NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
6
CONCAN DIVISION.
Superintendent.—Assistant
Surgeon T. B. Beatty.
Establishment.—Eighteen
Vaccinators.
Years.
1858....
1859....
Total
Vaccinated.
45,983
39,669
Compared with the
preceding Year.
Increase.
12,227
....
Decrease.
....
6,314
Success-
fully
Vaccinated.
43,856
36,971
Percentage
of Success.
95.3
93.1
REPORT FOR 1858.
THE number of vaccinations performed during the past year, as will be seen by the above
Table contrasted with the previous one, shows a large excess in favour of the year 1858. This
increase of work may, I consider, be partly attributed to the stimulus which the newly-proposed
system of payment by percentage has created amongst the Vaccinators, and which has caused
them to work with increased energy and vigour.* Of the total number vaccinated, 43,856
are recorded as successful, or 95 per cent. on the whole. There were 935 failures, which is at
the rate of 2 per cent.; 1,192 cases were reported as doubtful. As regards the successful opera-
tions recorded, I have had no reason to doubt the truthfulness of the Vaccinators' Returns. I
have taken every opportunity and means of testing their correctness, and though I was eight
months out of the year constantly travelling through the districts, engaged in examining the
Vaccinators' work, in only one instance I met with an incorrect Return. The success of a
clever Vaccinator, working with good lymph, is remarkable. I have repeatedly witnessed
from one hundred and fifty to two hundred children vaccinated by one man in a day, and in
returning to examine the result, have rarely found more than three or four failures.
In the Tanna Zillah, a very marked increase of work is observed last year compared with the
preceding. During the past year, the total number vaccinated was 16,948 ; in the year pre-
ceding 10,412, showing an increase of 6,536. In the Rutnagherry Zillah, during the year
1857, the number of operations was 23,344 ; and during the past year 29,035, giving an
excess in the present over the preceding year of 5,691. The lymph throughout the Division
has been reported good, and from the specimens I have seen, I consider it could not be
surpassed in excellence.
About the commencement of last year, a severe outbreak of Small-pox occurred in the
Rutnagherry Collectorate. The epidemic appeared almost simultaneously throughout the
Zillah, and continued for nearly six months. Immediate steps were taken to arrest its progress
as soon as possible, and by permission of the Director-General, four Assistant Vaccinators
were entertained temporarily, as long as their services were deemed requisite. Considering it
of importance to ascertain the effect of this disease on the population, I forwarded Returns to
the Acting Collector, requesting he would cause them to be filled in by the Mamlutdars
giving the information required. These Returns were made out, so as to show the number of
cases of Small-pox which had occurred in each Talooka during the period the disease lasted ;
* This subject is noticed in another place.
11
some of the northern districts—it is still practiced, its adoption is rapidly disappearing. So
little of inoculation is now being carried on in the Concan, that I do not regard it in the
light of an impediment to vaccination. For this great improvement in the Tanna Col¬
lectorate—viz. the eradication of inoculation,—I am entirely indebted to the assistance of the
present Collector—Mr. Morgan.
Beyond desiring that the Vaccinators be placed on a better footing as regards pensions to
the superannuated, and that some arrangement, better than at present exists, for the instruc-
tion of Probationers be made, I have no suggestions to offer regarding the more effectual
spread of vaccination.
I may allude to one improvement which has been introduced within the last year, as regards
the number of times each Vaccinator operates during the month. Formerly, in this Division,
fresh lymph was only obtained but once in every eight days from each man, and consequently
if, by any misfortune, the vaccine became lost in a distant part of the country, often a month
expired before it could be renewed, and the man's work re-established ; for in this Division
lymph is invariably taken direct from the child's arm, it being found not only a cheaper plan,
but infinitely more certain to convey fresh matter direct, than trust to the uncertainty of
vesicles being produced from the use of dry matter on glass. Every Vaccinator now operates
twice during the eight days, and in a different part of the Talooka where he is engaged.
Three days are allowed to elapse between each day of operation ; and a weekly Report is sent
to my office, stating the exact day and village where fresh vaccine may be found. This plan
I have found to answer admirably, and it seldom happens now that any Vaccinators' lymph
is lost for more than a few days. Twice in the week is as often as any man can collect
subjects for vaccination, and afterwards watch and note down the result of each operation
carefully.
In the beginning of September, I proceeded into the districts and commenced my tour of
inspection in Rutnagherry Zillah ; subsequently I proceeded to Tanna Collectorate, where
the work of three men was examined, and found to be excellent and correct. In the
beginning of December, I was obliged, owing to the illness of the then Civil Surgeon at
Tanna, to hasten into camp and assume medical charge of the duties of that station, and from
which I was not relieved until the very end of December.
15
page 45. I presume all Superintendents entertain similar opinions on this subject, and are
equally desirous to see a more liberal scale of salary introduced, with some arrangement
respecting pension after old age incapacitates for further service. This last point cannot, I
think, be too strongly insisted on. The introduction of a Senior Vaccinator into each Zillah,
charged with the duty of inspecting Returns, and reporting on supposed obstacles to
vaccination, as frequently urged by Vaccinators, would, I think, further the cause of
vaccination. I have found that Vaccinators too frequently succumb to these difficul-
ties—a fault inherent in the native character,—and the extent of the Division renders
immediate personal supervision, on the part of the Superintendent, impracticable in each
instance. The native district authorities engaged in their own duties, and generally taking but
little interest in vaccination, too frequently assent to whatever the Vaccinator alleges in
extenuation of his own negligence. By means of an intelligent and responsible Native
Inspector in each Zillah, larger and more reliable Returns would be obtained, and vaccine
registration, which at present only partially exists, might be effectually introduced. The
position of the Superintendent, I also respectfully submit, calls for some improvement in
furtherance of the cause of vaccination.
Vaccination was inspected during the year in nineteen Talookas of the Poona and
Ahmednuggur Collectorates. The Superintendent's attention has been especially directed to
the quality of the lymph and to the necessity of vaccine registration, without which it is
impossible to verify the Vaccinators' Returns.
16
SOUTHERN DECCAN DIVISION.
Superintendent.—Assistant
Surgeon J. Mills.
Establishment.—Eighteen
Vaccinators.
Years.
1858 . . . .
1859. . . .
Total
Vaccinated.
15,285
13,318
Compared with the
preceding Year.
Increase.
....
....
Decrease.
247
1,967
Success-
fully
Vaccinated.
14,313
12,278
Percentage
of Success.
93.6
92.1
REPORT FOR 1858.
THE total number vaccinated in 1858 was 15,285, against 15,532 in 1857, showing a decrease
of 247. This is accounted for by the fact that two Vaccinators, who were in regular work,
were dismissed in August last and were replaced by new men, while four Vaccinators during
the year were received into the Civil hospitals of their respective Collectorates. But
though the actual decrease is thus accounted for, the result shown is far from satisfactory, and
the amount of work done by each Vaccinator, as compared with that in other Divisions, would
seem to indicate either great want of zeal in the Establishment, want of active assistance from
the local authorities, or much disinclination on the part of the people to receive vaccination ;
and I think that all these causes had their share in retarding progress in this Division. In the
proportion of males and females, there is very little difference from 1857, being males 52.4,
and females 47.6 per cent. against 52.1 and 47.9 in 1857. In the numbers "under one year"
of age, there is not any improvement, the proportion being only 24 per cent. against 26.4 in
1857. The Returns of different Vaccinators show such very marked contrasts in this particular,
that I cannot but think that more depends upon individual operators, than on the fears or
prejudices of the people. Some indeed would appear to believe that they are doing wrong in
vaccinating very young children, notwithstanding all that is urged upon them on the subject.
The proportion of successful operations is not so large as in 1857, being 93.6 per cent. against
95.3. This difference I attribute rather to Vaccinators making more correct returns of all
operations,'than to any want of efficiency in the lymph, though it is evident that some Vaccina-
tors make a practice of returning none but successful operations. The percentage of success
from January to June exceeded by 1.6 that from July to December. The condition of the
lymph and vesicles has been good throughout the year. Small-pox was prevalent throughout
the whole Division to an unusual degree, especially during the months of March, April, May,
and June—hardly a Talooka escaped untouched. The total number of cases reported in the
four Collectorates during the year amounted to 5,925, and the deaths to 1,241, or nearly 21
per cent. These numbers are taken from the quarterly Returns forwarded by the Collectors,
which are often not received until after the epidemic has passed away. Whenever reports
have been received of the disease existing at the time in any district, assistance has imme-
diately been sent, if it could be spared; but at the time the epidemic was at its height—viz. in
March, April, and May,—it was so widely spread that it was impossible to withdraw Vaccinators
from one point to send them to another.
20
EASTERN DIVISION, GUZERAT.
Superintendent.—Assistant
Surgeon C. J. Ross.
Establishment.—Seventeen
Vaccinators.
Years.
1858....
1859....
Total
Vaccinated.
20,503
21,871
Compared with the
preceding Year.
Increase,
....
1,368
Decrease.
5,060
....
Success-
fully
Vaccinated.
17,920
18,894
Percentage
of Success.
87.4
86.3
REPORT FOR 1858.
IN 1857, 25,563 were vaccinated, and in 1858 only 20,503. The difference in the results of
the past and previous year is therefore startling and disheartening, and is due, in no small
measure, as was stated in last year's Report, to the suspension of the visitation of the Super-
intendent. The Vaccinators, however zealous they may have been originally, are apt to lapse
into habits of appalling idleness and unconcern, if they are not visited in their districts, and
have their work inspected from time to time. The Division has now been so long unvisited,
that the Vaccinators, in the continued absence of the Superintendent, have ceased, in a great
measure, to take the interest they once did in their work. They need every encouragement,
and the expected or unexpected appearance of the Superintendent acted as a stimulus to
greater exertions on their part, which has now been in abeyance for three years. The
idleness of Vaccinators in the year under review has been unchecked by threats of dismissal
and fines, and has effected the unsatisfactory results of the year more than sickness or any
other cause, not even excepting the indifference and prejudices of the natives themselves.
"With reference to the work itself, the numbers vaccinated amounted to 20,503. Of these, 11,826
were males, and 8,677 females. There were under one year 6,308, and 14,195 were above
one year. Of the total number vaccinated, 17,920 were successful.
The lymph has generally been reported good and effective. Small-pox seems peculiar to
many of the districts at certain seasons, and has been more prevalent and fatal this year than
last. Cases of inoculation have not been brought to notice. As stated in a former Report, the
main obstacle to the spread of vaccination lies in the ignorance and prejudices of the people.
These doubtless will disappear in time, but combined now with the apathy of native officials
and the increasing idleness of Vaccinators in the prolonged absence of the Superintendent
from their field of labour, they have told most unfavourably, I regret to say, on the results of
the year.
With reference to the monthly tours on which so much depends, I have only been able to
visit Keem Chokee, Jehungirepore, and Koorsud, in the Surat, and Unclesur, Heenglot,
Unclesur, Surnar, Kerwara, Dhaba, and Jambooseer, in the Broach Zillahs. It will thus be
seen that I have just begun to break ground in the most important part of the Superintendent's
duty, and from what has already been said on the subject, I anticipate for next year greater
results than have hitherto occurred since my appointment to the Eastern Division, Guzerat.
21
REPORT FOR 1859.
IN 1858 there were 20,503 operations, and in the year under review there were 21,871, or
an increase this year over last of 1,368. A greater increase than is now shown would have
appeared, if the Establishment had not been short-handed. The difference in the comparative
numbers vaccinated by each Vaccinator is more striking than I expected. I looked for greater
equality, in consequence of the promise which I made that I would give the sum of Rs. 50
to him who vaccinated the greatest number above two thousand. I am disappointed to
say that one man, and one man only, accomplished the number in question, and that he
merely exceeded the requirement by sixty-four. The stimulus of a pecuniary reward has most
signally failed in improving the returns from this Division. I am, however, inclined to
believe that a permanent impulse might be given to the work, if Government were to promise
a retiring pension to Vaccinators whose average number of operations amounted, after a given
number of years service, to a certain sum. Of the total number vaccinated, 12,347 were males,
and 9,524 females. The age of the majority vaccinated was above one year. There seems
an unwillingness, perhaps prejudice, on the part of parents to have their children vaccinated
at an earlier period. The successful cases numbered 18,894.
During the year the lymph has proved, and still continues good. But few cases of Small-
pox have occurred ; those mentioned in the Returns of March and April, took place in
Kupperwunj in the Kaira, and Ahmode in the Broach Collectorates. Reports that inoculation
is practised in the Division, seldom or never reach me, and I would fain hope that vaccination
is slowly, yet surely, making progress.
During the year, I visited all the Vaccinators in the Division, with the exception of those in
the Rajpeepla and Rewa Canta States. I had every reason to be satisfied touching the
practical knowledge each possesses of his work. There is, however, an amount of idleness
which has still to be got rid of. As to the best means of diffusing the benefits of vaccination,
I have, in conversation with the more intelligent natives, been astonished to find that some of
them made use of an argument, identical with that mentioned in Southey's Common-place
Book, page 394, which was adopted with good effect by the Bavarian Government, and is as
follows:—" The Bavarian Government commands all parents to vaccinate their children before
they are three years of age, unless they prefer to pay a fine which increases annually with the
age of the child." In 1811, the edict was removed. It had almost banished the Small-pox
which used to be very destructive. Some such measure, if adopted in India, would be certain
to fulfil the wishes of Government, so far as vaccination is concerned.
26
SIND DIVISION.
Superintendent.—Assistant
Surgeon T. E. P. Martin.
Establishment.—Fifteen
Vaccinators.
Years.
1858....
1859....
Total
Vaccinated.
47,130
49,525
Compared with the
preceding Year.
Increase.
6,353
2,395
Decrease.
....
....
Success-
fully
Vaccinated.
45,155
48,843
Percentage
of Success.
95.8
98.6
REPORT FOR 1858.
THE total number vaccinated during the year 1858 is 47,130, which, compared with 40,777—
the result of the previous year 1857—gives an excess of 6,353 in the past over the previous
year. The marginal table represents the progress of vaccination in Sind during the last six
years—from 1853 to 1858 inclusive; and it will be
seen that, during the last two years especially, a
very considerable extension of vaccination has been
effected amongst the population of this province,
the excess of the average of the last two over that
of the previous four years being 27,345. Large as
the result of the two last years may appear when compared with that of the preceding years, it
is considered that it in no respect represents the amount of vaccination that might be effected
in the province with a larger organisation of means to carry it out. There still remain large
areas where vaccination has yet to be introduced.
The comparative work of Vaccinators exhibits considerable difference in the success of indivi-
duals. There are a few Vaccinators who have attained an excellent knowledge of their work—
not of the manual operation merely, though in that there is marked difference where large
numbers have to be vaccinated, but in the equally important art of enlisting the aid of
Mookies, Zemindars, and subordinate executive officers where they have to carry out work.
These men always have good returns ; rarely make complaints of want of help; and if
difficulties present themselves, try to overcome them, and generally with a considerable
amount of success. There are other Vaccinators who cannot be reported of so favourably ;
their work is always moderate ; they have little energy or tact; constantly complain of want
of help ; and, in fact, have only genius enough for the mechanical operation, which, however,
they perform carefully and well. The difference of qualification thus described is well marked
in this Establishment, and will serve to explain the disparity of work of individuals. It is
right, moreover, to remark that two or three other Vaccinators, whose returns are the least
favourable, have suffered a good deal from fever. One Vaccinator has been discharged solely
on the ground of ill-health—a very serious disqualification when the really hard work
Vaccinators have to perform in this province is considered. The Vaccinator appointed to
succeed him has recently died, after a very short incumbency, much to my regret, for he
gave promise of very superior qualifications for the work he had to do.
Years.
1853 ..
1854.. 1855..
Total number
Vaccinated.
6,617 23,457
20,807
Years.
1856 ..
1857 ..
1858 ..
Total number
Vaccinated.
15,551
40,777
47,130
29
severe, a few children had been vaccinated sometime previously in another part of the province,
their parents having recently come to reside in these villages. The cicatrices in their arms
left no doubt of the fact of their having been properly protected; and all these children, with-
out a single exception, escaped the disease. Children and adults all around the houses occu-
pied by these cases of protection were seized with Small-pox, one after another; but they escaped
scatheless. This kind of trial continued for three or four months; and as a practical instance
of the good resulting from vaccination, nothing could have been more opportune, no other
circumstance could have so favourably influenced people of all kinds—those having active pre-
judices, and those merely indifferent. All classes of people within the influence of the disease
were glad to accept vaccination, and ready to praise the benevolence of the Government which
had provided it for them. The impression of its advantages took so decided and practical a
shape, that the principal Zemindars of the Talooka offered voluntarily to maintain a Vaccina¬
tor, who might also administer medicine for fever and for the common ailments to which
they are subject. It has been an object of the greatest interest with me, and continues to be
so, that, if possible, some means, additional to the Government Establishment, should be
entertained to vaccinate, and to distribute quinine and some of the simpler medicines to the
people. My mind has been fixed on this consideration, from the fact that there is an
immense amount of disease, principally fever, which remains untreated in the province.
The natives have no remedy for fever. Their applications are not only generally senseless,
but occasionally barbarous.
Reviewing the work of the year, it may be said that there is a great deal of good feeling, on
the part of the people, in favour of vaccination. If there has been any difficulty, it has usually,
on inquiry, proved to be from some cause either temporary or capable of removal. The
Mahomedan Mofussil population, as a rule, receive vaccination readily. The number is
increasing of those who bring their children from a distance to be vaccinated, rather than
forego the benefits of the operation. The Hindoos, as a people, can hardly be reported on so
favourably. In the agricultural villages, where there are very few of them, they bring their
children with great readiness, sympathising apparently with the genuine willingness of their
Mahomedan neighbours. In large towns, prejudices are stronger, and often not to be over-
come on the voluntary principle, which is the rule of action throughout the province. I have
the greatest pleasure, in conclusion, to attribute much of the success of vaccination in Sind, to
the very kind and liberal assistance I have at all times received at the hands of the Civil
authorities of the province.