NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
2
Number.
1
2
3
5
6
7
8
9
Circles.
Presidency ..
..
Central .. ..
Southern .. ..
Western .. ..
Eastern Gujarath ..
Western Gujarath..
Sindh .. .. ..
Baroda .. ..
Kutch .. ..
Aden
..
..
..
Military Stations ..
Total
..
Area in square miles.
19
27,516
25,569
28,361
15,939
30,224
49,306
4,399
6,500
11
....
1,87,844
Population.
644,405
4,823,947
4,762,457
3,109,370
3,147,853
3,644,852
2,322,765
2,000,225
487,305
19,289
115,100
25,077,568*
1874-75
Superintendent General.
1
...
...
...
...
...
...
...
...
...
...
1
Superintendents.
1
1
1
1
1
1
1
1
1
...
...
9
Assistant Superintendents.
...
6
5
5
4
3
6
1
1
...
...
31
Clerks.
2
2
2
2
2
2
2
1
...
...
...
15
Number of Vaccinators.
Govern-
ment.
Civil.
...
...
...
...
...
2
...
...
...
...
...
2
Military.
...
...
...
...
...
...
...
...
...
...
4
4
Municipal.
16
9
8
4
3
5
5
...
...
1
...
51
Local Funds.
...
48
38
42
25
7
43
...
...
...
...
203
Native States.
...
6
26
4
18
39
2
23
11
...
...
129
Total.
16
63
72
50
46
53
50
23
11
1
4
389
Number of Peons.
Government.
4
10
8
9
8
9
10
...
...
...
...
58
Municipal.
5
9
7
3
3
5
3
...
...
...
...
35
Local Funds.
..
48
38
42
25
7
43
...
...
...
...
203
Native States.
..
6
29
1
15
39
2
25
6
...
...
123
Total.
9
73
82
55
51
60
58
25
6
...
...
419
Total Strength.
29
144
162
113
104
119
117
51
19
1
4
864
1873-74.
Superintendent General.
1
...
...
...
...
...
...
...
...
...
...
1
Superintendents.
1
1
1
1
1
1
1
1
1
...
...
9
Assistant Superintendents.
...
5
5
5
4
3
6
1
1
...
...
30
Clerks.
2
2
2
2
2
2
2
1
...
...
...
15
Number of Vaccinators.
Govern-
ment.
Civil.
...
...
...
...
...
2
...
...
...
...
...
2
Military.
...
...
...
...
...
...
...
...
...
...
4
4
Municipal.
11
12
6
4
3
5
5
...
...
2
...
48
Local Funds.
...
48
37
42
25
7
43
...
...
...
...
202
Native States.
...
5
25
3
18
38
2
23
11
...
...
125
Total.
11
65
68
49
46
52
50
23
11
2
4
381
Number of Peons.
Government.
4
9
8
9
8
9
10
...
...
...
...
57
Municipal.
11
11
3
3
3
5
3
...
...
2
...
41
Local Funds.
...
48
37
42
25
7
43
...
...
...
...
202
Native States.
..
5
25
1
15
38
2
25
9
...
...
120
Total.
15
73
73
55
51
59
58
25
9
2
...
420
Total Strength.
30
146
149
112
104
117
117
51
22
4
4
856
* Exclusive of Railways, which amount to 8,750 souls.
5
Udaipur : the former at the end of the year, and the latter at the beginning
of the year 1875-76. Besides the increases which took place during the year
under report, I have to notice a further increase at the commencement of the
year 1875-76 of 3 local fund vaccinators in Belgáum collectorate: 1 in
Násik for the new táluká of Kulwan, and a second vaccinator for the very
large táluká of Dhanduká in Ahmadábád zilhá.
Work of the year is the
largest ever attained.
7. The past year's work shows not only the largest amount of work
ever done in a year, but also the largest increase that
has ever been obtained in any one year. It gives me
much pleasure to be able to say that the increase is
distributed over the whole country, though, as might be expected, the actual
rate of increase differs a good deal in the different circles ; but there is a very
considerable increase of work where it was most desired—I mean in the
Southern and Presidency circles.
Number vaccinated.
8. The total number of persons vaccinated and re-vaccinated was
732,624, which gives an increase of 80,401 over the
preceding year. The following figures show the work
of the year as compared with the preceding one; and I trust they will be ac-
cepted as evidence of the superintendents, assistant superintendents, and
vaccinators having endeavoured to do their duty well:—
1874-75.
Primary
Vaccinations.
646,574
19,393
665,967
Re-vaccina-
tions.
57,578
1,799
59,377
725,344
7,280
732,624
In Civil Life.
Itinerant Establishment.
Dispensary Establishment.
Civil Life Total.
Army Total.
Total Vaccinations in Bombay
Presidency.
1873-74.
Primary
Vaccinations.
600,471
18,560
619,031
Re-vaccina-
tions.
22,409
1,429
23,838
642,869
9,354
652,223
There have been increases
in the Itinerant Establishment of
at Dispensaries ... ... ...
81,272 and
1,203
82,475
There has been a decrease in the Army
of
Total Increase ...
2,074
80,401
Cause of decrease in
Army.
9. I am unable to say positively the cause of this decrease in the Army,
but judging from the monthly small returns of "un-
protected," I hazard the opinion that it is owing to
the want of subjects.
Causes of increases.
10. The chief increase is in the work of the local fund vaccinators, and
it is mainly owing to the constant supervision ex-
ercised by the assistant superintendents and to the
6
zealous way in which the superintendents themselves have carried on their
duty. The increased number of vaccinators (8) has helped only a very
little to swell the increase. I here show the increase in the number of
vaccinations, as compared with the previous year, in each establishment:—
203 Vaccinators ...
129 „ ...
51 „ ...
2 „ ...
Local Fund
Native States
Municipal
Government
Dispensaries
Total increase
59,605
20,325
884
458
1,203
82,475
Decrease in Army.
11. Only in the Army has there been any decrease ; but a decrease of
2,074 is very considerable when the total number is
only 7,280. The 4 military vaccinators have done
2,371 vaccinations in cantonments, which is just about the same number as
in the previous year. There is a decrease in the European Army of 394 and
in the Native army of 1,680. I must mention that the 4 military vacci-
nators vaccinated many more than the 2,371, but the others were entered in
the regimental returns of their stations. The decrease, as above mentioned,
appears to be due to want of subjects.
Number of primary vac-
cinations.
12. The number of persons primarily vaccinated was 671,089, exclusive
of the British Army returns, which make no distinc-
tion between primary and re-vaccinations; but I
apprehend that nearly the whole of the 728 in the
returns of the European Army were primary; I shall therefore consider the
total primary vaccinations as amounting to 671,817, thus :—
Itinerant Establishment ...
Dispensary
do. ...
British Army ...
Native do. ...
Total primary vaccinations.
646,574
19,393
728
5,122
671,817
Excess of operations over
persons in primary vac-
cinations.
13. Of these primarily vaccinated persons, 5,612 were operated on more
than once, having been unsuccessful on the first
operation ; but this is a very small portion of the
whole of the unsuccessful cases, which numbered
23,344. It is to be regretted that so few of the un-
successful are again submitted to the operation, and this circumstance
emphatically points out to us how necessary it is for the vaccinators to operate
so carefully as always to insure the highest possible success by the first opera-
tion, because many mothers willingly submit their children to one operation
who refuse to do so again if it fail.
Number of re-vaccinations.
14. The re-vaccinations numbered 60,807, of whom 375 were twice
operated on, the first operation having failed. The
most of the re-vaccinations were in the Sindh circle,
but the following figures show how they were spread over all the circles:—
7
Sindh ...
Southern ...
Western Gujarath ...
Eastern
do. ...
Presidency ...
Native Army ...
Central ...
Western ...
Baroda ...
Aden ...
Kutch ...
Muscat ...
Total re-vaccinations...
48,504
2,810
2,614
1,759
1,562
1,430
942
933
173
67
9
4
60,807
There has been no attempt made to push re-vaccination, except perhaps
in Sindh, because in most of the other circles the vaccinators have found quite
enough to do to carry out primary vaccination; but I think a little more
attention must now be given to this subject.
Percentages.
15. The percentages of sex, caste, age and result can be shown for
primary vaccinations in all establishments except the
British Army, but for re-vaccinations the percentage
can only be shown for the result of the operations.
Sex.
16. There are only two columns for entering the sexes, and they show the
sexes at all ages only—and not for the sexes at
particular ages. There were, exclusive of the British
Army, 352,214 males and 318,875 females—an excess of 33,339 males. So
in every 100 vaccinated persons there were 52.48 males and 47.52 females.
The census shows for the whole population at all ages 52.38 and 47.62 ; so
there is exactly one-tenth per cent. more males and one-tenth per cent. fewer
females in the vaccination returns than in the census. But if we take the
percentages of the sexes in the first year of life from the census report, and
compare them with the vaccination returns, the difference is greater, which
is owing to the larger number of the vaccinated children being above one year
old at the time they were vaccinated. Thus, the males in the census predo-
minate by only .98 in every 100 persons in the first year of life, whereas
between 1 and 6 years the excess of males is 2.02. The excess of males for
all ages in the vaccination returns is 4.96, or double the difference in the first
six years of life as shown by the census and less than half the difference
between the ages of 6 and 12. But what is singular is that in the year 1874*
the births show males 52.96 and females 47.04, or an excess of males of
5.92, which is a very different rate from the census. The inferences are,
first that either the vaccination returns or the census figures are not quite
correct; or, second, that a very considerable portion of the 376,248 who were
above one year old when vaccinated were really over six years old.
Sexes percentages as
compared with census.
17. I show the percentages of the sexes as com-
pared with the census figures and the birth-returns
for the year 1874:—
* I am indebted to the courtesy of Mr. Lumsdaine for this information, he havingkindly
lent me the proofs of his report for 1874 for a day.
8
Census 1—6 years ...
Vaccination returns—all ages ...
Census—all ages ...
Birth registers for 1874 ...
Males.
51.01
52.48
52.38
52.96
Females.
48.99
47.52
47.62
47.04
This small disparity is very satisfactory as compared with former years,
as it shows that we now get the children vaccinated at an earlier age. In
1866 the excess of males was 10, in 1873-74 it was 5.6, and now it is 4.96 in
every 100 persons.
Percentages of sexes in
circles and disparity.
18. The percentages of the sexes are here shown
by circles :—
Sindh
...
...
...
...
...
Presidency ... ... ... ...
Baroda ... ... ... ...
Eastern Gujarath
...
...
...
Southern ... ... ... ...
Western Gujarath ... ... ... ...
Kutch ... ... ... ... ...
Central ... ... ... ...
Army...
...
...
...
Dispensaries
...
...
...
...
Aden ... ... ... ...
Males.
56.97
55.32
54.25
52.15
51.90
51.78
51.17
50.93
54.78
53.07
78.73
Females.
43.03
44.68
45.75
47.85
48.10
48.22
48.83
49.07
45.22
46.93
21.27
Excess of Males.
13.94
10.64
8.50
4.30
3.80
3.56
2.34
1.86
9.56
6.14
57.46
The disparity is very great in the Sindh circle—no less than 13.94 ; in
Aden the difference is simply absurd. I cannot believe that these two ex-
cessive disparities can represent the disparity of the sexes in either Sindh or
Aden, and I believe that a little more care, on the part of the vaccinators there
in. entering the sexes in the registers, would show the disparity of the sexes
in those vaccinated, to be very much less than is here set down.
Castes.
19. In the vaccination returns there are columns for 1st Christians,
2nd Hindus, 3rd Musalmans, 4th Parsis and 5th
other castes. Exclusive of the British Army, the
vaccinated were by castes :—
Christians ... ...
Hindus ... ...
Musalmans ... ...
Parsis ... ...
Other Castes ... ...
Total ...
3,323
505,150
113,407
1,216
47,993
671,089
This gives a percentage of 0.49 for Christians, 75.27 for Hindus, 16.89
9
for Musalmans, 0.18 for Parsis, and 7.15 for all Other Castes combined.
Arranged in the way shown by the census this would give :—
Hindus ...
Musalmans ...
Other Castes ...
75.28
16.90
7.82
100
The Census shows :—
Hindus ...
Musalmans ...
Other Castes ...
83.42
15.21
1.37
100
It is evident from this that in the vaccination returns there is a larger
number included under the heading " Other Castes " than in the census report.
These figures show however that the Musalmans generally accept vaccina-
tion more freely than Hindus; and this quite accords with the general expe-
i-ienee of the department, except in Bombay city, where the proportion of Mu-
salmans vaccinated to Hindus is below the proportion they bear to each other
in the census; and it is remarkable that the Mahomedan community of Bombay
have always been backward in accepting vaccination. Why it should bo so, 1
am at a loss to say. The Mahomedans of Bombay city are certainly as intelli-
gent as any of their religious confreres in any other part of the presidency, and
they do not object to vaccination on either the score of religion or custom.
I can only guess that they are careless of life, and, being a busy people, do
not give time or thought to guard against a probable danger. I will now
show the percentages of the castes and the difference as compared with the
census :—
Percentages of Castes.
Castes.
Hindus ... ... ...
Musalmans ... ... ...
Other Castes
...
...
...
By census.
83.42
15.21
1.37
By vaccination
returns.
75.28
16.90
7.82
Difference.
— 8.14
+ 1.69
+ 6.45
I infer from these figures that in the vaccination returns a number of
Hindus are entered in the column for " Other Castes." This is not to be won-
dered at considering that the vaccinators have been educated to consider all
Dheds, Mangs, Chambars and Shikaris in the Thar Parkar as out-
castes, and that they should be entered in the column for " Other Castes."
This could be altered so as to make our returns more in uniformity with the
census; but if so, there would be some danger of the low caste Hindus
being passed over by fastidious vaccinators, so for vaccination purposes our
classification is better than the census one.
B 99—b
10
Ages.
Progress of infantile
vaccination.
20. There are two columns in the vaccination returns to enter the
ages of those who are vaccinated. The 1st column
is for all " under 1 year old " and the 2nd column
for all " above 1 year old ". Exclusive of the British Army returns there
were 294,841 under one year old and 376,248 above that age. This gives
an increase of 55,098 infantile vaccinations over the preceding year and an
increase of 219,686 as compared with the year 1857. The following figures,
taken from previous annual reports, but corrected to
show the number also vaccinated under 1 year old
at dispensaries and in the Native Army, show how
infantile vaccination has progressed in the past 18 years :—
Years.
1857
...
...
...
1868
...
...
...
1869-70 ... ... ... ...
1870-71
...
...
...
...
1871-72
...
...
...
...
1872-73
...
...
...
...
1873-74
...
...
...
...
1874-75
...
...
...
...
Infantile vaccinations.
75,155
177,276
191,221
169,072
183,397
209,395
239,743
294,841
Percentages.
30.4
41.1
41.8
34.5
34.8
36.8
38.3
43.9
I cannot get any very accurate figures on this subject previous to 1857.
I consider the percentage of 43.9 shown for the year under report is quite
as high as we can reasonably expect a peregrinating establishment to reach.
It is the highest that has yet been recorded, and is fully higher than I antici-
pated. I am not sure that I can absolutely guarantee the correctness of the
ages recorded, but no errors of any consequence have been noticed either by
myself or the superintendents when testing the vaccinators' registers;
and so far this speaks strongly for the general correctness of the ages, be-
cause superintendents tested 69,576 names in the registers and their assis-
tants tested 325,430. Still it is probable that the age columns are not so
carefully tested as the result ones, because they are much less important. I
consider this increase in infantile vaccinations most satisfactory.
Infantile vaccination by
circles.
21. It is interesting to show the percentages of infantile vaccinations
by circles as it shows, in a strong light, the progress
of vaccination made in each : although it must be
remembered that it is easier to obtain a high percen-
tage in the Presidency circle than in the others, because of there being
a large population in a small area.
Infantile vaccinations.
22. The following shows the percentage of
infantile vaccinations in the year 1874-75 on the total
number of vaccinations :—
11
In the Native Army ...
„ Presidency Circle ...
„ Dispensaries ...
„
Western Gujárath Circle.
„
Eastern
do.
„
Western Circle ...
„ Central
do. ...
„
Baroda
do. ...
„ Sindh
do. ...
„
Southern do. ...
„
Kutch
do. ...
„
Aden
do. ...
83.9
66.4
52.3
50.5
47.8
45.4
44.1
43.1
39.8
31.0
21.4
14.9
Infantile vaccination in
the Army and canton-
ments.
Of the circles, the Presidency again stands highest, and in British territory
the Southern again the lowest; but even the lowest presents a very fair
figure, and it is 6 per cent. higher than in the preceding year. Dr. Raby
deserves some credit for this improvement, which I have much pleasure in
noticing. His circle is still, however, a good way behind the others, except
Kutch, which is very backward; and what appears to me somewhat singular
is that the station vaccinator of Aden has only 14.9 per cent. of infantile
vaccinations. The Army infantile vaccinations are by far the highest, be-
cause the parents of all the children born in regiments and cantonments are to
some extent compelled to get their children vaccina-
ted, and those who come into the lines to live, if not
already protected by vaccination or small-pox, are at
once vaccinated. This is not an absolute rule, but it
is almost universally practised in the cantonments of this presidency with the
result of keeping our regiments and cantonments very free of small-pox. It
may be said that our cantonments are nearly thoroughly protected, and that
our regiments are so.
Results.
23. The returns show the results for primary vaccinations and re-
vaccinations separately. There are three columns
under each of these headings, viz., 1st, for successful,
2nd for unsuccessful and doubtful success, and 3rd, unknown, or those who
are not seen after the operation and in which the result of it is not known to
the vaccinators. In the British Army the successful cases only are given, so
they are excluded from these remarks.
Result
in primary
vaccinations.
24. There were 635,254 successful primary vaccinations, 23,344 un-
successful and doubtful, 18,103 unknown. In cal-
culating the percentage of success the " unknown "
is excluded, or rather, I ought to say, deducted from
the total. We have then by this method a percentage on the remaining total
of 96.4, or 1.6 higher than in the preceding year. This is satisfactory, but, as
I said in my last report, the percentage of success under the best circum-
stances ought to be 99. It is very unlikely, however, that we can ever have
our circumstances quite perfect with voluntary vaccination and a peregrinat-
ing establishment of vaccinators.
Result in re-vaccinations.
25. There were 45,618 successful re-vaccinations, 10,775 unsuccessful and
doubtful, and 4,789 unknown. The percentage of suc-
cess is 80.8 or 15.1 higher than in the preceding year.
This is an unusually high percentage of success for re-vaccinations, and it sug-
gests the idea that many primary vaccinations are entered in the re-vaccination
12
columns. I mentioned in my previous report that it is very difficult to define
exactly what success is in re-vaccinations, and personally I do not think
these figures are of any exact value as statistics. They are so far of value
that they show a large number of persons have been protected who had only
a very doubtful protection before submitting to the operation of the so-
called re-vaccination. Experience may yet show that re-vaccinations are
more successful than has been generally supposed—a good many of the earlier
writers on this subject based their opinions on very limited numbers. At
all events our knowledge now enables us to state that neither the most
successful vaccination nor the severest attack of small-pox can be predicated as
a sure protection against a future attack of small-pox. There were 651 persons
re-vaccinated in Shikárpur, Karáchi, and Kaládgi Jails and in Her Majesty's
29th Regiment N.I. Of these, 284 only were successful, or 45.6 per cent. If
the result has been noted by the medical officers themselves in each case, these
figures are valuable. Dr. Williams makes some remarks with reference to the
percentage of success, in the Sind circle, which I quote : " The percentage of
" success in re-vaccinations is 85.5—somewhat higher than it was last year.
" This is due to an attempt made to classify the results into ' good', ' mid-
" dling' and 'bad'; so that many that would formerly have been classified as
" unsuccessful come now under the 'bad' denomination. But I am not satisfied
" with this classification for re-vaccinations. I think a better plan would be
"to show on which day the areola formed, whether the 4th, 5th, 6th, 7th, or
" 8th day.
" There is so much diversity of opinion as to what constitutes a success-
" ful re-vaccination that a resort to some arrangement of this kind appears to
" be necessary to obtain results for comparison. An unsuccessful re-vaccina-
" tion should mean nothing but a failure, due either to a bad operation, inert-
" ness of the lymph, or absolute immunity enjoyed by the system against the
" vaccine and variolous diseases. We see by every case of small-pox that there
" are degrees of severity and we know that some persons enjoy immunity
" from it. The degree of infective capacity seems to be shown by the earli-
" ness of the appearance of the areola in cases of re-vaccination, and it would
" seem to me more rational to register the date of the formation of the areola
"and thus give us some idea of the amount of immunity enjoyed, than to
" compel every case to be classified as successful or unsuccessful as though it
" were a case of primary vaccination."
26. The following figures show the percentage of success by circles :—
Sindh
...
...
...
Central ... ...
Eastern Gujarath ...
Southern ... ...
Western Gujarath ...
Western ... ...
Presidency ... ...
Kutch
...
...
...
Baroda ... ... ...
Dispensaries ... ...
Army ... ... ...
Aden ... ... ...
In Primary
Vaccinations.
98.2
97.2
97.1
96.9
95.9
95.3
95.0
93.9
93.2
92.5
91.5
85.8
Average
96.4
In re-vaccina-
tions .
85.9
59.4
69.7
59.7
78.5
57.5
54.0
33.3
83.6
58.4
44.6
83.6
Average
80.8