NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
13
Table No. XIV.
Name of
Circle.
1. Presidency ...
2. Central ...
3. Southern ...
4. Western ...
5. Eastern Guze¬
rat.
6. Western do.
7. Sind
...
...
8. Baroda ...
9.
Cutch... ...
Aden...
...
Superintendent.
Dr. Anantá Chandrobá
Dr. J. Pinkerton ...
Dr. Raby
...
...
Dr. Cody
...
...
Dr. Colah
...
...
Dr. Blomfield... ...
Dr. Willìams ... ...
Dr. Aitkins
...
...
Dr. Dorábji Hormasji.
Dr. Hay
...
...
Total...
Success-
fully vac-
cinated
and re¬
vaccinated.
28,336
135,148
115,777
78,258
81,055
110,916
135,972
34,789
4,770
1,764
726,785
Total cost
excluding pay of
superintendents.
Rs.
7,688
26,470
29,074
23,407
20,770
25,240
24,659
7,326
3,258
216
1,68,112
a.
11
5
7
4
13
8
10
6
1
0
6
p.
1
7
9
5
8
11
8
1
10
0
0
Average
cost of
each suc¬
cessful vac-
cination.
Rs.
0
0
0
0
0
0
0
0
0
0
0
a.
4
3
4
4
4
3
2
3
10
1
3
p.
4
1
0
9
1
7
10
4
11
11
8
Number
of vacci-
nators.
16
63
74
51
46
54
49
23
12
1
389
As compared with 1874-75 there is a reduction, on the whole, of
3 pies. In the Presidency and Cutch circles the reduction is most
marked, being from annas 8-9 to 4-4 in the former and from
14-8 to 10-11 in the latter. In the Central circle there is a decrease
of 4 pies, in the Southern 3 pies, in Sind 5 pies, in Baroda 10 pies,
and in Aden annas 2-3. The Western and Western Guzerat circles
remain the same as in 1874-75, and there is an increase in Eastern
Guzerat circle of 2 pies. The great decrease in the cost of each
successful case in the Presidency circle is owing to the increase
in the number of persons vaccinated during the epidemic, and in
Cutch it appears to be due to better arrangements and extension
of vaccination in that province.
Average cost
of each suc-
cessful vac¬
cination.
33. The average cost of each successful vaccination, includ-
ing all charges, was annas 4-11, or 5 pies less than in the preced-
ing year, which is entirely owing to the extension of vaccination.
Seven pence farthing is a very moderate cost for each successful
vaccination.
Table No. XV.
Government
Municipal
Local Fund
Native States
1875-76.
Rs.
0
0
0
0
a.
1
3
2
3
p.
9
7
2
0
1874-75.
Rs. a. p.
......
0
0
0
4
2
3
7
4
1
34. The cost of each
successful vaccination by
establishments was less in
all than in the preceding
year, as shown in
this
table.
Inspections.
35. The following table shows the travelling and inspections
of superintendents of circles :—
14
Table No. XVI.
Name of
Circle.
1. Central ...
2. Southern ...
3. Western ...
4. Eastern Guze¬
rat.
5. Western do.
6. Sind
...
...
Superintendent.
Dr. Pinkerton ...
Dr. Raby ...
Dr. Cody ...
Dr. Colah ...
Dr. Blomfield ...
Dr. Williams ...
Total...
Number of
encamp-
ments.
66
55
71
70
49
93
404
Number
of travel-
ling days.
83
83
135
187
122
120
730
Distance
travelled
in miles.
1,671
942
2,515
2,082
1,237
2,907
11,354
Number
of villages
visited.
221
121
308
505
238
378
1,771
Number
of
vaccinated
children
inspected.
10,156
5,628
8,013
13,208
15,968
6,406
59,379
Although the number of children inspected is less than in the
preceding year, still. I think each superintendent has seen suffi-
cient children to test thoroughly the work of his vaccinators.
Dr. Williams in Sind has again the greatest number of encamp-
ments ; Dr. Cody stands next. Dr. Colah has again the greatest
number of travelling days. Drs. Williams and Cody have the
highest mileage. Dr. Colah inspected the greatest number of vil-
lages, and Dr. Blomfield the greatest number of children, but
Dr. Colah stands very close to him.
Names tested
in registers.
36. The following table shows the number of children in-
spected by calling the names from the vaccinators' registers :—
Table No. XVII.
Circles.
1. Central
2. Southern
3. Western
4. Eastern Guzerat ...
5. Western do. ...
6. Sind
Total...
Work tested by calling names from registers.
Present during
inspection.
Successful.
Good.
8,743
2,716
7,094
4,653
3,467
602
27,270
Middling.
606
231
461
6,444
1,027
2,665
11,433
Unsuccessful,
including bad.
495
131
314
1,279
725
3,113
6,060
Absent dur-
ing inspec-
tion.
Absence account-
ed for.
4,117
2,608
2,914
3,073
2,691
2,555
17,958
Absence unac-
counted for.
95
...
95
Number of persons whom the
vaccinator has returned as
vaccinated.
Successful.
13,517
5,260
10,206
14,854
7,358
8,116
59,311
Unsuccessful and
doubtful.
247
218
344
448
433
393
2,083
Unknown.
211
211
233
147
204
426
1,432
Total.
13,975
5,689
10,783
15,119
7,995
8.935
62,826
Excess of opera-
tions over Per-
sons.
10
...
..
...
...
10
16
of the year, excluding the army vaccinations, which are performed
under the supervision of the regimental medical officers.
12 Vaccina-
tors dismissed
for falsifying
registers.
40. The inspections show that the vaccinators' registers are,
on the whole, very satisfactorily kept. But I regret to notice
there were 2 vaccinators in British territory dismissed for falsi-
fication, one in Sind and one in the Southern circle. In Native
states 8 were dismissed in Kattywar for this crime, 1 in Cutch,
and a third in Kolhápur. So 12 vaccinators were dismissed for
falsification.
Conduct of
vaccinators.
41. Speaking generally the conduct of the vaccinators has
been satisfactory. In the Central circle the conduct of the vac-
cinators was very good'; Drs. Cody and Colah say the same of
those in their circles. Dr. Blomfield dismissed altogether 11
vaccinators, and fined 22 for various faults. The fines ranged
from Re. 1 to Rs. 30; several were fined as much as Rs. 15.
Considering the pay of a vaccinator is small, it seems to me these
fines are excessive in amount. However, I hope the conduct of the
vaccinators in Dr. Blomfield's circle will now be improved. In
Kattywar harsh measures were necessary to put down falsification,
and the dismissals had my hearty approval; but I am doubtful
about the good effect of inflicting very heavy fines on men drawing
such small pay as vaccinators.
Inoculation.
42. Inoculation is said to be practised in Cutch by 2 men
when small-pox prevails, and I regret to say I have had informa-
tion of it being also carried on by 2 inoculators in Ratnágiri
Zillah. I at once communicated with the Collector, but have
not since heard from him. The vaccinator of Dápuli taluka re-
ported that the police patel of the village of Wágra had 4 of his
own children inoculated with small-pox virus, and that 57 other
children of the village were also inoculated. I think Government
should make an example of this patel, if the Collector have not
already done so. I have not heard of this baneful practice being
pursued in any of the other circles. Mr. Larcom, the Political
Agent at Janjira, informs me that H. H. the Nawab has forbid-
den the practice of inoculation since the introduction of vaccina-
tion. I think the time has now arrived when Government might
forbid its practice in British territory, as there is now means every-
where for people to be vaccinated. A proclamation would be
sufficient.
Vaccino-sy¬
philis.
43. In no instance has syphilis been known to be com-
municated by vaccination, nor has any other ill-effect been ob-
served.
Small-pox.
44. The returns of small-pox which I receive from the Sani-
tary Commissioner are for the calendar year. The total number
registered, is 3,545, but in addition to these there were 54 deaths
in Aden, 1 in the British army, and 9 in the Native army:
total 3,609. This is 298 fewer deaths than in preceding year. I
again state my opinion that the returns of deaths from small-pox
are not of any exact value, because in Western India deaths from
measles are often recorded as from small-pox. The calendar year
1875 was, as regards small-pox, a non-epidemic one, but towards
17
the end of that year small-pox began to assume greater activity,
and in January it burst out into an epidemic of unprecedented
virulence in the city of Bombay, whence it has spread to the
Konkan and Deccan districts.
Small-pox in
Central circle.
45. In the Central circle the deaths from small-pox were
368, or 204 less than in 1874-75.
Small-pox in
Southern cir-
cle.
46. In the Southern circle 1,406 deaths are recorded, or
186 less than in the preceding year.
Small-pox in
Western cir-
cle.
47. In the Western circle the deaths were 420, or 169 of a
decrease as compared with the preceding year. Dr. Cody says :—
" The small-pox registration is on a par with that of the other
" vital statistics, and all are so imperfectly kept as to be alto¬
" gether misleading."
Small-pox in
Eastern
Guzerat cir-
cle.
48. In Dr. Colah's circle there were 880 deaths to 473 of
the previous year. In October I issued a circular to superintend-
ents calling their attention to the circumstance that small-pox
appeared to be acquiring more activity, and requesting them to
push vaccination wherever the disease appeared to be gaining
ground. On the receipt of my circular, Dr. Colah instituted
enquiries in the zillahs of Surat and Kaira as to the correctness
of the returns of deaths from small-pox, and in the following
table he shows that out of 702 deaths said to be from small-pox
only 86 could be made out to be for certain from that disease ;
while 328 were from measles, 70 from fever, 100 from other dis-
eases, 10 said to be dead of small-pox were actually living, and
108 could not be traced. This requires no commentary from me.
Table No. XVIII.
Names of talukas.
Number of villages.
Number of deaths from
small-pox in mámlatdárs'
returns.
Of those found on inquiry to have
died from
Small-pox.
Measles.
Fever.
Other diseases.
Not died but
living.
Not traceable on inquiry.
Surat Collectorate.
Mándvi
...
...
...
Bárdoli
...
...
...
Olpád
...
...
...
Chorási
...
...
...
Jalálpur
...
...
...
Chikhli
...
...
...
Bulsar
...
...
...
Párdi
...
...
...
Surat City
...
...
Randir Town
...
...
Bulsar Town
...
...
Total...
2
5
9
5
4
3
3
...
1
1
1
34
7
8
55
6
5
5
4
...
70
35
13
208
7
7
18
4
...
3
...
...
18
18
...
75
...
...
2
1 1
...
3
...
17
3
6
33
...
...
1
1
2
2
1
...
8
1
3
19
...
1
4
...
2
...
...
...
7
2
2
18
...
...
...
...
...
...
...
...
...
...
...
...
...
...
30
...
...
...
...
...
20
11
2
63
B 106—c
18
Table No.
XVIII.—continued.
Names of talukas.
Number of villages.
Number of deaths from
small-pox in mámlatdârs'
returns.
Of these found on inquiry to have
died from
Small-pox.
Measles.
Fever.
Other diseases.
Not died
but
living.
Not traceable on inquiry.
Kaira Collectorate.
Mehmadabad ... ...
Mátar
...
...
...
Kapadwanj ... ...
Thásra ... ... ...
Nariád ... ... ...
Ánand ... ... ...
Borsad ... ... ...
Total...
7
11
2
5
18
29
24
96
12
52
6
11
129
146
138
494
...
...
3
...
1
5
2
11
8
35
1
8
60
111
72
295
1
6
2
...
15
16
11
51
2
7
...
2
38
7
26
82
...
...
...
...
1
...
9
10
1
4
...
1
14
7
18
45
Small-pox in
Western Gu¬
zerat circle.
49. In Western Guzerat circle, Ahmedabad is the only British
zillah, and in it only is there registration. There were 177 deaths
to 388 in 1874-75, or a decrease of 211. Dr. Blomfield reports
that " small-pox did not prevail as an epidemic, except in the Lilia
" mahal of Kundla, where it commenced in February, and has
" continued to the end of the official year."
Small-pox in
Sind circle.
50. In Sind there were 48 deaths recorded by the Sanitary
Commissioner to 31 in 1874-75. Dr. Williams says he has receiv-
ed information, from his assistants and vaccinators, of 90 deaths
among 447 cases, or 22.4 per cent. of deaths to attacks, which is
not half as high as in the city of Bombay, and just little over half
the percentage in Aden.
Small-pox in
Cutch.
51. In Cutch Dr. Dorabji Hormasji says :—"Small-pox is
" not much heard of this year ; only a few solitary cases were re¬
" ported by the vaccinators."
Small-pox in
Aden.
52. In Aden, Dr. Hay states, " 157 cases of small-pox were
" treated during the year : all, with a few exceptions, occurred
" during the last three and half months of the official year." 13
were imported, and the rest occurred in Aden. Vagrants were
the greatest sufferers. The deaths were 54, or 41 per cent. of
attacks. Dr. Hay is of opinion the disease was originally import-
ed from Jeddah. 36 of the attacked had been vaccinated, and 3
had suffered from the disease before.
Small-pox in
Presidency
circle.
53. In the Presidency circle, i.e. Bombay city, the deaths
during the calendar year were only 246, or 12 fewer than in the year
1874. This is the smallest number of deaths since 1862, and
only in 3 years in the last 26 have there been smaller numbers.
Through the courtesy of Dr. Weir, the Health Officer of Bombay
city, I have returns of deaths till the 30th of April 1876. In these
first four months of the year, 2,717 deaths occurred among 5,870
19
cases of small-pox ; this is 46.2 per cent. of deaths to attacks. Mr.
Ananta Chandroba in his report says:—" The past year has been
" remarkable on account of the epidemic of small-pox that prevail¬
" ed during the last three months of the official year, and which has
" not yet (17th May 1876) died out. It is remarkable not so much
" on account of its extent, for some 5,000 cases only were reported,
" but rather on account of the suddenness of its advent, rapid spread
" over the city, virulence, and fatality. Indeed, such virulent
" small-pox has not been seen in the memory of man. In the course
" of January, February, and March 1876, 2,062 persons fell victims.
" During the first few months of the official year 1875-76 measles
" were very prevalent, and caused a considerable mortality ; and it
" was found on enquiry that not a few of the deaths from measles
" had been recorded as from small-pox. The following table
" shows the small-pox deaths by months as recorded by the Health
" Officer of the city of Bombay :—
Table No. XIX.
April 1875.
36
May.
32
June
25
July.
24
August.
11
September.
6
October.
4
November.
10
December.
39
January 1876.
200
February.
646
March.
1,216
Total.
2,249
" There was also another circumstance which struck many with
" terror, and that was a belief that there were many persons attack¬
" ed by the disease who had been vaccinated in infancy, or were
" protected by a previous attack of the disease. How far this
" belief had any support by facts, I am unable to say, but I have
" not myself seen a single instance of small-pox in a person pre¬
" viously protected by an attack of the disease. I know from per¬
" sonal experience that people here are very apt to confound small¬
" pox with chicken-pox, and persons having an attack of the latter
" are credited with having the former. That people protected by
" vaccination did get small-pox cannot be doubted, though the num¬
" ber of such cases have been very small indeed. That Europeans
" and foreigners showed great predisposition to the disease, is
" also a fact; and strangely, too, there was a high rate of mortality
" among them. It was these circumstances which caused the Euro¬
" pean community to be re-vaccinated in such numbers. I do
" not know of a single instance of small-pox in an European child
" who had been successfully vaccinated in Bombay."
54. With the view of obtaining precise information about
the epidemic of small-pox in the city of Bombay, I have addressed
the following letter to all practitioners and medical officers in the
city, No. 169 of 1876-77, dated Bombay, 1st May 1876 :—"Sir,—
It is very desirable the profession and the public should know
20
how far vaccination and re-vaccination have afforded protection
from death by small-pox in the present epidemic in the city of
Bombay. I, therefore, take the liberty of asking you, for the pub-
lic good and in the interest of science, to kindly fill up, in the form
on the back of this letter, the particulars of cases of small-pox
which have come under your cognizance as far as you can, and
return the form to me after the 1st July next, by which time I hope
the epidemic will have completely ceased.—I have, &c."
Table No. XX.
Showing the particulars as regards the protection and non-pro-
tection in cases of small-pox in the present epidemic ; also the
ages of the persons attacked by small-pox; the number of
cases and deaths in each class.
Classification.
1st.—Unvaccinated ... ... ... ...
2nd.—Stated to be vaccinated, but having no
cicatrix ... ... ... ... ...
3rd.—Vaccinated—
(a).—Having 1 vaccine cicatrix ...
(b).—
„
2
„
cicatrices ...
(c).—
„
3
„
„
...
(d).— „
4 „
„ ...
(e).— „
5 „
„ ...
(f).— „
6 or more
„ ...
A. Having well-marked cicatrices ...
B.
„
badly-marked „ ...
C. Re-vaccinated ... ... ...
4 th.—Having previously had small-pox ...
5th.—Ages—
(a).—Under 1 year old
...
...
(b).—From 2 to 6 years old ... ...
(c).— „
7 to 12 „
„ ... ...
(d).—Above 12
„
„ ... ...
Number of cases
in each class.
Number of
deaths in each
class.
If I can make anything of the information I will submit it to
Government.
Small-pox af-
ter successful
vaccination
or after
having been
protected by
small-pox
itself.
55. I asked superintendents to make a note of any instances
of small-pox occurring after good vaccination. Dr. Cody says :—
" There have been some instances reported, but I have seen none
" myself—they were in every case mild." Dr. Williams says :—
" There is no instance of recurrence of small-pox in any indivi¬
" dual, but many instances of its occurrence in people who have
" been inoculated with the small-pox virus; and several of them
22
" cinations are sufficiently prophylactic, there cannot be the shadow
" of a doubt; and eventhe death reports of the registration depart¬
" ment, imperfect as they are proved to be, give ample corrobor¬
" ation of the fact. Out of 2,272 deaths from small-pox, informa¬
" tion regarding previous vaccination is recorded in 1,998 cases ;
" and of these in only 149 instances is vaccination reported to have
" been performed. The rest were not vaccinated at all. That 149
" even is not the correct figure, will be seen when it is known that
" in two of these instances the children were barely 2 months
" old when they were attacked with small-pox. That these were
" previously vaccinated, and that too successfully, is not at all likely.
" One of these 149 previously vaccinated, is reported to have died
" from small-pox, the disease being only of 8 hours' duration !
" How this was found out, is to me a mystery, seeing that the pre¬
" liminary fever itself is of 3 days' duration; and, unless the
" eruption makes its appearance, nothing can be positively affirmed."
56. I will now review the work of the different establish-
ments—
Work of the
Government
vaccinators.
57. The 2 Government vaccinators employed in Rájkot
and Deesa vaccinated 4,763 persons, or 75 less than in 1874-75.
Their percentage of success in primary is 97.7, and in re-vaccina-
tions 50.9. The cost of each successful case was annas 1-9.
Work of mu-
nicipal vacci-
nators.
Table No. XXI.
Presidency Circle ...
Central
do. ...
Southern
do. ...
Western
do. ...
Eastern Guzerat Circle.
Western
do. ...
Sind Circle ...
Aden do. ...
Net Increase..
In-
crease.
20,951
224
104
218
173
...
210
1,085
22,965
21,766
De-
crease.
...
...
...
...
...
1,199
...
...
1,199
58. The municipal vaccinators numbered 50, or 1 less
than in last report—Gokák one having being abolished. They
performed 81,766 vaccinations, or 21,766 more than in the pre-
ceding year, chiefly accounted for by the great increase in the
Presidency circle. The in-
crease in the other circles is
slight, but in Aden there is a
very great increase in the one
vaccinator's work. A decrease
took place in the Western
Guzerat circle, chiefly notice-
able in the work of the vacci-
nators in the towns of Dhan¬
duka and Ahmedabad. The
superintendent does not notice
any reason for the decrease,
but it is probably owing in
the former town to there now
being 2 other vaccinators in
the taluka of Dhanduka, and
the latter to the subjects being
fewer. Each municipal vacci-
nator on an average operated on 1,635 persons, or 459 more than
in the year preceding, or 360 below the general average; but the
municipal vaccinators have a more limited sphere than the local
fund vaccinators, and it is more difficult to get a busy town people
to vaccinate their children than the inhabitants in rural villages.
The percentage of success was 95.7 in primary vaccinations, or
0.2 less than in 1874-75. The cost of each successful vaccina-
23
tion was annas 3-7, or 1-0 less than in the preceding year. On
the whole the work of these vaccinators has been satisfactory.
Work of the
local fund
establish-
ment.
Table No. XXII.
Central Circle ...
Southern do. ...
Western do. ...
Eastern Guzerat Circle.
Western
do. ...
Sind Circle ...
Net Increase ...
In-
crease.
8,256
8,145
3,321
...
1,460
14,376
35,558
34,662
De-
crease.
...
...
...
896
...
...
896
59. There were 207 local fund vaccinators, or 4 more than
in the preceding year—3 of an increase in Belgaum, 1 in Nasik,
and 1 in Ahmedabad, but in Sind one of the vaccinators in the
Upper Sind Frontier district was unemployed throughout the
year. These 207 vaccinators operated on 462,320, or 34,662
more than in the preceding year. The increase is most marked
in Sind, and there the increase
is wholly in re-vaccinations.
The best increases are in the
Central and Southern circles,
as shown by those figures.
The decrease in the Eastern
Guzerat circle is only to a small
extent, but as there is some
room for extension still in this
circle it is to be regretted.
Each vaccinator operated on
2,233 on an average, which is
238 above the average of the
whole department for this
year, and is 127 above their
average in 1874-75. The per-
centage of success in primary
vaccinations is 97.8, or 0.8 higher than in the previous year. Each
successful vaccination cost annas 2-2, or pies 2 below the previous
year. Progress is very satisfactory, but a few more vaccinators
are required in Poona and Ratnágiri zillahs.
Work of na-
tive states'
vaccinators.
Table No. XXIII.
Central Circle ...
Southern do. ...
Western do. ...
Eastern Guzernt Circle.
Western
do. ...
Sind Circle ...
Baroda do. ...
Cutch do. ...
Net Increase ...
In-
crease
3,663
5,053
...
...
4,514
...
8,844
2,208
24,282
15,797
De-
crease.
...
...
2,383
1,950
...
4,152
...
...
8,485
60. In native states there were 130 vaccinators employed, or
1 more than in the previous year; he was appointed in Cutch.
One of the 2 men in Janjira was reduced in October, so that at
the close of the year the actual number was 129. They vacci-
nated 227,453, or 15,797 over the year preceding the one under
report. The greatest increase
is noticed in the Baroda circle;
but there has also been con-
siderable progress in the
Southern, Western Guzerat,
Central, and Cutch circles.
The decreases occurred in the
Sind, Western and Eastern
Guzerat circles.
The de-
crease in Sind is in primary
vaccinations, and Dr. Williams
considers it due to want of
subjects.
In the Western
circle there was 1 vaccinator
reduced, and in Jawhár the
vaccinator was sick for some
time. The decrease in the
Eastern Guzerat circle is also