NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( vi )
between the operations of the past and previous year in each Circle. The
following shows the increase and decrease in each:—
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Central Circle .........................
Southern do. ...........................
Western do. ............................
Northern do. ...........................
Sindh do. ................................
Káthiáwád do. ........................
Rewá Kántá
do.
Presidency do
Barodá do. .............................
Kutch do. ...............................
Aden Municipality .................
Deduct Decrease
Total Increase..........
Increase.
19,269
11,131
5,795
......
......
11,680
327
3,711
......
1,058
446
53,417
18,620
34,797
Decrease.
......
......
......
13,736
4,716
......
......
......
168
......
......
18,620
Thus the largest increase is in the Central Circle, an increase which, added
to the increase of the previous year, shows an excess of no less than 38,202
over the year 1869-70. Next in order come the Káthiáwád, Southern, West-
ern, and Presidency Circles. The increase in all of these, except the Káthiá-
wád and Presidency Circles, I attribute principally to increase of establish-
ment. The causes of increase in the above two exceptions will be shown
below, under the headings of Municipal and Native States' Vaccination.
14. The Northern and Sindh Circles are the only ones in which an appre-
ciable decrease has taken place. In the former case it is the more to be
regretted, because there was a large decrease in the previous year also,
amounting in the two years combined to 21,847. The decrease in the year
under report is partially explained by a decrease in the number of the vacci-
nators employed ; for though in most of the other Circles the number of vacci-
nators was increased, yet the result of the re-organization was to diminish the
number on the Northern Circle Establishment. Hitherto the establishment
of this Circle has, in proportion to area, been much larger than any of the
others, and for years past the returns have shown a greater proportion of
operations on infants, which, I think, tends to show that the population of
Gujaráth is better protected than that of the other Circles. With regard to
the decrease in Sindh, it appears to me that, taking the population into account,
the number vaccinated largely exceeds the number of births. Sindh is said to
have a population of 20,95,910. At 30 per thousand, this population would
give a total number of 62,000 births annually. Many of these children would,
( vii )
however, die without being vaccinated, and in all probability the number of
those left to be operated on would not exceed 60,000. The excess of vaccina-
tions over births is no doubt due to arrears of work having been overtaken :
but these and other matters, in this and other Circles, shall be thoroughly
investigated as soon as the results of the Census of February last are known.
Average percentage of success
in Circles.
15. The following Statement shows the percentages of success in primary
and re-vaccination in each Circle, the averages
of the whole combined and those of the Dispen-
saries :—
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Central
Southern
Western
Northern
Sindh
Káthiáwád
Rewá Kántá
Presidency
Barodá
Kutch
Circle
do
do
do
do
do
do
do
do
do
Dispensaries .........................
Primary
Vaccinations.
95.2
93.4
96.4
95.6
97.4
96.6
96.2
90.2
95.9
94.4
91.8
Average 95.6.
Re-vacci-
nations.
73.4
61.1
75.1
82.8
70.5
79.5
64.4
50.16
...
64.0
72.2
Average 70.4.
Municipal Vaccinations.
16. The strength of the Municipal Establishment was the same as in the
year 1870-71, viz., 51 vaccinators. Changes,
however, have taken place. In the month of
August last, four appointments,—three in the Sátárá and one in the Sholápur
Zilhá,—were abolished, and four others,—viz., one for the town of Sátára, one
for the city of Surat, an additional one for the town of Karachi, and one for
Sakkhar,—were appointed during the past year. Some explanation seems
necessary regarding the abolition of the Municipal Vaccinatorships abovemen-
tioned. Government is aware that Mr. Chapman, when Collector of Sátárá,
and Surgeon Plumptre, when Superintendent of Vaccination, Southern Circle,
were the pioneers in the establishment of vaccination by means of municipality.
But as the municipal towns of the Sátárá Collectorate were too poor to support
a vaccinator of their own, a number of them were grouped together and a
vaccinator appointed to each group. For years this Collectorate has through
the foresight of the above gentlemen had a very complete establishment; but
on the introduction of the new scheme of Local Fund Vaccination, allowing
one Local Fund Vaccinator to each Táluká, it was found that there was not
room for two vaccinators in the Tálukás of Mán, Khatáw, and Koregáon, and
as the Municipalities are poor, it was thought advisable to abolish the Muni-
cipal Vaccinatorships, and devote the money thus set free to other needful
( viii )
objects. Though these appointments have been abolished, I may state that the
municipal towns will be as much attended to as before. The Sángolá Táluká
of the Sholápur Collectorate formerly was part of the Sátárá Zilhá, and the
vaccinator maintained there was on the same footing as the Sátárá vaccina-
tors, and the appointment was abolished in August last for the same reason.
17. Notwithstanding that the number of vaccinators was the same in
the past as in the previous year, the number of persons vaccinated in the
former amounted to 60,676 or 24,180 in excess of the latter.
The following
shows the increase and decrease according to Circles.
1.
2.
3.
4.
5.
6.
7.
Central Circle..............................
Southern „ ...............................
Western
„
..
..
Northern „ ...............................
Sindh
„
.
Presidency „ ...............................
Aden Municipality
Deduct decrease
Total increase..........
Increase.
3,400
1,573
......
1,300
6,911
10,877
446
24,507
327
24,180
Decrease.
......
......
327
......
......
......
......
327
Thus the largest increase recorded is in the Presidency Circle. The
causes of this are these : for eight months of 1870-71 there were six vaccina-
tors only, and all the operations performed during that period were credited to
Government establishment. From the 1st of December these were transferred
to the municipality, their number increased to eleven, and the operations per-
formed during the remainder of the year, credited to Municipal establishment.
In the past year, however, there were 11 vaccinators paid by the municipality
and employed during the whole year. The real increase in the number vac-
cinated in the city of Bombay is 3,710 persons. The average number of
operations performed by each vaccinator in 1870-71 was 1,068, while in 1871-72
each vaccinator operated on 1,405 persons, thus showing, that the increase is
not entirely due to increase of establishment. To the prevalence of small-
pox (always when present, a great cause of increase), and to the activity and
industry of Mr. Anantá and his subordinates, the increase must be in a great
measure due. But to this ought, I think, to be added, increased appreciation
of the prophylactic by the people. The increase in Sindh is due to increase of
establishment, but the causes of increase in the other Circles it is difficult to
determine, especially in the case of the Central Circle, where an actual de-
crease of three vaccinators took place. It is probably due to increased appre-
( ix )
ciation by the people of the benefits conferred by vaccination, increased interest
in the subject taken by the civil officials, and to the tact and energy of the
Superintendent, Dr. Gordon.
Vaccination in Native States.
18. During the past year vaccination has been carried on in Native
territory with much success. 155,714 persons
were operated on against 138,972 in the
preceding year,—an increase of 16,742,—and this, while the establishment has
been increased by one man only. The following will show the increase and
decrease according to Circles:—
1. Central
Circle
2. Southern do. .............................
3. Western do. ...............................
4. Northern do. ..............................
5. Sindh do. ...................................
6. Káthiáwád do. ...........................
7. Rewá Kántá do
.
8. Baroda do. ................................
9. Kutch
do
Deduct Decrease
Total Increase
Increase.
473
2,508
117
......
411
16,761
......
......
1,058
21,328
4,598
16,730
Decrease.
......
......
......
2,671
......
......
1,759
168
......
4,598
The only ones in the " Increase" column requiring notice are the Southern,
Káthiáwád, and Kutch Circles. The increase in the former is due, I think, to
the tact and energy of Drs. Gordon and Robb; there was no increase in the
number of the establishment. The returns of the Káthiáwád Circle show the
largest increase, but at the same time, as I shall show below, they show also a
very large number of false names.
19. The reported percentage of success in Native territory is 95.2, a
slight improvement on last year; and the cost of each successful operation was
Annas 3-7, or two pies less than in the preceding year.
20. Considerable changes were effected in the Native States' Vaccine
Establishment, especially in the Káthiáwád, Southern, and Western Circles.
In para. 9 of Dr. Pinkerton's Report for the year 1870-71, a suggestion by
Dr. Colah, that Native States should contribute to a common Vaccine fund, to
be placed at the disposal of the Vaccination Department for the maintenance
of the Vaccine Establishment, is noticed. For years past endeavours to effect
this have been made by the Superintendents of the Káthiáwád and Northern
Circles, and during the past year fresh attempts have been made. The result
in case of the Northern Circle is not yet known ; but in Káthiáwád, Dr. Blanc,
2 V R
( x )
assisted by the Political Agent, attained the desired object. The main points
of the scheme submitted by Dr. Blanc to the Native Chiefs, through Colonel
Anderson, were (a) reduction; (b) re-distribution; and (c) gradation of the
establishment: the latter on the same principle as was followed by Dr.
Pinkerton in re-organizing the general Vaccine Establishment. Generally the
scheme, as drawn out by Dr. Blanc, is an admirable one; but had it been
previously submitted to this office for sanction, as it ought to have been, there
are two proposals of which I could not have approved, and which, in my
opinion, ought not to have been made; and on a copy of the scheme being
afterwards forwarded to this office, I signified my disapproval of them to
Dr. Blanc. They are these, viz.:—
(a.)—That "The Chiefs of Káthiáwád should entrust the direction,
management, and control of vaccination entirely to the Superin-
tendent of Vaccination in Káthiáwád."
(b.)—That " With reference to the allowance of Rs. 50 per mensem made
by the Chiefs to this office for a writer, peons, contingencies, &c., it
will not now be so much required, as Government has sanctioned a
writer for this office; but many extra and untold expenses are
entailed upon the Superintendent, so that I believe that this allowance
should be continued as a personal allowance to himself."
Thus in one proposal Dr. Blanc has endeavoured to free himself of all
control by the Superintendent General of Vaccination, and in the other has
secured for himself an addition of Rs. 50 per mensem to his pay.
21. During the past year there was a great increase in the number of
vaccinations performed in the Káthiáwád Circle, but I regret to say that the
number of false names reported by Dr. Blanc and his assistants was also very
large indeed, amounting to no fewer than 2,104. What the cause of so large
an amount of falsification is I am unable to state. Dr. Blanc is of opinion
that it is not due to the carrying out of the scheme as drawn up by him.
Whether this is so or not it will be my duty to inquire. In the mean time,
I may say that directions, such as the following, issued by Dr. Blanc to the
vaccinators of the Káthiáwád Circle, have, in my opinion, a very strong
tendency to produce such a result. In a circular, of which a copy is given by
Dr. Blanc in his report, each vaccinator was directed to "visit during the year no
less than 150 villages," and informed that " the monthly return should show a
number of no less than 200 primary vaccinations." Further, vaccinators were
instructed that "in most Circles good vaccinators show a monthly return of from
3 to 400 vaccinations, and it is hoped that the vaccinators of Káthiáwád will
do the same." Were vaccination compulsory, such rules might be framed and
acted on with advantage, but in the present circumstances of the Vaccination
Department, with a population who only passively approve of vaccination, and
( xi )
very many of whom steadily object to it, the only result of the issue of such
orders will be falsification: especially by the less reliable members of the
establishment. The population of Káthiáwád is, in many places, sparse, and
the villages far between. To enable a vaccinator to overtake so many villages
yearly, it would be necessary to throw aside arm-to-arm vaccination altogether,
and to resort to the use of preserved lymph: the consequence of which would
be deterioration, if not absolute loss of lymph. Besides, were each vaccinator
to operate on 300 children per month, or 3,600 per annum, the result would
be a total number of 118,800 operations per annum, or more than double the
estimated number of births; and even taking Dr. Blanc's minimum, the result
would be 79,200, or fully 25,000 in excess of births. As Dr. Blanc has
repeated these instructions in his report for the past year, I have been obliged
to take notice of them here, in order to show that they do not meet with my
approval.
Assistant Superintendent of
Vaccination, Kolápur State.
22. The next change to which I shall allude is the appointment of an
Assistant Superintendent for the Kolápur State
and its Dependencies. The vaccinators em-
ployed therein number eleven, and on account
of the large size of the Southern Circle the superintendence of these men
has not been so close as could be wished. To remedy this, Dr. Robb recom-
mended, and Colonel Anderson, the Political Agent, approved, the appointment
of an Assistant Superintendent on the same pay as those lately appointed on the
Imperial Establishment. Previous to assuming charge, the man nominated is
undergoing thorough instruction. Much credit is due to Colonel Anderson
and Dr. Robb in the matter of this appointment, and I anticipate a great im-
provement in the quantity as well as quality of the work of the vaccinators.
Janjirá.
23. Many endeavours have of late years been made to induce the Khán
of Janjirá to employ a vaccine establishment
and to put a stop to inoculation, which was
actively carried on in his territory. It may be well to state that the Khán's
territory is situated in the Northern Konkan, and that its northern boundary
is only 25 miles from Kolába Light House, Bombay; that the area is said to
be 324 square miles, and the estimated population 70,000. With no very
sanguine expectation of success I, through the Political Agent, after pointing
out to His Excellency the dangers of inoculation, not only to his own subjects,
but to the population of the surrounding British territory and the City of
Bombay, the benefits to be derived from vaccination properly carried on, its
harmlessness, the strongly and frequently expressed wishes of His Excellency
the Governor in Council, and the small expenditure necessary for maintaining a
vaccine establishment, suggested that he should maintain a vaccinator of his
own. In reply, Mr. Larcom, the Assistant Political Agent, said that the Khán
had informed him that he, personally, had no objections to the employment of
( xii )
a vaccinator, but that he had submitted the question to the heads of villages,
and that they had unanimously reported their desire that things should be
allowed to remain as they were: the people having no wish for vaccination,
preferring the old method, viz., inoculation. On receipt of this reply, I pointed
out that, as a large number of His Excellency the Khán's subjects yearly
visited the neighbouring British territories for the purpose of getting their
children vaccinated, it appeared to me that the village officers must have
misinterpreted the wishes of the people, and at the same time I urged that His
Excellency should test the matter by appointing a vaccinator experimentally
for one year. The amount asked for was granted on condition that one of His
Excellency's own subjects be instructed and appointed. This, I am happy to
say, has been done, and the man, aided by Mr. Larcom's influence, is now
carrying on vaccine operations very successfully. In my letter No. 992, dated
20th November 1871, I had the honour to report this very desirable result for
the information of Government, and at the same time to suggest that Govern-
ment would be pleased to communicate their thanks to His Excellency the Khán,
for acceding to their wishes, and to Mr. Larcom for the very great assistance
rendered in carrying the matter to a successful issue. Government, in their
Resolution No. 3667, of the 9th December 1871, were pleased to act on this
suggestion.
24. Since the vaccinator commenced work, Mr. Larcom has done much to
remove obstructions and generally to facilitate operations. On the suggestion
of Mr. Cody, Circle Superintendent, Mr. Larcom has prevailed on His Excellency
the Khán, not only to issue a proclamation prohibiting inoculation in Habsán,
but to notify that vaccination shall in future be the only legal means of pro-
tecting the lives of his people from small-pox, and that every person carrying
on inoculation within his territories will be punished. The necessity of having
the vaccinator thoroughly instructed delayed the commencement of opera-
tions, but this will be compensated for in future by better and more reliable
work. Under Mr. Cody's and Mr. Larcom's fostering care, I feel sure vacci-
nation in Janjirá, will prosper, and that at the end of the year His Excellency
the Khán will see cause for continuing his support to it.
Dispensary Vaccination.
25. Statement No. V. shows a decrease of 13,418 in the number of
persons vaccinated. But this is only apparent.
In reality, there is an increase in the number
vaccinated at dispensaries, for in the statement of the previous year the
work of 15 station vaccinators was included. The appointments of these
men were abolished from the 1st of March 1871, and consequently their work
is not included in the return of this year. Excluding the work of these men
for the purpose of comparison, 10,220 was the number of vaccinations per-
formed by dispensary officers in the year 1870-71. The total vaccinations in
the year under report were 14,315—an increase of 4,095 over the previous
( xiii )
year. Much has been done in the past year by the Inspector General,
Indian Medical Department, to promote zeal and activity among the officers
in charge, and on several occasions I have impressed on Circle Superinten-
dents the necessity for doing their utmost to promote vaccination by this
means. The Inspector General, in his Circular No. 1003, of the 21st March
1872, has ordered that vaccine stations convenient to the people be fixed in
every dispensary town, and the officer in charge, assisted by a dispensary
servant, shall personally perform the operations; and I have requested Circle
Superintendents to bring to notice the name of every dispensary officer who,
he considers, does not carry out the orders of Government and the Inspector
General in this matter. The neglect of these orders by Mr. Sub-Assistant
Surgeon Wáman Wásudeo, in charge of the Hubli Dispensary, was recently the
subject of special warning by the Inspector General. The following statement
shows the increase and decrease in the work performed at dispensaries,
according to Circles, after deducting the work of the station vaccinators from
the Returns of 1870-71 :—
1.
2.
3.
4.
5.
6.
7.
8.
Central Circle .....................
Southern do. ....................
Western do. .....................
Northern do. ....................
Sindh do. .......................
Káthiáwád do. .....................
Rewá Kántá do. ....................
Kutch do. ............................
Deduct Decrease......
Total Increase.........
Increase.
2,244
784
......
1,617
......
87
349
543
5,624
1,529
4,095
Decrease.
......
......
743
......
786
......
......
......
1,529
Vaccination in Gwádar.
26. Referring to Government Resolution No. 1922, of the 10th
November 1871, regarding vaccination in
Gwádar, I regret that I am unable to give any
particulars, except that since the month of January last vaccination has
been successfully carried on, and that three hundred persons have been
operated on. I have taken steps to secure exact details and correct returns
during the current year.
English Vaccine Lymph.
27. One supply of vaccine lymph was received from the Central Vaccine
Institution of Scotland, and two from the
National Vaccine Institution, London, during
the past year: each through the Privy Council. The results of its use are
shown in the following tabular form :—
( xiv )
Vaccine Institu-
tion from which
received.
Central Vac-
cine Institu-
tion of Scot-
land.
Vaccine Circle in
which tested.
Central ..........
Southern .......
Western ......
Northern .......
Sindh
Total.......
National Vac-
cine Institu-
tion, London.
Central ..........
Southern............
Western .........
Northern .......
Sindh
Káthiáwád ...
Rewá Kántá...
Total......
National Vac-
cine Institu-
tion, London.
Central ..........
Southern............
Western .........
Northern .......
Sindh
Káthiáwád ...
Rewá Kántá
Presidency ...
Total......
Grand Total......
NUMBER OF
Tubes
tested.
4
4
3
4
4
19
4
3
3
4
4
4
3
25
4
4
2
3
3
2
2
2
22
66
Children
operated
on.
4
2
4
2
8
20
5
8
1
2
3
4
3
26
5
4
2
2
3
2
2
2
22
68
Punctures
or scratch-
es made.
12
10
25
10
24
81
29
35
6
11
13
23
18
135
22
24
11
11
19
6
12
11
116
332
Resulting
vesicles.
12
10
23
5
12
62
26
23
5
10
10
15
14
103
14
16
2
10
12
4
9
6
73
238
Summary of remarks on the
Vesicles by the Superintendents.
Good.........
Very good...
Very good...
Indifferent...
Fair
........
Excellent ...
Very good...
Not good ...
Good
Good
Very good...
Very good...
Verv good...
Very good...
Not good ...
Very good...
Good
Very good...
Very good...
Good
Lymph re-
ceived and
tested in the
month of
June.
Lymph re-
ceived and
tested in the
month of
November.
Lymph re-
ceived and
tested in the
month of
January.
Thus 332 punctures or scratches were made in the arms of 68 children
with lymph from 66 tubes, and the result was 238 vesicles more or less charac-
teristic. Of the 68 children operated on, 7 only were absolute failures. The
above shows very satisfactory results. Lymph propagated from this source
was distributed by Circle Superintendents to the majority of their subordin-
ates, and largely made use of by them, during the year.
28. Regarding the deterioration of lymph in this country, I am of opinion
that it is due more to refusals on the part of the people to allow it to be
drawn from the arms of their children, and to the want of care exercised by
the vaccinator, than to any influence of climate. Given a really good and