NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
3
The total operations of the year 1889-90 was 396,584, or 27,710 less than
the previous year, excluding, as before stated, the number of operations per-
formed in the Patna State in 1888-89.
The percentage of successful primary operations was 96.26, or 0.30 greater
when compared with 1888-89; and that of successful re-vaccinations 28.00,
against 78.21 in the previous year.
Operations by Khalsa Vaccinators.
7. The total number of vaccine operations performed by khalsa vaccinators
in 1889-90 was less by 26,644 than in 1888-89, and the decrease in primary
operations was very marked—it was 43,114.
There was, however, a large increase in re-vaccinations, which amounted to
16,470.
Of the successful primary operations there was a diminution in the whole
Province of 39,691 in comparison with 1888-89.
Of successful re-vaccinations, the figures of the past year show an increase
of 14,009 over those of 1888-89.
8. The percentage of success in primary and re-vaccinations in the last three
years is shown in the following figures :—
Primary ...
Re-vaccinations ...
1887-88.
95.94
73.71
1888-89.
95.90
79.17
1889-90.
96.44
81.78
It is necessary to explain that these figures represent the estimate of their
success by the vaccinators themselves. Native Superintendents calculate, as
the result of their examination of a part only of the work of each vaccinator,
that the percentage of success is more nearly correct at an average of 90.43 per
cent for the Province.
Civil Surgeons again, on a more critical examination of the results, but on
a much smaller number of cases, give 87.38 as the more accurate figure of
success for primary vaccinations in the whole Province.
The gradually increasing efficiency of re-vaccination is attributable to the
greater attention paid to the work by Civil Surgeons.
But there is evidence that the opportunity afforded for re-vaccination, as
suggested in Secretariat letter No. 3455-169 of the 5th June 1889, to the
address of the Inspector-General of Education, has not been taken advantage
of to the full extent in some districts.
9. The average number of operations performed by each vaccinator of the
Khalsa establishment was 1,719. It was 1,835 in the previous year. The average
varied from 1,197 in the Betul District to 2,878 in the Chhindwara District,
and between the individual work of vaccinators in various districts there is a
still greater difference.
There are several factors which influence these averages, such as the physical
difficulties of the country to be traversed and the comparative opposition to
vaccination by the population.
It is admitted too that the occasional misconduct of one or more vaccinators
will seriously affect the average working of the whole staff.
Several Civil Surgeons allude to the low birth-rate of 1889-90 and to the
heavy mortality of children under one year as causes of the diminished work of
the past season.
4
In this connection it is desirable to show how far the birth and mortuary
statistics of the Province support this view of Medical Officers, and to this end
a table has been drawn up showing the total births in the seasons 1888-89 and
1889-90, the number of deaths of infants under one year, the number of
children available for vaccination, and the number of successful operations
reported to have been performed on children under one year of age.
TABLE II.
District.
Saugor ...
Damoh ...
Jubbulpore ...
Narsinghpur ...
Hoshangabad ...
Nimar ...
Mandla ...
Betul ...
Chhindwara
Seoni ...
Balaghat ...
Bhandara ...
Nagpur ...
Wardha ...
Chanda ...
Raipur ...
Bilaspur ...
Sambalpur ...
Total
Number of births in 1888-89.
22,770
12,831
26,698
15,344
21,345
10,225
12,902
13,382
13,932
14,773
14,517
31,169
30,118
15,899
21,021
45,364
28,810
15,023
366,118
Number of births in 1889-90.
20,234
10,861
24,233
13,174
18,975
9,844
11,060
11,249
11,921
13,081
14,064
28,870
27,779
14,215
21,726
44,613
23,398
14,082
333,379
Deaths
among children
under one year in 1889-90
from all causes.
7,106
3,728
8,065
4,267
6,150
3,350
3,162
3,344
3,471
3,446
3,496
7,659
8,576
4,346
6,566
11,397
5,614
3,476
97,219
Number of children avail-
able under one year for
vaccine operations.
13,128
7,133
16,168
8,907
12,825
6,494
7,898
7,905
8,450
9,635
10,568
21,211
19,203
9,869
15,160
33,216
17,784
10,606
236,160
Number of successfully vac-
cinated children under one
year by vaccinators in
1889-90.
11,081
6,205
15,481
10,804
10,021
8,314
3,118
8,569
8,618
7,497
9,556
13,785
11,830
6,713
11,147
20,511
9,685
4,024
176,959
10. These figures show that in 4 districts only have all the children avail-
able for vaccination been protected. All the individuals born in the periods
of comparisons may have been unfitted for operation by tender age, but
there will have remained from each previous year a like number of unprotected
infants, and the figures showing the total available for vaccination may be con-
sidered as fairly correct.
This table shows that in the matter of the protection of infants available
for vaccination Raipur, Bilaspur, Bhandara, Nagpur, Sambalpur, Mandla and
Chanda were very deficient and in the order given. From some districts, reports
of the insufficiency of the vaccination staff have been received, and there is
evidence that this is the case, and the necessity will not be overlooked.
11. Of the 18 districts of these Provinces, 14 show a decrease in the
number of primary vaccinations and 4 an increase.
The increase at Damoh, Balaghat and Bhandara is very slight, but at
Raipur it is more than 2,000.
The decrease in the primary operations at Sambalpur is very great,
and amounted to 11,688; but, on the other hand, there was an increase of
13,896 in re-vaccinations, so that the total operations of this district including
both primary and re-vaccinations is 2,208 more than the previous year.
8
TABLE III.
Provincial ... ...
Feudatory States ... ...
Total ...
1887-88.
Pay of Estab-
lishment.
Rs.
38,510
3,030
41,540
a.
9
0
9
p.
4
0
4
Travelling
allowance.
Rs.
3,478
214
3,692
a.
7
4
11
p.
6
0
6
Contin-
gencies.
Rs.
794
70
865
a.
6
11
1
p.
3
3
6
Total.
Rs.
42,783
3,314
46,098
a.
7
15
6
p.
1
3
4
1888-89.
Pay of Estab-
lishment.
Rs.
41,028
*3,724
44,753
a.
5
13
2
p.
5
3
8
Travelling
allowance.
Rs.
3,642
*113
3,756
a.
1
2
0
p.
0
0
0
Contin-
gencies.
Rs.
786
*22
809
a.
13
13
11
p.
5
7
0
Total.
Rs.
45,458
*3,860
49,318
a.
0
12
13
p.
10
10
8
1889-90.
Pay of Estab-
lishment.
Rs.
41,202
3,024
44,227
a.
15
8
7
p.
8
2
10
Travelling
allowance
Rs.
4,689
a.
7
p.
5
...
4,689 7 5
Contin-
gencies.
Rs.
650
185
835
a.
5
2
8
p.
3
9
0
Total.
Rs
46,542
3,209
49,752
a.
12
10
7
p.
4
11
3
1887-88.
Average
cost of
each suc-
cessful
case.
Rs.
0
0
0
a.
2
1
1
p.
0
0½
10½
1888-89.
Average
cost of
each suc-
cessful
case.
Rs.
0
0
0
a.
2
1
1
p.
0½
1
11
1889-90.
Average
cost of
each suc-
cessful
case.
Rs.
0
0
0
a.
2
1
2
p.
3½
1½
1½
* Including Patna State (Rs. 1,005-2-0).
9
The Provincial. Establishment alone cost Rs. 46,542 as compared with
Rs. 45,458 for 1888-89.
The increase of Rs. 1,084 in the past season is due almost entirely to the
travelling allowance of medical officers on inspection duty. There was a small
increase in establishment of Rs. 174 on account of the promotion of vaccina-
tors, and there was a saving in contingencies of Rs. 136 compared with 1888-89.
The average cost of each successful vaccination was Re. 0-2-3½. It was
Re. 0-2-0½ in 1888-89.
26. In the Feudatory States the Vaccine Establishment cost Rs. 3,209
compared with Rs. 2,855 in the previous year The average cost of each
successful vaccination was nearly equal.
The returns of the Patna State could not be included in these calculations
as they were not received in time.
STATEMENT III.
27. There were 14, 692 vaccinations at the Dispensaries in the Province
during the past season. But these results are less by 100 than those of the
previous season.
Civil Hospital Assistants in charge of Sadar and Branch Dispensaries have,
in many cases been relieved of the duty of vaccination, and the grounds for
this appear inadequate. The subject will have attention during the year, and
also the necessity for the extension of Act XIII of 1880 to certain towns.
The vaccine operations performed by each Civil Hospital Assistant are
shown in the following table, and the work is certainly less than may reasonably
be expected.:—
TABLE IV.
District.
Saugor
...
Damoh
...
Jubbulpore
...
Hoshangabad
...
Name of Dispensary.
Deori ... ...
Rehli
...
...
Garhakota
...
...
Khurai
...
...
Damoh ... ...
Hatta
...
Pathuria
...
...
Jabera
...
...
Jail and Police ...
Murwara
...
...
Sehora ... ...
Bijeragogarh ... ...
Central Jail ... ...
Victoria Hospital ...
Civil Station ... ...
Hoshangabad ... ...
Harda ... ...
Seoni ... ...
Sohagpur ... ...
Pachmarhi ... ...
Number of
vaccinations at
each dispensary
in 1888-89.
115
149
300
203
102
322
235
166
227
153
249
253
226
309
...
409
157
278
221
68
767
1,052
1,190
1,133
Number of
vaccinations at
each dispensary
in 1889-90.
174 132
249
136
54
276
196
137
90
172
196
228
175
340
54
557
403
232
151
96
691
753
1,165
l,439
10
District.
Nimar
...
Mandla
...
Betul
...
Chhindwara
...
Seoni
...
...
Balaghat
...
Bhandara
...
Wardha ...
Chanda
...
Raipur
...
Bilaspur
...
Sambalpur
...
Name of Dispensary.
Pandhana ... ...
Asirgarh ... ...
Mandhatta
...
...
Civil Station ... ...
Mandla Main
...
...
Dindori ... ...
Police and Jail
...
...
Badnur Main ... ...
Multai
...
...
Chhindwara ... ...
Lodhikhera ... ...
Lukhnadon
...
...
Balaghat Main ... ...
Waraseoni ... ...
Katangi
...
...
Behir ... ...
Tirora ... ...
Sakoli ... ...
Pauni ... ...
Tumsar
...
...
Wardha Main ... ...
Binganghat ... ...
Arvi
...
...
Deoli
...
...
Sindhi ... ...
Jail and Police ... ...
Armori
...
...
Mul ... ...
Brahmapuri ... ...
Sironcha
...
...
Jail Hospital ... ...
Allapilli
...
...
Drug
...
...
Dhamtari ... ...
Arang
...
...
Paragaon or Bindranawagarh ...
Khuji ... ...
Nandgaon
...
...
Khairagarh ... ...
Bilaspur
...
...
Mungeli ... ...
Seorinarain ... ...
Sakti ... ...
Kawardha ... ...
Pendra
...
...
Pandaria
...
...
Sambalpur Main ... ...
Bargarh
...
...
Jail
...
...
Padampur ... ...
Sarangarh ... ...
Raigarh
...
...
Sonpur
...
...
Number of
vaccinations of
each dispensary
in 1888-89.
141
90
50
10
196
87
16
134
148
2,041
422
92
306
271
188
34
296
316
229
338.
129
153
127
44
72
6
266
203
135 93
121
...
337
264
106
5
41
...
...
6l
108
135
140
209
151
244
614
442
176
30
207
353
277
291
299
282
2,463
92
799
1,174
531
818
754
1,048
2,099
Number of
vaccinations of
each dispensary
in 1889-90.
121
73
51
8
106
101
38
81
151
2,170
294
83
259
433
227
76
412
144
237
307
73
158
121
109
144
7
277
114
101
56
147
38
125
358
322
8
175
49
37
38
183
163
176 135
214
225
454
527 79
123
211
329
7
253
245
232
2,473
83
995
1,100
612
733
1,074
1,134
1,710
11
28. Statement IV shows the progress of vaccination in these Provinces
since 1867. On the whole, it has been steady, but the past year of excessive
sickness in all districts not only prevented vaccinators from keeping up their
supply of lymph and maintaining the normal number of operations from April
to October, but it necessitated the employment of vaccinators in the hot season
in medical relief.
29. The vaccination staff itself shared in the sickness of the general
population, and the District Reports show that this was a cause of decline in
the work done, and this was specially so in some districts.
30. The inspection of the work of vaccination by Native Superintendents
was, on the whole, satisfactory, and Civil Surgeons have done excellent work in
this department of their duties.
31. The following notes are gathered from the Reports of Civil Surgeons :—
Saugor.—In this district vaccination was initiated at the end of October
from lymph which had been stored in tubes in the months of July and August.
In the town of Saugor it was begun in September, so that operations may be
said to have been almost continuous in this district.
Bovine and human lymph from various sources were used, but that which
proved the most active was the English animal lymph and that obtained by
cultivation in buftalo calves.
The lymph from cow calves was not found to be so active and reliable as
that from buffalo calves.
The total number of vaccine operations done was 18,549, of which 691 were
done by Civil Hospital Assistants.
32. Damoh.—There was no change in the strength of the vaccine Estab-
lishment of this district, a Native Superintendent and 6 vaccinators being
found sufficient: the Civil Hospital Assistants attending to the area with a five
miles radius around their Dispensaries. The establishment is well spoken of both
by the Civil Surgeon and Deputy Commissioner.
Three buffalo calves were vaccinated, two without any result, and the
third yielded only modified vesicles from which no lymph could be taken.
The total of primary operations was 9,034, and 731 more were done by Civil
Hospital Assistants The Civil Surgeon himself visited 624 villages and saw
a total of 4,842 children, and found that the percentage of successful cases
was 96.4.
The general attitude of the people towards vaccination is one of indifference
and opposition among the wealthier classes yielded to judicious persuasion.
In no instance did the Civil Surgeon hear of a death from small-pox among
the vaccinated.
33. Jubbulpore.—Here arm to arm vaccination was kept up throughout
the year, but a fresh and large supply of lymph was obtained from a buffalo calf,
which proved sufficient to start the work of the whole of the circles in the
district.
12
15,481 primary vaccinations were performed on children of less than one
year, and in addition 571 operations were done by Civil Hospital Assistants.
The establishment is not well spoken of as a whole. Three vaccinators
were dismissed for indifferent or bad work and one absconded. One of the first
named was a first class vaccinator. The conduct of the first three of these
suggests a want of care in the selection of men and oversight of their work.
The vaccine establishment of this district is supervised by an Assistant
Surgeon, who is reported to have visited 536 of the villages in the district and to
have seen 6,719 vaccinated children.
34. Narshinghpur.—Dr.
Cullon states that calf lymph collected at the
Head-quarters station supplied the whole district with perfectly fresh lymph
to begin with, and that operations commenced on the 15th October.
There were fewer operations performed in this district than in the year
previous. This is explained by the fact that in the previous year the vacci-
nators worked under great pressure, and the Civil Surgeon had to check them
for needless secondary vaccination.
Dr. Cullen very aptly remarks that the vaccinators may have all the assist-
ance which can be given by district authorities in the collection of children for
vaccination, but the success of their work will largely depend on the after visi-
to see results and to catch those who were absent at the time of their first visit.
The vaccination staff is well spoken of, especially the Native Superin-
tendent, who is reported to have visited 620 of the 981 villages.
35. Hoshangabad.—Operations were initiated by vaccinating a buffalo
calf with human lymph and a second with lymph taken from the first, so that
animal lymph was entirely used to begin with, and arm to arm vaccination kept
up subsequently.
The vaccination staff is reported on favourably and the co-operation of Civil
Hospital Assistants is also praised,except in the case of Harda where the Civil
Hospital Assistant is stated to have too much to do.
The number of operations performed in this district is slightly greater than
that of last year; and the percentage of successful primary vaccinations is
reported to have been 93.
36. Nimar.—There was a decrease of 1,461 primary vaccinations and an
increase of 226 scondary operations. The decrease is said to be due to the dimi-
nution of the number of available children. This deduction is made from the
statistics of births and deaths in the district. The Civil Surgeon visited 259
villages and saw 4,281 of the children who had been vaccinated, and he did not
find a single instance of falsification of the records. He was able to fix 86.1 as
the percentage of successful primary vaccination against 96.0 recorded by
vaccinators, the difference being accounted for by the natural inclication on the
part of the staff to make the best return of their work, in classing as successful
cases those in which the Civil Surgeon. thought "doubtful" a more strictly
correct record.
37. Mandla.— The physical difficulties to be overcome in reaching the very
scattered and sparse population of some parts of this district are specially dwelt
13
upon by the Civil Surgeon, and he suggests that more aid must be given.
English and Bombay lymph was used successfully to begin with. There was
no attempt made to cultivate animal lymph in this district. The Civil Surgeon
was prevented from doing much inspection in the district owing to urgent work
which confined him, but he visited 20 villages and saw 463 children.
This is one of the districts which did not suffer greatly from small-pox, but
yet it is found that 61 deaths from the disease occurred in infants under one
year.
38. Betul.— Various samples of lymph were tested by the Civil Surgeon,
and all proved inert except the English tube lymph. The total number of
operations was 9,807, including 232 done by Civil Hospital Assistants, and the
percentage of successful primary vaccinations 96.2.
The Civil Surgeon saw more than one-third of the children vaccinated, and
reports well of the conduct and work of the vaccinators. The district is reported
to have lost 212 persons by small-pox, and 76 of these were under one year of
age.
39. Chhindwara.—In this district the English animal lymph proved the
most active, and with it operations were commenced.
Two buffalo calves were vaccinated with human lymph, but unsuccessfully.
There was a considerable decrease of operations as compared with the
previous year. This was accounted for by the illness of one vaccinator and the
relative and absolute increase of the mortality of last year and the few births.
The number of re-vaccinations in the district was very large, and the average of
success of both primary and secondary vaccinations fairly good.
40. Seoni.—Lymph from many sources was tried, and here as in other
districts English lymph was found to be the best. Two buffalo calves were
successfully vaccinated with human lymph, and an additional supply obtained.
There was a decrease of operations in this district also, owing to the sickness of
vaccinators and the failure of another in his work.
There were 13,349 operations, of which the Native Superintendent reported
97.6 as successful. But there were only 41 re-vaccinations.
The Civil Surgeon visited 633 villages and inspected 4,620 cases, but he
was only able to allow 72.6 as the percentage of successful operations.
This district had 490 deaths from small-pox, and of these I find 205 as
having occurred in infants.
41. Balaghat.—Unlike other districts, lymph obtained from the North-
Western Provinces alone proved successful, and children vaccinated with it
furnished lymph for the vaccination of a buffalo calf. With the animal lymph
so obtained the whole district was supplied, and all subsequent operations were
performed from arm to arm.
The order to school masters to have the children of their schools present at
the visit of the vaccinators, was of much benefit in bringing to light numerous
cases of children who had escaped vaccination.
There were 13,562 vaccinations in the district or 700 more than in the last
year, and the percentage of success was 97.
14
The Civil Surgeon saw several cases of small-pox, but all were in persons
unprotected by vaccination. Seven of these were children between 6 and 7, of
the Marwari caste.
The Civil Surgeon reports favourably of the staff, and notes that he did not
find a single attempt to falsify the records.
42. Bhandara.—Vaccination
was continuous in this district throughout
the year, and considering the amount of sickness and the employment of the
vaccinators on Cholera duty, it is most creditable that the continuous supply of
lymph was maintained. By this means the work of the various circles could
begin early and the most precious time of the year occupied.
During the rains the Civil Surgeon vaccinated two calves and with the
best results. But English animal lymph was supplied, and some from Bombay
and the North-Western Provinces, the first named proving by far the most
active.
The Native Superintendent inspected more than half the children vaccinated,
and the Civil Surgeon estimates that the success of primary vaccination
was 89.6.
There were 21,677 operations in the district, of which 13,785 were done on
infants.
The vaccination staff appeared to have done excellent work in their own
department, and to have also given great aid to the sick poor in a very
unhealthy year.
The Civil Surgeon met with cases of small-pox among vaccinated children,
but failed to find, after diligent enquiry, that a single fatal case had occurred.
The fatal cases reported were all found to have been returned as unpro-
tected. The Mortuary Returns show that 313 deaths of infants occurred in this
district from small-pox.
43. Nagpur.—The report from this district is less satisfactory, both in
regard to the work done and the character of the vaccinators.
With regard to the work done a comparison may be made with the
adjoining district of Bhandara. In each district the population is about the
same per square mile, and the physical conditions which render it difficult or
easy to reach the villages are similar in both. Nagpur, with 14 vaccinators and
one apprentice, recorded only 18,592 successful primary vaccinations ; whereas
Bhandara, with 11 vaccinators and one apprentice, registered 21,213 successful
primary vaccinations.
There is seen to have been considerable delay in commencing operations in
the city and district.
No attempt was made to cultivate animal lymph.
No vaccine operations were done by Civil Hospital Assistants in the
district. The deaths from small-pox numbered 1,569, and of these 721 among
infants. I agree with the Deputy Commissioner that a radical change in the
establishment is desirable, and it will be carried out.
44. Wardha.—But for the general employment of vaccinators on cholera
duty in August, continuous vaccination in this district would have been main-
tained. In August no work was done, but in September operations were renewed
with lymph obtained from Bhandara, and by the arm to arm cultivation of this the