NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( xiii )
This state of matters appears to have continued for some years, and I think
it would be well were Government to bring the matter to the notice of His
Highness the Ráo. The total expenditure in the Kutch Circle during the
past year has been 2,188 Rupees ; of this Rs. 1,410 were paid from the Kutch
State Treasury, and Rs. 778 by the Bháyáds. I would recommend that the
whole of the money be collected in the State Treasury and formed into a
Vaccine Fund, as was done last year in Káthiáwád, and that the number and
pay of the establishment should be as follows :—
1 Assistant Superintendent on Rs. 50 per month
1 Vaccinator
on „ 20
„
=
1
Do.
on „ 18
„
=
3
Do.
on „ 14
„
=
6 Peons at Rs. 6 each =
„ 36
„
=
Contingencies at Rs. 2 each
„ 12
„
=
Total Rupees per annum ..
Per annum.
Rs. 600
„ 240
„ 216
„ 504
„ 432
„ 144
2,136
This estimate is in Company's Rupees, and shows a saving of Rs. 52 per
annum. If with this establishment, paid as above, the Circle was placed
under the charge of the Superintendent of the Káthiáwád Circle, I think the
number of operations would be, at least, trebled, and the work much better
performed. At present the men are so badly paid, it cannot be expected that
they should do much work. The highest pay is Rs. 12-10-0, the lowest
Rs. 7-12-0 per month.
Vaccination in Janjírá.
31. In my last report I had pleasure in informing Government of the
appointment of a vaccinator in the Janjíirá State.
I am happy to say that my anticipations, expressed
in para. 24, have been fully realized. The man
performed 1,364 operations without experiencing any unusual opposition or
difficulty.
Vaccination in Jamkhandi,
Miraj, and Sánglí.
32. In the Southern Circle some of the detached portions of Native
States, such as Jamkhandí, Miraj, and Sángli,
being very imperfectly vaccinated, an endeavour
was made during the past year to induce these
Chiefs to entertain special vaccinators for outlying portions of their districts,
and they have consented to the proposals. One vaccinator will be appointed
to the Jamkhandí State for employment in the Kundegal Táluká, one to Miraj
for service in Lakshameshwar, and a third to Sánglí for the Shrihattí Hákhá.
Much credit is due to these Chiefs for thus so liberally promoting the spread
of vaccination.
Vaccination in the Bhor State.
33. The Bhor State is situated to the south-west and west of Púná,
principally in the Deccan, but partly also in the
Konkan, to the south of the Bhor Ghaut. It is
( xiv )
said to have an area of 1,044 square miles, and the population of 117,729.
From its size, its population, the difficulty of travelling, its proximity to such
a large city and cantonment as Púná, and the fact that inoculation is actively
carried on in it, I am of opinion that at least two vaccinators are necessary. At
present there is only one. During the past year an attempt was made to in-
duce the authorities to entertain a second man, but without success. The
Kárbhári thought that, instead, the present vaccinator's pay might be increas-
ed, as an inducement to do more work, forgetting that one man, however well
paid, cannot do the work of two. As was to be expected, there has been no
increase in the number of operations performed. I shall again draw the
attention of the authorities to this subject.
Dispensary Vaccinations.
34. Though the number of operations performed at dispensaries, by
Dispensary Medical Officers, is in excess of the
previous year by 3,636, and though at many of
them fair progress has been made, yet I do not consider that, as a whole, the
officers in charge have done as much as they might have. No doubt they
have other duties to perform, but these are not more important than their
vaccination duty, and the latter, if properly performed, need not much
interfere with the former, an hour or two once a week being all that is
required for that purpose.
It has always appeared to me strange that where an ordinary district vac-
cinator, a man generally of little education and small pay, has few difficulties
to contend with, officers in charge of dispensaries—Sub-Assistant Surgeons as
well as Hospital Assistants—month after month and year after year complain
of ignorance, opposition, and apathy on the part of the people, and want of
assistance by the village officers and subordinate revenue officials, and assign
these as reasons for the small amount of work done. Where difficulties do
exist, men like Sub-Assistant Surgeons and Hospital Assistants, by reason of
their higher education, ought to be much more able to explain the benefits
of vaccination to the people, and to overcome their prejudices than a com-
mon vaccinator. Yet the vaccinator operating the same number of days
in the year will do quadruple the amount of work, and in a far more satisfac-
tory manner, than the generality of these men. Where failure does appear,
the causes of it seem, to me, to be these—(a) want of energy and zeal in
the cause of vaccination: looking upon it as an extra duty and as a degra-
ding occupation; (b) want of tact and patience, two faculties very much
wanted in a vaccinator in this country, as all who know native character well
will allow—that many of them have neither of these I have had frequent
opportunities of witnessing; (c) inability to perform the operation neatly,
quickly, and without unnecessary abstraction of blood. So very indifferent
are many of them in this respect that I would not allow any of them to vac-
cinate a child of mine.
(
xv
)
In many cases the operations are not performed by the Sub-Assistant
Surgeon or Hospital Assistant himself, the duty being delegated to some
raw apprentice or peon attached to the dispensary.
35. I am of opinion that every medical pupil and student for the ap-
pointment of Sub-Assistant Surgeon should, during the period of their
attendance at the Grant Medical College, be required to attend the Byculla
Vaccine Station, once weekly, for the purpose of being instructed by Mr.
Anantá Chandrobá both in animal and human vaccination. Also that no
one should be appointed to the medical charge of a dispensary until he has
passed a satisfactory examination in the art of vaccination, or at least until
he has procured a certificate of efficiency from the Vaccination Department.
Were some such regulation enforced, we should hear less of bad vaccination at
dispensaries, and of the inability of the officers in charge to vaccinate.
36. On examining the returns made by some of these men it will be
seen how utterly impossible it is for them to keep up a supply of lymph.
Seventeen of them performed on an average less than five operations monthly,
about one primary vaccination per week ; and of the total of 105 dispensaries
the returns of 25 only exceed the weekly average of five operations per man.
37. As vaccinators are held responsible for vaccination in their respec-
tive tálukás and towns, so I think should dispensary officers be held responsi-
ble for vaccination in the towns in which dispensaries are situated. They
should have entire charge in towns in which a municipal vaccinator is not
employed.
38. The increase in the number vaccinated at dispensaries is, I think,
in a great measure due to Inspector General's Circular No. 1003 of the 21st
March 1872, directing the officers in charge to fix vaccine stations in their re-
spective towns, at places convenient for the people, and there to perform
operations personally and with regularity, instead of dragging the people up
to the dispensary, which in some cases is situated outside the town; but
where there is a municipal vaccinator that should not relieve them of the
responsibility of doing all they can to promote the spread of vaccination.
Vaccination in Goádar.
39. Vaccination has been carried on throughout the year by the apothe-
cary in charge of the Goádar Agency, in Goádar
and the neighbourhood, on the Mekrán Coast. In
a population of 6,000 souls, 326 persons were vaccinated, with percentage of
success of 82.9.
Vaccination in Bushire.
40. Lymph was furnished to Dr. Waters, the Civil Surgeon of Bushire,
and vaccination was successfully introduced and
carried on there. I am, however, unable to give
the necessary. details: no return having been received in this office.
( xvi )
Re-vaccination.
41. The returns of the past year, at first sight, show a considerable fall-
ing off in the number of persons re-vaccinated.
This, however, I do not think, indicates any
retrograde movement. It is, I think, due to greater correctness in the returns.
Former incorrectness was mentioned by Dr. Pinkerton in para. 33 of his re-
port for 1870-71, and the greater correctness of the returns of the past two
years is due to the circular issued by him, and referred to in the above para-
graph, as well as to the closer scrutiny to which the returns of the vaccinators
and dispensary officers are now subjected.
42. In some Collectorates re-vaccination appears to make good progress ;
especially so in the Ratnágirí Collectorate, where 2,695 operations were per-
formed. In the Ahmadábád and Khedá Collectorates, also, the number re-
vaccinated has been large, and the number re-vaccinated at the dispensaries
is more than double that of the preceding year.
Quality of Lymph.
43. All the Superintendents report the lymph havingbeen kept in an active
state throughout the year. As usual, in a case
here and there it failed, but principally owing to
the illness, dismissal, or death of the vaccinator, not to climatic causes. Vacci-
nators are, or should be, encouraged to report the deterioration or failure of
lymph ; and, unless when the failure is found, on investigation, to be due to
carelessness, no one should be punished for it. Generally where failure did
occur, the lymph was renewed at once, either by transmission of lymph in
hermetically sealed tubes by post, or by the vaccinator procuring it from the
neighbouring táluká. Formerly, when vaccinators were "far between," the
latter method was difficult, but always the most satisfactory. Now, however,
that each táluká has its vaccinator, no difficulty is, or need now be, expe-
rienced. As usual, large supplies have been sent to officers both in and
beyond the limits of the Presidency, but, as a rule, no replies are received
detailing the result of its use, unless when it happens to have failed and more
is wanted. This, I think, is unfortunate, because valuable information might
be accumulated regarding the best methods of transmitting lymph by post in
this country.
English Lymph.
44. Two supplies only were received during the year—one in Novem-
ber 1872 and the other in January 1873—both
from the National Vaccine Institution, London,
through the Privy Council.
The following table gives the results of the use of each supply. As will
be seen, the lymph did not prove very good—nothing like so good as the
supplies of the previous year, The probable reason for this I am unable to
( xvii )
suggest. Nothing in its general appearance indicated that it was otherwise
than good:—
Vaccine
Institution
from which
received.
National Vaccine
Institution, London.
National Vaccine
Institution, London.
Vaccine Circle
in which tested.
Central ... ...
Southern ...
Western... ...
Northern . ...
Sindh...
...
Káthiáwád ...
Rewá Kánthá ...
Total......
Central...
...
Southern ...
Western... ...
Northern ...
Sind
... ...
Káthiáwád ...
Total......
Grand Total.....
Number of
Tubes tested.
5
4
3
4
3
3
3
25
5
4
4
4
4
4
25
50
Children ope-
rated on.
7
6
2
2
4
3
3
27
10
5
5
4
2
4
30
57
Punctures or
scratches made.
28
33
12
12
32
18
18
153
41
28
27
16
16
24
152
305
Resulting Vesi-
cles.
22
...
...
2
16
...
4
44
21
1
14
4
7
10
57
101
Summary of
Remarks on
the Vesicles
by the Super-
intendents.
Good...
...
Unsuccessful .
Unsuccessful .
Unsuccessful .
Indifferent ...
Unsuccessful .
Fair
...
...
Good ...
Unsuccessful.
Very good ...
Good ...
Fair .. ...
Fair ... ...
Remarks.
Lymph
re-
ceived and
tested
in
November.
Lymph
re-
ceived and
tested
in
January.
The general results may be thus expressed : 305 punctures were made in
the arms of 57 children with lymph from 50 tubes. Of the 57 cases
operated on, 23 were absolute failures, and 34 presented 101 vesicles more or
less characteristic. Lymph propagated from this source was distributed to a
large number of vaccinators, and made use of during the year.
Animal Vaccination.
45. Animal vaccination has, during the year, been successfully practised
at Bombay, Poona and Sakkhar; at the two
former throughout the year and at Sakkhar for
a short time in cold weather.
The people of Bombay are reported to take very kindly to cow-lymph, in
a great many cases preferring it to that taken from the arm of the human
subject. Out of a total number of 14,940 primary operations performed in
Bombay, cow-lymph was used in 12,663, and of these 90.3 per cent. resulted
successfully.
3 vac
( xviii )
46. In the letter of the Inspector General, Indian Medical Department,
forwarding my report for the year 1871-72 to Government, some doubts were
thrown on the protective power of animal lymph, and Government in their
Resolution thereon, para. 14, directed me to investigate, and submit a special
report on the subject. That report has been submitted, and in it will be found
all the information regarding the protective power of animal vaccination./ as
practised in Bombay, which as yet I have been able to collect. Meagre
though that information be, it is yet entirely in favour of the protective power,
purity, and trueness of the virus in use.
47. Out of 1,637 deaths from small-pox in the city of Bombay, during
the past year, information as to the vaccination or otherwise of 679 is given
by the Registrars. Of these 31, or 4.5 per cent., are reported to have been
vaccinated, but at least two of these are doubtful cases. This cannot be said
to be a high percentage, especially when it is considered that some, at least,
had been unsuccessfully operated on, and, therefore, could not be considered
protected by vaccination.
48. Seventeen medical practitioners, resident in Bombay, were asked, in
writing, by Mr. Anantá, if they had ever seen or heard of an undoubtedly
authentic case of small-pox after vaccination with animal lymph, and none of
them could give the name of a single person. Mr. Anantá has paid great
attention to this subject, and he has not the least doubt as to the protective
power of cow-lymph.
49. Provided the origin and purity of the lymph in use is correct and
good, I myself cannot see what doubt there can be in the matter, for the
lymph styled animal and human are from the same source originally. The
lymph in use in Bombay was introduced by Dr. Blanc, and its origin and
purity are vouched for by him. I have seen the vesicles in a great many
cases, both in Bombay and Púná, and I must say they were excellent; large,
well-formed, unbilicated, and, on fair skins, of pearly appearance.
50. During the past year 241 calves were inoculated: 233 with the
animal lymph in general use, and 8 with lymph received from M. Warlomont
of Brussels. Of the former, 228 or 97.8 per cent., were successful; of the
latter, 2 or 25 per cent., succeeded. This shows that the infective power of the
lymph continues undiminished.
Inoculation of Small-pox.
51. That this very injurious practice is still carried on, is evident. Se-
veral cases were reported during the year. One
of these occurred in Kelví Máhim, Tháná Col¬
lectorate, and others in the Native States of Bhor and Dharmpur and in the
province of Káthiáwád.
Inoculation in Kelví Máhim.
52. The case at Kelví Máhim was a very melancholy one, and one which,
in my opinion, ought to be taken notice of by
Government.
( xix )
A. dispensary has lately been started at Kelví Máhim, and in December
last the Sub-Assistant Surgeon in charge, while in search of children for vac-
cination, discovered that a number of them had been inoculated. Among
these were the children of the Pátil of Kelvi Mahim. Mr. Tribhuvandás
Mohandás immediately brought the matter and the children to the notice of
the Mámlatdár. That officer, however, took no notice of it, and did not ever
report it to the Collector of the district. Immediately on its coming to my
knowledge I addressed the Collector of Tháná, and requested him to investi-
gate the case, and take what notice of the conduct of the Mámlatdár and Pátil
might seem to him fit. In reply Mr. Walker Robertson informed me that,
on representation of the Superintendent of Vaccination Western Circle, the
matter had been enquired into, and he forwarded to me a copy of his letter to
the address of the Revenue Commissioner Northern Division with the decision
of that officer thereon. In the former Mr. Robertson says—" There is little, if
any, hope that vaccination will become general, and be freely resorted to by
the public, so long as the local authorities, in the place of Government, show a
repugnance to its use, and are indifferent to its introduction, as evinced in the
case of the Mámlatdár of Máhim. Conduct such as this deserves serious
notice being taken thereof, and the undersigned can but express a hope that
the Revenue Commissioner Northern Division will reduce him a step in the
grade of Mámlatdárs. As to the Pátil he should, the undersigned considers,
be prosecuted, under Section 337 of the Indian Penal Code, for aiding and
abetting in the commission of an act likely to endanger human life and the
personal safety of others."
The Revenue Commissioner, Northern Division, replied as follows:—"I
have the honour to request that you will inform Azam Dinkar Trimbak, Mám-
latdilr of Máhim, that I am sorry to observe such ignorance in a man of his
position. The success of the prosecution of the Pátil is doubtful. Opportunity
should be taken to get rid of him, but when such example is set by the
Mámlatdár, the Pátil can hardly be expected to hold very advanced ideas
on the subject of vaccination. I have taken a note of the Mámlatdár's
conduct."
53. In the concluding paragraph of his letter to my address the Col-
lector says—" The task (the suppression of inoculation), though, is doubly so
(difficult) when it is known that those who practise inoculation, and are the
agents by which small-pox is but too often spread from place to place, cannot
be prosecuted. The matter is one that imperatively calls, I think, for interfer-
ence on the part of Government; for I cannot recognize that private individu-
als should be openly permitted by the State to disseminatè a disease which
Government is striving, at considerable expense, to stamp out or reduce as far
as practicable."
( xx
)
54. It will be seen that the Pátil in this case, as I know frequently
happens, gave active support to the inoculator, and actually had his own chil-
dren vaccinated. Also that the Mámlatdár knowingly permitted the opera-
tions to be carried on. It appears to me that this is a matter which requires
the immediate attention of Government. With a vaccinator in every táluká,
and in many tálukás a municipal vaccinator as well in addition, there can be
no objection to making the inoculation of small-pox matter a penal offence.
That it is dangerous to life there can be no doubt, and that the men who prac-
tise it are aware of this is certain. That the prohibition of it would do good
to the progress of vaccination, in some districts, is also certain; for, then, the
people would learn that Government are desirous of putting a stop to it al-
together.
Whereas at present they appear to think it is tolerated, if not
approved.
Inoculation in Dharmpur.
55. In the beginning of the year the vaccinator employed by the Rájá
of Dharmpur reported to the Superintendent of
Vaccination, Northern Circle, that inoculation was
being carried on in the State. Dr. Colá at once brought the matter to the
notice of the Darbár, through the Political Agent. In reply Mr. Shaw Stewart
wrote as follows:—"The Dharmpur Rájá has written to me to say that
he has punished two persons who practised inoculation : one of these was
caught by the vaccinator, and the other by the Foujadár. They have both been
sentenced to one month's rigorous imprisonment, and to pay a fine of Rs. 25
or, in default, to suffer three months' further imprisonment! The Rájá further
says that he has made arrangements to look after such persons in future."
The action, thus promptly and decisively taken, appears to deserve acknow-
ledgment by Government.
Inoculation in Bhor State.
56. In the case of the inoculation in Bhor State I am unable to give the
result of the action taken by the authorities. The
State lies to the south-west and west, within a few
miles, of the city and cantonment of Puna. To my knowledge inoculators
are constantly at work in it, and I have little doubt that outbreaks of small-
pox frequently originate therein.
Inoculation in Káthiáwád.
57. In Káthiáwád numerous cases of inoculation came to the notice of
Dr. Butler, but most of them were over three
years' standing. They were all on the border of
the Gáikawád's territory, and in no case could
Dr. Butler ascertain the name or residence of the inoculator. In one case the
operations were said to have been performed by a woman. In all the site of
the cicatrix was the styloid process of the radius.
( xxi )
Inoculation of other
diseases.
58. During the year one case of supposed inoculation of another disease
was reported as having occurred in the Kolábá
Zilhá. I at once asked Mr. Cody to make a full
investigation into it personally. He did so, and
arrived at the conclusion that the child did not die from vaccination. The
father made a statement to that effect before Mr. Cody and the Mámlatdár.
Small-pox.
59. Returns of deaths from small-pox for the months of January and
March only have been received in this office. I
am, therefore, unable to give statistics of the mor-
tality from this disease during the past official year, except for the city of
Bombay, the return for which was courteously furnished me by the Health
Officer of that city,
From the reports of the Superintendents, small-pox appears to have been
very general, but to have prevailed principally in the Frontier Districts, in
the Collectorates of Ahmadábád, Khedá and Khándesh ; the southern portion
of Gujaráth appears to have escaped, Dr. Wyllie, Civil Surgeon of Ahmadábád,
is of opinion that the disease was imported from Márwád. This seems to be
most likely, and is in accordance with known facts. In Khándesh, also, the
disease seems to have been imported ; in this case from the Central Provinces
where small-pox is said to have prevailed extensively.
Small-pox prevailed in other parts of the Presidency, but not in an
epidemic, severe, or fatal form. Sindh appears to have been particularly
free from its ravages.
Small-pox in Bombay.
60. During the past year 1,637 persons died in the city of Bombay from
small-pox—one of the most preventible of diseases.
That the great portion of these persons would now
have been alive, had a compulsory vaccination Act been in force, no one, I think,
will doubt. I say a great portion advisably, because it has been ascertained
that many of those who died were not permanent inhabitants of the island,
that they had only recently come to reside there, and in some cases had
arrived in the incubitive stage of the disease.
In para. 46 I have given a few particulars as to the vaccination, or other-
wise, of nearly one-half of those who died, so I need not repeat them here.
The following table shows the number of deaths from small-pox accord-
ing to the months and the districts in which they occurred, as well as the
number vaccinated in each district, during the past official year :—