NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
[ 13 ]
In the town of Hoshiárpúr 257 persons were vaccinated,
of which 230 were successful. On my visit I examined 50
children lately vaccinated, and 56 others were vaccinated in
my presence. Naib Tahsíldár Muhammad Azím Khán took
great interest in the work, frequently accompanying the vac¬
cinators into the town, spending money on sweetmeats for the
children to be vaccinated, and doing all he could to persuade
the parents to have their children vaccinated. This is the
same man who gave Doctor Bennett good assistance in the
Núrpúr parganah last year.
GURDASPUR.—One native superintendent and five vacci¬
nators, vaccinated 4,809 persons in the Gurdáspúr parganah,
with a percentage of success of 98.91.
On 1st and 2nd January I inspected ten villages in this
district, and compared them with the village registers, which
gave 146 names as vaccinated, and 142 were examined, all of
which were successful. I found the character of the vesicles
or cicatrices good, and the number on each child, with few
exceptions, complete.
KANGRA.—One native superintendent and five vaccinators
worked in the Hamírpúr parganah nearly the whole season.
They vaccinated 8,720 persons, with a percentage of suc¬
cess of 98.93. Doctor Bennett and his staff of vaccinators
worked in the Núrpúr, Kángra and Pálampúr parganahs
during the hot months, making the total number vaccinated
in this district 13,146, and the percentage of success 95.78.
This is the only district I did not visit, as the time it
would take in reaching could not be spared. The native
superintendent who worked last year in this district was
removed, his work not having been satisfactory, and replaced
by another man who has worked very well.
GUJRANWLA.—One native superintendent and four vacci¬
nators worked in the Gujránwála and Háfizábád parganahs.
They vaccinated 16,145 persons, with a percentage of suc¬
cess of 97.79.
On 21st December I inspected the work in the town of
Gujránwála ; I found the vesicles were good, but I had to find
fault with the native superintendent for having vaccinated
several children only on one arm and in three places, whereas
the orders are that they are never to make less than six punc¬
tures.
Small-pox had broken out in the town at the time of my
visit ; I was informed that there were 50 cases and three
deaths ; there were 34 deaths from this cause during the year
1871.
The Municipal Committee were doing nothing.
The tahsíldár, Jowahir Lál, who has given excellent assist¬
ance, accompanied me in the town, and called together one or
two of the influential residents, including two members of the
Municipal Committee. I explained to them the danger they
were in of a severe epidemic if they did not exert themselves
to get the children protected; they promised to do all in their
[ 14 ]
power. The number vaccinated in this town is 590; the
percentage of success being 98.16.
SIALKOT.—One native superintendent and six vaccinators
worked in the Siálkót and Reya parganahs, and vaccinated
19,214, with a percentage of success of 99.62. I inspected
the work in this district on 28th and 29th December ; on the
first day I inspected three villages ; 86 children were entered
in the registers as vaccinated, 72 only were present, the
absent ones being satisfactorily accounted for ; of this number
70 were successful and two doubtful.
Small-pox in a village
near cantonments.
In one of these villages, only three miles from cantonments
and 1½ from the city, small-pox had broken out previous to
the arrival of the vaccinators ; four deaths took place among
unvaccinated children; 30 were vaccinated and two only
took the disease;one, the next morning after the operation ;
the two diseases running their course together unmodified.
The other child, said to have taken the disease several days
after the operation, had left the village, recovered.
In the town of Siálkót, having a population of 25,337,
there were 967 children vaccinated, with a percentage of suc¬
cess of 100. I inspected a large number of children in the
town who had been vaccinated about a month ago ; the greater
number were of the wealthier classes and khatrís.
The cicatrices were small and not so satisfactory as I
should wish to see. While examining these children a man
asked me to go and see his child, about nine years old, who
had got small-pox. I found the child covered with the eruption
of the eighth day. They had brought the child from Gujrán-
wála, where small-pox is rife; two days after leaving there, the
eruption broke out; I prescribed for it, and warned the father
not to allow the child to go out, nor others to come into
his house until the child was well. As far as I could make
out there were no other cases of small-pox at this time in the
town.
On the second day I examined 500 children from 31 vil¬
lages, and compared them with the village registers, which I
found quite correct, and the character and number of the
vesicles were extremely satisfactory.
Tahsíldárs Sanjí Mall and Jagganáth, of the Siálkót
tahsíl, and Surj Surn of the Reya tahsíl, all gave excellent
assistance. Although a large number have been vaccinated in
this district each year since 1868, the mortality from small-
pox keeps rather high; being, in 1871, 921 ; but this is much
less than it used to be before vaccination was performed on
this large scale : when in 1865, the deaths were 7,197 and
in 1867, there were 4,786 deaths ; and in 1868, 2,516 deaths
from this cause.
RAWALPINDI.—One native superintendent and four vaccin¬
ators worked in the Murree, Ráwalpindi and Attok parganahs,
in the former during the hot months, and in the two latter
during the cold season. They vaccinated 3,726. Dr. Bennett
with his staff of vaccinators visited the Gújar Khán, Kahúta and
Ráwalpindi parganahs, and vaccinated 17,964 persons; making
the total vaccinated in this district 21,690, with a percentage
of success of 97.42.
[ 15 ]
In the town of Ráwalpindi, having a population of 19,228,
424 children were successfully vaccinated by the provincial
vaccinators ; this together with the number (979) successfully
vaccinated by the municipal vaccinators, gives 1,403 successful
operations in this town.
Small-pox was epidemic in the town all through the cold
season. The number of deaths in 1871 was 114, and throughout
the district there were 1,382 deaths. For the last three years
there has been a very small mortality from small-pox in this
district, i.e., since it was visited by the provincial establish¬
ment during the cold season of 1867-68, when the mortality
fell from 1,617 during 1867, to 165 in 1868 ; and 36 during
1869.
Small-pox in a village
near the city caused
by inoculation.
On the 23rd December I inspected the work in this
district, and compared it with the registers, which I found
correct, and the quality of the work good. In one village I
visited about two miles from the city, I found on enquiry that
small-pox had broken out in October, and was prevalent in the
village at the time of vaccination (18th and 24th November).
I was informed that a Moulavi inoculator came to the village
in October, and inoculated at least one child, which was no
doubt the first cause of small-pox in this village ; 29 children
were vaccinated, three of whom took small-pox a few days
after, two slightly and one rather severely, but all recovered.
It appeared that small-pox first broke out in this village ; from
this it extended to the town of Ráwalpindi and then to
cantonments. Thus from one inoculation how many lives
were sacrificed ! From one man's act, hundreds of lives were lost,
and untold suffering the result. I am glad to say this inoculator
has been warned by the Civil Authorities.
DISPENSARY VACCINATION.
22. During the year under report the districts under the
Dispensary system of vaccination have been reduced from 22
to 18, and the number of Dispensary vaccinators from 54 to
46, two vaccinators having been withdrawn from each of the
districts of Siálkót, Gujránwála, Gurdáspúr and Ludiánah,
and incorporated in the provincial establishment. An addi¬
tional vaccinator has been sanctioned and appointed for Jhang,
which only had one vaccinator last year.
Number vaccinated by
Dispensary establish-
ment.
The total number vaccinated by this establishment is
54,596, being an increase on last year of 514 (excluding the
work of those vaccinators withdrawn since last year).
The percentage of success is 84.99 in primary vaccina¬
tion, being an improvement on 1870-71, when it was 81.03.
In revaccination it is 72.75 as compared with 75.88 for 1870-71.
The average number performed by each vaccinator is
1,213.24, being an increase of 113.24 on last year ; but this
is hardly correct, as the work performed by other operators
than dispensary vaccinators has been included ; owing to Ci-
vil Surgeons not keeping the records separately.
The cost of dispensary vaccination (not including travel-
ling allowance Civil Surgeons may have received) is Rs.4,976;
the cost of each successful case being anna one and ten pies.
[ 16 ]
GURGAON.—Vaccination is the most unsatisfactory in this
district of any in the Panjáb; only 531 persons have been
vaccinated by two men during the cold season, being less than
during 1870-71, by 837 ; the average number of operations
performed by each vaccinator being only 265.50, or about 1½
per day each. No information could be got from the Civil
Surgeon.* Either the vaccinators should be withdrawn from
this district, or more attention should be given to this in order
to put vaccination on a better footing.
ROHTAK.—There is a decrease in the number vaccinated
of 2,359 on last year's work. Dr. Cary, the Civil Surgeon,
states that no assistance is received from the Civil Authorities;
vaccination is however carried on from " arm-to-arm." The
percentage of success, 80.50, is good. Dr. Cary states that he
has no means of testing the truthfulness or otherwise of his
vaccinators' returns, except verifying a few cases now and then
in Rohtak.
HISSAR.—There is a decrease of 657 on last year, but
the average number of vaccinations, 1,224, performed by each
vaccinator, is still good. The vaccinators have worked in all
parts of the district. The Civil Surgeon, Mr. Cooper, states
that the district is pretty well protected; small-pox broke out
epidemically in May ; measures were taken to prevent its dis¬
semination ; nevertheless there were 1,545 deaths in this dis¬
trict during 1871.
" Vaccination is always carried on from arm-to-arm when
once the disease is established," and there is a considerable
improvement in the percentage of success from 55 last year
to 70.81 this year. The Medical Officer states that the vac¬
cinators' registers are signed by the lambardár of the village,
but it would be impossible to testify to the truthfulness of the
number vaccinated; he recommends the number of vacci¬
nators be increased. The Deputy Commissioner took much
interest in the work and rendered every assistance.
SIRSA.—Four vaccinators are entertained in this district ;
two at Sirsa, and two in the sub-division of Fázilká. The
work of the two at Sirsa shows an increase of 698, and the
average number vaccinated by each vaccinator is 1,417 ;
whereas the two at Fázilká, show a falling off of 768 in the
number vaccinated, the average per vaccinator being 689.
Vaccination has been performed with lymph and from arm-to-
arm, in the towns of Sirsa and Fázilká, and with crusts in the
district. The percentage of success is 84.76 in Sirsa, and
83.27 in Fázilká. The means of testing the vaccinators' re-
turns is from enquiry, and the seal of the lambardár affixed
to the registers. Five hakíms in the district are supplied
with crusts and lancets, and vaccinate in their beats. No
information is given as to the number vaccinated by the
hakíms. The Civil Authorities render assistance.
FIROZPUR.—The returns show a falling ofí of 635 in the
number vaccinated; there was also a decrease last year on the
work of the previous year. The average number of operations
performed by each vaccinator is 1,237.
* Received since the report was written on 6th June.
[ 17 ]
There is a considerable improvement in the percentage
of'success from 59.58 last year to 84.43 this year, owing to
arm-to-arm vaccination having this year only been performed;
much credit is due to Dr. Williams, who has taken consider¬
able interest in the vaccination, for discarding the use of crusts
under difficulties ; the people being generally averse to vacci¬
nation. Assistance has also been rendered this year by the
Deputy Commissioner. The vaccinators' registers are sent to
the tahsíldár, who sends them to the lambardárs to be
tested as to their correctness ; but the Civil Surgeon con¬
siders this no real check.
MONTGOMERY.—There is an increase of 83 in the number
vaccinated. The average number of persons vaccinated by
each vaccinator is 1961. The percentage of success, 88.05, can
hardly be depended on if vaccination is, as stated, carried on
by crusts. The Medical Officer, Mr. Kingsmill, believes the
returns to be pretty correct, but has no means of testing them,
though he says the Civil Authorities and Police Officers look
after the vaccinators and take great interest in the work.
MULTAN.—The returns show a decrease of 732 in the
number vaccinated, but there is an increase in the number
vaccinated in the town.
A severe epidemic of small-pox commenced in the town
of Multán during the summer months, and increased greatly
as the cold weather set in.
The native members of the Municipality did their utmost
to aid the vaccination. Dr. Rouse, the Civil Surgeon, and the
Sub-Assistant Surgeon, Juswunt Roy, attended regularly on
certain days in the town, and vaccination was performed from
" arm-to-arm" on a large scale, the native members of the
Municipality being present. Dr. Rouse begs that they and
the Sub-Assistant Surgeon may receive favourable notice
from Government; the latter having performed most of the
operations himself. I hope this will be granted, as it will en-
courage others to follow their example. There were 283
deaths from small-pox in this town. In the district vaccina¬
tion was performed from crusts and stored lymph.
There are no means of testing the returns; assistance
was given by the Civil Authorities.
MUZAFFARGARH.—There is a decrease of 17 in the number
vaccinated, and the average number vaccinated by each vac¬
cinator (541) is small. The percentage of success is 18.81.
Vaccination has been only partially performed from " arm-to-
arm." Mr. Cox, the Medical Officer, has visited places within
a radius of 14 miles from his head-quarters, and many of
the cases were vaccinated in his presence. He found the pre¬
sence of a Medical Officer had great effect with the people in
getting them to resort to vaccination, but that they appeared
to have very little faith in the vaccinators. Mr. Cox is
satisfied as to the correctness of the returns from his examin¬
ing the work of the vaccinators on two occasions.
JHANG.—There is an increase in the number vaccinated
of 155, although there is one vaccinator less than during
last season. Two extra vaccinators were temporarily enter¬
tained last year. There being only one dispensary vaccinator,
[ 18 ]
a second vaccinator has now been sanctioned. The average
number of vaccinations performed by each vaccinator is 528.
After the vaccine disease had been established, operations
were chiefly performed from arm-to-arm, and there is a
considerable improvement in the percentage of success, from
68.77 last year, to 80.19 this year.
Mr. Crossley, the Medical Officer, has the following mode
of testing the vaccinators' returns, which appears a good plan.
From the registers kept by each vaccinator, he selects every
5th name shown as successful, and examines each arm ; under
this scrutiny he found only two cases unsuccessful which
had been returned as successful, and these were satisfactorily
explained by the vaccinators and parents.
The Deputy Commissioner takes a warm interest in vac¬
cination ; and tahsíldár Thákúr Dás of Chiniót is brought
specially to notice by Mr. Crossley, who says—" Nothing could
exceed the warm interest taken by him; he went from street
to street advising parents and superintending operations;
in the district he took the vaccinators with him, and going from
village to village and helping them." I trust a letter of
acknowledgement may be given to this tahsíldár by the
Commissioner of the Division.
GUJRAT.—The work of 4 female vaccinators and 30
hakíms has been included with that of the dispensary vaccina¬
tors, which should have been given separately. Hence the
returns show a large increase in the number vaccinated. If the
total number vaccinated (7,839) be divided amongst 36 opera-
tors, the average per operator is 217.75, instead of 3,919.50, as
given in the returns. The percentage of success, 76.42, is small,
but is as good as can be expected when crust-vaccination is
performed. The Medical Officer, Doctor Quinnell, says he
tests the returns by personal enquiry on the spot, and by
reports from the Superintendent of Hakíms, zaildárs, &c.
&c. ; he and the Native Doctor perform operations in the
town of Gujrát.
The female vaccinators, selected from the more intel¬
ligent dháís, two for Gujrát and two for Jalálpúr, are, in the
opinion of Doctor Quinnell, fulfilling the object for which
they were appointed exceedingly well. " They obtain ready
admission to the purdah families where men vaccinators never
obtain access."
All the hakíms are now able to vaccinate, and their
services are being utilized as far as possible in extending
vaccine operations. A register is kept, and reports of the
number of operations performed sent in weekly. These regis¬
ters are examined by the Superintendent of Hakíms, who also
submits a report at the end of his weekly tour.
Although invaluable service may be rendered in the
cause of vaccination by hakims and female vaccinators,
if carefully looked after and properly instructed, I think
it necessary to point out the great danger of letting loose
a number of people, untaught, with useless lymph, or with
worse than useless crusts. Under these circumstances an in-
calculable amount of harm would be done ; nothing less than
the personal inspection of the children vaccinated, by the
[ 19 ]
Civil Surgeon or Sub-Assistant Surgeon, and satisfying
themselves that the vesicles are of the true Jennerian type,
and not less than four in number, should be allowed.
SHAHPUR.—There is a falling off of 2,422 in the number
vaccinated. The percentage of success is suspiciously high.
JHELAM.—There is a small increase of 46 in the number
vaccinated. The vaccinators have been working chiefly in
the Jhelam parganah during this season. Operations have
chiefly been performed from crusts ; arm-to-arm vaccination
only occasionally in Jhelam itself. The percentage of success
is 88.43. The Civil Surgeon, Doctor Gardner, says he has
no means of testing the vaccinators' returns, except by per¬
sonal inspection of the operations performed in the town of
Jhelam. No assistance is rendered by the Civil Authorities.
PIND DADAN KHAN.—Sub-division of the Jhelam district.
There is an increase of 78 in the number vaccinated. No oper¬
ations were performed in November. The percentage of suc¬
cess is 90.48.
HAZARA.—There has been a steady decline in the number
of operations in this district since 1868, when the number
vaccinated was 5,930; last year it fell to 1,679, and this year
to 1585 ; operations can be carried on in this district through-
out the year, but apparently the vaccinators do nothing most
of the hot season. Operations were performed with lymph
stored between pieces of glass, or in tubes, but whenever prac¬
ticable the arm-to-arm system was adopted. Crusts were not
used, hence there is a considerable improvement in the percent-
age of success, from 77.53 last year to 88.08 this year.
The Civil Surgeon, Doctor Johnson, says—" I can super-
vise to a limited extent vaccine operations when conducted in
the station or adjacent villages, but I have no means of prov¬
ing the accuracy of returns. " Assistance is received from the
Civil Authorities.
PESHAWAR.—There is an increase in the number vacci¬
nated of 209, but the percentage of success has fallen from
79.31 to 77.5. Vaccination has been performed with lymph
and crusts. The people are much opposed to lymph and
crusts being taken from their children. The vaccinators' re-
turns are tested by personal supervision and by reference to
Mohalladárs. The vaccinators have been chiefly working in
the town of Pesháwar and in villages within five miles of it;
assistance is given by the Civil Authorities. In the Yúzafzái
sub-division of the Pesháwar district (Mardán) there is a de-
crease of 346 in the number vaccinated. The percentage of
success is very low, 58.01, but only what must be expected
when vaccination is performed almost entirely with crusts.
Doctor Courtney, the Civil Surgeon, says—" I do not think
the vaccination in this sub-division at all satisfactory, the num¬
ber of failures is very great, and besides probably under-stated.
In those villages I visited I found all the children ( or nearly
all) whose names were set down as having been vaccinated,
hardly one had a perfect vesicle. The lymph is not in fault,
for I had no difficulty in the complete and successful vaccina¬
tion in cantonments. I believe very little good is done by
sending out the vaccinators, unless they can be under the
[ 20 ]
immediate supervision of the Civil Surgeon, and this I hope
to give them during the next season." He further says the
only means of testing the vaccinators' returns is by visiting
the villages in which they have been working. No assistance
is given by the Civil Authorities.
KOHAT.—There is an increase of 399 in the number vacci¬
nated, but the number, 544, is yet very very small. Vaccina¬
tion has apparently been neglected for some years in this
district, as the following will show :—
YEAR.
Number vaccinated ...
1867.
108
1868.
159
1869.
425
1870-71.
145
1871-72.
544
The percentage of success is 77.32. In cantonments
vaccination was performed from arm-to-arm, but in the dis¬
trict with crusts. The Civil Surgeon, Doctor Thom, says—
" It seems however that the people of this district insist upon
being only vaccinated from crusts; next year I propose to do a
little vaccination myself, in the district, and endeavour to vacci¬
nate with lymph." The returns are tested by writing to the
tahsíldár; great help was received from the Deputy Com-
missioner, Captain Plowden.
BANNU.—There is an increase of 466 in the number vac¬
cinated. The percentage of success is 72.80. Vaccination
has been chiefly carried on by crusts. The vaccinators have
been working generally throughout the district. Doctor
Farrell says he has no means whatever of testing the vaccina¬
tors' returns. " Assistance has not been found necessary."
MIANWALI.—Sub-division of Bannú district. Returns
only received for February and March, though the number
vaccinated (252) is only 8 less than last year. The percent-
age of success is 72.90.
DERAH ISMAIL KHAN.—There is a decrease of 386 in the
number vaccinated. The percentage of success is 88.75.
"When the vaccine disease is once established, operations
are continued with crusts and from arm-to-arm. The Civil
Surgeon, during his visits to district dispensaries, enquires into
the truthfulness of the vaccinators' returns. In future the
lambardár's seal will be affixed to the registers. The Civil
Authorities render every assistance.
In the Leiah Sub-division of this district there is also a
falling off of 223 in the number vaccinated. The percentage
of success is 82.71.
DERAH GHAZI KHAN.—The work of two extra vaccinators
paid from Local Funds has been included by the Civil Sur-
geon with that of the dispensary vaccinators, making an in-
crease of 2,629 on last year. The percentage of success, 90.35,
must be looked upon with suspicion, as it could only be ob-
tained by vaccination from arm-to-arm, whereas the Civil
Surgeon, Dr. Power, states that it was carried on with crusts,
stored lymph; and from arm-to-arm, to what extent with each
he does not say. He says he has no means whatever of test-