NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
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own villages. Dr. Martin states, however, that in Sind it is a mere money
difficulty, and that parents would not object, provided they were paid for it.
63. He then points out that the sum sanctioned for this purpose,—ten
rupees a year for each vaccinator,—is wholly inadequate ; and he recommends,
for sanction, a remedy which was suggested to him by a Deputy Collector who
takes an active interest in the subject. I beg to quote Dr. Martin's words :—
" It appears that Deputy Collectors have the control of a certain sum
of money to be disbursed discretionally for the benefit of the District. It
was suggested that the vaccinator might make out a bill,—signed by the
parents or guardian of the child and the head man of the village,—
showing that a certain sum had been received from him. This sum would be
paid by the Deputy Collector out of funds at his disposal. Could such a plan
be generally adopted, the cause of Vaccination would be strengthened, and no
possible hardship could accrue to the guardians of the children required for
Vaccination purposes."
64. I beg to recommend both these measures for the favourable considera-
tion of the Commissioner in Sind, and of Government.
65. I regret having to record that Dr. Martin, after six years of successful
labour in Sind, has recently vacated his post. No Superintendent ever effect-
ed a larger amount of good. His loss to the province will be great. During
these six years, the annual average number of Vaccinations was 48,000. This
statement affords strong evidence of untiring energy and of marked success, more
especially on bearing in mind that in 1856,—the year previous to Dr. Martin's
assuming charge,—the number was only 15,000. By the excellence of
his arrangements,—his energy of character,—his tact and judgment in inter-
course with the people,—and his painstaking devotion to his work, he has
brought Vaccination to a high point of success. I beg to offer him my best
acknowledgments, and to commend him to the favour of Government.
66. It is to be hoped that his successor, Assistant Surgeon Pinkerton, will
follow in Dr. Martin's steps with equal earnestness, activity, and zeal.
67. Before leaving the subject of Vaccination in Sind, it should be men-
tioned that, in consequence of the great practical interest which is taken in
it by Dr. Ritchie, the Deputy Inspector General of Hospitals, the dispensaries
throughout the province are becoming of great value in furthering its dissemi-
nation.
68. In a previous part of this report, I mentioned that some of the Super-
intendents attributed the diminished amount of work to the increasing
difficulty which is experienced in obtaining for vaccinators the assistance of
peons in the districts, and I stated my intention of adverting to the subject.
This I now propose to do, for I consider it one of very great importance to
the efficiency of the Department.
( xiv )
69. For the purpose of enabling the question to be fully and fairly viewed,
I must premise that by Clause 19 of the Vaccination Rules, sanctioned by
Government, the Civil authorities in the districts are authorized to afford the
occasional aid of peons, and I have reason to believe that until recently
such aid was freely given.
70. Complaints, however, have reached me from the Superintendents, and
more especially from those of the Northern and Central Circles, that the
assistance of peons has been to a considerable extent withheld. The reason
assigned for this is the recent reduction in the revenue establishment,—the
diminished number of peons being merely sufficient for the discharge of the
revenue duties for which they are entertained. If so, it would no doubt be
unreasonable to expect that the revenue establishment, which has been fixed
in accordance with the requirements of revenue duty, should be employed in
another department.
71. As an illustration of these complaints, I may mention that Dr.
Beatty reported, some time ago, that until recently, each vaccinator in the
Ahmednuggur Collectorate had been allowed the aid of a peon to assist
in collecting children for Vaccination, and subsequently for inspection; but
that in consequence of the reduction in the establishment, such aid had been
withheld, and that it had become, in consequence, almost impossible to carry
on work.
72. This withdrawal of peons by the Collector was no doubt forced upon
him by the circumstances just mentioned. I trust, therefore, I may not
be understood as making any reflection upon him. On the contrary, my best
acknowledgments are justly due to the Collector for his obliging readiness on
all occasions to aid the Department, for I have reason to know that he has
always given instructions to district officers to afford every assistance in their
power, short of attaching peons to vaccinators.
73. It is, I am aware asserted by many district officers, that whenever a peon
is withdrawn from a vaccinator, he invariably reports difficulties in order to
get the peon returned. I have no doubt there may be some truth in this. I,
therefore, urged Dr. Beatty to inculcate upon his establishment the necessity
of exerting greater self-reliance and energy, and of depending less on native
officials. I, at the same time, begged him to warn each vaccinator, that he
would not be considered fit for his post, unless he proved himself able to meet
and overcome difficulties by personal influence and persuasion.
74. I mention this for the purpose of showing that I have by no means lent
too ready an ear to complaints of this nature. I am perfectly convinced,
however, that peons are essentially necessary,—that the subject stands at present
on a most unsatisfactory footing,—and that the interests of the Department
require that the requisite aid should be afforded. My conviction of this
necessity is the stronger from having been assured, especially by Dr. Dick,
( xv )
that the complaints of vaccinators come chiefly from the best men in the
Department, and not from the worst.
75. That the reasons for this necessity may be clearly understood, I beg to
explain,—on the united testimony of all Superintendents,—that it seems to
be almost impossible for a vaccinator, on arriving at a town or village, to collect
children for Vaccination, and subsequently for inspection, if unaided. They
represent that a peon is indispensably necessary for this purpose. Sent on a
day in advance, and in communication with the native officials, he warns
the people to have their children collected at a certain place, and at an ap-
pointed hour. Without such aid, this cannot be done, at all events efficiently,
and much time is lost.
76. Nor is this their only value. The presence of a peon is an unmis-
takable sign to the eye of a native, that Vaccination has the approval and
sanction of Government. Thus a certain amount of moral support is afforded,
which is of essential importance to its further extension. I am, moreover,
assured, that the presence of a peon imparts confidence to the people, rather
than anything approaching intimidation.
77. Under all these circumstances, I beg most strongly to recommend that
Government will sanction the entertainment of one peon for every vaccinator,
employed by each Superintendent in British territory. The total number re-
quired would be 125, that being the number of vaccinators. They should be
attached permanently to the Department, and the expense charged against
Vaccination. I should anticipate, as the result, a great development and
extension of the system. Failing in obtaining such result, the peons might be
removed. Looking upon small-pox as being, under certain conditions, a pre-
ventible disease, I would urge the importance of making increased efforts to
render the protective system of Vaccination more efficient and complete.
78. The loss of life throughout India from the ravages of this dire disease
cannot, in the absence of accurate registration, be computed. That it annually
extends, however, to untold thousands, there cannot be a doubt. Putting aside
all the higher considerations involved in a question of such deep interest, and
viewing it solely on the low grounds of expediency, it is manifest that the
beneficial results arising from the mere saving of life would repay a hundred-
fold, hereafter, the outlay of the present moment; for the increasing demand on
all sides for labourers shows the increasing value of human life and labour.
79. The time is no doubt very far distant,—owing to political and many
other considerations,—at which, circumstances will admit of making Vaccination
compulsory. Neither, I fear, is the day near at hand, in which its value will be
so fully appreciated by the mass of the people, as to enable native practitioners
to obtain a livelihood by engaging in its practice, or even to induce native
municipal authorities to bear the expense of diffusing it. Still, these two latter
objects ought to be kept constantly in view, for Vaccination will only be ad-
( xvi )
vanced to a sound and healthy condition, when it will be able to dispense with
pecuniary assistance from the State.
80. Yet. as the objects of municipal taxation embrace, or ought to embrace,
all questions connected with the preservation of the public health,—of which
Vaccination is an important branch,—I do not quite understand why a portion
of such funds should not be devoted to its dissemination.
81. I trust it will not be regarded as utopian, if I venture to express my
expectation that the day is approaching, in which educated " Young India"
will fully recognize the vast value of Vaccination, and will earnestly strive to
diffuse its blessings among their fellow-countrymen, by making known their
belief in every quarter of the land. They would, by such a course, not only
give a great practical proof of the good effects resulting from education, but
they would very materially assist in securing the two objects, which I have
just said should be kept constantly in view.
82. There was but very little small-pox during the year in Bombay, or in
the province of Kattiawar. It appeared however to some extent in other dis-
tricts. During the earlier months it prevailed in an epidemic form in some parts
of Sind, and in nearly all the Collectorates of the Southern Circle, more espe-
cially in Belgaum and Dharwar. Again, during the hot season it prevailed
in parts of the Northern and Central Circles, especially in some of the Broach
districts, and in Cambay, Dhundooka, and Angria's Colaba, but not to a great
extent, nor in a severe form.
83. Wherever it made its appearance, active measures were immediately
adopted by the Superintendents and their establishments, to arrest its progress.
It is usually observed that, under such circumstances, prejudices are lost sight
of for a time. The people are roused for a moment to a sense of danger, and
cordially welcome Vaccination. The Deputy Inspector General of Hospitals
in the Southern Mahratta country mentions, for instance, that some months
ago a village in the Rutnagherry Collectorate, which had refused Vaccination,
was severely afflicted with small-pox, and that the inhabitants then eagerly
sought protection.
84. Testimony to the same effect is afforded by nearly all the Superinten-
dents, as well as by Civil Surgeons. There are exceptions however. Dr. Beatty,
for instance, states as the result of his experience, that during the prevalence
of small-pox as an epidemic, natives are most averse to Vaccination; that they
look upon the disease as an infliction sent by their gods, and show very great
reluctance to any interference with the dispensation.
85. The practice of inoculation is gradually disappearing from nearly every
part of this Presidency, excepting Sind. In Bombay itself, it has long been
unknown. In the Southern Circle not a case came to light during the year.
In the Central Circle one occurred in the Tanna Zilla. The operator was tried
before the Deputy Collector under the new Penal Code, which provides against
( xvii )
the continuance of the practice. The man pleaded ignorance, and was dis-
missed with a warning. An instance also occurred in the Northern Circle at
Bulsar. The Police interfered, and the circumstance was reported to the
Magistrate by the Superintendent.
86. In Sind, however, inoculation appears to be still carried on to a consi-
derable extent, and the Superintendent attributes to this mischievous practice,
the prevalence of small-pox in various localities. He fears there is no hope of
putting it down, except through the intervention of the Magistrate.
87. The character of the vaccine lymph has been well reported on by all
the Superintendents and Civil Surgeons, except at the Presidency itself,
where there was considerable deterioration during the monsoon, attributable
apparently to the hot and moist condition of the atmosphere.
88. It deteriorated, indeed, for a time, to so great an extent, that the Super-
intendent experienced some difficulty in keeping up a supply. Government are
aware that, for the purpose of guarding against the inconvenience resulting
from too limited a supply of lymph, Dr. Peet proposed, in his very able and
valuable report on Vaccination for the three years ending with December 1861,
to enter into an arrangement with at least two vaccine depôts in Great Britain,
with the view of ensuring the receipt of periodical supplies.
89. Consequent upon carrying out this arrangement, which was sanctioned
by Government, supplies were received during the year from the National Vac-
cine Establishment in London, and from the Royal Dispensary, Edinburgh.
The requirements at home, however, were so great, that the supply from the
former was very limited, while from the latter it has altogether ceased,—at all
events for a time,—Dr. Husband, the Superintendent, having informed Dr. Peet,
that the demand in Scotland exceeded his capability of meeting it.
90. These supplies, though undoubtedly of great use, have not quite
answered Dr. Peet's expectations. The most successful, and therefore the most
valuable portion thus received, consisted of lymph in hermetically-sealed capil-
lary glass tubes. Some of these were distributed in the Mofussil, but the result
was not very encouraging. In Sind, on the contrary, it succeeded so well, that
the Superintendent expressed a desire to be periodically supplied with tubes.
For the reason stated in the preceding paragraph, however, it will be impossible,
at all events at present, to comply with his request.
91. That lymph, obtained from Europe, sometimes succeeds, but more
frequently fails, is a fact quite in accordance with the result of general ex-
perience on this point in other parts of India. For instance, in an interesting
and able report on Vaccination, recently published, Dr. Pearson of the Bengal
Service states, " that to rely on England we should be doomed to perpetual
vexation and disappointment, for not one batch in ten arrives effective, and
uninjured by the heat of the passage."
3c
( xviii )
92. As an illustration, however, of the good effects which are occasionally
derived from even a single drop of European lymph, I may mention what re-
cently happened in the hands of Dr. Mills, at present Civil Surgeon at Kola-
poor, but who, at the commencement of the year under review, was Civil Sur-
geon at Dharwar.
93. In January 1862 the Rev. Mr. Huber, of the German Mission, gave
Dr. Mills, then at Dharwar, a single capillary glass tube, containing lymph
fresh from Europe. Three or four children were immediately vaccinated,
and Dr. Mills reports that every puncture took effect, forming large, healthy,
well-shaped vesicles, far superior to those produced by the virus at that time
in use. The result was so satisfactory, that Dr. Mills subsequently replaced
all the old lymph used at that station from the new supply.
94. But this was not the sole benefit. Shortly afterwards Dr. Mills became
Civil Surgeon at Kolapoor, and introduced the new Dharwar lymph so effect-
ually at that station, that the proportion of successful cases, under his personal
observation, rose from 93 per cent. in 1861 to 95 in 1862.
95. It affords me great gratification to report that the Superintendents,
generally, but especially those of the Sind and Southern Circles, cordially
acknowledge the ready and obliging assistance afforded by the European
Civil authorities on all occasions, when their aid and support were required in
furtherance of efforts to extend the usefulness of the Department.
96. I regret, however, to state, that many complaints have reached me of
indifference, and even of passive opposition, on the part of native officials.
This is greatly to be deplored. I would therefore venture to appeal to all Euro-
pean Civil functionaries in the Mofussil, to endeavour to induce their native
subordinates to give the same countenance and support, which they themselves
are so ready at all times to afford. The influence thus brought to bear would
be of incalculable importance.
97. In the absence of statistics of population, no opinion can be formed as
to the proportion which the total number of persons, who have been vaccinated
in this Presidency since the Department was formed, bears to the millions of
Western India.
98. It is, however, a subject of congratulation that more attention is now
being paid to such matters. The bill for taking a census of the Bombay
Presidency, recently introduced into the Legislative Council, will, on becoming
law, and on being carried into effect, materially assist in solving many
problems of deep interest, connected with questions appertaining to the public
health. Should its provisions be extended to the Mofussul, we may be able,
hereafter, to form some well-grounded opinion as to the proportionate extent
to which Vaccination has been carried.
99. Again, in the absence of an accurate registration of births throughout
the Mofussil, it is impossible to state whether Vaccination is keeping pace with
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the requirements of the population. I much fear it is not. Indeed it would
be unreasonable to expect that it is.
100. It was mentioned by Dr. Peet, in the report to which I have already
alluded, that previous to the passing of the Act, which rendered Vaccination
compulsory in England, the percentage of vaccinations to births, in the paro-
chial districts, was only 33. He at the same time showed that the correspond-
ing percentage in Bombay was upwards of 50. In other words, that out of
7,919 children born during 1861, 4,080 were vaccinated under one year of
age.
101. This will, I think, be admitted as very satisfactory as far as Bombay
is concerned. But in the absence of Mofussil registration, the same test
cannot be applied. I trust, however, the day is not very distant, in which the
importance of population statistics,—as bearing, among other matters, on
many vital questions connected with sanitary science,—will be so fully recog-
nized as to induce Government to appoint a Registrar General, who, in commu-
nication with the Civil, Political, and Police authorities of Western India,
would, in course of time, do for this Presidency what the official, bearing that
designation, has so long been doing for England.
102. Whatever may be the defects of the Vaccination system of this Pre-
sidency, I think it must be gratifying to the officers who are so earnestly en-
gaged in working it,—as well as to the Government which has for so many years
been labouring to promote its extension and development,—to find that it is
being planted in other parts of India. It appears from a recently published
number of " Selections from the records of the Government of the North
Western Provinces" (part 38), that after a satisfactory trial of what is therein
called the " Bombay System" in Rohilcund and Agra, the Lieutenant Go-
vernor has submitted to the Government of India, a proposal to extend the
system to the whole of the North Western Provinces, by dividing them into
four divisions of Vaccination, and by placing each under the superinten-
dence of a Medical Officer.
103. I am the more desirous of alluding to this subject, because there is
one feature in the proposed plan which might, I think, at a fitting time, be
introduced with great advantage into this Presidency. It is this. While each
of the four divisions is to be placed under a Superintendent, it is proposed
that one of these,—specially selected as possessing the highest qualifications
for the task,—should exercise supervision over the whole Department, so as
to ensure uniformity and completeness in the working of the system.
104. But this would by no means be the sole advantage. The additional
salary proposed (Rs. 400 a month) would offer an inducement to men of energy
and intelligence to remain in a Department, which, under existing circumstances
they are but too ready to leave, at a time when their matured experience
would prove of great value in promoting its interests.
( xx )
105. As an illustration of the truth of this remark, I would refer to the
case of Dr. Martin, who, after six years of energetic labour and unequalled
success in Sind, has just left the Department at a moment when he had suc-
ceeded in securing the confidence of the people.
106. I might also allude again to Dr. Asher, an officer of great energy
and ability, who during the past year effected much good in the Southern
Circle, and who likewise has just vacated his post of Superintendent.
107. His Excellency the Governor in Council, it is true, has been pleased
to recognise the services of both these officers by transferring them, at their
own request, to the Civil Surgeoncies of Ahmednuggur and Tanna; but I
regret, for the sake of the Department, that it held out no inducement to such
men to remain,—more especially to Dr. Martin, whose loss, I fear, may long be
felt, and whose qualifications would peculiarly have fitted him for the post of
Superintendent General.
108. Though not bearing directly on the question of Vaccination, yet in a
report having sole reference to a subject connected with the preservation of the
public health, it will perhaps not be deemed out of place to submit, for the
consideration of Government, the following statement, by the Superintendent
of the Southern Circle, of the deplorable sanitary condition of many of the
villages within his range.
109. It will perhaps be readily admitted, that no European official has
more frequent or better opportunities of closely observing the sanitary state of
dwellings, and the physical condition of their inmates, than a Superintendent
of Vaccination. Having travelled upwards of a thousand miles during the
year in different parts within his range, and having inspected the work of vac¬
cinators in a very large number of towns and villages, Dr. Asher thus describes
the deplorable condition of too many of the latter:—
"Within the walls of houses, cleanliness is to a certain extent preserved,
more so than in the persons of the occupants. But sweepings and offal are in
many villages deposited within a few yards of the doors, and no thought is
given, except at long intervals when wanted for manure, to the removal of
such accumulations of putrid animal and vegetable matter. In the verandas
of dwellings, shelter in the rainy season is given to cattle, where, too, a sick
and dying animal, wallowing in a mass of filth, is no uncommon sight, and
the carcass is frequently not removed for days, but lies at the very portals of
dwelling houses, rendering the neighbourhood most obnoxious."
" The wonder is, not that there is a mass of human suffering where animals
are crowded and die, and their carcasses are left to decompose in the only
passage for fresh air to man's abode, but that life and health are at all com-
patible with such circumstances. Might not some sanitary regulations be
enforced to remedy these abominations, and thereby diminish disease and
( xxi )
mortality? Were kilns for the consumption of refuse built in convenient and
suitable situations, or even places set aside as receptacles for such, in the
neighbourhood of all small villages, (which are here chiefly referred to), the
inhabitants might gradually be induced to use them, and a great improvement
be worked, without the help of any municipal authority."
I have the honour to be,
Sir,
Your most obedient Servant,
M. STOVELL, M.D.,
Principal Inspector General, Medical Department.