NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
5
for the operation ; and in some instances a fear of offending the dreaded " Devi "*
when actually present, or the fear of having to undergo certain trivial expenses
which vanity usually prompts them to make,—nothing beyond these seriously
obstructs the working of the vaccine establishment in Bombay ; but, too often,
these are more than sufficient to allow small-pox to spread at the cost of valuable
lives ; and nothing short of legal compulsion can, in my opinion, alter this state of
things. An Act of the Legislature rendering vaccination compulsory is much re-
quired in this city, and can alone remove these obstructions.
Progress of the vaccinia.
No disease other than the
cow-pox observed.
9. No irregularity in the progress of the vaccine disease, nor any ill effects
beyond an ulcerative action now and then, set up at
the seat of the vesicles, in scrofulous and weakly
children, which heal tardily, have come under my observation. I have very strong
reasons to believe that this ulcerative action is often, if not always, the result of
the scratching or irritation of the vesicles. The introduction of any other disease
but cow-pox must be quite out of the question, at
least in those that are vaccinated with animal-lymph.
In those comparatively few that were vaccinated
with lymph from the human subject also nothing of the kind was observed.
Protective influence of vac-
cination.
10. Vaccination continues to keep up its character of a prophylactic against
small-pox, in Bombay. No deaths from small-pox
occurring in persons known to be protected by
vaccination has come under my observation; nor
have I heard of any except the two cases already mentioned.
* Goddess of small-pox.
6
CENTRAL CIRCLE.
Superintendent.— Surgeon Major P. S. Turnbull, M.D.
Acting Superintendents.—Surgeons
J. Robb, M.B.. and W. R. Gordon, M.B.
Establishment.—6 Assistant superintendents, 2 clerks, 48 vaccinators under
local funds, 12 under municipalities, and 5 under native states. Total 65 vaccinators
and 21 dispensaries.
Population 4,828,850. Total cost Rs. 34,133-2-10. Average cost of each
successful case 5 annas and 2 pies.
Establishment.
Local Funds
Municipalities
Native States
Dispensaries
Years.
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
Total
number
of per-
sons vac-
cinated
and re-
vaccina-
ted.
97,154
99,126
13,458
12,722
5,097
5,492
3,851
4,201
Compared with
the preceding
year.
Increase.
...
1,972
...
...
...
395
...
350
Decrease.
...
...
...
736
...
...
...
...
Successfully
vaccinated.
86,643
90,475
10,306
10,242
4,412
4,874
3,126
3,575
Percentage of suc-
cess, excluding,
"those unknown"
from the total.
In pri-
mary
vaccina-
tion.
94.9
95.9
92.2
94.7
93.2
95.7
91.4
91.6
In
re-
vaccina-
tion.
63.3
63.3
37.5
20.0
100.0
33.3
31.3
51.7
Increase.
Decrease.
From the above table it will be observed that there is an increase in all the
establishments, except the municipal. In the local
funds and native states, I consider this due, in a
great measure, to the careful supervision, and con-
stant inspection of the vaccinators' work by the assist-
ant superintendents. The increase at dispensaries is no doubt due to the strin-
gent orders by the Surgeon General, which have been issued to the medical
subordinates in charge of dispensaries. Three new dispensaries have been opened
during the year, but at these there has not been much vaccination done as yet. At
two of them 48 children were vaccinated and at the third none. At the Wáí
dispensary there is a decrease of no fewer than 441, for which I am unable to
offer any satisfactory explanation. The municipal establishment shows a decrease
of 736. This has occurred from the abolition of the municipal vaccinatorships
of Khánápúr and Bárámatí. But it is satisfactory to observe that the number
successfully vaccinated is only 64 less than the previous year. Over the whole
circle there is an increase of 1,981 vaccinations.
Average operations per man.
2. The average number of persons vaccinated by each vaccinator exceeds
that of the preceding year by 78. The average
number vaccinated by each local fund vaccinator was
2,065, by each municipal vaccinator 1,060, and by
each native state's vaccinator 1,098.
Percentage of sex, caste, age
and success.
3. The following table will show the percentage of sex, caste, age and
success of those primarily vaccinated, and percentage
of success of those re-vaccinated as compared with
1872-73 :—
7
Year.
1873-74
1872-73
Sex.
Male.
51.2
51.5
Female.
48.8
48.5
Caste.
Christian.
.38
.18
Hindú.
84.5
86.2
Musalman.
4.5
5.1
Pársí.
.02
.01
Other Castes.
10.6
8.5
Age.
Under one
year.
37.8
28.6
Above one
year.
62.2
71.4
Percentage of
success.
In primary
vaccination.
95.8
94.8
In re-vacci-
nation.
63.0
62.5
As far as regards sex and caste, there is very little difference from the
preceding year, but it will be observed that there is the very satisfactory increase
of 9.2 per cent. of infantile vaccinations, and that the percentage of success in
primary vaccination is 1.3 above that of 1872-73.
Lymph, vesicles and cica-
trices.
4. The lymph in use throughout the year has been
reported to be good and active, the vesicles large and
characteristic, and the cicatrices deep and foveated.
Inspection of vaccinators'
work.
5. The vaccinators' work has been tested by the superintendent and assis-
tant superintendents calling over the names of 78,006
children from the vaccinators' registers, of these
95.6 per cent. were returned by the vaccinators as
successful vaccinations, but on inspection only 92.2 per cent. were found success-
ful. On examining this number in detail I find that 75.5 per cent. were found
to bear good vesicles or cicatrices, 13.2 middling and 3.5 bad.
6. As I have only been in charge of the circle from 8th March I have
confined my remarks to these few words which are based on the figures of the
present as compared with the previous year.*
As returns for ten months only of the year have been received, it is not pos-
sible for me to state exactly the results of the year's operations. I shall therefore,
in the following report confine myself to the period from the 1st April 1873 to
the 1st February 1874.*
2. I assumed charge of the circle from Surgeon Robb on the 12th August
last, after I was relieved of the Acting Superintendent Generalship, on the return
of Dr. Pinkerton from furlough, and am therefore personally acquainted with the
workiug of the circle during the seven months preceding the 8th March 1873,
the date of my giving over charge to Surgeon Gordon, and of my proceeding on
privilege leave for three months.
3. Government were pleased, in their Resolution No. 2783 of the 7th August
1873, to approve of a scheme which I submitted when I was Acting Superin-
tendent General for the re-distribution of the vaccine circles and ordered that
the re-distribution should take effect from the 1st November 1873. This was
done and as far as this circle is concerned, with the following result. Khándesh
and Násik collectorates with the Penth state were transferred from the Central
* Dr. Turnbull took three months' privilege leave on 8th March 1874, his report is therefore
for ten months of the year. Dr. Gordon compiled the annual returns and wrote the preceding
part of this Circle's report.
14
but then he prevaricated so much I could not rely on a single word he said.
I was obliged to bring these and other matters to the notice of the political agent.
In my report for 1872-73 as Acting Superintendent General of Vaccination I
made a few remarks on the necessity for employing an additional vaccinator in
the Bhor state. Since I re-assumed charge of this circle I have submitted through
the political agent a detailed statement of what I propose should be done. I hope
the scheme will be carried out.
From Bhor I went via Jejuri to Saswad and inspected the work of the Pu-
randhar taluka vaccinator and the Jejuri and Saswad dispensary medical officers
en route. The vaccinator I found working steadily and successfully. As also that
at Saswad some vaccination work had been done. But at Jejuri no work what-
ever had been done and the hospital assistant was unable to do any. From
Saswad I went to Poona, for the purpose of undergoing an examination in the
Marathi language. Having passed successfully I proceeded on the 3rd March to
visit the Mawal taluka and thence on the 8th I proceeded on three months' privi-
lege leave.
During four months I inspected the whole of the Ahmadnagar and Poona
collectorates, a considerable portion of Sholapur and the Malsiras and Wai talu-
kas of Satara with the native States of Bhor and Phaltan. I travelled 1,091
miles, visited 202 villages, and inspected 4,863 vaccinated children, the work of
about 25 vaccinators and 8 dispensary medical officers.
15
SOUTHERN CIRCLE.
Superintendent.—Surgeon
J. Raby.
Establishment.—5 assistant superintendents,* 2 clerks, 37 vaccinators under
local funds, 6 under municipalities,† and 25 under native states. Total 68 vacci-
nators and 20 dispensaries.
Population 4,757,127. Total cost Rs. 31,885-15-2. Average cost of each suc-
cessful case 6 annas and 3 pies.—
Establishment.
Local funds
Municipalities
Native states
Dispensaries
Year.
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
Total
number
of per¬
sons vac-
cinated
and re-
vaccinat¬
ed.
39,804
54,347
4,717
5,224
31,050
33,475
5,126
3,602
Compared with
the preceding
year.
Increase.
.....
14,543
.....
507
.....
2,425
.....
.....
Decrease
......
......
......
......
......
......
......
1,524
Successfully
vaccinated.
34,149
46,637
3,965
4,550
27,132
29,787
4,222
2,711
Percentage of
success excluding
those "unknown"
from the total.
In pri-
mary
vaccina-
tion.
90.8
92.2
91.9
94.5
92.9
93.7
87.5
89.8
In re-
vaccina-
tion.
51.1
61.2
59.1
58.9
73.5
61.0
64.1
35.9
Remarks regarding the ill
effects of frequent changes of
superintendents.
This is the first report I have had to submit since the re-organization of the
department in 1871, and though other reports have been submitted since then by
acting superintendents, who for the most part were only acting for a few months
of the year, and consequently could not become ac-
quainted with the vaccinators or the districts, yet
such justice could not, or was not done to this circle,
as under other circumstances and fewer changes
might have been the case. For instance in April 1872 Dr. Robb, who had been
acting for six months in this circle, was transferred to the Central circle, and
again a new superintendent appointed, who had to go over all the work of Dr.
Robb, in order to get a knowledge of the work and the vaccinators. The conse-
quence was that one collectorate of this circle was left entirely unvisited by any
superintendent for over three years.
Progress.
2. The return of numbers vaccinated by the different establishments for the
year 1873-74 compares very favourably with those of
past years, in most respects, excepting dispensaries
—and it affords me considerable satisfaction, which I
venture to think will be shared by the Superintendent General of Vaccination, to be
able to show such a decided improvement, not only in the numbers actually vac-
cinated, but in the higher percentage of success and in some reduction of the
* One of them is maintained by Kolhapur State.
† A seventh was appointed for Dharwad just before the year closed.
24
WESTERN CIRCLE.
Superintendent.—Surgeon
T. Cody.
Establishment.—6 assistant superintendents,* 2 clerks, 42 vaccinators under
local funds, 4 under municipalities, and 3 under native states. Total 49 vacci¬
nators, and 18 dispensaries.
Population 3,070,259.—Total cost Rs. 27,850-5-11. Average cost of each
successful case 7 annas and 1 pies.
Establishment.
Local funds . . . . . . . . . . . . . .
Municipalities . . . . . . . . . . . . .
Native states . . . . . . . . . . . . . .
Dispensaries . . . . . . . . . . . . . .
Years.
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
Total
number
of per-
sons vac-
cinated
and re-
vaccinat-
ed.
56,137
60,298
2,596
2,642
2,979
6,016
1,914
2,334
Compared with
the preceding
year.
Increase.
......
4,161
......
46
......
3,037
......
420
Decrease
......
......
......
......
......
......
......
......
Successfully
vaccinated.
51,096
54,482
2,311
2,352
2,652
5,612
1,589
1,964
Percentage of
success excluding
those. " unknown"
from the total.
In pri-
mary
vaccina-
tion.
93.6
93.6
95.6
93.1
94.5
95.7
86.7
856
In re-
vaccina
tion.
72.9
68.4
68.7
56.8
14.2
85.7
68.8
74.1
Changes in the circle.
The figures for the year 1872-73 in the above table are not those shown for
this circle as it then existed, but represent the returns
for that year from the different districts of which it
is now composed. While in the year 1872-73 this circle comprised the collecto¬
rates of Tháná, Kolábá, and Ratnágiri, with the native states of Jáwár, Janjirá
and Sáwantwádi. it new comprises the collectorates of Tháná, Kolábá, Násik
and Khándesh with the native states of Jawár, Janjirá, and Penth. and the returns
from the several districts for the year 1872-73 are taken from that year's printed
report and given here, so as to be able to contrast the work for that season with
the year under report.
Increase in circle.
2. So contrasted I have to show under every establishment head an increase
which aggregates 7,664. The most marked increase,
4,161, took place in the local fund establishment, but
this increase, though apparently large, falls short of what I might have expected ;
because the local fund vaccinators in Tháná collectorate are over two thousand
operations short this year as compared with last; and such a great drawback in
part takes away from the otherwise good progress made in the other collectorates.
This falling away in Tháná took place altogether during the rainy season ; as from
June to October inclusive the average number of operations monthly barely reach-
ed 700 for the whole collectorate. A large rainfall which materially interferes with
an itinerant vaccinator's progress, offers part explanation of this backwardness,
* Only 5 have as yet been employed.
32
EASTERN GUJARÁTH CIRCLE.
Superintendent.—Mancharjí
Beramjí Colá, M.D.
Establishment..—4 assistant superintendents, 2 clerks, 25 vaccinators under
local funds, 3 under municipalities, 18 under native states. Total 46 vaccinators
and 20 dispensaries.
Popluation, 3,112,490. Total cost Rs. 26,091-6-2. Average cost of each
successful vaccination 5 annas and 6 pies.
Establishment.
Local funds . . . . . . . . . . . . . . . . . . .
Muncipalities . . . . . . . . . . . . . . . . . . .
Native states . . . . . . . . . . . . . . . . . . .
Dispensaries . . . . . . . . . . . . . . . . . . . .
Years.
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
Total
number
of per-
sons vac-
cinated
and re-
vaccinat-
ed.
45,952
48,249
4,395
4,866
24,253
28,985
3,606
3,484
Compared with
the preceding
year.
Increase.
......
2,297
......
471
......
4,732
......
......
Decrease
......
......
......
......
......
......
......
122
Successfully
vaccinated.
42,396
44,234
3,620
3,771
22,364
26,846
3,250
3,223
Percentage of
success, excluding
those "unknown"
from the total.
In pri-
mary
vaccina-
tion.
96.1
95.0
96.5
92.9
94.4
94.7
93.9
94.7
In re-
vaccina-
tion.
73.4
71.1
76.2
52.6
80.6
66.6
48.9
43.1
Changes in the circle.
When my last report was submitted there were three circles of vaccination in
Gujaráth, viz., the Káthewád, Northern, and Rewá
Kánthá circles. This arrangement continued up to
the 1st November 1873 when certain changes occurred ; and as in 1854, so again,
Gujaráth is divided into two circles of vaccination, viz., the Western and Eastern
Gujaráth circles ; but there is this difference, Mahi Kánthá is now in the Eastern
Gujaráth circle whereas in 1854 it was in the Western Gujaráth circle. Ahmad¬
ábád zilha and the native state of Pálanpur, both very populous and in which vac-
cination was well established, have been taken away from my circle, and Panch
Maháls and Rewá Kánthá, both comparatively less populous and somewhat back-
ward in vaccination, have been transferred to it.
Increase.
Decrease in Khedá zilhá.
2. From the last printed annual report of vaccination I have taken the
work of the several establishments which now con-
stitute this circle and have drawn out the usual com-
parative statement at the head of this report: from which it will appear that,
there is a small increase of vaccination by the local funds, municipal and native
states' establishments and a very trifling decrease in the work performed at the
dispensaries : but in the grand total there is an increase of 7,378. Taking the
work of the zilhá establishments separately, as given in statement No. I., it appears
that, there is a goodly increase in all districts, except Khedá, where the decrease
amounts to 1,531. I am unable to state exactly the
cause of this decrease ; but the prevalence of small-
pox in this zilhá, from December 1872 up to May 1873, may have caused parents
to get the majority of their children vaccinated during the months when, the
38
WESTERN GUJARATH CIRCLE.
Superintendent.—Surgeon
Major E. R. Butler, M. D.
"Establishment.—3 assistant superintendents, 2 clerks, 2 vaccinators under
Government, 7 under local funds, 5 under municipalities and 38 under native
states. Total 52 vaccinators and 12 dispensaries.
Population 3,142,153. Total cost Rs. 24,421,-10-4. Average cost of each
successful vaccination 3 annas and 11 pies.
Establishment.
Government
Local funds..................
Municipalities
Native states...............
Dispensaries...............
Years.
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
Total
number
of per-
sons vac-
cinated
and re-
vaccinat-
ed.
3,177
4,380
13,067
13,512
7,061
8,008
87,415
82,775
1,679
2,578
Compared with
the preceding
year.
Increase.
...
1,203
...
445
...
947
...
...
...
899
Decrease
...
...
...
...
...
...
...
4,640
...
...
Successfully
vaccinated.
2,749
3,361
11,814
12,033
6,455
7,298
80,772
75,118
1,462
2,284
Percentage of
success exclud-
ing those unknown
from the total.
In pri-
mary
vaccina-
tion.
90.7
92.4
94.3
94.1
96.0
95.6
96.1
96.0
92.7
91.8
In re-
vaccina-
tion.
62.5
42.8
91.1
78.6
80.7
79.2
70.9
77.9
92.8
76.7
Change in circle.
The three principal subjects for report this year are:—1st, the union of the
Ahmadabad collectorate and the Páalanpur states with Káthewád under the name
of the Western Gujaráth circle:—2nd, the census
having been taken the population was found to be
much greater than that given in last year's report :—and 3rd, the large increase in
the number of vaccinations at dispensaries in Kathewád. It is rather early to
report upon the working of the Western Gujaráth circle, but Imay mention that it is
impossible to travel over the whole circle in one year ; and I am afraid on this
account, the Kathewád total of vaccinations, will not be so large as last year; for
it is a patent fact that after the superintendent has visited a táluká the returns
are always more voluminous.
Lymph.
2. The lymph generally has been good, but the vesicles as a rule were small.
The English lymph turned out well and the vesicles
produced by it were of fair average size. I have dis-
tributed it all over the Ahmadábád collectorate and over a great part of Kathewad.
Small-pox.
3. Three severe outbreaks of small-pox have been reported from the Dhan-
duká táluká, from Dhánk in Gondal and from Morvi.
In Dhanduká it is still prevailing, the affected villages
41
demanding fees ; he has since left the service. In Jámnagar the work was very
good but many villages had not been visited during the year. In Judiá and
Dharol the work was good and there were few unprotected childern. To sum up,
I travelled through the Ahmadábád collectorate, the south-west and north-west,
centre and cast, of Kathewád; and from what I saw, with the exceptions men-
tioned, I believe the majority of the people were protected by vaccination, and that
the vaccinators, as a body, were doing a fair average of work.
Conduct of assistant super-
intendents and vaccinators.
10. I have great pleasure in bringing to the notice of the Superintendent
General the able assistance I have received from
Assistant Superintendent Rancboddás Mangaldás and
Assistant Superintendent Sardármia Nánamia ; they
have done most valuable service in controlling the spreading of small-pox,
as already mentioned. The vaccinators have on the whole worked well ; there are
a few exceptions. Most of them have suffered more or less from sickness, and
I have found great difficulty in procuring men to act for them, indeed in many
instances the breach has not been filled and has resulted in the loss of lymph,
which has, in some places, been re-introduced with much difficulty ; very many
supplies of lymph in tubes having been destroyed in the post office by the stamping.
6 VAC
42
SINDH CIRCLE.
Superintedent.—Surgeon
J. Williams, M.D.
Establishment.—6 assistant superintendents, 2 clerks, 43 vaccinators under
local funds, 5 under municipalities and 2 under a native state, and 21 dispensaries.
Population 2,300,711. Total cost Rs. 32,538-4-11. Average cost of each suc-
cessful vaccination 5 annas and 3 pies.
Establishment.
Government
Local funds
Municipalities
Native states
Dispensaries..................
Years.
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
1872-73
1873-74
Total
number
of per-
sons vac-
cinated
and re-
vaccina-
ted.
288
......
65.402
92,521
8,228
10,482
1,941
4,331
2,455
3,790
Compared with
the preceding
year.
Increase.
......
......
......
27,119
......
2,254
......
2,390
......
1,345
Decrease.
......
288
......
......
......
......
......
......
......
......
Successfully
vaccinated.
276
......
62,287
85,879
7,145
8,963
1,486
4,066
2,194
3,359
Percentage of
success excluding
those "unknown"
from the total.
In pri-
mary
vaccina-
tion.
100.0
......
97.9
97.8
94.6
95.3
79.1
95.2
93.7
92.8
In re-
vaccina-
tion.
100.0
......
73.6
79.5
61.3
72.3
......
......
72.7
98.3
Decrease.
Increase.
There was no Goverment vaccinator engaged last year, hence the decrease
of 288.
Ther e
were 111,124 persons vaccinated
against 78,314 in the preceding year, being- an in-
crease of 32,810. Of these 954 belong to the native territory of Jodhpur and 389
to Khilat state. The increase is due chiefly to in-
creased exertion on the part of the assistant superin-
tendents and the vaccinators, owing to the constant invasions of small-pox into
nearly every part of Sindh ; it is due also to the appointment of two additional
assistant superintendents : to H. H. Mir Alimurad appointing a second vaccina-
tor to work in his state and to increased efforts on the part of dispensary officers.
Revaccination accounts for 5,433 of the increase, and after deducting those vac-
cinated in the territories of Jodhpur and Khilat, there remain 26,034 as the in-
crease in primary vaccinations in this circle. Shown according to collectorates, the
increase is distributed as follows :—Shikárpur 16,197 ; Thar and Párkar 4,559 ;
Karáchi 4,093 ; Jacobabad 3,007 and Haidarábád 1,229. These figures remind
me that Mr. Hássá Mal, assistant superintendent, was in charge of his district—
Upper Sindh—for less than four months in the year previous ; that Mr. Lál
Baksh was in charge of the Thar and Párkar for six months only ; and that two
of the Jacobabad vaccinators were at work for some five months only in that
year. This shows how valuable the above assistants have proved themselves to
be. The increase seems pretty evenly distributed over caste and sex, but in point
of age those " above 1 year " largely predominate. This is due to an effort