NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( vi )
16. The castes were as follows:—
Hindoos . . . . . . . . . . .
Mussulmans . . . . . . . . . . .
Christians . . . . . . . . . . .
Parsees . . . . . . . . . . .
Other castes . . . . . . . . . . .
198,427
56,036
1,913
912
10,707
Total.. 267,995
17. I mentioned in the last report, as a proof that vaccination was gradu-
ally making its way into general favour with the people, that the proportion
of operations in the infantile population was steadily increasing. The number
of vaccinations in 1862 in children under one year of age was 80,177. The
returns for 1863 give 92,948, being an increase of 12,771.
18. To a certain extent this is no doubt satisfactory, but I hope to find a
still larger increase year by year. The feelings and prejudices of the people
on this point seem to vary very much in different localities. Thus, while the
returns from the Deccan and Southern Maratha Country continue to be con-
spicuous, above all others, for their very large proportion of operations in
persons above one year of age, those from Kattiawar and Sind are much more
satisfactory; while in the Collectorates of Gujerat the number of vaccinations
in children under one year of age was actually larger than in those above it.
19. It is remarked, indeed, by the Superintendent of the Northern Circle,
that the unwillingness to submit young infants to vaccination, which is ob-
served elswhere, is rarely met with in Gujerat. The returns from the Civil
Surgeons at Ahmedabad, Kaira, Broach, and Surat, give evidence to the
same effect. They all show a very large proportion of operations in early
life. At Shikarpoor there seem to be no prejudices on the subject, for while
only 252 vaccinations were performed in persons above one year of age, no
less than 1,366 were in children under that age.
20. I have dwelt at some length on this point, because I regard it as one
of very great importance, inasmuch as the result of the accumulated experi-
ence of Europe shows that vaccination during infancy, properly performed,
gives a far greater security from small-pox, than when resorted to at any
later age. I would therefore very earnestly entreat the Superintendents of the
Central and Southern Circles,—in which the prejudices against early vaccina-
tion are much stronger than elsewhere,—to endeavour by every means in
their power to overcome these prejudices, and to make parents comprehend
its paramount advantages.
21. The question assumes a still greater importance, when it is borne in
mind that the occurrence of a case of small-pox after vaccination does great
mischief by increasing the feeling of distrust, which prevails among the Native
( vii )
population, with regard to its permanent efficacy as a safe-guard. A longer
experience, and a more extended education, will no doubt assist in gradually
removing this feeling. In the meantime, the Superintendents, I have no
doubt, take every available opportunity of pointing out the fact, that vaccina-
tion not only effects an enormous amount of good by diminishing the extent
of small-pox, but by modifying the character of this disease when it does
appear, changes a deadly disorder into one of comparatively slight importance.
22. In proof of the correctness of this remark, it may be mentioned that
the returns of the London Small-pox Hospital, extending over a long series
of years, show that the average rate of mortality among the patients, therein
admitted, unprotected by vaccination, has been 37 per cent., whereas the
mortality among the patients, properly protected, has been less than half of
one per cent.
23. The Superintendent in Sind even states on the latter point, that after
making many inquiries, and taking no little pains to find out, he has never
heard of a single successfully vaccinated child having died of small-pox.
24. With the exception of Bombay itself, where small-pox prevailed to a
great extent at the commencement of the year, and of Kurrachee where it was
equally prevalent towards its close, the disease does not appear to have shown
itself in a severe form in any part of the presidency. Throughout Gujerat it is
reported to have been much less prevalent than usual, and the Superintendent
in Kattiawar mentions that he had not seen a single case in a protected sub-
ject. There was very little in the Northern Deccan, but in the Southern
Maratha Country it was met with in nearly all the zillahs during the earlier
part of the year, though apparently in a mild form. In Sind a few cases
appear to have shown themselves in nearly every district, but not in a severe
form. Wherever it did make its appearance, active measures were immedi-
ately adopted by the Superintendents and their establishments to arrest its
progress.
25. It was mentioned in the last report, that with exception of Sind, the
practice of inoculation appeared to be gradually disappearing from nearly
every part of the Presidency. I stated, however, that one case had come to
light in the Tanna zillah, and one at Bulsar. During the past year no case
came actually to the knowledge of either of the Superintendents. Dr. Dick,
however, of the Northern Circle, has recently received information that it is
still practised in the Bulsar pergunna, and he is the more inclined to believe
that such may be the case, from the circumstance of the extreme unwillingness
of the people in that district to accept of vaccination.
26. He states that the bias of the villagers for vaccination or inoculation
depends very much on the patel, and that as the latter is perfectly indifferent
on the subject, he affords his support to the inoculator in consideration of
( viii )
the fees which he receives. Dr. Dick is of opinion that an effectual stop to
the system might be put by holding the village officials responsible, as they
must always be aware of the inoculator's proceedings. As the new Penal
Code provides, I believe, against the continuance of the practice, I would
suggest whether it would not be desirable for Government to communicate
with the Magistrate of Surat on the subject.
27. With regard to the practice in Sind, I am happy to state that not a
single case came to light during the year, and the Superintendent is of opinion
that recent steps taken by the Commissioner will completely put an end to it.
28. The character of the vaccine lymph has been well reported on by
nearly every Medical Officer, the resulting vesicles having been generally well
developed and well-marked. Dr. Ritchie, for instance, the Deputy Inspector
General of Hospitals, who has long taken an active interest in the Depart-
ment,—and under whose supervision the Dispensaries in Sind are year by year
becoming of greater value in furthering the advance of vaccination,—reports
that the prophylactic virtue of the lymph throughout that province continues
unimpaired. Testimony to the same effect has reached me from nearly all
quarters.
29. It is evident, however, from the recorded observations of two Superin-
tendents, that one of the most important duties of these officers is to examine,
as frequently as possible, the condition of the lymph used by their establish-
ments, so as to ensure its remaining undeteriorated. Dr. Plumptre, for in-
stance, found it necessary to change the lymph used by two of his vaccinators
in the Southern Circle, owing to the insufficiently developed vesicle which it
produced. He mentions that he obtained supplies on several occasions from
Dr. Mills, the Civil Surgeon at Kolapore, and that the vesicles, produced
therefrom, satisfied him that the lymph well deserved the favourable mention
which was made of it in my last report.
30. In the Northern Circle, again, Dr. Dick considered it desirable to
introduce fresh lymph, and he anticipates good results from having done so,
as the vesicles proved more perfect, and the failures more rare.
31. There is good reason to believe, however, that failures will hence-
forward become still more rare; for the increased allowance, recently sanctioned
by Government, for remunerating Native parents for allowing their children
to be conveyed from village to village, for the purpose of ensuring the virus
being transmitted from arm to arm, has in this respect materially increased
the efficiency of the Department.
32. It has frequently been represented that no extensive operations could
be depended on, unless this method was more fully adopted, as the previous
system of trusting to the effects of lymph forwarded from place to place on
glasses and on ivory points, was too often attended by want of success, as well
as by great delay.
( ix )
33. Dr. Beatty regards the change as a "great boon," while Dr. Plumptre
and others are of opinion that, by leading to the discontinuance of the objec-
tionable mode of procedure, just mentioned, the purity of the lymph will be
promoted, and the percentage of successful cases consequently increased.
34. The Superintendents of the Central and Sind Circles have recently
suggested the advantage of being supplied with empty capillary glass tubes.
They think that their vaccinators could easily be instructed in the method of
filling them, and that thus a constant supply of lymph would at all times be
available for transmission wherever it might be required. I have already
anticipated this suggestion, however, for in June last I directed the Medical
Storekeeper to procure a supply from England with this object in view, and
it may be expected to arrive at an early date.
35. In paragraph 4 of the Resolution passed by Government on my last
report, it was suggested that much assistance might be afforded to the per-
sonal efforts of the Superintendents, and their vaccinators, by collecting and
publishing in the vernacular of each district, and by distributing among the
people, the particulars of any striking facts which might be met with proving
the benefit of vaccination.
36. This subject has not been lost sight of. I impressed on Superinten-
dents the necessity of bearing it in mind, and requested that every opportunity
which presented itself for carrying into effect the desire thus expressed by
Government, might be taken advantage of.
37. The Superintendents have not failed to give attention to the subject,
but hitherto no very marked instances have been met with. Dr. Beatty, for
instance, reports that when travelling through his districts he took much
pains to collect facts, such as he formerly brought to notice, sufficiently strik-
ing for publication, but that he had failed in meeting with such.
38. Dr. Pinkerton also states that no special case came to his notice
during the year. He adds, however, that after having travelled over the
greater part of Sind, and after having examined thousands of children and
hundreds of villages, he feels sure that nobody could proceed from one end of
the province to the other, without reading in the faces of the rising generation
the striking benefits of vaccination;—that whereas nearly every adult is
marked with small-pox, a large portion of the population, below ten years of
age, has been vaccinated, and has escaped the disease.
39. An interesting feature in the proceedings of the year,—and one which
eventually may exercise great influence on the Department,—is the commence-
ment of vaccination by municipalities. In the last report I suggested that, as
the objects of municipal taxation embrace, or ought to embrace, all questions
connected with the preservation of the public health,—of which vaccination is
an important branch,—a portion of the proceeds of such taxation ought to be
devoted to the dissemination of the prophylactic. Government were pleased
2 vac.
( x )
to support this view, and expressed an opinion that all municipalities of any
size or importance might with advantage permanently employ a vaccinator, in
whose labours, and in checking whose returns, the Municipal Commissioners
might be induced to interest themselves.
40. Thanks to the intelligent zeal of Dr. Plumptre, the Superintendent of
the Southern Circle, and to the hearty co-operation of Mr. Chapman, the
Collector of Sattara, the system has been commenced in that zillah, by group-
ing together several municipal towns into what Mr. Chapman calls a
" division," and by employing therein a vaccinator on 15 rupees a month.
Six such divisions have been formed as an experimental measure. The size of
each is such as will permit of all the towns therein being visited by the vacci-
nator once every three months.
41. As far as the Collectorate of Sattara is concerned, this arrangement is
equivalent to doubling the staff of vaccinators, without any increase of expen-
diture on the part of Government. I shall watch its progress with much interest,
for I attach very great importance to the successful commencement of a plan
which promises to identify local municipal bodies with efforts to render the
protective system of vaccination more extended, efficient, and complete.
42. Dr. Plumptre has commended the subject to the consideration of the
Collectors of the other zillahs within his range ; and I trust the Superintendents,
generally, in communication with the Civil authorities, will endeavour to
introduce the system into their respective circles. In a further part of this
report I have extracted in full all the remarks made by Dr. Plumptre on the
subject.
43. It is satisfactory to learn, that the Municipal Commissioners of
Kotree have likewise recently adopted the system, and have sanctioned an
expenditure of 15 rupees a month for a vaccinator. The Municipality of
Hooblee also entertain a vaccinator of their own.
44. It gives me great pleasure to state that the Superintendents, generally,
express their cordial acknowledgements for the substantial assistance they
have at all times received from the Civil, Political, and Police authorities.
Dr. Plumptre dwells especially on the warm interest taken by Mr. Chapman
in the extension of the safe-guard.
45. Dr. Butler, again, the Superintendent in Kattiawar, pointedly alludes to
the very valuable assistance afforded by the Political Agent in that Province.
He mentions that Major Keatinge had written to each Chief requesting his
countenance and support—that he had a copy of the last report, and of the
remarks made thereon by His Excellency in Council, translated and forwarded
to each Chief,—and that he never failed to impress on them in conversation
the importance of exerting their influence in behalf of the cause.
46. It is gratifying to be able to report, that with one exception, I have
every reason to be satisfied with the exertions made by each Superintendent
( xi )
during the year. The junior in the Department, Dr. Pinkerton, the
Superintendent in Sind, is spoken of very highly by Dr. Ritchie, the
Deputy Inspector-General of Hospitals, particularly for his exertions in per-
sonally testing the work of his vaccinators. The employment returns at the
end of the report will show that he travelled upwards of 1,500 miles, and
personally inspected more than 7,000 children. In doing this, he travelled
further, and inspected more children, than anybody in the Department.
47. Dr. Dick, of the Northern Circle, travelled nearly as far, and made
a very extended tour, during which he examined the work of no less than 29
vaccinators, scattered in different localities throughout his extensive range.
Dr. Beatty, of the Central Circle, personally inspected nearly twice the number
of children which he did the previous year, and travelled to a much greater
extent.
48. Dr. Butler, the Superintendent in Kattiawar, both travelled further,
and inspected more children, than during 1862, although his duties at Rajkote
only admitted of his spending a very limited time in the districts. Mr.
Anunta Chundroba, the Superintendent at the Presidency, also did his work
well.
49. In the Southern Circle, Dr. Plumptre inspected more children than
during the previous year, and although he did not travel quite so far, he
particularly distinguished himself by organizing, in communication with
Mr. Chapman, the scheme of municipal vaccination in the Sattara zillah. He
also did every thing in his power,—in common, I have no doubt, with the
other Superintendents,—to excite an interest in the Department, and to make
it popular, by rendering medical aid to all requiring it, by visiting the Chiefs
in the Native States through which he passed, by encouraging visits from
Native officials, by visiting the schools, and by pointing out the benefits of
vaccination to the people.
50. I regret that I am unable to speak in equally favourable terms of the
exertions made by the Superintendent in the Rewa Kanta. Though in
charge of a very limited district, no progress has been made. On the con-
trary, there was a decrease in the number of vaccinations instead of an
anticipated increase, and the cause has rather retrograded than advanced. It
is but just, however, to the Superintendent, to state that his health suffered a
good deal towards the close of the year, and I am desirous that every
allowance should be made on this account.
51. With a few exceptions, the general conduct of the vaccinators
was very satisfactory, and I am bound to add, that a considerable number
exhibited a most praiseworthy diligence and zeal.
52. I regret having to record that Dr. Beatty, after eight years' labour as
Superintendent in different parts of the Presidency, has recently left the Depart-
ment, his services having been required by Government for other duty. The
( xii )
loss of his matured experience will be severely felt. I beg to offer him my
best acknowledgments for the deep interest he has taken in promoting the
success of the cause entrusted to his care, and at the same time to express the
high opinion I entertain of the ability and judgment which have characterized
his proceedings.
53. In paragraphs 6 and 31,I alluded to two important measures, recently
sanctioned by Government, which have very materially increased the efficiency
of the Department; but there is still another to record which, while conferring
an invaluable boon on a considerable number of deserving men, cannot fail
to prove of the greatest benefit to the cause. I allude to the recent admission
of Native vaccinators to the privilege of pension.
54. The necessity of improving the condition and prospects of these men
has often been pointed out. It has frequently been represented that no
efforts to extend the usefulness of the Department, commensurate with its
great importance, could reasonably be expected to prove successful, except
on the condition of such improvement being made. Government fully recog-
nized the necessity, and submitted the subject for the favourable consideration
of the Government of India. It is now most gratifying to me to be able to
record that sanction for this great booh has recently been received.
55. Not only will the present race of men, with this brightening view be-
fore them, be stimulated to greater energy and activity ; but with the improve-
ment thus made in the status and prospects of a vaccinator, a better class of
men may reasonably be expected to enter the Department. This, in itself,
I regard as a point of much importance, for the greater personal influence of
such men could scarcely fail to prove of the highest value in smoothing
difficulties, and in removing prejudices.
56. The adoption, by Government, of these three important measures, bears
convincing testimony to the great practical interest taken by His Excellency
in Council in everything relating to the improvement and efficiency of the
Department. I am quite sure they will be fully appreciated by the Superin-
tendents and their establishments, and I am equally sure they will be responded
to on their part by increased exertions, leading to far greater results than have
ever yet been shown.
I have the honour to be,
Sir,
Your most obedient Servant,
M. STOVELL, M.D.,
Principal Inspector-General, Medical Department.
Bombay, 31st March, 1864.
( xiii )
INDEX TO THE FOLLOWING REPORTS.
VACCINATION UNDER SUPERINTENDENTS—
Presidency Circle.. .. .. .. .. .. .. .. ..
Central
do. .. .. .. .. .. .. .. ..
Southern
do. .. .. .. .. .. .. ..
Northern
do. .. .. .. .. .. .. ..
Sind
do. .. .. .. .. .. .. ..
Kattiawar
do. .. .. .. .. .. .. ..
Rewa Kanta do. .. .. .. .. .. ..
Peynt (Nassick) .. .. .. .. .. ..
VACCINATION UNDER CIVIL SURGEONS—
Tanna .. .. ..
Poona .. .. ..
Ahmednuggur .. ..
Sattara .. .. ..
Sholapoor .. ..
Dhoolia .. .. ..
Nassick .. .. .. ..
Belgaum .. .. ..
Dharwar.. .. ..
Kolapoor .. .. ..
Rutnagherry .. ..
Honore .. .. ..
Vingorla .. .. ..
PAGE
15
15
16
16
17
18
18
19
19
20
20
21
21
Aden
..
..
..
..
Bushire .. .. .. .. ..
Ahmedabad .. .. .. .. ..
Kaira .. .. .. ..
Surat .. .. .. ..
Broach .. .. ..
Rajcote .. .. ..
Kutch
..
..
..
..
Karrachee .. .. ..
Hydrabad .. .. ..
Shikarpoor .. .. ..
Kotree .. .. .. ..
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
..
..
PAGE
1
1
4
6
9
12
13
14
PAGE
22
22
23
24
24
25
25
26
26
27
27
28
Table No. 1
No. 2
No. 3
No. 4
No. 5
No. 6
3 vac.
VACCINATION UNDER SUPERINTENDENTS.
PRESIDENCY DIVISION.
Local Superintendent.—Sub-Assistant
Surgeon ANUNTA CHUNDROBA.
Establishment.—Three
Vaccinators.
YEARS.
1862....
1863....
Total
Vaccinated.
6,081
7,016
Compared with the
preceding Year-
Increase.
....
935
Decrease.
....
....
Success-
fully
Vaccinated.
4,748
5,494
Percentage
of
Success.
78.1
78.3
During the past year 7,016 persons were vaccinated, being 935 more than in the preceding
year. Of these 4,062 were males, and 2,954 females; 4,302 were above, and 2,714 under one
year of age ; 4,208 were Hindoos, 1,017 Mahomedans, 977 Christians, 663 Parsees, and 151 of
all other castes. Of the total number of operations 5,494 were successful, 658 unsuccessful,
and 864 doubtful, giving 78.3 as the percentage of success.
Small-pox prevailed to a great extent at the commencement of the year, and the number of
applicants for vaccination was correspondingly great, but as there was little or no small-pox
during the last month, the number fell off to an equally great extent, and consequently the
total for the year was not what would have been expected from the extensive prevalence of
small-pox.
CENTRAL CIRCLE.
Superintendent.—Assistant
Surgeon T. B. BEATTY, M.D.
Establishment.—Thirty-one
Vaccinators.
YEARS.
1862....
1863....
Total
Vaccinated.
39,701
48,562
Compared with the
preceding year.
Increase.
....
8,861
Decrease.
....
....
Success-
fully
Vaccinated.
36,872
45,008
Percentage
of
Success.
92.8
92.7
v 1