NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
No. 3170 OF 1880.
FROM
LIEUT.-COLONEL J. G. BELL,
Officiating Commissioner,
Hyderabad Assigned Districts,
To
THE SECRETARY FOR BERAR TO THE RESIDENT,
Hyderabad.
DATED AMRAOTI, 30th June 1880.
SIR,
I HAVE the honour to forward the Annual Vaccination Report for
1879-80, received from the General Superintendent in this office on the
11th instant.
See paras. 32 and 33.
2. The results, as given in the Report, must be deemed, on the whole,
very satisfactory. The number of operations was 69,807, against 54,199 in
the previous year, and the ratio of successful cases per mille of the popu-
lation rose from 20.8 in 1878-79 to 28.3 in the year under report. Doubt-
less the unhealthiness of the previous year had something to do with the
decrease in vaccination. For the prevalence of disease must have had a
depressing effect on both subject and operator. Vaccination must be making
some progress when we find, as shown by Dr. Little in his para. 7, that
there has been an increase of nearly 13 per cent. in the number of children
born, who have been protected by means of vaccination from the inroads of
small-pox. The reason why the ratio of success obtained in Berar in former
years has been shown to be less than in other provinces, is very clearly
shown in Dr. Little's para. 8. I think it is only fair that cases in which the
results of vaccination are really unknown should be deducted before the
percentage of success is obtained. I say really unknown because further
on, in his Report, Dr. Little shows how
much these unknown cases may affect general
averages.
3. In the Akola and the Buldana Districts, there is the greatest
increase in work done, which is attributed by Dr. Little to the ready
assistance rendered by the Deputy Commissioners of those districts, and to
the activity and zeal of the Superintendents. It must, however, be admitted
that the Deputy Commissioners' calls upon their Tahsildars must have been
zealously responded to by those officials, for it is impossible that Deputy
Commissioners can, with their other more onerous duties, take any personal
part in inducing people to get their children vaccinated. They can, and no
doubt do, make their influence felt. either for or against vaccination; but it
is, I think, to the taluk and village officials, as well as to the judicious and
conciliatory behaviour of the Native Superintendent and his vaccinators,
that, we must look for any appreciable increase in vaccination.
4. In his para. 15, Dr. Little gives the amount of inspection done by
Civil Surgeons, who are Superintendents for the head-quarter circles of
their districts. The Civil Surgeon, Akola, would seem to have done no
inspection work, while that of the Civil Surgeon, Amraoti, is merely
nominal.
B152
( 2 )
As both these officers are in administrative as well as in medical charge
of the two large jails at Akola and Amraoti, I do not see how they can be
expected to do inspection work outside their sadr towns. As Superin-
tendents of their jails their time should be fully occupied, subject, as it is
already, to encroachments made by calls upon it, to enable them to fulfil
their duties as Superintendents of Dispensaries, and I agree with
Dr. Little in thinking that it would be advisable to hand over their circles to
the Native Superintendents.
5. In his Chapter IV. Dr. Little explains (para. 25 the falling-off in
the number of vaccinations at dispensaries, a subject to which I referred in
my review of the Inspector General's Report on dispensaries.
6. In his Chapter VI. Dr. Little shows the season's work and
results according to disiricts. He is able to speak well generally of the
Superintendents as well as of the conduct of Vaccinators.
7. A suggestion is made in paras. 45 and 67 for facilitating arm-to-
arm vaccination, on which Dr. Little might be asked to report at length.
8. In his general remarks, Chapter VII., Dr. Little refers to the
passive opposition displayed by the higher classes of Hindus and Mahome-
dans, and also, I regret to see, of Government servants, who seem to show
an indisposition to have their children vaccinated. To overcome this oppo-
sition Dr. Little, in his para. 81, suggests that it should be " compulsory
on all Government servants to have their children vaccinated" and that
Deputy Commissioners should have " the power of insisting on vaccination
within their respective districts." There can be no objection to the first
proposal, if Government servants are engaged with a knowledge before-
hand that they will be required to have their children vaccinated, as a con-
dition of their remaining in the service, but to make vaccination generally
compulsory throughout the province would not, I think, be altogether desir-
able.
By patience and judgment on the part of Superintendents and Vaccina-
tors, and a certain amount of co-operation insisted upon from Tahsildars, it
is to be hoped that the operations of this Department, which undoubtedly
show well for the year under report, will yet make further strides, and
satisfy the expectations of even so zealous an officer as Dr. Little.
I have the honour to be,
Sir,
Your most obedient Servant,
J. G. BELL,
Offg. Commtesioner,
Hyderabad Assigned Districts.
TABLE OF CONTENTS.
CHAPTER I.—INTRODUCTION.
Raising and distribution of lymph. ... ... ...
Result of humanized lymph obtained from England ... ...
Introduction of animal vaccination and process of raising cow lymph described ...
Renewal of lymph in Wun District by inoculating a calf with virus of small-pox ...
Para.
1
2
3
4
CHAPTER II.—SEASON'S WORK FOR THE PROVINCE.
Statement No. I.—Season's work compared with previous year ... ...
Average number of operations performed by each Vaccinator ... ...
Number of infants successfully vaccinated compared with the estimated annual
birth-rate ... ... ... ... ... ...
Ratio of success obtained in Berar during 1878 compared with other provinces by
Sanitary Commissioner with Government of India ... ...
Percentage of successful cases in primary vaccination compared with other provinces
for four years ... ... ... ...
Details of primary vaccination performed during the year ... ... ...
Percentage of success for the province ... ... ...
Work done in each district compared with each other for two years ...
Increase in work in the Akola and Buldana Districts due to ready assistance ren-
dered by District Officers ... ... ...
Work done by Native Superintendents during the year compared ...
Inspection work done by Civil Surgeons ... ... ...
5
6
7
8
9
10
11
12
13
14
15
CHAPTER III.—STRENGTH AND PARTICULARS OF ESTABLISHMENT AND
COST OF THE DEPARTMENT.
Strength of the vaccine staff ... ... ... ...
Capability of Native Superintendents ... ... ... ...
Sanitary reports from Native Superintendents
...
...
...
Vaccinators as a body ignorant and uneducated ... ... ...
Employment of lads in the Vaccine Department who have passed the 6th Educational
Standard ... ... ... ... ...
Sickness amongst Vaccinators ... ... ... ...
Appointment, promotions, &c. ... ... ... ...
Cost of the Department. Average cost per head of each successful case ...
16
17
18
19
20
21
22
23
CHAPTER IV.—DISPENSARY VACCINATION.
Work done at dispensaries ... ... ... ...
Falling-off in the number vaccinated compared with previous year explained ...
Extraordinary success obtained under re-vaccination explained ... ...
24
25
20
CHAPTER V.—COMPARISON WITH PREVIOUS YEAR.
Comparative statement of numbers successfully vaccinated for a series of years ...
Greatest amount of work performed during the year 1877-78 since the organization
of the Vaccine Department ... ... ... ...
27
28
CHAPTER VL—SEASON'S WORK AND RESULT, ACCORDING TO DISTRICTS.
Amraoti District.
Strength of establishment, area and population ... ... ...
Number vaccinated compared with previous year ... ... ...
29
30
B152—2
ii
TABLE OF CONTENTS.
Inspection work done by Native Superintendent ... ... ...
Percentage of successful cases
... ... ... ...
Vaccinators punished for falsifying returns ... ... ...
Higher class of Hindus and the Mahomedans opposed to vaccination ...
Average cost of each successful case ... ... ...
Number of children under one year vaccinated compared with birth-rate ...
Inspection by General Superintendent ... ... ...
Conduct of Native Superintendent
...
...
...
Para.
31
32
33
34
35
36
37
38
Ellichpur District.
Strength of establishment, area and population ... ... ...
Number vaccinated—ratio of success—inspection by Native Superintendent ...
Inspection by General Superintendent ... ... ...
Natives in Government employ opposed to vaccination ... ...
Conduct of vaccination staff ... ... ... ...
Cost of each successful case ... ... ... ...
Suggestions for remuneration to lymph subjects for keeping up arm-to-arm vac-
cination ... ... ... ... ...
Commendation to Native Superintendent ... ... ...
39
40
41
42
43
44
45
46
Wun District.
Strength of establishment, area and population
...
...
...
Number vaccinated ... ... ... ...
Quality of English lymph not so good as that raised in the district ...
Replenishment of lymph from cow vaccination ... ... ...
Work of vaccination staff ... ... ... ...
Number of children under one year successfully vaccinated ... ...
Cost of each successful case ... ... ... ...
Commendation to Native Superintendent
...
...
...
47
48
49
50
51
52
53
54
Basim District.
Strength of establishment, area and population
...
...
...
Failure of first and second supplies of animal lymph ... ...
Number vaccinated ... ... ... ...
Number verified by Native Superintendent ... ... ...
Opposition to vaccination in village of Roda ... ... ...
Work of vaccination staff ... ... ... ... ...
Cost of each successful case ... ... ... ... ...
Native Superintendent recommended for pension ... ... ...
55
56
57
58
59
60
61
62
Akola District.
Strength of establishment, area and population ... ... ...
Number vaccinated ... ... ... ...
Number of villages inspected by Native Superintendent ... ...
Number of children under one year successfully vaccinated ... ...
Higher classes of natives opposed to vaccination ... ... ...
Work of vaccination staff... ... ... ...
Conduct of Native Superintendent ... ... ...
63
64
65
66
67
68
69
Buldana District.
Strength of establishment, area and population ... ... ...
Number vaccinated ... ... ... ...
Ratio of success ... ... ... ...
Work done by Native Superintendent... ... ... ...
Number of children under one year successfully vaccinated ... ...
People in most of the towns and large villages opposed to vaccination ...
Conduct of vaccination staff ... ... ... ...
Pommendation to Native Superintendent ... ... ...
70
71
72
73
74
75
76
77
TABLE OF CONTENTS.
iii
CHAPTER VII.—GENERAL REMARKS.
Supervision by General Superintendent ... ... ...
Necessity of frequent and careful inspection of vaccination work... ...
The attitude and feeling of the people as regards vaccination ... ...
During epidemics people easily submit to vaccination ... ...
Immunity from small-pox of persons successfully vaccinated ... ...
Epidemic of small-pox ... ... ... ...
Decline in the mortality in 1877-78-79, compared with 1872-73-74, due to bene-
fits derived from vaccination ... ... ... ...
Assistance rendered by District Officers ... ... ...
Commendation to Tahsildars ... ... ... ...
Commendation to Mr. Bapu Rao, Native Superintendent of Vaccination ...
Para.
78
79
80
81
82
83
84
85
86
87
( 2 )
CHAPTER II.
SEASON'S WORK FOR THE PROVINCE.
Statement No. I.—Season's work
compared with previous year.
5. Statement No. I. shows the work accomplished by the vaccine staff
during the year. The total number of persons
vaccinated was 69,807, as against 54,199 in the
previous year, and the ratio of successful cases
per 1,000 of the population 28.3, against 20.8 in 1878-79. This increase,
both in the total number vaccinated and in the ratio of success, is due par-
tially to increased activity of the vaccination staff and partly to a generally
healthy year.
Average number of operations per-
formed by each Vaccinator.
6 The average number of operations
performed by each Vaccinator was 1,396, against
985 in the previous year.
Number of infants successfully vacci-
nated compared with the estimated
annual birth-rate,
7. The number of infants successfully vaccinated was 41,659, which
gives a ratio per cent. of 47.6 to the estimated
annual birth-rate of 1879, as having been pro-
tected from small-pox, against 34.9 in 1878, a
higher percentage than that attained in other
provinces, as shown in the annual report of the Sanitary Commissioner with
Government of India for 1878.
Ratio of success obtained in Berar
during 1878 compared with other pro
vinces by Sanitary Commissioner with
Government of India.
8. The Sanitary Commissioner with the Government of India, in his
Report for 1878, remarks that the ratio of
success is not so high in Berar as in most of
the other provinces, though the percentage
reached is a very fair average.
The cause of this seems to have been due to the fact that in the other
provinces the " unknown " cases have been deducted from the total vacci-
nated before taking the percentage of success, whilst in Berar the percentage
was worked on the total number vaccinated.
Percentage of successful cases in pri-
mary vaccination compared with other
provinces for four years,
9. The following statement shows the
place Berar would have taken, compared with
the other provinces for the last four years, had
this mode of calculation been adopted:—
TABLE No. I.—Comparing percentages of successful cases in primary
vaccination
with other provinces for four years.
Names of province, &c.
Berar ... ... ...
Bengal ... ... ...
North-Western Provinces ...
Oudh
... ... ...
Punjab ... ... ...
Central Provinces ... ...
Madras Presidency ... ...
Bombay Presidency... ...
Percentage of successful cases.
1875-76.
84.5
97.20
90.24.
85.
98.43
95.01
?
?
1876-77.
88.6
?
92.03
83.38
90.96
95.20
?
?
1877-78.
89.9
99.13
93.21
85.94
98.81
94.53
82.28
94.27
1878-79.
90.5
98.52
85.56
94.67
96.03
85.83
94.86
As it does not appear to be correct to take into account unknown results
in computing the ratios of success, I have in these returns deducted all
unknown cases from the total before working the percentage.
( 4 )
Work done by Native Superintend-
ents during the year compared.
14. Table No. IV. compares the work per-
formed by Superintendents during the year : —
TABLE No. IV.—Showing verification of vaccination work by Native Superintendents of Vacci-
nation during 1879-80.
Districts.
Amraoti ...
Ellichpur ...
Wun ...
Basim ...
Akola ...
Buldana ...
Total ...
Total
number
of per-
sons vac-
cinated
by Vac-
cinators
under
Native
Super-
inten-
dents
during
the year.
11,450
8,105
9,426
7,302
15,568
13,711
65,562
Total
number
of vac-
cinated
persons
verified
by Na-
tive Su-
perin-
ten-
dents.
5,215
6,207
6,637
4,094
8,413
7,553
38,119
Percent-
age of
verified
cases by
Native
Super-
inten-
dents to
total
number
vaccina-
ted in
each dis-
trict.
45.5
76.6
70.4
56.0
54.0
55.9
58.1
Percen-
tage of
verified
persons
to total
number
vaccin-
ated in
the pro-
vince.
7.9
9.5
10.1
6.2
12.8
11.5
58.1
Number
of inha-
bited.
villages
in the
district.
1,048
468
1,096
833
985
890
5,320
Number
of villa-
ges in
which
work
was per-
formed.
748
429
905
668
781
734
4,265
Number
of villa-
ges in
which
work
was exa-
mined
by Na-
tive Su-
perin-
ten-
dents.
270
423
387
307
355
383
2,125
Number
of villa-
ges situ-
ated in
every
square
mile.
.38
.48
.28
.28
.37
.32
.33
Number
of miles
travelled
by Na-
tive Su-
perin-
ten-
dents.
1,189
1,477
1,320
1,090
1,031
1,127
...
Number
of miles
travel-
led by
Native
Super-
inten-
dents
daily
during
the
working
season.
7.8
9.8
8.7
7.2
6.8
7.4
...
From this it will be seen that the Superintendents of Akola and
Buldana verified the greatest number of cases, and those of Amraoti and
Basim the least.
The Superintendents of Ellichpur and Wun travelled the greatest num-
ber of miles and visited the greatest number of villages, whilst the Akola
Superintendent shows the lowest in this respect.
Inspection work done by Civil Sur-
geons.
15. The following table shows the inspection work done by Civil Sur-
geons, who are Superintendents for the head-
quarter circle of their respective districts, and
have one Vaccinator attached to each district.
TABLE No. V.—Showing examination of work done by Civil Surgeons in 1879-80.
Districts.
Akola ... ...
Amraoti ... ...
Ellichpur ... ...
Wun
... ...
Basim ...
Buldana ... ...
Names.
Surgeon T. Hume, M. B. ...
Mr. G.E.King ... ...
„ J. Vital ... ...
„ P. Chamarett ... ...
„ J. Duckworth ... ...
Hony. Surg. A. R. Menasse ...
Number of
villages
visited.
?
7
1
21
33
29
Total num-
ber of vac-
cinated
persons in-
spected.
?
157
74
203
273
624
Total num-
ber of per-
sons vacci-
nated dur-
ing the
year by
Vaccina-
tors under
Civil
Surgeons.
1,063
894
134
327*
1,033
794
Remarks.
* Vaccinatod
by hospital
establishment
under the
Civil Surgeon.
( 5 )
On account of their jail duties, the Civil Surgeons of Akola and Amraoti
plead inability to supervise vaccination in their respective circles. If these
duties are such as to prevent them supervising and checking the work of the
Vaccinators under them, it would be advisable to hand over their circles to
the Native Superintendents.
At Ellichpur the head-quarter circle comprises only the cantonment
and Paratwarra. Hence the Civil Surgeon is shown to have visited only
one village. The Civil Surgeon, Buldana, performed the most work, having
verified 624 cases out of a total of 794 vaccinated. The Civil Surgeon,
Basim, comes next with the low number of 273 out of 1,033 vaccinated,
though he visited 33 villages to the Civil Surgeon, Buldana's 29, and drew
more travelling allowance.
There has been a considerable falling-off in the work done by the Civil
Surgeon, Wun, for which no explanation is offered.
CHAPTER III.
STRENGTH AND PARTICULARS OF ESTABLISHMENT AND COST OF THE
DEPARTMENT.
Statement No. II. exhibits the strength and cost of the Department
during the year.
Strength of the vaccine staff.
16. The vaccine staff in 1879-80 was as
follows;—
Native Superintendents ... ... ...
Head Vaccinators ... ... ...
Vaccinators, 1st class... ... ...
Do.,
2nd class ... ... ...
Do.,
3rd class... ... ...
Apprentices ... ... ... ...
Peons ... ... ... ... ...
6
6
12
10
23
6
7
Capability of Native Superintend-
ents.
17. The Superintendents are, on the
whole, intelligent and active men, and efficient
to perform the duties assigned them.
Sanitary reports from Native Super-
intendents.
18. These officers have been employed not only in supervising vaccina-
tion, but on general sanitary duty, in accord-
ance with the views of Government. In their
weekly reports, they are required to remark on
the condition of the villages they visit, with regard to cleanliness, water-
supply, prevalence of disease, and the condition of the registration of births
and deaths. As these sanitary reports were only introduced in October
1879, they have not gone farther than my office, for as the men were new to
the work and deficient in sanitary training, the information given was not
of much value. I purpose, however, next year, forwarding these reports
after perusal to the Deputy Commissioners of Districts, so that all sanitary
defects discovered in outlying villages may be brought to their notice.
Vaccinato s as a body ignorant and
uneducated.
19. The Vaccinators are, as a body, uneducated and ignorant of the
simplest sanitary rules, and but very few of
them, if any, were fitted for promotion to the
grade of Superintendent.
Employment of lads in the Vaccine
Department who have passed the 6th
educational standard.
20. With a view of obtaining a better class of men for the department,
I have made a rule that only lads who have
passed the 6th standard are eligible for admis-
sion, so that in due time the higher appoint-
ments will be more easily and efficiently filled.
B152—4.
( 6 )
Sickness amongst Vaccinators.
21. There was a good deal of sickness amongst the Vaccinators during
the year, and two died. When a man falls sick,
there is frequently no one to take up his work,
and consequently the work must suffer.
Appointments, promotions, &c.
22. The following appointments and pro-
motions were made, and punishments inflicted
during the year:—
Appointments.
5 Apprentices.
1 3rd Class Vaccinator.
Promotions.
1 from 1st Class to Head Vaccinatorship.
3 from 2nd to 1st Class Vaccinatorship.
4 from Apprenticeship to 3rd Class Vaccinator.
Fines ..
Reductions ...
Dismissals ...
6.
3.
3.
Cost of the Department.
Average cost per head of each suc-
cessful case.
23. The cost of the Department for the year was Rs. 16,469-1-10,
against Rs. 17,253-1-11 for the previous year.
The decrease was due to vacancies occurring
during the working season and not having
been filled up, and to some vaccinators having
been employed during 1878 on cholera duty.
The average rate per head for each successful case, excluding the work
done by medical subordinates, was 4 annas 3 pies, or 1 anna 10 pies less
than last year. The explanation of the fall in the cost per case is that the
establishment did more work than in 1878-79.
CHAPTER IV.
DISPENSARY VACCINATION.
Work done at dispensaries.
24. Statement No. III. exhibits the work
performed at dispensaries.
Falling-off in the number vaccinated
compared with previous year explained.
25. The total number vaccinated was 2,373, against 3,831 in the previous
year. This falling-off may be explained by the
fact that work was also carried on in dispensary
towns by the Vaccination Department which had
not been done heretofore, and consequently there would be fewer children
for the hospital assistant to vaccinate.
Extraordinary success obtained un-
der re-vaccination explained.
26. The ratio of success attained was primary vaccination 84.5, and
re-vaccination 89.4, against 87.1 and 86.6
respectively in 1878-79. It would appear that
hospital assistants have through ignorance
included secondary vaccination under re-vaccination, which accounts for the
extraordinary success obtained under this head. Instructions have been
issued to Civil Surgeons on the subject.
CHAPTER V.
COMPARISON WITH PREVIOUS YEARS.
Comparative statement of numbers
successfully vaccinated for a series of
years.
27. Statement No. IV. is a comparative
statement showing the numbers vaccinated, and
with what success, in the Hyderabad Assigned
Districts for a series of years.