearing the difficulties, which not
unfrequently occur, in obtaining fresh lymph from village to village, or from
those which arise from obstinate delays on the part of the people, or want
of success. All these were formerly prolific causes of false returns: the
Vaccinator dreading to report his misadventure to his Superintendent, pre-
ferred to trust the result to chance. A Superintendent, when visiting a
Vaccinator, should never leave him without being certain of his ability to
guard himself against these serious troubles attending his work.
Sex.
33. There were 210,378 males and 181,037 females vaccinated, or 54
of the former to 46 of the latter. This is about
the usual proportion observed.
Infantile vaccination.
34. 159,575 children under one year were operated on, and 231,840
above one year, giving a proportion of 41.00 of the
former to 59.00 of the latter. This is an improve-
ment on the general return over former years, for in 1865 it was 35, in 1866
it was 37, and is a satisfactory indication that vaccination is more ap-
preciated. It appears, however, as has been stated in previous reports, that
the subject of infantile vaccination is more favourably received in some
districts than in others; and unless the ages are entered incorrectly by the
Vaccinators and of this there is not much evidence—there is still very
( xiii )
manifest the frequently shown aversion to it in the Southern Circle. The
highest percentage is still maintained in the Northern Circle (Gujerat). The
proportion in various Circles is here shown :—
Circles.
Central ........................
Southern ....................
Northern ........................
Sind........................
Kattiawar ........................
Rewa Kanta ....................
Presidency ....................
Government Vaccination.
Under.
30
18
66
33
40
53
46
Above.
70
82
34
67
60
47
54
Native Chiefs' Vaccination.
Under.
50
27
56
32
36
43
36
Above.
50
73
44
68
64
57
64
35. Attention to infantile vaccination is one of the most important duties
of the Superintendents and their establishments, for it is a well-known fact
that the deaths from small-pox in this country,—setting aside those the pro-
duct of inoculation,—as a rule, occur amongst the unvaccinated children of
towns and villages whose inhabitants persist in refusing to accept vaccination;
and only when the disease is amongst them, and they are full of its dread,
is the Vaccinator hurriedly called from his regular work to render his aid to
those that have been spared.
Small-pox.
36. Small-pox was prevalent during the year to a considerable extent.
From the reports of the Vaccinators, which are
almost the only means of ascertaining, it had occur-
red to a greater or less extent in 15 districts in the Central Circle, 21 in
the Southern, 17 in the Northern, 9 in Kattiawar, but prevailing generally
from March to May in this country, and 19 in Sind. It was also re-
ported slightly in the Rewa Kanta and Punch Mahals, and in the Western
Circle, in several villages, especially those situated on high-roads; e.g., Panwell,
Kurjut, and Nagotna. In the Pahlunpore State, at the termination of 1867
and the commencement of the year 1868, it broke out in Tehrwada and
neighbouring villages, and 140 deaths occurred within a short period. The
State Vaccinator was as soon as possible at the place, but too late to be of
much service. The negligence of the village officials in failing to bring this
state of things to notice was reported to the Political Agent.
37. In the Mahee Kanta it also was present in the hot months. The
Political Agent on being applied to readily assented to the employment of
an additional Vaccinator.
( xiv )
38. In Kattiawar the disease prevailed to a great extent. The Superin-
tendent states that some of the cases he saw were measles, which also
creates great havoc amongst the children. The system of vaccination,
to which I before alluded, is here at fault, and the superintendence weak.
Thirty-eight Vaccinators are employed in this country,—thirty by the Chiefs and
eight by Government. The Reports of Surgeon Blomfield show that so large
a number of men working over an immense extent of territory require strict
supervision, which under the present system cannot possibly be afforded.
Thirty-eight men vaccinating in Kattiawar operated on-37,357 children;
whereas thirty-six men in the Central Circle performed on 71,037, almost
double the number, and the work well done.
39. In Bombay, small-pox prevailed throughout the year 1867; the
registered deaths from it were 1,053 ; and the following table, for which I am
indebted to the Health Officer of the Municipality, shows the periods of life,
and in what castes, the mortality occurred : there may probably have been
between 5 and 6,000 children who suffered from small-pox in Bombay during
the year. One-third or more of these added to the number vaccinated under
one year, viz., 5,072, and this again to a probable number of unvaccinated
children who may have, under one year, escaped the disease, would go far
to prove that not much more than about one-third of the children born in
the year are vaccinated :—
Day ..........
Months ..........
Years ..........
Ages.
1 to 15 ....................
16 to 30 ..................
1 to 6 ................
7 to 23 ................
2 to 4 ................
5 to 6 ................
7 to 9 ................
10 to 13 ............
14 to 24 ................
25 to 34 ............
35 to 44 ................
45 to 54 ................
55 to 64 ................
65 to 74 ............
75 to and over ................
Total.. ..
Deaths from Small-pox in
1866.
4
..
81
334
317
91
76
37
66
49
12
8
2
2
..
1,079
1867.
6
3
124
283
324
96
45
54
68
47
4
..
1
..
..
1,055
( xv )
Race or Caste.
Boodhist, — Jain, &c. ..........
Brahmin ....................
Lingæt....................
Bhatia ....................
Hindoo of other Cast ..........
Hindoo Out-cast ............
Mussulman ....................
Parsee ....................
Jew ........................
Native Christian ................
Indo-European ................
European ....................
Negro-Afriean ................
Chinese
................
Other and Unknown Races ......
All Races and Castes ........
1867.
January.
..
..
..
..
8
..
6
..
..
..
..
..
..
..
..
14
February.
2
4
..
2
33
5
14
2
..
3
..
..
1
..
..
66
March.
5
12
..
3
103
30
76
4
3
7
..
1
3
..
..
247
April.
9
5
..
3
97
21
61
6
1
8
..
1
..
..
..
212
May.
6
3
..
2
97
17
50
10
1
1
..
2
1
..
..
190
June.
6
..
2
1
75
16
32
11
..
7
..
1
..
..
..
151
July.
4
1
..
1
41
13
13
4
..
4
..
..
..
..
..
81
August.
1
..
..
..
32
2
3
..
..
1
..
..
1
..
..
40
September.
..
..
..
..
9
3
3
1
..
..
..
..
..
..
..
16
October.
..
..
..
..
6
2
2
..
..
..
..
..
..
..
..
10
November.
..
2
..
..
7
1
1
..
..
..
..
..
..
..
..
11
December.
..
1
..
..
10
4
1
1
..
..
..
..
..
..
..
17
Total.
33
28
2
12
518
114
262
39
5
31
..
5
6
..
..
1055
The deaths from small-pox in unvaccinated children in the Presidency City
are here shown to occur chiefly between the seventh month and the twenty¬
third; those due to each month progressively are not known; but as far as
this evidence goes it plainly proves the prophylactic to be necessary before
the seventh or eighth month of infant life. This is more clearly shown in a
table of mortality from small-pox occurring in 1868, which I purposely place
in this Report:—
( xvi )
Table showing the Mortality from Small-pox in the City of Surat, from the
1st of February to the 29th of March 1868.
CITY OF SURAT.
Districts.
Maidhaspoora ......................
Haiderpoora ........................
Sayethpoora ........................
Sudrampoora ....................
Beggampoora ....................
Nawapoora ........................
Sullabathpoora ....................
Singadiawaur ....................
Naunpoora ........................
Chouk Bazar ....................
Goppipoora ....................
Moolaka Chakla ................
Waddee Kullia ....................
Total....
Deaths from Small-pox.
Age.
Months.
From 1 to 6
5
3
6
7
2
25
..
1
2
..
..
1
2
54
From 6 to 12.
4
5
2
4
1
17
4
..
1
2
..
1
..
41
Years.
From 1 to 3.
7
2
1
3
6
12
2
2
..
..
1
..
..
36
From 3 to 5.
3
4
1
2
..
7
..
1
..
..
..
1
1
20
From 5 to 9.
1
..
..
..
4
3
..
..
..
..
..
..
..
8
From 9 to 12.
..
1
..
1
..
1
..
..
..
..
..
..
..
3
From 12 to 15.
..
..
..
..
..
..
..
..
..
..
..
..
..
..
Above 15.
..
..
..
..
..
..
..
..
..
..
..
..
..
..
Total.
20
15
10
17
13
65
6
4
3
2
1
3
3
162
The disease occurred in Surat in two months of the present year, and 162
children died in this city in the period named, 95 of whom were under one
year of age; of these, 54 were under 6 months. Vaccinators were present,
but their assistance was refused.
( xvii )
Value of infantile vac-
cination.
The Superintendent of Vaccination in Sind, in his report has some
remarks on this subject. The susceptibility to
small-pox, and consequently the susceptibility to
the more certain action of vaccination, are argued
on to the conclusion that vaccination in infancy, i. e., under one year, need not
be much insisted on.
40. The above tables of deaths at Bombay, and recent outbreaks at
Surat and Pahlunpoor, show when the susceptibility in this country is
greatest; and the conclusion is that, if vaccination is to be prophylactic, it
must be performed under one year, and somewhat before the period of
greatest susceptibility to small-pox.
41. It is the duty of Superintendents and their establishments to do
all in their power to foster this opinion in the minds of the people, for,
especially in a system of vaccination like that of this Presidency, the un¬
vaccinated must be operated on in the progress of the work, regardless, to
a certain extent, of age.
Registration.
42. The Superintendents of Vaccination have not hitherto been able
to obtain reliable returns and reports of small-pox
in their districts from the various authorities ; but in
future, the Resolution of Government in Financial Department, No. 535, dated
10th May 1867, requires the registration of births and deaths, and it is pre-
sumed the causes of the latter, to be kept in every village.
43. In Bombay the registration of births, under the Municipal Act,
gives no idea of what the vaccination requirements are. Taking it, however,
as a reference, we find that the registered births for the year 1867 were 5,115,
and that the vaccinations performed under one year were 5,072. This would
be a most gratifying result, but the registration shows that the rate of births
to population is only about 7 per thousand; whereas the acknowledged
rate to population is about 30 to 33 per thousand. As, however, Bombay
is peculiarly situated, with reference to what may be called its floating
population, I am of opinion that twenty, perhaps even less than that, should
be taken as the rate of births per 1,000, which would give about 308 births
to be registered weekly, and, allowing for decreasing causes, between thirteen
and fourteen thousand to be vaccinated under one year in Bombay per an-
num. From the foregoing, it may be observed that the registration of births
in Bombay under the present system cannot be taken as a guide to correct
vaccination.
3 v a c
( xviii )
44. It is at the same time evident that, from the constant presence of
small-pox, there is a great necessity for the spread of vaccination in the city
and outskirts of Bombay. In the Resolution of Government, No. 986, dated
27th May 1867, on my. last Annual Report of Vaccination for 1866, it is
directed that early attention should be given to the subject of increasing
deaths from small-pox. A year has elapsed since then, deaths from small-
pox have been much as they were, notwithstanding the earnest endeavours
of the Department; and the only and best means I can, after much considera-
tion on the subject, recommend, is a system of compulsory vaccination. In
stating this it does not appear to me that much is required to be said in
addition to the foregoing remarks; but it may be as well to bring to the
notice of Government, briefly, the system of vaccination which was inaugurated
in 1858. The old system of domiciliary vaccination, its abuses being many,
was changed in this year under the recommendation of Dr. Peet, the then
Honorary Inspector of Vaccination in Bombay : a paid Superintendent was
appointed with a small number of Vaccinators under him; there were six public
stations for vaccination, and the Superintendent himself vaccinated at each
of these in course; the Vaccinators were employed in searching out children
for vaccination ; in endeavouring, after the operations, to ascertain results, and
bring as many forward for inspection as possible. This system is at pre-
sent in existence, and is one which leaves so very much to the people them-
selves, that it is wonderful to see so many avail themselves of it. Such a
system, however, is utterly unsuited to altered times, and to a world port like
Bombay, where every exertion should be used to place it in sanitary equality
with, and even in advance of, other towns and cities.
45. The details of what should be the working of a system of compulsory
vaccination cannot be entered upon in this Report; but the employment of all
medical practitioners, including those qualified by the University of Bombay,
or by the original examination of Grant Medical College, should be one
essential part of it, and the continuation of public vaccination stations
another.
46. The local Superintendent of Vaccination in Bombay, a Brahmin,
graduate Grant Medical College, of much intelligence and long experience,
reports on this point:—
" My experience, and that of every Officer of the Vaccine Department, has
shown me, beyond any possibility of being denied, the great eagerness and
anxiety disclosed by almost all classes in the community to get their children
vaccinated.
( xix )
" Such of the Abyssinian Force as were vaccinated gave us abundance
of fresh lymph, with which we could vaccinate all who applied during the last
months of the year, but so soon as that source of supply was exhausted we
were as badly off for vaccine lymph as ever,—and it was the greater pity as
the want occurred at the very time it was most needed, when, on account of
the setting in of the small-pox season, the number of applicants for the
operation began to increase.
" Nothing short of legislative enactment can meet this. I am fully
persuaded that if an enactment, making it compulsory to get one's child
vaccinated, and, when successfully vaccinated, to allow lymph from it, is
passed, it will not meet with any serious opposition from any portion of the
community on the score of religion."
47. The willingness shown to exist by the Superintendent must be
taken with some drawback, for it is chiefly in the season when small-pox is
known to exist that so many come forward.
48. The insufficiency of vaccine lymph, alluded to by the Superin-
tendent, exists simply in the unwillingness of the people to allow the
removal of lymph in any way from the arms of their vaccinated children.
This is the great difficulty the Superintendent in Bombay has to contend
against: it is one which compulsory vaccination would go far to reduce,
without bearing much on individual prejudices.
Inoculation.
49. The subject of prohibition of the practice of inoculation with
small-pox matter has for several years engaged
attention, and has been recommended frequently to
the notice of Government. It is under consideration whether a law, similar
to that made for Bengal in 1865, shall be enacted for Bombay.
50. The reports of Superintendents do not point to the knowledge of
the existence of any general inoculation. In Sind it has, however, been
clearly shown to have originated, and kept up small-pox for months in one
district.* There is no doubt that it exists, and is freely carried on, amongst
the Belooches. The following extract from the annual Report of the medical
Officer in charge of the Jacobabad Dispensary is characteristic :—
" In the neighbouring villages the Belooch had their children inoculated
by one of their tribe in preference to having them vaccinated, and I know of
one instance where ten children were twice inoculated who had been previ¬
* This was brought to the notice of Government at the time as bearing on
Bengal Act. IV. of 1865, for making the practice of inoculation penal.
( xx )
ously vaccinated,—the inoculation was, however, unsuccessful,—so little faith
had these people in the immunity conferred by vaccination."
51. The absence of reports of inoculation in the various Divisions I do
not look upon as decisive of its non-existence; without doubt it does exist
in the outlying parts of our territories and in Native States, as particularly
shown in the Report of Mr. Dorabjee Hormusjee, G.G.M.C., in charge of
His Highness the Rao of Kutch's Dispensary and Hospital. He says:—
" With the exception of one caste, the Borahs, the people generally are
averse to vaccination, but are greatly in favour of inoculation; for I have
observed, during the epidemic of small-pox that broke out last year, that
numbers of them flocked to the Inoculators, even at the sacrifice of some
money, but none of them of their own accord had recourse either to the
Dispensary or to the Vaccinators, except the Borahs.
" I have no doubt that the epidemic raged very violently, because inocu-
lation was practised to a great extent. Unless, therefore, inoculation be made
criminal or punishable by law, and vaccination be made compulsory to some
extent, it is not unlikely that another epidemic may break out with equal
violence."
Character of the vaccine
lymph.
52. The character of the vaccine lymph in use is reported on favour-
ably. It has been renewed by lymph from the
" National Vaccine Institution." The results of the
use of this lymph, which was distributed to various
Superintendents, were as follows:—
Circles.
Presidency ..............
Central ....................
Southern ................
Northern ................
Sind ........................
Rewa Kanta ................
Kattiawar ................
Tube result.
Successful ................
Successful................
Insert ..................
Not properly successful.. ..
Successful ................
Insert ....................
Insert ....................
Ivory-point result.
Inert.
Inert.
Inert.
Inert.
Inert.
Inert.
Inert.
( xxi )
English vaccine lymph.
53. Vaccine lymph sent from England on ivory points and on glasses
is, as has been previously stated, almost invariably
useless, while tube lymph is generally successful.
I would submit that the quantity sent out in tubes is still insufficient, as it
is desirable that fresh English lymph should be as frequently as possible
distributed throughout the Presidency, particularly in Bombay itself.
54. When vaccine lymph is observed to deteriorate it is at once
changed, for no greater blow to vaccination can be dealt than continuing to
vaccinate with unsound lymph. Complete supervision, close checks, ability
to renew lymph from tubes, more frequent supplies from England, and
encouragement to frequent intercourse between the Vaccinators themselves,
aid in keeping down any tendency to such incorrect vaccination.
Assistance from the Civil
authorities.
55. The support given by the Civil and Political authorities is warmly
acknowledged by the Superintendents. It is this
intelligent aid that gives confidence alike to Vacci-
nators and to people; for in some parts, " without it,"
as stated by one Superintendent, " my utmost exertions would be of little
avail."
Superintendents.
56. The services of Superintendents have during the year met with
my approval ; and I beg to record my opinion of the
satisfactory manner in which their work has been
performed. The zeal of Doctors Pinkerton and Turnbull, Mr. Blomfield, and
Dr. Muncherjec Byramjee Colah, has been prominent.
57. The establishments have been favourably mentioned by the
Superintendents. During the year the Wukeel of His Highness the Khan
of Khelat asked for the temporary services of a Vaccinator. This was sanc-
tioned by Mr. Mansfield, as the introduction of vaccination into the heart
of Belochistan, under such favourable circumstances, was not to be neglected.
An experienced Vaccinator was sent in April with carefully charged capillary
tubes. The Vaccinator who was accredited to His Highness the Khan, did
his work well ; there was no objection raised to vaccination itself: they were
glad, indeed, to have it; but His Highness was unwilling to force his subjects
to allow lymph to be taken from the vesicles. The objections of the people
were strong against this; in fact, they were " insurmountable." The conse-
quence was the Vaccinator could not keep his lymph going. The Superin-
tendent of Vaccination, Sind, says, and I trust that what he says will prove
correct, that the " result of the few hundreds vaccinated may yet induce His
Highness to entertain Vaccinators of his own." The good conduct and
( xxii )
zeal of Kishen Chand, local Vaccinator in Sind, who thus carried vaccination
into the territories of His Highness the Khan of Khelat, were much appre-
ciated by His Highness ; and Sir H. Green, Commanding the Frontier, brought
his conduct most favourably to attention, in the hope " that his successful
exertions to introduce the blessings of vaccination into the wild countries be-
yond our border might be deemed by Government worthy of some notice."
Suggestions.
58. In paragraph 4 of this Report I have alluded to the injury done
to vaccination by incomplete superintendence. I
must now state that such inducements as are avail-
able should, in my opinion, be given to Officers employed as Superintendents,
to make them desirous of retaining such appointments; for the good to be
done by a Superintendent who knows, and is known in, his Division is
incalculable. The inducement which appears to me the most reasonable
refers to the pay of these Officers, and to point out my meaning I must
extract from the G. O. G. I. No. 370, dated 4th April 1867 :—
Civil Appointments.
Superintendents of Vaccination ..
Civil Surgeon, 1st Class ........
Ditto 2nd Class ............
Military.
Medical charge of a Native Regt..
Ditto
Cavalry, with Horse
allowance.
Surgeon
Major.
Rs.
950
1,050
950
1,000
1,090
Surgeon.
Rs.
750
850
750
800
890
Assistant
Surgeon,
5 years.
Rs.
550
650
550
600
660
Assistant
Surgeon under
5 years.
Rs.
400
500
400
450
510
From this scale it is shown that a Superintendent of Vaccination is classed
with the lowest paid medical Officer in the Service; viz., the Civil Surgeon of
the 2nd Class, who has Jail superintendence and other advantages, to which
the Superintendent of Vaccination has nothing to compare. The onerous
duties of a Superintendent during the season of his supervision I need
not enter on: they are such as to lead me respectfully to urge on Government
the recommendation that their pay should be arranged according to the rate