NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
40
of syphilis. I have not seen a single case of even a doubtful transmission of syphilis
as a result of vaccination. It will be seen that my experience of this subject is entirely-
negative.
SIND CIRCLE.
Superintendent.—Assistant
Surgeon J. WILLIAMS, M.D.
Establishment.—Seventeen
Vaccinators under Government, thirteen under Local
Funds, one under a Native Chief, one under a Municipality, and twenty Dispensaries.
Population, 2,500,000.
Total cost (excluding Dispensary vaccinations), Rs.
19,995-9-9. Average cost of each successful vaccination, 5 annas and 4 pies.
Establishments.
Government ........
Local
Native Chiefs
Municipality ........
Dispensaries .........
Years.
1868
1869-70
1868
1869-70
1868
1869-70
1868
1869-70
1868
1869-70
Total
Vac-
cinated .
38,859
38,179
23,612
22,981
2,105
1,260
1,150
784
3,522
2,745
Compared with the
preceding year.
Increase.
......
......
......
......
......
......
......
......
......
......
Decrease.
......
680
......
631
......
845
......
366
......
777
Success-
fully Vac-
cinated.
38,053
36,681
22,966
22,085
1,891
1,235
1,089
707
3,265
2,494
Percentage
of Success,
excluding
Unknown.
......
98.0
......
99.1
......
100.
......
93.3
......
90.9
Decrease.
There has been a decrease in each of the above establishments. In the Govern-
ment and Local Fund establishments a decrease
was to be expected ; for in 1867 the numbers were
33,821 and 21,854, the considerable increase of 6,788 in 1868 being explained,
in the annual report of my predecessor, the late Dr. Ffolliott, by " a large influx
of emigrants from the famine districts of Hindustan, which furnished several thousand
children for vaccination." There are many famine-stricken people from bordering
States in Sind yet, and this may account for the numbers vaccinated being so
high as they are ; for I had expected a somewhat considerable diminution in the
total number vaccinated, owing to the unusually large and long continued rainfall,
the cholera epidemic, and the great sickness prevalent after the rains. But, in addition
to these causes, in consequence of the "famine prices" ruling in Sind, I had, for six
months, to reduce the local Vaccinators from thirteen to twelve, and to divide the
" savings" in the manner that appeared to me best amongst the "twelve," to enable them
to carry on their work efficiently; otherwise, I am sure, there would have been a far
41
greater " decrease " in the number vaccinated by Local Fund Vaccinators, as they
would have been obliged to dispose of their horses. This reduction of the number
of Vaccinators and redistribution of pay was done under the sanction of the Commis-
sioner in Sind. Considering, then, that the whole of Sind (excluding the Dispensaries
and Civil Surgeoncies) should, according to the calculations of both my predecessors,
not give more than 60,000 vaccinations a year, I think that the Government and
Local Fund Vaccinators have worked admirably. The decrease in the amount of work
done by the Vaccinator of Kheirpoor State, paid by His Highness Meer Ali Murad,
is very considerable, and much to be regretted. The cholera epidemic, and the unusual
amount of sickness prevailing from September to February, consequent upon the very
heavy rains, sufficiently account for the diminution of vaccinations by Dispensary
officers. Many of the officers in charge of Dispensaries commenced vaccinating, time
after time, only to give it up owing to the excessive sickness. The greater number of
them seem to me most anxious to carry on vaccination, and I hope that this year will
show a considerable increase in the number vaccinated.
Sex.
2. The proportion of males to females vaccinated in the talookas is 55.5 to 44.5,
whilst in the Dispensary towns the ratio is 58.4
males to 41.6 females.
Castes.
3. In the talookas there were 11.25 Hindoos vaccinated to 81.3 Mussulmans;
the remaining 7.45 being made up of other castes,
including 4 Christians and 1 Parsee (in the 62,120
total vaccinated). Other proportions obtain amongst the Dispensary vaccinations,—
Hindoos 50.4, Mussulmans 48.3; the remaining 1.3 per cent. being made up of 16
Christians, 4 Parsees, and other castes 15 (in a total of 2,745). These proportions are,
I believe, in accordance with the populations ; the Hindoos chiefly inhabiting towns, and
the Mussulmans the districts. But does this account for the difference observable in the
number of females to males vaccinated in towns ?
Ages.
4. Of those vaccinated at the Dispensaries 46.74 per cent. were under one year
old, and of those vaccinated by the Government and
Local Fund Vaccinators 39.5 per cent. were under
one year, or very nearly at the rate of two under one year to three over one year. I think
the percentage of those vaccinated under one year in towns might be a good deal higher,
but the percentage of children vaccinated under one year in the talookas seems to me
to be as high as it can be expected to reach, for it takes a man about two years to
vaccinate the whole round of a talooka.
Percentage of Success.
5. The proportion of successful vaccinations in the talookas, viz. over 95 per cent.,
seems to me very fair. The lower percentage of the
Dispensary vaccinations is partly attributable to seve-
ral failures in vaccinating from tube lymph, and partly to children not being brought
for inspection after having been vaccinated, which necessitates a considerable number
being entered as doubtful.
6 v s
44
the apathetic in open Durbar. Mr. Moore, too, the Assistant Commissioner, very
kindly gave me every permission and help in inpecting the school children. Speaking
generally, the schoolboys are sons of Hindoos, and well marked with small-pox. For
instance, at the Tharoosha School, I saw 73 children, of whom 14 only were vaccinated,
20 were unvaccinated, and 39, or upwards of half the children, were marked with
small-pox. Now the 39 were the children of the wealthier Hindoos. I scarcely need
add that at the Durbar held in Tharoosha, Sir William Merewether gave a " lecture on
this disgraceful state of things." Vaccination progresses favourably now at Tharoosha.
Quality of Lymph.
11. The quality of the lymph has been perfectly good throughout the year,
showing that the Vaccinators have been careful to
extract the lymph at the proper time. The vesicles
consequently are typical, and the areola in due time is formed ; a slight pitting is left
after the scab has fallen. For the last few months I have experienced much difficulty
in supplying lymph to Dispensaries for want of capillary tubes. It happens at times
that there may be no Vaccinator within many miles of a Dispensary so as to send a
child with lymph there. I may here mention that people object very much to have
lymph taken from the vesicles ; but I think that a more liberal payment would generally
overcome the majority of objections, the allowance now given, particularly in the Local
Department, is insufficient.
Native Assistant Superintendents.
12. Hassah Mull, the Head Vaccinator, and Assoo Mull, one of the Vaccinators,
have rendered me, in their capacity of Native Assist-
ant Superintendents, very material assistance, during
the year. They arc given a small allowance from the Local Funds, which enables them
to carry on some supervision over the other Vaccinators, as well as carry on their own
work. Hassah Mull has worked the district north of Hydrabad, and Assoo Mull the
southern portion with the Thurr and Parkur. I had to dismiss two Vaccinators for
neglect; they were both working in the Lár, and within a very few weeks twice lost
their lymph. Two others left the Department within the year—Chandiram, on account
of sickness, and Soomar had to return to his home owing to the death of his father.
I must again mention the very great obligations I am under for the assistance and
kindness shown me by Sir William Merewether, the Commissioner in Sind ; Major
Tyrwhitt and Major Wallace ; for without such real and personal help as they have
afforded me I should not have been able to accomplish one half of what I have done.
My duties, instead of being laborious and irksome, have been comparatively light and
pleasant.
Nover Keen any ill effects from
Vaccination.
13. I have, both in England and here, examined and vaccinated many thousands
of children, and have never observed any ill effects of
any description arising from vaccination. I have seen
cases where a vesicular eruption appeared like chicken-
pox together with the vaccine vesicle, and disappeared with it: I have never seen any
scrofulous or specific disease produced by vaccination.
45
KATTIAWAR CIRCLE.
Superintendent.—Surgeon
E. R. BUTLER, M.D.
Establishment.—Eight
Vaccinators under Government, thirty-seven under Native
Chiefs, and 2 Native Assistant Superintendents.
Population, 1,582,468. Total cost, Rs. 13,706. Average cost of each successful
case of vaccination, 4 annas and 4 pies.
Establishment.
Government ......
Native Chiefs ...
Years.
1868
1869-70
1868
1869-70
Total
Vaccinated
10,523
10,040
39,023
44,939
Compared with the
preceding year.
Increase.
......
......
......
5,916
Decrease.
......
483
......
......
Successfully
Vaccinated.
9,905
9,426
35,924
41,579
Percentage
of Success,
excluding
those Un-
known.
......
96.8
......
95.9
Increase.
I have again the pleasure to report an increase in the total number of vaccina-
tions for the year 1869-70. The total number
vaccinated is 54,067, showing an increase of 4,521
over the year 1868. The increase is due to an
increased number of Native Chiefs' Vaccinators, and to the exertions of the Native
Chiefs' Vaccinators alone. There is a falling off in the total number performed by
the Government Vaccinators. The reason of this decrease is, I think, entirely attribut-
able to the ravages of cholera; three of the Vaccinators had to strike work for
some time in the rains on this account. The Chiefs' Vaccinators' returns would, no
doubt, have shown a greater total but for the same reason. In one town nearly 400
children are said to have died of cholera.
2. In my Report for 1868, I stated that I computed 50,000 children was the
maximum annual number, in proportion to the population, available for vaccination. I
then forgot to allow for increase of population, which, the Political Agent informs me,
is considerable for the last year or two. The population given is the same as for
1868, no census having been taken since.
General progress.
3. The general progress of vaccination is decidedly good. The last Chief (Mallia),
who was unprovided with a Vaccinator, has lately
entertained one. I think there is a tendency to
employ too many by two or three Chiefs : they are emulous of one another in this
respect. In fact, the number employed now by the Chiefs is sufficient to do the
whole work in Kattiawar ; and the Government Vaccinators, with the exception of two
(who might be retained for the purpose of being sent at a moment's notice to any
46
place where small-pox may break out), should be removed. I have had more requests
from heads of villages "to send Vaccinators" during the last year than I ever received
before. Several instances have come before me of parents taking their children many
miles to the nearest station, rather than wait for the annual visit of their own Vac-
cinator to operate on their children. I have received no complaints from Vaccinators
of ill treatment or of serious impediments being place in their way when carrying on
work,—a constant occurrence for some five or six years' back.
State of Lymph.
4. The state of lymph throughout the year has been generally good, especially in
the Rajkote, Wankaneir, and Nowanuggur Talookas.
Twelve fresh importations of lymph have been
received during the year from England and different parts of the Bombay Presidency.
Also some animal vaccine was sent from Bombay, which proved inert. All the
English lymph proved active, all the Indian inert. The vesicles from the English
lymph, after the second and third propagation, are reported large and characteristic.
Generally, throughout the Circle, the vesicles I have seen have been small.
Number of Vaccinators.
5. One Vaccinator and 46 Assistant Vaccinators have been employed during the
year, including two Native Chiefs' Superintendents
and two Apprentices. Of these Assistant Vaccinators
44 have been on duty the whole year, one for nine months, and one for three months
only. There has been no change in the number of the Government Vaccinators.
Four additional have been appointed by the Chiefs,—three of them by the Thakore of
Bhownuggur, and one by the Thakore of Mallia (there are two Mallias, one is a small
talooka belonging to Joonaghur, the other the above mentioned).
Conduct of Vaccinators.
6. Vaccinator Runchore Munguldass (General No. 32) performs the office work,
and travels about with the Superintendent. I cannot
report too highly of his diligence and abilities.
Collectively, I cannot report favourably of the Assistant Vaccinators, neither Govern-
ment nor Chiefs.
Vaccinators of low Castes.
7. At the commencement of the year, the number of low caste people vacci-
nated was noticed to be very small. I received com-
plaints from Bantwa and Porebuuder that the Vacci-
nators of these two places refused to vaccinate Dhers and Bungies. This is a very
old subject of contention with the Vaccinators. When I first came to Kattiawar many
of them refused to vaccinate low-caste people; rather than do so, several of them re-
signed or suffered dismissal. On the present occasion, the difficulty has been overcome
in three of the 1st class talookas, by each having appointed one man especially for this
duty. The Porcbunder and one of the Gondul Vaccinators resigned, two were dis-
charged, and one suspended ; the remainder have all given their word to vaccinate all
castes, as was intended when they were first appointed. The high-caste people
are as much to blame, if not even more so, than the Vaccinators in this matter : a great
many of them refuse to allow the same Vaccinator to vaccinate their children, and the
47
low-caste children too. Besides the above changes, one Vaccinator, employed by the
Chief of Jhusdun, died.
Vaccinators dissatisfied with
their pay.
8. Most of the Vaccinators are dissatisfied with their pay,—the Government
men on account of the grain batta, which was given
to them and then taken away, and which they are
now anxiously expecting to receive in the shape of
travelling allowance, as was recommended last year. The Native Chiefs' Vaccinators
are dissatisfied, because most of them get less than the Government men, and because
others get as much as Rs.20 and Rs. 25 a month.—(Vide Form A, Statement No. III).
I think good pay is the one thing wanted to make the Vaccinators thoroughly efficient,
and if they are to get an increase, the travelling allowance would be the best way of
giving it. Where responsibility is great, the pay should be in accordance. I cannot
finish this subject more appropriately than by quoting a passage from Dr. Colah's
Report for 1868 :—" Besides mere mechanical skill, other qualities are needed in a Vacci-
nator. He must, to a certain extent, be an educated man, possessed of a moral conscious-
ness that he has to do a work, upon the proper performance of which, will, in a great
measure, depend the life of a human being ; and he must also possess an unusual
amount of patience and energy to quietly work his way over the prejudices of the
people, and the tact to gain their confidence. With industrious and energetic habits,
a conciliatory disposition is essential. It is not likely that men possessed of such
qualities could be found to serve for very low wages."
Practicability of improvement.
9. In my last year's report I entered most fully into the subject of improving
the system of vaccination. This year, when the
Superintendent General of Vaccination was at Raj-
kote, he examined most carefully into all its bearings. I am afraid, under the present
state of the organization of the Vaccination Department in Kattiawar, improvement is
impracticable, although there is plenty of room for it
Small-pox.
10. A few cases of small-pox have been reported from several talookas at differ-
ent times ; mild in form and not of an epidemic
nature, most of them were reported in the months of
of January, February, and March, 1870. I have seen and heard of many cases
in the Bujjana, Veerungaum, and Patree Talookas; the two last are in the Ahme-
dabad Zillah, but Kattiawar villages are round and about them. The cases I saw were
confined to wandering Marwaree children.
11. Inoculation is not carried on as a trade in Kattiawar. I sometimes hear of
isolated cases, but they have been the work of itinerant Inoculators passing through
the peninsula, and not of it.
False Returns.
12. I am sorry to report that I have proved home to two men several cases of
false returns, both Chiefs' Vaccinators,—one man
was discharged ; the other forgiven, his work in other
respects being so eminently good. The discharged man is one of those before men-
48
tioned belonging to Mangrole. Besides the above mentioned false returns, I found
several other suspicious cases, but could not prove them.
Weekly Returns.
13. The weekly returns are decidedly a good institution; independent of the
information they give to those in authority over the
different stations, they have also been the means of
compelling the Vaccinators to keep up a continuous supply of lymph. Before they
were introduced the Vaccinators were constantly allowing their lymph to lapse, often
causing a break of weeks. I seldom get demands now for fresh lymph on this
account.
Chiefs all give assistance.
14. The Chiefs, one and all, have given me
great assistance, and all those I have visited have
been most courteous.
Peons paid by Chiefs.
15. Previous to 1869-70 the Peons on duty with the Superintendent and
Government Vaccinators were paid by Imperial Local
Funds, (tribute?); now they are paid by the Chiefs.
This is one reason why the cost to Government of the Vaccination establishment is less
for 1869-70 than formerly.
Tour.
16. The employment return shows most of the particulars connected with my
tour. In April and May I was in Rajkote, doing all
the duty, both Civil and Military. June, July
August, September, and part of October, I was also in camp, engaged with my own
Civil duties there. I was not able to travel much in October and November on account
of the late rains : the roads were so heavy in some places I could only get over two
or three koss a day. The locusts also severely interfered with my inspection duties ;
wherever they settled the people seemed fascinated by them ; and as long as they
remained it was utterly impossible to collect the children. During the year I have
visited every talooka except Jafferabad, Limree, and Jhusdun, and inspected all the
Vaccinators' work except seven. From March 1869 to March 1870 I have visited
every talooka, save one, and inspected every Vaccinators' work except one.
Never seen a case of Syphilis
traceable to Vaccination.
17. I have now inspected 40,000 children, and have never seen a case of
syphilis that could be traced to vaccination as the
way or means by which it was introduced.
Work of Vaccinators.
18. In reference to the Vaccinators' work not one of them had done perfectly
satisfactory work, there was some fault or another :
one had vaccinated very few, another had done it
very carelessly,—resulting in bad lymph, or small vesicles, or both ; others had made
false returns.—(See conduct of Vaccinators).
Constant supervision the great-
est means of obtaining good
results.
19. 1 have been upwards of nine years doing duty as a Superintendent of Vacci-
nation ; and the more I see of its successful working,
the more confident I am that constant and inces-
sant practical supervision is one, if not the greatest,
means to that end. During the last year our travel-
49
ling allowance has been curtailed by nearly one half, I respectfully submit that the
present rate of travelling allowance to Superintendents does not pay much more than
half the travelling expenses, and that, necessarily, the inspection duties, if properly per-
formed, must be so at the expense of the Superintendents' pay as well as his insufficient
travelling allowance.
Dispensary Vaccinations.
20. The Dispensary Vaccinations are very few in number, because each village,
where the Dispensaries are situated, has its own
(Chief's) Vaccinator. The Hospital Assistants at the
Dispensaries simply vaccinate the children of the Government servants at the stations,
and any chance case that may be an inmate of the Dispensary Hospital.
REWA KANTA CIRCLE.
Superintendent.—Assistant
Surgeon J. T. WELSH, M.D.
Establishment.—Five Vaccinators under Government and ten under Native Chiefs-
Population, 360,000. Total cost, Rs. 4,262. Average cost of each successful
case of vaccination, 3 annas and 10 pics.
Establishment.
Government, Punch
Mahals
Native Chiefs
Years.
1868
1869-70
1868
1869-70
Total
Vaccinated
7,507
9,476
7,083
10,166
Compared with the
preceding year.
Increase.
......
1,969
......
3,083
Decroase.
......
......
......
......
Success-
fully Vac-
cinated.
7,094
8,975
6,649
9,192
Percentage
of Success,
excluding
Unknown.
95.5
96.7
96.0
94.9
Increase.
The increase in the Punch Mahals during the past, as compared with the preced-
ing year, is accounted for chiefly by the carnest and
diligent manner in which the men, stimulated by
the changes made in the rank and pay of their appointments, have carried on their
work. In previous years all five men were of the same rank—Assistant Vaccinators—
and drew the same pay, Rs. 18 per month; but in the beginning of the present year
a change was made : one of the Assistants, Balajee Purbhooram (General No. 254)
was promoted to the rank of Vaccinator on a monthly pay of Rs. 24 ; two retained
their old rank ; and the remaining two were reduced to the rank of Apprentice Vac-
cinator, with a loss of Rs. 4 each monthly. Since then the aim of the Vaccinator
has been to prove that he was worthy of the preference shown him ; and the others
have been told that future promotions will not be regulated entirely by length of
service. They are each, in their respective ranks, endeavouring to establish a claim for
preferment. The increase is also, to a certain extent, due to greater assistance received
from the village officials, and the decreasing opposition of the people to the operation.
7 v s