NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( xv )
careful vaccinator, always in good health, with plenty of healthy and willing
subjects for operation, no objection on the part of the people to allow vaccine
lymph to be taken from the arms of their children, and I feel sure the virus
will continue good and active. But seeing that such conditions are not always
attainable, I am of opinion that these annual supplies of lymph from England
should be continued.
Lymph in general use.
29. The lymph in general use throughout the year has been quite as
good as in former years. As above indicated
fresh supplies were distributed to a large num-
ber of the vaccinators. In fact, in some Circles it has almost been renewed.
Dr. Keith informs me that nearly every vaccinator and dispensary officer in
Sindh has been supplied with lymph such as that alluded to in the concluding
portion of para. 27, and Dr. Gordon, of the Central Circle, reports to much the
same effect.
Purity of lymph.
Inoculation of syphilis.
30. Regarding the purity of lymph, perhaps it will be remembered that
a few months ago a Pársí gentleman of good
position brought very grave charges against a
subordinate member of the Vaccine Establish-
ment in Bombay. The charges were, gross want of care in the selection of
lymph, the syphilitic inoculation of his child through lymph drawn from a
child then suffering from that disease, and the consequent death of his child.
These charges were not supported by any direct evidence, merely by the
opinions of Medical Officers who had never seen the vaccinifer, and who judged
solely by the appearances of the disease from which the child suffered. After
a most careful, and, as far as could be, (considering that the case was not brought
to notice till fully 8 months after the vaccination of the child,) searching
investigation, His Excellency the Governor in Council was pleased in Resolu-
tion No. 1162, of the 11th March 1872, to decide that " a very full and
exhaustive inquiry has been made into the circumstance of the vaccination
and subsequent death of the child of Mr
, and His Excellency the
Governor in Council is compelled to concur in the opinion expressed by the
Inspector General, Indian Medical Department, that it has not been establish-
ed." Such reports, however, show how very careful the members of the Vac-
cination Department should be in the selection of lymph, and generally in the
performance of their duties. One result of the inquiry has been to show the
necessity for a proper registration of vaccinifers. In the month of December
I issued a circular giving directions for the careful selection of lymph, proper
performance of the vaccine operation, what to do and what to avoid doing, as
well as for the formation of an additional column in the vaccinator's register,
showing, opposite the name of every child vaccinated, the register number of
the vaccinifer. This circular was translated into Maráthí, Gujaráthí, Sindhí, and
Kánadí languages, lithographed and issued to every Assistant Superintendent,
( xvi )
Vaccinator, and Dispensary Officer in the Presidency for their guidance. Circle
Superintendents were also requested to see that their subordinates were care-
fully instructed in, and warned as to the consequences of neglect of these rules.
Animal Vaccination.
31. Three supplies of " animal" lymph were received from M. Warlo-
mont, of Brussels, but, unlike the supplies of the
previous year, all failed. Fortunately, however,
our supply did not fail, and during the whole year animal vaccination was
carried on very sucessfully under the judicious and careful superintendence of
Mr. Anantá Chandrobá. During the present outbreak of small-pox it has
been an invaluable source of lymph supply, and but for it, in the absence of
compulsory vaccination, the utmost endeavours of the Department would have
been fruitless, so strong is the objection of the people generally to allow
lymph to be taken from the arms of their children. In all 130 heifers were
inoculated, and out of these 2 only failed. Such results speak well for the
activity of the lymph and the manner in which Mr. Anantá has performed
this very responsible duty.
32. Animal vaccination has also been practised in other places than
Bombay. In Puna, Mr. Bálkrishna Chintobá, and in Sakkhar, Honorary
Assistant Surgeon Leahy have successfully practised it—the former with one or
two short interruptions during the whole year, and the latter during the cold
weather. In the " Rains" of 1871, I frequently visited the Púna Dispensary,
and personally observed and assisted in the performance of the operations.
Small-pox Inoculation.
33. During the year no report of inoculation being practised was
received, and I am hopeful that hereafter, with
a vaccinator in every táluká, free vaccination
will compete successfully with it, and that in a few years inoculation will be
almost unknown.
Small-pox.
34. Except for the City of Bombay, I am unable to give any reliable
small-pox statistics for the past year. The fol-
lowing statement, for which I am indebted to
the courtesy of Dr. Hewlett, shows the number of deaths from small-pox in
the City of Bombay, in each month of the past official year :—
Months.
Deaths from Small-pox . .
April 1871.
216
May
„
189
June
„
107
July
„
45
August
„
20
September „
7
October „
9
November „
9
December „
10
January 1872.
63
February „
162
March
„
376
Total.
1,213
( xvii )
Thus in every month of the year small-pox has prevailed in Bombay.
In the beginning of the year, the severe outbreak then prevailing, had by
the month of August nearly subsided ; but in the month of January following
it again broke out with increased virulence, and in March so severe was it
that I was obliged to suggest to Government (a) that the amount allowed by
the Municipality on account of animal vaccination should be increased, so as
to admit of our inoculating one calf daily instead of, as usual, every sixth day,
and thus ensure the plentiful supply of pure vaccine lymph ; (b) that increased
facilities be given for the transmission of lymph by the vaccinators in the
Mofussil direct to the Local Superintendent by post; (c) that, to enable the
Health Officer to carry out Act VI. of 1867, a place for a Sanitarium should
be appointed by Government as soon as possible; and (d) that a Compulsory
Vaccination Act should be passed without delay. These recommendations
His Excellency the Governor in Council was pleased to approve of, and I am
glad to say that small-pox is now on the decline.
35. Throughout the Deccan, especially in the larger towns, small-pox
appears to have been general, but not very fatal. A few local outbreaks were
brought to notice, and immediate measures taken for their suppression : one,
in the village of Khándas, in Táluká. Karjat, of the Tháná Collectorate, where
prompt measures were successfully taken by Mr. Cody for stamping out the
disease; another, in the Native State of Káthí, north of Khándesh, where a
vaccinator was sent and arrangements for the vaccination of the people made by
Dr. Gordon ; a third outbreak was reported at Máhijí, in Khándesh, during
the fair annually held there. Here also Dr. Gordon made the necessary
arrangements. In the Sindh and Northern Circles very few cases are said to
have occurred. Some cases of measles were reported under the name of
small-pox in the former Circle. But in the absence of statistics nothing
positive can be stated, and I think that measures should be taken to supply
the Department with some reliable information.
An attempt with this
object was made a few years ago, but without success. Perhaps the Sanitary
Commissioner might be able to give the number of deaths in each mortuary
Circle.
Conduct of Vaccinators.
36. The conduct of the vaccinators generally has been good. In the
Central Circle, Dr. Gordon says he has seldom
had occasion to complain of them. " Small
fines have been imposed for disobedience of orders and laziness, but most
of them have devoted themselves to their work with assiduity and perse-
verance." One man was dismissed for absence without leave, one discharged
on account of continued sickness, and three of the senior vaccinators were
pensioned.
In the Southern Circle their conduct is reported to have been creditable.
One man resigned, one died, and two were dismissed—one on account of
drunkenness, and the other of disobedience of orders.
3 V R
( xviii )
In the Western Circle, Mr. Cody reports rather unfavorably of the
vaccinators of the Tháná and Kolába Zilhás, principally for indolence and
carelessness.
Dr. Mancherji Colah reports unfavorably of a few men in the Northern
Circle. Two were dismissed and one resigned.
Of the vaccinators in Sindh, Dr. Keith reports that their conduct, with
few exceptions, has been very good. Three were dismissed.
Dr. Blanc reports very unfavorably of the character of the vaccinators of
the Káthiáwad Circle in his temporary charge, and says that, " with one or two
exceptions, a more untrustworthy and indolent set of men it would be difficult
to find." As to the indolence, Dr. Blanc appears to be mistaken: for the
returns of the Káthiáwád Circle show that on an average the vaccinators
performed 1,927 operations per man, which, with the exception of the Western,
is much larger than the average of any other Circle, and is fully 500 opera-
tions per man above the average of. the whole Presidency. With regard to
their untrustworthiness I may state that they were reported on favorably by
Dr. Shepherd in the previous year.
The reports on the conduct of vaccinators in the Rewá Kántá and Pre-
sidency Circles are favorable.
Assistant Superintendents.
37. This grade was created in the month of August last, and as yet we
have not had time to test fully their utility, but
during the current year I hope to be able to
collect materials from which to form an opinion. In the mean time, I may
state that the special reports regarding them by Dr. Gordon, of the Central
Circle, Dr. Blanc, of the Káthiáwád Circle, Mr. Cody, of the Western Circle,
Dr. Mancherji, of the Northern Circle, and Dr. Haliday, of the Rewá Kántá
Circle—are very favorable ; that the report by Dr. Robb, of the Southern Circle,
is less so ; and that by Dr. Keith, of the Sindh Circle, is unfavorable to two
out of the four Assistant Superintendents. One of the latter has been already
remanded to his former duties; and I may state that those only who are
favorably reported on will be confirmed in their appointments.
Superintendents.
38. Very many changes in the Circle Superintendents have taken place
during the year: all, except those of the Northern
and Sindh Circles, having been changed, some of
them more than once. The following will show the number of officers who
held charge of each of the Circles during the year :—Central 3, Southern 4,
Western 4, Káthiáwád 2, Rewá Kántá 3, and in the Northern, Sindh, and
Presidency, 1 each. With so many changes among the Superintendents,
and the numerous changes among the subordinates occasioned by the carrying
out of Dr. Pinkerton's scheme of re-organization, I and my office establish-
( xix )
ment have been kept very busily engaged, more especially as I had at one
time charge of the offices of the Superintendents of the Central and Western
Circles in addition to that of the Superintendent General.
39. In the Resolution of Government on the Annual Report on Vacci-
nation for the year 1870-71, para. 7, it is stated that " His Excellency the
Governor in Council considers that the present Table, No. VII., requires
amendment, and the extent of attention that has been paid by the Superin-
tendent to each Collectorate and to each Táluká should be shown." In accordance
with this, I have altered Statement No. VII. so as to show the name of every
Táluká and Native State in the Presidency, and the amount of attention paid
to each by the Superintendent of each Circle and his assistants, separately and
collectively, and I trust it will be found intelligible. A column showing the
number of persons vaccinated during the year is added, so as to show a
comparison between them and the total number inspected. The following
Statement shows the totals of each Circle according to the old form :—
NAME OF
Superintendent.
Drs. Turnbull and Gordon..............
Drs. Gordon, Robb, &c
Dr. Blanc, Mr. Cody, &c
Dr. Mancherji ...........................
Dr. Keith
Dr. Blanc, &c. ..............................
Messrs. Cody, Long, &c. .............
Circle.
Central*
Southern ...........
Western † .........
Northern ..........
Sind ..................
Káthiáwád ........
Rewá Kántá ......
Total...
Number of Sta-
tions visited.
53
42
34
44
100
77
43
393
Number of tra-
velling days.
103
111
83
158
138
130
87
810
Distance travel-
led in miles.
1,144
983
857
2,502
2,238
1,582
628
9,934
Number of Vil-
lages visited.
149
131
140
303
421
286
135
1,565
Number of Vac-
cinated children
inspected.
3,427
4,766
3,302
14,586
14,667
12,189
3,519
56,456
Number of Vac-
cinators whose
work inspected.
19
23
20
30
32
31
15
170
* The office was stationary for 3 months of the travelling season.
† Office was stationary for part of the travelling season.
Dr. Mancherji travelled the greatest number of miles, and Dr. Keith inspected
the largest number of vaccinated children. However, there is a falling off
in nearly all the Circles, due almost entirely to frequent changes amongst the
Superintendents, and, in some cases, as in the Central Circle, to the office
being stationary for a considerable period of the travelling season.
The Superintendents generally have carried on their duties in a very
creditable manner; especially, I may be permitted to name, Drs. Gordon,
Mancherji Colah, Blanc, and Robb. Dr. Gordon has, I regret to say, left
the Vaccination Department, in which he acted for nearly three years, to take
up a permanent appointment in the Military Department. From his intimate
acquaintance with the working of the Department, his zealous, active, and
industrious habits, his loss to the Department is great. From what I have seen
of Dr. Robb, however, I am hopeful that he will prove a worthy successor.
( xx )
Assistance by the Civil
Authorities.
40. The Civil Authorities generally have rendered great assistance to
the officers of this Department, and have shown
increased interest in the operations carried
on.
Village Registers of
Vaccination.
41. Regarding the advisability of the adoption of a system of Village
Vaccine Registers I have not the slightest doubt,
and have long advocated it, not only as a means
of insuring truthful and accurate Returns, but
as a permament record. Shortly after joining the Vaccine Department in the
year 1864, I addressed myself to this subject. At that time registration of
vaccine operations was no doubt carried on, but so irregularly and imperfectly
as to be of no use whatever ; there was nothing to ensure their permanence
or correctness; none of the numerous forms in use were suitable : so after
much consideration I came to the conclusion that nothing short of the intro-
duction of a new and uniform system of registration properly carried out
would succeed. A new form was constructed, and each of the Collectors were
requested to issue instructions for their being regularly kept by Village
Officers; and to Mamlatdárs, directing them to stamp the leaves of the
Register Book in the same manner as is done with the Revenue Account Books.
This was done, and no difficulty experienced. Below I give the form of
Register then adopted, and now in use, in every town and village in the Cen-
tral Circle ; and I beg here to quote para. 15 of Dr. Gordon's Report to show
how useful they have been found, and how complete the system now is in the
Central Circle.
" The system of village vaccination and small-pox registers is now almost
complete within this Circle, except in some parts of the Sátárá Collectorate
into which the registers have only been lately introduced. During my tour, I
only found one village in which they were wanting, and that was mainly
owing to late changes of the Village Officers. These registers are looked upon
as part of the village records, and no ' daftar' is considered complete without
them. They are not only valuable as a check upon the vaccinators, but are
most useful records of the progress of vaccination in the villages, and are
always easily accessible to the Revenue Officers, most of whom, I am glad to
say, examine them along with the other village papers."
The form is as follows:—
( xxi )
Register of Vaccination, Village
Táluká
Collectorate
No.
1
Child's
Name.
2
Father's Name,
Surname, and
place of which a
resident. *
3
Caste.
4
Sex.
Male.
5
Female.
6
Age.
Under
one year.
7
Above
one year.
8
Date of
Vaccina-
tion.
9
Signature of the
Vaccinator. †
10
* Place of which a resident is intended for persons who are not inhabitants of the
village in which the operation is performed. The village of which they are inhabitants
should be inserted after the surname. If the town is a large one the division or street may
be written when the person vaccinated belongs to the town in which operation is performed.
† N.B.—The vaccinator should sign this after examination only, and should his signa-
ture not have been taken, and if, after warning the village officers, the Register has not been
made up, the vaccinator should report the matter to the Superintendent. A memorandum
of the names of villages in which work has been done, and registers not kept, should be sent
in to Superintendent monthly.
As will be seen, it is very simple, and this I consider one of its recom-
mendations. All professional details are excluded from it, for village officers
cannot be expected to give these with any degree of accuracy; and without
accuracy they would be valueless.
43. Correct registration of the kind above recommended ensures (a)
correctness of the vaccinator's returns; (b) some countenance to vaccination
and assistance to vaccinators by the village officials, and in this way tends to
raise vaccination in the estimation of the people ; (c) permanency of the
record for future use.
To enable them to make out the Register correctly, one at least of the
village officers must be present during the operations. They are responsible
for the correctness of the Register, and so is the vaccinator; for the last
column requires his signature. Here, then, we have the Pátil, the Kulkarní,
and the Vaccinator,—three individuals,—responsible for its correctness. The
vaccinator is obliged to sign it, or report to the Superintendent his reasons
for not having done so ; and if, after signing a Register which was correct, he
rendered a false Return, the falsification would be at once detected : for every
month, through the Revenue Officials, an extract of the Village Register is
rendered to the Superintendent, and if, on comparing it with the vaccinator's
Return, any difference is discovered, both are sent to the Mámlatdár for inquiry.
This system reduces to a minimum the chances of incorrectness in the Annual
( xxii )
Statements, and ensures an accurate and permanent village record for use
hereafter for statistical purposes. One thing wanted is an authoritative
decision by Government, directing that these Registers be kept in every
village throughout the Presidency and Sindh; and, to make them as permanent
as possible, that the books be stamped and kept with as much care as those
of the Revenue Accounts.
44. The last column of the Register was introduced by me with these
objects:—
1st.—To ensure the Register being kept by the village officers; vaccinators
being directed to report to the Superintendent the name of every
village in which the Register is not kept, and his signature taken.
2nd.—To make the vaccinator as well as the village officers responsible
for the correctness of the Register.
45. During the past year I have endeavoured to introduce this system
of village vaccine registration into all the Vaccine Circles, and with some
success, but the necessary authority of Government would greatly facilitate
matters.
At my request Dr. Blanc, with the sanction of Colonel Anderson and
the concurrence of the Native Chiefs, introduced the system into the Káthiá-
wád Circle as a remedy to the very large amount of falsification brought to
light by him and his assistants.
In the Southern Circle also an endeavour was made: the Collectors and
Political Officers were communicated with, but, with exception of from Colo-
nel Anderson, no replies had been received up to the date of Dr. Robb's re-
port. Colonel Anderson, always ready to assist in a good object, at once gave
his sanction, and issued the necessary orders for the Register being kept in
every village in the Kolápur State and its dependencies.
Since the year 1865 these Registers have been kept in the Tháná and
Kolába Zilhás of the Western Circle,—having been introduced by me when
they formed part of the Central Circle,—and Mr. Cody has obtained the
sanction of Mr. Elphinstone to their being kept in every town and village in
the Ratnágirí Zilhá, and orders will shortly be issued to that effect.
Tour.
46. During the past year my tour was a very extended one. I visited
the Sindh, Northern, Rewá Kántá, Western, and
Presidency Circles. In November I went to
Bombay and to Karáchí by steamer. Thence I travelled to Kotrí, where I
met Dr. Keith, inspected the work of the municipal vaccinator, and saw some
work in the neighbourhood. Thence I went to Haidarábád, where I inspected
the work of another vaccinator, which was excellent. After examining the
records of the Superintendent, and finding them satisfactory, I returned viâ
( xxiii )
Karáchí, by steamer, to Bombay in December. In the month of January I
went on tour in Gujaráth, visited Ahmadábád and the neighborhood. Thence
to Mahmudábád in the Kaira Collectorate, where I met Dr. Mancherji, and
visited several villages around. Work generally good. Leaving Mahmudá-
bád in company with Dr. Mancherji, I travelled, viâ Súnj, to "Wadthal. Visited
Wansolí; saw the results of the use of lymph received from England, and
found it successful. From Wadthal we marched to Alíná, where we examined
the work and fresh lymph of the Nariád Táluká vaccinator. The work of the
current month was good, but that of the previous three months was middling
only. As many of them had been performed by the sepoy, the vaccinator was
warned. From Alíná we moved on to Thásrá. Here I met Mr. King, t he
First Assistant Collector, and consulted him about the Nariád Municipal Vac-
cinator, whose pay the Committee had reduced to Rs. 12 per mensem. Mr.
King kindly promised to do what he could regarding it, and his pay was
afterwards restored to its former amount. The work in Thásrá was fair. The
Mámlatdár, Mr. Dáráshá Dosábháí, appears to take an interest in vaccination, as
well as other matters, and gave every assistance during my stay in his táluká,
for which I beg to thank him. From Thásrá I moved to Pálí, where I crossed
the Mahi River, and thence, viâ Tooá-kán-kán, marched to Godhrá in the Panch
Maháls, where I met the Superintendent of the Rewá Kántá Circle, Mr. Long ,
inspected his office records (which were not so satisfactory as could be wished),
examined the Dispensary and the work of the Táluká vaccinator. From
Godhrá I went to Kalol, and thence through the Barodá territory to Barodá,
where I met the late Surgeon-Major Rimington, and consulted him regarding
vaccination in His Highness the Gáíkawár's territories. Leaving Barodá, I
returned to Púná in the end of February. In the beginning of March I again
visited Bombay, where small-pox was very prevalent; thereafter went by
steamer to Harní in the Southern Konkan, where I joined Mr. Cody, then on
tour. Thence we went to Dápulí, inspected the Dispensary and performed
vaccinations in the town, which were satisfactory. From Dápulí we travelled
to Khed, Kashelá-kowtá, and Poládpur. Everything I saw was satisfactory.
Leaving the Western Circle, I was obliged to return to Púná as speedily as
possible, and I did so viâ the Pár Ghát and Máhábaleswar. In the end of
March small-pox still continuing unabated, if any thing increasing, I was
emergently called to Bombay to concert measures for the promotion of
vaccination. These measures are noticed in para. 34 of this Report.
P. S. TURNBULL, M.D., Assistant Surgeon,
Acting Superintendent General of Vaccination,
Bombay Presidency.
Púná, 25th June 1872.