NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
[ 21 ]
ing the vaccinators' returns whether they are truthful or
not. Every assistance is rendered by the Civil Authorities.
MUNICIPAL VACCINATION.
Number of vaccinators
entertained, and num¬
ber of operations.
23. Twenty-three vaccinators have been entertained by
the undermentioned Municipalities during the present season,
being an increase of 12 vaccinators on last year. All excepting
at Dehli and Bhíwáni are entertained temporarily, some for
the whole season, others for a less period. They have per¬
formed 11,241 operations, with a percentage of success of
86.42.
The cost has been Rs. 1,186-6-0, being at the rate of 11.12
pies per successful vaccination.
LAHORE.—In October I addressed a letter to the Secretary
Municipality enquiring whether they would entertain two or
more vaccinators for their city. At their meeting on 25th
November they resolved that the funds would not permit the
expenditure proposed.
In December I wrote again, and then I received a letter
stating that the Municipality was willing to entertain three men
to the end of March. Three vaccinators were therefore sup-
plied from the provincial establishment, and paid Rs. 105.
The amount of work performed by these three men, 1619, is
very small indeed, although assisted by the local native
superintendent. The members of the Municipality gave no
assistance, taking no interest whatever in the work. In
February Dr. Bennett endeavoured to help the vaccinators,
but all to no purpose ; in the 15th para. of his report he
describes in detail the unsatisfactory state of things he found.
There is so much for congratulation that a beginning has
at last been made, and it is to be hoped next year they will
carry out the proposition of entertaining two well known
hakíms. Last year one native superintendent and four
vaccinators worked in the city for 4 months, and only
vaccinated 1314 persons, although the Superintendent, Dr.
Bennett, was in the district to look after them.
DELHI.—The Municipality continues to entertain five
vaccinators for their town, which cost Rs. 407-6. They
have only vaccinated 1,180 persons ; a sad falling off from
last year when they vaccinated 4,622 persons. The percent-
age of success is 97.22. The native members of this Munici-
pality, who showed such zeal and interest in the vaccination
last year under the influence of Major McMahon, then Deputy
Commissioner of Delhi, have this year taken no interest in
the work.
At a meeting I attended on 3rd February I complained
to them of this; their reply was that last year they put them¬
selves to a considerable amount of trouble and rendered great
assistance, for which they received no commendation. I may
here mention that the only means of persuading natives, even
of the highest position and influence, to lend a helping
hand, is by the promise of a letter of praise and commendation.
Two of the members then came with me into the
town, where I hoped through their assistance to vaccinate a
[ 22 ]
number of children of the better classes, but entirely failed,
all imaginable reasons being given but the right one. I
inspected several children who had been vaccinated seven
days ago, and I found the quality of the work good.
The two members then proposed that if I would attend the
general meeting on the 5th, they would make arrangements
for vaccination in the town afterwards. This I did, but being a
wet morning, the native members considered it would be use-
less to attempt vaccination. I went alone into the poorest
parts of the town, where a few children were vaccinated.
AMRITSAR.—This Municipality entertained four vaccina-
tors for five months, the cost being Rs. 200. They have
performed 2,519 operations in the town, with a percentage
of success of 96.31. As in Lahore, the native members
evidently considered that, having voted a sum of money, they
had done everything that could be expected of them.
On 16th December I visited this town with the municipal
vaccinators, who took me from street to street ; after wander¬
ing some distance they succeeded in showing me a few
children. The work was of good quality, but they were doing
very little, only amongst the Cashmíris and poorest classes.
The number of operations could just as easily have been
performed by one man as by four. I wrote and informed
the Deputy Commissioner of the result of my visit; on 23rd
December the Commissioner, Major Davies, wrote to the
Deputy Commissioner, requesting that the vaccination be
carried out on the plan of division of the city into circles, and
asking for a return showing the result in each circle at the
end of the season, and stating that he had impressed on each
member in charge of a circle the necessity of using his
influence to secure the success of this important work.
Apparently all the notice that is taken of this is a reply
forwarded by the Deputy Commissioner from the Civil Surgeon,
Dr. Taylor, who says—" To ensure success of the vaccine
operations, European supervision is necessary, and I suggest
that Dr. Bennett or Dr. Newton be requested to bestow a
little of their time and attention on the city of Amritsar,
which, as the largest and most densely populated town of the
Panjáb, is surely the first place for the operation of measures
protective against disease." It is curious that Dr. Taylor,
being the resident Medical Officer, did not consider it part of
his duties to supervise and help on this important work, which
would, no doubt, have been attended with good results.
The table of operations, classified according to circles, called
for by the Commissioner, shows 2,530, and 11 children
respectively in three circles, as having been performed under
the superintendence of three native members. Ten other
circles have not a single operation performed under the aus¬
pices of a member. I am indebted to the Commissioner,
Major General Taylor, for the correspondence on this subject,
who predicts that in time the native members will be induced
to put aside their prejudices.
Bad as the state of vaccination is in Amritsar, there is
this cause for congratulation, that a beginning has been made;
[ 23 ]
I believe on no previous occasion have so many been vacci¬
nated during one season.
RAWALPINDI.—Small-pox being epidemic in this town early
in the cold season, the Municipality entertained two vaccina¬
tors on Rs. 7 a month each from 11th December. These
men vaccinated 1,189 persons, with a percentage of success of
86.79, the cost being Rs. 53.
Up to the end of November, two of the provincial vacci¬
nators worked in this town.
On the 25th December, I inspected the work of the
municipal vaccinators, who took me from street to street and
door to door amongst the poorest and most wretched of the
inhabitants, and with difficulty showed me about a score of
children they had managed to vaccinate since their entertain¬
ment ; they were entirely alone, without any assistance or su¬
pervision. They were vaccinating with crusts, the result
being about 75 per cent. unsuccessful, and even those that were
successful were inefficiently protected, having only one or two
vesicles. The vaccinators stated that they were instructed to
vaccinate in two or three places only, and that if one vesicle
rose, that was all-sufficient; this is contrary to all authorities
on vaccination, and to statistics, which show the mortality from
post-vaccinal small-pox to be in inverse ratio to the number
of vesicles or scars produced by vaccination.
I wrote and informed the Deputy Commissioner, Major
Urmston, of this unsatisfactory state I found vaccination in,
who brought the matter before a full meeting of the Munici¬
pality, and explained to them the great importance of the
measure, and the native members promised to give the under-
taking their warmest support.
The very great improvement reported by Doctor Bennett
on his inspection in March is very satisfactory.
The Bhíwáni Municipality has continued to entertain one
vaccinator at a cost of Rs. 120 for this sub-division of
the Hissár district. He has vaccinated 826 persons, with a
percentage of success of 59.45. This small rate of success is
probably correct, and the result of using crusts.
KEHROR.—The Municipality entertained two vaccinators
at a cost of Rs. 121 for this sub-division of the Multán
district, an extra vaccinator having been entertained this year
on account of the prevalence of small-pox. These men vacci-
nated 1,758 persons, with a percentage of success of 94.28.
JHANH.—The Municipality entertained six vaccinators for
three months at a cost of Rs. 180. These men vaccinated
2,150 persons, with a percentage of success of 78.75. They
were employed throughout the district.
LOCAL FUNDS.
24. Seven vaccinators have been employed and paid
from Local Funds Rs. 219-2-0; one at Shujáhábád, two
at Derah Ghází Khán, and four female vaccinators at Gujrát.
[ 24 ]
The operations performed by these vaccinators (excepting at
Shujáhábád) have been included in the Dispensary returns.
Thirty-one hakíms were employed in vaccination in the
Jhelam district, and vaccinated 1,366 persons with a percent-
age of success of 83.41. The Superintendent of Hakims
reports that a great part of the cold season was taken up in
teaching them, and that they have improved very much since
the arrival of the pamphlet on vaccination, and that he hopes
next season will show considerable progress both in number
and quality. They receive no extra allowance for this
duty.
NATIVE STATES.
25. BHAWALPUR.—This State continues to employ four
vaccinators, one in each of the four sub-divisions. The cost
has been Rs. 480. They have vaccinated 9,811 persons,
being an increase of 6,823 as compared with last year. The
percentage of success, 68.13, is a considerable falling off from
last year, when it was 82.38.
In this State 19 hakíms have been employed in vacci-
nation, and performed 7,010 operations, being an increase of
4,042 operations. The percentage of success is only 31.61,
as compared with 66.71 last year.
Thus it appears that the increase in numbers vaccinated
has been obtained at a sacrifice of quality.
MANDI.—One vaccinator has been entertained at a cost of
Rs. 110, who vaccinated 211 children only, with a per-
centage of success of 62.95.
CHAMBA.—In this State two vaccinators were entertained
in November ; they have only vaccinated 107 persons, with
the small percentage of success of 488.19.
Rs. 192 were sanctioned for the year, but only Rs. 36
expended. The Sub-Assistant Surgeon states that the people
were opposed to vaccination on account of extreme cold, and
therefore the work was stopped. Colonel Reid, the late
Superintendent, informed me that he hoped to increase the
staff of vaccinators as required, and to put a stop to inoculation,
which was extensively performed in this State. I trust next
year will show a considerable improvement.
Mortality from small-
pox in the Panjáb.
26.—SMALL-POX.—During the year 1871, the mortality
from small-pox has been about one thousand less than
during the previous year ; but it is still higher than it was
during 1867 and 1868. But it should be taken into considera-
tion that the registration of deaths is, year by year, improving:
it being most probable that all the deaths were not registered
in former years.
Of the total deaths from this disease (25,611) in the
Panjáb, no less than 21,215 occurred in rural circles, and only
4,396 in all the towns having a population of 5000 and
upwards.
[ 25 ]
The following shows the number of deaths during each
month of the year 1871, taken from the published returns of
the Sanitary Commissioner :—
January.
2,138
February.
2,551
March.
3,395
April.
4,284
May.
4,734
June.
3,382
July.
1,574
August.
693
September.
403
October.
321
November.
616
December.
1,520
Total.
25,611
The districts of Sháhpúr and Jhelam have had the highest
mortality, viz., 3,614 and 3,187 respectively ; it was also very
high again in the Gujrát district, viz., 1,963. These districts
have not been visited by Provincial Establishment.
The Ludiánah district, which had the highest mortality
of all in the Panjáb during 1870, has, during the year 1871,
the smallest number, 27, with the exception of Simla, which has
none. I think it is only fair to attribute this small mortality in a
great measure to the effect of the operations performed in this
district during the latter part of 1870 and beginning of 1871.
Of course it must also be accounted for by the large number
who were protected by the disease itself.
Kángra still has a small number, 75, though higher than
in the previous year. Hoshiárpúr has only 92 deaths, Fírozpúr
only 91 deaths. Derah Ghází Khán has a higher mortality
than it has had since 1866, though yet not high, viz., 130.
Proposal for checking
the spread of small-
pox, submitted for
opinion of Commis-
sioners.
27. In my last year's report I proposed a measure for
checking the spread of small-pox, viz., to report the first case
that occurred in a village or town, the house to be put in
quarantine, and the unprotected vaccinated. His Honor the
Lieutenant Governor admitted the desirability of some such
measure, but would call for the opinion of Commissioners of
Divisions as to the practicability of enforcing quarantine
measures, which he considered, unless rigidly enforced, useless.
The result of this enquiry was, that house quarantine
would be impossible, and village quarantine very unpopular.
As I feel that I have been to a certain extent misunder-
stood, I fear owing to my not having sufficiently explained my
meaning, I think it desirable to state briefly, though more
clearly, my proposal, which there could be no difficulty in
carrying out, no agency being required.
At present small-pox commonly goes on from week to
week, or even longer, in villages, without the Civil Authorities
having any knowledge of it, until the number of deaths
becomes great, or extends over a sufficiently large area, to cause
it to be reported. Several instances might be given, but those
mentioned in the present report as occurring in villages close
to Ráwalpindi, Siálkót and Ambálah, will suffice. The con-
tagion of small-pox does not extend beyond many feet of the
affected person ; and if persons suffering from the disease are
not allowed to leave the house, nor others to enter except
those attending on the sick one, and the clothes and house
[ 26 ]
disinfected, the spread of the disease would generally be
prevented.
If a general order were issued to all lambardárs or heads
of villages, explaining the nature of the disease and holding
them responsible that the affected person is not allowed to
leave his house, and to warn the people in the village against
going into the infected house, together with instructions for
disinfecting the clothes &c., they would practically be carried
out.
28. INOCULATION.—Believing that small-pox inoculation
was much more extensively practised in the Panjáb than was
generally known, I thought it would be useful if an enquiry
were made throughout the Panjáb. I wrote to the Inspector
General of Police, Colonel Hutchinson, who kindly instituted
enquiries through District Superintendents.
The following
is the purport of their replies, supplemented by previous
knowledge: —
It appears that in the Dehli, Hissár and Ambálah
Divisions (Commissionerships) inoculation has never been in
much vogue, with the exception of Simla and part of
Ambálah, where it has ceased for some years to be practised.
In the Multán, Siálkót, and Gujránwála districts, it formerly
prevailed, but has now given place to vaccination.
It is partially practised in the northern portions of the
Gurdáspúr and Muzaffargarh districts, and in Jhang it is
practised to a small extent, but is gradually dying out. It is
extensively practised throughout the districts of Kángra,
Gujrát, Jhelam, Sháhpúr (especially in the Salt Range, where
in three months 540 people were inoculated), Hazárá, Hoshiár-
púr (especiallythe U'nah sub-division, performed by Brahmans),
in the Attok sub-division of the Ráwalpindí district, and
seldom in the other parts of the district, where it is not popu-
lar; vaccination having now gained a good footing and sup-
planted it. In Pesháwar, where Dr. Bellew states that it is
practised every spring (February and March), mostly by the
Mián fraternity, more especially of Káka Khel.
"The
Miáns, numbering about 100, are distributed over the whole
valley, of whom about half practise inoculation." It is also
practised in the Deraját Division and in Kohát.
The above will be useful in noting the gradual disappear-
ance of this objectionable practice, and the substitution of
vaccination.
29. INOCULATION OF HEIFERS.—The attempt to inoculate
heifers at the Hissár cattle farm has again failed : the medical
officer having tried on several occasions. The Superintendent
General of Vaccination, Bombay, kindly sent me six tubes of
animal vaccine; and on a second occasion ten ivory points
charged with animal lymph. With part of this I operated on
a calf myself, but unsuccessfully, and the remainder I sent to
Mr. Cooper at Hissár; but unfortunately he was unsuccessful 1
with this also.
30. VACCINE LYMPH.—Towards the latter part of Septem
ber, the supply of English vaccine having arrived, I gave sor
[ 27 ]
to the native superintendents who were working near Simla,
to commence vaccination with; the vesicles produced from this
were very small and inactive, but after one or two transmis-
sions they very much improved, and, being perfect in character,
the disease was propagated solely from these, and the old dis-
carded ; it having been the custom each year to renew the
lymph under the idea that it might deteriorate.
The following supplies of vaccine lymph were distributed
to Civil Surgeons and Regimental Medical Officers:—173
capillary tubes, 93 vaccine crusts, 29 ivory points, and 26
glasses charged with vaccine lymph.
31. The Conduct of the Establishment has on the whole
been very good; nearly all have shown zeal in their work, and
no serious fault has occurred. Native Superintendents Attar
Mull, and Nának Chand, the former in the Siálkót, the latter
in the Gujránwála district, deserve special praise for the very
large number of operations they have performed in those dis-
tricts.
List of those brought to
favorable notice.
32. Before concluding this report, I have the honor to
request the favor of His Honor the Lieutenant Governor
granting letters of commendation to the following native
gentlemen :—
The Rána of Erkí (Bhagul); Extra Assistant Commis-
sioner Gopal Sahai; Sub-Assistant Surgeon Juswunt Roy,
Multán ; and the Municipal Committee of Multán; and com-
mendatory parwánahs from the Commissioners of their Divi
sions to the following native officials:—
Tahsíldár Ujágur Mull of Jagádhri.
"
"
"
"
"
"
"
Nund Lall of Naráingarh.
Rádha Kishen of Ludiánah.
Jawahir Lall of Gujránwála.
Jugga Nath
Sanji Mall
Suj Surn
of Siálkót.
Thákar Dás of Jhang, and Náib-Tahsíldár
Muhammad Azim Khan of Hoshiárpúr.
Vaccination returns ap-
pended.
33. The numerical returns are appended.
No. I. Showing particulars of vaccination performed by
the Provincial Establishment.
No. II. Showing the numbers and result of vaccination
during each month of the year.
No. III. Showing the total expenditure on account of
vaccination.
No. IV. A comparative statement for the last five years.
No. V. Showing particulars of vaccination performed
by dispensary vaccinators.
No. VI. Showing particulars of vaccination performed
by municipal and other vaccinators.
No. VII. Showing the total of all vaccine operations
in the Panjáb, and No.
[ 28 ]
VIII. Showing the number of deaths from small-pox in
each town and rural circle in the Panjáb during 1871.
I have the honor to be,
Sir,
Your most Obedient Servant,
ISAAC NEWTON, SURGEON,
Offg. Supdt. Genl. of Vaccination, Panjáb.
[ 29 ]
FROM
JOHN BENNETT, ESQUIRE, M. D.
OFFG. SUPERINTENDENT VACCINATION,
PANJAB,
To
ISAAC NEWTON, ESQUIRE,
OFFG. SUPERINTENDENT GENERAL OF VACCINATION,
PANJAB.
SIR,
I have the honor to submit the Annual Report of Vaccination
for the year 1871-72.
Establishment.
2. The establishment during the working season consisted of the
following:—
6 Native Superintendents.
24 Vaccinators.
2 Chaprassies.
Commencement of hot
season's work in Kan.
gra district.
3. In the tahsíl of Núrpúr, where the establishment had been
at work at the end of the last vaccinating season, I stopped operations
on the 1st April, on account of the heat, and proceeded towards Kángra
where the temperature was still sufficiently cool for carrying on suc-
cessful vaccination. In this tahsíl, and especially in the town of Kángra,
great opposition was at first met with ; the people were so averse
to vaccination, that for several days hardly anything could be done.
The tahsíldár, coming to my assistance, convened a meeting of the
Municipal Committee, Mohalladárs &c, and succeeded so far in removing
their prejudices, that several influential men promised to have
their children vaccinated. A second attempt to vaccinate in the town was
made, and this time with better success; over 200 children having been
brought forward to be operated on; after this success in the town, favour-
able results were obtained in the villages, and the work went on satis-
factorily till the 13th April; when, the heat becoming too great, the vac-
cinators were obliged to move on to higher altitudes. Reports about this
time having been received from Harípúr (a small town twelve miles
from Kángra) that small-pox was prevalent there, I visited the place
and found that the disease had arisen from operations performed by a
resident inoculator. In this town alone as many as 71 recently inoculated
cases were brought for inspection. The cases were all of a mild type,
and although the disease was at its 10th or 12th day, the general
variolous eruption was for the most part very indistinct; and the
febrile symptoms that usually occur to a marked extent at this stage
of the disease were of such a trifling nature as to cause little incon-
venience or uneasiness. The local inflammation around the seat of
inoculation was also slight in character, and it was evident that the
virus used had lost much of its strength from the length of time it
had been kept. The inoculator, who was present and showed the
cases to me, informed me that it was the custom to perform the
operations from old crusts kept for three or four years, and that it
was considered dangerous to inoculate with fresh virus. I took the
opportunity of explaining to him the superior advantages of vac-
cination, and he promised to discontinue the practice of inoculation
for the future.
The local native superintendent of this district had been at
work in the Kángra tahsíl during the winter months; but being
lazy and deficient in intelligence, as well as having a prejudiced class