NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
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particular inquiries regarding the prevalence of small-pox. For this reason the
Collector of Surat was requested to favour me with the original village returns of the
talookas of Chowrasee and Unklesur, and similarly the Broach Sub-Collector was
requested to send the village returns of all the four talookas of Broach.
3. From the Collector of Surat, the village returns of talooka Unklesur only
were sent to me, and these reached me very late, after I had left Surat for the Broach
Districts, so that I had no opportunity of making any inquiries regarding them; and
with reference to the returns of talooka Chowrasee, I was informed that " the Mamlut-
dar of Chowrasee does not receive nominal returns of small-pox from the Tullatees of
the several villages, but merely verbal statements, which they again receive from the
Vaccinators."
4. The Sub-Collector of Broach directed all the Mamlutdars under him to
forward to me the returns required. In obedience to such orders, I received village
returns of the Broach, Wagra, and Jumboosur Talookas; the Mamlutdar of Amode
stated his inability to send any village returns of his talooka, as none such existed.
5. On a comparison of village returns, received as above, with the English return,
one very important discrepancy was observed in ' the headings of the two. The
heading in the third column of the English return is " Total number of cases of
Small-pox during the year 1866 ;" whereas in the village returns of the talookas
of Wagra and Jumboosur (from which the English returns were partly made up),
the heading in the third column is " Total number of cases of Small-pox and Vacci-
nation during the year 1866."
And in the Gujarati returns of the villages of
Unklesur Talooka, there is this additional difference, that they are stated to be for the
year 1866-67, whilst the return made up from these in English is shown as a return
for 1866.
6. Granting the figures put in the third column of the Gujarati returns to be
correct, there would be, then, this important correction to be made in the English
return; viz., to deduct from the total in the third column (17,268) the total of the
fourth and fifth columns (11,378+4,661). This will give 1,229* as the correct
number of cases of small-pox during the year.
7. But the question is, are the village returns made up from such sources as
could be relied upon ? With reference, at least, to the making up of one talooka
return (of Chowrasee), I have, in paragraph 3 of this letter, quoted the Collector of
Surat's statement on this point; and from the inquiries I made in the different talookas
of Broach, I find that this statement is in the main correct. The village returns of
the other talookas are principally made up from the oral statements of different parties.
There is no register kept in any village, containing information on the various points
of the small-pox return.
* This includes 213 cases of small-pox which are said to have occurred in the City of Broach,
vaccination in which is not under this department, but under the superintendency of the Civil Surgeon
of that place.
13
12. The more one inquires into this subject the more it becomes clear that
small-pox breaks'out only in such villages as have hitherto resisted the introduction
of vaccination in to them. Even at so recent a date as December last, it broke out in
two large villages of the Jumboosur Talooka, viz., Sarode and Kavee,—villages thickly
inhabited by Borah Mahomedans, who had in previous years hindered vaccination.
In these villages also, on the recent breaking out of small-pox, vaccination was had
recourse to by the villagers eagerly. The breaking out of small-pox in a village
where vaccination is freely permitted has not yet been known.
13. From these inquiries it appears to me that there is no reasonable cause of
apprehension regarding the work of our Vaccinators.
SIND CIRCLE.
Superintendent.—Surgeon
J. PIKERTON, M.D.
Establishment.—Seventeen
Vaccinators under Government, thirteen Local, and
one under Native Chiefs.
Establishment.
Government..
Local............
Native Chiefs.
Years.
1866.......
1867
.
1866.......
1867
1866
1867
Total
Vaccinated.
44,126
33,821
23,594
21,854
975
2,529
Compared with the
preceding year.
Increase.
....
....
....
....
....
1,554
Decrease.
....
10,305
....
1,740
....
....
Successfully
Vaccinated.
40,970
32,353
21,300
21,022
820
2,297
Percentage
of Success.
92.8
95.6
90.3
96.2
84.1
90.8
The progress of vaccination in Sind continues to be satisfactory. There is a
considerable decrease in the total number of vaccinations in the past year as compared
with 1866.
The decrease in the Government Return is
Ditto
Local
ditto
The increase in the Khyrpoor Return is
Total Decrease
10,305
1,740
12,045
1,554
10,491
It is to be remembered that in the year 1866 the number of vaccinations was the
highest ever obtained in any year. When the local establishment was formed, I enter-
tained the belief that for a few years the combined operations of the Government and
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influence His Highness to keep up Vaccinators, I would most willingly go there, and
try what I could do; but after the recent trial, I fear some time must elapse before I
could do much good.
7. The following are a few causes of the decrease in the number of vaccinations
performed by some of the Government Vaccinators : 1st. Jettah Mull, Wuttun Mull,
and Nubby Bux were employed in thinly populated talookas; 2nd. One Assistant
Vaccinator was dismissed the Service for being absent from his talooka without leave;
3rd. Thackoordass lost one month's work by being prevented from returning to his
talooka from privilege leave during the time intercourse was forbidden with Upper
Sind on account of the prevalence of cholera there. But the chief reason of the
decrease is, as already stated in the opening paragraph of this Report, the diminished
number of unprotected persons in the province.
8. The Government Vaccinators vaccinated 18,661 males and 15,160 females,
being 55.17 and 44.82 per cent., respectively. The local Vaccinators vaccinated
12,020 males and 9,834 females, or 55.0 and 44.99, respectively, in each hundred. The
Khyrpoor Vaccinator vaccinated 1,409 males and 1,120 females, or 55.71 of the
former and 44.28 of the latter in every hundred. On the total, the percentage of
males is 55.29, and of females 44.69. This is nearly the same proportion as the
sexes bore to each other in the Report for 1866 ; the difference being only 0.40 less
of males, and the same fraction more of females, this year in every hundred.
9. The following shows the percentages of the castes vaccinated by three
Establishments :—
Castes.
Christians .............
Hindoos
Mussulmans ..............
Parsees ..............
Other Castes ..............
Totals ....
Government.
.002
13.37
78.22
....
8.40
99.99
Local.
.004
11.07
82.8
....
6.09
99.96
Native States.
.03
22.14
76.07
....
1.73
99.97
Average.
.012
15.53
79.03
....
5.40
99.97
The most important feature in the foregoing table is the great increase of vacci-
nations among Hindoos,—15.53 per cent.,—being far more than in previous years, and
is probably fully more than the proportion Hindoos bear to the rest of the population
of the province. In former years it was a constant source of regret that Hindoos
were generally averse to vaccination, but this shows that their aversion is disappearing ;
though it still is a fact that many Hindoos do object to vaccination, and prefer to
accept the " dispensation of Providence" to using any precautions against small-pox,
either by way of vaccination or variolous inoculation: indeed, it would seem that
many are rather glad when their children take small-pox. Last hot season I saw a
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this date) the vesicles, or their cicatrices, on the arms of nearly fifty thousand persons ;
and as I have invariably made it a rule to see several days' lymph of each Vaccinator
when I have been examining his work, I have seen in the fifty thousand a large
number with the vesicles on the arms on the eighth day after vaccination. During
this experience, I have often noticed that infants of only a few months old are less
susceptible of vaccinatian than older children ; taking this in conjunction with the
lesser susceptibility to small-pox also, it appears to me to be unnecessary to urge very
strongly the vaccination of infants under one year old. As a rule, in Sind the people
do object, though not much, to vaccinate very young infants, except when small-pox
is present, and then they bring them readily to be vaccinated, although only a few
days old. For statistical purposes, I am of opinion that our present Vaccination Form
should have three columns of ages,—(a) under one year, (b) above one and under two
years, and (c) above two years. I think there were about thirty persons in every
hundred vaccinated last year above two years old, and about seventy per cent. under
that age.
11. The following Table shows the results of the operations performed last
year :—
Establishment.
Government .......................
Local ..................................
Native States ......................
Average 1867 ....................
Do. 1866 ..........................
Increase .............................
Decrease ...........................
Percentage of.
Successful.
95.64
96.19
90.82
94.22
89.05
5.17
....
Unsuccessful.
1.05
1.35
7.5
3.31
4.99
....
1.68
Doubtful.
3.28
2.44
1.62
2.44
5.9
....
3.46
Total.
99.97
99.98
99.98
99.9
99.8
....
....
The prominent feature in this table is the large increase of successful cases last year
as compared with 1866 ; the chief reason of which is that the Vaccinators, having done
less work, were able to ascertain correctly the result in a greater proportion of cases
than in 1866. I consider this high success some compensation for the diminished
number of vaccinations last year. I have always maintained that the quality of
the vaccinations is of more importance than the quantity of them. It is our duty to
see that all operations are as perfect as possible, for we have, in a manner, thrust
vaccination on the peoples of India; and if we ever win the affections of the masses to
vaccination, it must be by virtue of the success of our operations, and not by the quantity
of them. Last year I examined 7,437 vaccinated persons, and of these only 134 were
unsuccessfully vaccinated, or 1.8 per cent. : this closely agrees with the returns of the
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on glass, has often struck me as being unusually great. I have noticed in Lower Sind
that, immediately the sea breeze gets soft in the hot months of July, August, and
September, when the wind blows from the sea, the difficulty is much lessened, and in
the cold months it entirely disappears.
14. Small-pox was spread and kept going for some months in the Mahomed
Khan's Tanda District by several inoculators, and there is some reason to believe that
it was propagated in another district. Among the rural part of the population there
was very little small-pox. In several towns, the larger portion of whose inhabitants
are Hindoos, there were severe outbreaks; for instance, in the towns of Manjanda
and Nowshera. The first information which I received of the existence of small-pox
in Manjanda was on the 24th ultimo, and three days afterwards Jettah Mull com-
menced vaccinating there. He has informed me that the disease has existed for the
last eight months in that town; that there had been 182 attacks and 44 deaths,
or 24.2 deaths in every 100 attacks ; and that not one of the hundred and odd
children whom he vaccinated there last year had been attacked. I will not comment
on the carelessness or indifference of the Mooktiakar, in not reporting to me the exist-
ence of small-pox at the commencement of the outbreak. I could then, as easily as
eight months later, have sent a Vaccinator at once to Manjanda ; but while I will not
comment on such apathy, I may, and do, regret the frightful waste of human life
resulting from it, and I regret it the more the more I think of the thinnesss of
our population. The inhabitants of Manjanda are chifly Hindoos, and are undoubtedly
themselves chiefly to be blamed, for had they chosen they could all have been vacci-
nated last year when Jettah Mull was working there. In the town of Nowshera, whose
inhabitants are also chiefly Hindoos, there has been a good deal of small-pox, and it is
still difficult to get the inhabitants to submit their children to vaccination. In both
towns the disease is reported as having disappeared. I have just received information
of a considerable outbreak of small-pox in Larkhana District, in which I have four
men at present, who at once commenced operations at the several places where the
disease has appeared. The affliction of the contumacious Hindoos is still a living
evidence of what this province would suffer from small-pox, were it not for the bene-
ficent protection of vaccination enjoyed by the vast majority of the population under
fifteen years of age. The following shows the number of monthly returns in which
small-pox was reported in the districts named:—
Nowshera,
Mahomed Khan's Tanda,
Halla,
Shabunder,
Doaba,
Jacobabad,
Roree,
Shikarpoor,
9 months.
6
5
5
4
4
3
2
do.
do.
do.
do.
do.
Chiefly in the Hindoo town of Nowshera.
Kept up by inoculators.
Very few cases. Do. suspected.
Do.
Do.
Do.
Chiefly in the town of
Jacobabad.
do.
do.
Very few cases.
Do.
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Larkhana,
Sukkur,
Thurr and Parkur,
2
2
1
months. Broke out in November, chiefly in the town of
Larkhana.
do.
Chiefly in the town of Sukkur.
do.
Very few cases.
It may seem strange that, with so many Vaccinators, small-pox should have
existed so long in a few districts ; but the difficulty of getting Hindoos in the larger
towns to vaccinate their children, is the sole reason of the disease continuing so long
in Nowshera, and in Mahomed Khan's Tanda it was kept up by variolous inoculators.
I would also notice that I have now more certain information of the disease than
formerly, as I have more Vaccinators to give it in their weekly and monthly reports.
As soon as ever a Vaccinator knows of the existence of small-pox any where in his
talooka, he goes at once to vaccinate at its seat. On the whole, then, I do not think
there was more small-pox in the province last year than there generally has been in
years preceding it. To enable me to take immediate measures to prevent small-pox
from spreading, I would beg to suggest that a proclamation be issued from the office
of the Commissioner in Sind, directing all Revenue and Political Officials, from the
highest down to the tappidars, to communicate direct, and at once, any outbreak of
small-pox to the Superintendent of Vaccination. I would also beg that a sufficient
number—probably 2,000 copies—of the proclamation be printed for distribution among
the more influential Mussulmans and Hindoos in all the tappidarates. I append a
draft of the proclamation for issue, if approved by the Commissioner of Sind.
15. On the subject of inoculution, I cannot do better than quote from my letter
No. 210, dated 15 August last, addressed to the Deputy Inspector General of Hospitals
of this Division:—
Paragraph 2nd. " On the 15th February last, a Patel, by name Shukul, wrote to
" the Deputy Collector of Mahomed Khan's Tanda, informing him of the presence of
" small-pox in his village of Shukul Koso, and asking permission to variolously
" inoculate unprotected children. The Deputy Collector sent me Shukul's letter,
" and forbade the practice of inoculation on the 23rd February. I endorsed the letter
" to Kowrah Mull, who was, and still is, employed in that district, and instructed
" him to proceed to the village where small-pox was reported to exist, and to vaccinate
" the unprotected children at once. Kowrah Mull, after proceeding to the seat of
"small-pox, reported, on the 17th March, that a man of the Mashakhpots caste had
"been inoculating for some time, but that he could not learn his name. After making
"many inquiries, he learned that Shukul Koso (the man who asked permission to
" inoculate) had brought a man named Bachel, of the Mashakhpots caste, to inoculate
" in the village of Shukul Koso ; and it was after setting small-pox going that Shukul
" wrote for permission to inoculate on account of the existence of small-pox
"which he himself had produced, or caused to be produced, in his village of
" Shukul Koso, Inoculator Bachel lived in the village of Hajee Powar, in the
" talooka of Mahobut Dera, in the Mahomed Khan's Tanda District. Kowrah Mull
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myself and Assistant have travelled 5,441 miles and inspected 12,464 vaccinated
persons in 695 villages during the past year. Every Vaccinator's work has been
examined except one, and the work of several Vaccinators has been examined more
than once.
18. Neither myself nor the two Assistants discovered a single instance of falsifi-
cation of records, although 8,671 names were called from the Vaccinators' Registers.
19. The means of obtaining statistics regarding small-pox do not at present exist
in this province: without a system of village registration, or perhaps a system
of registration in each Deh, it will be impossible to get any thing like even approximately
correct statistics of births and deaths, or of any diseases. However, as I said in
my Report for 1863,I may say more emphatically again, that the faces of the younger
part of the population are living proofs of the benefits of vaccination ; and the pitted
faces, the blind, the halt, and the lame among the older, affords ample evidence of how
small-pox ravaged the country in years gone by. And again, the remarks which I have
made on the outbreak of small-pox in the Hindoo town of Manjanda, where there
died about 25 per cent. of the people attacked, still show how deadly small-pox is.
20. The conduct of the Vaccinators has been generally very good ; still I have
had to find fault with two for working with deteriorated lymph. One was dismissed
the service for being absent from his talooka without leave. No complaints were
made against any Vaccinator during the past year, except one ; and as Major Trywhitt
has not yet completed the investigation into it, I will only say that it refers to a
Vaccinator not having paid enough to the parents of two children taken for vaccination
purposes from their own to other villages. The foregoing gives, I trust, a fair
account of the progress of vaccination, and of the working of the Government and
Local Vaccination Establishments, in Sind.
KATTIAWAR CIRCLE.
Superintendent.—Surgeon
E. R. BUTLER, M.D.
Acting Superintendent.—Assistant
Surgeon A. M. BLOMFIELD.
Establishment.—Eight
Vaccinators under Government and thirty under Native
Chiefs.
Establishment.
Government....
Native Chiefs ..
Years.
1866
1867
1866
1867
Total Vac-
cinated.
6,563
7,829
26,759
32,046
Compared with the
preceding year.
Increase.
....
1,266
....
5,287
Decrease,
....
....
....
....
Successfully
Vaccinated.
6,417
7,550
24,878
29,807
Percentage
of Success.
97.8
96.4
93
93
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1. Three Government Vaccinators were dismissed during the year for misconduct ;
the places of these have been filled up by men who have been instructed under my
personal superintendence.
2. One acts as Carkoon to the Superintendent, a duty which he performs remark-
ably well. He has taught himself English, never having been to school, and he reads and
writes it well. He has the entire conduct of the Gujerathi correspondence, which is
very considerable, and requires an intimate acquaintance with the various districts of
the province. He receives no remuneration beyond his pay of 20 rupees per month,
with which he is obliged to support his family, and keep a tattoo, which is absolutely
necessary for him when accompanying me on a tour of inspection.
3. The other seven Government Vaccinators have performed 7,829 operations,
which is 1,200 in excess of last year, but still falls far short of what they ought to
perform. I see in last year's Report that the average of vaccinations performed by
each man in Sind is more than double that done in this district, but there I believe
each man gets batta when travelling, while here they get no allowance beyond their
their monthly pay, which is not sufficient to make them care much about the Service.
4. The percentage of success is put at much too high a figure. I have never
seen any work so good except that of the Station Vaccinator, who only brings the
successful cases for my inspection.
I have endeavoured to impress on them the fact that a case cannot be considered
successful unless two well-marked cicatrices at least remain.
5. Five of them have been instructed in filling capillary tubes, and the other
two have been summoned to Rajkote for the same purpose.
6. Chiefs' Vaccinators.—Thirty have been employed during the year, and several
others will be appointed from the beginning of 1868.
7. The number of operations shows an increase of 5,287 over the previous year,
and the average for each man is rather more than that of the Government Vaccinators.
8. Five of the number were discharged for misconduct, and four others took their
discharge of their own will ; their places have all been filled up.
9. Thirteen have been punished by fines, some of them more than once; this is
the only form of punishment that can be inflicted, with the exception of dismissal,
and has generally been found efficacious.
10. All whom I have come in contact with have been instructed in filling
capillary tubes, and have not been allowed to go out until they have become fully com-
petent. Seventeen of the number have been thus instructed, and are well able to carry
on their work; specimens of the lymph with which they are working are occasionally
called for, in tubes.
11. The staff of these men would, I believe, be largely increased if the subject
were urged upon the Chiefs by the Political Agent. Colonel Keatinge had taken means