NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( 2 )
was first introduced into the Assigned Districts, and justify the expectation
that the benefits it confers will become more and more apparent to, and
appreciated by, the people.
The Resident would wish to see every officer in the Government
service exerting himself to aid the operations of the Vaccination Department
by the judicious exercise of his influence and in such other ways as may
be possible. The assistance rendered in this respect by district officers
has no doubt been very valuable, and is highly appreciated by Government.
5. The Civil Surgeons of Yeotmal and Basim have merited the
acknowledgments of the Resident by their active supervision of the vaccine
operations in the circles under their charge. On the other hand, Sir R.
Meade regrets to observe that the Civil Surgeons of Amraoti, Akola, and
Ellichpur are stated to have failed to perform this part of their duty. It is
presumed that there was some special reason for the Acting Civil Surgeon at
Akola being kept strictly to his Head-Quarters, and so prevented from
aiding in supervising the vaccine operations in his district.
The Resident is glad to hear that the District Superintendents of Vacci-
nation worked so entirely to Dr. Abbott's satisfaction. His thanks are due to
them, and also to the Tahsildars named at para. 31 who are said to have spe-
cially distinguished themselves in rendering assistance in vaccination matters.
The rewards, amounting to Rupees 185, recommended in para. 33 to
be given to certain vaccinators who did the best work, are sanctioned, and
the services of the village officials now brought to notice will be duly
acknowledged by presenting them with suitable certificates under the
signature of the Resident. In many cases, however, the names of the officials
in question have not been given, and these should now be ascertained and
reported for the Resident's information.
6. Lastly Sir R. Meade cordially acknowledges Dr. Abbott's labors
as Superintendent of the Vaccination Department. He concurs in the
opinion expressed at para. 11 of the report that the working of this Depart-
ment is the most important duty Dr. Abbott is called upon to perform, and
would exceedingly regret if other duties interfered to any serious extent
with his due supervision of vaccination operations in the Assigned Districts.
(By Order.)
HYDERABAD RESIDENCY,
The 16 th August 1876.
A. J. DUNLOP,
Offg. Second Assistant Resident,
From the Commissioner, Hyderabad Assigned Districts, to the Second Assist-
ant Resident, Hyderabad, (No. 2000-210.)—Dated Chikalda, 9th June 1876.
SIR,—I have the honor to forward the report on Vaccination for
the year 1875-76, with the following remarks.
2. The establishment consists of:—
1 Superintendent.
6 Native Superintendents.
52 Vaccinators,
Vaccination is carried out from 1st October to 31st March; while the testing of
the work done continues until May.
3. Three Civil Surgeons, viz., of Wun, Basim, and Buldana, interested
themselves a good deal in examining the work, and generally in supervising
the operations; but none of the other three Civil Surgeons, viz. of Akola,
Amraoti, and Ellichpur, have rendered any assistance. Mr. Chamarett the Civil
Surgeon of Wun, deserves special mention for his exertions during the year.
4. The following figures show the work done by the Native Superintend-
ents :—
Akola ... ... ...
Amraoti ... ... ...
Buldana ... ... ...
Ellichpur...
... ...
Wun ... ... ...
Basim ... ... ...
No. of villages
visited.
467
411
410
No. of opera-
tions verified.
7,985
6,253
5,866
All in which operations were
performed.
414
317
4,827
4,496
This is a satisfactory out-turn. The Superintendent remarks that the greater
part of the Vaccinators' work is excellent; that there are no fictitious cases, and
that results are correctly recorded.
5. I agree with the Superintendent that he cannot maintain too close a
supervision over his subordinates.
6. The results of the year are as follow :—
Years.
1875-76 ... ...
1874-75 ... ...
Total number of
cases.
48,658
42,949
Percentage of
Unsuccessful
and doubt-
ful cases.
21.4
19.8
Unknown
cases.
4.5
4.9
The slight difference in unsuccessful cases is satisfactorily explained.
( 2 )
7. The following figures show the work in each district:—
District.
Amraoti ... ... ...
Akola ... ... ...
Wun ... ... ...
Buldana ... ... ...
Basim ... ... ...
Ellichpur ... ... ...
Total ...
Number vaccinated.
1874-75.
8,471
12,455
9,302
9,048
6,999
6,666
52,941
1875-76.
14,490
13,859
9,002
8,409
7,851
6,971
60,582
The increase in Amraoti is marked, and proves the good that may be done
by a Deputy Commissioner (Captain Mackenzie) who encourages vaccination.
8. The castes of those vaccinated were :—
Christians ... ... ...
Hindus ... ... ...
Muhammadans ... ... ...
Others... ... ...
26
44,714
2,190
13,652
Muhammadans have strong prejudices against vaccination.
9. The total expenditure was Rupees 18,871, against Rupees 19,464 in the
previous year : the cost per child vaccinated fell from 7 annas 3 pies in 1874-75
to 6 annas and 2 pies in 1875-76.
10. This reduction in cost coupled with the large increase in operations
speak well for the Department, and Dr. Abbott has justly merited the thanks of
the Resident. Perhaps the most satisfactory feature of all is, that the people
are now beginning to feel and acknowledge the benefits of vaccination. Except
among Muhammadans, old perjudices against it are melting away, and much
of this is due to the exertions of the Deputy Commissioners and of the Tahsil-
dars named by Dr. Abbott. I trust the Resident may be pleased to sanction
the grant of the rewards recommended by the Superintendent amounting i n
all to Rupees 185.
I have, &c.,
(Signed) W, NEMBHARD,
Lieut.-Colonel,
Commissioner, Hyderabad Assigned
Districts.
CHAPTER I.
INTRODUCTION.
Vaccination under what rules car-
ried on.
VACCINATION in Berar, as in other parts of
India, is not compulsory. It is carried on in this
province under the rules promulgated in 1873.
Establishment.
2. The establishment consists of one Super-
intendent, the writer, who has many other duties
to perform; six native Superintendents—one for each district—and 52 Vacci-
nators.
Working season recess.
3. The vaccination season begins on the 1st
of October, and ends on the last day of March.
During the recess the Vaccinators are not employed, but are expected to im-
prove themselves at their homes, and, on their return to work, are generally
examined to see what progress they have made in the subjects studied
during the recess.
Vaccinators under Civil Surgeons.
4. The Vaccinators attached to head-quar-
ters' circles are subordinate to the Civil Surgeons
of the several districts.
Remainder of establishment under
Superintendent.
5. The remainder of the establishment works
under the orders of the writer.
Superintendents in Camp till May.
6. The Superintendents of Vaccination re-
main out till May in completing the examination
of the work done by the Vaccinators.
Promotions and degradations.
7. The following promotions and degrada-
tions took place during the year:—
PROMOTIONS.
2 Superintendents from 3rd to 2nd Grade.
1 1st Class Vaccinator to 3rd Grade Superintendent.
1 2nd Class Vaccinator to 1st Grade Vaccinator.
3 3rd Class Vaccinators to 2nd Grade Vaccinators.
REDUCTIONS.
1 3rd Class Superintendent to 1st Grade Vaccinator.
1 1st Class Vaccinator to
3rd
do.
1
Do.
2nd
do.
2 2nd
Do.
3rd
do.
Dismissals ... 6
Fined
... 14
Work examined by Civil Surgeons.
8. The Civil Surgeon of Yeotmal did excel-
lent work in the general supervision of vaccine
operations, and in the examination of work done.
( 2 )
The Civil Surgeon, Basim, also did good work in this respect, and verifi-
ed 700 operations.
Nor was the Civil Surgeon, Buldana, neglectful of this portion of his duty,
though he was for a portion of the season indisposed.
But none of the other Civil Surgeons examined any of the work done by
the head-quarter Vaccinators.
The Civil Surgeon, Akola, was on leave, and the Deputy Surgeon-General
did not allow his locum tenens to leave the station to examine the work, or to
visit outlying Dispensaries.
The Civil Surgeon, Amraoti, writes: "I was unable to go into the district
" this season owing partly to increased work, and partly to indisposition,"
and the Civil Surgeon, Ellichpur, explains that " there was no opportunity
" for him to go out until it became so excessively hot that to do so would be
" dangerous to life," but as in previous years, when the medical officer in
charge of the Troops at Ellichpur was also Civil Surgeon, the District Super-
intendent of Vaccination examined most of the work done by the head-quar-
ter Vaccinator.
Work done by District Superin-
tendents of vaccination.
9. The District Superintendents of Vacci-
nation have done remarkably well: better even
than in the previous year. They have visited
more places, and verified a greater number of operations.
The Superintendent, Akola district, visited 467 villages, and examined
7,985 children operated on.
The Superintendent of Amraoti verified 6,253 operations in 411 villages.
In the Buldana district, the Superintendent examined 5,868 cases in 410
villages.
The Ellichpur Superintendent visited all the villages in which work was
done, and examined 5,866 children operated on.
The Superintendent, Wun district, has a large district, with a sparse popu-
lation to work in : nevertheless, he examined 4,827 children in 414 villages.
The Basim Superintendent joined after nearly 3 months of the season
had passed; yet he visited 317 villages, and verified 4,496 operations.
Superintendent's inspection.
10. I myself visited some villages in all the
districts, and examined a fair share of the work
done in this, and the previous year, in the months from November to the be-
ginning of March. In my tour of inspection, I was obliged to reduce one
Superintendent; but with the work of the other Superintendents, I was well
satisfied. I believe they all work well, as indeed is shown in the last para ;
and what is of equal importance, they do not side with the Vaccinators; but
record fairly and honestly their conviction on each case seen.
Of the work of the Vaccinators examined, some, and indeed the greater
part, of it was excellent, but, as might be expected, in a large establishment
like this, all the members of it are not alike, and therefore the work of some
Vaccinators was not as good as it might have been; but, I think, it is all fairly
stated in the statements submitted with this report, There are no " paper-
cases," and the " results" are all correctly recorded.
Importance of verification of work
believed in by Superintendents.
11. Some people, I believe, think that I
spend too much of my time in the verification of
work, and lay too much stress on the importance
( 3 )
of a careful examination of the work done in every village; but I expect those
who think so may have had but little experience in the management of a
Department such as the vaccination one is, as organized in India, where vac-
cination is not compulsory, but may be accepted or not by the people just as
they choose. For my own part, I look upon the working of this Department
as one of the most responsible duties I have to perform, and so long as I am
responsible—as far as the means at.my disposal enable me to be—for protect-
ing the population against small-pox, I do not intend to lessen my endeavours
in this respect, believing, as I do, " that a complete and efficient system of
vaccination can only be attained by rigid inspection, and carefully ascertain-
ing the truth or otherwise of the recorded results."
CHAPTER II.
VACCINATIONS PERFORMED.
Commencement of season.
12. With a view to having a supply of lymph
in each district by the 1st of October, the date
on which the season commenced, operations were begun in August at Badnera
with lymph obtained from the Central Provinces, and at Akola in September
with a supply which came from Bombay.
By the end of this month—September—work had been commenced on a
small scale in each district.
In October, English lymph reached my office as follows, and was made
use of:—
11th ...
13th ...
10 tubes.
do.
On my return from six weeks' privilege leave in November, I proceeded
into camp, and on the 7th, at Balapur, had a calf vaccinated. This enabled
me to get a good many children vaccinated, and also to furnish each Superin-
tendent with a supply of good lymph, so that where the lymph was doubtful
in quality, it could be allowed to die out, and vaccination with virus of good
quality recommended.
Statement No. I., additions to.
13. Under the heading "Remarks in State-
ment No. I.," I have shown the number of cases
verified by the native Superintendents opposite to each Vaccinator's work.
Vaccination performed, as com-
pared with previous year.
14. The results of the year's work, as com-
pared with the previous one, are shown below:—
Years.
1875-76 ...
1874-75 ...
Total number of
cases.
48,658
42,949
Percentage of
Unsuccessful and
doubtful cases.
21.4
19.8
Unknown cases.
4.5
4.9
Increase of dubious cases explain-
ed.
15. The slight increase in the number of
unsuccessful and doubtful cases is attributable
to orders issued by me to Superintendents to ex-
clude from successful cases all in which the vessicle was broken before the
7th day, and others in which there was the least doubt on their mind about
( 4 )
the successfulness of them. I felt it imperative on me to issue such orders,
as now that so many people are being vaccinated in Berar, about half those
born in the year, it may be hoped, the benefit of vaccination may become ap-
parent in a diminution of the deaths from small-pox in the epidemic which, I
believe, commenced in November last, as compared with the one which com-
menced in November 1872.
Duration and deportment of epi-
demic of small-pox.
16. In my Sanitary Report I showed
that an epidemic of small-pox in Berar had a life
existence of four years' duration.
It became apparent as a new invading epidemic when the cold season
set in in November.
It passed through different phases of increase and decrease, which
were due to atmospheric causes; hot weather favoring its
advance, and dampness retarding it till it reached its height,
or maximum of intensity—in the march but one following its
invasion—19 months.
And that during its decline, which occupied 29 months, its de-
portment was also governed by climatic influences.
My statistics of two consecutive
years cannot show the effects of vac-
cination in keeping down small-pox.
17. From the foregoing it follows that
there can be no useful object gained by compar-
ing the number of vaccinations performed with
the deaths from small-pox in two consecutive years to show the effect of vac-
cination in keeping down the disease.
How the effect can be shown.
Tears,
1868 ...
1869 ...
1870 ...
1871 ...
1872 ...
1873 ...
1874 ...
1875 ...
* Number of births
registered.
35,268
33,780
52,847
59,869
57,824
61,516
78,845
80,402
18. For a useful comparison of this sort to
be made out, the parallel years of small-pox epi-
demy must be selected; but as the registration* of
vital statistics, imperfect as it even now is, is infinitely
more correct than it was some four or five years since,
I would rather refrain, for the present, from attempt-
ing to show it. The figures, to enable one to do so, are,
however, always procurable in my office; and, indeed,
for the past five years are tabulated for that purpose,
but seem unworthy of being produced here.
Number vaccinated in each dis-
trict, as compared with 1874-75.
19. The number vaccinated in each district,
as compared with the previous year, was as fol-
lows :—
District.
Amraoti
...
...
...
...
...
Akola ... ... ... ... ...
Wun ... ... ... ... ...
Buldana ... ... ... ... ...
Basim ... ... ... ... ...
Ellichpur ... ... ... ... ...
Number vaccinated.
1875-76.
14,490
13,859
9,002
8,409
7,851
6,971
1874-75.
8,471
12,455
9,302
9,048
6,999
6,666
The increase of work in the Amraoti district is most marked. It took place
during the last four months of the season. Thus, in these months, 11,990
children were vaccinated, as against 6,116 in the corresponding months of the
previous year. A great deal of this success must be attributed to the assistance
( 5 )
given to the Vaccinators by the Deputy Commissioner, Captain Mackenzie,
who, it may be remembered, took charge of the district early in December.
In the Akola district, too, the advance made is satisfactory, and in the
Basim and Ellichpur districts, it will be observed that some progress has also
been made.
While in the Wun and Buldana districts, the decrease is attributable to
sickness among the members of establishment working in these districts.
20. The castes of those vaccinated, as compared with the foregoing year,
were as follows:—
Castes.
Christians
...
...
...
...
...
...
Hindoos
...
...
...
...
...
...
Muhammadans
...
...
...
...
...
...
Other castes ...
...
...
...
...
...
Years.
1874-75 ...
1875-76 ...
1874-75 ...
1875-76...
1874-75 ...
1875-76 ...
1874-75 ...
1875-76 ...
No. Vacci-
nated.
11
26
41,013
44,714
2,177
2,190
9,740
13,652
Vaccination among Muhammadans
not making progress.
21. Vaccination among Muhammadans does
not appear to be advancing. This is much to be
lamented, as so long as any cominunity or class
of people refuse to have their children protected, they become a source of
danger to those around them.
Number of infants to older people
vaccinated.
22. The proportion of infants vaccinated dur-
ing the past three years was:—
In 1873-74 ...
„ 1874-75 ...
„ 1875-76 ...
31 per cent.
38 do.
35 do.
And, I believe, no better proof than this can be adduced of the growing popu-
larity of vaccination among the people, as I recollect well that in 1872 it
was with the greatest difficulty the mothers of young children could be in-
duced to give up their children to be vaccinated. The small falling-off in the
year under report, as compared with its predecessor, is attributable to the
great mortality which took place among children in 1875, as pointed out in
my Sanitary Report.
Statement No. II. Operations by
months.
23. In this statement is shown the work
done in each month of the year. The decrease
in the number of successful cases, as compared
with the previous year, is attributable to the causes set forth in the previous
para.—number 15.
Re-vaccination not yet commenced.
24. Re-vaccination has not yet been com-
menced in Berar, as primary vaccination fully
occupies the time of all hands.
( 6 )
CHAPTER III.
EXPENDITURE.
Comparative expenditure for two
years.
25. It is needless to enter into details of
this here, full particulars being given in the
statement.
The total expenditure and average cost per child vaccinated in the cur-
rent and previous years were ;—
In 1874-75 ... ... ...
In 1875-76 ... ... ...
Expenditure.
Rs.
19,464 ...
18,871 ...
Cost per child.
Rs.
0
0
A.
7
6
P.
3
2
and the decrease of expenditure is mainly owing to my not having an Assist-
ant for three months of the working season ; whereas I had one in the pre-
vious year, and the amount drawn for travelling allowance and contingencies
being less than in the previous year.
CHAPTER IV.
COMPARISON WITH PREVIOUS YEARS.
Comparative Statement of Depart-
ment for five years.
26. The statement shows all that is neces-
sary. The steady progress in the advance of vac-
cination is marked, as is also the reduction in the
average cost per successful case.
The number of persons vaccinated in 1870-71 was 19,638, and the average
cost per successful case was Rupees 0-9-2, as against 60,582, and Rupees 0-6-2
respectively in the year under report.
The decrease in the number of successful cases I believe to be attribut-
able to results being more carefully recorded now than they were previously.
CHAPTER V.
CONCLUSION.
Number vaccinated and deaths
from small-pox in each circle.
27. Agreeably to the instructions contained
in para. 3 of Home Secretary's letter No. 682,
dated 28th October 1875, I submit a statement
showing the number of persons successfully vaccinated, and the deaths from
small-pox in each circle for the year.
Some years hence, when registration of vital statistics will be more per-
fect, or even if it continues to be carried on as correctly as it now is, a state-
ment of this sort if carried out to show the results of a series of years, and
a contrast made between parallel years of small-pox epidemy, much light
will be thrown on the effect of vaccination in keeping down small-pox; but as
it has been before shown that registration is so much more perfect now than
it was a few years back, it is impossible to show this at present.
( 7 )
New form ordered by Government.
28. Also in accordance with the wishes of
Government, a statement is submitted showing
the number of persons vaccinated from the year 1867-68 to 1875-76.
What is to be done when people
refuse to be vaccinated, yet a diffi-
cult question.
29. It has been before remarked that Mu-
hammadans do not accept vaccination readily: the
same remark applies to some other castes of peo-
ple too, and it is difficult to know how to act in
regard to these when they listen neither to the advice of the district officials,"
nor to the persuasion of the Vaccinators. Yet it is hard on those who accept
vaccination that such a danger as unvaccinated people may prove to be
should be allowed to remain among them. Further, there is no doubt but
that those who do not hesitate openly, or for the matter of that tacitly, to
oppose us in carrying on vaccination—as now and again occurs—interfere
greatly with the progress of work, as those who are lukewarm in the cause,
or are ignorant, hold back.from having their children vaccinated when they
hear vaccination spoken against, and it is difficult to know how to act in such
cases. Were I to prosecute the people who interfere with me in the perform-
ance of my public duty, practically I would be making vaccination compul-
sory, which cannot be thought of in the Assigned Districts when it is not
compulsory in our own provinces: besides, if I did prosecute, I believe my
doing so would render the Department unpopular, and also take up much of
my time, which could be otherwise more beneficially occupied.
Happily, however, such cases as I have adverted to are of rare occur-
rence now as to what they were five years ago. Nevertheless, they should be
mentioned lest the impression should get abroad that vaccination is popular
with all classes, which really is not the case.
Popularity of vaccination.
30. However, undoubtedly, vaccination is
much more generally popular than it was; and
there are many places where vaccination would now progress whether assist-
ance was received from District Officers or not. Yet I cannot shut my eyes to
the fact that but for the exertions of District Officers, I would have been
unable to have placed vaccination on its present footing in Berar, which I
believe to be a stable one, and therefore in thanking those officers most cor-
dially for past services, I will ask for a continuance of them.
Commendation to Tahsildars.
31. The Tahsildars have all rendered assist-
ance to the Department, but of those who have
rendered most, I select one from each district for special mention, namely:—
Ardisar Dinsaji ...
Ambados Sunto ...
Wamun Rao ...
Trimbuck Row ...
Sadat Meer Khan ...
Muhammad Abd-ul Bari
Akot.
Wun.
Chandur.
Malkapur.
Pusad.
Ellichpur.
Commendation to Patails.
32. It is also due to the Patails of the vil-
lages named on a separate slip that their ser-
vices to the Vaccinators should be brought to notice, and I trust that they
may be recognized by presenting them with a card, showing for what it was
given them, or in some other such manner.