NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( v )
8. There were seven vaccinators employed, but the operations were insigni-
ficant in number for so large a district. There was no mode of verifying the
accuracy of returns, beyond obtaining the signature of the Tahsildars of
talooks, unless the Civil Surgeon himself was able, now and then, to visit
some place where a vaccinator had recently been at work, and thus to test
personally the actual results with the returns. The Civil Surgeon had little
or no control over the vaccinators, all power being placed in the hands of the
Collector.
9. There appeared, moreover, to be difficulties to contend with, connected
with the feelings and prejudices of the inhabitants themselves. It was
represented by Dr. Williams, the predecessor of the present Civil Surgeon,
not only that the people generally were most unfavorably disposed towards
Vaccination, but that the Brahmins, as a body, fostered the most absurd
traditions in favour of small-pox, and threw every obstacle in their power in
the way of vaccinators. It was even said that many of the Native officials
might as reasonably be expected to forward the views of Missionaries, as to
assist a vaccinator.
10. Dr. Williams was requested by a Native official, holding a high posi-
tion, to treat his children for fever. A few questions elicited the fact that they
had been ill ten days. On asking why he had not applied earlier, he replied
that he had hoped they were going to have small-pox, and that his caste
custom would not permit of any medicine being given in that disease. On
Dr. Williams speaking to him about Vaccination, he replied that "his caste
liked to have small-pox." Yet this man was said to be an intelligent person
compared with many around him.
11. It was further reported that so prevalent and fatal was small-pox, that
hundreds of the population died of it every year.
12. In this state of matters I suggested to Government, in July, that exist-
ing arrangements should at once be put an end to, and that North Canara
should be brought under the Vaccination system of this Presidency, in the
same manner as all the other Collectorates. Government were pleased to
approve of this course. The district was accordingly added to the Southern
Circle, and placed under the management of its Superintendent.
13. As this arrangement only came into force towards the close of the year,
the returns from North Canara will not be included in this report.
14. Several changes took place during the year among the Superintend-
ents. Assistant Surgeon Dick succeeded Assistant Surgeon Rustomjee
Byramjee in the Northern Circle, in February; and Assistant Surgeon Beatty,
on his return from Europe in March, replaced Assistant Surgeon Plumptre in
the Central Circle. Assistant Surgeon Asher succeeded Assistant Surgeon
Peach in the Southern Circle; and Assistant Surgeon Butler, Dr. Lord, in the
Kattiawar Circle.
( vi )
15. I now proceed to state the general results of the year. The total
number of Vaccinations was 244,681, being 14,987 less than in 1861. This
cannot be regarded as otherwise than unsatisfactory. Some Superintendents
attribute the diminished numbers to the prejudices and indifference of the
natives,—to sickness and indolence on the part of some of the vaccinators,—
to want of support from native officials,—and to increasing difficulty in
obtaining the assistance of peons in the districts.
16. But with the exception of the last-mentioned cause,—to which I will
advert presently,—the state of matters described has always been in existence,
more or less, even when Vaccination was progressing favourably. It, therefore,
cannot be viewed as now specially explaining the falling off in numbers.
17. It would at present be premature to hazard an opinion, whether or not
the diminution is in any way connected with the reorganization of the
Department, which took place in 1861, consequent upon the Notification by
Government, dated 24th July of that year. The experience of another year
or two will be required, before we can be put in possession of sufficient data
for determining that question.
18. It should be borne in mind, however, that in accordance with that Noti-
fication, the amount of European agency was materially diminished. Two
Divisions of Vaccination were absorbed into others, and the services of two
Assistant Surgeons, who were the Superintendents, were placed at the disposal
of Army head quarters.
19. With the view of compensating for this loss, it was intended by Go-
vernment that each of the three most extensive Circles should be provided with
two native sub-assistant surgeons, as Deputy Superintendents. Their chief
duties were to assist the Superintendents in the inspection of the work of native
vaccinators,—to explain to the inhabitants of the districts, in which they
might be employed, the objects of Vaccination,—and to encourage its diffusion
by persuasion, and by all other legitimate means.
20. I mentioned in my last report, however, that with one exception, sub-
assistant surgeons had declined these appointments, even though carrying with
them an increased rate of pay. The main objections of some were based on the
necessity of constant travelling, and on the expense thereby involved, while to
others the duty was distasteful as withdrawing them from the practice of their
profession.
21. With the view of obviating the objection connected with expense,
Government were pleased, in May last, to sanction a travelling allowance for
each Deputy Superintendent. To provide for this increased expenditure, the
number of appointments was reduced from six to four.
22. But even with this additional inducement to enter the Department, it
remains distasteful and unpopular. Subsequent to the announcement of the
( vii )
grant of travelling allowance, and with the view of filling up vacancies amongst
the Deputy Superintendents, I took measures in August to ascertain how
many sub-assistant surgeons, then employed by Government in different parts
of the Mofussil and in Sind, would voluntarily enter the Department. The
result showed that ten out of twelve declined. The two, who volunteered,
were Sub-Assistant Surgeons Cooverjee Dorabjee and Wamon Wassoodeo.
The former was attached to the Southern, and the latter to the Central Circle.
23. In justice to my predecessor, Dr. Rooke, I think it should be placed
on record that the reduction in the number of European Superintendents was
not made by Government on his recommendation. On the contrary, Dr Rooke
maintained that to diminish the amount of European agency was to impair
the efficiency of the Department. At the date of my last report, I had too re-
cently assumed charge of my present office, to feel justified in expressing an
opinion on the point, but the knowledge acquired by a twelve-months' experi-
ence of the working of the Department, enables, nay even compels, me to ex-
press my concurrence in Dr. Rooke's view.
24. I fully admit that much may be advanced in support of the plan,
which was adopted, of introducing educated native agency. The intimate
intercourse with the people, of a native Government servant holding a certain
position, whose sole duty is to encourage the diffusion of Vaccination,—his
familiarity with their feelings, prejudices, and customs,—his thorough acquain-
tance with their language,—and the opportunity of having returns verified by
a perfectly trustworthy person, might well lead to the expectation that great
benefit would result from such agency, in smoothing difficulties and in over-
coming obstacles.
25. I sincerely trust that such expectation may yet be realised, but I
must confess, I much doubt whether these advantages can compensate for
the loss of European energy and activity, and for the further loss of those
beneficial results arising from the prestige, which in the Mofussil is always
attached to a European functionary.
26. Neither can I conceal from myself that the result, hitherto, has not
been encouraging. I have already mentioned that the Department is disliked;
and it cannot be denied, that in the Northern Circle,—the only one in which
the new system was in operation throughout the year,—there has been a
diminution, instead of an increase, in the number vaccinated.
27. The result in one Circle, however, and for so limited a period, is quite
inconclusive. The system is entitled to a fair and lengthened trial. It never-
theless behoves the Deputy Superintendents to exert themselves to the utmost,
if they desire to prove that their admission into the Department is calculated
to prove beneficial to it.
28. The diminution in the number of Vaccinations was not confined to
one or two Circles, but was general throughout all, with the sole exception
( viii )
of the Southern, in which,—owing mainly, I believe, to the untiring energy
and great personal activity of Dr. Asher,—there was an increase of more than
5,000. He travelled about 1,100 miles, visited nearly 200 towns and villages,
and personally inspected upwards of 3,500 children.
29. Dr. Martin, however, of the Sind Circle, did still more. He travelled
about 1,300 miles, visited nearly .500 towns and villages, and personally in-
spected upwards of 8,000 children. When Superintendents exert themselves
in this manner, there is seldom much want of activity or painstaking among
their subordinates.
30. In no other Circle was there a corresponding amount of exertion on
the part of the Superintendent. It is but fair, however, to Dr. Dick, of the
Northern Circle, to say that he only joined the Department in February,
and that he was detained at Surat for some weeks in October and November,
owing to the absence of the Civil Surgeon on sick certificate. I trust no
Superintendent will ever again be detained a single day from his districts, or
be put on any additional duty, except under very emergent circumstances.
To do so, is seriously to injure the Department.
31. I ought also to explain that Dr. Butler, of the Kattiawar Circle, only
joined the Department in April, and that owing to the transfer of his predeces-
sor to Mahableshwur, the active work of superintendence was suspended
during the previous months of the year.
32. It should further be mentioned that Dr. Beatty, of the Central Circle,
only returned from Europe and assumed charge late in March, and that for
some weeks towards the close of the year, he was incapacitated for work by
illness.
33. I do trust, however, and fully expect, that the " employment returns"
of the present year will show that each Superintendent has been exerting him-
self to the same extent as Dr. Asher, or Dr. Martin. Nor shall I feel satisfied
unless this proves to be the case. For the purpose of stimulating the vaccina-
tors to increased exertion,—of verifying their returns by carefully scrutinizing
the work they have performed,—and of explaining to communities the nature
and value of the prophylactic,—a Superintendent ought to be constantly on the
move during the working portion of the year.
34. But though, judged by the test of numbers, the results of the year
cannot be pronounced satisfactory, there are, nevertheless, one or two facts
which seem to prove that Vaccination is gradually making its way into the
favour of the people, and apparently obtaining even a hold upon their affections.
35. One of these is the increasing proportion of Vaccinations in the infantile
population,—a point both of interest and importance. The returns for 1857
showed that 70 per cent. of Vaccinations were in persons above one year of age,
and only 30 below it. Two years later, the returns from the Deccan Division
showed that only 10 per cent. were in children below that age. It was clearly
( ix )
evident that native parents at that time had a very strong aversion to Vaccina-
tion during infancy. The returns for the past year show, on the contrary,
that out of 244,681 Vaccinations, no less than 80,177 were in children
under one year of age. In other words, every third person was vaccinated,—
as all people ought to be,—during infancy.
36. The relative proportion varies very much in different localities. Thus
while the returns from the Deccan and Southern Mahratta country are con-
spicuous, above all others, for a large majority of operations in persons above
one year of age, those from the Collectorates in Gujerat show that out of 39,000
Vaccinations, 21,000 were in children below that age. In other words, 52 per
cent. of operations were performed during infancy.
37. Nor is this gratifying fact, of a growing increase of operations in the
infantile population, confined to the returns from the Superintendents. It is
still more markedly shown in those from the Civil Surgeons at Surat, Ahme-
dabad, and Shikarpoor. At the two last-mentioned stations, especially, a very
large majority of Vaccinations was in infants.
38. As remarked by Dr. Dick, this state of matters seems to prove that
prejudices are subsiding, and indifference diminishing. Constituted, indeed,
as human nature is, it could not be otherwise in the face of facts which occur
every now and then, and convincingly prove to the people the enormous value
of the prophylactic.
39. In one of Dr. Beatty's reports, for instance, it was stated that during
a severe outbreak of small-pox in the Rutnagherry Collectorate, in 1858, the
returns from the Unjunwel and Severndroog talookas were very striking, in
showing the difference in the ratio of mortality between the unvaccinated and the
vaccinated. In the former, 57 children, none of whom had been vaccinated,
were attacked with the disease, and 17 per cent. died. In the latter, there were
177 people who had previously been vaccinated, and not one death took place
among them.
40. Again, it was mentioned in one of Dr. Martin's reports, that in 1859
small-pox prevailed in a very severe form in a talook of the Jerruck districts.
The people were greatly alarmed. It was a happy circumstance in the interests
of Vaccination, that in two villages, where the disease was most fatal, there
were some children who had been previously vaccinated, and not one was.
attacked. Other children were seized in all the surrounding houses, but these
escaped. The effect was strikingly beneficial, for this practical proof of the
value of Vaccination at once removed prejudices, and all classes eagerly sought
its protective power.
41. At the same time it cannot be denied, that in many places, there lurks
a vague fear and distrust of its permanent efficacy. Time alone can, of
course, remove this feeling. It is also unhappily apparent, that the very class
whose influence, if exerted in behalf of Vaccination, would readily obtain for it
2c
( x )
universal acceptance, is, as a body, opposed to its introduction. I allude to
Brahmins. I have already given the testimony of the medical officer of
North Canara on this point, and it closely corresponds with evidence from
other quarters. Dr. Asher, for instance, states that" Brahmins are pre-eminent
in hardness of belief and in opposition."
42. This feeling of distrust occasionally deepens to positive aversion; and,
in one instance, it extended even to open opposition. Dr. Dick mentions that
in the southern districts of the Surat Collectorate, the prejudices are so strong
that recently some inhabitants of a village assembled in a riotous manner and
drove the vaccinator out of it. No similar occurence, however, has taken place
elsewhere; and Dr. Dick, while mentioning it, states at the same time that the
people generally seem to appreciate the benefits of Vaccination, and that he has
often heard them express their gratitude to Government for disseminating so
great a blessing.
43. With regard to sex—
132,245 were males, and
112,436 „ females.
This relative proportion is nearly similar in each Circle, and varies but little
from that of previous years. Dr. Wyllie, the Civil Surgeon of Ahmedabad, is
inclined to interpret the marked disproportion of the sexes, as expressive of a
higher solicitude, on the part of parents, for the safety of their male than of
their female children.
44. The castes were as follows :—
Hindoos . . . . . . . . . . .
Mussulmans . . . . . . . . . . .
Christians . . . . . . . . . . .
Parsees . . . . . . . . . . .
Other Castes . . . . . . . . . . .
177,423
56,707
1,416
669
8,466
It has often been a matter of surprise, that amongst such an intelligent
people as the Parsees, so very few appear to avail themselves of the advantages
of Vaccination.
45. Out of the total number vaccinated, 10 per cent. of the operations were
unsuccessful. Thus, out of 244,681 Vaccinations, 221,275 were reported as
successful. I say reported as successful, because facts come to light every now
and then, which throw a shade of suspicion over the perfect trustworthiness
of the returns received by Superintendents from their native vaccinators, and
I by no means wish to convey an impression that the Department is a model
of truthfulness.
46. That the returns are in the main correct, there is good reason to believe;
but, notwithstanding the most strenuous endeavours on the part of Superinten-
dents to verify their accuracy by personal inspection, and by other means, I
much fear there is occasional falsification. It should therefore be understood
( xi )
that the figures are to be regarded, not in the light of perfect accuracy, but
merely as an approximation to it.
47. To expect, indeed, perfect trustworthiness in men on the scanty salary
of native vaccinators,—men, moreover, who are stamped as unworthy of receiv-
ing pensions, when unfitted by age for further work,—would be to expect what
in the nature of things is an impossibility. If efforts are to be made to extend
the usefulness of the Department, commensurate with its great importance, it
is evident that the prospects of these men must be improved. The privilege
of admission to the benefit of the pension rules must be conceded, and an
inducement thus held out to a better class of men to enter the Department.
48. Government, however, have fully recognized this necessity, and have
been pleased already to bring the subject to the notice of the Supreme Govern-
ment. It is, therefore, unnecessary to add another word.
49. I have now to make a few brief remarks on such portions of the re-
ports by one or two of the Superintendents as seem to require special notice,
and I will first allude to the report from the Southern Circle.
50. I have already mentioned that the general results of the year in this
Circle were very satisfactory. I must explain, however, that this remark
applies mainly to the work done in the British territories, for with the
marked exception of the Sawunt Waree State, it was by no means the case in
the territories of the native Chiefs.
51. This want of progress is attributed by the Superintendent to the very
little interest evinced by the Chiefs in the subject. It is said they cannot
comprehend the advantages that would result from the general diffusion of
Vaccination. They, therefore, give little thought, and no care, to the matter,
and though profuse in promises, they take no steps to overcome difficulties
and remove impediments.
52. Dr. Asher suggests, as a means of changing this state of things for the
better, that the Jaghirdars should be urged by the political authorities to
evince more interest in the subject,—to exact greater diligence from their vaccin-
ators,—and to teach a wholesome lesson to their dependents, and to the
general community, by receiving Vaccination readily in their own families.
53. In the event of this course failing to gain the object in view, he thinks
it might hereafter become a question, whether the Jaghir vaccinators should
not be brought more under the direct control of the Superintendent, by Go-
vernment amalgamating the Jaghirdar establishment with its own, on receiv-
ing from the Chiefs contributions to a vaccinating fund, for the express purpose
of undertaking to spread Vaccination in their territories.
54. In throwing out this suggestion, which seems well worthy of considera-
tion, the Superintendent seems to think that as the Chiefs are totally indif-
ferent in the matter, and that as they pay a vaccinator, not from any inherent
wish for his services, but merely as a piece of policy, they would not object to
( xii )
such an arrangement, or oppose it on the ground of its being an infringement
on their prerogatives or dignity.
55. Greater progress appears to be making in the Rutnagherry Collectorate
and in the Sawunt Waree State, than elsewhere in the Circle. The Superinten-
dent attributes this, in the former case, to the circumstance, that the inhabitants
of the Concan are more intelligent and open to persuasion than their fellow-
countrymen above the ghats; and, in the latter, mainly to the fact of the
Political Agent having long taken a warm interest in the subject.
56. As a proof of the extent to which Vaccination has been carried in
Sawunt Waree,—and of the marked benefit which has been derived,—the
Superintendent mentions that out of a large number of children examined in
the schools, he found them almost universally protected by Vaccination.
57. On applying the same test to the schools in the Belgaum, Dharwar,
and Sattara Collectorates, he found, on the contrary, that for one boy protected
by Vaccination, half a dozen bore on their faces unmistakable evidence of
having suffered from small-pox, thus clearly proving that Vaccination was far
from being in so advanced a state.
58. I regret to record that Dr. Asher has recently left the Department. I
must beg to be allowed to offer him my best acknowledgments for the warm
interest he has taken in promoting its success, and at the same time, to express
the high opinion I entertain of the ability and judgment which have charac-
terized his proceedings.
59. Happily for the interests of the Department, he is succeeded by an officer
who is intimately acquainted with its duties and requirements. Assistant
Surgeon Plumptre served for some time as Superintendent under my direct
control, when I was Deputy Inspector General of Hospitals in the Poona
division of the Army.
60. In the Sind Circle, the Superintendent points out that two important
measures are urgently required to extend the benefits of Vaccination:—
1st,—an additional number of vaccinators to cover the immense area of
the Province; and,
2nd,—an arrangement to assist more effectually in sending vaccinated
children from place to place to keep up the supply of lymph.
61. Dr. Martin urges,—what is now generally admitted on all hands,—that
no extensive operations can be depended on, unless the lymph be transmitted
from arm to arm. He states that he has repeatedly tried both crusts and
glasses, and has found them unsatisfactory. He further points out,—what has
often been noticed by others,—that one great objection to the use of dry, instead
of fluid, matter, is that the resulting work is uncertain and inferior.
62. It is a remark frequently made by every Superintendent, that parents
object to having their children removed for vaccinating purposes from their