NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
xv
6. His Excellency the Governor in Council approves of the views express-
ed on the subject of the vaccine lymph in paragraphs 34 and 35 of Dr. Stovell's
report. The Secretary of State will be requested to communicate with the
National Vaccine Establishment in London, in order to obtain and forward to
this country a supply of lymph in the month of November of each year in the
manner suggested by Dr. Stovell, and to arrange with the Peninsula and
Oriental Steam Navigation Company to cause it to be kept in the ice-house
of their steamers during the passage from Suez.
Government Resolution No. 1100,
dated 25th June 1864.
7. Vaccination, through the agency of the Municipalities, has been in-
troduced into the Sattara Districts, and
into the towns of Hooblee, Dharwar,
Kotree, Poona, and Tanna. His Excellency
considers that although the experiment in the Sattara Districts did not at first
realize the anticipations entertained by Dr. Plumptre, the result is by no
means discouraging.
8. The very greatest assistance may be derived from the development of
this agency. The Commissioner in Sind and the Revenue Commissioners should
direct the attention of the Municipal Commissioners to it. His Excellency the
Governor in Council does not see any grounds for Dr. Plumptre being dissatis-
fied with the results in Sattara. His disappointment is owing to his having ex-
pected too much from the Municipal Commissioners. They will provide the funds,
and they will give valuable advice as to the feelings of the people and the
means to be taken to overcome their prejudices, but he cannot reasonably
expect them to exercise that supervision for which they have no special quali-
fications, and the Collector of Sattara was right in requesting the Superinten-
dent to control the proceedings of the Municipal Vaccinators. So long as
care is taken to consult the Municipal Commissioners or any general course
of proceeding, details will be much better supervised directly by the Superin-
tendent of Vaccination.
9. It is clear that the staff of Vaccinators in large towns is too weak. The
want can be best supplied by the appointment of Vaccinators by the Municipal
Commissioners, so as to leave the Vaccinators paid by Government more leisure
for work in the Districts. In the Presidency town the number of Vaccinators
appears to be ridiculously small, considering the number of persons still unvac-
cinated, and the Governor in Council requests that special inquiry may be
made on this point, and that Dr. Stovell will suggest how the want may be
supplied. If facilities be given for vaccination the people will accept it more
freely, and the great object, next to the supplying of good vaccine matter, is to
render vaccination accessible to the mass of the population. With only three
xvi
Vaccinators for all Bombay and one for Poona it is very doubtful whether this?
object is attained.
10. The state of vaccination in Sind, as reported in paragraphs 44 and 45
of Dr. Stovell's report, is considered by Government to be very satisfactory.
11. On the subject of paragraphs 47 and 48, the Principal Inspector-Gene-
ral may be referred to the Government Resolution No. 564, dated 3rd April
1865, with which copies of the Murathee, Guzerathee, and Canarese transla-
tions of the Vaccination Report for 1863 were forwarded to him.
12. It is not desirable to translate any more reports, as there is a great
deal in these reports which, however interesting for record, cannot be appre-
ciated by the native population. If Dr. Stovell will direct one of the Superin-
tendents of Vaccination to mark any passages in the Report or Appendices
which it may be considered useful to circulate, these extracts can be translated
and distributed.
13. In conclusion, the Governor in Council desires to record his appre-
ciation of the valuable services of the several Superintendents whose exertions
have been prominently brought to notice by Dr. Stovell.
F. S. CHAPMAN,
Officiating Chief Secretary to Government.
BOMBAY : PRINTED AT THE EDUCATION SOCIETY'S PRESS, BYCULLA.
REPORT
ON
VACCINATION THROUGHOUT THE BOMBAY
PRESIDENCY AND SIND,
FOR THE YEAR 1865.
Bombay :
PRINTED FOR GOVERNMENT
AT THE EDUCATION SOCIETY'S PRESS, BYCULLA.
1866.
REPORT
ON
VACCINATION THROUGHOUT THE BOMBAY
PRESIDENCY AND SIND,
FOR THE YEAR 1865.
Bombay:
PRINTED FOR GOVERNMENT
AT THE EDUCATION SOCIETY'S PRESS, BYCULLA.
1866.
REPORT
ON
VACCINATION THROUGHOUT THE BOMBAY
PRESIDENCY AND SIND
FOR THE YEAR 1865.
From the PRINCIPAL INSPECTOR GENERAL, Medical Department,
To the CHIEF SECRETARY to GOVERNMENT, General Department.
SIR,—I have the honour to submit to His Excellency the Governor in
Council the annual report on Vaccination for 1865. It consists
1st.—of a brief statement of the general working of the department
during the year;
2ndly.—of extracts from the reports by the Superintendents of Vaccination
and by Civil Surgeons; and
3rdly.—of tabulated, figured results.
Changes among the Super-
intendents.
2. Two of the Superintendents were compelled to proceed to Europe
during the year on sick certificate, viz. Assistant
Surgeon Dick of the Northern Circle, and Assistant
Surgeon Fleming of the Rewa Kanta. The depart-
ure of the former is much to be regretted, for he had not only devoted himself
for some years to the subject of vaccination, and with marked success, but
being a good linguist and a man of conciliatory manners, he had gained the
confidence of the people of Gujerat. His duties for a time were performed by
Surgeon Shepherd, the Civil Surgeon of Surat, but this was a mere tem-
porary arrangement, and in December Assistant Surgeon Cook was ap-
pointed to officiate as Superintendent during Dr. Dick's absence. Assistant
Surgeon Fleming was at first succeeded by Assistant Surgeon Alleyne, but
he resigned the post towards the end of the year, and Assistant Surgeon
( iv )
Welsh was nominated in December to officiate during Mr. Fleming's
absence.
3. At the close of the year the Superintendents were as follows :—
Northern Circle—Assistant Surgeon Dick, M.D., (Europe S. C.)
Do.
do.
„
„
Cook, M.D., (Acting.)
Central
do.
„
„
Turnbull, M.D.
Southern
do.
„
„
Plumptre.
Sind
do.
„
„
Pinkerton, M.D.
Kattiawar do.
„
„
Butler, M.D.
RewaKanta do.
„
„
Fleming, (Europe S. C.)
Do.
do.
„
„
Welsh, M.D., (Acting.)
Presidency do. Sub-Assistant Surgeon Anunta Chundroba.
Total number vaccinated.
4. There is, I think, good reason to be satisfied with the amount of work
performed, for while the number of vaccinations
in 1864 was 332,894, the number for the past year
was 358,198, showing an increase of 25,383.
5. It is due to Drs. Plumptre and Pinkerton to state that the largest
portions of this increase are shown in the returns from their respective
Circles, the Southern and Sind, and are mainly attributable to their excellent
arrangements and great exertions. It should likewise be mentioned that
there is an improvement in the Rewa Kanta, which hitherto, as stated in
previous reports, had not been in a satisfactory condition. There was also a
marked increase under the Civil Surgeons at Kurrachee, Kotree, Ahmedabad,
and Sholapoor, but a considerable falling off at Sattara, Rutnagherry, Surat,
and Rajkote.
Vaccination in Sind from
local funds.
6. The greatest increase in any one Circle was in Sind, amounting
to upwards of 16,000, including the work done by
the recently formed local establishment. It was
mentioned in the last report that, with the view of
increasing the efficiency of the department in Sind, and of extending the
benefits of vaccination more thoroughly and completely over every part of the
province, the Commissioner had sanctioned a plan proposed by Dr. Pinkerton,
the Superintendent, for appointing eleven vaccinators, to be paid out of
local funds, as a supplementary aid to the Government establishment.
7. The arrangement has worked well, and gives promise of effecting
much good, for it is believed that, with this increase, the establishment will
be able to go over the whole province sufficiently often to keep the infant po-
pulation protected. It came into operation in the early part of 1865. During
( v )
the first two months the newly appointed men were taught by the old vaccina-
tors how to operate and keep their records, and generally the method of carry-
ing on work. During the remainder of the year they vaccinated nearly 12,000
children, and the Superintendent reports that they have more than realized
his expectations.
General accuracy of Re-
turns.
8. Out of the total number of operations, about 8 per cent. proved either
unsuccessful or doubtful. Thus out of 358,198
vaccinations, 332,176 are reported as successful.
Every practicable means appear to have been taken
by the Superintendents, both personally and otherwise, to test the accuracy
of the returns received from their vaccinators, and there is good reason to be-
lieve that in the main they are correct. The testimony of the Superintendents
on this point becomes stronger year by year. In his recent report, for in-
stance, Dr. Butler states that throughout his tour in Kattiawar, he " did not
find a single false return." Testimony to the same effect is borne by Dr.
Turnbull, who reports that, though he visited 395 villages, and inspected
upwards of 12,000 vaccinated children, he did not discover a single false name,
although on each occasion the names of the children were read over, and
he carefully examined their arms one by one. Dr. Pinkerton also states that,
although he travelled nearly 1,700 miles, examined the work of 18 vacci-
nators in 400 villages, had the children's names called over from the
registers, and at the same time saw the vaccination marks on their arms,
he did not detect a single false name.
Occasional falsification
of Returns.
9. Yet, notwithstanding the strong evidence thus brought forward, in-
stances of falsification do occasionally come to light;
and it is mentioned in the report from the Northern
Circle, that while Dr. Dick was on his tour in Gujerat,
he personally ascertained that the returns of two villages near Hansote had
been falsified by a vaccinator. The man was in consequence brought before
a Magistrate, under Section 182 of the Penal Code, and sentenced to one
month's imprisonment. It is thus evident that the figures must not be re-
garded in the light of perfect accuracy, but merely as an approximation to it.
Sexes.
10. With regard to sex
193,510 were males and
164,688 were females.
This relative proportion corresponds very closely with that of previous
years.
( vi )
11. The castes were as follows :—
Castes.
Hindoos ...................
Mussulmans
Christians ....................
Parsees ......................
Other castes .................
259,064
78,450
1,794
850
18,020
Infantile Vaccination.
12. Of the total number of operations, 232,099 were performed on persons
above one year of age, and 126,079 on those below
it. In other words, 64.8 per cent. of the former,
and 35.2 of the latter. Compared with the returns
of former years, this is so far an improvement, that it shows a slight increase
both in the extent and in the relative proportion of infantile vaccination,—a
fact of some importance, inasmuch as vaccination in early life affords a far
greater security from small-pox than when resorted to at a later age.
13. The average per-centage of infantile vaccination in Sind was some-
what less than in the previous year, and was owing to operations having been
carried on to a greater extent in new fields, such as Thurr and Parkur, and
the Jacobabad districts, where the number of unprotected children above one
year of age was much greater than in other parts of the province, which had
been well gone over for many years. In the Deccan, on the contrary, where
the prejudices of the people against early vaccination had always been stronger
than elsewhere, the per-centage rose from 11 to 23, a fact of great interest, as
seeming to prove that these prejudices are gradually subsiding. Throughout
Gujerat the average rate was 54 per cent., being as usual higher than else-
where, excepting in the town of Shikarpoor where it rose to 96, the highest
rate ever recorded in this Presidency. This fact reflects great credit both
upon the present and preceding Civil Surgeons, the explanation being that
the inhabitants have been so carefully protected by vaccination for many years
past, that the operations are now almost necessarily confined to children born
within the year.
Good effects of unceasing
attention to Vaccination.
14. It was mentioned in the last report that Shikarpoor was probably
better protected against small-pox than any other
town throughout the Presidency, and as a proof of
the great advantage of unceasing attention to vacci-
nation, it was stated that not a single case of the disease had occurred there
for a long period. I may repeat this remark, for not a solitary case was met
with during the year. The good effects resulting from this state of matters,
moreover, are by no means confined to the town itself. They have become far
( vii )
more extensive, for the Superintendent in Sind mentions in his recent report
that the larger and more intelligent Zemindars are now more willing to use
their influence in favour of vaccination than they formerly were, particularly
in the neighbourhood of the town of Shikarpoor; and he attributes this feeling
in a great measure to the fact of vaccination having been so steadily and con-
tinuously practised for years by the Civil Surgeon, and to the surrounding
inhabitants having observed the immunity from small-pox, which has resulted
therefrom.
Small-pox.
15. With regard to the prevalence of small-pox, the reports received
from all quarters show that, with the exception of
Aden and Ahmedabad, there was much less of that
disease throughout the entire Presidency than in the
previous year, and that where it did prevail, it assumed in most places
a milder form than usual. In the Northern Circle it is reported to have made
its appearance in a few villages in the Cambay and one or two other districts,
but not elsewhere. In Kattiawar Dr. Butler mentions that it prevailed in
several villages in the Dedan talooka, particularly at Khater Kotree, where
it proved fatal to upwards of a hundred children, but he was assured by the
Patel that not a single vaccinated child had died. Throughout the Deccan
there appears to have been very little indeed, and nowhere in an epidemic
form, except in a few villages near Dhoolia. In the Concan no notice is
taken of its prevalence except at Vingorla, where the Deputy Inspector
General reports its having raged among the families of the fishermen; so
much so indeed that these people,—who, of all classes, are the most inveterate
in their antagonism to vaccination,—were roused for a moment to a sense of
danger, and eagerly sought the protective power of vaccination. In Sind
there was no epidemic small-pox in any part of the province, and only a
few sporadic cases were reported.
16. At Aden it prevailed, as usual, to a great extent. It is in fact a
disease from which that place seems never to be entirely free, owing, as men-
tioned by the Civil Surgeon, to its liability to contamination from Africa and
other parts of the East. Unhappily, too, from some peculiar atmospheric or
other causes difficult to understand, the lymph at that station seems not
unfrequently to lose its specific property so completely, that attempts to keep
up an unfailing supply by continuous vaccination have repeatedly failed, so
that for a considerable portion of the year vaccination was unavoidably
suspended. Frequent supplies of lymph were sent from here, but in scarcely
a single instance did it prove efficient.
( viii )
17. In Bombay itself the mortality from small-pox was less than during
the two previous years. In 1863 the deaths from this cause were 1,113, and
in 1864 they reached 1,678, while last year they were only 561. It must not
be supposed, however, from this statement, that I wish to imply that the suc-
cess of vaccination was really much greater in 1865 than in the two preceding
years. Far from it, for the actual increase in the number of vaccinations was
only 334. Moreover, the statistics of small-pox in Bombay show that the
number of deaths since 1848, (when Dr. Leith first commenced his valuable
mortuary returns) has greatly fluctuated, the wave of mortality, from some
inexplicable cause, rising every second or third year to its greatest height
and then receding, and this without the least connection apparently with the
actual state of vaccination. Facts of this nature lead to the conclusion that,
apart from the progressive condition of vaccination, the extent and virulence
of small-pox are dependent on certain epidemic influences, of the precise
nature of which we are at present profoundly ignorant.
18. Owing to the want of accurate registration throughout the mofussil,
it is only of the Presidency town itself that any statement can be made with
confidence, relative to the precise extent of mortality from small-pox; and
recollecting that in 1863 upwards of 2,000 people died of this disease
in London, where vaccination has been compulsory by law since 1854,
I think it must be admitted that there is no reason to be surprised at the
amount of deaths from this cause in Bombay, where vaccination is not
compulsory.
Inoculation.
19. In the last report allusion was made to the mischievous practice and
fatal consequences of inoculation, and I suggested
the desirability of procuring a legal decision on the
point whether, or not, sections 269 and 270 of the
Penal Code gave Magistrates power to take proceedings against inoculators,
as differences of opinion appeared to exist on the subject. The Magistrate
of Tanna, in whose districts inoculation was said to be in practice, was
directed by Government to report on my remarks. He replied by sending
copy of a letter addressed by his predecessor to the Superintendent Central
Circle, in which it was stated that " to render a man amenable to these
enactments, his act must be proved to be either illegal, negligent, or
malignant, and that the only chance of conviction rested on being able to
show that the act was illegal, for it could not be either malignant or
negligent." It then said that " the High Court had ruled that no general
order of the Magistrate, declaring the practice of inoculation illegal, was valid,"
( ix )
and added that it was " a question whether a special order, served on the
practitioner, would be admitted to be more cogent."
20. This reply from the Magistrate having been sent to me by Government
for any remarks I might wish to make, I referred to paragraphs 25 to 28 of
the report for 1864, in which were stated certain facts proving that the
practice of inoculation did great harm by spreading and perpetuating small-
pox, and that it also caused great mortality. I, at the same time, suggested
whether a Legislative enactment might not be passed to render such practice
penal, if the provisions of the Code were ineffectual for the purpose.
21. I was subsequently informed by Government that, under the existing
law, parties practising inoculation could not be proceeded against, and that
Government would await the receipt of further information before deciding
on the expediency of having recourse to legislation.
22. It, therefore, now becomes necessary to submit all the information on
the subject which the reports from the Superintendents for the past year will
enable me to supply. It is reported from the Northern Circle that Dr. Dick,
while on his tour in the districts of Bulsar and Bugwara, found that inocula-
tion was much practised by the caste of Ghatees, and that they secure encour-
agement, if not direct aid, from some of the village Patels, to whom they
offer a small fee for each child inoculated. Dr. Dick also noticed many
recently inoculated children, and traced some deaths, and also some cases of
small-pox, as the direct results of inoculation. This he officially reported to
the Magistrate, but the result is not mentioned. Dr. Butler, the Superin-
tendent in Kattiawar, mentions that he visited two villages where inoculation
had been performed, but that he could not find any traces of the inoculator.
He adds that this was the first time he had met with any cases of inoculation
in that province. In no other part of the Presidency was a single case
brought to light during the year, not even in Sind or in the Tanna Collector-
ate, which in previous years were its two strongholds.
23. It will now remain with Government to decide whether it will be
sufficient, for the purpose of ensuring the abolition of the practice, " to trust
to the gradual spread of knowledge, and to the appreciation by the people of
the practical benefits of vaccination," or whether it "may be expedient to
interfere."
Inoculators.
24. In connection with this subject, it should, I think, be recorded in this
place that it was suggested by Government that
men, who had hitherto gained a livelihood by the
practice of inoculation, might probably be induced to
2 vac
(
x
)
take employment as vaccinators, and that inoculation might thus be super-
seded by vaccination. It was further suggested that if payment were made
by successful results, no harm could result from a trial. The attention of the
Superintendents was accordingly directed to the subject.
25. From the reports received from these Officers it appeared that the
Superintendent in Sind had personally, on several occasions, endeavoured to
induce inoculators to take service as vaccinators, but without success. He
stated his belief, however, that there are now very few left in that province,
and that with the increase recently made to his establishment, inoculation
would cease. He seemed to think that the chief reasons for their declining
to take service were the smallness of the pay, and the restraint of being kept
regularly at work. He mentioned having been told that in former years an
inoculator would make hundreds of rupees in a season, and that a rich
Zemindar frequently gave him valuable presents for inoculating his family.
26. With regard to Gujerat, it was reported that there was only one
known inoculator, and that he refused employment as a vaccinator. In the
Southern Circle no case of inoculation had come to light for a long period
while in the Central Circle inoculators appeared to confine their work to the
Tanna collectorate. It was further reported that they are not only men of
low caste and wholly uneducated,—points in themselves sufficient to bar their
employment as vaccinators,—but that they are of mature age, and would
consequently be unlikely to attend to the close training requisite for making
vaccinators, and to the discipline required to keep them at work.
27. With regard to payment by results, it was the unanimous opinion of
the Superintendents that the plan would be found impracticable, inasmuch
as to guard against fraud, it would necessitate the inspection, by the Super-
intendent, of every vaccinated child,—a course of proceeding which, with the
present number of the inspecting' staff, would be simply impossible, while to
pay by results, on the word of the vaccinator, would be to offer inducements
to falsify returns.
28. It appeared also from the records in this office, that some years ago
an attempt was made to introduce inoculators as vaccinators, but that the
plan was abandoned in consequence of failure. On my representing these
circumstances to Government, and on my expressing an opinion that it
would not be advisable to make any further attempt in this direction, it was
decided that the difficulty of establishing an effectual system of check pre-
cluded the possibility of introducing the plan of payment by results.