NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
COMPARATIVE STATEMENT No. IV.—(Concld.)
Establishment.
Government...
Municipal...
Local or District Funds...
Native
States...
...
Dispensaries... ...
Army...
Europeans...
Natives...
...
Total...
Persons primarily vaccinated.
Total number.
Number suc-
cessfully
vaccinated.
Total number.
Number suc-
cessfully
vaccinated.
Total number.
Number suc-
cessfully
vaccinated.
Total number.
Number suc-
cessfully
vaccinated.
1888.
...
13,744
328,681
51,562
13,958
...
...
...
407,945
...
13,142
315,365
50,036
12,914
...
...
...
391,457
1889.
...
16,355
335,525
56,878
13,425
...
...
...
422,183
...
15,541
321,912
54,793
12,378
...
...
...
404,624
1890.
...
13,839
294,927
43,366
12,777
...
...
...
364,909
...
13,217
284,545
41,199
11,867
...
...
...
350,828
1891.
...
15,204
326,220
53,794
13,808
...
...
...
409,026
...
14,293
814,959
51,698
12,955
...
...
...
393,905
NOTES
ON THE
ANNUAL STATEMENTS
OF
VACCINE OPERATIONS
IN THE
CENTRAL PROVINCES
FOR
THE YEAR 1891-92.
NAGPUR:
PRINTED AT THE SECRETARIAT PRESS.
1892.
[PRICE EIGHT ANNAS.]
No. 4883.
Extract from the Proceedings of the Chief Commissioner, Central Provinces,
in the General Department,— dated Nagpur, the 18th July 1892.
READ—The Annual Statements of Vaccination operations in the Central Provinces for the
year 1891-92, with Notes by the Superintendent-General.
READ ALSO—the District Reports.
RESOLUTION.
The Provincial strength of the Vaccine Department was increased by 2
during the year 1891-92, owing to the employment of one extra vaccinator
each by the Harda and Chanda Municipalities. The strength of the Vaccine
Establishment in the Feudatory States was increased by 5 vaccinators, of whom
1 was employed in the Makrai State, which was brought for the first time this
year within the sphere of the Department.
2. The total number of operations performed in the year 1891-92 in the
Khalsa (British Districts) and in Feudatory States (excluding Makrai) was
445,427, or 3,438 more than in the previous year. Adding the figures for
Makrai (293) the Provincial total is 445,720. These favourable results are due
to more work having been done in the Feudatory States. In the Khalsa, the
number of operations declined from 384,944 to 381,069.
3. On examining the Khalsa returns in detail, it is found that the
decrease occurred both in primary operations and in re-vaccinations, but chiefly
in the former. The district figures show that Raipur and Sambalpur are mainly
responsible for this outcome, the former having 6,398 fewer primary vacci-
nations, and the latter 4,680 fewer re-vaccinations. In Raipur, vaccination
was much hindered by the prevalence of cholera and the employment of vacci-
nators on special cholera duty. In Sambalpur, the Civil Surgeon ordered that
pressure was not to be put on parents to get children re-vaccinated, because the
people did not like it. This concession, however, did not avail to increase the
number of primary vaccinations in the district. The number of persons vacci-
nated by Hospital Assistants attached to Dispensaries (in both the Khalsa and
Native States) amounted to 17,526, or 1,837 more than in the previous year.
4. While the total number of successful primary vaccinations in the
Khalsa (326,829) was smaller than in the previous year, the number of children
under one year of age who were vaccinated in 1891-92 exceeded the total for
1890-91 by 13,715. The decrease was in the number of vaccinations of
children between the age of one year and six years. The percentage of successful
primary operations in the Province generally (96.40) was nearly the same as
in the year preceding. In re-vaccinations the percentage of success was 79.57
as compared with 77.62 in 1890-91.
2
5. The total cost of the Vaccine Establishment in the Khalsa for 1891-92
amounted to Rs. 46,880, or Rs. 1,133 more than in the previous year. Nearly
half of this increase is due to expenses incurred in the cultivation of animal
lymph at Pachmarhi. An account of the circumstances under which this
cultivation was undertaken and of the results of the experiment is given in the
Appendix to the Report. The Chief Commissioner was so far satisfied with the
results that he has sanctioned a continuance of the experiment during the
current year. At the same time he is disposed to view with more favour the
plan of obtaining lymph from buffalo calves obtained locally and vaccinated
for the purpose—upon the principle followed in Berar and in the Punjab. In
several districts this plan was successfully tried during the year.
The total cost of the Vaccine Department in both the Khalsa and Feuda-
tory States amounted to Rs. 51,143.
6. The Vaccination Act is (as was noted in last year's Review) in active
operation in the Cantonment of Jubbulpore, and the Chief Commissioner has
recently sanctioned its introduction (after expiry of the usual period of notice)
into the Municipalities of Nagpur, Narsinghpur and Harda. The Municipality
of Jubbulpore has negatived the proposal to introduce the Act there.
7. At the request of the Chief Commissioner, Dr. Pilcher made a tour, in
the month of February, in all the Tahsils of the Nagpur District and tested the
vaccination work by village to village inspection. It is satisfactory to find that
he has been able to record (in paragraph 22 of the Report) a favourable account
of what he saw. It will be useful if the Superintendent-General during the
ensuing cold season makes a similar detailed investigation in some other districts,
and preferably in another Commissioner's Division.
ORDER.—Ordered, that a copy of this Resolution (with the usual number
of spare copies) be submitted to the Government of India in the Home Depart-
ment, and that a copy be forwarded to the Superintendent-General of Vaccina-
tion, for information and guidance ; also, that it be published in the Supplement
to the Central Provinces Gazette, and that copies, bound with the Report, be
distributed as usual.
[True Extract.]
L. K. LAURIE,
Offg. Secretary.
Secretariat Press, Nagpur:—19-7-92—200
No. 1699-505.
FROM
W. CENTER, ESQ., M. D.,
OFFG. SANITARY COMMISSIONER AND SUPERINTENDENT-GENERAL
OF VACCINATION,
Central Provinces,
To
THE SECRETARY TO THE CHIEF COMMISSIONER,
Central Provinces.
Dated Nagpur, the 28th June 1892.
SIR,
I have the honour to submit, for the information of the Chief Commis-
sioner, the Annual Statements of Vaccine operations in the Central Provinces
for the year 1891-92, with notes thereon by Dr. Pilcher, in accordance with
the orders of the Government of India in the Home Department, No. 28-1579-95
of the 15th July 1887.
I have the honour to be,
Sir,
Your most obedient Servant,
W. CENTER,
Offg. Sanitary Commissioner
and Supdt.- General of Vaccination,
Central Provinces.
Notes on the Annual Statements of Vaccine operations in the
Central Provinces for the year 1891-92.
The following brief notes on the operations of 1891-92 are given with
reference to, and in explanation of the appended Statements.
2. The area in which vaccine operations were performed in 1891-92
remained about the same as in 1890-91, but in the year under review 293
operations performed in the Makrai State, in the Hoshangabad District, have
been included in the Statement.
STATEMENT I.
3. The Provincial strength of the Vaccine Department was increased
by 2, as compared with that of the previous year. One extra vaccinator each,
was employed by the Harda and Chanda Municipalities. The strength of the
Vaccine establishment in the Feudatory States also was increased by 5 vacci-
nators, as follows:—
In the Kanker State
„
Sonepur ...
„
Bamra ...
„
Makrai (newly added) ...
Total ...
1
2
1
1
5
4. The total number of operations performed in the year 1891-92 both
in the Khalsa and Feudatory States, excluding the operations performed in the
Makrai State, was 445,427, or 3,438 more than in the previous year.
While there was an increase in the number of primary operations, the total
of persons re-vaccinated remained about the same as in 1890-91.
5. The number of successful primary operations, excluding the figures of
the Makrai State, increased by 3,434.
6. It is very satisfactory to record that the operations performed on
infants, both in the Khalsa and Feudatory States, again increased this year by
17,321, as shown below :—
Operations performed
on children under one year.
In the Khalsa ...
„
Feudatory States ...
Total ...
13,715
3,606
17,321
In the above calculation the operations performed in the Makrai State
are not included.
7. The percentage of successful primary vaccinations remained almost
the same as in 1890-91, but re-vaccinations were 1.95 per cent. greater than in
the preceding year. Thus:—
Percentage of successful operations.
1890-91 ...
1891-92 ...
Primary.
96.39
96.40
Difference
...
Re-vaccinations.
77.62
79.57
+ 1.95
2
Operations by Khalasa Vaccinators.—
1890-91 ...
1891-92 ...
Difference ...
Total operations.
384,944
381,069
— 3,875
Primary.
341,424
338,624
— 2,800
Re-vaccinations.
43,520
42,445
— 1,075
8. From the above figures it will be seen that the operations performed
by the Khalsa vaccinators in 1891-92 were less when compared with those of
the preceding year.
9. The average number of operations performed by each vaccinator in
the Khalsa was 1,871, or 37 less than that of 1890-91.
10. Of the 18 districts of these Provinces, 9 show an increase in the
primary operations, and 9 a decrease. The increase varied from 2,750 in
Mandla to 158 in the Nimar District: the decrease from 6,398 in the district
of Raipur to 76 in Saugor,
The following table gives, in three groups, the actual increase and decrease
in the number of operations performed between the seasons 1890-91 and
1891-92:—
Increase or decrease on comparing the seasons 1890-91 and 1891-92.
District.
Saugor ...
Damoh ...
Jubbulpore ...
Narsinghpur ...
Hoshangabad ...
Nimar ...
Mandla ...
Betul ...
Chhindwara ...
Seoni ...
Balaghat ...
Bhandara ...
Nagpur ...
Wardha ...
Chanda ...
Raipur ...
Bilaspur ...
Sambalpur ...
Total ...
Total of Primary and
Re-vaccination.
+1,723
- 276
-1,051
+ 60
-1,790
- 176
+ 3,919
- 174
- 878
-1,530
- 145
+ 1,270
+ 568
+ 1,829
+ 5.890
- 6,407
- 545
- 5,662
- 3,875
Primary.
-
76
- 565
- 963
+ 875
-1,579
+ 158
+ 2,750
+ 1,275
+ 545
-1,523
+ 277
+ 2,080
+ 623
- 163
+ 1,684
- 6,398
- 818
- 982
-2,800
Re-vaccination.
+1,799
+ 289
-
88
- 815
- 211
- 334
+1,169
-1,449
-1,423
-
7
- 422
- 810
-
55
+ 1,492
+4,206
-
9
+ 273
- 4,680
- 1,075
11. The Civil Surgeon accounts for the decrease in the Hoshangabad
District in the absence of one vaccinator, who was deputed for duty at Pach¬
marhi to aid in the cultivation of animal lymph. But it was in greater measure
due to the very severe fatality from cholera. The disease remained in this
district till nearly the end of the year.
In the Chhindwara District the Civil Surgeon attributes the decrease of
work to the laxity of two vaccinators. With regard to the decline in the
number of operations performed in the Raipur District, Surgeon-Major Evers
reports that vaccination was much hindered by the prevalence of cholera, and
in the fact that vaccinators had to be employed on special cholera duty.
In Sambalpur the small decrease, when compared with the figures of
1890-91, the Civil Surgeon explains as in no way redecting on his staff, but was
due to the smaller number of children available for vaccination. Re-vaccination
he found to be very much disliked by the people ; and fearing it might affect
the results in primary operations, he ordered re-vaccination to be done only in
such cases where ready consent was given by parents and others. The Civil
Surgeons of Jubbulpore, Seoni and Bilaspur have not explained the falling off
in the operations done in their districts.
12. The number of persons successfully vaccinated per thousand of popu
lation for the whole Province is 38.25, against 37.94 in the preceding year.
Operations by Vaccinators in the Feudatory States.
13. In the Feudatory States vaccination was somewhat more efficiently
done on the whole. But there was a slight decrease of work in the Khairagarh,
Sakti, Sarangarh and Kalahandi States.
STATEMENT II.
14. The total cost of the Vaccine Establishment in the Khalsa for 1891-92
amounted to Rs. 46,880-3-11, or Rs. 1,133-1-11 more than that of the previous
year.
Nearly half of the increase is due to the expenses incurred in the cultivation
of animal lymph at Pachmarhi, charged to Provincial account, and to the cost
of blank forms which is for the first time debited to District Fund. The
remainder is in fact due to the more liberal travelling allowance passed to Civil
Surgeons in the matter of half cost of tentage, and a slight increase to the
Vaccine Establishment.
15. The average cost of each successful vaccination in the Khalsa for the
year was Re. 0-2-¾, against Re. 0-2-¼ in the preceding year.
16. The cost of the Vaccine Department of the Feudatory States of the
Chhattisgarh Division and of the Makrai State amounted to Rs 4,263-5-4, as
compared with Rs. 4,094-2-2 in the previous year, showing an increase of
Rs. 169-3-2.
17. The average cost of each successful operation was Re. 0- 1-1⅓, against
Re. 0-1-2½ in the previous year.
18. The total cost of the Vaccine Department in both the Khalsa and
Feudatory States amounted to Rs. 51,143-9-3, against Rs. 49,841-4-2, or to
Rs. 1,302-5-1 more than in 1890-91.
STATEMENT III.
19. The total number of persons vaccinated by Hospital Assistants
attached to the Dispensaries in the Central Provinces, in both the Khalsa and
Native States, in 1891-92 amounted to 17,526, or 1,837 more than in the previous
year; of which 15,305 were Primary, and 2,221 Re-vaccinations. The total
number of persons successfully vaccinated was 14,090, and of these 10,686
were performed on infants.
STATEMENT IV.
20. The figures in this statement, as noted in the last year's report, have
only been exceeded in the years 1883 and 1889.
Inspection.
21. The Civil Surgeons and Native Superintendents of Vaccination as
usual inspected most of the vaccine operations in their respective districts, with
the following results :—
1.
2.
3.
Percentage of success as seen on inspection
by Civil Surgeons
Do.
do. by Native Superintendents..
Do.
do.
as returned by Vaccinators.
90.29
93.70
96.40
22. In the month of February I made a tour in all the Tahsils of the
Nagpur District, at the Chief Commissioner's request, and tested the work
which had been done in 191 villages. I found, with few exceptions, that vacci-
nation had been carefully and thoroughly performed, and that little active
opposition had been encountered by the staff of vaccinators.
Sources of lymph.
23. Arm to arm vaccination was maintained in most of the districts of
these Provinces throughout the year.
But an endeavour was made, in reference to paragraph 3 of the orders of
the Government of India in the Home Department letter No. 302 of the 15th
October 1890, to cultivate animal lymph for distribution to all districts.
The experimental cultivation was carried on at Pachmarhi, and proved
so far successful that the Chief Commissioner has sanctioned a further and
more extended trial, with the view to place in the hands of every vaccinator in
the Province a sufficient quantity of animal lymph with which to begin the
operations of the coming season. A brief account of these experiments are
appended to this report.
In many districts buffalo calves were vaccinated, and the lymph obtained
from them was used by the vaccinators of the districts.
A few tubes of animal lymph were obtained from Berar and Bombay, and
they were sent to some of the Feudatory States.
In 1891 a vaccinator was, with the approval of the Chief Commissioner,
sent from Raipur to Berar to watch the details of animal vaccination carried on
there. On his return to Raipur 3 calves were vaccinated, 2 on the 4th October
and the 3rd on the 9th idem. The lymph so obtained was passed through a
second series of calves, and the supply of animal lymph from this source was
sufficient to enable the Civil Surgeon to send 50 tubes of it with each vaccina-
tor to commence work in their respective circles.
The Vaccination Act of 1890 was extended to the Cantonment of Jubbulpore
by Notification No. 844 of the 13th February 1890, and the Civil Surgeon
reports that there has been no necessity to do more than issue notices to the
parents or guardians of children who had not been vaccinated. The Act has
not been introduced elsewhere in these Provinces.
The attention of the District authorities of Raipur, Bilaspur, Nagpur
and Bhandara was called to paragraph 4 of the orders of the Government of
India on the review of the Vaccination Report of these Provinces for the
season 1890-91, with the result that greater protection has been afforded—though
there is still room for improvement.
Considering the sparseness of the population, that it is very scattered, and
that the physical difficulties to be overcome by the vaccinators are very great
in all districts, the results obtained in this Department are satisfactory ; and I
should add that this success is largely due to the personal inspection of Civil
Surgeons in their cold-weather tours in their respective districts.
J. G. PILCHER, F. R. C. S.,
Sanitary Commissioner,
and Superintendent-General of Vaccination,
Central Provinces.
APPENDIX.
In the last annual Report on the Vaccine operations in these Provinces,
it was shown that the experimental use of calf lymph was tried at Jubbulpore
and Nagpur in the season of 1889-90, in accordance with the instructions of
the Government of India, as contained in Home Department's printed letter
No. 3—203 of the 29th June 1889, with which was circulated the Report on
the cultivation of animal lymph in Europe and India, prepared by the late
Surgeon-Major Barclay.
The experiment at Nagpur from imported animal lymph was unsuccessful,
but better results were obtained at Jubbulpore, where calf lymph was cultivated
and solely used in the City and Cantonments.
But the general results were such as to lead the Chief Commissioner to
remark, in forwarding the Report of the experiment to the Government of India,
" that the difficulty experienced in procuring calves and the cost of the animals,
" taken with the unwillingness of the people to accept direct vaccination from
" the calf, confirm the Chief Commissioner in his opinion that the best plan
" will be for these Provinces to obtain their supply of animal lymph from
" Bombay or Calcutta, where arrangements have been matured for its manu¬
" facture at central Depôts."
But the difficulty of procuring animal lymph in sufficient quantity from
any depôt in India led to the consideration of the question of establishing a
Provincial Depôt, and it was recommended that an experiment on a limited
scale should be made at Pachmarhi.
Here, in September 1891, an Assistant Surgeon and Veterinary Civil
Hospital Assistant were sent, and preparations made to furnish each district
with a sufficient portion of lanoline lymph—animal lymph diluted with lano¬
line—with which to begin the season's operations.
After examination by the Veterinary Civil Hospital Assistant, the calves
were vaccinated either with fresh human lymph or, in subsequent operations,
with calf lymph ; but calf lymph was not used after the fifth cultivation. The
calves were returned to their owners in all cases.
The paste was prepared by triturating the lymph with lanoline instead of
glycerine, after the method of Surgeon-Major King of Madras, and consisted of
1 part of lymph to 5 of lanoline.
The paste was distributed as it was prepared; and as the quantity varied
with each cultivation, some Civil Surgeons received more and some less in
the first issue, but in the two issues an average of 60 grains were supplied to
each district.
The first issue was made in the last ten days of October, and the second
in the first ten days of November.
"With regard to the cost of the experiment, it was found that for an expen-
diture of Rs. 171, 17 calves were inoculated and yielded a sufficient quantity
of lymph for 1,081 grains of paste, or 63 grains of lanoline paste for each calf.
2
Deducting initial expenses in the erection of the shed for the calves and
in the purchase of instruments, which expenditure will not have to be incurred
again in the coming season, each calf may be calculated to cost Rs. 3-8-0, and
that figure may be taken as the value of 63 grains of lanoline paste.
The reports of Civil Surgeons on the use of the paste were not entirely
satisfactory, in that the results obtained varied considerably in different districts
both in regard to the activity of the paste and the length of time during which
it would remain ' sweet and good.'
But making due allowance for the greater instability of animal lymph;
that it could only be distributed in a diluted form; that the dilution with lano-
line was a solid and therefore less readily absorbed; and that the vaccinators
were inexperienced in the details of operating with it, there is abundant evidence
that the paste will remain good for 20 days at least; that it is efficient, and will
be perfectly successful when the vaccinators have become familiar with its
qualities and the mode of using it.
The Chief Commissioner has sanctioned the proposal to increase the cultiva-
tion of animal lymph, so that each vaccinator in. the Province and in the Feu-
datory States and Zamindaris may be furnished with a portion with which to
commence the operations of the season.
It may be possible hereafter to extend the cultivation, so that animal lymph
may be exclusively used throughout these Provinces; but it will be safer to
proceed with these experiments gradually, for it is not certain that the required
number of calves will be forthcoming at Pachmarhi for so large an under-
taking as the cultivation of lymph for the whole of these Provinces.
I am much indebted to Civil Surgeons for the care taken to test the animal
lymph paste; and where results were less satisfactory, failure was due to the
difference in the physical qualities between fluid lymph and the paste, rather
than to any want of appreciation of the importance of that part of the experi-
ment entrusted to them.
J. G. PILCHER, F. R. C. S.,
Deputy Surgeon-General,
and Sanitary Commissioner,
Central Provinces.
Secretariat Press, Nagpur—12-7-92.—200.