NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
13
From these figures it will be observed that as regards primary vaccina-
tions in circles, Sindh again has the highest success, and the Presidency and
Western circles the lowest; but by circles the lowest is only 3.2 less than the
highest. It is with much pleasure I note the improvement in the success
here as compared with last year. The percentage of success in primary
vaccinations is very satisfactory indeed, and as regards its general correctness
there can hardly be any doubt, because a very large proportion of the vac-
cinated persons have been seen by the supervising officers of the department.
As regards the success in re-vaccinations the Army is the lowest, except
Kutch, where there were only a very few re-vaccinations altogether ; and as
the results are noted in the Army by qualified medical officers, they are much
more reliable than the other figures.
27. It may be as well here to show also the resulting success of the
operations as performed by the different establishments :—
1 st.
2nd.
3rd.
4th.
5th.
6th.
2 Government civil vaccinators obtained
51 Municipal
do.
do.
203 Local Fund
do.
do.
129 Native States
do.
do.
In Dispensary returns...
In Native Army
Primary
Vaccinations.
97.6
95.9
97.0
95.9
92.5
91.5
Re-vaccina-
tions.
76.7
70.2
84.2
73.9
58.4
44.6
The low rate of success in the Army is probably due to there being so
few vaccinations performed at a time, and consequently medical officers not
being always able to choose a vaccinifer with perfect vesicles from which to
vaccinate.
28. I have now shown the actual work of the department as a whole ;
I will now endeavour to show, by the light of the census, what the number of
primary vaccinations per annum might be.
Population.
29. The population of this presidency is 25,086,318 as shown by the
census, and the area is 187,757 square miles. The
birth-rate in British territory as registered is about
17.7; but this is well-known to be too low, and Mr. Lumsdaine has computed
it to be 40.96 per mille of population. If we take the computed rate and
apply it to native states, as well as to British territory, it will give a total of
births of 1,027,535 per annum in this presidency. Excluding still-born, this
is theoretically the number that might be vaccinated, but to carry out the
theory it is evident that every living child would require to be vaccinated as
soon as born—practically such a thing cannot be done. But it will be in-
teresting to try and find out how many children could be vaccinated annually.
The vaccinators have each an average area of 487 square miles to go over,
and speaking generally, it takes them two years to go over the population in
their areas; or in other words, half the area and population of this presidency
are gone over annually. I have asked Mr. Lumsdaine for the number of
deaths in the first year of life, but he has not calculated it for the whole
presidency on the census figures. I will, however, make an estimate based
on known figures. Mr. Randle has drawn up a diagram of deaths, based on a
parliamentary blue book of the session of 1873, for England and Wales, and
it is shown to be on an average 18 per cent. in the first year of life. The
15
actual protection afforded. I have again to notice that the protection varies
very much in the different circles as shown below :—
Circles.
Native Army ... ... ...
Aden ... ... ... ...
Sindh ... ... ... ...
Western Gujarath ... ... ...
Eastern Gujarath ... ... ...
Central ... ... ... ...
Western ... ... ... ...
Southern ... ... ... ...
Presidency ... ... ... ...
Baroda ... ... ... ...
Kutch ... ... ... ...
Total number of
persons prima-
rily vaccinated
successfully.
4,846
785
90,827
105,985
85,912
124,276
77,232
103,453
12,482
26,569
2,792
635,159
Populations.
100,571 *
19,289
2,322,765
3,644,852
3,147,853
4,823,947 †
3,109,370
4,762,457
644,405
2,000,225
487,305
25,063,039 ‡
Number of pri-
mary successful
vaccinations
per 1,000 of
population.
48.1
40.6
39.1
29.0
27.2
25.5
24.8
21.7
19.3
13.2
5.7
25.3
In British territory the successful vaccinations are 26.9 per mille of the
population and 22.3 in native states.
Quality of lymph, vesi-
cles and cicatrices.
31. The quality of the lymph is by far the most important subject in
this report, and as the superintendents' reports are
not to be printed, I will quote freely from theirs, so
as to place on record, which can be easily referred
to, the actual words, as far as possible, of the officers themselves of the diffe-
rent circles.
Lymph in Presidency
circle.
1st.—In the Presidency circle, i.e., Bombay city, the lymph is mostly
obtained from calves. In December, January, and
again in March the operations failed more or less in
several animals, which so far crippled the establish-
ment ; all the rest of the year the supply has been abundant. Mr. Anantá
Chandrobá says : " Animal vaccination continues satisfactory. 285 animals
were inoculated with cow-lymph during the year; and, with the exception of
4 failures, all of which occurred during the latter part of March, they were
very successful. Some 6 or 7 heifers did indeed sicken in the months of
December and January, but the operations in them were successful."
Lymph in Central circle.
2nd In the Central circle I inspected the lymph in the collectorates of
Poona, Sholápur, Sátárá and Ratnágiri, and in all I
found it excellent. Generally the reports of the
* This population is very doubtful.
† Exclusive of the native state of Jat.
‡ Railway and British Army population is not given here.
18
49 tubes of English lymph were used; 55 children were operated
on ; 282 insertions were made, and there resulted 34 good and 10 imperfect
vesicles. The success cannot be considered as good as desirable ; but it
gave a supply of English lymph, which once started we could multiply
to any extent required.
Whence
received.
England.
Vaccine circle in
which tested.
Presidency ...
Central ... ...
Southern
...
...
Western
...
...
Eastern Gujarath
Western do. ...
Sindh
...
...
Baroda ... ...
Kutch
...
...
Total...
Presidency ...
Central ... ...
Southern ... ...
Western ... ...
Eastern Gujarath...
Western do. ...
Sindh ... ...
Baroda
...
...
Kutch
...
...
Total...
Grand Total...
Number of
Tubes tested.
2
3
3
3
3
3
3
2
2
24
2
2
2
3
3
4
3
3
3
25
49
Children opera-
ted on.
1
4
3
4
3
3
3
2
3
26
1
3
3
4
3
5
4
3
3
29
55
Insertions.
5
16
16
22
14
12
20
12
12
129
6
12
12
18
14
30
31
18
12
153
282
Resulting vesicles.
4
5
...
...
2
3
...
1
3
18
...
10
4
...
1
8
...
1
2
26
44
Character of
vesicles.
Very Good
Good
Unsuccess-
ful.
Do.
Imperfect
success.
Small.
Unsuccess-
ful.
Small.
Good.
Unsuccess-
ful.
Good.
Do.
Unsuccess-
ful.
Bad.
Good.
Unsuccess-
ful.
Small.
Do.
REMARKS.
Failed in one child.
Failed in one child.
Subsequent
vaccinations good.
Failure in one child.
Failed in one child.
Failed.
Lymph excellent.
One tube only had good lymph.
No sign of a vesicle.
No lymph could be obtained.
Failed in 3 children.
Failed in 2 children, and subse-
quent vaccinations bad.
Failed in 1 child.
20
shown below. The increase in the Government establishment has been kept
down by my holding charge of the Central circle.
Establishments.
Imperial ... ... ... ...
Municipal ... ... ... ...
Local Fund ... ... ... ...
Native Chiefs ... ... ...
Total...
Total expenditure.
Rs.
1,07,444
15,686
59,753
37,778
220,663
a.
12
14
8
2
5
p.
3
0
11
7
9
Compared with the preceding year.
Increase.
Rs.
2,246
27
595
1,718
4,586
a
0
1
8
3
13
p.
6
5
5
1
5
Decrease.
Rs. a. p.
......
......
......
......
......
It is a pleasing feature in the above expenditure that native states,
municipalities and local funds together have increased their expenditure in
about the same rate as Government. In a paper now before Government
I have shown how the vaccination charges ought to be considerably reduced by
debiting a portion of the superintending charges to sanitation, because the
supervising officers now are health officers as well as superintendents of
vaccination.
Cost of each successful
vaccination, excluding the
pay of superintendents.
38. The cost of each successful vaccination is considerably influenced
by the pay of the superintendent. In the Western
Gujarath, Baroda and Kutch circles the cost of super-
intendence is much less than in the other circles,
because the superintendents hold other substantive
appointments from which nearly the whole of their pay is drawn, and again,
the cost has been less than usual in the Central circle, owing to my
having charge of it in addition to my duties of superintendent general.
The pay of a superintendent may also vary in different circles according
to rank and length of service. This quantity is, therefore, such a variable
one that in comparing the cost of each successful case in one circle with
another, it should be excluded. I have, therefore, excluded it from the
following table, and also the cost of the four army vaccinators, because they
do a great many vaccinations in regiments which do not appear in these four
vaccinators' own returns:—
Name of
Circle.
1.
2.
3.
4.
5.
6.
7.
8.
9.
Presidency ... ...
Central ... ...
Southern ... ...
Western ... ...
Eastern Gujarath ...
Western
do. ...
Sindh
...
...
...
Baroda ... ...
Kutch
...
...
Aden ... ... ...
Superintendent.
Dr.Anantá Chandrobá.
Dr. J. Pinkerton ...
Dr. Raby
...
...
Dr. Cody
...
...
Dr. Cola
...
...
Dr. Blomfield
...
...
Dr. Williams
...
...
Dr. Seward ... ...
Dr. Dorábji Hormasjí...
Dr. Nolan ... ... ...
Total...
Successfully
vaccinated
and re-
vaccinated.
43,182
120,826
102,438
75,229
82,950
105,177
126,777
26,702
2,795
826
656,902
Total cost ex-
cluding pay of
superinten-
dents.
7,250
26,303
27,292
22,557
20,423
23,584
25,850
7,085
2,566
216
163,128
1
10
9
3
6
3
1
1
3
0
7
7
2
5
2
9
0
5
0
3
0
9
Average cost
of each suc-
cessful vac-
cination.
0
0
0
0
0
0
0
0
0
0
0
8
3
4
4
3
3
3
4
14
4
3
9
5
3
9
11
7
3
2
8
2
11
Number
of
vaccina-
tors.
16
63
72
50
46
53
50
23
11 3
385
21
Cost of each successful
vaccination including all
charges.
Vaccination is again dearest in Kutch, but each successful vaccination
was less than in the preceding year by one anna and seven pies. I wish I
could add that it is as good as it is dear. But I fear it is just the reverse.
Vaccination in Bombay city is the next most expensive; but here it is good,
and I do not think it ever can be as cheap in a large city as in the coun-
try districts. The cost in the rest of the circles does not vary very much,
but the Western is the highest a little, and Sindh the lowest. The general
average cost of each successful vaccination, after excluding the pay of the
superintendents, was 3 annas and 11 pies, or 7 pies less than was shown in
the previous report; but, including all charges, it was 5 annas and 4 pies,
or 10 pies less than in the proceeding year.
Although the average cost of each successful
vaccination has been nearly one anna reduced, still I
am afraid our cost is high as compared with other
provinces in India; but I do not think it is now too high for the work
done, and for the surety that it is well done. It may still be reduced a
little by the further extension of vaccination.
Inspections by the offi-
cers of the department
39. What I have already written affords conclusive evidence that
all the officers who have been working with me in
the department last year have exerted themselves
in a way that I cannot speak too highly of. When
I say I am entirely satisfied, I express in terse and plain language what 1
mean ; but if anything more be required, the figures below prove how active
and energetic all have been :—
Name of.
Circle.
1.
2.
3.
4.
5.
6.
Central
...
...
Southern
...
...
Western
...
...
Eastern Gujarath ...
Western
do. ...
Sindh
...
...
...
Superintendent.
Dr. J. Pinkerton ...
Dr. Raby
...
...
Dr. Cody
...
...
Dr. Cola
...
...
Dr. Blomfield
...
...
Dr. Williams ... ...
Total...
Number
of encamp-
ments.
50
81
78
72
58
116
455
Number
of travel-
ling days.
79
127
134
166
128
153
787
Distance
travelled
in miles.
1,126
1,353
2,135
1,885
l,489
3,221
11,209
Number of
villages
visited.
156
260
371
430
237
500
1,954
Number
of vacci-
nated
children
inspected.
8,142
13,734
9,469
16,515
15,129
11,616
74,605
Before making any remarks on these figures, I must state that I held
charge of the Central circle, and it is entered for the sake of showing the
total inspections. The above figures do not show my travels, &c., in other
circles in my capacity of superintendent general. Dr. Williams made
the greatest number of encampments ; Dr. Cola travelled the greatest number
of days ; Drs. Williams and Cody travelled the greatest number of miles;
Drs. Williams and Cola visited the greatest number of villages ; and Drs.
22
Cola, Blomfield, Raby and Williams inspected the greatest number of vacci-
nated children.
Two methods of test-
ing the correctness of the
returns.
40. There are two methods of testing the vaccinators' work : one is by
calling over the names of the vaccinated children and
seeing one by one that the entries in all the columns
of the vaccination registers have been correctly
filled up, as regards name, sex, caste, age and results ;
the second method is by collecting as many children as can be got together
without much inconvenience to the people, and ascertaining the character
of the vesicles or vaccine marks on their arms. The first method is,
of course, by far the best, but it cannot always be done in large towns such
as Poona, Dharwad, and many others. However in these towns most of
the civil surgeons or dispensary officers see the vaccinator's work weekly,
and this guards against falsification to an extent that may be accepted as
sufficient. In the above table I have shown the total number of children
inspected by superintendents. I now show below the number inspected
by the first or better method of calling over the names from the vaccinators'
registers :—
Circle.
1. Central ... ... ...
2. Southern
...
...
3. Western
...
...
4. Eastern Gujarath ...
5. Western
do. ...
6. Sindh
...
...
...
Total...
Work tested by calling names from registers.
Present during
inspection.
Successful.
Good.
5,969
5,184
8,257
4,626
4,176
2,225
30,437
Middling.
571
635
391
8,452
986
3,411
14,446
Unsuccessful in-
cluding bad.
464
459
388
1,316
968
2,193
5,788
Absent during
inspection.
Absence account-
ed for.
2,701
3,200
2,683
3,177
3,202
3,607
18,570
Absence
unac-
counted for.
...
58
...
...
243
4
305
Number of parsons whom the vaccina-
tor has returned as vaccinated.
Successful.
8,765
8,625
10,990
16,533
8,745
10,095
63,753
Unsuccessful and
doubtful.
518
399
325
767
468
550
3,027
Unknown.
452
512
404
271
362
795
2,796
Total.
9,735
9,536
11,719
17,571
9,575
11,440
69,576
Excess of opera-
tions over persons
30
...
...
...
...
...
30
Dr. Cola called over no less them 17,571 names, and Dr. Cody 11,719.
Dr. Williams is very nearly as high as Dr. Cody—but the smallest sum is
quite sufficient for the object in view. I must add a remark here in ex-
planation of the term " middling "—it means that the vesicles or cicatrices
were not perfect—a middling success is a genuine success, but not a perfect
one.
Work done by the su-
perintendents.
41. These figures speak for the work of the superintendents during the
past year. I can add nothing to what I have already
said, and can only repeat that I am entirely satisfied,
and I trust Government and the Surgeon General
24
Operations of the differ-
ent circles.
47. There has been an increase in the number of vaccinations in all
circles. Aden and Muscat are entered here for the
sake of the total, but they are not circles in any
sense ; they are merely towns. In Aden only is
there a decrease. The following figures show the increase in each circle :—
Circles.
1. Presidency
...
...
...
...
2. Central
...
...
...
...
3. Southern ... ... ... ...
4. Western
...
...
...
...
5. Eastern Gujarath ... ...
6. Western
do.
...
...
7. Sindh ... ... ... ...
8. Barodá ... ... ... ...
9. Kutch
...
...
...
...
Aden ... ... ... ...
Muscat
...
...
...
Total...
Total number of persons
vaccinated and re-vaccinated.
1874-75.
14,707
130,347
112,551
83,723
90,644
116,535
142,767
29,795
3,034
1,097
144
725,344
1873-74.
13,907
121,541
96,648
71,290
85,584
111,253
111,124
27,781
2,476
1,265
......
642,869
Deduct decrease... ...
Net Increase...
Compared with the
preceding year.
Increase.
800
8,806
15,903
12,433
5,060
5,282
31,643
2,014
558
......
144
82,643
168
82,475
Decrease.
......
......
......
......
......
......
......
......
......
168
......
168
Work of the Govern-
ment establishment.
48. The two Government civil vaccinators are employed in the camp and
environs of Rájkot and of Dísá. They operated
on 4,838 persons, or 458 more than last year. They
averaged 2,419 operations each. The percentage of
success in primary is 97.6, and in re-vaccinations 76.7.
Work of the municipal
establishment.
49. There were 51 municipal vaccinators at work, or 3 more than in
the preceding year. They operated on 60,000, or 884
more than in the previous report. The increases and
decreases are shown here by circles :—
Presidency Circle
Central
do. ... ... ...
Southern
do. ... ... ... ...
Western
do. .. ... ... ...
Eastern Gurjarath Circle ... ...
Western
do. ... ...
Sindh
...
do. ... ...
Aden ... ... ... ...
Net increase
Increase
800
...
2,834
422
...
637
...
...
4,693
...
Decrease.
...
1,675
...
...
1,065
...
901
168
3,809
884
25
Causes of decreases in
municipal
vaccinators'
work.
The decrease in the Central circle is owing to the abolition of the vacci-
nators in the towns of Walwa, Karhad and Narayan-
gaon. The decrease in the Eastern Gujarath circle is
attributed by Dr. Cola to the lymph deteriorating
in Surat city. The decrease in Sindh circle is due to the reduction of one
vaccinator in Karáchi town.
Causes of increases in
municipal
vaccinators
work.
The increase in the Presidency and Southern circles is due to an
increase in the number of vaccinators. In the
Western and Western Gujarath circles the increase is
due apparently to the increased activity of the
vaccinators themselves, which Dr. Cody, for his
circle, says is the result of increased supervision by the assistant superin-
tendents.
Average vaccinations by
each municipal vacci-
nator.
The average number of persons operated on by each municipal vacci-
nator was 1,176, which is 652 less than the average
for the whole presidency. This is not surprising,
because the spheres of the municipal vaccinators are
more limited than the other vaccinators have.
The
percentage of success in primary vaccinations is 95.9, or 3.0 higher than in
the previous report. The cost of each successful vaccination is four annas
and seven pies, or seven pies less than in 1873-74.
Work of the local
fund establishment.
50. The number of local fund vaccinators was 203, or 1 more than
before, and he was appointed in Kanada zilhá. These
men operated on 427,658 persons, or 59,605 more
than in the previous year. This immense increase is
due to the greater activity of the vaccinators, to their using the birth registers
to find out where the unprotected are and how many children there are avail-
able for vaccination, to the close supervision of the assistant superintendents,
and to the zeal and ability of the superintendents of circles.
The following
figures show the increase in each circle :—
Central Circle
Southern .. ... ... ... ... ...
Western ... ... ... ... ... ...
Eastern Gujarath ... ... ... ...
Western do. ... ... ... ...
Sindh
...
...
...
...
...
Total Increase... ... ... ...
7,754
10,827
9,897
2,293
1,120
27,714
59,605
The greatest increase was in Sindh and was all re-vaccinations, there being
actually a decrease of primary vaccinations. The best increase here is in
the Southern circle, and Dr. Raby deserves credit for realizing the hope express-
ed by Government in their resolution on my former report. There is still room
for progress in the Southern circle, and I am sure it will be made. Each
local fund vaccinator averaged 2,106 persons operated on, or 284 more than in
the preceding year. The percentage of success in primary vaccinations was
97.0 or 1.8 higher than in the previous report. The percentage of success
B 99—d
26
in re-vaccinations was 84.2. The cost of each successful case was 2 annas
4 pies, or 6 pies less than last year.
The work of the 129
native states' vacci-
nators.
51. The native states of this presidency maintained 129 vaccinators, or
four more than in the previous year. The increase
of vaccinators was one in Bhor, one in Sangli, one
in Janjira, and one in Gondal. The number of persons
vaccinated was 211,656, which gives an average of
1,640 to each vaccinator. The percentage of success was 95.9 in primary and
73.9 in re-vaccinations. Each successful vaccination cost three annas and one
pie, or two pies less than in last report. The increase by circles is here
shown :—
Central Circle ... ... ... ... ...
Southern do. ... ... ... ...
Western do. ... ... ... ...
Eastern Gujarath Circle ...
Western
do. ... ... ... ...
Sindh Circle ... ... ... ...
Baroda do. ... ... ...
Kutch do. ... ... ...
Total Increase ...
2,656
2,735
1,558
2,823
2,613
5,368
2,014
558
20,325
The only considerable increase here is in Sindh circle, and regarding it
Dr. Williams says :—" The increase in the work done in H. H. Ali Murad's
" territory is due to the facts that two vaccinators were hard at work all the
" year, and that they had literally new ground to work through; for as
" vaccination had not been for years attempted till 1873-74, there was a
" large accumulation of unprotected children in each village. This may be
" seen at once by a reference to the ages of those vaccinated, of whom 1,675
" were under one year, whilst 7,861 were above one year ; a ratio of about
" 17 to 82, or one to five nearly. The increase consists almost entirely of
" primary vaccinations; there were only 163 re-vaccinations performed."
Dispensary vaccination.
52. Vaccination reports have been received from 110 dispensaries, and
5 jails have each sent in separate returns. The persons
operated on amounted to 21,192 or 1,203 more than
in the preceding year. The percentage of success in primary vaccinations
is 92.5, or 1 per cent. better than in last year's report. The percentage in
re-vaccinations is 58.4, or 4.7 less than in the year 1873-74. The average
operations for each dispensary amounted to 184 for the whole year. Dr.
Pearson of the N. W. Provinces has condemned dispensary vaccination,
and he is a great authority. The experience of this presidency is that
the operations are much less successful by dispensary officers than by
the vaccinators. Still I think the object which I have held in view is
one of so much importance, that I think the continuance of vaccination
at dispensaries justifiable even though the percentage is not as high as
it ought to be. The object I have held in view is this—that vaccination
should be practised at a fixed place and time, and thus be an educating agency
in the cause of vaccinaton. If we patiently wait and do our best, it may be
hoped that dispensaries may yet realize the desired object. The progress
that can be made as regards numbers is limited, and as regards success too
in a measure, because in many places only a small number can be vaccinated