NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( 29 )
During my cold-weather tour through a part of this district I inspected
a number of children both at Kángra and Jawálamukhi, and reported to the
Civil Surgeon that the work was not satisfactory ; the vesicles were badly
developed, the scars very superficial, and in many cases I found only one or two
marks. Dr. Dennys made careful enquiry into this matter so far as he was able,
and the result appears that the work was done almost entirely, if not exclusively,
by Hospital Assistants. They were supplied again with fresh lymph wherewith
to start work again on a better footing. The Hospital Assistants have, however,
been unable, through various causes, want of time, &c, to keep the lymph going,
and the work has again come to a stand-still.
The Civil Surgeon reports that he has good reason to believe that a large
number of operations performed by Hospital Assistants have not been included
in the monthly returns of the district, and he is unable to say why they did not
send in any returns, and their not doing so must undoubtedly decrease to a great
extent the total number of operations performed in the district during the year.
Orders have been issued, however, to the effect that in future all Hospital
Assistants are to report in the usual form the number of cases performed by
them monthly.
Dr. Dennys states in his report that the system at present in force of
employing Hospital Assistants as vaccinators in their respective municipalities
has not been a success. He has had numbers of complaints of various sorts
regarding the work done by these men, who complain that they cannot find the
time to go about from mohalla to mohalla vaccinating without greatly interfer-
ing with their dispensary duties, and that no help can be obtained by them
from tahsíl and district officials in the work of vaccination. And further on it is
stated that the system of dispensary vaccination, which has been carried
on largely in the district, has been an endless trouble to him, and has been
a failure.
For want of funds the present district staff cannot be strengthened by the
entertainment of additional vaccinators, but I would suggest that where
Hospital Assistants experience difficulties, such as that brought to notice by
Dr. Dennys, they should not be employed in vaccination work. Much of the
difficulty brought to notice by the Civil Surgeon will doubtless be obviated by
the proposal recently adopted by the Committee to utilize the services of the
Hospital Assistants for vaccination purposes within a convenient distance of their
respective jurisdictions, and this arrangement will, to a certain extent, set the
vaccination staff free to give more time and attention to points where small-pox
may happen to be unusually troublesome.
AMRITSAR.
The vaccination establishment entertained, and the annual cost thereof,
during the years 1882-83 and 1883-84 are as below :—
Establishment
Native supervisor ... ... ...
1st class vaccinators ... ... ...
2nd „ „ ... ... ...
3rd „
„ ... ... ...
Total ...
1882-83
Number
1
2
3
8
14
Annual
cost
Rs.
480
360
432
960
2,232
1883-84
Number
1
2
3
8
14
Animal
cost
Rs.
480
360
432
960
2,232
( 41 )
The Civil Surgeon inspected 5,669 children; out of this number 5,323
were found successful, 195 unsuccessful, and 151 doubtful.
There is sometimes considerable difficulty, judging from the appearance
of the scar some months after vaccination, to determine whether the result has
been successful or not; in many cases which appeared doubtful, the scar being
superficial and small, and presenting no honeycombing, the Civil Surgeon enquired
carefully as to whether the vesicles had formed well at the time of ripening, and
very often the answer was in the affirmative. The vaccinators assert most
positively that where lymph has been taken from an arm, the resulting scar is
liable to be small and superficial. The Civil Surgeon has not been able to
verify this. In general the result is less satisfactory in the municipalities as can
be seen from the greater ratio of unsuccessful and doubtful cases. In almost all
cases six punctures were made, except in the case of very young children, where
only two to four punctures were made.
By far the greater number were marked with six vesicles, and in most
cases all six had taken and showed a typical scar.
The system of vaccination all over the district is by puncture, scratching
being never tried.
The Deputy Commissioner and the District Superintendent of Police
rendered great assistance in the work of vaccination; without their hearty co-
operation the carrying out of the Civil Surgeon's scheme would have been
impossible.
His Highness the Nawáb of Mamdot gave kind aid on the occasion of the
Civil Surgeon's visit to the villages in his State. The great assistance given by
the Assistant Surgeon, Malk Jawála Sahái, whose interest in vaccination is
unflagging, is also brought to notice.
RAWALPINDI.
The vaccination establishment entertained, and the annual cost thereof,
during the years 1882-83 and 1883-84 are as below :—
Establishment
Native supervisor ... ... ...
1st class vaccinator ... ... ...
2nd „ „ ... ... ...
3rd „ „ ... ... ...
Total ...
1882-83
Number
1
1
3
6
11
Annual
cost
Rs.
480
180
432
720
1,812
1883-84
Number
1
1
3
6
11
Annual
cost
Rs.
480
180
432
720
1,812
Total vaccinations (including primary and re-vaccina¬
tions) ... ... ... ...
Successful cases ... ... ... ...
Percentage of successful cases ... ... ...
Persons successfully vaccinated per 1,000 of population
Average number vaccinated by each vaccinator ...
Cost of each successful case ... ... ...
1882-83
15,496
14,706
97.06
18.11
1,549.60
Re. 0-2-4
1883-84
20,425
18,505
94.85
23.03
2,042.50
0-1-11
The work performed
by the above establish-
ment during the two years
is shown in the margin.
The average number of operations returned by the vaccinators of this
district during the year is 20,425, being an increase of 4,929 over the number
vaccinated in the previous year. There were 18,505 primary cases returned as
successful against 14,706 in the previous year ; and the percentage of success
94.85 as compared with 97.06, being a decrease of 2.21. The number of
( 48 )
Vaccination appears to be fairly popular among the Muhammadans, but the
Hindús are greatly opposed to it. A few of the more intelligent Muhammadans
know the difference between inoculation and vaccination, and between a good and
a bad cicatrix. In a very few of the villages the people admitted that it had
conferred great benefits on them and immunity from small-pox.
The occurrence of small-pox was twice reported, and immediate measures
were taken to isolate the cases and vaccinate all the villages. At Dahraj, a
village 12 miles from head-quarters, a case having been reported, the 1st-class
vaccinator and a vaccinator immediately went there and vaccinated all the
children in that village and the neighbouring wells. The Civil Surgeon himself
also went out and saw the case.
The other case occurred in the Bár of the Shorkot tahsíl, where an
inoculator from Montgomery had been at work. Here also a vaccinator was
immediately sent out, and vaccinated all unprotected children. In both instances
the measures adopted were effectual in stamping out the disease.
One hundred rupees were placed at the Civil Surgeon's disposal by the
Deputy Commissioner for distribution among those who had done their work
well, and among a few zaildárs and others who had given assistance in
vaccination.
During the season the Civil Surgeon inspected the registers and found
them, on the whole, correct without any false entries ; occasionally the results
were not entered, but this was rare. He considers the vaccinations performed
in this district very good indeed.
MONTGOMERY.
The vaccination establishment entertained, and the annual cost thereof,
during the years 1882-83 and 1883-84 are as below :—
Establishment
Native supervisor ... ... ...
1st class vaccinator ... ... ...
2nd „ „ ... ... ...
3rd
„
„
...
...
...
Total ...
1882-83
Number
...
1
1
4
6
Annual
cost
Rs.
...
180
144
480
804
1883-84
Number
1
1
1
4
7
Annual
cost
Rs.
360
180
144
480
1,164
Total vaccinations (including primary and re-vaccina-
tions) ... ... ... ...
Successful cases ... ... ... ...
Percentage of successful cases ... ... ... ...
Persons successfully vaccinated per 1,000 of population
Average number vaccinated by each vaccinator ... ...
Cost of each successful case ... ... ... ...
1882-83
9,630
9,202
96.64
21.58
1,926.00
Re. 0-2-0
1883-84
11,194
10,718
96.07
26.15
1,865.66
0-1-10
The work performed
by the above establish-
ment during the two years
is shown in the margin.
The average number of operations returned by the vaccinators of this district
during the year is 11,194, being an increase of 1,564 over the number vaccinated
in the previous year. There were 10,718 primary cases returned as successful,
against 9,202 in the previous year; and the percentage of success 96.07 as
compared with 95 64, being an increase of 0.43. The number of re-vaccinations
was 38 against 9 of previous year. The number successfully vaccinated per
mille of population was 25.15 against 21.58 in the preceding year; increase
3.57. The aggregate cost amounted to Rs. 1,246 as compared with Rs. 1,170,
an increase of Rs. 76 ; and each successful case cost Re. 0-1-10, decrease
Re. 0-0-2.
( 53 )
BANNU.
The vaccination establishment entertained, and the annual cost thereof,
during the years 1882-83 and 1883-84 are as below :—
Establishment
Native supervisor ... ... ...
1st class vaccinator ... ... ...
2nd „ „ ... ... ...
3rd
„
„
...
...
...
Total ...
1882-83
Number
1
1
1
3
6
Annual
cost
Rs.
480
180
144
360
1,164
1883-84
Number
1
1
1
3
6
Annual
cost
Rs.
480
180
144
360
1,164
Total vaccinations (including primary and re-vaccina-
tions) ... ... ... ...
Successful cases ... ... ... ...
Percentage of successful cases ... ... ... ...
Persons successfully vaccinated per 1,000 of population
Average number vaccinated by each vaccinator ... ...
Cost of each successful case ... ... ... ...
1882-83
6,719
6,326
94.30
19.02
1,343-80
Re. 0-3-8
1883-84
10,242
9,938
97.03
29.88
2,048.40
0-2-0
The work performed
by the above establish-
ment during the two years
is shown in the margin.
The average number of operations returned by the vaccinators of this
district during the year is 10,242, being an increase of 3,523 over the number
vaccinated in the previous year. There were 9,938 primary cases returned as
successful against 6,326 in the previous year ; and the percentage of success 97.03
as compared with 94.30, being an increase of 2.73. No re-vaccinations were
performed this year, but the number in the previous year was 11. The number
successfully vaccinated per mille of population was 29.88 against 19.02 in the
preceding year; increase 10.86. The aggregate cost amounted to Rs. 1,220
as compared with Rs. 1,458, a decrease of Rs. 238; and each successful case cost
Re. 0-2-0, decrease Re. 0-1-8.
No primary vaccinations were inspected by the Civil Surgeon (Dr.
G. McB. Davis) during the year.
From the 1st October to end of December 1883 the vaccination staff was
employed in the Bannu tahsíl, during January in the Laki tahsíl, except one
man who was retained at head-quarters. In February one man from Laki
was sent to Miánwáli tahsíl. The number of villages traversed for vaccination
purposes was 431, viz., 255 in the Bannu, 163 in the Laki and 13 in the
Miánwáli tahsíls.
The Civil Surgeon's report is very brief, and no record of the number of
vaccinated children inspected by him has been kept. All that he states on
the subject is that "when the work was going on near the head-quarters' Dis-
pensary, frequently children who had been vaccinated were brought to the Civil
Surgeon for inspection."
PESHAWAR.
The vaccination establishment entertained, and the annual cost thereof,
during the years 1882-83 and 1883-84 are as below :—
Establishment
Native supervisor ... ... ...
1st class vaccinator ... ... ...
2nd „ „ ... ... ...
3rd „ „ ... ... ...
Total ...
1882-83
Number
1
1
2
4
8
Annual
cost
Rs.
480
180
288
480
1,428
1883-84
Number
1
1
2
4
8
Annual
cost
Rs.
480
180
288
480
1,428
( 58 )
persuasion and pressure, but it was with difficulty that 15 to 20 per cent. were vaccinated,
and in the whole Khatak country no one allowed his child to be taken away elsewhere for
the purpose of furnishing lymph. Vaccination was carried on by lymph from glasses.
"Now in December 1883 the villages of Tagh, Muhammad Khoja, Kahi and Balyámni
in Hangu tahsíl were visited, and the children vaccinated with great difficulty.
"I further beg to state that the lambardárs of all the tahsíls in the Kohát district who
did not assist the vaccination work have been reported on to the Tahsildárs of their respective
tahsíls, but they have not as yet been reprimanded, and for this reason the work was
retarded. When the officers pay attention to this, it is hoped that work will go on all right."
In transmitting the vaccination report to this office, the Deputy Com-
missioner, Mr. St. G. Tucker, makes the following observations :—
"As regards vaccination, I believe it is generally becoming more popular, though the
prejudices of the people on the subject will not be overcome all at once. The Teri people
in particular, who are the most backward, are still very much opposed to it. The vaccinators
would, of course, like to have official pressure brought to bear on the lambardárs and people—
in other words, that vaccination should be made compulsory. I do not myself consider
that the district is sufficiently advanced for a system of compulsory vaccination to be
enforced. If orders are issued to the Tahsíldárs to encourage vaccination, they send a
chaprási with the vaccinator, who at once seizes and vaccinates every child that he can
lay hands on. The vaccinators naturally seek to impress the people with the idea that they
(the people) have no option in the matter. I have accordingly found it necessary to acquaint
the people, as far as possible, with the real facts, and that vaccination, though most benefi-
cial, is not to be enforced against the wishes of the people themselves."
APPENDIX TO STATEMENT No. I.
STATEMENT SHOWING THE DETAILS OF THE VACCINATION OPERATIONS PER-
FORMED BY THE SPECIAL AND CANTONMENT STAFFS ACCORDING TO LOCALI¬
TIES DURING THE YEAR 1883-84.
1
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
1
2
3
4
5
6
7
8
9
10
11
12
13
1
2
3
2
NAMES OF LOCALITIES
(Special Staff, Eastern Circle.)
Mandi, Native State ...
Biláspur „ ...
Bághal „ ...
Keonthal „ ...
Bashahr „ ...
Suket
„
...
Nálagarh „ ...
Kalsia „ ...
Patiála „ ...
Bhajji
„
...
Balsan „ ...
Jubbal „ ...
Taroch „ ...
Kumhársain „ ...
Theog „ ...
Pataudi „ ...
Kothi
„
...
Sángri „ ...
Baghát „ ...
Kotgarh „ ...
Solan
„
...
Kot Khái „ ...
Mailog „ ...
Loháru „ ...
Bharauli „ ...
Kunhiár „ ...
Dhámi „ ...
Darkuti „ ...
Mángal „ ...
Dagshai „ ...
Bija
„
...
Kuthár „ ...
Kasauli „ ...
Total ...
(Special Staff, Western Circle.)
Murree town ...
„ tahsíl ...
Gharial ...
Gujar Khan tahsíl ...
Pind Dádan Khan town ...
„ tahsíl ...
Abbott-abad town ...
Nawashahr town ...
Abbott-abad tahsíl ...
Haripur town ...
„ tahsíl ...
Baffa town ...
Mansahra tahsíl ...
Total ...
(Cantonments.)
Umballa ...
Meean Meer ...
Subáthu
...
Total ...
3
Average number of vaccina¬
tors employed throughout
the season
13
7
1
1
1
3
4
Total number of persons
vaccinated
10,201
9,184
5,218
5,037
4,319
3,621
3,384
1,337
962
834
818
712
703
695
658
634
625
499
414
296
263
238
228
217
193
186
182
100
79
62
61
53
23
52,036
66
678
4
3,455
196
372
90
80
2,243
153
1,723
432
3,736
8,457
1,610
621
118
2,349
PRIMARY
Total
10,151
8,114
5,168
4,065
4,210
3,503
3,358
1,337
955
825
818
690
667
695
658
632
584
489
299
296
263
237
228
217
188
186
163
100
79
62
61
53
23
49,374
66
678
4
3,455
196
372
48
80
2,243
152
1,721
432
3,736
8,412
1,535
510
118
2,163
Successful
Under one year
3,216
2,035
1,200
685
1,826
837
1,855
381
320
155
160
270
198
164
63
479
139
60
84
91
92
64
69
82
109
30
39
32
20
14
12
21
15
14,817
50
139
...
491
...
... 46
51
1,928
128
1,413
184
2,756
6,506
1,100
189
77
1,366
Over one and un-
der six years
5,374
3,247
3,037
1,504
1,981
1,769
1,087
884
356
614
658
429
439
374
434
138
228
273
201
134
161
159
159
213
64
85
43
68
59
48
49
17
8
24,294
16
32
...
65
...
...
1
29
212
14
93
115
823
1,287
359
278
40
677
Total of all ages
9,965
7,558
5,039
4,015
4,024
3,425
3,322
1,337
851
809
818
680
674
695
658
617
534
473
281
296
263
236
228
217
175
186
163
100
79
62
61
53
23
47,917
66
171
...
556
...
... 47
80
2,140
142
1,506
299
3,579
7,793
1,459
467
117
2,043
5
RE-VACCINA¬
----
Total
50
1,070
50
972
109
118
26
... 7
9
... 22
306
...
...
2
41
10
115
...
... 1
...
... 5
...
19
...
...
...
...
...
...
2,662
...
...
...
...
...
...
42
...
...
1
2
...
...
45
75
111
...
186
Successful
4
607
20
420
29
37
8
...
...
...
... 8
10
...
...
...
15
5
30
...
...
...
...
... 1
...
2
...
...
...
...
...
...
1,196
...
...
...
...
...
... 24
...
...
...
2
...
...
26
57
90
...
147
PERCENTAGE
OF
SUCCESSFUL
Primary
97.05
92.64
95.04
91.57
99.15
94.45
Re-vaccination
44.93
57.77
76.00
81.08
...
79.03
2
B.—DISPENSARY VACCINATION.
STATEMENT No. III, SHOWING DISPENSARY VACCINATION IN THE PUNJAB PROVINCE DURING THE YEAR 1883-84.
1
DISTRICTS
Gurgaon ... ... ...
Hissar ... ... ...
Sirsa ... ... ...
Umballa ... ... ...
Ludhiána ... ... ...
Gurdáspur ... ... ...
Lahore (Mayo Hospital) ... ...
Gujrat
...
...
...
Jhang
...
...
...
Pesháwar ... ... ...
TOTAL ...
2
Number of
Dispensaries in
each District to
which a vacci¬
nator is attached
5
2
2
1
2
2
1
3
3
...
21
3
Average number
of vaccinators*
attached to Dis-
pensaries during
the season
5
2
2
1
2
2
1
8
3
2
28
4
Total number
of persons
vaccinated
1,686
679
1,013
16
527
129
160
l,596
1,032
989
7,827
5
Average number
of persons vacci-
nated by each
vaccinator
337.20
339.50
206.50
16.00
563.50
64.50
160.00
199.50
344.00
499.50
279.53
6
7
8
9
PRIMARY VACCINATION
Total
1,659
679
796
15
527
129
160
1,589
989
986
7,529
Successful
Under 1
year
1,193
372
288
9
498
101
160
1,338
850
363
5,172
1 and
under 6
303
149
449
5
23
18
...
179
80
502
1,708
Total
of all
ages
1,496
521
737
15
521
119
160
1.517
930
906
6,922
10
11
RE-VACCINATION
Total
27
...
217
1
...
...
...
7
43
3
298
Successful
18
...
203
1
...
...
...
5
17
3
247
12
13
PERCENTAGE OF
SUCCESSFUL CASES
Primary
90.17
76.73
92.59
100.00
98.86
92.25
100.00
95.47
94.04
91.88
90.60
Re-vaccination
66.66
...
93.55
100.00
...
...
...
71.43
39.53
100.00
82.88
* i.e., Civil and Assistant Surgeons, Hospital Assistants, Compounders and Hakíms.
4
REPORT
ON
VACCINATION
IN THE
PUNJAB
FOR THE YEAR
1885-86.
Published for Authority
Lahore:
PUNJAB GOVERNMENT PRESS,
1886.
( 3 )
In paragraph 29 of the Vaccination Report for the year 1885-86, now
under review, it is said that the special staff of the Eastern Circle shows a
decrease of 23,844 vaccinations, as compared with the results of the previous year.
The Officiating Sanitary Commissioner has since explained that a large number
of vaccinations were performed in the Sirmur and Bashahr States in 1884-85,
because no vaccination had been done in those States for some time, and conse-
quently there were a large number of un-vaccinated children. The State of
Sirmur was not visited in 1885-86, as the staff was unable to cover the whole
of the Hill States. Twenty-eight localities were, however, visited, as against 19 in
1884-85; but the ground covered was apparently less populous in children requir-
ing vaccination.
ORDER.—Ordered that the above remarks be printed and circulated for
general information; also that the Review be published in the Punjab Government
Gazette.
By order of the Hon'ble the Lieutenant-Governor.
W. M. YOUNG,
Secretary to Government, Punjab.
MEMO OF ERRATA.
In para. 7, line 2, for 2,211, read 2,212, and for 1,970, read 1,978.
At page 6, line 1, for 3,477, read 3,497.
In para. 17, line 9, for 2,405, read 2,408.
In para. 28, line 3, for 24,131, read 22,131.
In para. 28, heading to column 2 of the statement for vaccinations, read vaccinators.
In column 2 of the statement under para. 28, average number of vaccinators for
Western Circle, for 7, read 8.
In para. 29, line 2, for 24,844, read 23,844.
In statement No. I, in column 3, population of the district of Rohtak, for 653.609,
read 553,609.
In the Lahore district, in the same column, for 624,106, read 924,106.
In Appendix to statement No. I, column 5, primary successful operations over one
year and under six years in Kalsia, for 1,249, read 1189; in Chachraee in the same column
for 742, read 745; and in the column of total for all ages, for 1,501, read 1,541 ; in Balsan,
in column over one year and under six years, for 288, read 268.
SECTION VII.—VACCINATION.
Changes in the super-
ior establishment.
FROM the 1st April 1886, under the orders conveyed in Government of
India No. 182, dated 9th March 1886, the appointments
of Deputy Sanitary Commissioner, Western Circle, and
Deputy Superintendent of Vaccination, were abolished. Dr. B. Doyle, the
Deputy Sanitary Commissioner of that Circle, was re-appointed a Civil Surgeon
in the Punjab, and was re-transferred to this Department on 1st April 1886
as Deputy Sanitary Commissioner, on the departure on furlough of Dr. John
O'Neill, Deputy Sanitary Commissioner, Eastern Circle. No provision has yet
been made for Pandit Balkishen, the Deputy Superintendent, but his case has
been referred to the Punjab Government and is now under the consideration of
His Honor the Lieutenant-Governor. No other changes of any material nature
have been made in this Department during the year under report.
Agencies
through
which vaccination is
carried on.
2. There are four separate agencies through which the work of vacci-
nation is carried on in this Province, viz.:—(1) the District
Staff, (2) the Special, (3) the Cantonment, and (4) the Dis-
pensary. Of these the most important is the District Staff.
Every district in the Province has its own establishment of one Native Super-
visor and from 1 to 13 vaccinators (of three different grades) who, under the
orders of the Civil Surgeon, carry on the work of vaccination in their respective
districts during the cold season. This staff consists altogether of 32 Native
Supervisors and 250 Vaccinators. Next comes the Special Staff, consisting
now of one Native Supervisor and 24 Vaccinators, all paid from Provincial
Revenues. The principal duties of the Special Staff are (1) to vaccinate in the
Native Hill States, (2) to maintain a sufficient supply of lymph throughout the
year, and (3) to render assistance to the District Vaccinators on emergent
occasions such as on the outbreak of small-pox, &c. The Cantonment Staff has
5 Vaccinators, viz., one each in the Cantonments of Umballa, Ráwalpindi,
Pesháwar, Siálkot and Meean Meer, but under the orders of the Government of
India (No. 8/702, dated 13th November 1875,) vaccination is to be carried on
in those Cantonments having a population of less than 10,000 souls by the
District Vaccinators through the co-operation of the Civil Surgeon of the
district in which the Cantonment is situated and the Military Medical Officer
attached thereto. The dispensary vaccination is carried on by hospital
assistants, hakíms, dressers, &c., who are not under the control of the Sanitary
Commissioner.
Cost of the several Es-
tablishments in 1884-85
and 1885-86.
3. The cost of the several establishments is shown
below for the years. 1884-85 and 1885-86.
District Staff
...
...
...
...
Special do ... ... ... ...
Cantonment ... ... ... ...
Dispensary ... ... ... ...
Total ...
1884-85.
Rs.
53,534
28,860
258
82,652
1885-86.
Rs.
51,638
31,492
908
84,038