NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
Vaccination.
No. 2399.
GENERAL DEPARTMENT.
Bombay Castle, 30th August 1871.
Letter from the Inspector General, Indian Medical Department, No. 2817,
dated 24th July 1871—Submitting, with his remarks, the report of
the Superintendent General of Vaccination for the year 1870-71.
RESOLUTION.—During the year 1870-71 the total number of vaccine
operations in civil life amounted to 519,143 ; of these 489,024 were primary
vaccinations, and 30,119 re-vaccinations.
The increase in the number of vaccinations performed during the year
under report over those in the preceding year amounted to 38,898.
Assuming the population of the Presidency, including Native States, to
be 21,000,000, Dr. Pinkerton considers the number of primary vaccinations
should not be less than 600,000 a year.
2. The per-centage of success in primary vaccinations is stated to be
96.2, and in re-vaccinations 73.2.
The following is the per-centage of castes primarily vaccinated:—Chris-
tians 0.5, Hindoos 74.9, Mussulmans 18.7, Parsees 0.2, and other castes 5.6.
3. In all the services 326 vaccinators have been employed, and the
total cost of the Department has amounted to Rs. 1,70,051. During the
preceding year 275 vaccinators were entertained, and the total cost of the
Department was Rs. 1,36,201. There has thus been an increase of 51 vac-
cinators, and of Rs. 33,850 in the amount expended.
The following table shows the proportion in which the total was paid by—
1st.— Government ...........
2nd.— Municipalities ......
3rd.— Local Fund ......
4th.— Native States ......
Total Cost.
1,18,310
...
10,354
...
11,258
...
30,129
...
1,70,051 ...
Amount of
increase expended.
17,512
3,660
3,914
8,764
33,850
Each successful vaccination has on an average cost six annas.
4. It is satisfactory to find that the number of vaccinators entertained
by Municipalities has increased. There are now 51, being an increase of 18
23 vac
2
over those maintained in the preceding year. The Municipality of Bom-
bay has during the year under report engaged 11. The Superintendent
General recommends that Municipal assistance should be given in the form
of a money subsidy, and that the Municipalities should have no control
over the vaccinators. His Excellency in Council is inclined to doubt the ex-
pediency of this proposal, and considers that much good may be effected,
especially in Mofussil towns, by the direct personal interest the members of
the Municipality may take in the way in which the vaccinator carries on his
duties. It is not long ago that Dr. Pinkerton reported an instance of the
Municipality withholding a vaccinator's pay because they considered he had
been idle.
5. During the year under report the scheme for the entire re-organiza-
tion of the Department has been matured, and has since come into operation.
The principal features in the new organization are the multiplication of the
number of vaccinators and the exercise of a closer supervision over them.
Besides those employed by Municipalities, each Talooka will have a
separate vaccinator for the benefit of the rural population, and a competent
well-paid Native Assistant Superintendent will be appointed to each Collec¬
torate.
These arrangements, from which the very best results may confidently
be anticipated, have been brought about by the Local Funds paying for the
Talooka or rural vaccinators, and thus enabling the additional Superinten-
dents to be paid for by Government. His Excellency in Council desires to
express his acknowledgments to those Presidents of the Local Funds Com-
mittees who have readily acquiesced in and given their support to this most
important change.
6. The Collectors and their Assistants have invariably co-operated
heartily with the Vaccination Department, but they will now have a more
direct interest in seeing that the Local Funds contributions are utilized to
the utmost. Perhaps the most useful and direct form which their assistance
can take is that of seeing that the village officers keep the lists and vaccina-
tion registers correctly and punctually. They should also insist upon timely
intimation being given of the outbreak of small-pox in any particular locality,
in order that the attention of the Assistant Superintendent may be specially
directed to its suppression.
7. The success of the new system will entirely depend upon the manner
in which the European Superintendents exercise a direct personal control
over the Assistants. The Superintendent General expresses himself satisfied
3
with the manner in which the Superintendents have travelled over and visited
their charges. But His Excellency in Council considers that the present
Table No. VII. requires amendment, and the extent of attention that has
been paid by the Superintendent to each Collectorate and to each Talooka
should be shown. Several Collectorates have apparently not been visited at
all during the past year.
8. His Excellency in Council has read with interest Mr. Anunta Chun-
droba's account of his proceedings in connection with the introduction of
animal vaccination into the Town of Bombay. The zeal with which he has
acted is deserving of much praise. The Secretary of State will be requested
to communicate through the proper channel the thanks of this Government
to Mr. Warlomont, of Brussels, for his kindness in furnishing supplies of
animal lymph.
9. The Inspector General, Indian Medical Department, has noticed
with dissatisfaction the little progress that has been made in Dispensary vac-
cination. He is requested to issue a Circular to all Medical Officers in charge
of Dispensaries informing them that vaccination is not one of the least im-
portant parts of their duty, and that inattention to it will be severely noticed.
It would be well perhaps to require duplicate copies of the periodical returns
to be sent direct to his Department.
10. There is no reason to suppose that the practice of inoculation is
prevalent, and with the increased facilities now offered for vaccination, it is
hoped that it will soon entirely disappear.
A Bill for rendering vaccination compulsory in the Town and Island of
Bombay is now under the consideration of Government.
11. His Excellency in Council has much pleasure in according his en-
tire satisfaction at the manner in which Dr. Pinkerton and the officers under
him have conducted their duties.
(Signed)
W. H. CROWE,
For Chief Secretary to Government.
To
The INSPECTOR GENERAL, INDIAN MEDICAL DEPARTMENT.
The REVENUE COMMISSIONER, N. D.
The REVENUE COMMISSIONER, S. D.
The COMMISSIONER IN SIND.
The MUNICIPAL COMMISSIONER for the CITY OF BOMBAY.
REPORT
ON
VACCINATION THROUGHOUT THE BOMBAY
PRESIDENCY AND SINDH
FOR THE YEAR
1871-72.
Bombay
:
PRINTED AT THE
GOVERNMENT CENTRAL PRESS, FORT.
1872.
No. 4234 OF 1872.
Bombay, 11th December 1872.
FROM THE INSPECTOR GENERAL,
INDIAN MEDICAL DEPARTMENT,
To THE SECRETARY TO GOVERNMENT,
GENERAL DEPARTMENT.
SIR,—I have the honour to submit to His Excellency the Governor in
Council the Annual Report of Vaccination in the Bombay Presidency and
Sindh for the year 1871-72.
2. There has been some, probably unavoidable, delay in printing the
report, which was sent to the Press by the Superintendent General of Vac-
cination on the 2nd of July.
3. The total number vaccinated has been 549,118—an increase of 22,417
over the previous year.
4. The cost of each successful vaccination has been 6 annas and 1 pie,
a slight increase over the preceding year, when the cost was 6 annas.
5. The great feature in the history of the year has been the entire re-
organization of the establishment on the following principles :—
1st—That each táluká should be provided with an Itinerant Vacci-
nator ;
2nd.—That each Vaccinator should be paid from Local Funds ;
3rd.—That each Collectorate should be provided with an Assistant
Superintendent of Vaccination paid from Imperial Funds.
6. From the table given in para. 6 of the report, it will be seen that
there has been an increase in establishment of—
21 Assistant Superintendents,
19 Vaccinators,
35 Peons,
7 Clerks.
7. In the expenditure, also, there has been an increase of Rs. 14,408.
8. The work generally has been of an average kind, with a further
decline in the number of vaccinations in children under one year of age.
a V R
2
9. It can scarcely be anticipated that the increased establishment should
make itself felt, in the better quality of the work done, so soon after its or-
ganization.
10. But in the matter of infant vaccination, which is of great importance,
probably the next report will show an improvement, as the Táluká Vaccinators
have now an area, to work over which will be more manageable than has been
the rule heretofore. It will also be possible for these men to be in possession
of useful information as regards the relative locality, population, and annual
number of births in the táluká villages in which they have to work.
11. It will be interesting in the next report to enter into details as to
a few specimen tálukás, to show how the new organization succeeds, and
whether it is even yet sufficiently strong to cover the ground within a year,
which should be the object of every Vaccinator in the táluká allotted to him.
12. Much of the success of the new scheme will depend upon the zeal and
intelligence of the " Assistant Superintendents " and in the judgment display-
ed by the Medical Officers in charge of Circles in utilizing their services.
13. Government would probably think more highly of these latter officers,
who are emplyed for so many months in the year in the districts amongst the
people, if they could exert themselves to acquire a knowledge of the language
of the people.
14. The influence of Superintendents would be greatly increased there-
by, and complaints and misunderstandings lessened.
15. There has been an improvement in dispensary vaccination during
the year, the increase over the previous year being 4,095.
16. The lymph in general use is reported to have been of an average
kind.
17. The use of " animal lymph" has been very considerable in Bom-
bay, and has been extended to Púna and Sakkhar.
18. As the protective power of this lymph is by no means proved to be
the same in degree as that known to be possessed by " human lymph," it is of
importance to note what is said of it in the report.
19. In the large city of Bombay it is said that the number of vaccina-
tions has increased over the previous year by 3,710, and the Local Superintend-
ent observes " our percentage of success has considerably improved owing
to the excellent cow-lymph always in use during the year, the percentage of
the year being 81.8, whilst that of the preceding year was 86." The improve-
ment is not apparent from the figures.
3
20. The facility with which animal lymph can be used is well shown
in the report of the Local Superintendent, and he is convinced (after an expe-
rience of 28 months) that animal vaccination has done a great amount of good
in Bombay, and is capable of doing the same almost to an unlimited extent
in future, and then he proceeds to describe the extensive and very fatal epi-
demics of small-pox which have been the scourge of the city for the past two
years.
21. As out of 12,094 operations 8,200 were performed with animal
lymph, that is, more than 0/3rds, it is desirable to gain information of the protective
power of the lymph used in these cases, and it will be well to make a report
on this point next year, especially in reference to the statement that the same
localities were attacked in both of two epidemics in the 2nd year in spite of
previous small-pox and, it is presumed, active vaccination.
22. It is a good sign that Native Princes are beginning not only to
permit but to encourage vaccination in their States. Instances are found in
Kátthiáwád, Kolhápur, Janjirá.
23. Considering the many changes amongst the Executive Officers
during the year, and the difficulty inseparable from the starting a new organi-
zation with untrained men, the work of the year has been creditable to the
Superintendent General of Vaccination and the Executive Officers.
I have the honour to be,
Sir,
Your most obedient Servant,
A. WRIGHT,
Inspector General, Indian Medical Department.
( ii )
Causes of Increase.
4. On account of numerous changes and transfers, involving interrup-
tion of work, which took place in the month
of August, I was apprehensive that, though the
Vaccine Establishment had been increased, there would be a decrease in the
number of operations. Fortunately these fears have not been realized.
When an increase in the establishment takes place, especially when the in-
crease is effected in the middle of the year and the operators added are raw
and inexperienced, it is a very difficult matter to show anything like a correct
comparison between that and the preceding year. This difficulty I labour
under in this report. However, on careful consideration, I think the com-
parison will be best shown by contrasting the average cost of each successful
operation; and taking into consideration the numerous interruptions to work
occasioned by the entire re-organization of the establishment, and the large
number of raw and inexperienced vaccinators entertained, I think the compari-
son is in favor of the year under report. The cost of each successful operation
was annas 6-1 in the past, and annas 6 in the previous year—an increase of half
a farthing only for each successful operation. Dr. Pinkerton, in the Annual
Report of 1870-71, para. 53, anticipated an increase in cost in the year 1871-72 :
it is therefore very satisfactory to be able to state that the increase has been
so small. Now that the various establishments are in good working order, I
hope to be able to show a reduction in cost in the report for the current year.
5. In paras. 13, 14, 15, and 16 of the Report for 1870-71, Dr. Pinkerton
pointed out the changes which, under the re-organization of the establishment,
were to take place. Shortly, they were these :—(a) that each Táluká should
be provided with an Itinerant Vaccinator; (b) that each vaccinator should be
paid from Local Funds; and (c) that each Collectorate should be provided with
an Assistant Superintendent of Vaccination paid from Imperial Funds. The
re-organization in accordance with these principles was ordered by Government
to take effect from the 1st August 1871. This was carried out, and the principal
changes were as follow:—(1) All vaccinators on the Imperial Establishment,
except three, were transferred to Local Funds, and the number on the latter
establishment increased so as to provide one man for each Táluká; (2) a clerk
was appointed to the Office of each Circle Superintendent in place of the
vaccinators employed therein as Kárkuns ; and (3) a man chosen from among
the vaccinators was appointed as Assistant Superintendent of Vaccination, one
for each Zilhá, for the purpose of itinerating, frequently inspecting the work
of the operators, and thus ensuring better work and more reliable returns.
Strength of Establishments.
6. Considering the great changes that have been effected during the
past year, I think it well to place on record the
strength of the Vaccine Establishments as they
existed on the 31st of March 1872, and these Compared with those of 1870-71:—
( iii )
Establishments.
Imperial
Local Fund ...
Municipal
..
Native States...
Total...
1871-72.
Superintendent
General.
1
...
...
...
1
Superintendent
of Circles.
8
...
...
2
10
Assistant Super-
intendents.
24
...
...
3
27
Clerks.
9
...
...
1
10
Vaccinators.
3
197
51
119
370
Peons.
52
197
43
110
402
1870-71.
Superintendent
General.
1
...
...
...
1
Superintendent
of Circles.
8
...
...
2
10
Assistant Super-
intendents.
...
2
...
4
6
Clerks.
1
1
...
1
3
Vaccinators.
143
39
51
118
351
Peons.
161
40
42
124
367
This table shows an increase in the number of vaccinators amounting to
19. But of these, many were employed for a month or two only, and none of
them carried on work independently previous to the 1st September. This
was in consequence of the necessity for having them thoroughly instructed.
No greater evil can befal vaccination than the appointment of inefficient and
ill-instructed men. One or two such, I regret to say, were appointed in the
Sindh Circle, but they were soon removed, and I have taken precautions to
prevent such an occurrence in future.
Total Expenditure.
7.
The total expenditure by the Vaccine Department during the past
year amounted to Rs. 1,84,459, an increase
of Rs. 14,408 over that of the preceding
year. This increase is fully accounted for by the larger establishment main-
tained since August last, and by several vaccinators on the Municipal Establish-
ment, appointed towards the end of the year 1870-71, having been on duty
during the whole of the past year. The following table shows the cost of main-
tenance of each establishment, and the cost of each successful operation :—
Establishments.
Imperial ..........
Local Fund
Municipal
Native States ...
1870-71.
Total Expendi-
ture.
1,18,310
11,258
10,354
30,129
0
0
0
0
0
0
0
0
Average Cost of
each successful
operation.
0
0
0
0
8
3
6
3
1
2
5
9
As. 6.
1871-72.
Total Expendi-
ture.
95,696
41,210
15,184
32,368
3
2
7
7
8
11
6
1
Average Cost of
each successful
operation.
1
0
0
0
4
3
4
3
9
0
8
7
As.
6-1.
( iv )
Thus it appears there has been an increased expenditure in every estab-
lishment except the Imperial. The decrease in the latter is due (a) partly
to. the saving effected by the re-organization of establishment sanctioned in
Government Resolution No. 1203, of the 9th May 1871, and (b) partly to the
medical officers officiating as Superintendents having been of lower rank,
and consequently drawing smaller pay.
Average cost of each successful
operation.
8. Each successful operation by Government establishment cost Rs. 1-4-9,
or more than double last year. It should be
borne in mind, however, that during eight
months of the year,—i. e., from the 1st of August
to the 31st of March,—the work of three vaccinators only has been credited to
it; and further, that the whole of the administration charges are debited to
this establishment. In future no good can result from comparing the cost of
the Government with that of the other establishments. Of the cost of the
other establishments, I am happy in being able to say, that though there has
been an increase in the total expenditure, yet the cost of each successful opera-
tion has been reduced in all of them, as will be seen below ; and this, after all,
is the best test of the efficiency and relative cost of each :—
Local Fund .........................................
Municipal ...........................................
Native States ......................................
1870-71.
As.
3
6
3
p.
2
5
9
1871-72.
As.
3
4
3
p.
0
8
7
The cost of Municipal vaccination, considering that none of the expense
of administration is debited to it, has always been too high. It is therefore
very satisfactory to learn that a very substantial reduction has been effected
in the past year. The average cost of each successful operation is 1 anna and
9 pies, or 27.3 per cent. lower than in the previous year. In Local Fund and
Native States' Establishments, small reductions have been effected. Taking
the combined establishments, the average cost of each successful operation was
annas 6-1 against annas 6 in the previous year.
Sex.
9. Of the total number of persons vaccinated, 2,76,950 were males, and
2,44,571 were females, or respectively 53.9 and
46.1 per cent., or very nearly the same as in
1870-71.
Caste.
10. The following will show the percentage of the people of various
castes who availed themselves of the services of
the vaccinator, and for comparison, the percent-
age for 1870-71 is also added:—
1870-71....
1871-72....
Christians.
0.5
0.6
Hindus.
74.9
75.2
Musalmáns.
18.7
17.7
Pársís.
0.2
0.2
Other Castes.
5.6
6.1
( v )
Age.
11. I regret my inability to report an increase in the number of
children vaccinated under one year of age. The
number per cent. is this year 34.5 against 36.3
last year. This is the more to be regretted, because there was a considerable
falling off last year also, and I fear there will not be much improvement in
this respect for two or three years to come—not until the ground has been
carefully gone over. In some of the Circles, as in the Central and Southern,
on account of the smallness of establishment, large numbers until now remain
unprotected. In the Central Circle, for instance, previous to the re-organization
of August last, there was one itinerant vaccinator for every two Tálukás, and it
was found impossible for one man to go over such an area more frequently
than once in three years or thereabouts. The consequence was that during
the absence of the vaccinator, and before his return, a large number of children
had attained an age exceeding one year. Now that each Táluká has an
itinerant vaccinator, I anticipate, in a year or two hence, a gradual increase
in the number of operations on infants.
Percentage of Success.
12. In calculating the percentage of success I have been obliged to ex-
clude the returns of the European Army alto-
gether, on account of successful cases only being
reported. The following statement shows the percentage of success met
with by the Itinerant and Dispensary Operators and the Medical Officers of
the Native Army :—
Itinerant—Statement No. I...........
Dispensary—Statement No. V....
Army—Statement No. VI
Primary
Vaccinations.
95.6
91.8
89.5
Average
95.4
Re-vacci-
nations.
70.4
72.2
48.3
Average
67.3
Thus the percentage of success met with in the combined establishments
has been:—
In primary vaccinations .............................
In re-vaccinations ......................................
95.4
67.3
But I fear the returns of the Itinerant and Dispensary Establishments
show too high a percentage in re-vaccination. Though many precautions
have been taken to ensure correctness, yet it appears to me that in one or two
of the Circles at least, secondary operations (that is, operations performed a
second time after failure in the first), have been registered as re-vaccinations.
13. Having thus pointed out the general results of the operations of the
past year, taking the Presidency as a whole, I shall now show a comparison