NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( xv
)
It will be observed that vaccination is dearest in Kutck, and I think it need
not be so, were the establishment there properly organized. In Bombay vacci-
nation must always be more expensive than in the other circles for many
reasons. The cost in Aden was unnecessarily high because, by a mistake there
were 2 vaccinators instead of only one—this has been remedied. The cost
in the Western circle is the next highest but, I think, we may expect a
decrease there in the current year. The other circles do not vary very much,
The general average is only 4 annas 6 pies, which is a very moderate
sum.
Commendation of superintendents.
23. It affords me the very greatest pleasure to report that all the
officers serving in the department have
done their best to perform their duties to
the very best of their powers. How well
this has been done is plainly demonstrated in the following table of figures
showing the work of each superintendent: —
Name of
Circle.
1.
2.
3.
4.
5.
6.
Central
Southern
Western
Eastern Gujarath..
Western do. ...
Sindh
Superintendent.
Drs. Robb and Turnbull.
Mr. Raby
Mr.Cody.....................
Dr. Cola
Dr. Butler
Dr. Williams
Total ......
Number of en-
campments.
58
61
109
66
86
126
506
Number of tra-
velling days.
87
139
215
166
184
155
946
Distance travel-
led in miles.
1,233
1,488
2,288
2,064
2,135
2,822
12,030
Number of villa-
ges visited.
201
246
494
503
393
532
2,369
Number of vacci -
nated childern
inspected.
5,916
9,738
14,425
12,947
29,025
20,925
92,976
These figures show that Drs. Williams and Cody made the greatest number
of encampments ; that Drs. Cody and Butler travelled the greatest number
of days; Drs. Williams and Cody travelled the greatest number of miles.
I may add that Dr. Williams travelled 212 miles by rail without much ap-
parent object as far as vaccination is concerned. Drs. Williams, Cola and
Cody visited the greatest number of villages—but it must be observed
that the number of villages is no very good guide to estimate the work of a
superintendent, because in Sindh every cluster of 2 or 3 houses is reckoned a
village, whereas in the Dekhan such a hamlet would be reckoned a wádá or a
part of the village proper. Superintendents might I think fairly reckon a wádá
as a village, as far as their inspections are concerned—indeed, it seems to me
that it would be better for them to do so. It is probable then, that the ex-
cess of villages inspected by Dr. Williams is so far only apparent and not real.
Drs. Butler and Williams, inspected, by far, the greatest number of
vaccinated children; but to estimate the work of inspecting children I must
add the following table which shows the number of vaccinated children
whose names were called from the registers—which is the real test of the
vaccinators' work :—
( xvi )
Circle.
1.Central............................
2. Southern
3. Western
4. Eastern Gujarath
5.Western do ...............
6.Sindh ..............................
Total
Work tested by calling names from register.
Present during
inspection.
Successful.
Good.
3,773
3,753
10,376
6,427
6,963
4,323
35,615
Middling.
393
820
...
3,805
...
290
5,308
Unsuccessful
including bad.
432
684
898
1,510
931
209
4,664
Absent dur-
ing inspec-
tion.
Absence
ac-
counted for.
2,187
2,745
4,485
3,477
1,642
1,753
16,289
Absence unac-
counted for.
1
125
16
...
5
20
167
Number of persons whom
the vaccinator has return-
ed as vaccinated.
Successful.
5,903
7,001
14,494
13,831
8,559
6,091
55,879
Unsuccessful
and doubtful.
351
486
772
866
607
205
3,287
Unknown.
532
542
543
495
375
299
2,786
Total.
6,786
8,029
15,809
15,192
9,541
6,595
61,952
It will be observed from these figures that Mr. Cody and Dr. Colá
stand by far the highest—but I am of opinion that even the lowest is
quite as high as there is any necessity for—now that this work is so
thoroughly done by the assistant superintendents. In the Central circle
Drs. Robb and Turnbull inspected, by calling the names, the lowest number
of children, except Dr. Williams in Sindh, and yet there were quite suffi-
cient names called over 1st to prove that, the vaccinators' records were
correct and 2nd to test the inspections of the assistant superintendents.
I consider it no longer necessary for superintendents to inspect as much
as before the creation of assistant superintendents ; five or six thousand
names called over in the year is I believe ample to test the work
of the vaccinators and to see that the assistant superintendents report
their inspections faithfully. Superintendents, I think, should try to see
as many vaccinators as possible on their tours, giving words of encourage-
ment here and of censure there: they should make a point of visiting
places where there are difficulties to overcome, and help and encourage
both the vaccinator and assistant superintendent to overcome them.
The office work has, of course, increased pari passu with the strength
of the department and it is now one of the most important parts of a super-
intendent's duty. I think the names of Drs. Butler, Williams, Cody and
Colá deserve special mention. Dr. Turnbull was not in charge of the
Central circle for the whole year as he acted for me as superintendent
general for fully four months, but I know his circle is in first rate order,
which is the result of his long and able superintendence of it. I am of
opinion that superintendents of vaccination might be made very useful to the
sanitary department without in any way impairing their efficiency as officers
of this department.
( xvii )
Assistant superintendents.
24. The assistant superintendents have been, with one or two excep-
tions, reported as all that can be desired—in short,
they have, after three years' trial, realized all
that was expected of them. The exceptions are two in the Southern
circle, both of whom I have seen, and I feel sure that both will greatly
improve. In the above remarks I refer to these men, as assistant superinten-
dents of vaccination only, but I have no doubt, they might also be made
useful to the sanitary department: for instance they could inspect village re-
gisters of births and deaths, and each could bring to notice any very obvious
insanitary conditions observed in his zilhá. It gives me very great pleasure,
indeed, to report so favorable on this body of officials and to add that they
give promise of a still further and more extended usefulness.
Government
may rest assured that the creation of this class of vaccine officials has turned
out a perfect success. I will here record the names of Mr. Hásá Mal in the
Sindh circle and Mr. Balwantráo Rájárám in the Central circle as pre-eminent
among them for zeal and intelligence. The former distinguished himself in
Upper Sindh by stamping-out several outbreaks of small-pox and the latter
in Sátárá zilhá has brought the vaccinators there into first rate order ; I will
reward him by promotion to 2nd class on 1st August next, when he will
have completed his qualifying 3 years in the 3rd grade. Mr. Hásá Mal is
already in the 2nd grade—Mr. Ranchoddas Mangaldas and Sardarmiya Nana-
miya have been prominently brought to notice by Dr. Butler as very zealous
in the performance of their duties. Others have done their duty well but
have not been specially brought to notice because in 1873-74 there were no
exceptional circumstances in the other circles to contend with.
Operations of the different estab-
lishments.
25. There has been an increase of operations by all establishments, but
not by all circles, as there is a decrease in the
Presidency and Barodá circles as the follow-
ing figures show :—
Circles.
1
2.
3.
4.
5.
6.
7
8.
9.
Presidency..............................
Central....................................
Southern.................................
Western.................................
Eastern Gujarath...................
Western do. ...........................
Sindh.......................................
Baroda....................................
Kutch....................................
Aden ..........................................
Total
Total number of persons vac-
cinated and revaccinated.
1873-74.
13,907
121,541
96,648
71,290
85,584
111,253
111,124
27,781
2,476
1,265
642,869
1872-73.
16,415
119,560
80,697
63,626
78,206
110,432
78,314
29,661
2,232
684
579,827
Deduct decrease
Not increase ......
Compared with the pre
ceding year.
Increase.
......
1,981
15,951
7,664
7,378
821
32,810
......
244
581
67,430
4,388
63,042
Decrease.
2,508
......
......
......
......
......
......
1,880
......
......
4,388
3 vac
( xix )
officer, although this is not a special peon still I think it will be sufficient.
In Kulladghi and Dharwad there is a municipal vaccinator wherever there
is a dispensary.
All students are to qualify as vac-
cinators before receiving a charge.
29. It has been arranged by the Surgeon General that the students of
the Grant Medical College shall study vaccina-
tion after passing their examinations and be-
fore receiving charge of a dispensary. This
is in obedience to the order in the Resolution quoted in the preceding para.
The 202 local fund vaccinators'
work,
30. The local fund establishment of vaccinators numbered 202 or one
more than in 1872-73 ; the additional one was
appointed to the Supa petha by Mr. Macdonald
when small-pox was raging in it. They opera-
ted on 368,053 or 50,537 more than in the preceding year. The average number
for each vaccinator is 1,822. From the figures below, showing the increase
by circles, it will be observed that the greatest increases took place in the
Sindh and Southern circles—and the least in the Western Gujaráth circle : —
Central Circle.................................
Southern do....................................
Western do....................................
Eastern Gujaráth Circle..................
Western Gujaráth do.....................
Sindh Circle.................................
Total increase...
Increase.
1,972
14,543
4,161
2,297
445
27,119
5,0537
The number of persons primarily vaccinated in Sindh is considerably in
excess of the estimated births, so no further increase is likely to occur
there and in the Western Gujaráth circle the vaccinations nearly equal the
available children so no increase is likely to occur there either, but some further
increase may be expected in the other circles, and a very considerable increase
may be expected in the Southern circle.
The work of the 125 native states'
vaccinators.
31. The number of vaccinators maintained by native states was 125
or 6 more than in the preceding year. I
have already mentioned that these in-
creases were made by the Chiefs of Sángli
and Miraj and by H. H. Mír Alí Murád
and H. H. the Ráo of Kutch. The number of persons operated on was
191,331 or an increase of 8,670. Each vaccinator's average is 1,530.
The following figures show where the increases and decreases occurred:—
Increase.
Central Circle..............................
Southern do..............................
Western do
Eastern Gujaráth Circle
Sindh Circle ...........................
Kutch do
Total increase
Deduct decrease...
Net increase
395
2,425
3,037
4,732
2,390
244
13,223
4,553
8,670
Decrease.
Western Gujaráth Circle
Baroda
do.
Total decrease
2,673
1,880
4,553
( xxi )
The following scale of pay for the 11 vaccinators was introduced from 1st
September 1873 :—
1 Vaccinator for the Vishálgad táluká at Rs. 25 pur mensem.
1
Do.
do.
1
Do.
do.
1
Do.
do.
1
Do.
do.
1
Do.
do.
1
Do.
do.
1
Do.
do.
1
Do.
do.
1
Do.
do.
1
Do.
do.
Kolhápur
Buthargad
Shirol
Ajre
Ichalkaranjí
Báwrá
Panálá
Kágal
Gadhinglaj
Torgal
do.
do.
do.
do.
do.
do.
do.
do.
do.
do.
22
18
16
16
16
16
15
14
14
14
do.
do.
do.
do.
do.
do.
do.
do.
do.
do.
The assistant superintendent receives Rs. 75 per mensem which is
just the same pay as the 3rd class assistant superintendents in Government
employ receive. Colonel Anderson has, during the time he has been Politi-
cal Agent in Kolhápur brought his influence to bear on the progress of vac-
cination not only in Kolhápur state but also in the Southern Marátha country
generally. In 1863 the vaccinations were 18,341 ; for 1873-74 they reached
28,041 or an increase of nearly 10,000—and the number of vaccinators has
only been increased from 19 to 24 during the same time.
34. Through Colonel Anderson's influence we recently got the Chief
of Sánglí to appoint a vaccinator for Shirhatti from 1st April 1873 and one
for Mangalvedá from December last. This chief now maintains three vacci-
nators.
Bhor.
35. In Government Resolution on last report the advisability of having
a second vaccinator in the Bhor territory was
noticed. I am happy to say that the Kárbhári
has just arranged to appoint a second.
Kutch.
36. In Kutch the vaccine arrangements are still very defective and
the progress of vaccination in that province is
the worst in Western India; but Captain
Goodfellow, the Political Agent, is giving the
subject his attention and he gives me reason to hope that matters will
shortly be improved. I would here bring to the notice of Government that
Surgeon Wall, while on general duty at Bhuj, introduced the practice of animal
vaccination there and also taught H. H. the Ráo's medical officer the method
of carrying it on. As Dr. Wall had to leave Bhuj with a regiment he could
not continue the practice long, but he deserves notice for his zeal in the
cause of vaccination and for voluntarily having taken the trouble to try and
improve the state of vaccination in H. H. the Ráo's territory.
Dispensary vaccination.
37. There is an increase of 1,358 persons operated on at dispensaries.
I regret to observe a large falling off in
the dispensaries of the Southern circle and
a small decrease in those of the Eastern Guja-
rath circle. There is a large increase in the Sindh dispensaries. I would
beg to bring to the notice of Government the meritorious exertions of the
( xxii )
late Assistant Surgeon Bálkrishna Chintobá, who did the most vaccinations
of any dispensary officer and practised animal vaccination at the Poona
dispensary; Assistant Surgeon Mackenzie, Kumptá dispensary ; Honorary
Surgeon Sinclair, Civil Hospital Kolhápur; Mr. Pollard, Dispensary Dápuli ;
Mr. Narsú Guráppá, Dispensary Sholápur ; Assistant Surgeon Shántárám
Vináyak Kantak, Godhrá dispensary; and Mr. Eskiel Isac, Larkháná dispen-
sary. The increase and decrease is shown by cirles below :—
Increase.
Central Circle.....................
Western do........................
Western Gujaráth Circle...
Sindh Circle........................
Total increase...................
Deduct decrease..................
Net increase........................
350
420
899
1,335
3,004
1,646
1,358
Decrease.
Southern Circle............
Eastern Gujaráth Cir-
cle..............................
Total decrease...............
1,524
122
1,646
Although there is an increase, which is so far satisfactory, still I do not
think the progress of vaccination at dispensaries is as good as I should like to
see it. In my opinion the great object of carrying on vaccination by dispen-
sary officers is to educate the people of the larger towns to seek vaccination
at a certain place on a certain day. To achieve this will probably require the
length of time it takes an infant to grow to be an adult and become the mo-
ther of a family—when she will probably seek the protection of vaccination
for her children where she herself was vaccinated.
Army vaccination.
38. There is a slight increase of 824 vaccinations in the army as
compared with the preceding year. The
total number of persons operated on was 9,354
in a population of about 123,000. The returns from the British army only
show successful cases. In the native army there were 2,585 revaccinations
but I am unable to say how many there were in the British army.
Average number of persons opera-
ted on by each vaccinator.
39. According to Statement No. I. the average number of persons
operated on by each vaccinator is 1,652 or
146 more than in the preceding year. The
average number of persons operated on by
establishments is as follows :—
1st,
2nd,
3rd,
4th,
2Government vaccinators' average is
48 Municipal
do.
do.
202 Local Fund
do.
do.
125 Native State
do.
do.
2,190
1,231
1,822
1,530
But it is more interesting to show the average work of each vaccinator
by circles. From the following figures it will be observed that Sindh and
Western Gujaráth circles are considerably ahead of all others and the
Presidency and Southern circles are again the lowest among Government
( xxiii )
circles : but Kutch circle is absurdly low and Barodá circle might easily
be improved. The average number for each vaccinator can never be very
high in the Presidency circle and I think the past year's average is very
fair for it : —
Circles.
1.
2.
3.
4.
5.
6.
7.
8.
9.
Sind....................................
Western Gujaráth...............
Central.................................
Eastern Gujaráth
Western
Southern
Presidency
Barodá.................................
Kutch
Average number of
persons vaccinated
by each vaccinator.
2,146
2,090
1,805
1,784
1,407
1,348
1,264
1,207
225
Names of Superintendents.
Surgeon J. Williams, M.D.
Surgeon Major E. R.Butler, M.D.
Surgeon Major P. S. Turubull, M.D.
Dr. Mancherji Beramji Cola.
Surgeon T. Cody.
Surgeon J. Raby.
Mr. Ananta Chandroba, G.G.M.D
Surgeon Major G. E. Seward, M.D.
Mr. Dorabji Hormasji, G.G.M.D.
Small-pox.
40. In table No. VII. I have added a column showing the number of
deaths from small-pox in each registration
circle during the calendar year 1873 and the
total number of deaths from this disease was 9,946 ; in the previous year
it was 26,699. I may at once say that no reliance can be placed on these
figures. In Bombay city the number of small-pox deaths for the official
year 1873-74 was 405 and in the preceding year it was 1,637; but even in
Bombay the figures are not reliable. Of the 405, it was said 19 had been
vaccinated and on investigation it was found that 3 or 4 of the 19 had not
died of small-pox at all ; but it was found that two boys who had been regis-
tered as successfully vaccinated died of small-pox about three months after
being vaccinated. It would have been more satisfactory if Mr. Anantá Chan-
droba could have made quite certain that these 2 boys really had been
successfully vaccinated. The boys were vaccinated on 20th January 1873:
they lived in the same house, were vaccinated together, got small-pox at the
same time and died about the same time. In the European army there were
10 persons attacked by small-pox in the calendar year 1873 and one died, the
rest recovered. The girl who died was about 16 years old, was vaccinated in
infancy and re-vaccinated in 1864. In the native army 116 cases of small-pox
occurred during the official year 1873-74 and 66 remained from the previous
year under treatment ; of these 5 died, 160 recovered, I was transferred and
16 remained under treatment at the end of the year. Of the 182 cases, 161
were vaccinated, so I suppose 21 were unvaccinated, but whether they were
protected by small-pox or not does not appear from the returns, nor can
I say whether the 5 deaths occurred among protected or unprotected, but as
3 deaths occurred among children it is probable they, at least, were unprotect-
ed. The question naturally suggests itself why were these 21 unprotected in
( xxiv )
the native army where all children should be vaccinated, and adults vaccinated
or revaceinated.
Small-pox in Sindh and Southern
Circles.
41. Dr. Williams gives some interesting information regarding the in-
troduction and stamping-out of small-pox in
Sindh (vide page 4-5). Mr. Macdonald appoin-
ted an extra vaccinator for the Supa petha to
overcome small-pox there; and old and young flocked to the vaccinator who
was aided very much by Mr. Ram Krishnapa the Mahalkari of Supa (vide
page 18, para. 9).
Inoculation.
42. It is reported that inoculators had
been carrying on their baneful work in
Wai táluká ; but I am unable to say to what
extent they did so.
43. One of the Presidency circle vaccina-
tors was permitted to accept an appointment
of assistant superintendent of vaccination in
the Berars.
Govind Moray transferred to the
Berars as an assistant superin-
tendent.
Vaccino-Syphilis.
44. It appears to be very generally admitted that the virus of syphilis
may be communicated to a person along with
the vaccine virus; but it can only be so by the
vaccinator being so careless as to imply an
utter neglect of the most ordinary observation and caution. The com-
munication of syphilis by vaccination must be one of the very rarest
occurrences in the world and the testimony of the officers of the Bom-
bay Vaccination Department alone proves this to be the case. Not one
of us has ever seen such a case and only one case has ever been even
spoken of, and in that case Dr. Turnbull's enquiries proved conclusively that
vaccination had nothing to do with the syphilis. During the past year the
medical officers of the department inspected 92,976 vaccinated children and
the worst things they saw were neglected sores and an abscess or two—acci-
dents which must be expected. The assistant superintendents saw 217,269 vac-
cinated children and in no case was there the least suspicion of syphilis having
been communicated by vaccination. The attention of all in the department
has been directed closely to this subject during the past 4 years and nothing
has been seen.
Departmental rules.
45. During the year I drew up a set of rules for the department which
will form a section in the new Medical
Code, now being brought out. The vac-
cination forms have all been numbered with
a serial number and bear the distinctive letter V. Several of the superintendents
have drawn up subsidiary rules for the guidance of themselves, assistant super-
intendents and vaccinators and the others are about to do so.
Superintendents to pass in the lan-
guage of their circles.
46. Government in their Resolution No. 107 dated 13th January 1874
directed all superintendents of vaccination
to pass in the language of their districts
by the end of next rains or forfeit their
appointments. And all officers appointed
to be superintendents in future must so pass within a year or forfeit the
amount of difference between their pay of rank and the pay of a super-