NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( xxii )
a population of five or six millions, the area I could not ascertain. The gang
system works admirably well in Calcutta and the surrounding metropolitan
circles, but it is expensive. The expense might have been kept down by letting
them remain under Dr. Charles, and Dr. Powell's pay &c. would have been
saved, but the Medical authorities in Calcutta were desirous of having active
supervision by a Commissioned Medical Officer, and Dr. Charles could not very
easily travel much, as he is Professor of Midwifery in the Calcutta Medical
College. We have very few districts in which the population is dense enough
to give employment for five or six vaccinators working in gangs, but it might
be tried in the few that are well populated, such as Kaira and Tanna as well
as in the Island of Bombay, where it is now on trial. In Madras the Circle
Superintendents (Medical men) have been abolished, and there are now only
the Superintendent General, Surgeon Shortt, and 23 Superintendents, who
are not medical men, but men who have been selected from among the
general body of 255 vaccinators. Dr. Shortt, and the Inspector General
Indian Medical Department in Madras, both assured me that this system is
not working at all well, and they trust that the Government of Madras will
return to the Circle system, with a Medical Officer as Superintendent in each
Circle, as well as the 23 men who are called Superintendents, who would
then hold the position that our Native Assistant Superintendents will hold.
I beg here to express my thanks for the courteous and kind attentions which
I received from Dr. Charles, Superintendent General of Vaccination in
Calcutta, Dr. John Cameron in Oudh (recently acting as Superintendent of
Vaccination and Sanitary Commissioner) and from Dr. Shortt, Superinten-
dent General of Vaccination in Madras. These gentlemen gave me every
assistance and information in their power : and I would beg to suggest that
this Government acknowledge the same through their Governments.
20. It will be seen from the foregoing that I consider the best system
of vaccination for this side of India consists in having—1st, a Superintendent
General ; 2nd, Medical Officers as Superintendents of Circles; 3rd, a Native
Assistant Superintendent for each Collectorate; 4th, a Vaccinator for each
talooka; and 5th, a Municipal Vaccinator for every town of 20,000 souls or
more, but that in Bombay City and in the densely populated Collectorates of
Kaira and Tanna the Vaccinators might be worked in gangs as in the Calcutta
system, so that they could be always under the eye of the Native Assistant
Superintendent, instead of working separately.
Pay of Vaccinators higher
in Bombay than elsewhere
21. In the Lower and Upper Provinces of Bengal and in Madras the
pay of the Vaccinators and Native Assistant Super-
intendents is less than we can get men to serve for
( xxiii )
owing chiefly to the neces-
saries of life being dearer.
in this Presidency, because the necessaries of life
are much cheaper there than here. We might just
as well expect a skilled workman in London to work for as little wages as an
Indian one, as to expect a Vaccinator on this side of India to serve for as
small a pay as one on the Bengal side. As long as the value of labour is
measured by the value of life-necessaries this can never be.
Dispensary Vaccination.
22. Vaccination has been carried on by nearly all the Medical Subor-
dinates and others in charge of Dispensaries, but I
cannot say that much progress has been made. Some
of the officers had no practical knowledge of vaccination before they took
charge of a Dispensary, and take no great interest in it. On the other hand
many of them do their best to further the spread of vaccination in the towns
in which they live. There was an increase of vaccinations at the Dispensaries
in Sholapoor, Alibagh, Dapoolie and several others as exhibited in State-
ment No. 5, but there is still room for much improvement at nearly all
Dispensaries. I am quite alive to the difficulties that the officers in charge
of Dispensaries have to contend with, and I can only trust that time will
remove many of them and that Medical Subordinates and others in charge
of Dispensaries will do their utmost to carry on vaccination in their Stations.
Mr. Apothecary Waite, of the Khandeish Bheel Corps, Honorary Assistant
Surgeon Pollard at Dapoolie, Mr. Apothecary Munday at Vingorla, Mr. Apo-
thecary Sinclair at Kolapoor, and some few others have done well. In Ahmed-
abad Sub-Assistant Surgeon Ruttonjee Hormusjee took some pains to
introduce animal vaccination, but did not succeed; he has given some
interesting details of his experiments, which will be found in their proper place
further on.
Inspection of Dispensa-
ries by Superintendents of
Vaccination.
23. When on tour last cold season the Super-
intendents inspected the Dispensaries which came
in their routes, as directed in the 7 para. of the re-
solution on my last report.
Changes among the Su-
perintendents.
24. During the past year there were a few changes among the Superin-
tendents. In the Central Circle Dr. Turnbull re-
turned from furlough and took over charge from
Dr. Gordon. There was no change in the Southern, Western, Northern and
Presidency Circles. In Sind Dr. Williams went to England on sick leave
about the end of the official year and handed over his office to Dr. Roche, Civil
Surgeon of Kotree. In Kattiawar, Surgeon Blomfield acted for some months
and Surgeon Shepherd the rest of the year; but he also has again left and
( xxiv )
Surgeon Blomfield is again acting. In Rewa Kanta Dr. Welsh, who had
resigned some months before, handed over charge to Dr. Cody in autumn
last.
Summary of the inspec-
tions of Superintendents.
25. The following table shows the inspections
&c., performed by Superintendents during the
year :—
Names of
Superintendents.
Drs. Gordon and
Turnbull
Mr. Raby
Dr. Blanc
Dr. Colah .......
Dr. Williams ...
Mr. Shepherd ...
Mr. Cody ......
Circles.
Central ......
Southern ...
Western.....
Northern ...
Sind
Kattiawar ...
Rewa Kanta .
Total ...
Number of Sta-
tions visited.
80
85
62
63
90
49
31
460
Distance travel-
led in miles.
1,637
2,183
1,487
2,857
4,374
1,556
1,120
15,214
Number of tra-
velling days.
174
133
99
188
115
139
58
906
Number of vacci-
nated children
inspected.
11,809
6,579
10,196
17,128
18,598
12,168
4,124
80,602
Number of vil-
lages visited and
inspected.
243
187
200
400
532
214
146
1,922
Number of vacci-
nators
whose
work was in-
spected.
47
37
34
43
41
39
19
260
It will be observed that the whole of the Superintendents have travelled well
and inspected 80,602 vaccinated persons, and also the work of a large num-
ber of vaccinators. The above table shows that the Superintendents have one
and all worked with a will. Dr. Williams has again inspected the greatest
number of children. Dr. Colah stands very close to him. I consider that
Drs. Gordon, Turnbull, Blanc and Mr. Shepherd have examined sufficient
children to test the work of their vaccinators. Mr. Raby is again behind,
but I can now testify from personal knowledge that it is more difficult to see
a thousand children in some parts of his Circle than it is to see double that
number in Sind, or the Northern Circle. Mr. Cody in his four travelling-
months inspected and travelled well too. Where all have travelled so
much, inspected the work of so many vaccinators, and seen so many vacci-
nated children it is difficult for me to commend one more than another. The
great amount of Mr. Williams' mileage was partly caused by his visit to
Guadur on duty, and to Bombay to study the subject of animal vaccination.
It would hardly be fair to judge the merits of a superintendent merely by
the number of children and villages he inspected, because there are many
(
xxv
)
other duties connected with a Circle which it is very difficult to gauge, and
which must be attended to as well as the more important duty of inspecting
the vaccinated children. For instance Mr. Raby has taken great pains to
test his vaccinators' monthly returns through the Police Superintendents,
which has given him a great deal of office work.
Lymph.
26. In the Government Resolution No. 1320, dated 7th June, the
Resident at Hyderabad was informed that supplies
of lymph would be furnished to officers in the
Hyderabad territory. This has been done by the Superintendent of the
Central Circle. Lymph has also been supplied to H. H. the Rao of Kutch's
establishment, and to all other applicants for it.
Supplies
of
English
lymph received.
27. In November last I received a packet containing 24 tubes of
vaccine lymph from the National Vaccine Institu-
tion, London. It was forwarded to Dr. Colah, and it
succeeded in all the children vaccinated from them
except one. On the 9th January last I received through the Inspector General
Indian Medical Department a packet containing 26 charged vaccine tubes; 7
were issued to the Central, 5 to the Presidency, 6 to the Southern, and 7 to the
Western Circle. In the Central Circle Dr. Turnbull had 14 children vaccinated
from 7 tubes and ten took, many of whom had excellent vesicles. In the
Western Circle 8 children were vaccinated and the result was not considered
satisfactory by Dr. Blanc, who only got one good vesicle out of the lot; they
all took more or less except one. In the Southern Circle Mr. Raby had 5
children vaccinated and two only proved successful. I am of opinion that
never more than one child should be vaccinated from one English tube.
The lymph in general
use is good.
28. The lymph in use throughout the presidency has been reported as
generally good; here and there it deteriorated and
was renewed. In the Western Circle Dr. Blanc re-
ports that in November and December it deterio-
rated very much in many talookas, but by the middle of January he had it
good every where. Dr. Colah believes that there is a tendency for the lymph
to degenerate in the monsoon chiefly on account of want of care on the part of
the parents of vaccinated children. Mr. Raby says that some of his vacci-
nators are apt to take lymph from too ripe vesicles. This has been forbid-
den and should not occur. The Civil Surgeons and Dispensary officers have
almost unanimously reported their lymph as good.
Inoculation.
29. Dr. Blanc says that inoculation is still practised in Rutnagherry,
and Dr. Turnbull saw some recent cases of small-
pox inoculation in the Jowlee talooka of Sattara
iv vac
( xxvi )
collectorate, but he has taken steps to prevent the practice in future. The
practice of inoculating with small-pox virus has almost disappeared, and I do
not very well see how the inoculators will be able to compete with our
vaccinators when we have one in every talooka. The practice is a very
pernicious one and every official ought to set his face against it. When we
shall have a vaccinator in each talooka no one will have any excuse for
seeking inoculation, because vaccination will be within the reach of all.
Small-pox.
A column should be
introduced into the new
death registers for
measles.
30. In the Central Circle there was no epidemic of small-pox, and only
3,621 cases occurred in the year 1870 of whom 321
died or about 9 per cent. Considering the population
is nearly 5,000,000 the number of deaths is small. There were 556 deaths in
1870, in the Island of Bombay with its 800,000 of a population, or relatively
fully eight times more than in the Central Circle. I do not see any hope of
preventing deaths from small-pox in Bombay until a Compulsory Vaccination
Act be passed. The disease prevailed in all the collectorates of the Southern
Circle, but it must have been in a very mild form as few deaths occurred
except in the talooka of Mongoode, where it appears that it was rather
severe. To arrest the disease an extra vaccinator was put on there and paid
out of Local Funds by Mr. Elphinstone. In the Western Circle only a few
cases were brought to notice in the Rutnagherry Collectorate. The Northern
Circle had an unusual immunity from small-pox. In Sind there was a great
diminution of deaths from the disease as compared with the preceding year ;
there were 121 deaths, 86 of which occurred in the town of Kurrachee,
leaving only 35 for the rest of Sind, and of these Dr. Williams ascertained
that at least 5 were deaths from measles. There ought to be a column in the
new form for Death Registers for measles, otherwise
the deaths from that disease will be entered in the
small-pox column and of course vitiate all our com-
parisons. I am of opinion that Government ought
at once to give orders for a column for measles to be added to the new form.
There were a few cases of small-pox reported in H. H. the Rao of Kutch's
territory.
In the reports of Civil Surgeons and from Dispensaries the presence of
small-pox was noted as follows:—
Poona ..............................................
Nassick............................................
Dhurumgaum...................................
None.
Commenced in February last and still
continues, 5 deaths, all unvaccinated.
None.
( xxvii )
Sholapoor ..........................
Belgaum. ...............................
Dharwar. .......................
Karwar .............................
Kulladghi ............................
Kolapoor .............................
Tanna ...................................
Bandora.................................
Callian. ..................................
Alibagh ..................................
Rutnagherry ...........................
Dapoolie...............................
Vingorla................................
Ahmedabad ..........................
Godra....................................
Dhoolia ................................
Ahmednuggur ......................
Kotree ..................................
Kurrachee ............................
Aden ....................................
None.
A few cases in cantonment in April
and May 1870.
Much less than preceding year.
Prevalent, 17 deaths. No particulars.
None.
Did not prevail to as great an extent
as in preceding year.
None.
A few cases in March.
None.
Do.
None in town.
Do.
Do.
Do.
Do.
No remark regarding the disease.
Do.
Do.
Prevalent for 3 months in this year.
Ceased in May 1870.
It appears that small-pox has been generally very little fatal up to the
close of the year 1870-71, but I fear much that it is now on the increase
(May), and it seems to be spreading over the whole world. I hope our vac-
cination will stand the test and demonstrate its power to guard from death
by the most fell and loathsome of all diseases. In the last 20 years small-
pox has destroyed 17,472 lives in Bombay city. I am indebted to the kind
courtesy of Dr. Hewlett, Health Officer of Bombay, for the following figures :
Deaths by small-pox in Bombay Island given by quarter-years for the
past 20 years.
1st Quarter, 1851-70 = 6,283 deaths ; average per quarter
2nd
Do.
1850-69 = 9,401
„
„
„
3rd
Do.
1850-69 = 1,338
„
„
„
4th
Do.
1850-69 =
450
„
„
„
Total
17,472 deaths.
314
470
669
22
( xxviii )
Need I add a word more in favour of the opinion of the Bombay Associa-
tion that Bombay should have a compulsory Vaccination Act? Without it,
no intelligence, no forethought on the part of the Vaccination Department
can prevent small-pox being endemic in Bombay, even if it were not
constantly imported, which it is, from maritime Asia. Mr. Anunta Chandroba
has given some information in his report about the difficulty of carrying on
vaccination in times of small-pox, because of the prejudices of some Hindoos
against doing anything to arouse the wrath of the goddess Shitala (Small-
pox) . The real remedy is to vaccinate before the advent of the disease in
any particular street, but I do not believe we will ever be able to vaccinate
much over half the children born in Bombay without compulsion, nor do
I believe it would be possible in any other city of an equal size without a
vaccination Act rendering vaccination compulsory.
31. When small-pox appears in a place, the local officers should im-
mediately communicate with the Superintendent of the Circle. When we
shall have a vaccinator in each talooka the local officers will be able to direct
the attention of the talooka vaccinator to the circumstance, and he will at
once commence to vaccinate in and around the place.
Conduct of Vaccinators.
32. The conduct of the vaccinators as a whole has been good. In the
Central Circle Dr. Turnbull had in no case to do more
than inflict a small fine on any of the Government
vaccinators. One Native State's vaccinator was dismissed for being absent
without leave. In the Southern Circle one Government vaccinator was dis-
missed for falsifying his returns. The falsification was discovered by the
Police checking a monthly return sent by the Superintendent, Mr. Raby ; the
man absconded, so could not be tried. In the Western Circle Dr. Blanc reduced
one for drunkenness, discharged one for falsifying his records, and one was
convicted by a Magistrate of having misappropriated an anna of his lymph
allowance.
On conviction Dr. Blanc recommended his dismissal. I felt
bound to act on the recommendation as the man had been convicted of a
crime, though much against my will, for instead of misappropriation it is
possible that it was an error of accounts. It seemed hard to dismiss a man
after many years service for such a very trifling sum. In future Superinten-
dents of Vaccination will request and receive the permission of the Superin-
tendent General before prosecuting a vaccinator. Dr. Blanc has a few days ago
recommended this man to the merciful consideration of Government, and I
place that on record, but will not support it further than by merely thus bring-
ing it to the notice of Government. Dr. Blanc has recommended that he be
reinstated in a lower grade, but adds there is no vacancy in his Circle- In the
( xxix )
Northern Circle two Native States' vaccinators were dismissed for falsifying".
In Sind two Local Fund vaccinators were discharged by Dr. Williams for
errors in their returns in the matter of re-vaccinations; the punishment was
much too severe and will not occur again. It has been a most difficult thing
to get vaccinators to understand the arbitrary meaning attached to the word
re-vaccination. In Kattiawar Circle 2 Chiefs' vaccinators were dismissed for
falsifying. In Rewa Kanta Circle one Chief's vaccinator was discharged for
being absent without leave. In the Presidency Circle Mr. Anunta Chandroba
reports his entire satisfaction with the conduct of his vaccinators. It is
probable that we will always have a few black sheep, but I think in several
instances last year we have made a few blacker than is consistent with good
common sense, and in several instances the punishments were far too severe.
We have no right to expect perfection, and our punishments ought to be
inflicted with a just consideration of the circumstances, and in general with
the object of improving rather than degrading the vaccinators as a body.
Re-vaccination.
33. In the annual returns for the year preceding the one under report
the columns for re-vaccination were entirely blank.
It will be remembered that in our old forms no
columns existed for showing re-vaccinations separately from primary vaccina-
tions, and any re-vaccinations which were performed were shown with
primary vaccinations, indeed no distinction was made. The new forms are,
in respect of showing the re-vaccinations separately, a great improvement on
the old. It is now well recognized by the Medical Profession in general that
infantile vaccination does not invariably protect the individual against either
an attack of small-pox, or death from that disease, though it is rare that
death occurs when the individual has four or more good vaccine cicatrices.
It is also known that an attack of small-pox itself does not invariably protect
from a second attack which may end fatally. From all the known facts it
would even appear that a re-vaccination is as powerful if not more so to
protect from small-pox than an attack of small-pox itself. During the past
year there were according to the returns fully 30,000 re-vaccinations, but
many officers and vaccinators at first entered secondary vaccinations in the
re-vaccination columns, which was wrong, and has no doubt raised the number,
how much I cannot say. A circular has been issued on the subject to all
charges, and this will not happen again.
Variolation.
34. Dr. Blanc attempted a few times to produce small-pox in the cow
by inoculating with the virus of human small-pox,
but he gives no particulars of the trials. They all
failed. I also tried to do so along with Dr. Charles when I was in Calcutta,
(
xxx
)
and we also failed. It is a difficult thing to achieve, but it has been several
times done in India, especially by Dr. Shortt in Madras. I do not know
that it is of much use to us since we have animal vaccination going on.
Retro-vaccination.
35. Mr. Cody, Superintendent of the Rewa Kanta Circle, succeeded in
inoculating a calf with human vaccine virus, and he
had very good and active lymph produced.
Animal Vaccination.
New animal lymph re-
ceived from M. Warlo-
mont, of Belgium.
36. During the past year Mr. Anunta Chandroba has kept up animal
vaccination in Bombay. There were a good many
failures in the first half of the year, but latterly his
success has been very good indeed: experience has made him more skilful.
The great advantage to the Department of having animal vaccination going on
in Bombay is that it enables us to do without taking so much lymph from
children's arms, to which many of the parents have an insuperable objection.
The cost of animal vaccination has been borne partly by the Cowasjee
Jehangeer grant* and partly by the Municipality's grant. I think there is
every prospect of Mr. Anunta Chandroba being able to keep up the practice
permanently. During last rains Dr. Blanc practised it in Poona, but it did
not seem to be appreciated by the people there. He and I both tried to get
the members of the Municipal Committee to take a personal and individual
interest in the matter, but I cannot say that we succeeded. Mr. Oliphant,
the Collector of Poona, gave us all the assistance in his power. After the rains
were over, Sub-Assistant Surgeon Balcrishna Chintoba, who is in charge of
the Charitable Dispensary in Poona, continued the practice for some time, but
finally lost his lymph, and also I think his inclination to be troubled with
animal vaccination. An unsuccessful attempt to introduce the practice in
Dharwar was made by Mr. Raby. Dr. Blanc has
several times received new animal lymph from M.
Warlomont for Mr. Anunta Chandroba. I would
beg to recommend that Dr. Warlomont's kindness
be acknowledged, through the Secretary of State for India and the Belgian
Government. Dr. Colah succeeded in commencing animal vaccination
in his Circle, and the experiments were continued in Ahmedabad, but
ended in failure. In Sind, Honorary Assistant Surgeon Leahy has
succeeded in Sukkur, but it has not yet been going on very long. In
Rewa Kanta Mr. Cody succeeded with animal vaccination and gives an
interesting account of it in paras, 10, 11, 12 and 13 of his report. In
Kattiawar, Dr. Shepherd informs me that animal vaccination was introduced
* Referred to in the 20th para. of last report.