NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
31
he was somewhat well, but no sooner had he returned to his work, than he took again
very ill, and died in November. He was one of the best men next to Dana Bhava,
of Pahlunpore, and I therefore regret his loss. As early information of his death was
received by me, I was able to make arrangements for the carrying on of work in
Kakhrej talooka, and vaccination there has again been going on since the end of
November.
31. There were many breaks in vaccination during the year ; more than what is
usual. The majority of these occurred after unusually heavy rains, and the consequent
high floods in all parts of this Circle. Some of the Vaccinators were prevented from
going to their week's work in consequence of their stations being surrounded by water;
these lost their lymph entirely. Others were out on their week's work in villages, and
were there weather-bound; these lost their lymph partially. The following is a list of
places where lymph was lost, in consequence of the above-mentioned cause :—
Total loss of lymph.
Prantage,
Dholka,
Morassa,
Bardolee,
Soopa,
Chicklee,
Sadra,
Hursole.
Partial loss of lymph.
Veerungaum,
Sanund,
Dhundooka,
Koth,
Ranpoor,
Wagra.
Bulsar,
Pardee,
Bugwara.
Some of them took measures themselves to obtain fresh supplies from neighbour-
ing Vaccinators; to others, who could not do so, fresh lymph, in tubes charged by
myself from the Chowrasee Vaccinator's fresh work, were sent. Many of them were
able to resume work within two or three weeks of the break. One man, the Vaccinator
of Prantage (General No. 154), lost much time ; all the supplies of lymph sent to him
were reported to have produced bad vesicles. I was ultimately obliged to direct him
to go to a long distance, and procure good lymph from the Bavesie Vaccinator.
32. There was more sickness among the Vaccinators during the months follow-
ing the floods, viz., in September and October. Some were laid up with guinea worms,
others with axillary abscesses, and a few with fever, and lost their lymph in conse-
quence. From August up to October were months of no little anxiety to me, for it
was not till the month of November that nearly all were again in working order.
33. Making a rough calculation of the loss of time by different Vaccinators
from the above causes, I find that in the Government establishment the loss is equal
to the work of two Vaccinators for eleven months. In the Native States establish-
32
ments, the loss amounts to the work of two Vaccinators for eight months of the year.
But for these breaks, the increase in the year's work would have been very consider-
able.
34. Of the Vaccinators of this Circle I may say, with the exception of a couple
or so who are decidedly idle, nearly all are industrious. They have met my demands
for increased work to their utmost capability, and their general conduct, as far as it
has come under my observation, has been very exemplary.
35. In paragraph 29 of this Report I mentioned the circumstance of the dis-
missal of two Vaccinators for the misappropriation of money to their own use, instead of
giving it to parents of children, carried for vaccine purposes from one village to
another. My attention was drawn to the getting up of "remuneration putrucks"
and of Forms V. 2, of all Vaccinators, and I found that the village Patels, whose business it
was to attest the truthfulness of the forms, and thereby be a check on the Vaccinators,
were in the loose habit of putting their signatures on them anyhow, even on blank
forms, without ascertaining in the least to what statement their signature was re-
quired : thus the object for which these forms were introduced was lost. To remedy
this evil, I addressed the four Collectors in this Circle, requesting them to make it known
to all the Patels, through the Mamlutdars of talookas, that in no instance were they to
sign blank forms, and that their duty was to acquaint themselves fully with what was
written on the forms, and to refuse putting their signature to anything that was not
true. This has now been done, and as much good as could result by making the
object of the putrucks known is, I believe, now derived. Independently of this, a
certain method is adopted of filling up these forms, and of checking the monthly
returns, which now leaves very little room for exercising dishonesty.
36. From October last, in accordance with instructions contained in Circular No.
2,990, dated 27th August 1868, of the Inspector General, Indian Medical Department,
the Vaccination Returns of three of the Dispensaries (Dholka, Veerumgaum, and Dokaré)
in this Circle were received by me. These are incorporated in the yearly returns. Two
Hospital Assistants only, viz., of Dholka and Veerumgaum, sent their annual remarks,
which I beg to append in original.
SIND CIRCLE.
Superintendent—Assistant
Surgeon J. FFOLLIOTT.
Ditto
Surgeon J. PINKERTON, M.D.
Acting Ditto
Surgeon Major J. GILBERT.
Ditto
Ditto
M. STYLE.
Establishment—Seventeen
Vaccinators under Government, fifteen Local, eighteen
Dispensaries, and one under a Native Chief.
Population, 2,500,000. Total cost, Rs. 19,757-15-2. Average cost of each
Vaccination, 4 Annas and 7 Pies.
33
Establishment.
Government ....
Local .................
Dispensaries
....
Native Chiefs ..
Years.
1867
1868
1867
1868
1867
1868
1867
1868
Total Vac-
cinated.
33,821
38,859
21,854
23,612
3,069
3,365
2,529
2,105
Compared with the
preceding year.
Increase.
....
5,038
....
1,758
....
296
....
....
Decrease.
....
....
....
....
....
....
....
424
Successfully
Vaccinated.
32,353
38,053
21,022
22,966
....
3,144
2,297
1,891
Percentage
of success.
95.6
97.9
96.2
97.2
87.3
90.0
90.8
88.7
The results of vaccination in the Sind Circle during the past and preceding years
are exhibited in the above table, from which it will be seen that there has been an
increase in the Imperial and local returns of 7,092, as compared with the year 1867,
and a decrease of 424 in the returns from the Khyrpoor State.
2. Deducting the work done in Dispensaries, which was not previously included
in the returns from the Superintendent of Vaccination, the net total increase is 6,668
over the total number vaccinated in 1867.
3. The aggregate number vaccinated during the year 1868, has amounted to
67,941, of which 66,054, or 98 per cent. nearly, have been successful. These results
are satisfactory ; but we do not hope to show so large a number year by year until the
population increases considerably. If the population of Sind (inclusive of the Khyr-
poor State) is only 2,500,000, the number of children available annually for vaccination
should be 60,000 only for some years to come. The past year has been exceptional, as
in addition to sporadic small-pox which kept the Vaccinators constantly working hard
to check it, a large influx of emigrants from the famine districts of Hindustan has fur-
nished several thousand children for vaccination. These emigrants, even if they remain
in the country, will not give the Vaccinators much additional work for some years hence,
and the returns are likely to fall considerably below the numbers vaccinated in 1868.
Arranged according to Sex, there were 37,470 males,
or 54.4 per-centum.
„
„
„
„ 30,471 females
„ 44.8
„
„
„
Age
„ 24,428 under 1 year
„
36.
„
„
„
„
„
43,513 above 1 year „
64. „
„ „
Caste
„
9,279 Hindoos
„ 13.6 „
„
„
„
„ 53,918 Mussulmans „ 79.3
„
„
„
„
„
4,727 Other Castes „
7.1
„
This is nearly the usual percentage obtaining in Sind, and demands no special
remarks.
4. The following table shows the cost of each successful operation, calculated
separately for Imperial, local, and other establishments. As the former is debited with
5 v
34
the cost of administration, it is of course considerably the highest ; but taken in the
aggregate, the cost of each successful operation is 5 Annas and 2 Pies only. Another
table is appended, showing the cost of all operations, successful or otherwise.
5. Number successfully vaccinated by
Imperial Establishment ....
Local .................................
Native Chiefs ....................
Dispensaries .....................
38,053 cost each 6 Annas 4 Pies.
22,966
„
3 Annas 11 Pies.
1,891
„
3 Annas.
3,144
„
Nominal.
Total cost of each successful operation, 5 Annas and 2 Pies.
6. The quality of the lymph has been very good so far as I have inspected, and
all the Vaccinators contrive to report favourably upon this point.
7. Small-pox has been sporadic throughout the year, but, except in the towns of
Roree and Sukkur, it has not spread, nor caused much mortality. It was introduced
to the former town in April, or early in May, by some boatmen from the Native
State of Bahawulpoor, and appears to have been propagated both in Roree and some of
the neigbouring villages by inoculation. The total number of cases ascertained by me
to have occurred in the towns and districts during the past year amounts to over
300, out of which there were 31 deaths.
8. It is doubtful whether vaccination will be ever willingly and universally
accepted by the Hindoos. Time and education may do a good deal towards enlight-
ening them on the subject; but time and education have failed with Christians, and
after a trial of 70 years it has been found necessary to compel its adoption in the
country where it was first discovered and practised. No Brahman or Syud who
ventures to reason on the subject can make a good objection to vaccination. As they
both practice inoculation, the religious argument is a mere pretext, and of less force
than custom, to which they are bound by prejudice. Mussulmans frequently object
to it, on the ground of its affording less complete protection than inoculation to
small-pox, and I have taken some pains to put them right upon this point, as there is
only a half truth to support it. It is quite true that vaccination gives less protection
against small-pox than inoculation, or a previous attack of the disease, but it affords
much greater protection against an attack ending fatally.
9. The following tables by Dr. J. Thompson and M. Favart, compiled from
statistics furnished of epidemics of small-pox in Europe, show the relative protection
afforded by vaccination, inoculation, and a previous attack of small-pox :—
Cases ...................
Deaths .................
Proportion ...........
Unprotected.
205
50
1 in 4
Small-pox a
second time.
71
3
1 in 23
Small-pox after
Vaccination.
310
1
1 in 310
35
Marseilles epidemic of 1828 reduced to an uniform scale of 15,000—
Estimated number ..................
Attacked .................................
Died
...................................
Proportion attacked
Ditto
of Deaths to attacks ..
Unpro¬
tected.
15,000
7,500
1,875
1 in 2
1 in 4
Previous
Small-pox
or inocula¬
tion.
15,000
150
30
1 in 100
1 in 5
Vacci¬
nated.
15,000
1,000
10
1 in 15
1 in 100
10. In the absence of any law enforcing vaccination in India, much may be done
by Mooktyarkars, and other native officials, in securing the vaccination of all children
within their jurisdiction. In large villages and districts there is usually little or no
opposition to the Vaccinator; but in large towns he cannot get on without the per-
sonal assistance of the Mooktyarkhar or local native officials. While on this subject,
I may remark that the people object very strongly to allow lymph to be taken from
their children's arms ; and forcing them to carry children frequently a long distance in
addition, is often a real hardship. A more liberal allowance of glass tubes would be
the remedy, if the Vaccinators could withstand the temptation of stopping and resum-
ing work at their own convenience, which glass tubes would enable them to do
without trouble.
11. I would strongly recommend a small increase of pay to the Vaccinators.
They are a very hard-working set of men, and their present pay is hardly sufficient to
keep themselves and families in common necessaries. Being always on the move, they
are each obliged to keep a pony, and are seldom able to live with their families, which
of course increases their little expenses.*
12. Inoculation, in my opinion, cannot be stopped, except by making it penal.
13. As I have had charge of the Sind Circle for little- over four months only, a
retrospect of my employment during that period must necessarily be brief, as I have not
visited the whole of my districts, and am up to the present time making myself acquainted
with the best method' of working, and maintaining the existing efficiency of the
establishment.
14. In the month of November I visited Mahomed Khan's Tanda and districts,
and inspected the Vaccinator's work there, which I found satisfactory. As there were
a few hundred unprotected children in the town, I set vaccination going, and the Hos-
pital Assistant has since informed me that the work has been finished, and will be re-
sumed in the ensuing cold season, if a sufficient number of children are available.
* Their pay has been increased.
36
15. October and November were spent in office work, and inspection of work in
the neighbourhood of Meanee and Muttari. There is a bigoted Mussulman population
in these parts, as well as in the town of Muttari, but it is almost completely protected
by vaccination, to which they make no objection whatever. Part of the Halla districts
were also inspected in November.
16. The month of December was employed in the Nowshera districts and visit-
ing a few towns in the Khyrpoor State ; and my 1st Assistant accompanied me in
all my inspections until we arrived at Sukkurund, where I detached him to test some
villages in the neighbourhood of Shadadpoor, where the amount of work appeared to
be unusually large. In no case has any falsification of returns been detected; but
I have been obliged to fine one Vaccinator Rupees 10 for extorting money in payment
of vaccination, and withholding gratuities from the parents of lymph children.
17. Small-pox has prevailed extensively in the bordering Native States (with the
exception of that of His Highness Meer Ali Murad, who employs a Vaccinator), and
though it has been introduced at many points in Sind, it has remained sporadic, and
attacked the unprotected only.
KATTIAWAR CIRCLE.
Superintendent.—Surgeon
E. R. BUTLER, M.D.
Establishment.—Eight
Vaccinators under Government, and thirty-four under
Native Chiefs.
Population, 1,580,240. Total cost, Rs. 12,380. Average cost of each Vacci-
nation, 4 Annas.
Establishment.
Government ....
Native Chiefs ..
Years.
1867
1868
1867
1868
Total Vac-
cinated.
7,829
10,523
32,046
39,023
Compared with the
preceding year.
Increase.
....
2,694
....
6,977
Decrease.
....
....
....
....
Successfully
Vaccinated.
7,550
9,905
29,807
35,924
Percentage
of Success.
96.4
94.1
93.0
92.0
Before commencing my report for 1868, in justice to the gentlemen who have been
acting for me, during the past two years, and in fairness to myself, and the Assistant
Vaccinators of Kattiawar, I beg to say a few words, with all due respect, in reference to
the 38th paragraph of the Inspector General's Report for the year 1867. The Inspector
General states that the " system of vaccination is at fault." The system is the only
one that can be carried on under the present state of things, for two principal reasons:
The Assistant Vaccinators for the most part are kept and paid for by the wealthy Chiefs,
the greater number of poorer Chiefs neither can, nor will, keep Assistant Vaccinators,
38
occurred illustrative of this. The Mangrole Chief engaged a Vaccinator ; after two or
three months, I received no returns from him ; I wrote three months successively for
his returns, and getting only evasive answers, and no returns, I sent a man to act,
and ordered the Mangrole Vaccinator into Rajkote. He came, accompanied by the
Mangrole Wukeel. They made a complaint that the Joonaghur Durbar had withheld
the returns, because they had not been transmitted through them. I asked the
Wukeel "Who paid the Vaccinator?" He, answered: "the Mangrole Durbar."
Then I said, " Send one return to me, and one to the Joonaghur Durbar." They were
quite satisfied, but Joonaghur was not. The head Karbaree of that State came to me,
and said, " If this were done, it would be a proof that the Mangrole Chief owed Joona-
ghur no allegiance," and requested that the whole correspondence might be forwarded
to the Political Agent for his decision, who gave it in favour of Joonaghur. In conse-
quence of this, the Mangrole Chief refused to give the Vaccinator his salary. During
the dispute no work has been carried on ; Joonaghur, however, is willing to pay the
Vaccinator.
3. The Inspector General also states that " the superintendence is weak." For
nearly one year, during the time I was away on sick leave, there was no practical
superintendence whatever ; there was virtually no Superintendent of Vaccination in
Kattiawar ; the duties were carried on by the medical officer in charge of the regiment
at Rajkote. Besides which, there is no vaccination office establishment. The
senior Vaccinator writes the official correspondence, and travels about with the
Superintendent, who has to find him a tent, and pay for fodder for his horse ; for he
certainly could not do either on rupees 20 per month, which is all the pay he gets,
and he must have some means of getting about.
During the greater part of 1867 Dr. Blomfield was Acting Superintendent of
Vaccination, but on account of his being ordered to take charge of the 17th Regi-
ment N. I. and station at Rajkote, he was only able to travel eighty days ; so that
for nearly two years there was no practical supervision, except those eighty days.
4. The disturbed state of Kattiawar has also been a serious obstacle to vacci-
nation being properly and efficiently carried on in some parts of the province.
5. The returns for the year 1868 show a considerable increase on the total for
1867, greater in proportion than the increase of 1867, above the total for 1866.
I thought last year the number had nearly reached the maximum ; the great increase
is therefore more satisfactory than I had any reason to expect, as from the best
computation I can make, 50,000 subjects yearly are all that can be estimated as
available for vaccination. I have not made this calculation altogether from the annual
birth rate, as it is so very difficult to estimate that correctly, on account of the
migratory habits of the people; but have taken into consideration the large number of
strangers that visit Kattiawar yearly.
43
13. I have received lymph several times from England and from different parts
of India, but it has all proved inert. I have neither heard of nor seen an outbreak of
small-pox during my short tour, although I have travelled 1,110 miles, visited 132
villages, and inspected 5,051 children. I saw two children, each having been well
vaccinated, as the marks bore evidence, who had suffered severely from small-pox, one
five and the other three years ago ; this is the first time I have even seen a case in
Kattiawar of small-pox following vaccination. The first case was attacked three days
after the vesicles (vaccine) made its appearance. The lymph we are at present
using has one peculiarity, it very frequently produces a sore with a deep excavation,
which takes months to heal; I saw one child who had been vaccinated four months ago,
and one of his arms was not then healed, this lymph was introduced from England in
January 1867.
14. I found two false returns, both forwarded by the same man.
15. The Political Agent and his assistants have given me great assistance.
16. Colonel Anderson, the Political Agent, has for some months past ordered
the vaccination returns to be printed in the Local Weekly Gazette ; it is not always
done, for want of space, but, nevertheless, it has a good effect, as all the talookdars
subscribe to the paper.
REWA KANTA CIRCLE.
Superintendent—Assistant
Surgeon J. T. WELSH, M.D.
Establishment—Five
Vaccinators under Government, and seven under Native
Chiefs.
Population, unknown. Total cost, Rs. 3,741. Average cost of each Vaccination,
4 Annas and 1 Pie.
Establishment.
Government.
Punch Mahals ..
Native Chiefs ..
Years.
1867
1868
1867
1868
Total Vac-
cinated.
7,967
7,507
5,359
7,083
Compared with the
preceding year.
Increase.
....
....
....
1,724
Decrease.
....
460
....
....
Successfully
Vaccinated.
7,373
7,094
5,054
6,649
Percentage
of Success.
92.5
94.4
94.3
93.8
Although there has been a falling off in the number of children vaccinated in the
Punch Mahals, the progress of vaccination in this Circle throughout the year has been
satisfactory. The decrease occurred in the work of Jaithalal Gunputram (General No.
253), Dohud, and Mahasunker Cassiram (General No. 255) Halole, two of the best
Vaccinators in the Circle, and can scarcely be complained of when the large increase
recorded in the reports for the years 1866 and 1867 is taken into consideration. The
total number of vaccinations in the Punch Mahals during the years 1863, 1864, and 1865
44
amounted to 9,534 ; whereas, in the years 1866,1867, and 1868, the number amounts
to 21,301. Unvaccinated children are therefore less numerous than they were ; and I
believe the Vaccinators worked harder during the past year than in any previous year.
That they would have done more had they been entitled to travelling batta may be
taken for granted.
2. The increase in the work done by the Vaccinators in the Native States is
considerable this year, and is to a certain extent due to the appointment at Major Bar-
ton's request of an additional Assistant Vaccinator, to carry on work in the Sunkeira
Mewas. He joined his appointment in the month of September, during which and the
following months he vaccinated 371 children. The Assistant Vaccinator in Soonth and
Kuddana, who during the two months he was employed in 1867 only vaccinated 99
children, has this year performed 619 vaccinations. The Assistant Vaccinator in
Barriah has also been very industrious ; the increase in the number of vaccinations
performed by him being 539. As Barriah, Soonth, and Kuddana are about the most
jungly and least civilized parts of the Circle, the success met with is the more pleasing.
3. The area of the Punch Mahals is 1,675 square miles, and the population is
said to be 168,738. Taking the birth-rate at 30 per thousand, the annual addition to
the population would be about 5,000, or in round numbers, some 2,000 less than the
average number vaccinated yearly for the last three years.
4. The area of the Native States is 12,326 square miles. The country, with the
exception of a portion of Rajpeepla, is hilly, jungly, and thinly populated.
5. In my report for the year 1867 I drew attention to the inaccuracy of the
returns on the subject of infantile vaccination, and pointed out that the number of
children vaccinated under one year of age was greatly exaggerated. In 1866 the per-
centage of operations under one year of age in the Punch Mahals was 62, in 1867 it fell
to 53, and in 1868 it is only 42, which, however, is still too high. In the Native States
a similar change has taken place. If the ages had been as correctly noted during former
years as they were during the last, I believe there would have been a large increase in
the percentage instead of an apparent decrease. While on tour I always make parti-
cular inquiries as to the age at the time of vaccination of each child inspected.
From the following statements it will be seen that there has been little or no
actual decrease in the number of children vaccinated during infancy.
Punch Mahals.
Year.
1866
1867
1868
Supposed annual
number of births.
5,000
....
....
Vaccinations.
Under one year.
3,633
4,231
3,159
Above one year.
2,200
3,736
4,348
Percentage un-
der one year.
62
53
42