35
Vaccination in large towns
not to be entrusted to dispen-
sary officers only.
8. When, three years ago, our rural vaccinators were withdrawn from work-
ing in all towns which have a dispensary, and the
vaccination of these towns was entrusted to the dis-
pensary officers, for several reasons, I felt great doubt
about the advisability of the step. At any time and
under any person, the carrying on of vaccination in large towns is a work of dif-
ficulty. With an unnecessary amount of labor, and a great waste of time, a few
children can only be vaccinated at a time. Even our vaccinators, who are expert
operators and experienced men, accustomed to the drudgery work of hunting from
house to house for unvaccinated children, and who feel that their daily bread
depends upon their work, could not with all their tact and energy do much at a
time : it was therefore, scarcely to be expected that hospital assistants, unac-
customed to this work, could cope with the many difficulties that existed in these
places : and almost every where, it took no time, for such of the people, as were
well-disposed towards vaccination, to find out the want of practical knowledge and
skill of the dispensary officers. The natural consequence of this was that, an
accumulation of unvaccinated children occurred in all large towns : and this hap-
pened markedly in Khedá zilhá.
With two exceptions, viz., Balsád and Rándir,
all the towns having dispensaries in Surat zilhá are small with a population of from
one to four thousand inhabitants, and in them, the difficulty of finding out unvac-
cinated children is comparatively loss. Similarly in Broach zilhá with the except ion
of Jambusar and Ankleshwár, all the other towns have a small population. But in
Khedá zilhá—omitting Nariád which has a separate municipal vaccinator—all the
others are large towns, having a population ranging from seven to fifteen thousand :
in all of these, an accumulation of unvaccinated children occurred, and the result
was that, small-pox broke out in them, to a severe extent. I would beg to recom-
mend that the táluká vaccinators be allowed to carry on vaccination in such of the
towns as have a population of 5,000 inhabitantsor more without a municipal vaccinator.
No other than vaccine dis-
-ase communicated by vaccina-
tion. Occasional sores &c.
9. Each year thousands of vaccinated children come under inspection, and the
only ill effects that I have observed following vaccination are axillary abscesses
and abscesses leading to deep ulceration in the site of
the punctures ; of such ill effects, during the seven years
that I have been in the department, I cannot have
observed more than about two dozen cases; and two
cases, the worst of the kind. came under observation in the last month of the year
under report, one at Poichá and the other at Hingoliá, both in the native state of
Rájpiplá. The Poichá child was vaccinated a year ago, and all the children vac-
cinated from the vaccinifer including the sick child were examined. On none
was any bad effect observable : even on the sick child the left arm bore beautiful
and large vaccination cicatrices, whereas on its right arm a large abscess resulted
which, not having been opened freely, the pus infiltrated into the tissues, discharg-
ing externally by a few minute openings. This state, existing for one year, had
brought the child into a dangerous condition, and though I asked the parents to
bring it to my camp (3 kos off) that I might lay open the abscess and apply some
dressing, the parents did not do so. The second case was a girl seven years old
vaccinated a couple of months ago. None of the children in the same village
suffered from any ill effect and this child's right arm was well; whereas all the
three punctures on the left arm had formed into abscesses producing sinuses in all
directions. The child at my request was brought to my camp where all the sinuses
were freely laid open and some carbolic dressing was applied. I have observed no ill
effects of any other kind which may be directly attributed to vaccination. Where
thousands of operations are performed and that by non-medical men,a few such cases
of ill effects must be expected. Of vaccine syphilis I have not observed a single case.
Small-pox after well marked
successful vaccination.
10. As regards instances of small-pox occurring after unmistakeably suc-
cessful vaccination, it will appear from the small-pox
return the sum of which is given in para. 6, that out
of a total of 2,389 cases, 1,879 were recoveries, of