NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
34
Tube 6, Feline blood-stain extract dilute Antihuman fowl serum No reaction.
„ 7, Bovine blood-stain extract dilute
"
"
"
8, Saline solution
"
"
" 9, Stain-extract dilute
Normal fowl serum
"
Now if we take some of our stain-extract and inject it into five guinea-pigs
and, on the 15th day thereafter, we give to three of these a dose of human serum,
to one a dose of, say, equine serum, and to the fifth canine serum; and we
take three other untreated guinea-pigs and give them the three kinds of sera
mentioned, we shall have a good control of the results of our precipitin test.
Supposing that two of the now humanised previously-treated animals show marked
symptoms—probably all three will show a fall of temperature—and none of the
others are apparently a whit the worse for the injections of serum that they have
just received, we have strong confirmatory proof of the correctness of our
diagnosis of the origin of the blood-stain in question.
The preliminary fixing of the facts that the stain is due to blood and that
this blood is mammalian, would in actual practice be carried out by the Chemical
Examiner; the serological tests would have to be carried out at one Central
Laboratory in Calcutta.
V I I . — S u m m a r y .
From what has been said we may draw conclusions that may be set forth
briefly as follows:
—
1 . B y m e a n s o f t h e p e r o x i d e o f h y d r o g e n a n d l e u c o m a l a c h i t e - g r e e n t e s t s
we may ascertain whether blood is present in the stain before us, and
confirm this observation by employing the spectroscope.
2. Then, by means of the microscope we may ascertain whether the red
blood-corpuscles present are those of a mammal.
3. Having arrived at knowledge of their being those of a mammal we can,
even in the tropics, tell whether that mammal is man or one of the
domestic animals.
4. For this purpose we can apply the precipitin test. The antisera
required for this test we can obtain by treating fowls and rabbits with
the bloods of man and other animals. Our animals need a more pro-
longed course of treatment and higher doses than is the rule in tem-
perate climates; and more of them will be found to yield worthless
antisera. Still, with patience and care we shall have a good supply
of the needed antisera, and may obtain these most economically by
treating our animals by means of intravenous injections.
5. The antihuman sera will enable us to ascertain whether or not the stain
to be examined has been caused by human blood. The bloods of
35
apes, even of those very closely related to man— e.g., the Orang Utan
—may thus safely be distinguished from human blood.
6. The bloods of the various ruminants may be distinguished one from the
other by the modification of the test that was introduced by Ham-
burger.
7. The age of the stain, at least up to 27 months, makes no difference:
all stains are fairly easy to extract, and the extract is not affected by
the age of the stain.
8. The antisera must be kept frozen and protected from light in order that
they may not lose their power.
9. The work of preparing antisera can only be carried out where (1) we
have a large freezing chamber; (2) we have a lying-in hospital near
the laboratory, as human placental blood is needed, in large quantities
and as fresh as possible, for the treatment of our animals: the vital
question being that concerning the presence or absence of human
blood, and this requiring for its answer large quantities of antihu-
man serum.
1 0 . I t i s n o t l i k e l y t h a t a n t i s e r a o f t h e s t r e n g t h r e q u i r e d f o r t h ecomplement-
deviation test will ever be obtained in sufficient quantity to enable
one to carry out this test in Calcutta, as a matter of routine in the
case of the very numerous blood-stains that would fall to be exam-
ined by the expert. If antisera of proper strength be obtained they
could be used to obtain confirmation—not correction—of the informa-
tion obtained by the use of the precipitin test.
1 1 . T h e
a n a p h y l a x i s t e s t
p r o m i s e s w e l l . M o r e w o r k o n i t i s n e e d e d t o
establish clearly its value in all circumstances and under the most
varying conditions, as demanded for forensic medical work. Its use
would necessitate a delay of at least fourteen days between the
receipt of the suspected blood-stains and the carrying out of the test.
12. The biochemical tests in forensic medical practice must be performed
by an expert.
No. 39
(NEW SERIES)
SCIENTIFIC MEMOIRS
BY
OFFICERS OF THE MEDICAL AND SANITARY DEPARTMENTS
OF THE
GOVERNMENT OF INDIA
THE APPLICABILITY TO MEDICO-LEGAL PRACTICE
IN INDIA OF THE BIOCHEMICAL TESTS FOR
THE ORIGIN OF BLOOD-STAINS
BY
LIEUT.-COLONEL W. D. SUTHERLAND, M.B., I.M.S.
(Edited by the Director-General, Indian Medical Service)
Issued under the Authority of the Government of India by the Sanitary
Commissioner with the Government of India
CALCUTTA
SUPERINTENDENT GOVERNMENT PRINTING, INDIA
1910
Price Annas 8 or 9d.
NOTES
ON
VACCINATION
IN THE
CENTRAL PROVINCES AND BERAR
DURING THE YEAR
1921-22
NAGPUR
PRINTED AT THE GOVERNMENT PRESS
1922
[PRICE—ONE RUPEE]
NOTES
ON
VACCINATION
IN THE
CENTRAL PROVINCES AND BERAR
DURING THE YEAR
1921-22
Agents for the sale of Books published by the Central Provinces
Government.
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KEGAN PAUL, TRENCH, TRUBNER & Co., 68/74, Carter Lane, London, E. C.,
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A. J. COMBRIDGE & Co., Madras.
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A. M. & J. FERGUSON, Booksellers, Ceylon.
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THE PROPRIETOR, New Kitabkhana, Poona,
TABLE OF CONTENTS.
Introductory ... ... ...
Administration ... ... ...
Establishment ... ... ...
Total number of vaccinations performed
...
...
Vaccinations performed by the special staff ...
Vaccination by the dispensary staff and other agencies
Cost of department ...
...
...
Preparation and supply of lymph ... ...
Inspection of vaccination ... ...
Vaccination in municipal towns ... ...
Deaths from small-pox
...
...
General remarks ... ... ...
PARAS.
1
2
3
4
5—9
10
11 — 12
13
14
15
16
17
NOTES ON VACCINATION
IN THE
Central Provinces and Berar during the year 1921-22.
Introductory.—As this is only the second year of the
triennial period 1920—1923, this report deals only briefly with
vaccination work performed in the year as compared with the
previous year 1920-21.
2. Administration.—During the year Major Rennie,
I.M.S., was in charge till the 25th June 1921 when I returned
from leave and resumed charge.
3. Establishment.—The sanctioned establishment of
Assistant Superintendents of Vaccination and vaccinators
continued the same except in Mandla and Saugor districts.
In the former, the number of vaccinators was reduced by five
and in the latter by one —the reserve vaccinator who is
specially entertained to take up the duties of men going sick,
on leave, etc , a false economy.
4. Total number of vaccinations performed in
the province.—The total number of vaccinations, primary
and revaccinations, performed by all agencies was 410,382
against 439,494 or a decrease of 29,112 in comparison with
the preceding year. The primary vaccinations numbered
364,961 and the revaccinations 45,421 against 377,599 and
61,895 in 1920-21 ; so there is a considerable fall in both in
the year under report. Most of the district reports attribute
this to the non-cooperation movement and the unfair treat-
ment accorded to the staff by the District Councils most of
whom have not yet adopted the new time-scale of pay or
distributed the grant given by Government to cover the
arrears from January 1921. Though there is ample evidence
to corroborate these assertions, I am of opinion that the low
birth-rate since the influenzal epidemic of 1918, the famine
conditions prevailing for the past two years and the unusual
prevalence of epidemic disease in some districts have all led
to a decrease of work which is actually more than what one
2
would expect in such circumstances. Mr. Smith the Deputy
Commissioner of Betul, where village vaccination actually
increased, rightly remarks " I am surprised that there has
been such an increase in primary vaccinations in a year
when for a thing to be recommended by Government has
been enough to raise up prophets to cry it down."
5. Vaccinations performed by the special staff.—
Of the 410,382 operations performed during the season,
409,979 (364,660 primary and 45,319 revaccinations) were
done by the vaccination staff. The primary vaccinations are
less by 12,796 as compared with the year 1920-21. The
largest decrease (6,693) was in Jubbulpore where plague,
cholera, malarial fevers and famine were all rife, and where as
the Commissioner, Mr. Slocock, says "the Jubbulpore Dis-
trict Council seems to be running amock with its resolution
for throwing all expenditure on the Local Government".
The next district showing a decrease is Drug where the fall
amounts to 5,928. This district also suffered much from
cholera and malarial fevers. The other districts which
show a considerable decrease in primary vaccinations are
Akola (2,048), Mandla (1,466), Bhandara (1,382), Balaghat
(1,112) and Narsinghpur (1,075). In all these districts, epi-
demic diseases were prevalent, but the attitude of the Dis-
trict Councils towards their staff has also much to do with it,
The staff is a touring agency. each man has to visit about
250 to 300 villages every year and deal with every epidemic
outbreak in them. To treat this staff unfairly or with in-
difference will produce undesirable results, which indeed are
already evidenced by numerous resignations.
6. Government after duly consulting District Councils
and Boards authorised a time-scale of pay for vaccinators
dating from the 1st January 1921 and in many cases gave
grants amounting in all to Rs. 24,346 to cover the extra cost
involved' up to the end of last financial year. This has
brought the question of cost and control of vaccination to a
head, some Bodies demanding recurring grants while others
wish to be free from the so-called " interference" by the
Civil Surgeon. The situation, which is largely the result of a
misapprehension, is being dealt with by Government and it
is to be hoped that an understanding will be arrived at as to
the financial difficulties. The only real solution of the ques-
tion of technical control appears to me to lie in the appoint-
3
ment by Local Bodies of their own Health Officers which
would remove many other difficulties and relieve the Civil
Surgeons of a thankless task.
7. It is hardly surprising to hear that in some districts
the people have opposed vaccination. In Jubbulpore it is
stated that in 91 villages the parents of 1,177 children
refused to have their children vaccinated. This is perhaps
due to the preachings of non-cooperators
In the district of
Raipur one of- these men has been convicted for opposing a
vaccinator in his duties. I hope other districts will follow
the example set by the Raipur district authorities.
The time is not far distant when District bodies might
consider the importance of extending compulsory vaccination
to villages, A new Act would be required if this is done.
8. The average amount of work done per man varies
greatly—it is highest in Yeotmal 2,365—-one man having done
3,505 while in other districts the average is only half this
amount.
9. Revaccinations have decreased from 61,045 in the
previous year to 45,319 in 1921-22, though cases of small-
pox have been occurring throughout the year in almost all
districts. If the local bodies do not take early action, I have
no doubt that a severe epidemic of small-pox will be the
inevitable result.
10. Vaccination by the Dispensary staff and
other agencies.—In regard to operations by other agencies
68 vaccinations were done in the Nagpur Jail and 41 in
Hoshangabad. The railway staff in Chanda, Bina (Saugor)
and Raipur performed 123, the Dhamtari mission (Raipur) 27
and the vaccinator attached to Chhindwara coal mines 144.
11. Cost of Department.—-The total cost of the
department was Rs. 1,72,341-14.6 against Rs. 1,60,431-13-11
in 1920-21. The increase is due to the payment in some
districts of the increased rate or time scale of pay recently
sanctioned by Government and also on account of the pay-
ment to vaccinators of 'begar' or coolie allowance and
rewards for good work. In consequence of this, the cost per
successful case rose from Re. 0-6-7 to Re. 0-7-6 during the
past year and if the sale proceeds of lymph and calves at
4
the Vaccine Institute were taken into account, the cost per
successful case stands at Re. 0-6-8 against Re 0-6-1 in the
previous year.
12. For some years Government has been placing at
the disposal of Commissioners allotments for distribution to
District Funds for general purposes. In Nerbudda and
Chhattisgarh Divisions considerable sums from this money
have been allotted for medical and vaccination purposes which
have not been shown in the financial statement of the annual
Vaccination report. These grants some of the local bodies
have been utilising purely on vaccination, e. g., Nimar, to
which the Commissioner has allotted Rs. 4,000 and Govern-
ment allowed a further sum of Rs. 891 to meet the arrears of
pay in consequence of the introduction of time-scale of pay
from 1st January 1921. Of this amount, i. e., Rs. 4,891, the
Council spent Rs. 4,195-7-3 and have a balance of
Rs. 695-8-9
The Council, however, say that they spent
some of their own funds also on vaccination, but the accounts
do not show that they spent anything. Similarly, in Betul
the allotment made by the Commissioner was Rs. 4,521 and
the District Council obtained from Government an additional
Rs. 133-4-7 as leave allowances of the vaccination staff
making a total of Rs. 4,654-4-7. Of this sum, the total
amount spent on vaccination was Rs. 4,543-3-5 which leaves a
balance of Rs. 111-1-2 from provincial funds in the hands of
the District Council. In my opinion such indiscriminate
grants from provincial funds should be stopped.
13 Preparation and supply of lymph.—Only
glycerinated calf lymph prepared at the Vaccine Institute was
used in all the districts. The supply is stated by all to be
satisfactory and the lymph good. The following is a report
on the working of the Institute submitted by the Superintend-
ent in charge, Civil Assistant Surgeon A. F. C. Gomes :—
"The whole province comprising 22 districts was supplied
regularly with vaccine lymph on indents and casual supplies were
given to all the Feudatory States of the province, to the Railways,
to the Jails and to the Military and Mission Hospitals of this province.
Two hundred and thirty-nine calves were successfully vaccinated
during the year and the total yield of pulp amounted to 8,723.34
grammes, equivalent to 755,440 doses of vaccine, 466,465 doses were
issued to the vaccinators of the province and 72,095 in casual
supplies.
5
The average purchase price per calf was Rs. 14 and on an
average Rs. 9 was realised per calf on sale in the local bazaars.
The total expenditure incurred was Rs. 24,336-15-1 of which
Rs. 9,504-7-5 were spent on salaries and travelling allowance and
the rest in contingencies. Rs. 11,280-9-0 were realised during the
year as follows :—
On sale of lymph Rs. 8,483-7-3, sale of calves Rs. 2,236-8-0
and the rest as miscellaneous.
The Assistant Superintendent conducted the vaccinators' train-
ing class. Seventeen fourth grade vaccinators were trained and
given certificates of efficiency in vaccination and sanitation by the
Director of Public Health, while four Assistant Superintendents of
Vaccination were also given a month's training before being per-
mitted to assume charge of their districts.
The cost per dose of vaccine manufactured was 5½ pies only.
The results of primary vaccination were 99 per cent case success
and 92 per cent insertion success and from re-vaccination 62 per
cent case success and 47 per cent insertion success."
The cost of preparation per dose has fallen to 5½ pies
from 7 pies in the previous year. This is due to the appoint-
ment of a Civil Assistant Surgeon on less pay as Superin-
tendent instead of a Military Assistant Surgeon. The local
bodies and others who obtain the lymph from the institute
were charged three pies per dose. In future they will be
charged at six pies per dose.
14. Inspection of vaccination.—During the season,
the Civil Surgeons and their Assistants and Sub-Divisional
Medical Officers inspected 6.20 per cent of the primary and
8.05 of, the revaccinations performed by the special staff
The Assistant Superintendents of Vaccination inspected
50.37 per cent of the primary and 17.65 per cent of the re-
vaccinations which is much less than they did in the previous
year. This inspection is now a matter of great difficulty as
explained by the Civil Surgeon, Buldana, who failed to get
any children for inspection at a village near Khamgaon.
In many districts the Civil Surgeons' touring has been
reduced to vanishing point. In accordance with the Book
Circular tents are available with the Deputy Commissioner
for vaccination touring.
The epidemic dispensary staff also has inspected a
large number of vaccinations but they do not find place in
6
the returns appended to this report. The Civil Surgeons will
be instructed to exhibit their inspections also in the returns
in future.
15. Vaccination in Municipal towns.—-During the
past year 25,594 children under one year of age were suc-
cessfully vaccinated in the municipal towns. Though the
number is higher than in the preceding year, I am unable to
say that the work in these towns has been satisfactory for
during the course of my tours of inspection I found a good
number of unvaccinated children in many of the towns. The
reasons for this have already been mentioned in previous
reports and it is not worth while recapitulating them here.
Major Grisewood, Civil Surgeon, Raipur, drew up some
instructions as to how vaccination work should be carried on
in municipal towns. Similar instructions were issued in
previous years and are I think useful. Every effort is being
made to bring home to the municipal committees the necessity
for taking energetic action in the matter as the balance of
unprotected children is great, e. g., Jubbulpore 3,395 plus
1,031 from former years.
16. Deaths from small-pox.—Deaths from small-
pox numbered only 1,216 during the year. It is a matter for
surprise that the disease has not broken out in epidemic form
owing to bad vaccination work during the past three or four
years, but as stated in the previous report such a state of
affairs cannot continue long. There will come a day when
the Local Bodies will be awakened from their torpor.
17. General Remarks.—The Civil Surgeon, Akola,
suggests private practitioners being allowed to vaccinate the
children of their patients. There is no objection to this,
provided the medical practitioner furnishes the Civil Surgeon
with the statistics required for inclusion in the annual and
other returns. Materials will be supplied on payment from
the Institute.
T. G. N. STOKES, M.B., Lt.-Col., I.M.S.,
Director of Public Health,
Central Provinces.
NAGPUR:
The 1st August 1922. )
STATISTICAL STATEMENTS.
STATEMENT No. I.—Showing particulars of vaccination in the
Central Provinces and Berar during
the year 1921-22.
STATEMENT No. II.—Showing the cost of the department
in the Central Provinces and Berar
during the year 1921-22
STATEMENT NO. III.—Showing dispensary vaccination in the
Central Provinces and Berar during
the year 1921-22.
STATEMENT No. IV.—Showing the number of persons
primarily vaccinated and number of
those persons who were successfully
vaccinated in the Centra] Provinces
and Berar since 1911-12.
STATEMENT No. V.—Showing particluars of vaccination veri-
fied by inspecting officers during the
year 1921-22.
APPENDIX A.—Showing the number of vaccinations performed
in municipal towns on children under
one year of age in 1921.22
;
APPENDIX B.—Showing the annual mortality from small-pox
for seven years and the annual pro-
portion of persons protected by
vaccination during each of the seven
years.
APPENDIX C.—Diagram showing the death-rate from small-
pox per 10,000 of population during
the year 1921-22, the average rate of
mortality from small-pox per 10,000
of population for the five years
ending 1920-21, and the proportion
of persons successfully vaccinated
during the year 1921-22 and the
preceding six years in each district
of the Central Provinces and Berar.
PAGES
2—11
12—19
20 — 21
22—25
26—29
30—33
34—37
2
A.—VACCINATION
STATEMENT No. I.—Showing the particulars of Vaccination
Number.
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Circles and Districts
2
Nagpur Division.
Nagpur ...
Bhandara ...
Wardha ...
Chanda ...
Balaghat ...
Total ...
Jubbulpore Division.
Jubbulpore ...
Saugor ...
Damoh ...
Seoni
...
Mandla ...
Total ...
Nerbudda Division.
Hoshangabad ...
Nimar
...
Narsinghpur ...
Betul ...
Chhindwara ...
Total ...
Chhattisgarh Division.
Raipur ...
Bilaspur ...
Drug ...
Total ...
Population
of
district
according
to
census of
1921.
3
792,521
717,747
463,696
660,630
511,634
3,146,228
745,685
528,380
287,126
348,871
386,446
2,296,508
445,733
396,554
315,162
363,737
491,835
2,013,021
1,406,676
1,231,765
743,246
3,381,687
Average
population
per
square
mile.
4
206.39
181.02
190.98
70.94
163.36
138.74
190.61
133.36
101.96
108.82
76.42
121.17
121.06
93.81
159.49
93.94
100.20
109.47
143.89
161.69
159.99
153.44
Average
number
of
vaccinators
employed
through-
out the
year.
5
19
13
12
13 8
65
18
13
7
8
16
62
10
9
8
8
10
45
26
24
16
66