NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
3
The decrease in primary operations was confined to the work of the Pro-
vincial department, while the increase in the re-vaccination cases occurred in
both the Provincial and Feudatory State Departments.
9. The number of Vaccinators was increased by 16, the increase being
confined to the Feudatory State Department.
10. With a large decrease in the number of operations and a large
increase in the number of operators there was of necessity a diminution in the
average number of persons vaccinated by each Vaccinator, and it reached the
high figure of 234.
11. The total cost of the 2 Departments was considerably larger than in
the previous year, the increased cost being due chiefly to the larger staff
employed and also to the vaccinating instruments being shown (in contin-
gencies) this year for the first time.
The average cost of each successful operation by the whole Vaccine
Department was Rs. 0-0-2½ more than in the previous year.
In calculating the cost of each successful operation by the Provincial
Department one-third of the Sanitary Commissioner's salary is included; but
if (to give a fair comparison) we exclude this, we find the cost to be by Provin-
cial Department Rs. 0-1-8 and by Feudatory State Department Rs. 0-1-7.
DISPENSARY VACCINATION.
(Provincial and Feudatory State ).
12. A comparison of the work done in the two past seasons is given
below:—
Total number of operations ... ...
Ditto
primary ... ...
Ditto
re-vaccination ...
...
Percentage of success in primary vaccination ...
Do.
re-vaccination ... ...
1884-85.
25,612
23,964
1,648
92.20
75.00
1885-86.
18,134
16,796
1,338
91.32
67.78
Difference in
1885-86.
- 7,478
- 7,168
- 310
- 0.88
- 7.22
13. The total number of operations performed by Dispensary Hospital
Assistants is 7,478 less than in the previous year, the decrease being in both
primary and re-vaccination cases and by the Hospital Assistants in charge of
both Provincial and State dispensaries.
14. As usual the ratio of success claimed by Hospital Assistants is
considerably lower than that returned by the Vaccinators.
The ratio of success in Hospital Assistants' work as found by Civil Surgeons
on inspection is in some cases higher, and others lower than that of the work
of Vaccinators.
4
PROVINCIAL VACCINE DEPARTMENT.
15. The chief facts connected with the working of this department in
the 2 past years are as below :—
Total number of operations ... ...
Ditto
primary ... ...
Ditto
re-vaccination ... ...
Ditto
vaccinators ... ...
Average number of persons vaccinated by each
vaccinator ... ... ...
Percentage of success in primary vaccination ...
Ditto
re-vaccination ...
Total cost of department ... ...
Pay of establishment ... ...
Travelling allowance ... ...
Contingencies ... ...
Cost of each successful case ... ...
1884-85.
360,448
346,753
13,695
186
1,918
96.55
71.28
Rs.
39,588
35,877
3,416
294
0
a.
9
8
14
1
1
p.
6
11
8
11
10¾
1885-86.
327,793
313,329
14,464
186
1,748
95.77
71.62
Rs.
39,686
36,110
2,972
603
0
a.
14
9
15
5
2
p.
6
7
11
0
0½
Difference
in 1885-86
- 32,655
- 33,424
+ 769
=
-170
- 0.78
+ 0.34
Rs.
+ 98
+ 233
- 443
+ 309
+ 0
a.
5
0
14
3
0
p.
0
8
9
1
1¾
16. Vaccination was not carried on in the following Raipur zamindaries
during the year under review :—Gandai, Parpori, Silheti, Lohara, Barbaspur
and Thakur Tola.
17. There has been a decrease of no less than 32,655 in the total number
and of 33,424 in that of primary operations performed during the year.
18. The decrease in primary operations took place in all the districts
except Saugor, Damoh, Narsinghpur (including that by Municipal Vaccinator)
and Nagpur, and is greatest in Raipur (10,911) Jubbulpore (5,951) Seoni
(4,992) and Mandla (3,593).
The causes assigned by Civil Surgeons for the smaller amount of work
done will be found in the precis of their reports.
In the Raipur district no vaccination was carried out in 6 of the zamin-
daries in which 3,531 operations were performed in the previous year, but after
deducting these there still remains a deficit in the work by the district and
zamindaries' staff of 7,306 operations, for which the Civil Surgeon confesses
he cannot give any satisfactory reason ; but part of it may be due to 3 of the
Vaccinators being comparatively new hands. The reason given for there not
having been any work in the 6 zamindaries is that no trained Vaccinator was
available.
That the Vaccinators had material to work upon is proved by the Civil
Surgeon having come across many children unsuccessfully vaccinated in former
5
years, on whom the operation had not been repeated up to the time of his
inspection.
The decrease in the Jubbulpore district is assigned by the Civil Surgeon
to less work having been done by the old Vaccinators and to 4 of the staff being
new, and especially to the loss by death of one of the best men.
The Civil Surgeon of Seoni attributes the decrease to the great mortality
that took place in the district, and he shows that the number of primary opera-
tions exceeded the number of infants calculated to be available.
The Civil Surgeon, Mandla, says that the decrease is " owing to the adults
" having been nearly all vaccinated and only children left ;" but as he does
not give any information as to the number of children available it is impossible
to say if this explanation is correct.
As regards the other districts in which the decrease exceeded 1,000, in
Chhindwara the decrease is accounted for partly by one Vaccinator having
done very little work and partly by the heavy mortality that occurred during
the year. The decrease in Bhandara appears due to the Vaccinators having
failed to work as they should have done. No reason is assigned by the Civil
Surgeons of Bilaspur and Sambalpur for the smaller number of operations.
19. The total number of re-vaccination operations for the Province is
769 more than it was in the previous year. The increase was greatest in
Mandla (1,772), Hoshangabad (983) and Nimar (278).
The Civil Surgeon, Mandla, says that of the 1,772 re-vaccination operations
1,717 or 96.9 per cent were successful, which makes it doubtful if the operations
were not cases of repeated vaccination or operations on adults.
The Civil Surgeon, Hoshangabad, states that the greater part of the persons
re-vaccinated were children of from 3 to 9 years of age, and that he cannot
recollect having seen a single adult who had been re-vaccinated.
If a child of three years of age had been successfully and sufficiently
vaccinated in infancy, its re-vaccination was unnecessary, and therefore objec-
tionable as tending to make vaccination unpopular : but it is a good instance of
the difficulties met with in carrying out work by a half educated class of men
like Vaccinators.
Special instructions had been given by the Civil Surgeon that re-vaccina-
tion should be promoted as far as possible, and so the Vaccinators finding they
could most easily get the small children operated on them.
In Nimar the Civil Surgeon found at the commencement of the season
that the Vaccinators were ignorant of the real meaning of the term " re-vacci-
nation" and that as a consequence the classification was not correct ; but this
was rectified, and the percentage of success (32.67) would indicate that most of
the cases were correctly returned.
There is a decrease of 1,622 in the number of re-vaccination operations in
Betul, but, as stated in last year's report, the term was in former years applied
6
to repeated operations, and the decrease is really due to classification being
properly carried out this year.
20. The total number of Vaccinators employed has remained the same :
but in the Narsinghpur and in the Seoni districts a Vaccinator was employed
specially for the Municipal towns to relieve the Hospital Assistants of the work,
while in the Raipur district the number employed in the zamindaries was two
less than in the previous year.
Grave irregularities in the way of levying fees by the Vaccinators having
been discovered at the commencement of the season in the Sambalpur district,
the Native Superintendent was suspended, and at its close a Hospital Assistant
was deputed to inspect the work : two Vaccinators were tried by the Magis-
trate and punished with rigorous imprisonment for 12 months.
21. The average number of operations performed by each Vaccinator is
170 lower than in the previous year and reaches 2,000 in only 5 districts, viz.
Chhindwara (2,376), Balaghat (2,208), Sambalpur (2,047), Wardha (2,032),
Mandla (2,007). The number is lowest in Betul (1,177), Seoni (1,369) and
Narsinghpur (1,433).
The greatest falling off in the work of each-Vaccinator as compared with
that of the previous year took place in the districts of Seoni (796), Jubbul-
pore (454), Raipur (315), Betul (291), Mandla (254), and Chhindwara (233).
22. The percentages of success are as returned by—
Vaccinators ...
Civil Surgeons ...
Native Superintendents ...
1885-86.
96
92
92
1884-85.
97
92
92
The highest percentage of success is claimed by the Vaccinators of Mandla
(99.14), and as usual those of Chanda returned the lowest (88.22). The high-
est ratio of success found by any Civil Surgeon was that in the Mandla
district (98) and the lowest that in the Damoh district (84), while Native
Superintendents place the extremes in the Wardha (99) and Jubbulpore (85)
districts.
The table at page 14 giving the results of inspection shows for each district
the percentage of success claimed by Vaccinators and that found by the Civil
Surgeon and Native Superintendent on inspection.
The ratio for the Province returned by both Civil Surgeons and Native
Superintendents is 92 per cent, which is the same as in the previous year.
The Civil Surgeon, Betul, is of opinion that unsuccessful cases were not
brought forward for his inspection, and that this accounts for the ratio of suc-
cess found by him being higher than that claimed by the Vaccinators.
The Civil Surgeon, Chanda, does not offer any explanation of his having
found the ratio of success upwards of 5 per cent higher than that claimed by
the Vaccinators.
7
The very much lower percentage of success returned by the Civil Surgeon
than that claimed by the Vaccinators of the Nimar district is due to the more
thorough and more educated inspection of the former.
23. The small difference in the pay of Establishment is due to changes
in the grades of the men employed. The amount entered under the head of
travelling allowance does not include that of the Assistant to the Civil Surgeon,
Nagpur, which was not drawn up to the close of the year.
The increase in the cost of Contingencies is due to that of instruments
being included this year, it having been met from District Funds instead of
having been adjusted as in former years by the Comptroller from Provincial
Funds. Each successful operation cost rather more than in the previous year,
the highest rate being Rs. 0-2-8 in the Seoni district, and the lowest (Rs. 0-1-0)
in that of Sambalpur.
The smaller number of operations performed accounts for the increased
average cost of each successful case in the Province, and the suspension of the
Native Superintendent accounts for the average cost being so low in the Sam-
balpur district.
FEUDATORY STATE VACCINE DEPARTMENT.
24. The work of this Department is shown below :—
Total number of operations ...
Do. primary...
Do.
re-vaccination ...
Do.
Vaccinators ...
Average number of persons vacci-
nated by each Vaccinator ...
Percentage of success in primary
vaccination
Do.
re-vaccination ...
Total cost of Department ...
Pay of Establishment ...
Travelling allowance ...
Contingencies ...
Cost of each successful case ...
1884-85.
29,744
29,738
6
22
1,352
96.81
50.00
Rs.
2,003
1,872
36
95
0
a.
0
0
0
0
1
p.
0
0
0
0
1½
1885-86.
38,545
38,446
99
38
1,014
96.78
93.93
Rs.
3,723
3,412
212
98
0
a.
1
5
8
4
1
--
ll
9
0
2
7
Difference in
1885-86.
+ 8,801
+ 8,708
+
93
+
16
- 338
- 0.03
+4393
Rs.
+ 1,720
+ 1,540
+ 176
+
3
+
0
a.
1
5
8
4
0
--
ll
9
0
2
5½
25. But the figures cannot be justly compared with those of the previous
year, for while vaccination was carried out in the Chuikhadan State in 1884-85
there was none in 1885-86, and the work effected in the Kalahandi and Patna
States is entered this year, while no returns were received last year.
8
26. The suspension of work in the Chuikhadan State was due to trained
Vaccinators not having been available, and the Civil Surgeon, Raipur, points
out (rightly I believe) that it is difficult to get trained men to serve in this
State and some of the zamindaries as they receive pay only during the work-
ing season.
27. If we exclude the work in the Chuikhadan, Kalahandi and Patna
States from the figures for the two past years, there is a decrease in the total
number of operations of 7,442.
The decrease has occurred in the work of the Vaccinators of the follow-
ing States:—
Khairagarh,
Sarangarh,
Raigarh.
Bamra.
Rehrakol.
In Sakti and Kawardha the amount of work is practically the same in the
two years, and in Sonepur there has been an increase.
The Civil Surgeon, Raipur, does not offer any explanation of the diminu-
tion in the work by the Khairagarh Vaccinators, which is only half what it was
in 1884-85.
The Civil Surgeon, Sambalpur, attributes the diminution in the number of
operations in Raigarh to the Vaccinators not having worked hard, and that in
Rehrakol to the State being thinly populated and to a dislike to vaccination
on the part of the Raja and people. In Bamra the vaccination is managed
entirely by the Raja.
28. The only State in which the average number of operations performed
by the Vaccinators was any thing like what it should be is Nandgaon : but
some of the men have of necessity a very small population to work on.
29. The percentage of success is slightly lower than it was in the previous
year.
The Civil Surgeons placed the ratio of success 3 per cent and the Native
Superintendent 10 per cent lower than that claimed by the Vaccinators.
30. Two Native Superintendents were appointed to overlook the work in
the following Feudatory States and Zamindaries :—
Khairagah.
Nandgaon.
Khuji.
Chuikhadan.
Kawardha.
Burbaspur.
Thakurtola.
Pendra.
Kenda.
Matin.
Lapha.
Chhuri.
Uprora.
Korba.
Sakti.
Raigarh.
Sarangarh.
9
These appointments will undoubtedly, if the Superintendents work properly,
do much to improve the vaccination in the States and Zamindaris : but much
still remains to be effected in the arrangements for carrying on the work.
PROVINCIAL DISPENSARY VACCINATION.
31. The following is the work done by the Hospital Assistants in the
Province during the past two years.
Total number of operations
—
Do.
Primary
—
Do.
Re-vaccination
—
Percentage of success in primary vaccination —
Do.
Re-vaccination
—
1884-85.
24,460
22,812
1,648
92.11
75.00
1885-86.
17,400
16,062
1,338
91.27
67.78
Difference in
1885-86.
-7,060
-6,750
- 310
-0.84
-7.22
32. In letter No. 3163-152 of the 18th August 1885, the Chief Com-
missioner laid down that (1) Hospital Assistants in charge of Dispensaries
might be relieved of the duty of vaccination by the Deputy Surgeon General
acting on a representation of the Dispensary Committee, but that if not so
relieved vaccination is to be regarded as part of their duty; (2) the period
during which and the area within which Hospital Assistants in charge of dis-
pensaries shall vaccinate shall be prescribed by the Dispensary Committee with
the consent of the Civil Surgeon ; (3) Dispensary Vaccination is not to be per-
formed by any officer of lower grade than a Hospital Assistant.
In accordance with these rules 15 Hospital Assistants in charge of dispen-
saries were altogether relieved of vaccination duty, or directed to vaccinate only
such children as are brought to the dispensary.
The work of 30 was confined to the towns in whieh the dispensary is
situated, and in the case of 10 the area out side the towns in which the Hospital
Assistant is to work was reduced.
These changes together with the prohibition of the performance of Vacci-
nation by compounders and others of the Hospital Establishment are sufficient
to account for the decrease in the total number of operations : 3,329 operations
having been performed in the previous year by the 15 Dispensary Medical
Officers who were this year relieved of vaccination duty.
In the districts of Damoh, Mandla, Chhindwara and Balaghat the Hospital
Assistants performed a larger number of operations than in the previous year.
The Civil Surgeon, Jubbulpore, attributes the much smaller number of
operations partly to reduction of the area in which two of the Hospital Assist-
ants worked and partly to the discussion as to whether vaccination properly
formss part of Dispensary Medical Officer's work, but the number of operations
in one of the reduced areas (Murwara) is larger than it was in the previous year,
and the Chief Commissioner's orders lay down most distinctly that vacciation.
10
shall be regarded as part of the duty of every Hospital Assistant in charge of a
Dispensary, except in cases where the Deputy Surgeon General declares' it to be
otherwise.
The very large decrease in the number of operations by the Hospital Assis-
tant in charge of the Seoni-Malwa dispensary is due to his circle having been
confined to municipal limits, whereas in former years he vaccinated in villages
as far away from his dispensary as 7 or 8 miles and included in the vaccination
circles.
The Civil Surgeon does not afford any explanation of the large falling off
in the number of operations by the Dhamtari dispensary Hospital Assistant;
but from what I saw there this year, I am quite sure that the dispensary work
suffered from the absence of the Hospital Assistant while vaccinating. I suspect
also that many of the operations in former years were performed by others
than the Hospital Assistant.
33. Jubbulpore and Chhindwara are again the only districts in which the
Hospital Assistants performed re-vaccination to any extent.
34.The percentage of success is lower than that of last year in both pri-
mary and re-vaccination operations and it is in both cases considerably lower
than that claimed by vaccinators.
35. The following table shows the work done by Hospital Assistants at
each dispensary.
District.
Saugor
...
Damoh
...
Jubbulporo
... ...
Narsingapur
...
Hoshangabad
...
Name of Dispensary.
Saugor
...
...
Sadar Bazar ... ...
Shahgarh ... ...
Deori
... ...
Khurai ... ...
Banda ... ...
Rehli ... ...
Garhakota ... ...
Police
...
...
Jail ... ...
Damoh ... ...
Pathuria ... ...
Hatta
...
...
Jabera ... ...
Jail and Police ... ...
Jubbulpore ... ...
City Branch ... ...
Thaggi ... ...
Murwara ... ...
Sehora
... ...
Bijeragogarh ... ...
Civil Station ... ...
Jail Hospital ... ...
Gadarwara
... ...
Narsinghpur ... ...
Chhindwara ... ...
Jail and Police ... ...
Hoshangabad ... ...
Kothi Bazar ... ...
Harda ... ...
Seoni ... ...
Sohagpur ... ...
Pachmarhi ... ...
Number of vac-
cinations at each
dispensary in
1885-86.
...
19
70
271
174
42
122
341
...
...
271
247
353
233
336
28
1,273
476
697
682
535
129
421
...
...
...
...
313
145
228
213
231
6
1,039
1,440
4,241
1,136
Number of vac-
cinations at each
dispensary in
1884-85.
22
218
64
253
175
150
232
350
...
10
297
231
264
70
112
280
2,013
485
559
903
572
397
362
270
301
162
481
208
537
919
337
11
1,474
974
5,571
733
2,493
11
District.
Nimar
...
Mandla
...
Betul
...
Chhindwarra
...
Seoni
...
Balaghat
...
Bhandara
...
Nagpur
...
Wardha
...
Chanda
...
Raipur
...
Bilaspur
...
Sambalpur
...
Name of Dispensary.
Khandwa ... ...
Pandhana ... ...
Civil Station ... ...
Burhanpur ... ...
Mandhatta ... ...
Asirgarh ... ...
Mandla ... ...
Ramgarh (Dindori) ...
Jail and Police ... ...
Badnur ... ...
Multai ... ...
Chhindwara ... ...
Lodhikhera
... ...
Seoni ... ...
Lakhnadown ... ...
Balaghat ... ...
Waraseoni ... ...
Behir ... ...
Bhandara ... ...
Tirora ... ...
Sakoh ... ...
Tumsur ... ...
Pauni ... ...
Itwari ... ...
Rai Bahadur ... ...
Heude ... ...
Umrer ... ...
Khapa ... ...
Mowar ... ...
Katol ... ...
Ramtek ... ...
Wardha ... ...
Hinganghat ... ...
Sindi
... ...
Arvi ... ...
Deoli ... ...
Jail and Police ... ...
Sironcha
...
...
Warora
...
...
Brahmapuri ... ...
Armori ... ...
Mul ... ...
Chanda ... ...
Jail ... ...
Allapilly ... ...
Raipur ... ...
Sadar Bazar ... ...
Arang ... ...
Drug ... ...
Dhamtari ... ...
Jail ... ...
Police ... ...
Bilaspur ... ...
Mungeli
... ...
Seorinarain ... ...
Jail and Police ... ...
Pandaria ... ...
Pendra ... ...
Sambalpur ... ...
Bargarh ... ...
Police ... ...
Jail
... ...
Number of vac-
cinations at each
dispensary in
1885-86.
...
146
20
...
86
120
122
291
...
249
166
1,618
715
...
68
191
260
6
72
169
138
110
235
...
...
...
...
301
...
...
...
108
293
149
203
76
146
99
187
328
320
199
...
48
11
...
...
173
206
607
...
...
87
328
114
...
145
170
274
132
12
46
372
413
415
2,333
68
457
724
301
975
1,192
986
844
464
Number of vac-
cination at each
dispensary in
1884-85.
135
108
... 62
49
59
136
222
10
277
165
l,384
845
616
45
141
170
99
258
426
131
103
222
... ...
453
292
292
226
148
153
274
261
212
265
59
46
17l
276
241
359
244
... 51
8
115
348
510
305 1,212
...
68
75
224
131
... 205
34
239
270
44 33
413
368
442
2,229
661
410
1,140
1,272
1,117
1,350
2,558
669
586
12
FEUDATORY STATE DISPENSARY VACCINATION.
36. The work by the Hospital Assistants in charge of these institutions
during the past 2 seasons is as follows :—
Total number of operations ...
„
„ primary ...
„
„ re-vaccination ...
Percentage of successful cases—
„
„
„
primary ...
„
„
„
re-vaccination ...
1884-85.
1,452
1,152
...
...
94.01
...
1885-86.
734
734
...
...
92.23
...
Difference in
1885-86.
-418
-418
...
...
1.78
...
37. The Hospital Assistants in charge of the Dongargarh and Raj¬
nandgaon dispensaries did not do any vaccination work in the year under
review, whereas in 1884-85 they performed 281 operations.
The Civil Surgeon does not mention if they were relieved of this duty.
There was a falling off in the work done by the Hospital Assistants in
charge of the other State dispensaries, as will be seen from the following
figures:—
District.
Raipur
...
Bilaspur
...
Sambalpur ...
Name of Dispensary.
Dongargarh ...
Raj-Nandgaon ...
Kawardha ...
Sakti ...
Sarangarh ...
Number of vaccina-
tions at each dis-
pensary in 1885-86.
...
...
375
194
569
165
Number of vaccina-
tions at each dispen-
sary in 1884-85.
71
210
39
240
281
634
237
SMALL POX.
38. The 6 districts in which the largest proportion of deaths to population
from this disease was registered between 1st April 1885 and 31st March 1886
are:—
Bhandara with 858 deaths
Nagpur
„
Wardha
„
Chanda
„
Betul
„
Mandla
„
621
232
208
92
87
= 1.25 per 1000 of population.
= 0.89
= 0.60
= 0.39
= 0.30
= 0.28
The districts of Nagpur, Chanda and Bhandara have been among the 6
with the highest small-pox death rate for the last 3 years and Wardha for the
last 2.