NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
No. 2085 OF 1874.
FROM
THE SURGEON GENERAL,
INDIAN MEDICAL DEPARTMENT,
To
THE SECRETARY TO GOVERNMENT.
Bombay, 9th July 1874.
I have the honour to forward the Annual Report on Vaccination
for the year 1873-74, in which there are many points of interest.
2. The total number of persons operated on was 652,223,
which is 63,866 over the preceding year ; the most marked increase
being in the itinerant establishment, which accounts for 61,684 of
the total increase. The dispensaries show an increase of 1,358, and
the army of 824.
3. This large increase in the numbers vaccinated and re-vacci-
nated shows probably not only greater exertion on the part of the
Superintendents and their subordinates, but also increased apprecia-
tion on the part of the people, evidenced by greater willingness
on their part to submit their children to the operation ; but the
largest factor is undoubtedly the increase in the number of vaccina-
tors and the constant supervision over them exercised by the Assis-
tant Superintendents. This has resulted from the reorganiza-
tion of 1871.
4. Where progress has not been so great, the Superintendent
General attributes the want to the vaccinators being too few in
number for the population and area.
5. It is gratifying to know that among so many vaccinators, in.
only one instance was a register found incorrect ; and even this may
be attributed to carelessness on the part of the vaccinator, rather
than to an attempt to falsify the record, as it extended to only 6
names altogether. I may here add that the conduct of the vaccinators
in general has been satisfactory.
6. The percentage actually verified by Superintendents comes
so near to the numbers given by the vaccinators that, in my opinion,
the latter may be accepted as correct, and these show a good amount
of successful work done.
a
2
7. The disparity between the sexes, which was formerly so
great, has, by more careful registration, been reduced; and last year
the males were 52.8 to 47.2 females in each 100, being a difference
of 5.6, whereas in 1866 this amounted to 10.
8. The percentages of caste are much the same as for several
years back.
9. There was an increase in the number of infantile vaccina-
tions of 37,059, which is more than half the total increase ; the
percentage of children under one year in the total vaccinated is 38, or
1.2 higher than in the preceding year. Dr. Pinkerton thinks that
probably 41 or 42 per cent. of infantile vaccinations is about the
highest that can be reached by an itinerant establishment, such as
ours is. In this view I concur. But where large populations are
stationary, as in Bombay City, a much higher ratio can be obtained—
thus in Bombay City last year the rate was 65.3 per cent. I regret
to observe that the Southern Circle returns show only 25 per cent. of
infantile vaccinations, or 13 per cent. less than the average for
the whole Presidency. I recognize the general improvement which
has taken place last year in the Southern Circle, and trust that
Surgeon Raby will, in his next report, be able to show in this
particular, as well as in general, more favourable results. All
thorough vaccination must aim at protecting infant life, because in-
fants suffer most, both actually and relatively, from small-pox when
unprotected.
10. The success in primary vaccinations was 94.8, which is
only a little higher than in the preceding year (0.2). It was
highest in Sindh, and lowest in the Presidency and Southern Circles.
In re-vaccinations it was 65.7 in the general returns; but in the army
returns it was 48.2, which the Superintendent General thinks more
likely to be corrrct. Dr. Pinkerton notices the difficulty in the way
of attaining uniformity in noting the results of re-vaccination, and
he states, " it is difficult to fix an arbitrary standard of success in
re-vaccination, and most medical men even record differently : thus
one will register a success, even though the vaccine vesicle has run
its course to a pustule in five days ; another considers that all the
typical manifestations must be observed."
11. The lymph in all the Circles was good and abundant,
except in the Presidency Circle, where during July and August the
animal lymph failed. Dr. Cola remarks on the tendency of the
lymph to degenerate in Gujarath during the rainy season, but the
Superintendent General believes that carefully selected vesicles and
children, with carefully performed operations, are quite equal to
meet and obviate this. The tendency to degeneration is probably
greatest in the hot season everywhere ; but even then, there is no
difficulty in carrying on vaccination, as the work in Sind and the
Presidency Circles, which have the extremes of heat and moisture,
3
proves. Last year the lymph supplied from England was not so
successful as usual and no reason can be given for it. The Secretary
of State might be requested to communicate the source of each
supply sent out.
12. Animal vaccination is still carried on, and is very much
esteemed in Bombay ; and though the percentage of success is not so
high as when human lymph is used, still it must always be viewed
as a valuable adjunct ; as here, few persons allow lymph to be taken
from the vesicles on their children, and some parents prefer the
animal to human lymph.
13. Although there has been an increase in the total expendi-
ture of the department, the cost of each successful vaccination has
been less by 6 pies than in the preceding year.
14. The progress of vaccination is satisfactory in all Govern-
ment districts, except Belgaum and Dharwad. A further extension
would follow an increase in the number of vaccinators there, and
the Superintendent General wishes the attention of the Collectors
called to the advisability of having more than one taluka vaccinator
where the population exceeds 100,000. In Native States, the pro-
gress has been satisfactory, and promises further improvement.
Although vaccination at dispensaries may not be all that can be
desired, still some progress has been made and more will gradually
follow. I am glad to observe that several of the officers in charge
of dispensaries have been favourably noticed by Dr. Pinkerton, espe-
cially Assistant Surgeon Mackenzie and Honorary Surgeon Sinclair.
15. The Superintendent General views with anxiety and fore-
boding of ill the falling off in the numbers vaccinated in Bombay,
and he is of opinion this can be met only by a compulsory Vacci-
nation Act. Certainly the results are altogether disproportionate
to the cost. The reason of this is evidently due chiefly to there
being a Superintendent to so small a circle as Bombay Presidency
Circle is, his pay alone adding about 7 annas to the cost of each
successful case. Speaking generally, it is difficult for a vaccinator
in a city to vaccinate as many as he can do in a rural district.
16. As regards inoculation, Dr. Turnbull notices that it had
been practised in the Wái Táluká, but the Superintendent General
is unable to say to what extent. It is evident there could have been,
very little of it.
17. The Superintendent General thinks no reliance can be
placed on the record of deaths from small-pox for statistical purposes.
18. Dr. Pinkerton estimates the population at 24½ millions,
which includes the civil population of Mhow, Nimach, and Nasirabad,
and he thinks there are at least 735,000 births per annum. After
writing off 1/13th of the births for deaths, &c., he considers the depart-
4
ment might vaccinate 678,462 children primarily, or probably even
more, according to the annual increment of population. He takes
the birth-rate at 30 per mille, which, in my opinion, is a low rate.
On this basis 9/10 ths of the available children were vaccinated last
year. This very satisfactory result is attributed to the re-organiza-
tion of 1871.
19. The average number of persons vaccinated by each vac-
cinator for the whole Presidency is 1,652, or 146 more than the pre-
ceding year. It was highest in Sindh and lowest in the Presidency
and Southern Circles.
20. In the last 4 or 5 years, in at least a million of observa-
tions, there has not been a single instance brought to light of syphilis
having been communicated by vaccination ; nor has ever any such
occurrence been known in the Bombay Presidency.
21. The suggestion of the Superintendent General of Vaccina-
tion, that Government might avail itself of the services of the Medi¬
cal Officers of the Vaccination Department in the general sanitation
of the country, might be made of great value. I would rather agree
with the Superintendent General in maintaining the present number
of Superintendents and allowing them to be Sanitary Officers for their
own districts, believing as I do they must thus become a power
for great good in the furtherance of this cause so greatly to be desir-
ed. These officers, with their assistants, so constantly moving about
in the districts and visiting thousands of villages, might certainly be,
as the Army Sanitary Commission suggested, made useful for effi-
rient inspecting service in helping towards the removal of local di-
sease causes. The Bombay Vaccination Department partakes very
much indeed of the character of what might be a most efficient sani-
tary service for the Presidency ; and it appears to me that the
Sanitary and Vaccination Department working together might, in
a very short time, collect a fund of useful information, which would
go far towards enabling this Government to take active sanitary
steps when they may be able to do so.
22. Government will be glad to know that the Assistant Super-
intendents have " completely realized the expectations formed of
them," and may be disposed to extend their usefulness in the mat-
t er of sanitation so strongly advocated by the Army Sanitary Com-
mission, as the Superintendent General reports this might be done
without injuring their efficiency in their own branch, or adding
much, if any, to the expenditure.
23. A new feature in this report is the carefully prepared
details regarding the progress of vaccination in each zilha, which
give the important points of the tabulated statements, and enables
the general reader easily to apprehend the state and condition of vac-
5
cination in every part of this Presidency. These details show that
the progress varies very much in different districts and circles.
Thus in Sindh 42.1 per mille of population were primarily vaccinat-
ed, while only 13.4 in the Presidency Circle, and 17.2 in the Southern
Circle, were protected during the past year.
24. Considering the amount and the quality of the work
shown in this report, I most cordially endorse the words of the
Superintendent General regarding how much more it says in favour
of the organization of the department, and for the energy of the
Superintendents, their assistants and vaccinators, than words can do:
and I beg to add, I am entirely satisfied with the work of the past
year, and to commend the Superintendent General and Doctors
Williams. Butler, Cody and Cola to the favourable notice of Govern-
ment.
I have the honour to be,
Sir,
Your most obedient Servant,
(Signed)
W. THOM,
Surgeon General,
Indian Medical Department.
REPORT
ON
VACCINATION THROUGHOUT THE BOMBAY
PRESIDENCY AND SINDH
FOR THE YEAR 1873-74.
Divisions of the report.
This is the sixth report by the Superintendent General of Vaccination.
It is divided into the usual parts, viz., 1st the general
report, which is a summary of the work of the
whole department, and in it the chief points of the
circle superintendents' reports are noticed ; 2nd, extracts from the reports of
superintendents, civil surgeons and dispensary officers and also several special
reports on revaccination; and 3rd, the tables of returns showing the number
of vaccinations in each circle; the cost of vaccination in each circle and for the
whole department: the vaccinations at dispensaries, jails and in the army :
also the number of vaccinated children inspected by superintendents and
their assistants and the number of small-pox deaths in each registration circle.
Alterations in the vaccine
circles.
2. Before proceeding to show the work of the year it will be well to
notice the changes which have taken place in the
circles since last report was submitted. In the
reorganization of the department which was made
in 1871 there was a saving of some ten thousand
rupees, which Government in their Resolution No. 1202 dated 3rd April 1873
ordered to be expended in improving the department, because they had
pledged themselves not to effect a saving of provincial money at the
expense of local funds. Accordingly, Dr. Turnbull when acting Superin-
tendent General, drew up a scheme which was submitted to Government in
his letter No. 378 dated 3rd June 1873 and finally approved by Govern-
ment Resolution No. 2783 dated 7th August 1873, and brought into effect
from the following November. The changes may briefly be expressed
thus:—
1st, the Rewá Kánthá circle was abolished and its districts thrown into
the Northern circle, which then became the Eastern Gujaráth circle ; 2nd,
the Ahmadábád collectorate and Pálanpur states were taken from the Nor-
thern circle and thrown into the Káthewád circle, which then became the
Western Gujaráth circle. This new distribution of districts divides Gujaráth,
as it was in 1854, with the exceptions, that the Mahí Kánthá is now in the
Eastern Gujaráth circle instead of the Western Gujaráth circle and Baroda
territory does not form a part of Western Gujaráth circle as it did in 1854
but is now a separate circle by itself; 3rd, Násik and Khándesh collectorates
and Penth state were taken from the Central circle and added to the Wes-
tern circle; 4th, Ratnágirí collectorate was taken from the Western circle
1 vac
( ii )
and added to the Central circle ; and 5th, Sáwantwadi state was taken from
the Western circle and thrown into the Southern circle ; 6th, it was recom-
mended that, after Dr. Butler vacates his dual appointment of civil
surgeon of Rájkot and superintendent of vaccination, in the Western Gujaráth
circle, the two appointments should be separated, and that there should
be a superintendent for the Western Gujaráth circle, who shall have no
other than vaccine duties to perform—as yet the Government of India's
sanction to this part of the scheme has not been received ; 7th, an additional
assistant superintendent in each of the large zilhás of Sátárá, Khándesh,
Násik, and two additional for the Province of Sindh were sanctioned ; 8th,
a second clerk in the office of the Western, Eastern Gujaráth, Western
Gujaráth and Sindh circles, and a third peon in each superintendent's office,
were also sanctioned. These changes will exhaust the saving effected by
my reorganization of 1871—provided the Government of India sanction
a superintendent for the Western Gujaráth circle, who shall not be the
civil surgeon of Rájkot.
Circles, as they now stand.
3. There are now 9 circles of vaccination,
viz :—
1st. The Presidency circle which is the city and island of Bombay.
2nd. The Central circle which comprises the collectorates of Púná,
Ahmadnagar, Sholápur, Sátárá and Ratnágirí ; the native states of Akalkot,
Bhor, Jat, Átpadi and Phaltan.
3rd
The Southern circle which includes the collectorates of Belgáon,
Dhárwad, Kánadá and Kaládgi; the native states of the Southern Maráthá
country, Kolhápur and Sáwantwádí.
4th. The Western circle, which contains the collectorates of Tháná,
Kolábá, Násik and Khándesh; the native states of Penth, Jawár and Janjí-
rá : the 6 Mowas and 15 Dang states and also the estates of 5 political
Surinjamdars in Khandesh.
5th. The Eastern Gujaráth circle, which comprehends the collectorates
of Surat, Broach, Khedá and the district of Panch Maháls ; the native states
of Rewá Kánthá, Mahí Kánthá, Cambay, Bánsdá, Dharampur and Sachin.
6th The Western Gujaráth circle, which consists of the collectorate of
Ahmadábád, the province of Káthewád and the Pálanpur states.
7th. The Sindh circle, which comprises the collectorates of Karachi,
Haidrábád, Shikárpur, the political superintendencies of Thar Párkar and
Upper Sindh Frontier and the native state of Khairpur.
8th. The Barodá circle, which is the territory of H. H. the Gáíkawád.
9th. The Kutch circle, which is the territory of H. H. the Ráo.
Strength of the department.
4. The strength of the department at the end of the year is com-
pared, below, with the preceding year and the
areas and populations of circles are also shown.
( iii )
Number.
1
2
3
4
5
6
7
8
9
CIRCLES.
Presidency ..........
Central ..........
Southern ..........
Western..........
Eastern Gujaráth ...
Western Gujaráth ...
Sindh............
Barodá..................
Kutch
Aden.....................
MilitaryStations ........
Total
Area in square miles.
19
27,656
28,104
24,519
25,774
30,246
52,978
*20,000
6,500
12
...
215,808
Population.
644,405
4,828,850
4,757,127
3,070,259
3,112,490
3,142,153
2,300,711
2,000,225
486,900
19,289
123,220
24,485,629
1873-74.
Superintendent General.
1
...
...
...
...
...
...
...
...
...
...
1
Superintendents.
1
1
1
1
1
1
1
1
1
...
...
9
Assistant Superinten-
dents.
...
5
5
5
4
3
6
1
1
...
...
30
Clerks.
2
2
2
2
2
2
2
1
...
...
...
15
Number of Vaccinators.
Govern-
ment.
Civil.
...
...
...
...
...
2
...
...
...
...
...
2
Military.
...
...
...
...
...
...
...
...
...
...
4
4
Municipal.
11
12
6
4
3
5
5
...
...
2
...
48
Local Funds.
...
48
37
42
25
7
43
...
...
...
...
202
Native States.
...
5
25
3
18
38
2
23
11
...
...
125
Total.
11
65
68
49
46
52
50
23
11
2
4
381
Number of Peons.
Government.
4
9
8
9
8
9
10
...
...
...
...
57
Municipal.
11
11
3
3
3
5
3
...
...
2
...
41
Local Funds.
...
48
37
42
25
7
43
...
...
...
...
202
Native States.
...
5
25
1
15
38
2
25
9
...
...
120
Total
15
73
73
55
51
59
58
25
9
2
...
420
Total Strength.
30
146
149
112
104
117
117
51
22
4
4
856
1872-73.
Superintendent Gene-
ral.
1
...
...
...
...
...
...
..
...
...
...
1
Superintendents.
1
1
1
1
2
1
1
1
1
...
...
10
Assistant Superinten-
dents.
...
5
5
4
4
3
4
1
1
...
...
27
Clerks.
2
2
2
1
2
1
1
1
...
...
...
12
Number of Vaccinators.
Govern-
ment.
Civil.
...
...
...
...
...
2
...
...
...
...
...
2
Military.
...
...
...
...
...
...
...
...
...
...
4
4
Municipal.
11
14
7
4
3
5
5
...
...
2
...
51
Local Funds.
...
48
36
42
25
7
43
...
...
...
...
201
Natives States.
...
5
22
3
18
38
1
23
9
...
...
119
Total.
11
67
65
49
46
52
49
23
9
2
4
377
Number of Peons.
Government.
4
8
7
7
10
8
7
...
...
...
...
51
Municipal.
11
13
3
3
3
5
3
...
...
1
...
42
Local Funds.
...
48
36
42
25
7
43
...
...
...
...
201
Native States.
...
5
20
1
13
38
1
25
4
...
...
107
Total.
15
74
66
53
51
58
54
25
4
1
...
401
Total Strength.
30
149
139
108
105
115
109
51
15
3
4
828
* This is a rough estimate.
( iv )
There are only six vaccinators in this Presidency paid by Government;
they are 2 (civil) for Rájkot and Dísá and 4 (military) for the canton-
ments of Púná, Mhow, Nímach and Nasirábád: all the others are paid
from local funds, municipal funds and native states. From the above
table it will be seen that there are 6 government, 48 municipal, 202
local funds' and 125 native states' vaccinators: total 381. There are
420 peons. Nearly all vaccinators have a peon, each assistant super-
intendent has one, each superintendent has 4 and so also has the Super-
intendent General 4. There are, as compared with 1872-73, exactly the
same number of government vaccinators, 1 more local fund vaccinator,
but 3 fewer municipal and 6 more native states : on the whole there is an
increase of 4. At the end of the official year the Presidency circle estab-
lishment of municipal vaccinators was increased by 5 at the cost of 6
peons who were reduced ; so there are now in Bombay city 16 vacci-
nators and 5 peons. Just about the close of the year a municipal
vaccinator was appointed for Dhárwád and one is to be appointed for
Kárwár and another for Gulatgad. The municipal vaccinators for Bárá-
mati and Khánápur were abolished in July and November and the
Wálwá and Karhád municipal vaccinators were abolished at the end of
the year. The increase of vaccinators in native states is owing to the
Chief of Sánglí appointing a vaccinator in each of his districts of Shir-
hattí and Mangalvedhá. The Chief of Miraj appointed a second vacci-
nator for Lakshameshwar. H. H. Mír Alí Murád has appointed a second
vaccinator and in Kutch there was an increase of two.
Total number of persons
vaccinated and revaccinated.
5. The number of persons vaccinated last year is more, in nearly all
circles than in the year preceding, but the rate of
increase differs a good deal in the different cir-
cles, which I shall notice further on.
The following figures show the number of persons who were vacci-
nated and revaccinated in the year 1873-74 and the preceding one:—
1873-74.
Primary
Vaccinations.
600,471
18,560
619,031
Revaccina-
tions.
22,409
1,429
23,838
642,869
9,354
652,223
In Civil Life.
Itinerant Establishment
Dispensary Establishment
Civil Life Total
Army Total
Total Vaccinations in Bombay
Presidency
1872-73.
Primary
Vaccinations.
546,566
16,960
563,526
Revaccin-
ations.
14,630
1,671
16,301
579,827
8,530
588,357
There is thus an increase, as compared with the preceding year, of 63,866
persons operated on. This increase is the largest that has over been made
in any one year and it is distributed as follows :—
Itinerant establishment .....................
Dispensary do. ....................
Army do . ....................
Total increase......
61,684
1,358
824
63,866