NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( xxxi )
that some means of informing the local Officers of the whereabouts, &c. of
Vaccinators should be adopted. I thought that weekly returns from the
"Vaccinators to the Mamlutdars, who should forward them to the Collector,
would meet Mr. Robertson's object, and on bringing the subject to the
notice of Dr. Arnott, he authorized me to introduce the weekly return form
throughout the Presidency. This has been done, and I am happy to say
that the Superintendents generally speak of it having been very useful.
The object of it is—first, to keep the Superintendents and Revenue Officers
aware of the villages in which the Vaccinator is working; and, second, to
interest the Subordinate Revenue and Village Officers in the progress of vac-
cination. I am sorry to say that the new rules regarding franking is
interfering with the usefulness of these returns, because a Vaccinator cannot
frank to a Mamlutdar, and there is no provision in my Budget for 1870-71
for such a number of postage stamps as would be required. I am of opinion
that the best plan would be to allow Vaccinators to frank all returns of
vaccination to Mamlutdars as well as to their Superintendents.
Can Syphilis be transmitted by
vaccination.
37. During the last few years there has been a good deal of discussion
in Europe about the communicability of syphilis
by vaccination, and it seems to be accepted
by many eminent men of the Medical profes-
sion that syphilis has been in several instances communicated to healthy
children from a syphilitic vaccinifer. This is not the place to enter into a
discussion as to whether a typical vaccine vesicle may contain syphilitic as
well as vaccine virus, but it seems to be quite certain that the blood of a
syphilitic person is capable of communicating syphilis. All Vaccinators
should be instructed by Superintendents of Circles never to vaccinate with
lymph mixed with blood, and that only healthy children with typical vaccine
vesicles should be used as vaccinifers. I called on Superintendents to report
their experience in this matter, and the following is a summary of each
report:—
1st.—Dr. Gordon, Central Circle, has examined 14,000 children, and did
not see an instance of syphilis having been communicated by vacci-
nation.
2nd.—Mr. Raby, Southern Circle, has examined 8,000, and has never
seen a case.
3rd.—Dr. Blanc, Western Circle, believes in its possibility. Has ex-
amined about 5,000 children, and has never seen a case.
4th.—Dr. Colah, Northern Circle, has examined nearly 50,000 children,
and never saw a case.
( xxxii )
5th.—Dr. Williams, Sind Circle, has examined over 18,000, and has
never seen a case.
6th.—Dr. Butler, Kattiawar Circle, has been nine years connected with
the Vaccination Department, and never saw a case of syphilis trace-
able to vaccination.
7th.—Dr. Welsh, Rewa Kanta Circle, has been nearly five years a
Superintendent, and has never seen a case of syphilis resulting from
impure lymph.
8th.—Mr. Anunta Chandroba, Presidency Circle, in twenty years'
experience never saw syphilis communicated by vaccination.
In conclusion, I would say that during the seven continuous years I have
been in the Department, I have never seen a case which I could trace to
vaccination, although for years this subject has engaged my attention. I
have examined about 60,000 vaccinated children. Syphilis in many parts of
this Presidency is not a rare disease. I do not wish for one minute to say
that syphilis may not be communicated by vaccination; all I do say is, that
I have never seen it, nor has any one of the Superintendents—and yet we
have examined over 200,000 vaccinated children. This evidence is negative ;
but we can't have positive evidence without experiments, and I would not
ask any one to submit to experiments to obtain positive evidence. How-
ever, experiments of Cullerier and others " on the effects of intentional admix-
ture of syphilitic matter and vaccine, and of the vaccination of large numbers
of persons with vaccine intentionally taken from persons suffering with
constitutional syphilis, add positive evidence of the most powerful kind
against the possibility of transmitting syphilis by an ordinary vaccination
with lymph taken out of a true Jennerian vesicle."* It is possible that
these experiments may have been vitiated by the persons who were experi-
mented on having already been syphilized. We now know that all Hunter's
and many of Record's experiments on syphilization were vitiated by the
circumstance that the persons experimented on had already suffered from
syphilis. From all that I have read on the subject in the last few years, I
come to the conclusion that syphilis may possibly have been communicated
by vaccination, but that the evidence given in support thereof could not
prove it by induction.
38. At the commencement of 1869 I was in the Southern Circle; from
there I went through Sawunt Warree, and in my last report mentioned that
I was well pleased with the progress of vaccination in that State, where
* The " Practitioner," No. XVII., November 1869.
( xxxiii )
Colonel Schneider has done so much to render it popular. In the Western
Circle I examined some vaccinations in Vingorla town, and schools there.
The result in the schools were :—
1. English Schools
2. Native School (Boys)
......
3. Native School (Girls)
Vaccinated ...................
Had small-pox .............
Unprotected .................
Total
Vaccinated ..................
Had small-pox .............
Unprotected..................
Total
Vaccinated ...................
Had small-pox .............
Total .........
37
3
3
43
91
9
14
114
29
1
30
I was very well pleased with the efforts made by Mr. Apothecary Han-
son. From Vingorla I returned to Bombay by steamer. I visited the
Superintendent of the Western Circle at Oorun, and inspected his Office
records. I visited the Kattiawar Circle, to learn, by a personal interview
with Dr. Butler, something about the arrangements in his Circle for super-
intending the large number of Native Chiefs' Vaccinators, and came to the
conclusion that the system, though not by any means perfect, was about as
good as could be practically got at. I suggested to Colonel Anderson, the
Political Agent in Kattiawar, that it would be advisable for the Superintend-
ent to be consulted by the Chiefs before appointing, dismissing, or fixing
the pay of their Vaccinators; and this, I am happy to say, the Chiefs almost
invariably do. In August I proceeded to Europe on privilege leave. During
my absence my duties were ably performed by Dr. Niven. When "at home"
I got some insight into the working of the Vaccination Acts in England,
Scotland, and Ireland, which was useful to me in drawing up the draft of
the Bombay Vaccination Act. On returning to India, at the end of Novem-
ber, I drew up and submitted a draft of the Bombay Vaccination Act, and
then started for the Rewa Kanta Circle, through which I went in company
with Dr. Welsh. I visited a number of villages in Rajpeepla and Punch
5 v a c
( xxxiv
)
Mahals, and was much, pleased with the progress of vaccination in this
Circle. Dr. Welsh, deserves great credit for the advance which has been
made during his time of office as Superintendent. When he joined his
appointment in 1865 there were five Government and five Native States' Vacci-
nators; there are now ten of the latter. In 1865 the vaccinations were 7,331;
in 1869-70 they are 19,642; and he invariably tests the Vaccinators' work
by calling the names from the registers. From the Rewa Kanta I passed
into the Northern Circle, and joined the Superintendent at Moondah, in the
Kaira Collectorate. I saw the children of a good many villages in the
collectorates of Kaira and Ahmedabad. We called the children's names
over from the registers. One or two of the Vaccinators had their registers
wonderfully correct, and none had any false names, but I regret to say that
I saw several Vaccinators working with deteriorated lymph; this should
never happen; and while in every other respect I can speak very highly of
Dr. Colah's arrangements, I regret that any Vaccinators should ever, under
any circumstance, use bad lymph. Many of the vaccine marks were bad, show-
ing that the lymph had been deteriorating for some time. After very carefully
considering the cause of the deterioration, I came to the conclusion that the
chief cause of it was the Vaccinators being in the habit of vaccinating too
many children from one vesicle. Dr. Colah issued instructions to all his
Vaccinators not to vaccinate more than five or six persons from one vesicle,
and he renewed the lymph of nearly every Vaccinator in his Circle immediately
from the English lymph which I gave him. After passing through Kaira
and Ahmedabad Collectorates I entered Kattiawar, and along my route I
examined the villages. In Walleh I saw one hundred and thirteen children,
all of whom, except two, had good marks. In Limra twenty,—two unsuccess-
ful, eight had bad, and ten had good vesicles. In the school here there were
fifteen children, only two of whom had been vaccinated. In Babra, with
Captain Russel's assistance, I saw eighty-six children, of whom thirty-four
were well vaccinated, two unsuccessful, twenty-two had suffered from small-
pox, and twenty-eight were unprotected. I saw some good vesicles here.
In Surdhar I saw seventy-eight children, nearly all of whom had good marks.
In Rajkote two hundred and fifty children were examined, nearly all had
good marks, three were unsuccessful, and a very few had bad marks. At
Darole and another village I saw sixty-four vaccinated children, all good.
At Jooria one hundred and sixty nine vaccinated children were examined,
only one or two of whom had bad marks; there was excellent lymph here.
On the whole, then, the work in Kattiawar Circle which I saw was very fair.
From Jooria bunder I crossed the Gulf of Kutch to Kutch. In Bhooj I saw
(
xxxv
)
His Highness the Rao's Medical officer, Mr. Dorabjee Hormusjee, and sug-
gested to him that some arrangement should be made for superintending
His Highness the Rao's Vaccinators, and that their number should be in-
creased. I was sorry that I did not meet Major Shortt, the Political Agent,
at Bhooj. He had gone with His Highness the Rao to meet His Royal
Highness the Duke of Edinburgh. But I have much pleasure in stating that
His Highness the Rao has since my visit appointed one more Vaccinator and
a Superintendent. In Bhooj I saw only nine vaccinated children; all had
good marks. From Kutch I returned to Bombay, by boat, about the end
of the official year.
J. PINKERTON, M.D., Surgeon,
Superintendent General of Vaccination.
Bombay Presidency.
Matheran, 3rd June 1870.
VACCINATION UNDER SUPERINTENDENTS.
CENTRAL CIRCLE.
Superintendent.—Assistant
Surgeon P. S. TURNBULL, M.D. (on leave).
Acting Superintendent.—Assistant
Surgeon W. R. GORDON, M.B.
Establishment.—Twenty-nine
Vaccinators under Government, two under Native
Chiefs, fourteen under Municipalities, and seven Dispensaries.
Population, 4,125,788. Total cost, Rs. 18,780-3-0. Average cost of each success-
ful case of vaccination, 4 annas and 7 pies.
Establishment.
Government
......
Native Chiefs ...
Municipalities ...
Local Funds ...
Dispensaries
Years.
1868
1869-70
1868
1869-70
1868
1869-70
1868
1869-70
1868
1869-70
Total
Vaccinat¬
ed.
52,957
55,959
1,602
2,635
5,953
7,975
........
1,902
603
789
Compared with the
preceding year.
Increase.
......
3,002
........
1,033
........
2,022
........
1,902
........
186
Decrease.
......
......
......
......
......
......
......
......
......
Successfully
Vaccinated.
51,001
53,405
1,495
2,508
5,241
6,978
.......
1,561
436
674
Percentage
of Success,
excluding
those Un¬
known.
97.6
97.0
94.6
95.5
93.7
94.4
.......
85.4
76.4
89.7
Increase.
Cause of Increase.
In submitting the Report for the year 1869-70, it is with much pleasure that I
am able to show a satisfactory increase in the
number of vaccinations, as compared with the year
1868.
From the above table it will be seen that there is an increase in every estab-
lishment, amounting in the aggregate to 8,145. But for comparison, from this must
be deducted the number vaccinated by the three Local Fund Vaccinators, who were
appointed during the year, leaving an actual increase by the same number of Vacci-
nators as there were last year of 6,243. I attribute this—1st, to the continuous active
supervision throughout the year; 2nd, to the in-
creased pay of the Vaccinators; 3rd, to the distribu¬
1 v s
2
of " zahirnammas" to every village in the Circle ; 4th, to the universal use of the
amended return, introduced by Dr. Turnbull, of the unprotected children in even-
village ; and, 5th, also in a great measure, I believe, to the fact that the benefits of
vaccination are now more fully appreciated by the natives.
Average number of vaccinations
by each Vaccinator.
Importance of Native officials
interesting themselves in vaccina-
tion.
2. The highest number of operations was performed by Tattia Dhondeo (Gene-
ral No. 244). He vaccinated 4,407 persons, exclusive of the two Vaccinators employed
in my office; the average number of operations
performed by each in the Government establishment
was 2,072. Considering the difficulties to be over-
come, the number of vaccinations performed by many of the Vaccinators is very fair
indeed. Some, however, have not exerted themselves sufficiently in proportion to
the assistance and support accorded them. I have imposed a few fines for laziness
and negligence, but in most cases my representations have been at once responded to.
I must here observe that much might be done to make vaccination more effectual, if
all the native officials could be made to take suffi-
cient interest in this very important part of their
duties. From many talookas I receive no complaints
of want of assistance ; but in not a few little or no
Support is given, and I have had on several occasions to bring to the notice of the
Collector or Mamlutdar the frequent complaints by Vaccinators of want of assistance
on the part of the village officials.
Sex.
3. Of the total number 51.8 were males, and
48.2 females; nearly the same as last year.
Case.
4. The following table will show the percent-
age of each caste as compared with 1868 :—
Years.
1868
1869-70 ....
Christian.
0.3
0.01
Hindoo.
88.7
87.4
Mussalman.
4.2
5.2
Parsee.
......
.0008
Other Castes.
6.9
7.3
These figures are very similar to last year, and call for no special remark.
Age.
5. The number of infants vaccinated is greater by one per centum than in 1868 ;
the percentage for 1869-70 being 38.2 under, and
61.7 above one year of age.
Percentage of Success.
6. Of the total number vaccinated by the several establishments within the
Circle, 97. per centum were successful, excluding
those doubtful. This percentage is a little too
high, as will be seen from the following table of the monthly inspections of children :—
3
Months.
October
.
November
December ............
January
.
February ..............
March ..................
Total...........
Number of Villages inspected.
39
46
36
34
31
30
216
Number of persons in
Vaccinators' Registers.
Present
during
inspection.
Successful.
893
1,552
1,684
1,290
1,046
785
7,250
Unsuccessful.
55
118
108
89
58
63
491
Absent
during
inspection.
Absence ac-
counted for.
925
1,995
1,091
630
3,072
722
8,435
Unaccounted
for or false.
17
46
...
...
...
...
63
Number of persons whom
the Vaccinator has returned
as vaccinated.
Successful.
1,793
3,468
2,788
1,945
3,812
1,489
15,295
Unsuccessful.
39
90
53
50
172
47
451
Doubtful.
58
153
42
14
192
34
493
Total.
1,890
3,711
2,883
2,009
4,176
1,570
16,239
Vaccinated children seen, but
names not called from the
Register.
121
80
132
41
50
71
495
From this table it appears that I have during the last six months called
16,239 names from the Vaccinators' registers. There were present during inspections
7,741, and of these 93.6 were successful; but of the 16,239, the Vaccinators had
returned 97.1 as successful, excluding those doubtful. The number (63) entered in
the above table as unaccounted for, or false, occurred in the returns of one Vaccinator,
who was dismissed the Service. This will be alluded to subsequently.
State of Lymph.
Vesicles.
Lymph exchanged.
7. The quality of lymph in use during the period under review has been, on the
whole, satisfactory, with the exception of the two
instances mentioned in the résumé of my tour. The
vesicles have been generally normal and well deve-
loped ; the cicatrices well marked, pitted, and
characteristic. Lymph has been exchanged with
Superintendents of the several Circles within the Presidency. With a certain amount
of care and attention in the selection of vesicles from which to propagate the virus, I
believe that vaccine lymph may be maintained for some years in a state almost as
healthy and active in this country as in England. During the last six months seventeen
tubes charged with English lymph have been received from the Superintendent General.
The lymph in ten of these tubes proved successful on application. Two were broken in
transmission through the Post Office. The lymph on five ivory points also received proved
inert. From these sources of English lymph, supplies have been distributed over the
greater part of the Circle. During the year 1869-70 I have distributed 282 capillary
tubes, charged with lymph. With the exception of one occasion, when glasses were spe-
cially asked for, tubes have always been supplied. I regret that I am unable to show
4
in a tabulated form the results. The replies received have been so few that such is not
practicable ; but I am of opinion that a fair amount of success has attended its use.
Inoculation.
8. No reports of inoculation have been received during the year; and if such a
practice exists within this Circle, it is only to a very
limited extent in some of the outlying districts of
Khandeish.
Apathy and indifference on the
part of the people, and paucity of
Vaccinators, are the chief obstacles
to the extension of vaccination.
9. Apathy and indifference appear the great impediments to the extention of
vaccination ; but there is also another and a very
great one indeed, viz., the paucity of Vaccinators
over the country. In the course of my tour I have
endeavoured personally to persuade and conciliate
the people ; and as I heard the occurrence of small-pox in those vaccinated advanced
as an objection, I have, wherever small-pox existed, endeavoured to convince them of
the advantages of vaccination. The inhabitants of large villages are more prone to
prejudice than those of small. It is very seldom that this prejudice extends to villages
in the vicinity of the large towns. The Vaccinator in the Niphar Talooka pointed out
to me instances confirming this, and also that he has known prejudice exist only for
a time. He visited the village of Doghur about the beginning of the year 1869, but
could obtain no subjects ; but on again visiting the place in November, he found the
people anxious for vaccination.
10. During the year 1869-70 I have examined the work and lymph, and tested
the returns, of twenty-two Government Vaccinators, nine Municipal, one Native State,
and also work at four Dispensaries. All have been found correct, with the exception
of the returns of Narayen Gopall (General No. 241), who was dismissed the Service.
With reference to testing the correctness of these returns, I must mention that my
Carkoons, Balcrishna Rajaram (General No. 207) and Ramjee Khunderao (General
No. 240), have rendered most effective assistance, being ever ready to check the
slightest difference between the Vaccinator's return and the village register.
Cost.
11. The following table shows the expendi-
ture and cost of each successful vaccination in the
several establishments:—
Establishment.
Goverment ..........
Municipal ...........
Local Funds ........
Native States........
Dispensaries ........
Total
Successfully
vaccinated.
53,405
6,978
1,561
2,508
674
65,126
Expenditure.
Rs.
15,124
2,654
480
522
a.
3
0
0
0
p.
0
0
0
0
None.
18,780 3 0
Cost of each success-
ful Vaccination.
4 annas and 6 pies.
6
„
1 „
4
„
11 „
3
„
3
„
Nominal.
4 annas and 7 pies.
5
Thus it appears that the cost of each successful vaccination in the Government
establishment, although debited with the cost of administration, is less than in the
Municipal or Local Funds' establishment.
Municipalities' Vaccinators.
Joonere Municipality and seve¬
ral others have appointed Vacci¬
nators.
12. There are fifteen Municipal Vaccinators in this Circle, and the numbers vac-
cinated by them contrast very favourably with the pre-
vious year, there being an increase of 2,022 opera-
tions. Two of these Vaccinators have been appointed within the last month, one by
the Municipality of Joonere, and the other con-
jointly by the Municipalities of Kheir, Warreh, Mun-
cher, and Allundee, in the Kheir Talooka. The
former is the native Doctor in charge of the Dispen¬
sary. The latter only began work on the 1st April, but his appointment shows very
clearly that the benefits of vaccination are becoming more fully appreciated by the
natives. Until very lately, little or no vaccination had ever been performed in any of
the four villages for which he is appointed. I had meetings with three of these
Committees, and, from the desire expressed to possess a Vaccinator, I am inclined to
believe that the work will be carried on energetically and effectually. The Vaccinator
employed by the Sangola Committee resigned, but his place was filled up with as little
delay as possible. The Vaccinators maintained by the Municipalities of Sholapore and
Nassick were dismissed without any reference being made to me on the subject; other
men have been appointed to both places, one on my recommendation, and the other
on the recommendation of Mr. Burn, in charge of the civil duties at Nassick.
Notwithstanding the increase, the numbers vaccinated monthly by most of these
Vaccinators have not come up to my expectations. No doubt they have many diffi-
culties to contend against; but from what I have seen, I believe the chief cause to be
the want of interest felt by the individual members of Municipalities in the promotion
of vaccination. All Municipal Vaccinators, except those of Poona and Nassick, operate
in the surrounding villages within a radius of three miles.
Native States' Vaccinators.
13. In this Circle there are only two Vaccinators under Native Chiefs. During
the period under review there is an increase of 1,033
vaccinations, as compared with 1868 ; the Vaccinator
in the Peint State was sick for about six weeks, otherwise the increase would have
been still greater. So far as I am aware, every facility is afforded to these men for
carrying on their work.
Local Funds' Vaccinators.
14. Vaccination by Local Funds' Vaccinators began during the year. In April
1869, the Collector of Poona informed me that
Rs. 720 had been sanctioned in the Local Fund
Budget for the maintenance of Vaccinators within the zillah. Three Vaccinators were
appointed in August upon a monthly pay of Rs.13, and one rupee for contingencies.
So as to increase their pay I solicited a further grant for the current year, but I
understand the Committee have declined to sanction it; so far as I am aware no