NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
19
13. The first work I examined was that of General No. 58, Mahdew Vaniek, in
the talooka of Bassein. The town of Bassein, with a large number of villages in its
neighbourhood, came first in order. I found the work here very well done, that
is to say, what I saw of it, and the returns quite correct. I regret to say that small-
pox prevailed there at that time to some extent. It was principally confined to a
temporary village, erected and inhabited by the fishermen with their families, during
the dry season, for their greater convenience in pursuit of their daily avocations. Its
site is generally under water during the monsoon, and seems to be composed of mud
caked by the sun's rays. It certainly seemed a most likely place to foster or beget an
epidemic disease, for a more frightful stench I never experienced than assailed me on
every side from the quantities of animal matter that were strewn about in every conceiv-
able stage of decay. The people, too, I found were any thing but willing or anxious
to have their children vaccinated ; they readily enough produced the old operations for
inspection, but were tardy, or rather unwilling, to have new ones done, though small-
pox at the time was making its ravages amongst them. This, I think, may be attri-
buted to the extra care and attention a child who has been vaccinated would be likely
to entail on them, at this their busiest part of the year, rather than to any real objection
they have to the operation itself.
14. The other portions of the talooka which I visited were I found comparatively
free from this disease ; the people were much more alive also to the benefits to be
derived from vaccination, and showed me in comparison a far greater number of opera-
tions, all of which seemed well and carefully performed.
15. I next examined the work of General No. 296, Kondajee Mukumdrow.
His returns I found correct, but his lymph was exceedingly bad. I renewed it for
him with some points of English lymph I received from the Superintendent General
of Vaccination for trial, and warned him to be more careful for the future. I must
here mention the difficulty I found in collecting children for inspection in the towns
of Bhewndy and Callian. The officials were eager enough to render every assistance
in their power, but such good intentions were frustrated by the indifference of the
people. In the smaller towns and villages I found it easy enough to see all, or nearly
all, the operations the Vaccinator had performed, and was consequently in a position
to satisfy myself as to the quality of his work ; but in the larger towns I could not
do this so easily.
16. During my tour I am sure I saw just as many children unprotected as were
vaccinated. A good many of them no doubt were protected by small-pox and in a few
rare instances I saw marks of inoculation, but this was propagating the evil that vac-
cination is intended to guard against. Looking at the. fewness of the Vaccinators in
such a large Collectorate as Tanna, it is impossible that it should be otherwise. There
are only six men to meet the requirements of a district nearly 10,000 square miles in
area, and having a population of nearly one million.
20
NORTHERN CIRCLE.
Superintendent—MUNCHERJEE BYRAMJEE COLAH M.D. (Acting).
Establishment—Thirty-three Vaccinators under Government, twelve under Native
Chiefs, two under Municipalities, and three Dispensaries.
Population 2,715,765. Total cost, Rs. 18,734-8-0. Average cost of each Vac-
cination, 3 Annas and 2 Pies.
Establishment.
Government ....
Native Chiefs ..
Municipalities ..
Dispensaries .. ..
Years.
1867
1868
1867
1868
1867
1868
1867
1868
Total.
Vaccinat-
ed.
68,282
71,203
20,553
23,080
1,253
2,175
..
200
Compared with the
preceding year.
Increase.
..
2,921
..
2,527
..
922
..
..
Decrease.
..
..
..
..
..
..
..
..
Successfully
Vaccinated.
63,293
65,403
18,376
20,939
1,176
1,999
..
178
Percentage
of Success.
91.2
91.8
89.4
90.7
93.8
91.9
..
89.0
Vaccination in this Circle has been carried on satisfactorily during the past year.
The above abstract of the annual returns shows an increase of 2,921 in the number of
children vaccinated by the Government establishment, and an increase of 2,527 in the
operations performed by the Native States' Vaccinators. Comparing the totals of the
last six years, it appears, from the subjoined table, that the past year's work exceeds
slightly the total of 1865, the year in which the highest number was attained.
Years.
1863
1864
1865
1866
1867
1868
Total vaccinated by Go-
vernment Establishment.
49,346
67,487
70,212
69,085
68,282
71,203
Total vaccinated by Native
Chiefs' Establishment.
16,317
19,564
20,118
22,043
20,553
23,080
Total vaccinated by Muni-
cipal Establishment.
None.
None.
160
57
1,253
2,175
2. The increase in the several establishments though not very considerable, is
yet creditable to the Vaccinators employed, and speaks well of their zeal and industry,
inasmuch as it was attained under many adverse circumstances, which are stated in
paragraphs 31 and 32 of this Report. It is, I believe, principally due to the unpleasant
21
prevalence of small-pox during the year bringing out many children for vaccination,
who otherwise would have been kept out of the Vaccinator's reach ; to a certain extent
also, it may be attributed to the increased energy of the Vaccinators.
3. To this report is annexed a table which gives a comparative view of the work
performed during the years 1867 and 1868, with some other particulars. From this
table it appears that the majority of the Vaccinators have performed more work in the
expired year than in 1867.
4. The total number of operations performed by the three establishments is
96,458 ; of this 60,212 were children under one year of age, and 36,246 above that age.
This gives 62.4 per centum of the former, and 37.5 of the latter. Taking the sexes,
the operations in males exceeds females, the percentage being 53.5 in males, and 46.4
in females.
5. As regards the general result, the percentage of success in the Government
(91.8) and Native States' establishments (90.7) is almost the same as in last year. In
the Municipal establishment it is 91.9, being two per centum lower than in the previous
year. But I think the percentage is actually much greater, vaccinated children leaving
their villages before the week day, or concealed by their parents through fear of lymph
being taken from them, are entered as doubtful. In the greater part of the doubtful
cases the result, according to my experience, is successful.
6. The lymph in use in this Circle is to all appearances good; the resulting
vesicles are normal in size and appearance. It is not, however, so good as it was in
past years, because the cicatrices are not so large, and in the course of two or three
years they become very indistinct.
7. Three supplies of English lymph were received in the year under report. The
first supply in capillary tubes was successfully used in Cambay in the month of Febru-
ary. The second supply was on ivory points ; it was received in August; and on
trial, failed entirely. The last supply, received almost at the close of the year, was
partly in tubes and partly on ivory points ; it was used at Mundul, and failed entirely.
Supplies of English lymph, even when found successful, do not produce results equal
to the lymph in general use, and are therefore not of any use. It is very desirable
that endeavours be made here for procuring cow-lymph, and, if successful, the replace-
ment of the ordinary lymph now in use by such fresh cow-lymph, would be very
beneficial.
8. During the year supplies of lymph in capillary tubes were sent to the Staff
Surgeons of Nusseerabad and Aboo Sanitarium, the Superintendent of Rajpootana Dis-
pensaries and Vaccination, the Civil Surgeon, Kaira, the Medical Officer in charge of
the 14th Regiment N. I., Mhow, to the Local Superintendent of Vaccination, Bombay,
and to the Dispensaries of Dakore and Gogo.
9. The year was marked by the prevalence of a severe epidemic of small-pox.
This disease made its appearance in December 1867 in this Circle. For the first two
23
ordered to Pahlunpore. Both together commenced operations, but their combined
efforts were successful to only a limited extent; for, working three days in a week in
the Kusba, they could only get sixty children for Vaccination. The Mahomedan
population resisted even during the epidemic. The Vaccinator of Pahlunpore, Dana
Bhava, is now of twenty years' standing in the service. From my personal observation
of this man, borne out by the testimony of another medical officer now high in the
service, but who was for a length of time Superintendent of Vaccination of this Circle,
I can say of him that in industry and zeal in popularizing himself and his art, in his
personal demeanour to all, there is now no equal to him among the Native States'
Vaccinators. Yet strange to say, at the time of the above occurrence, fault was
found with him. From information, which must have been entirely incorrect, he
was said to be inefficient, and not fit for the post, and his removal was desired. The
loss would have been felt nowhere more than in Pahlunpore. I was able to make
a satisfactory representation on the subject, and was allowed to retain this man in
his post.
14. Though the carrying on of vaccination in a place infected with small-pox is
beneficial, yet among ignorant people, such a proceeding is often more or less hazardous,
inasmuch as it may bring discredit on vaccination by children already infected with
the contagion of small-pox being vaccinated during or about the close of the period of
incubation of the disease, and thereafter both diseases, variola and vaccinia, breaking
out on the children, and it may so happen that a child, after being thus vaccinated,
may have small-pox very severely and die. It is, therefore, of the utmost importance
for this Department that it may receive all possible assistance from high influential
quarters during quiet times, when no epidemic influence prevails, instead of such assist-
ance being rendered to it in epidemic seasons only.
15. As to the extent to which small-pox prevailed in the different parts and
towns of this Circle during the year, with the exception of reports received from our
Vaccinators, I have no other good source of information. The following table con-
tains the information thus collected:—
Months.
January
February
March ........
Ahmedabad
Zillah.
Rampoor.
Rampoor.
Kaira Zillah.
Mhoonda ...
......
Mhoonda,
Thasra,
Cambay.
Broach
Zillah.
Jumboo¬
seer.
......
......
Surat Zillah.
Chowrasee,
Unklesur,
Olpar.
Chowrasee,
Olpar,
Mandvee.
Olpar,
Bulsar,
Mandvee,
Bugwar.
Native
States of
Pahlunpore,
......
Pahlunpore
Kusba.
Deesa,
Pahlunpore,
Rahdunpore.
Native
States of
Mahee
Kanta.
......
......
......
24
Months.
April ............
May ............
June ............
July ............
August ............
September ...
October ..........
November ......
December ......
Ahmedabad
Zillah.
Rampoor.
......
......
......
......
......
......
......
......
Kaira Zillah.
Mhoonda.
Mhoonda.
......
......
......
......
......
......
......
Broach
Zillah.
......
......
......
......
......
......
......
......
......
Surat Zillah.
Olpar,
Chicklee,
Bulsar,
Mandvee,
Bugwara,
Pardee.
Chowrasee,
Chicklee,
Mandvee,
Olpar.
Chowrasee,
Mandvee,
Olpar.
Mandvee,
Pardee.
........
Mandvee.
......
Chowrasee,
Mandvee.
Chowrasee,
Mandvee.
Native
States of
Pahlunpore.
Deesa,
Phalunpore.
......
......
......
......
......
........
......
Rahdunpoor
Districts.
Native
States of
Mahee
Konta.
......
......
......
......
......
......
......
Baid.
......
The above is not a complete list. I believe, in addition to the places mentioned,
small-pox must have prevailed in many other localities.
16. From what is reported, it appears that whereas small-pox prevailed in the
other districts of this Circle to a limited extent, its occurrence in Surat districts was
general. It is therefore of some importance to know what is the state and progress of
vaccination in these districts. Of the Vaccinators I may say that they are as good
and efficient as in the other Zillah ; many of them are old and experienced hands.
That they are not inactive, and that vaccination in their districts is progressing, will
appear from the following statistics of the past eight years :—
Years.
1861....................
1862
....
1863
1864
1865
1866
1867
1868
Total number of Vaccinations
in Surat Districts.
6,269
8,359
9,513
14,584
16,562
18,717
16,489
19,129
26
of inoculation in the Surat districts. At present there is, I believe, a strong prohibitory
order on every Patel of a village not to allow inoculation ; nevertheless, it is being
permitted ; and when found out, and the case investigated, the invariable rule for the
Patel and the people inoculated, is to state that the subjects of inoculation had gone
to friends or relations in the neighbouring villages of the Bansda or Dhurrumpoor
States, and were there inoculated. There will always be some inoculators prejudicing
the minds of ignorant people, practising their injurious vocation, and thereby keeping
up the poison of variola to activity. Nothing short, therefore, of making inoculation
criminal, and prohibiting it by law, will meet the necessity of the case. Towards the
suppression of what greater evil can Government interfere for the welfare of the
people ? Is not small-pox more highly contagious and more certainly destructive to
the people than syphilis ? and yet Government have passed an Act to prevent syphilis.
22. As regards this subject of inoculation, and the measures necessary for the
more effectual spread of vaccination, I would quote here paragraph 3rd of my letter,
No. 300 of 2nd October last, addressed to the Superintendent General of Vaccina-
tion, Bombay Presidency :—
"3. As to the best means of preventing small-pox from spreading, these
may be briefly stated to be as follows :—
"a. Isolation of cases of small-pox.
"b. Suppression of inoculation.
" c. Legislative help towards the progress of vaccination.
" d. Re-vaccination.
" On each of these heads, I would make a few remarks.
" a. Isolation of small-pox cases.—The most efficient measure for checking the
prevalence of small-pox would be the complete isolation of cases as they occur in any
locality. This measure has been lately proposed by Sir James Y. Simpson, of Edin-
burgh, and known as the proposal for stamping out small-pox. The simple isolation
of small-pox cases would be incomplete; there ought to be conjoined with it a thorough
disinfection of the rooms occupied by small-pox cases and of their clothing and bedding
in malignant and fatal cases; the entire destruction of the bed and clothing of deceased
by burning ought to be enforced.
" b. Suppression of inoculation.—I am not aware to what extent this baneful
practice of inoculation prevails in other parts of this presidency. In the southern
part of this Circle, during each hot season, reports of its existence are made
to me by the Vaccinators. I believe that this most injurious practice is being
carried on pretty freely, though surreptitiously, in these districts. Inoculation is at all
times pernicious in its results, but it is most so during epedimic seasons of small-pox,
inasmuch as it multiplies the sources of contagion. It is therefore of the first im-
portance to cause most stringent measures for the suppression of inoculation.
28
has to do a work upon the proper performance of which will in a great measure
depend the life of a human being. And he must also possess an unusual amount of
patience and energy to quietly work his way over the prejudices of the people, and
the tact to gain their confidence. With industrious and energetic habits, a conciliatory
disposition is essential. It is not likely that men possessed of such qualities could be
found to serve for very low wages. Up to May last the majority of the Vaccinators
(Apprentices and Assistants) received Rs. 15 and Rs. 17 per month, and the Peons
Rs. 7. This was low enough, but since May they have been receiving Rs. 12
and Rs. 14, and the Peons Rs. 5. Upon such scanty pay it is impossible for these
people to maintain themselves and their families.
It is very necessary that for the efficacious performance of vaccination, the scale
of pay of the Vaccinators be sufficiently high to secure good men, and to keep them
above the necessity of begging gratuities from people. The subject of the revision of
the salaries of the vaccination establishment is now under the consideration of Govern-
ment, and the Vaccinators are anxiously awaiting to know the result.
24. To ensure efficacious performance of work, it is necessary that the super-
vision of the establishment be perfect. The experience of two years in this Circle
has convinced me of the extreme necessity of better supervision of its Vaccinators.
The Circle ought to be only so extensive as to enable a Superintendent to examine
the lymph of the different Vaccinators every year, or at most every year and a half;
whereas, this Circle is so very extensive as to require nearly three working seasons to
complete an inspection of the work of all Vaccinators.
25. The extent of this Circle is shown in the following Statement, which contains
the names of the different Zillahs taken from north to south, together with the area in
square miles and population of each :—
Names of places.
Native States of Pahlunpore...................
„ Mahee Kanta ...............
„ Cambay ......................
Zillah Ahmedabad .................................
„ Kaira ...........................................
„ Broach ........................................
„ Surat ............................................
Total....
Area in square
miles.
6,041
5,000
432
4,415
1,365
1,196
1,741¾
20, 190 ¾
Population.
304,493
333,564
175,000
679,761
574,606
190,155
468,186
2,715,765
26. And the following shows the total cost of vaccination in each establishment
during the year, as well as the cost of each vaccination :—
29
Establishments.
Government
Native Chiefs .................
Municipal .......................
Total number
vaccinated.
71,203
23,080
2,165
Total expenditure
during the year.
Rs.
15,224
3,072
438
a.
8
0
0
p.
0
0
0
Cost of each vaccina¬
tion.
Rs.
0
0
0
a.
3
2
3
p.
5
1
2
Calculated as above, it appears that the cost of each vaccination in the Govern-
ment establishment is greater than the others, but the chief expenditure in the Govern-
ment establishment, viz., that of supervision, ought to be borne by all, inasmuch as
all are placed under one Superintendent. Taking the three establishments together,
the cost of each vaccination is 3 Annas and 2 Pies.
Total Vaccinations.
96,458.
Total Cost.
Rupees 18,734.8
Cost of Each.
Rs. 0 3 2.
27. To give a brief résumé of my tour : I was at the commencement of the year
working at Ahmode, in Broach Zillah. My stay at Amode and at the next station,
Jambooseer, was more prolonged than usual in the examination of the work of General
Nos. 190 and 96. Finishing my work in Broach districts, I arrived at Karalee, and,
crossing the Mhye, reached Salol on the other side of the river, and from thence travelled
to the Native State of Cambay, and examined the work of its Vaccinator, Goolab Jumiet.
Travelling from Cambay northwards, I encamped at Khanpore, in Kaira Zillah, for
three days, and inspected most of the fresh work of the Cambay Vaccinator, as well as
of General No. 127. Crossing the Saburmuttee by Boroo Mottee, I entered Ahmeda-
bad districts, and travelled to Dhollera, Dhundooka, Rampore, and Dholka, inspecting
work of several Vaccinators of the talookas named, (General Nos. 91, 170, 177 and 52).
When I finished my work at Dholka it was quite the close of March, and as I had to
be present at the Sessions Court in Broach in the first week of April, to give my evi-
dence in a legal proceeding against a Vaccinator of this establishment, I closed work at
Dholka, marched to Ahmedabad, and went down to Broach by rail, where I was detained
only two or three days. I next took my camp to Unclesur, and commenced the exami-
nation of the Surat districts. The work of General No. 293 was thoroughly inspected
from Unclesur, Panolee, Hansote, and Elao, which last place I left at the close of
April for Mandvee talooka. From Turkesur, Jhamp, and Tursada, the work of Gene-
ral No. 248 was fully examined. From Tursada I travelled to Bardolee, from which
place, and from Surbhon, the work of General No. 193 was thoroughly examined.
Travelling southwards I entered Soopa talooka in the early part of June, and before
the proper setting in of the monsoon had time enough to satisfy myself of the work
of General No. 275. On the 15th June I was in Surat, my usual monsoon station,
and occasionally went to some of the villages of Chowrassee talooka to inspect the
lymph of General No. 19, and to take lymph for supplying the different Vaccinators
of the Circle. I left Surat for the districts again nearly at the close of October, and
30
by the end of the year was able to inspect the work of General No. 309, in charge of
Olpar talooka ; of General No. 287 of Broach talooka, and of General Nos. 56, 20,
31, and 296 of Duskroe, Sanund, Veerungaum, and Mundul talookas, of Ahmedabad
Zillah. To sum up, I inspected, in all, the work of twenty-two persons ; of these 18
belonged to the Government establishment, one was a Native State Vaccinator, and two
Municipal Vaccinators, of Dholka and Veerungaum, at which last place the vaccina-
tions carried on at the Dispensary were examined. My travelling extended over 2,309
miles, 323 villages have been visited, and 11,716 children examined.
28. Of the twenty-two Vaccinators whose work was examined, the lymph of
fourteen was found to be good; six Vaccinators were working with deteriorated lymph,
which did not produce quite satisfactory vesicles, and one was working with very bad
lymph. In every instance the lymph was discontinued directly, and replaced by good
matter from neighbouring Vaccinators.
29. There have been in all five dismissals during the year, and these were
necessitated by the following circumstances :—Hemutram Jugutram, of Wagra (General
No. 235), and Trimucklall Kalidas, of Ahmode (General No. 190), were found to have
been systematically misappropriating small sums of money to their own use instead of
giving them to parents of children that were taken from one village to another for the
purpose of carrying on arm-to-arm vaccination. Both of these were prosecuted for
the offence, but only the latter was convicted, and sentenced to three months' rigorous
imprisonment. Bhai Sunker Ghelabai, of Bardolee (General No. 183), was the Vaccinator
who was working with very bad lymph. His faults as a Vaccinator were very grave.
He studied more his ease and convenience than his duty, and used lymph on the 10th
or 11th day ; and, in order to evade detection, put false dates in his weekly and monthly
returns. All his past work was very bad. It was discovered that he often sent his
peon to the villages to carry on vaccination, instead of going himself to do his own
work. His neighbour, Hurry Vulub Narunjee (General No. 275), the Vaccinator of
Soopa, was found to have been falsifying his returns to a large extent. Both of them
were therefore dismissed. Another Vaccinator, Sankleshrow Seevram, of Morassa
(General No. 300), was dismissed the service on account of extreme laziness and mis-
conduct.
30. In the Native States there have been very few changes. In paragraph 10 of
my last report I had mentioned that in the Mahee Kanta territories, vaccination was
carried on by four Vaccinators, but as these were unable to meet emergencies, the num-
ber of Vaccinators was increased from four to five. The new man was found to be
utterly unfit ; he did not get on smoothly with his work, and was constantly report-
ing himself to be ill, and losing his lymph. He was therefore discharged, and another
candidate sent in his place. In Pahlunpore States one Vaccinator, Shumser Hassum,
of the Kakhrej talooka, took ill in August, and following my advice went to Deesa, and
put himself under the treatment of the Staff Surgeon. In October he reported that