NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( xxi )
"To inoculate the calf different plans are followed, either superficial inci-
" sions of about half an inch in length, smaller and deeper incisions, or val-
" vular punctures. Dr. Warlomont prefers the long incision, Dr. Lannoix the
" smaller one. I have tried both, and now generally inoculate by long incisions
" and by valvular punctures, kindly suggested to me by Mr. Marson. The
" long incisions give more lymph, but I believe that it is not quite so active
" as the one obtained by the valvular puncture. I therefore prefer the last for
" vaccinating children, and from the first I collect lymph for inoculating other
" heifers. I make on the mammæ or scrotum, and on the abdomen, from
" one hundred to one hundred and fifty punctures or incisions. I inoculate a
" heifer every eighth day. If at that date I find on the heifer some vesicles
" still transparent, I use them for inoculating the fresh calf. Sometimes none
" are found in that condition ; at other times only a very few; it is, therefore,
" necessary on the sixth and seventh days always to collect a certain amount
" of lymph for inoculating the next calf, as well as to have a supply on hand
" in case of accident. Although lymph in tubes frequently fails when applied
" to man, it retains for several weeks all its properties when inoculated into
" the bovine race. Care must be taken before filling the tubes to add a drop
" of glycerine to the lymph, otherwise it would adhere so strongly to the
" tubes that it could not be blown out again. I am careful that every incision
" and puncture is well touched with lymph. Between the thighs, and on the
" mammæ themselves, on account of the higher temperature of these parts, the
" vesicles rise sooner, and are also the first to lose their limpidity; therefore
" I have seldom found any of them fit for use on the eighth day. When the
" weather is warm, in order to have some good vesicles for the eighth day
" (for inoculating the next heifer), I make on the abdomen a certain number
" of punctures with lymph preserved for a month or six weeks ; whether the
" cause lies in the lymph or in the cooler spot, the important fact is that
" usually the vesicles developed under these conditions are a day late. But
" as in man, the individual susceptibility of the calf has also some influence.
"In the majority the eruption is beautiful, all the vesicles following a regular
" course, and yielding an abundance of lymph. In a few rare instances a
" great many of the vesicles are arrested in their development, or are quite
" superficial, almost dry, and early lose their transparency. To inoculate a
" calf carefully it requires about an hour ; as soon as the operation is com-
" pleted, the calf should be removed from the table, made to drink some milk,
"and tied in his stable. A cloth bandage in summer, one of flannel in
" winter, should at once be tied round the abdomen. By this the parts are
" kept warm, the calf is not annoyed by the flies, nor can he lick the inocu-
" lated spots. For this reason also the head-rope should be rather short."
( xxii )
21. I am of opinion that there should be a Vaccinator in each Circle
appointed to carry on animal vaccination : the expense of it in the districts
would, I think, be small. In order to enable Superintendents to acquire a
knowledge of the method of operating, I have recommended that all Super-
intendents of Vaccination be allowed to come to Bombay on a short visit, to
gain a practical knowledge of animal vaccination.*
Inoculation.
22. None of the Superintendents in their report make any mention of
inoculation having being practiced in 1869-70,
with the exception of the Superintendent in
Sind, who says that an instance was reported, but not substantiated on inves-
tigation.
Small-pox.
23. In the Central Circle small-pox prevailed more or less in every ta-
looka except one, but it was epidemic in Indee
and Shindghi Talookas only. At paragraph
13 of Dr. Gordon's Report he shows the number, deaths, &c., from small-pox
in each collectorate of the Central Circle. There were 21,943 cases of the
disease in 1869. " Of these, 93.5 per centum were unprotected, and 6.48 had
been previously vaccinated. Of the former 12.3 per centum died (a very small
death rate), and of the latter 8.9 per centum. Of the 6.48 protected and after-
wards affected by small-pox, 1.5 were vaccinated in infancy, and 4.9 in after
life; of the former there died 4.2, and of the latter 10.2 per centum. Thus it
appears that infantile vaccination is nearly two and a half times a better pro-
phylactic than vaccination in after life. In detail I do not place very much
reliance upon these returns, more especially with reference to the number of
cases occurring after vaccination. During my tour, I on several occasions tested
the correctness of the Returns for 1868. As statements of the total number
of cases of small-pox, they are not very far from correct. As to the numbers
entered as previously vaccinated I discovered some grievous errors. As in-
stances, I may mention the returns of the villages of Ankola and Wakharrie,
in the Nassick Zillah ; the returns from the former showed that fifty-eight
cases of small-pox had occurred during 1868, and that all of them had been
previously vaccinated. Upon careful inquiry I found this to be altogether
incorrect, only one child had been previously vaccinated. The same was
the case with the return from Wakharrie." In the Southern Circle, Mr. Raby
says that he receives no returns of small-pox, but reports have occasionally
reached him of its prevalence, and he always sent a Vaccinator to the affected
locality as soon as possible. It was rife in parts of Dharwar, Canara, and
Belgaum Collectorates. Dr. Blanc, Superintendent of the Western Circle,
* This was sanctioned in Government Resolution No. 1232, dated 26th May 1870.
( xxiii )
received returns of small-pox from Tanna and Colaba Collectorates, and he
has tabulated them in paragraph 20 of his Report; but he says " evidently no
weight can be attached to these returns." The Northern Circle was almost
free of small-pox. In the Sind Circle 471 deaths were returned for the year
1869. Only a few cases were reported in the months of January, February,
and March 1870, in the Kattiawar Circle. In the Rewa Kanta Circle there
were thirty-seven cases in the Punch Mahals, out of which four died. There
were more cases in the Native States of this Circle, but no particulars were
obtained by Dr. Welsh, the Superintendent. In the Presidency Circle (Island
of Bombay) there were 1,725 deaths from small-pox. It appears that, with
the exception of the Presidency Circle (Island of Bombay), the Circles have
been less affected during 1869 by small-pox than in most previous years.
With regard to the Presidency Circle, the registration of small-pox is pro-
bably not perfectly correct, but I think it is more so than in any other part
of this Presidency, and there is not the least doubt about there having been a
severe epidemic and many valuable lives lost in the town of Bombay. As
long as Vaccination is not compulsory, an epidemic every three or four years
may be predicted, because small-pox is always being imported from the
maritime coasts of Asia, and less than half the children born annually are
vaccinated, so that there is always a ready field of victims for the disease to
lay hold of. This will be all changed if the proposed Vaccination Bill becomes
law. Mr. Anunta Chandroba, the Superintendent, says that compulsory
vaccination and " animal vaccine" lymph in abundance will put an end to
epidemics of small-pox in Bombay.
Small-pox existed, more or less, at the following stations :—
Poona, from January till March 1869.
Sattara, prevailed in early part of year.
Dapoolie, eight cases, all recovered.
Belgaum, twenty-three cases in Military lines, all vaccinated, and all
recovered. Disease prevalent in April 1869.
Dhoolia, prevalent in April and May 1869. 14 cases seen, 2 died.
Bhooj, a few cases.
Dharwar, less than last year in districts.
Ahmedabad, prevailed from January to June 1869. 117 deaths. A
Small-pox Hospital instituted out of town.
Karwar, nine deaths, not vaccinated.
Gogo, one case in April 1869, recovered.
Kurrachee, in January 1869, fourteen cases ; from January to April 1870
sixty-six cases, and the disease still in town.
( xxiv )
Truthfulness of Vaccinators'
Returns.
24. I regret that an instance of falsification by a Government Vaccinator
took place in the Central Circle, and another
in the Western Circle. In Kattiawar two in-
stances of falsification by Native States' Vac-
cinators were discovered. Falsifications have not been many, considering the
number of Vaccinators, and I think the returns may be accepted as not very
far from the truth—at least as regards the total number of vaccinations.
The best means of preventing falsification is for the Superintendents to show
the Vaccinators that a false name must be discovered, by calling the names
over from the registers when testing the work of each Vaccinator. But some
of our Circles, such as the Sind, Central, and Southern, are so large, that the
Superintendents cannot visit each Vaccinator every year. I trust that we
will soon have some Native Assistant Superintendents in each Circle, and then
I feel assured that falsification of records will no longer be a stigma on the
Department. Mistakes of all kinds may be excused by circumstances.
Falsification should always be punished by dismissal from the Service; there
is no excuse for it. I regret that Dr. Butler pardoned a Native State's
Vaccinator, in whose records he discovered some false names; the man should
have been dismissed.
Conduct of Vaccinators.
25. The conduct of the Vaccinators, with a few exceptions, has been
generally well spoken of by all the Superin-
tendents. Some have been found fault with
for—first, laziness ; second, quarrelsomeness ; third, for being absent without
leave ; fourth, for working with bad lymph, &c. A small fine was generally
imposed in the first two cases; pay stopped in the third, as well as loss of
service for pension. The instances of the fourth occurred chiefly in the
Northern and Western Circle, and some of the men were heavily fined.
It would be much better for a Vaccinator to do nothing rather than vaccinate
with bad lymph; there is no excuse for it, for with capillary tubes any Vac-
cinator can be supplied in a few days with good lymph.
Total Vaccinations.
26. I have already said in my first paragraph that this report embraces
two periods; the first period is from 1st January
to 31st March 1869, and the second period is
from the 1st April 1869 to 31st March 1870, or the official year.
During the first period there were vaccinated in—
Civil life ...............................................
In the Army ......................................
Total
115,534
2,001
117,535
(
xxv
)
During the second period, or official year 1869-70, there were vaccinated
in—
Civil Life ...............................
In the Army ...........................
Total......
457,862
6,805
464,667
Increase.
There is an increase in civil life of 31,609, and in the Army of 874 ;
total increase in 1869-70, as compared with
1868, is 32,483.
Success.
27. The vaccinations in civil life are shown in two statements, viz.
No. I. and No. V. The former exhibits the
work of Government, Municipal, Local Funds,
and Native States' Vaccinators (these are itinerant) ; the latter shows the
vaccinations performed at Civil stations (these are stationary). The following-
shows the success in each of these:—
1st—Government Vaccinators ................
2nd—Municipalities ditto ...............
3rd—Native States ditto .................
4th—Dispensary Vaccination ..............
97.2
95.2
96.7
89.6
Average 96.7.
The percentage of successful in 1868 was on the grand total in civil
life 93.5; this year it is 96.2. This increase of success is only apparent and
not real, and is due to the method of calculating it. In former years the
percentage of success was calculated on the total, so that the "unknown"
were really reckoned as unsuccessful. This year, however, the unknown
cases have been deducted from the grand total, and then the percentage of
successful calculated. Were the percentage of success calculated the same
way as in former years, it would be 93.1, or 0.4 less than last year. I fear it
must be acknowledged that the success shown by itinerant Vaccinators is
too high. Vaccinators are too apt to consider every case successful, even if
there be only abortive vesicles produced. Superintendents of Vaccination,
Civil Surgeons, and others holding independent Medical charges, should in-
struct Vaccinators, that, unless there be at least one perfect vesicle, which
has run its course regularly, there cannot be a certainty of success ; two,
three, or four imperfect vesicles cannot be considered equal to one good
vesicle. It appears that some of the returns show a greater total than the
4 vac
( xxvi )
actual number of persons vaccinated. Thus A B vaccinates fifty persons in
May, and returns them thus—twenty successful, twenty unsuccessful or
doubtful, and ten unknown. In June he vaccinates one hundred persons,
twenty of whom were the twenty unsuccessful in May. He thus returns one
hundred and fifty persons vaccinated, when, in point of fact, there were only
one hundred and thirty persons operated on. Such a method of reckoning
is clearly wrong, and it may be avoided in this way:—A B vaccinates in May
fifty persons as above; he should return them thus—twenty successful and
ten unknown, total thirty; and a remark may be added that twenty will be
vaccinated again and the result included in next month. Every unsuccessful
case should be vaccinated at least twice before the result is reported.
Sex.
28. In civil life there were 245,508 males and 212,354 females vacci-
nated, or 53.6 of the former to 46.4 of the latter.
In 1868 the disparity was much greater. It
is probable that the excess of males is still considerably more than in the
general population. Superintendents are now testing the columns of sexes,
and I have no doubt we will get them more correct year after year.
Caste.
29. Of the different castes the following shows the percentage of each :—
Christians, 0.5; Hindoos, 74.4; Mussulmans,
19.1 ; Parsees, 0.2 ; and other castes, 5.5.
There are some slight differences in these percentages from those in last
report, but they are hardly worth noticing in particular.
Age.
30. There were 191,221 under, and 266,641 above, one year old
vaccinated in 1869-70, or 41.8 per cent. of the
former to 58.2 of the latter. This is nearly
the same as in the two former reports. Until the number of Vaccinators be
increased considerably we will not be able to obtain a much greater propor-
tion under one year old. The proportion of infantile vaccination is highest
in the Northern Circle, in which there is a Vaccinator for each talooka; no
other Circle has a Vaccinator for each talooka, and in no other Circle is the
number of infantile vaccination so high. There were 64,488 under one year
to 35,393 above one year old in the Northern Circle.
Causes of increase and decrease
in Circles.
31. Compared with 1868 there has been an increase of vaccinations in
all establishments as a whole, but there has
been a decrease in some of the establishments of
Circles. The following figures show where the
increase and decrease occurred:—
( xxvii )
(a)—Government Establishment in—
1st—Central
Circle
2nd—Southern do. ......
3rd—Western do. ......
4th—Northern do. ......
5th—Sind do. ......
6th—Kattiawar do. ......
7th—Rewa Kanta do. ......
8th—Presidency do. ......
Deduct—Decrease ......
Increase
Increase.
3,003
4,537
3,562
......
......
......
1,969
......
13,071
3,628
9,443
Decrease.
......
......
......
930
680
483
......
1,535
3,628
(b)—Municipal Establishment in—
Central Circle .............
Southern do. .............
Western do. .............
Northern do. .............
Sind do. .............
Deduct—Decrease......
Increase......
2,022
......
758
652
......
3,432
461
2,971
......
95
......
......
366
461
(c)—Native States Establishment in—
Central
Circle
Southern do...................
Western do...................
Northern do...................
Sind do...................
Kattiawar do...................
Rewa Kanta do...............
Deduct—Decrease......
Increase
1,033
2,172
2,640
......
......
5,916
3,083
14,844
1,191
13,653
......
......
......
346
845
......
......
1,191
( xxviii )
(d)—Local Funds Establishment in—
Central Circle ................
Southern do. ...............
Sind do. ...............
Deduct—Decrease
Increase......
Increase.
1,902
3,843
......
5,745
631
5,114
Decrease.
......
......
631
631
The causes of increase are given as follows :—Dr. Gordon, in the Central
Circle, attributes it to—first, increased and continuous supervision; second,
increase of pay to Vaccinators ; third, to the distribution of zahirnamas to
villages; and, fourth, calling over the names of the unprotected in villages.
There has been an increase of Vaccinators in the Central, Southern, Western,
Northern, Kattiawar, and Rewa Kanta Circles, which is the chief cause of
increase in these Circles. In the Northern Circle there was one Government
Vaccinator less, and one Native States' Vaccinator more. In the Kattiawar
Circle the increase is due to the increase of Natives States' Vaccinators.
The decrease in the Presidency Circle is attributed to the prevalence of
measles and fever. I think the increase in the Western Circle is due to
increase of pay and better supervision. In the Rewa Kanta, Dr. Welsh
attributes the increase to—first, increased aid from village officials ; second,
greater activity on the part of the Vaccinators; third, increased number of
Vaccinators ; and, fourth, less opposition on the part of the people. I think
a good deal is also due to the efforts of Dr. Welsh himself. In Sind the
cause of decrease is attributed to the reduction of one Local Fund Vaccinator,
presence of cholera, and it being probable that the establishment could not
vaccinate more. In general terms, it may be stated the causes of increase
are—first, increased number of Municipal, Local, and Native States' Vaccina-
tors ; second, increased pay, producing more activity among the Vaccinators ;
and, third, less opposition on the part of the people.
Cost.
32. The following figures show the cost of each establishment and the
cost of each successful vaccination. It should
be borne in mind that the Government Estab-
lishment is debited with the entire administration charges:—
( xxix )
1.
2.
3.
4.
Government ...........
Municipal ...............
Local Fund ..........
Native States .......
Total cost.
Rs. 1,00,798
„ 6,694
„ 7,344
„ 21,365
Rs. 1,36,201
Cost of each successful
Vaccination.
Rs.
„
„
„
Rs.
0
0
0
0
0
6
5
4
5
5
8
3
2
6
6
In 1868 the estimated total expenditure was Rs. 1,11,524, and the average
cost of each vaccination was four annas and two pies. The increase of the
total is owing to—first, increased pay to Vaccinators; and, second, an increase
in the number of Municipal, Local, and Native States' Vaccinators. The cost
of each vaccination in 1869-70 was four annas and nine pies, or seven pies
more than in 1868; but, as shown above, the cost of each successful case was
five annas and six pies, or eightpence three farthings English money. This I
consider very cheap indeed. Notwithstanding the whole charges for superin-
tendence and administration are charged to the Government establishment,
yet the cost of each successful vaccination by it is very little more than in
the other establishments. This is very creditable to the Government Vacci-
nators.
Assistance from Civil Authori-
ties.
33. I have much pleasure in being able to state that the Superintend-
ents have unanimously acknowledged the aid
which they and the Vaccinators have received
from the Revenue and Political Officers. In
the Central Circle, Dr. Gordon says:—" It is mainly through the interest
taken by these Officers in vaccination that matters go on so smoothly. Mr.
Raby states that Colonel Anderson has obtained for the Kolapore State
Vaccinators about the same rates of pay as the Government Vaccinators get.
In the Southern Circle Mr. Robertson has appointed six Vaccinators in the
Dharwar Collectorate to aid the Government establishment, and he takes
great interest in vaccination. Dr. Blanc, in the Western Circle, warmly
acknowledges the assistance he has received from the Civil Authorities. In
Sind, Dr. Williams brings to notice the great assistance he received from
Sir William Merewether, the Commissioner in Sind; Major Tyrwhitt,
Political Superintendent Thurr and Parkur ; Major Wallace, Acting Collector
of Hydrabad ; and Mr. Tyndall, Deputy Collector of Sehwan; and he further
adds that the Subordinate Revenue Officers begin to see that it is there duty
to further the progress of vaccination, by explaining to the people the bene-
(
xxx
)
fits of it. In Kattiawar, Dr. Butler says the Chiefs have given every
assistance, and were most courteous to him when on his tour. He says
there is a tendency to employ too many Vaccinators ; but I have no doubt
Dr. Butler will have influence enough to prevent the Chiefs doing so. Too
many is as great an evil as too few. I have now gone through every one of
our Circles, and I feel perfectly certain that the splendid progress of vacci-
nation in Western India is due in a great measure to the countenance and
aid so freely given by the Revenue and Political Officers; I never found them
backward in helping us when called on for aid; and many of them go much
further, and display an anxiety that vaccination may be placed within the
reach of all in their districts.
Transfer.
34. In my last report I recommended that Sattara Collectorate be
transferred to the Central Circle (Maratha-
speaking), and Kulladghee to the Southern
Circle (Canarese-speaking). Government approved of that, and on the
1st April 1870 the transfer took place.
Commendation of Superintend-
ents.
35. On a review of the work of 1869-70, I come to the conclusion that
the Department has worked well as a whole;
and I have much pleasure in stating my satis-
faction thereat. It is true that in several Circles instances of falsification
came to light, but until there be closer supervision, I can hardly lay any
blame for that, either on our system, or on the Superintendents. The
Superintendents have, I think, done their duty well, some of them exceed-
ingly well, and I would beg to bring the names of Drs. Butler, Welsh, and
Gordon to the favourable notice of Government. I regret that Dr. Welsh has
resigned his appointment. His zeal and industry in the Rewa Kanta has
during his superintendence of four and a half years brought a neglected Circle
into first-rate order, which, I hope, will be maintained. Dr. Blanc has intro-
duced animal vaccination into India, and has taken considerable trouble to
establish it. For this service as well as for his energetic superintendence,
I would beg also to bring his name to the notice of Government.
Weekly Returns, &c.
36. For several years back weekly returns of vaccination have been in
use in the Sind Circle. They were introduced
by Dr. Martin, when he was Superintendent of
Vaccination in Sind; but it was left for me, on succeeding him, to bring them
into general use there. After I became Superintendent General, Mr. Robert-
son, Collector of Dhanwar, who takes great interest in vaccination, suggested