NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
39
I have very little doubt they will have brought up the number of vaccinations to
fully its usual average. The quality of the work done is excellent; as a rule they
vaccinate in no less than eight places, so as to ensure a sufficient number of vesicles
for thorough protection.
Vaccinators records' nearly
absolutely correct.
2. The records of the men were found nearly absolutely correct, excepting those
of Chelaram and Khayal Mull, who managed to make their
returns incorrect in connection with revaccination. They
were both dismissed, and the man Assanund was discharged
on account of inability, through (pretended) sickness, to work in Lar.
No opposition to vaccina-
tion except in towns where
Hindoos abound.
3. There is no opposition to vaccination anywhere except in the large towns; in
fact the country (agricultural) people are very grateful
for being protected against small-pox. The cultivators are
chiefly Mussulmans; the Hindoos amongst them being com-
paratively few, offer little or no opposition to being vacci-
nated, but where the Hindoos are numerous, as in large towns, there the progress of vac-
cination is more or less arrested. The Hindoos readily acknowledge that vaccination
saves them from an attack of small-pox ; but that is the very reason they object to it
they look at small-pox from a religious point of view, and they apparently consider
any interference with the cause of small-pox as tantamount to a sin.
Animal vaccination.
4. For this reason I consider that animal vaccination ought to be accepted by
Hindoos. The cow is a sacred animal, and if it be the
medium to protect them against small-pox, instead of being
objected to, its value would á priori be enhanced. In order to lessen as much as
possible the scruples of Hindoos or any other people against vaccination and to have
a supply of lymph that the most fastidious might rely on, I suggested to the Com-
missioner in Sind that animal vaccination might be given a trial: he at once approved
of it and pointed out Hydrabad as a desirable place, as having the advantage of being
constantly under the supervision of the Civil Surgeon. But unfortunately Dr. Holme-
sted objected to its introduction at Hydrabad, so we had to look out for another
station. At this juncture I happened to fall in with Major Wallace, Acting Collector
of Shikarpoor. I stated the whole case to him ; he said he felt sure that Mr. Leahy at
Sukkur would take it in hand, and the Sukkur Municipality would very probably
vote sufficient money to carry it out. I am happy to be able to say that Mr. Leahy
has most willingly undertaken the task, and that the Sukkur Municipality has most
readily and munificently granted the money. Thus animal vaccination will obtain a fair
trial in Upper Sind, where also it will have to withstand the severe ordeal of intense
heat. My best thanks are due to both Major Wallace and Mr. Leahy for their hearty
assistance.
Re-vaccination.
5. Re-vaccination has not yet had a fair start in Sind ; the people do not see the
use of it, neither do the vaccinators : those entered as re-
vaccinations are for the most part primary vaccinations.
11 vac
40
The vaccinators hunt up children of between five and ten years of age, and if they have
no marks of vaccination and the parents say they have been vaccinated, the vaccinators
operate upon them and enter the operation as a re-vaccination, which is almost inva-
riably successful.
Dispensary Vaccination.
6. At the Dispensaries vaccination has been carried on
perseveringly, but there was a decrease on the previous
year of 928.
Deaths from Small-pox.
7. I am glad to be able to report a considerable diminution in the number of
deaths from small-pox this year. In 1869 there was a
total of 244 cases, whilst in 1870 there are only 121 reported,
or less than one-half; again if we deduct from this 86 cases which happened at
Kurrachee, not under my charge, the number is reduced to 35 ; from this I have a fur-
ther reduction to make, for on my tour I found that the five cases reported from
Oobaoro were not of small-pox but of measles : this brings the number under my
charge down to 30, less than one-eighth the number reported last year.
The new form for death
registers should have a
column for measles.
8. In connection with this subject I beg to express my opinion that the latest
form of death report should have a column for measles, or
the consequence will be that cases of measles, or other
skin disease will be entered as small-pox. This happens
now, and I have had reports from Oomerkote, Meerpoor Buttora, Oobaoro, corrected
from small-pox to measles. I trust Government will see the necessity for giving a
column for measles and the other exanthematous diseases, as well as for small-pox.
Tour.
9. After my return from the Thurr and Parkur Districts I went to Upper Sind in
April last, in company with Sir William Merewether, with the view especially of further-
ing vaccination at Jacobabad, which is the only town in
which the Civil Medical Officer makes no attempt at
vaccination. I was unable to reach Jacobabad, by a severe attack of fever following
exposure to the sun, but the Commissioner did an immense deal towards inducing the
people to be vaccinated, and one of my vaccinators (Kishen Chand), together with the
first Assistant Superintendent, vaccinated many people in the town and camp of
Jacobabad. I afterwards went to Guadur, and arranged measures with Major Ross for
carrying on vaccination in Southern Beloochistan, but we have been prevented from
carrying out those measures owing to Major Ross being away in Persia on a political
mission. Later, I visited Bombay to learn the method of animal vaccination. In my
cold season tour I marched along the Western boundary of the Kurrachee and
Shikarpoor collectorates, through the districts of Jacobabad across to the Eastern
boundary of Shikarpoor, then through Sukkur down the right bank of the Indus.
I scarcely need say that I have travelled over a great extent of country and examined
many children.
10. My sincere thanks are again due to Sir William Merewether, who has most
cordially assisted me in every way. My thanks are also due to all the Officers in Sind,
who have invariably given me every assistance.
41
KATTIAWAR CIRCLE.
Superintendent.—E.
R. BUTLER, M.D.
Acting Superintendents.—Surgeons
Shepherd and Blomfield.
Establishment.—9 Vaccinators under Government, 39 under Native Chiefs, and 2
Native Assistant Superintendents.
Population 1,580,240. Total cost Rs. 15,593. Average cost of each successful
vaccination, 4 annas and 8 pies.
Establishment.
Government ...............
Native Chiefs
Dispensaries .............
Years.
1869-70
1870-71
1869-70
1870-71
1869-70
1870-71
Total
Vaccinated.
10,040
9,771
44,939
47,995
1,315
159
Compared with the
preceding year.
Increase.
......
......
......
3,056
......
......
Decrease.
......
269
......
......
......
1,156
Success-
fully vacci-
nated.
9,426
9,084
41,579
43,970
1,315
149
Percentage
of success,
excluding
those un-
known.
96.8
95.0
95.9
94.0
100.0
93.7
Dr. Butler went on leave in the early part of April 1870, and I (Mr. Blomfield)
took charge of the duties, as he did not return to Kattyawar. I continued in charge
until the 29th of September, when Mr. Shepherd was appointed and continued in charge
until the 26th of March 1871, when he left for Bombay, giving charge of the office to
Vaccinator Runchoredass.
2. During the time I was in charge I was unable to leave Camp, and therefore
saw only those cases vaccinated in the station and town of Rajcote. Those children
that I inspected presented large and well-formed vesicles, the lymph being of excellent
quality.
Number of Vaccinators.
3. Thirty-nine vaccinators have been entertained by the Chiefs of the province,
which is two more than last year. Nine have been paid by
Government, one who was the Station vaccinator, having
been transferred to this establishment.
Conduct of Vaccinators.
4. In looking over the monthly returns I see that the conduct of the vaccinators
has generally been favourably spoken of, with the exception
of Assistant Vaccinators Shaik Shumshere and Pragjee
Anundjee, of the Government establishment, both of whom have been reported as
lazy and have been fined on that account. Two Chiefs' vaccinators were discharged
for sending in false returns, and one took his discharge on his own account. All
have been replaced.
42
Small-pox.
5. Small-pox was reported to prevail in Manickwara
in March, and I have heard of its being in the villages
in the neighbourhood of Rajcote.
6. The Talookdars in the neighbourhood of Rajcote have complained that since
the transfer of the Station vaccinator no one has visited their villages for the purpose
of vaccinating ; this work will probably be done during the monsoon, when the Super-
intendent is in Rajcote.
REWA KANTA CIRCLE.
Superintendent.—Assistant
Surgeon T. CODY.
Establishment.—Five
Vaccinators under Government, ten under Native Chiefs,
and one Dispensary.
Population estimated at 700,000. Total Cost Rs. 7,892.* Cost of each success-
ful vaccination 7 annas and 3 pies.
Establishment.
Government, Punch
Mahals
Native Chiefs
Dispensary ..............
Years.
1869-70
1870-71
1869-70
1870-71
1869-70
1870-71
Total
Vaccinated.
9,476
6,496
10,166
12,658
......
116
Compared with the
preceding year.
Increase.
......
......
......
2,492
......
116
Decrease.
......
2,980
......
......
......
......
Success-
fully Vac-
cinated.
8,975
5,792
9,192
11,541
......
94
Percentage
of success,
excluding
unknown.
96.7
93.5
94.9
95.1
......
82.3
Decrease in the Punch
Mahals.
This table exhibits a large decrease this year, on the preceding one, amongst the
Government vaccinators employed in the five talookas com-
prising the Punch Mahals. The decrease, though a large
one, was to be expected in some measure, inasmuch as the year 1869-70 was quite an
exceptional one as regards vaccination in these districts, and the returns for it were
swelled to an extent not attainable in the ordinary course of things. The chief cause
for this large increase in the returns for 1869-70 was an influx of immigrants who that
year sought refuge in the Mahals from the famine-stricken districts of Marwar, and
they, being mere birds of passage, could only affect the returns for the one year alone,
as they returned to their own country on the cessation of the famine. My predeces-
sor, Dr. Welsh, too, stated in his report for 1869-70 that a large amount of arrears of
* This includes pay of Superintendent from the month of September 1870.
43
work had been got through that year, and that he did not consider it probable that
the returns would attain their then dimensions in the subsequent or any succeeding
year.
2. Again the year itself under report has been an exceptionally bad one as re-
gards vaccination in these districts, in consequence of the very unhealthy condition of
the circle for two or three months subsequent to the close of the monsoon ; and I do
not believe it could, from this cause, contrast favourably with the one preceding it as
regards numbers, even in the absence of the large number of operations performed
amongst the children of the immigrants that augmented that year's returns to such
an extent. During the months of October, November and a portion of December,
malarious fever raged to such an extent that work was partly at a stand-still through-
out the Circle, and very nearly completely so in one or two districts of the Punch
Mahals. A good many of the vaccinators were incapacitated by it; and those who
were able to carry on their work could not procure children to operate on, in consequence
of the extent to which they, as well as their parents, suffered from fever. When these
two facts are considered I think the wide difference between the total number of opera-
tions performed in the Punch Mahals this year and last is not to be wondered at; and
there is no reason to infer, as might be done from the large decrease in the Govern-
ment establishment, that vaccination is becoming unpopular or the vaccinators less
energetic in the performance of their duties.
Increase in Native States.
3. Looking at the returns from the Native States, or the Rewa Kanta proper, it
will be found that there has been an increase in the num-
ber of operations this year to the extent of 2,492. This
increase is due to an increased number of vaccinators who, with one exception which
shall be mentioned hereafter, have been working steadily throughout the year ; and
also, and 1 think more immediately, to the great interest taken in vaccination by Major
Barton, the Political Agent. It is chiefly owing to his exertions on its behalf that
vaccination has made such steady and sure progress in the States for which he is Po-
litical Agent, and entirely due to his representations to the Chiefs that they have thus
diffused the benefits of the prophylactic amongst their subjects. Without his co-opera-
tion the Superintendent could do very little towards the extension of vaccination in the
Native States, and, as far as I am concerned, I have never had to ask a second time
for his assistance whenever I required it.
4. Taking the Circle as a whole, and considering also the total number of re-
vaccinations, I think vaccination may be fairly said to have held its own for the year
1870-71.
Vaccinators.
5. There were fifteen vaccinators in all employed during the year, of which
number five were employed by Government, and worked
in the Punch Mahals, and the remaining ten by the Chiefs
of the States of the Rewa Kanta.
44
Government Vaccinators.
6. There was no change in the Government establishment during the year; but
in three instances there was a break of work that materially
affected the returns. In two cases the break occurred
as a result of illness—one man having had to take a month's sick leave, and in the
other the Dohud vaccinator, who also acts as Karkoon in my office, was taken for four
months off his work in consequence of his having to accompany me on my tour. Fines
were inflicted in a few instances, there being no case of misconduct calling for a more
severe punishment.
Native Chiefs' Vaccinators.
7. In the Native States two changes occurred, one in Rajpeepla consequent on
the death of one of the vaccinators employed there, and
the other in the Soonth and Kuddana States by the dis-
missal of the vaccinator for being absent without leave. In the former case the man
died on the 5th of November, but must have been seriously ill for some time pre-
viously, as I found, on examining his records (for which purpose I went to Nandode)
that he had performed no work after the month of July. In consequence of the
defective means of communication with this State, or more properly I should say
the apathy and indifference of the Durbar, I was not made acquainted with this man's
illness and demise until the end of December, and I was not able, with every effort I
could use, to have a successor appointed until the 1st of February last, so that there
was a break of work of six months in that portion of the State where he was employed,
and during this time the Durbar did not take the least notice of, or exhibit the
slightest anxiety about this cessation of work. In the other case there was no break
of work as I appointed a successor immediately on the man's dismissal. Fines were
imposed in, I must say, a good many instances, but they were all for offences of no
very great importance.
8. Taking the vaccinators altogether, both in the Mahals and Rewa Kanta, I
cannot say more of them than that their conduct was "fair" during the year, and
there was no particular distinction on the part of any single one of them, since I joined
the appointment at least, that would warrant my bringing forward his name for special
notice.
Dispensary.
9. In the month of October a dispensary was opened at Godra, and pari passu
with the other duties of it the Sub-Assistant Surgeon in
charge began vaccination. Since then it has been working
very steadily, so much so that I consider it quite able to meet all the requirements of
Godra town as far as vaccination is concerned, and I have consequently directed the
vaccinator of that talooka to confine his work altogether to the district villages and
leave the work of the town of Godra to be performed by the Medical Officer in
charge of the dispensary.
Lymph and Vesicles—
Animal Vaccination.
10. Shortly after receiving over charge of the appointment I determined to in-
troduce animal vaccination, and thereby supersede the
lymph I found in use by a supply fresh from the original
source. I did not form this resolution as a consequence of
47
simple and easily seen is partly devoid of attraction, while that which is mysterious
and incomprehensible obtains a certain amount of respect and attention. This fact I
have seen exemplified in Dohud, where a class of people, who usually affect to despise
vaccination and are not usually seen at the vaccinator's rendezvous, came to me with
their children as soon as they learned they would be vaccinated direct from the cow.
Altogether the practical deductions I have drawn from the use of animal vaccination,
are :—First, by its means the value of vaccination as a protective agent against small
pox is somewhat enhanced ; and secondly, it renders vaccination less distasteful to some,
and generally speaking more popular.
Returns.
14. Glancing at the returns it will be found that of a total number of 18,516
primary operations, 9,237, or 49.8 per centum, are males,
and 9,279, or 50.2 per centum, are females. This pre-
ponderance of females over males takes place altogether in the Rewa Kanta, for
in the Mahals the figures stand, males 3,065, females 2,937, or 51.065 and 48.935
per cent. respectively; while in the Rewa Kanta the percentages are males 49.3,
females 50.7. I am not prepared to give a reason for this preponderance of females
over males in the Rewa Kanta ; but I may not be out of place in offering it as a
strong proof of the absence of female infanticide in these districts. As regards
caste, Hindoos comprise 89.9 per cent. of the total number of operations ; they also
form the larger portion of the population. There are, however, some very large
Mussulman communities, but I regret to say that vaccination seems to make very little
way amongst them ; and, from their intractable natures, there is little reason to hope
for an improvement for some time at least. Amongst the Bheels, vaccination is going
on very steadily ; and there is now an amount of protection amongst them that bids
fair to lessen any apprehension about small-pox epidemics. The percentage of in-
fantile operations, as compared with those of childhood and adolescence, is small, being
only 29.4 against 70.4, both calculated on the grand total. This great difference is
chiefly amongst the Rewa Kanta vaccinators, as in the Punch Mahals the number of
infantile operations bear a far greater proportion to the total, being 44.3 per centum.
I think I may safely say these figures are correct, for I took particular care, while
making my inspections on tour, to test as far as practicable the accuracy of the
vaccinator's returns as regards age. It is to be regretted that the number of infantile
operations are not proportionately greater in the Rewa Kanta ; but the vaccinators have
a great deal to contend with there in the popular objections to have children vaccinated
below a certain age ; I have no doubt but that in time they will be able to overcome
these objections and bring the figures to nearly the same as in the Punch Mahals.
Re-vaccination.
15. The following small table will give the result of
re-vaccinations during the year:—
12 vac
48
Punch Mahals ...................
Rewa Kanta ......................
Total......
Results.
Successful.
243
90
333
Unsuccessful.
180
44
224
Unknown.
71
10
81
Total.
494
144
638
This table shows a certain amount of popularity for re-vaccination in the Punch
Mahals, while it does not seem to make head in the Rewa Kanta. Chiefly, I imagine,
from the large number of primary operations there are still left to be performed in
the latter portion of this circle. The percentage of success, 59.7, excluding unknown,
shows that there are good reasons why the operation should be favoured; and in-
contestibly proves that, if not an absolute necessity, it is, at least, a wise precaution.
Tour.
16. I was on tour for the four months of December, January, February, and
March; but as the particulars of how I was employed
during the time are summarized in the employment and
inspection returns accompanying this report, I will not do more here than give a gene-
ral detail of the vaccinators and their work as I visited each. In October and No-
vember I examined the work of Assistant Vaccinator Jaithalall Gunputram, who is
constantly stationed in Dohud as he has to do the vernacular work of the office. He
was working with the animal lymph, which gave very fine vesicles. His returns were
correct and his register neatly kept. In December I visited at Jhallode Apprentice
Vaccinator Pursotum Dyaram; at Godra Vaccinator Ballajee Purburam ; at Kallole
Assistant Vaccinator Mahashunker Cassiram, and at Hallole Apprentice Vaccinator
Dajee Kaiwulram. With the first man I found the returns and register quite correct;
but they were kept so slovenly that I had to fine him and give him a severe reprimand
for what was evidently the result of pure carelessness. With the second man I found
a mistake in one of the monthly returns, he having entered as successful a name that
should have been entered as unsuccessful. This he explained as a clerical error, and on
examination I found such to be the case, as the name was properly entered in his own
register. As this was the only mistake I discovered, after a searching examination,
and as I was otherwise satisfied with the neatness and order of his register, I let him
off with a warning to be more careful in future. His lymph was good, but I never-
theless replaced it by animal lymph. The third man had just returned from sick leave
when I visited him, and had no lymph, it having been lost during his absence. I
started it again for him by vaccinating a number of children at Weizulpoor from a
calf. What I saw of his previous work satisfied me, and his returns were correct.