NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
7
PROVINCIAL DISPENSARY VACCINATION.
24. The work of the 2 past years is given below :—
Total number of operations ...
Do.
primary ...
Do.
re-vaccination ...
Percentage of success in primary vaccination ...
Do.
re-vaccination ...
1885-86.
17,400
16,062
1,338
91.27
67.78
1886-87.
17,044
15,475
1,569
92.05
68.32
Difference in
1886-87.
—356
—587
+ 231
+ 0.78
+ 0.54
25. In accordance with the rules laid down in Chief Commissioner's letter
No. 3163-152 of 18th August 1885, 2 Hospital Assistants were relieved in
1886-87 of the work of vaccination and the area in which three others worked
was reduced: these changes account for a large part or all of the decrease in the
work of the Hospital Assistants at Murwara, Hoshangabad, Dindori, Budnur
and Khapa.
In Damoh the difference is attributed to the children of more than one
year having been available and operated on in 1885-86, and in Chhindwara the
decrease is due chiefly to the illness of the Medical Officer of the Lodhi-
khera dispensary.
No explanation is afforded of the smaller amount of work by Hospital
Assistants in the Chanda and Bilaspur districts.
The Civil Surgeon, Mandla, thinks that the Hospital Assistant of the Dis-
pensary has not time to do the work properly.
The Hospital Assistants in the Jubbulpore and Chhindwara districts did
by far the greater part of the re-vaccine operations, but the number of such
operations increased in the Hoshangabad and Balaghat districts.
26. The ratio of success for Hospital Assistants is almost the same as in
1885-86.
27. The following table shows the work done by Hospital Assistants in
charge of Dispensaries :—
District.
Saugor
...
Name of Dispensary.
Saugor ... ...
Sadr Bazar ... ...
Shahgarh ... ...
Deori ... ...
Khurai
...
...
Banda ... ...
Rehli
...
...
Garakhota ... ...
Number of vac-
cinations at each
dispensary in
1885-86.
...
19
70
271
174
42
122
341
1,039
Number of vac-
cinations at each
dispensary in
1886-87.
14
...
60
231
208
52
167
355
1,087
8
District.
Damoh.
...
Jubbulpore
...
Hoshangabad...
Nimar
...
Mandla
...
Betul
...
Chhindwara
...
Seoni
...
Balaghat ...
Bhandara
...
Nagpur ...
Wardha
...
Chanda
...
Name of Dispensary.
Damoh
...
...
Pathuria
...
...
Hatta ......
Jabera
...
...
Jail and Police ... ...
Jubbulpore
...
...
City Branch
...
...
Thaggi ... ...
Murwara
...
...
Sehora
...
...
Bijeragogarh ... ...
Civil Station ... ...
Jail Hospital ... ...
Hoshangabad ... ...
Kothi Bazar
...
...
Harda
...
...
Seoni
...
...
Sohagpur...
...
Pachmarhi
...
...
Pandhana ... ...
Civil Station ... ...
Mandhatta ... ...
Asirgarh
...
...
Mandla ... ...
Ramgarh (Dindori)
...
...
Jail and Police ... ...
Badnur ... ...
Multai ... ...
Chhindwara ... ...
Lodhikhera ... ...
Seoni ... ...
Lakhnadown ... ...
Balaghat ... ...
Waraseoni ... ...
Behir ... ...
Katanghi ... ...
Bhandara
...
...
Tirora ... ...
Sakoli ... ...
Tumsur ... ...
Pauni ... ...
Khappa ... ...
Wardha ... ...
Hinganghat ... ...
Sindhi
...
...
Arvi
...
...
Deoli ... ...
Jail and Police ... ...
Sironcha
...
...
Warora ... ...
Brahmapuri
...
...
Armori
...
...
Mul ... ...
Chanda
...
...
Jail
...
...
Allapilly ... ...
Number of vac-
cinations at each
dispensary in
1885-86.
271
247
353
233
336
28
1,273
476
697
682
535
129
421
313
145
228
213
231
6
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
1,440
4,241
1,136
372
413
415
2,333
68
457
724
975
1,192
Number of vac-
cinations at each
dispensary in
1886-87.
113
236
305
145
327
15
1,634
620
343
568
732
186
436
...
514
270
289
283
23
139
16
56
119
97
138
3
79
82
1,787
377
116
74
215
275
117
201
59
247
142
261
282
...
122
298
143
212
140
14
94
159
246
216
221
67
...
22
1,126
4,534
1,379
330
238
161
2,164
190
808
991
929
1,025
9
District.
Raipur
...
Bilaspur
...
Sambalpur
...
Name of Dispensary.
Arang ...
Drug ...
Dhamtari ...
Bilaspur ... ...
Mungeli
...
...
Seormarain
...
...
Pandaria ... ...
Pendra ... ...
Sambalpur ... ...
Bargarh ... ...
Police
...
...
Jail
...
...
Number of vac-
cinations at each
dispensary in
1885-86.
173
206
607
87
328
114
145
170
274
132
12
46
986
844
464
Number of vac-
cinations at each
dispensary in
1886-87.
92
320
493
51
199
137
221
162
338
69
...
...
905
770
407
FEUDATORY STATE DISPENSARY VACCINATION.
28. The following table gives the work by the Hospital Assistants in
charge of these institutions during the past 2 seasons :—
Total number of operations ... ...
Ditto
primary
...
...
Ditto
re-vaccination
... ...
Percentage of successful cases of—
primary vaccination ... ...
Ditto
re-vaccination ... ...
1885-86.
734
734
...
92.23
......
1886-87.
613
613
...
93.47
......
Difference in
1886-87.
—121
—121
...
+ 1.24
......
29. Vaccine operations were carried out at one more State dispensary
(Raigarh) than in 1885-86; and if we deduct the number performed by the
Hospital Assistant in charge of this dispensary there is a deficit of 323 in the
number of this year's operations. A marked decrease took place in the work of
the Hospital Assistants of the Kawardha and Sarangarh dispensaries. The
reports of the Civil Surgeons do not give any explanation of this decrease.
The work that was formerly done by the Hospital Assistants in charge of
the Dongargarh and Rajnandgaon dispensaries has for the past 2 seasons been
made over to the Circle Vaccinators.
SMALL-POX.
30. The Provincial ratio of deaths from this cause in 1886-87 was 0.34
per 1,000 of the population, and the 6 districts with the highest rate are—
Bhandara with 1,343 deaths = 1.96 per 1,000 of the population.
Chanda
„ 275 „
051
„
Saugor
„
264 „
0.47
„
Sambalpur „ 128 „
0.34
„
Damoh
,„
94 „
0.30
„
Balaghat „
97 „
028
„
11
32. The inspection of the work in the districts of Nagpur and Jubbul-
pore was as in 1885-86 carried out by the Assistant to the Civil Surgeon and
by an Assistant Surgeon respectively,
33. The Civil Surgeons of Hoshangabad and Sambalpur spent considerably
less than a month on tour. Heavy surgical work at the dispensary and cases of
sickness among the European residents being the cause in the case of the Civil
Surgeon, Hoshangabad, and bad health, the presence of cholera and cases of
sickness at Head-quarters in that of Dr. Poynder. These 2 Civil Surgeons had
also Medical charge of the Wings of the Native Infantry Regiment at their
respective stations. The amount of work seen daily by the Civil Surgeon,
Sambalpur, while on tour is very small.
Dr. Willmott. Civil Surgeon of Bhandara, the smallness of whose inspec-
tion work was noticed in last year's report, has in this year's District report ex-
plained that he was unable to start on his tour till the beginning of February
and that shortly after he had started he had to return to and remain at Head-
quarters on account of work in connection with the jail. As the report last
year was not written by Dr. Willmott he could not explain the circumstances.
34. The Native Superintendent of Bilaspur was, owing to illness, a very
short time on tour and the Native Superintendent of Betul was also too short a
time on inspection duty. The inspection work of the Native Superintendent
Bilaspur, was not satisfactory. The Native Superintendent for Feudatory States
in Bilaspur and Sambalpur is said to have done his work honestly and well in.
the former district, but to have shown a want of method in his work in the
latter.
35. I inspected the vaccination work in the districts of Nagpur, Wardha,
Chanda, Bhandara and Balaghat in the course of my tour.
36. The lymph supply failed as it does every non-working season in
some districts: the English lymph proved good with some exceptions. Dr. Cullen
renewed his supply from animal lymph which he had procured in London. The
attention of Civil Surgeons has, in acoordance with the orders of the Govern-
ment of India, been called to the subject of improving and renewing their sup-
ply by passing the lymph through the calf.
I found in the course of my inspections, as I have on previous occasions, that
Vaccinators are not sufficiently careful in selecting and using only lymph that
is quite free of all admixture of blood, pus, &c., that is taken on the proper day
and that has not become inert or worse from long keeping.
The use of points for the storage of lymph was stopped to a considerable
extent last season, and will, I hope, be altogether suspended. The percentage of
success in the Nimar district that resulted this year from the use of lymph
raised directly from animal lymph is not higher than the ratio of former years,
which speaks well for the quality of the supply usually employed.
37. The total and the successful primary operations are both more nume-
rous than in 1885-86, but not as many as in 1884-85.
13
42. No falsification of the returns was found at the Civil Surgeons' or my
inspection ; but the Civil Surgeon's report shows that in the Raipur district there
was still the same carelessness on the part of Vaccinators in filling in the results,
as found by myself in 1886, so that it is doubtful if their results can be accepted
as trustworthy.
In the other districts the worst that was found was that cases considered
doubtful and in a few cases unsuccessful by the Civil Surgeon had been entered
as successful by Vaccinators; this I also found in my inspection, and it will
always be so.
43. The proportion of the persons vaccinated seen both by Civil Surgeons
and by Native Superintendents was larger than in 1885-86.
The question of the standard of work for Native Superintendents is now
under the consideration of the Chief Commissioner.
44. I saw but a comparatively small amount of the current year's work in
the Nagpur district, as I inspected it early in the season, but I am convinced
from what I saw that the Vaccination establishment has greater difficulties to
contend with in this than in other districts in the way of opposition from the
Malguzars and people.
In the Wardha district there is also opposition, but not so general nor so
strong as in Nagpur. The work seen by me was generally good.
In the Chanda district, though in one or two circles the work was good, it
was on the whole decidedly indifferent and in one circle very bad. It was the
first year that the Native Superintendent had worked in the district, and as the
Civil Surgeon was ill all the first part of the working season and had to go on
sick leave on 8th February, no Civil Surgeon's inspection work was done till after
that date and then by a Medical Officer new to the district
The work in the
Bhandara district was generally good, but in two circles vaccination had evi-
dently been neglected in former years and badly done this season, the result
being many cases of small pox in several of the villages which I inspected. In
Balaghat there does not appear to be any opposition and the work is with few
exceptions good.
45. The work of the Hospital Assistants showed me that some of them
require more careful teaching
DISTRICT VACCINATION.
46. The following is a precis of the reports submitted by Civil Surgeons :—
Saugor.—The supply of lymph was kept up throughout the year. Vacci-
nation failed in the rains, but it was recommenced on their close by lymph
which had been stored in tubes. The English lymph proved successful in half
the cases. The number of operations was 888 more than in 1885-86, and the
increase would have been larger but for the sickness of one of the Vaccinators.
The percentage of success claimed by the Vaccinators was 95.05 and that
found by the Civil Surgeon was 95.51.
In the City and Cantonment 5 per cent of the population were vaccinated.
14
DISPENSARY VACCINATION.
There was an increase of 48 in the total number of operations by Hospital
Assistants, 5 having done more and 3 less work than in the preceding season.
The Hospital Assistants in charge of the Main and Sadr Bazaar dispensaries
did no vaccination, the work being made over to the Vaccinator.
The percentage of success of the Hospital Assistants' work as seen by the
Civil Surgeon is 95.72 or slightly higher than that of the Vaccinators.
The Civil Surgeon was 40 days on tour, saw the work of 351 villages and
4,074 cases of vaccination.
The Native Superintendent inspected the work in 742 villages and saw
10,145 vaccination cases ; he is well reported of.
The Police returned the number of deaths from small-pox as 264, An
out-break of disease was if not due at least prolonged by neglect of duty on the
part of the Vaccinator in whose circle it occurred.
Damoh.— The supply of lymph was kept up in the head-quarter town and
neighbouring villages throughout the non-working season : the English lymph
proved unsuccessful. There was a very small falling off (99) in the total number
of operations, due entirely to the illness of two Vaccinators in whose cases alone
is there a decrease.
The percentage of success as returned by the Vaccinators is slightly higher
than it was last year. The Civil Surgeon spent 40 days in camp, inspected the
work in all the circles, saw upwards of 4,000 children and found the ratio of
success very slightly higher than he did in 1885-86. No falsification of the
returns was detected.
In only very few instances are unsuccessful cases
returned as successful, but occasionally cases considered doubtful by the Civil
Surgeon are entered by the vaccinators as successful.
The Native Superintendent was in camp 137 days and saw nearly 8,000
cases of vaccination : he is reported as showing more energy than he did last
year. The attitude of the. people generally remains unchanged, being one of
indifference, but the higher and wealthier still offer passive opposition.
DISPENSARY VACCINATION.
The number of operations performed by the Hospital Assistants is 314 less
than it was in 1885-86, the decrease is chiefly at Damoh and Jabera, and is due
the Civil Surgeon reports, not to neglect on the part of the medical subor-
dinates there, but to there having been a large number of unprotected children
of from 2 to 3 years of age vaccinated at Damoh in 1885-86, and to the unpro-
tected infants of two years having been operated on at Jabera in the previous
season.
The Civil Surgeon thinks the Hospital Assistant at Hatta might have
done more work in the villages. The dispensary vaccination work at Damoh is
confined to the town.
15
SMALL-POX.
There were 102 deaths from this cause against 86 in 1885-86. The Civil Sur-
geon says that there is no doubt many children escaped vaccination in 1885-86,
as there were a large number of marriages, and the children were moving
about with their parents; further there are many small villages in the hilly jungly
parts of the district which are visited by the Vaccinators only once in 2 years.
The Civil Surgeon considers that an additional Vaccinator is required in
order to thoroughly carry out vaccination all over the district.
Jubbulpore.—The supply of lymph was kept up during the non-working
season. The number of operations was 5,606 more than it was in 1885-86.
The percentage of success as returned by the Vaccinators is 94.75, by the
Assistant to the Civil Surgeon as 90.5, and by the Native Superintendent as 88.
In a few cases doubtful vaccinations were recorded as successful and un-
successful as unknown, but falsification of returns was not detected.
There were 1,414 more cases of re-vaccination than there were in 1885-86,
with a success of 79 per cent which is very near the figure of success attained
in the jail, where the operations are performed under the Civil Surgeon's per-
sonal supervision. The Assistant Surgeon who did the inspection work was on
tour 58 days (including time spent in sanitary inspection) visited 460 villages.
and inspected upwards of 5,000 cases of vaccination.
He examined the work in all the circles, and found it well done. The
Native Superintendent spent 163 days on tour; visited 1,034 villages and saw
13,172 children, being more than half of those he had to see. The Civil Sur-
geon reports that he has been fairly active in his inspection and in reporting the
quality of Vaccinators' work,
There is no active opposition on the part of the mass of the people, but
they strongly object to "arm to arm" vaccination. The better classes are still
as strongly opposed to vaccination as ever.
DISPENSARY VACCINATION.
The Hospital Assistant performed 232 more primary but rather fewer
re-vaccination operations.
The Hospital Assistant at Murwara was relived of all vaccination work.
SMALL-POX.
22 deaths from this cause were reported during the year: the Civil Sur-
geon is of opinion that there is not any concealment of the disease, but that on
the contrary every kind of rash is reported as small-pox.
Dr. Rice is of opinion that a Municipal Vaccinator should be appointed for
the town of Jubbulpore and that the district staff should be increased by 3.
He brings to notice the good work done for several years by Hospital Assistant
Chuni Lal, in charge of the City Branch Dispensary, as evidenced by the fact
that for the past 12 years there has not been an out-break of small pox in the.
City of Jubbulpore.
16
Narsinghpur.—The lymph failed in the hot weather and operations were
suspended till the arrival of the English lymph, which proved good.
There was an increase of 124 in the number of operations performed by the
District staff and of 41 in that by the Municipal Vaccinators.
The percentage of success claimed by Vaccinators is almost the same as it
was last year, but that returned by the Native Superintendent and Civil Sur-
geon is 5 per cent less than in 1885-86, the decrease being due to indifferent
work found in two of the circles. The Civil Surgeon reports that very few of
the children under one year old have escaped vaccination. Vaccination has been
chiefly arm to arm and the use of points has been entirely stopped: the vesicles
seen were in the large majority of cases good.
No false entries were detected in the registers.
The Civil Surgeon was in camp 58 days and saw about a third of all the
persons vaccinated.
The Native Superintendent visited each circle twice or thrice and saw
two-thirds of the vaccinated persons ; he is well reported of.
The attitude of the people is one of indifference and there is vary little if
any opposition to vaccination now.
There is not any Dispensary vaccination, the Municipal Vaccinator doing the
work in the 3 dispensary towns.
SMALL-POX.
There were 71 deaths from this cause.
Hoshangabad.—A. supply of good lymph was kept up at Head-Quarters
throughout the year : the English lymph proved good, and by the middle of
October there was a sufficient supply of lymph to enable the Vaccinators to
start their work.
There was an increase of 2,323 in the number of operations, and the increase
would probably have been greater but for changes and sickness among the
staff.
The ratio of success returned by Vaccinators was slightly lower than it was
in 1885-86, and that given by the Native Superintendent and Civil Surgeon is
about 5 per cent lower; the cause of this difference is said to be more extensive
inspections by the Native Superintendent and greater care and thoroughness in
it. One of the Vaccinators worked in the Cantonment of Pachmarhi for a
month and vaccinated 115 persons; the Civil Surgeon is of opinion that the
arrangement interfered with the district work of the Vaccinator. Heavy Sur-
gical work at the Dispensary, cases at Head-quarters among the European popu-
lation in which his attendance was necessary and the charge of the troops, pre-
vented the Civil Surgeon being on tour for more than 11 days : he inspected the
work of 5 of the 9 Vaccinators, but saw only 590 children.
DISPENSARY VACCINATION.
There was an increase of 226 in the number of operations performed by
17
Hospital Assistants, the increase being at all the dispensaries. At Hoshanga-
bad the Hospital Assistant was relieved of this work, which was made over to
the Medical Officer of the Kothi Bazaar dispensary.
SMALL-POX.
There were 300 cases with 13 deaths reported by the police, most of the
cases occurred in the Hoshangabad, Harda and Timurni circles and in the towns
of Hoshangabad and Harda.
Nimar.—The English lymph proved good, but as Dr. Cullen had brought
out some tubes of calf lymph from England, he replaced the supply of lymph
with this, and practically the whole of this season's vaccination has been carried
on with lymph raised from calf lymph.
Dr. Cullen who had studied the subject of vaccination from the calf while
in England was anxious to keep up a supply of calf lymph in the town of
Khandwa, but the Municipal Committee objected to the expense of maintaining
a supply of calves.
The number of operations performed in the past season exceeded consider-
ably that of 1885-86 both primary and re-vaccination. The percentage of success
being almost the same as in the previous year for the former and 6 per cent
higher for the latter. The percentage returned by the Civil Surgeon and Native
Superintendent is in some cases higher than that claimed by the Vaccinators, the
explanation being in the case of Municipal towns that cases unsuccessfully vac-
cinated at first and returned as such by the Vaccinator had been operated on a
second time and proved successful, the results being seen by the Civil Surgeon
and Native Superintendent after the Vaccinators had left the town; and in the
case of the rural circles that the results of the few cases operated on at the
Vaccinators' last visit to villages were not ascertained by them, and so not
entered in their registers, as the inspection of these few cases would have caused
considerable loss of time.
The Civil Surgeon believes that the Vaccinators' averages are fairly truth-
ful and in no case did he find names in the register which were not in the
village form.
Vaccination is, as soon as the work is fairly started, entirely " arm to arm,"
the use of tubes being confined to the case of far distant villages to which a
child cannot be brought: points are altogether forbidden. The system of taking
a Vaccination Census was carried out and in 11 villages, a list of which the Civil
Surgeon gives, and in which the full number of children according to the report
books had been vaccinated, no less than 613 children were found who had not
been protected. The increase in the number of re-vaccination is due to the
discovery (by taking a census) of many children bearing only one mark and as
such considered doubtfully protected.
The Civil Surgeon was out the full 6 weeks on inspection, but his tours
were much interrupted by being called back to Head-quarters, and he was
unable to visit the outlying parts of the district, Chandgarh and Gondwana—
which are thus 3 years without inspection by the Civil Surgeon.