NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( xi )
devise a scheme for paying batta to Vaccinators for all successful vaccinations
over and above a fixed number,—a plan which, would encourage zeal and
energy." I reported on this suggestion in my letter No. 803, dated 9th
August last, to the Inspector General, Indian Medical Department, as
follows :—
" 2. I beg to submit that I am of opinion that it would not be
advisable to pay batta to Vaccinators for all successful vaccinations
above a fixed number. I consider that such a scheme would be impracti-
cable,—1st. Because all vaccinations cannot be inspected by Superintend-
ents ; therefore the Vaccinator's returns would require to be accepted
as correct. This, I think, would be a strong incentive to falsify the regis-
ters. 2nd. It would be very difficult to fix a number above which the
batta should be paid, because, from our little knowledge of the popula-
tion per square mile, one Vaccinator might find it easy to vaccinate
more than the limited number, and another might find it impossible
to do so ; and yet the latter man might be the more worthy of the two,
and might have worked the harder of the two. 3rd. This plan was
tried by Dr. Beatty some years ago, when he was a Superintendent of
Vaccination, and it failed."
I have no wish to press the matter of travelling batta to Vaccinators
again on Government, as it is very probable that Government will shortly be
relieved of all charge on account of Vaccinators by their being maintained
by Local Funds, Municipalities, Native States, &c; but I will add that our
Vaccinators, as a rule, require no inducement to do plenty of work, and I
fear that many of them do too many vaccinations. What we most want is
quality and not quantity. When there shall be a Vaccinator to each talooka,
then it might be useful to hold out a stimulous to exertion and zeal; at pre-
sent it is not necessary, for nearly every Vaccinator can get plenty of child-
ren to vaccinate, and the labour is not so much in vaccinating them, but in
collecting and selecting children, seeing them again on the eighth day, per-
suading the parents to give a vaccinifer, recording names and results.
Reduction of the travelling
allowance of Superintendents
from Rs. 8 to Rs. 5 per diem.
13. My budget estimate for 1869-70 was reduced by Rs. 10,000,
and as there remained too little to meet the
past year's expenditure, it was suggested in
the Government of India's letter No. 1836,
dated 8th July last, made known in this Government's Resolution No. 1699
dated 20th idem, to reduce the travelling allowance of the Superintendents
from Rs. 8 to Rs. 5 per diem. This was done, and I regret to say that all the
( xii )
Superintendents have complained, and state that Rs. 5 per diem are not
sufficient to cover their expenses. I selected Dr. Butler, Superintendent of
Vaccination in Kattiawar Circle's letter for submission to Government; and
I briefly stated in my endorsement No. 1103, dated 4th March last, that
" I can say, from my own knowledge, that Rs. 5 per diem for our Superintend-
ents will not cover all the expenses of travelling," &c.; and pointed out to
Government that our Superintendents get no other kind of allowance, such
as tentage, office allowance, nor are they supplied with tents. This Govern-
ment in their Resolution No. 756, dated 29th March, again recommended that
the former rate of travelling allowance bo granted.
Certificates of Vaccination from
candidates for Government em-
ploy.
14. In Resolution No. 1138, dated 12th May 1869, Government made
known that they were not prepared to adopt
the rule that a certificate of successful vaccina-
tion, when there is no evidence of protection by
small-pox (or insusceptibility), be exacted from
all candidates for Government employ. I will not urge a reconsideration of
this, but I may mention that the recruits of the Bombay Native Army have
for many years past been vaccinated, when not otherwise protected; and it
is worth mentioning that there have only been fifteen deaths from small-pox
among the Sepoys in the last ten years. I have never heard of recruits on
this side of India objecting to be vaccinated. They quietly submit to it, as
a necessary preliminary to their enlistment. Again, the employés of the
Telegraph Department suffered so severely from small-pox, that it was
directed in Circular No. 1897 of 1868-69, dated 20th March 1869, from the
Superintendent, Sub-Bombay Division, to the Assistant Superintendent in
charge Bombay Office, that all employés in the Telegraph Department be
vaccinated when it does not interfere with caste prejudices : and they were
vaccinated or re-vaccinated without a murmur, as far as I know.
Superintendence of Dispensa-
ries.
15. Mr. Grey, Collector of Belgaum, made a suggestion early in 1869,
that Superintendents of Vaccination might,
when on tour, inspect Dispensaries. The sugges-
tion was referred to me for opinion by the
Inspector General, Indian Medical Department, in his letter No. 1090, dated
12th April 1869. I stated in my answer thereto, No. 284, dated 19th idem,
that Superintendents have time enough to inspect Dispensaries without
detriment to their vaccination duties, and that, in point of fact, they do now
inspect the vaccination work at Dispensaries. At the same time I stated
( xiii )
that 1 was not so clear about making them controlling and directing Officers
of Dispensaries, because that would make them responsible Officers; and it is
impossible to say how much work would be required to bring the Dispen-
saries into good working order, and to keep them so. As inspecting Officers
only, Superintendents might write in a book in each Dispensary when on tour
their remarks on—1st. The general character of the Medical Subordinates or
others in charge. 2nd. The method of carrying on work at Dispensaries, and
any suggestions for improving it. 3rd. The state of the building—(a) site,
good or bad, with reasons for opinion; (b) capacity, whether sufficient for
the requirements of the place, &c.; (c) cleanliness ; and (d) ventilation,
where there are wards in the Dispensary. 4th. State of medicine, instruments,
and records. 5th. Any other subjects worth noting. The remarks so
written to be copied and forwarded by the Medical Subordinates or others
in charge of Dispensaries to the Deputy Inspector General of Hospitals of
the Division, and to the Collector of the District.
Vaccination Registers to be kept
in all Villages.
16. I think the best method of registering vaccinations in villages is
that adopted in Scotland. It is done by simply
writing in the birth register, under the child's
name, the words " successfully vaccinated,"
"insusceptible," or " postponed." I would beg to suggest that village regis-
trars of births be directed to enter under each child's name the words
"successfully vaccinated," or "unsucessfully vaccinated," as the case may be.
I think for the present anything more elaborate would very likely be less
correct than this simple method of registering vaccinations in villages.
Superintendence.
17. I am very happy to say that there was very little interruption in
the superintendence during the period under
report.
Dr. Gordon
held charge in the Central
Circle.
Mr. Raby
ditto
Southern
ditto.
Dr. Colah
ditto
Northern
ditto.
Dr. Butler
ditto
Kattiawar
ditto.
Dr. Welsh
ditto
Rewa Kanta ditto.
Mr. Anunta Chandroba ditto
Presidency
ditto.
The only changes which occurred were,—Dr. Williams succeeded the late
Dr. Ffolliott in Sind in May 1869, and Dr. Blanc took up his appointment of
Superintendent of the Western Circle from Mr. Cody in December 1869.
( xiv )
18. In Table No. VII. I have summarized the monthly employment
returns of each Superintendent; and the following is a condensed form of the
employment returns of the seven Superintendents for the year 1869-70 :—
Names of
Superintendents.
Dr. Gordon ......
Mr. Raby
Dr. Colah
Mr. Cody and
Dr. Blanc
Dr. Ffolliott and
Dr. Williams..
Dr. Butler
Dr. Welsh .....
Total...
Circles.
Central
Southern
Northern
Western ...
Sind
Kattiawar
Rewa Kanta...
7
Number of Sta-
tions visited.
84
78
42
50
129
73
41
497
Distance travel-
led in Miles.
1,506
1,701
2,208
1,215
3,164
1,294
680
11,568
Number of tra-
velling days.
183
129
167
105
138
135
69
926
Number of
Children in-
spected.
14,013
6,197
21,618
7,514
18,696
8,133
3,873
80,044
Number of Vil-
lages visited
and inspected.
314
190
321
166
548
237
193
1,972
Number of Vac-
cinators whose
work was in-
spected.
33
44
30
19
31
34
10
201
From the above it appears that Dr. Gordon travelled most days. Mr.
Raby inspected the work of the greatest number of Vaccinators, but his
numbers of children and towns inspected are smaller than all, except
Dr. Welsh, who is only permitted to travel four months, and is not a
full-timed Superintendent. Dr. Colah inspected the greatest number of child-
ren, and I can testify to the great care with which he makes his inspections.
The numbers in the columns for travelling days, children, villages, and
Vaccinators in the Western Circle, are small, and this is owing to there having
been a change of Superintendents in the midst of the working season, as well
as to there being fewer Vaccinators to examine. Dr. Butler and Dr. Welsh are
not full-timed Superintendents, the former having six and the latter four
touring months in 1869-70. I must say that the work they both did in their
tour is very creditable indeed, and, speaking generally, the table shows that
the Superintendents have worked very well, and spared no pains to do as much
travelling and inspecting as they could. Dr. Williams has done, I think, the
most work; but Drs. Gordon and Colah stand very close to him; indeed I find
some difficulty in stating their exact positions. I think Mr. Raby might
have inspected more children and more villages, but in some parts of his
Circle the population is thin; in other respects his tour is satisfactory.
( xv )
Lymph.
19. In my letter No. 145, dated 23rd October 1868, when reporting to
the Inspector General, Indian Medical Depart-
ment, what was the best method of getting
lymph from England, and the best season to have it sent out, I recommended
that lymph should be sent out in capillary tubes only, as points nearly
always failed, and that it should be tested lymph; that is to say, it should be
kept in England for three weeks, and then one tube of the set charged from
each child should be tried, and if it succeeded that it would guarantee the
virtue of the rest. It was recommended that fifty tubes of lymph should
leave England about the middle of October and December, and that one-
half of each should be obtained from the National Vaccine Establishment,
London, and the other half from the Central Vaccine Institution for
Scotland; and that half of the English and half of the Scotch should be sent
in the usual way through the post, and the other half in the Ice-room of the
Peninsular and Oriental Company's Steamers.
On the 8th November, a packet of thirteen tubes was received from the
Central Vaccine Institution of Scotland.
The following shows their distribution and result of use :—
Issued to
Central circle .................................
Western do. .................................
Northern do. ...............................
Sind do. ...................................
Presidency do. .........................
Total......
Number of
Tubes.
2
3
2
3
2
12
Result.
Succeeded.
Do.
Do.
Do.
Failed (?)*
* It is not quite certain that there was not a mistake made.
On the 6th December, a packet, containing ten tubes and forty ivory
points, were received from the National Vaccine Establishments London, and
the following is the result:—
( xvi )
Issued to
Central Circle
Presidency do. .............
Western do. .............
Northern do. .............
Sind do. .............
Kattiawar do. .............
Rewa Kanta do. .............
Total...
Number of
Tubes.
......
4
......
......
......
3
3
10
Result.
......
Failed (?)*...
......
......
......
Succeeded ...
Do.
...
Number of
Points.
5
8
5
5
5
5
5
38
Result.
Failed.
Do.
No report.
Failed.
Do.
Do.
Do.
* It is not quite certain that there was not a mistake made.
On the 12th January 1870, I received a packet of ninteen tubes from the
National Vaccine Establishment, London, and the following is the result:—
Issued to
Central Circle ...........................
Presidency do. ...........................
Southern do. ...........................
Western do. ...........................
Northern do. ...........................
Kattiawar do. ...........................
Total......
Number of
Tubes.
3
3
3
3
3
3
18
Result.
Succeeded.
Do.
Do.
Do.
Do.
Do.
On the 18th January thirteen tubes were received from the Central
Vaccine Institution for Scotland, and the result is—
Issued to
Presidency Circle ..........................
Western do. ..........................
Northern do. ..........................
Sind do. ..........................
Total......
Number of
Tubes.
4
3
2
4
13
Result.
Succeeded.
Do.
Do.
Do.
( xvii )
The foregoing tubes came out by post.
On the 24th January 1870 I received a case (No. 1) containing thirteen
tubes from the Central Vaccine Institution of Scotland, which came out in
the Ice-room of the Mail Steamer. The whole were used by Dr. Colah in
my presence, in Neriad, on six children: one child had five good vesicles,
another four; two others had two small vesicles, and two failed.
On the 5th February I received a case (No. 2), containing twenty tubes,
from the National Vaccine Establishment, London, which also came out in
the Ice-room of the Mail Steamer. The whole were sent to Dr. Butler. Six:
children were vaccinated by himself from six tubes, all successfully; fourteen
tubes were distributed in two's to seven Vaccinators, from which fourteen
children were vaccinated,—two failed, two had bad vesicles, and ten
succeeded.
On the 5th February I received a case (No. 3), containing twelve tubes,
from the Central Vaccine Institution of Scotland, which also came out in
the Ice-room of the Mail Steamer. These tubes were used by the Superin-
tendent of the Central Circle, and proved successful in every instance
except one.
It appears from the foregoing, that lymph sent out in tubes is infinitely
better than on points, for the latter all failed, and the former nearly all "took;"
unless the manner of using the points were bad, the conclusion to be drawn
is that they are useless. I can hardly think it was the manner of using
them which caused their being inert, because their failure was general, not
even, one exception, and for years back lymph on points generally has failed
in all hands. It does not appear that there is any advantage in sending the
tubes in the Ice-room of the Mail Steamers, as the lymph which was sent by
post was just as successful as it. It further appears that lymph sent out at
the commencement and middle of last cold season nearly all proved success-
ful. I would recommend, then, that tested lymph in tubes be sent out by
post next cold season, and that it be sent direct to the Superintendent
General of Vaccination, Bombay, because when it has to come through several
departments it is apt to be delayed. A packet from the National Vaccine
Establishment, London, and another from the Central Vaccine Institution of
Scotland, should leave Europe about the 1st October and 1st December,
and each should contain twenty-five tubes. I consider it useless sending
ivory points.
The lymph in general use during 1869-70 was reported well of in the
Central, Kattiawar, Southern, Sind, and Rewa Kanta Circles. In the North-
3 vac
( xviii )
ern and Western Circles several Vaccinators were found working with bad
lymph. In the Presidency Circle there was a deficiency of lymph until
animal vaccination was begun. When on tour in the Northern Circle I saw
some very indifferent lymph. In all cases when lymph deteriorates it is
renewed, and Vaccinators should be encouraged to ask for now lymph when-
ever they have any suspicion of their lymph having degenerated. Any Vacci-
nator found carrying on work for a length of time with bad lymph should be
dismissed the Service, because to thus produce bad vaccination knowingly is
inexcusable.
The Superintendents of Circles will take care to inform
Vaccinators that they must work only with good lymph. In most of the civil
stations the lymph was good throughout the year. In Sattara it deteriorated
in September, but renewed itself on the subsidence of the rainy season. In
Kaira it was renewed several times. When I was in Kaira I saw some very
indifferent vesicles and vaccine marks, which, I believe, were more owing to
the carelessness and want of skill on the part of the Vaccinator, than to the
state of the lymph. Dr. Wyllie says the vesicles were small, and that the
lymph should be renewed. In Larkhana, Rutnagherry, and Kurrachee, it
became bad, and was replaced by good lymph.
" Animal Vaccine."
20. When Dr. Blanc returned from Europe he brought with him some
cow-pox lymph in tubes and on ivory points
from London. He obtained his first supply
from M. Warlomont in Belgium, who had obtained his first supply from the
natural pox on the cow, and now propagates it by inoculating from one calf
to another. Dr. Blane when on leave practised the same method in London
for six months with perfect success, and it was from that stock that he
brought his "Animal Vaccine" to India. He expressed to me a wish to
establish " animal vaccination" in Bombay. I was delighted to give him
every assistance, and I have much pleasure in stating that the first inocu-
lation proved a success. This was in December last. He then instructed Mr.
Anunta Chandroba how to inoculate the calf and take the lymph from the
vesicles. Ever since then Mr. Anunta Chandroba has carried on animal
vaccination, and in his Report he speaks of it being a great boon to Bom-
bay, on account of its being a source of pure lymph, as well as being a
method of having abundance of it. He has had some difficulty in getting
supplies of heifers, and acknowledges the great assistance afforded him by
getting them from the Bombay Municipality for three months free of
expense. I would also beg to bring to the notice of Government this ready
and willing aid given to the Department by Mr. Crawford and Dr. Hewlett,
who have both interested themselves very much in " animal vaccination ;"
(
xix )
indeed I may say that had they not done so, it could not have been carried
on; and I beg to suggest that Government acknowledge the aid rendered by
both these Officers. I cannot speak too highly of Mr. Anunta Chandroba's
exertions in overcoming the difficulty attendant on the introduction of
" animal vaccination," even though that difficulty was almost confined to the
question of obtaining heifers. It appears that the people at once took to
" animal vaccination" kindly, and even Bhattias and Bunnyas prefer cow-lymph
to human-lymph. I have to record the liberality of Mr. Cowasjee Jehangeer,
who generously undertook to defray the expenses of " animal vaccination" for
one year, and gave us a grant of Rs. 540 for that purpose. Government
thanked "that gentleman for this additional proof of his liberal philanthropy."
In Resolution No. 280, dated 2nd February last, it was stated that " His
Excellency in Council is satisfied with the results of the experiments already
made, and approves of Dr. Blanc's and Mr. Chandroba's exertions in this
matter." Dr. Blanc, in the month of February, inoculated a heifer at Tarra-
poor, in the Tanna Collectorate, with perfect success, and the people rushed
to get their children vaccinated from the cow, showing that no prejudices
need be apprehended in the districts any more than in Bombay. The first
estimate which was made of the probable cost of " animal vaccination" in
Bombay was Rs. 540 per annum ; but it was forgotten that the butchers would
not be allowed to slaughter the calves used, for some time, thereby increas-
ing the expenditure. Dr. Blanc informs me that in London, Paris, and
Brussels, the calves are slaughtered immediately after the lymph is taken
from the vesicles, and no expense incurred by keeping them for three or four
weeks after the operation. It would now appear that the cost will be very
much more than was estimated. Mr. Anunta Chandroba enters very fully
into the subject in his Report, and comes to the conclusion that five calves
will be required every month, and that, to buy them, each will cost Rs. 15,
besides Rs. 7½ for feeding; thus requiring Rs. 112½ per mensem, a large
portion of which, however, would be recovered by the sale of the calves. I
think this charge should be met by the Municipality. I had the pleasure
of speaking to Mr. Crawford lately on the subject, and I have much pleasure
in stating that he hopes to be able to supply us with calves ; and I have no
doubt he will be able to do so at a much cheaper rate than the above.
The method of propagating animal vaccine is very simple. Dr. Blanc, in
an article in the Medical Times and Gazette of 25th September last, says:—
" It is necessary to insist upon the following fact:—The vaccine lymph
"at present used by animal vaccinators in France and Belgium, and by myself,
" and by those I have supplied in England, is spontaneous cow-pox taken from
(
xx
)
" from cows. This lymph has never passed through the human body, and
" has no connexion with the Neapolitan lymph, of whose origin at one time
" some doubts were expressed.
" In selecting the calves we propose to inoculate, great care should be
" taken to ascertain that the animal is in perfect health and in first-rate
" condition. The question of health is not of much importance with reference
" to the possibility of the transmission of disease, because, if in any way
" ' seedy,' the inoculation will partly or completely fail, but with this failure
" the link is interrupted ; and if no preserved, lymph has been kept in reserve,
" much inconvenience must necessarily follow. Calves from five or six months'
"old should be preferred; too young they sicken, too old they are difficult
" to manage It will necessarily require a much more lengthened series of
" inoculations in order to arrive at some precise rules ; but, as far as I have
" observed, it appears to me that strong calves give a stronger lymph, delicate
" calves a weaker lymph; also that in white or light coloured calves the
'' eruption appears sooner, the vesicles are larger and arrive at maturity a day
" earlier than in black or brown calves. In warm and moist weather the
" eruption is quicker in its development, in cold weather somewhat later.
" From these two observations I would therefore advise that dark calves
" should be selected in warm weather, and white or light coloured calves in
" cold weather. Male or female calves are alike suitable; the only important
" point is to select those whose skin is fine and transparent, and the mammæ
" or scrotum full and plump.
" In order to vaccinate the calf, it should first be bound and held firmly
" upon a table by a couple of assistants; any strong table will answer the
" purpose. Mine is of common dealwood, provided with six iron rings. Two
" men seize the calf and place it on the table. The fore-legs are bound
" together and then tied to the front rings, the right hind-leg is tied to the
" posterior ring on the table, and the left hind-leg is lifted up and fixed by
" a rope to a ring placed above. A loose rope is passed over the neck, so as
" to keep the head down. The calf thus secured is easily managed. To avoid
" dirt, a circular hole is made in the table, to which is adapted a zinc pot, in
" which the excreta are received. First of all, the mammæ or scrotum and
" the surrounding abdominal region must be very carefully shaved. I dis-
" pense with the Continental practice of scraping the poor brutes in order to
" excite vascular action; I allow them the luxury of a good lather of soap
" and a sharp razor; but after the shaving, the parts are frictioned with a
" dry towel.