NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
OF VACCINATION.
3
2nd. They object to more than one point of insertion for a simi-
lar reason. These points if conceded—as often they must be—diminish
the chances of the vaccination " taking," and the vesicles are more
exposed to injury.
3rd. In some places they absolutely refuse to have it done with
a lancet, though not objecting so strongly to the "needle scratcher"—
elsewhere they reject the " scratcher" but allow the lancet.
4th. In all cases they object most strongly to re-vaccination, when
the virus has failed to take at first. For this last they have good reason;
as, according to their customs, they have to undergo a second time all
the self-denial and expense of repeating again the religious ceremonies
and the abstinence from certain kinds of food, as well as giving fresh
fees and presents to the Brahmins.
5th. The greatest difficulty is experienced in procuring lymph or
crusts from the successful cases for the benefit of others, the mothers
often fancy that a portion of something essential to the child's life or
health is being abstracted, and they will not take the trouble to watch
for the crusts becoming ripe, and save them when they drop off.
6th. As to " arm to arm" vaccination, it has been found
hitherto that they would not listen to the idea for a moment. More-
over, under the " purely persuasive" system at present pursued, it is
almost impossible to collect all the children together at the same time
and on the right day, thus necessitating endless waste of time and
labour in going backwards and forwards several times to the same village,
each time obtaining only a driblet of cases.
Superinten¬
dent's arrival.
8. On my own arrival in February, the Sub-Assistant-Surgeon
was shortly transferred elsewhere, and finding that the circle operations
had been commenced at Hazareebaugh, I thought it better—the season
being so far advanced—to continue them in that district rather than
make a fresh start at Ranchee. I found the same difficulties as he had
done, and being myself quite new to the work, I thought it best also
to be guided by the opinion of the more experienced local officials
whom I also consulted, and determined for the present, at least, to con-
tinue the plan that I found in use.
Classes of
vaccinators.
9. The vaccinators employed in the Hazareebaugh District have
been of three classes:—
1st. Two Mussulmans, who were found utterly unacceptable to
the population at large, while as the few Mussulmans have no objection
to Hindoo operators, there was no advantage in retaining the Mussul-
4
RANCHEE CIRCLE
mans' services, they were therefore discharged on 8th February, imme-
diately after my arrival.
2nd. Four Bengalis were specially sent up by the Inspector-
General of Hospitals, L. P., in December last; to them also the people
generally object, as being strangers to them; but they are intelligent, and
their work, though small in amount, has been very good in quality; they do
not like the district, however, and are dissatisfied with the pay. One of
them resigned his post on the 1st April, and the other three wished to do
so also. They have no knowledge of English (for keeping records) nor of
the local languages of the district, nor have they the slightest influence
with the people; for these three reasons I thought them unsuitable for
employment as " Head Vaccinators " on the higher rate of pay (at Rs. 20
per month) and submitted a recommendation that they should be
discontinued here, and be replaced by natives of the district. Orders
have since been received for their discharge accordingly.
3rd. Sindooriahs of late years have practised inoculation largely
in the Hazareebaugh district; the story appears to be, that up till some
nine or ten years ago all the inoculation in the Hazareebaugh zillah was
in the hands of some Bengali baids living at Ectrakh* who made an
annual tour through the villages. But about that time it is said that
" they feared to come " owing to an idea of Government having set its
face against their practices. On their thus leaving the field open, the
Sindooriahs, sellers of vermillion (Sindur) &c., at once came forward in
their place which they have retained till now, and have completely
obtained the confidence of the people.
The Bengali baids used to take, as their lowest fee, four annas for a
male child, and two annas for a female, and they continued in attendance
till the child was considered well enough to be bathed (about the fourteenth
day.) Besides this, they always got food and drink; and very often a
buksheesh besides, from 1 Rupee upwards, from well-to-do parents. In
some cases I am assured that the present was as much as 20 to 50 Rs.
They worked only during three months, January, February and March, and
one of my informants made a guess that an ordinary operator's average
gains per season might probably reach from Rs. 100 to 150. I am
informed that in all these points the Sindooriahs follow the custom
of their Bengali predecessors.
Three of these Sindooriahs have been employed as Government
vaccinators during the past season, and have proved decidedly successful.
* A large native town six miles from Hazareebaugh.
OF VACCINATION.
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10. In the Ranchee district the vaccinators have been of various
castes and creeds, but all residents of that part of the country. Three
have been employed about Ranchee and one * in the Sub-Division of
Palamow.
11. In Chyebassa, four Hindoo Tekaits (Bengalis) have been
employed as Government vaccinators, these men have their homes, how-
ever, in the district of Maunbhoom.
12. In Purulia, with a temporary exception, no men have been
employed on Government pay as vaccinators, a special system having
been started by Captain Money, the Deputy Commissioner, of which
more hereafter.
Number of
vaccinators.
13. Twenty vaccinators, and three head vaccinators, total 23, have
been santioned for the whole circle, but as yet no head vaccinators have
been appointed, it being very difficult to find suitable men ; indeed,
if it is intended that these three head-men should entirely superintend
the vaccination in three of the four districts, while the Superintendent
himself looks after the fourth, it is very doubtful, I think, whether the
remuneration offered, Rs. 20 per month, for the five working months, and
16 per month, during the non-working season, is sufficient to attract the
stamp of men required; they would necessarily be left almost to them-
selves for long periods, and too far away in the interior usually, for either
the Civil Surgeon to assist the Superintendent in overlooking their opera-
tions, or for the latter officer to do it for himself, as he would be occupied
in his own district. Men are wanted, therefore, who can be trusted to
work satisfactorily by themselves, and whose returns of work done can be
accepted as reliable; moreover, (it appears from a reference to the
Accountant-General) they would send in to the Superintendent, who
must be greatly dependent on them in these matters, the pay bills for
the men working under them, and on his countersignature would draw
the pay and distribute it; it is, therefore, the more necessary that they
should be men of a responsible and trustworthy character. It is hoped,
however, that three good men may be procurable as head vaccinators
before the beginning of next working season.
Amount of
work done, and
the percentage
of success.
14. The Return appended shows the total number of vaccina-
tions for the past season for the whole Circle to be 6,447, of which 5,118,
or 75.7 per cent. are returned as successful.
* A Tekait.
6
RANCHEE
CIRCLE
Hazareebaugh
District.
To take the four Districts separately.
Hazareebaugh has been by far the most satisfactory; in that zillah
there were 1,357 cases, of which 879 were successful, being at the rate
of 64.7 per cent. These absolute numbers may seem small; but it is
to be remembered that this was the first season of the new system,
the number of operators employed necessarily small, and the difficulties
of all kinds to be encountered very great. So much as this could not
have been done but for the earnest support of the Deputy Commis-
sioner and the Civil Surgeon, and of the authorities generally. As the
operators gain experience, it is hoped that a higher average may be
attained still. The percentage of success is, I submit, to be considered
satisfactory, in that it is thoroughly reliable. Indeed, I doubt whether
sometimes cases have not been excluded as not quite coming up to the
mark which might perhaps have been considered fairly successful; every
" successful" case has been verified by a competent officer, either by
the Sub-Assistant-Surgeon, who was in charge before my arrival, or by
myself, or by Dr. Delpratt, the Civil Surgeon. To Dr. Delpratt my
warmest acknowledgments are due for his very cordial aid and support
generally, as well as for most valuable assistance in personally inspect-
ing cases in my absence, and also in many other ways in which I have
sought his co-operation, which has invariably been most willingly and
efficiently accorded.
Ranchee Dis-
trict.
In Ranchee district (as also, I believe, at Purulia and Chyebassa)
supervision has unavoidably been not so close and complete. The large
amount of current medical duties at Ranchee (with the cantonment of
Dorundah) and illness, left but little time for supervising vaccination.
The Return shows 1,589 cases, of which 966 were successful, being a
percentage of 60.7, from this proportion (less than that of Hazareebagh)
and the result of inspections; I think these numbers also trustworthy.
Chyebassa Dis-
trict.
Of Purulia and Chyebassa I have no personal knowledge.
The Returns of Chyebassa show a total of 2,995 cases, 2,858
successful, giving a proportion of 95.4 per cent.
Purulia Dis-
trict.
In Maunbhoom, only one man was employed (during only three
months) on Government pay. The Return shows a total of 506, and
415 successful, a proportion of 82 per cent.
15. In Maunbhoom, in January 1867, Captain Money, the Deputy
Commissioner, started the system described in Supplement to Calcutta
Gazette for August 7th, 1867, page 341, of allowing the regular Tekaits to
vaccinate on their own account, without any pay from Government, on
merely being supplied with vaccine virus and lancets; in fact they were
OF VACCINATION.
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to do everything just as usual, merely vaccinating instead of inoculating.
An idea had got about the district that inoculation was forbidden by
Government which made them willing to come forward. This system at
first seemed to promise very well; but of late, there being no means of
watching their operations, they took to inoculating again in several
instances, as shown on enquiries made by Captain Money through the
Civil Surgeon. Doubtless, they had of late discovered that they could not
be punished for inoculation, as it was not illegal, and it in every way
suits their customs, convenience, interests and prejudices much better to
inoculate than to vaccinate.
16. The success of Captain Money's system wholly depends (as
he himself is of opinion) on these men being constantly checked by
supervision; but under present circumstances proper supervision is
impossible, they are beyond the reach of the Civil Surgeon; and as
regards the Superintendent of vaccination, he has four zillahs to look
after, and cannot devote the whole of his time to one only, nor if he could
do so, would he be able to supervise all these men without systematising
his work and taking the different lines of country in some kind of
regular order, which necessarily he, and not they, must be allowed to
arrange; whereas each of these Tekaits, Captain Money states, has an
hereditary right by ancient custom to all the inoculation (or, under the
proposed system, vaccination) within a certain area. (There would
therefore be difficulty, from their mutual jealousies, in employing
any particular man out of his customary limits.) These men of
course adopt just whatever system, or want of system, best suits
their own convenience, and the wishes and customs of their patients.
Thus, in some months, scarcely anything is done anywhere , again in
other months they are operating all over the district in a great many
different places at once and without any method or regularity, thus
defying all attempts at systematic supervision. As long as it is
perfectly optional with them whether they adopt vaccination or not, they
are not likely to alter their system to suit the plans of the
Superintendent who, indeed, cannot in any way compel them to
take up vaccination at all, or to desist from inoculating.
17. If inoculation were prohibited, and the people thereby com-
pelled to accept vaccination, or to remain unprotected, it would then
be possible for the circle staff to adopt a scheme for vaccinating the
whole country gradually in some kind of order, as circumstances might
require, and with every hope of success,
8
RANCHEE CIRCLE
18. We cannot be surprised at the unwillingness of the people to
accept vaccination voluntarily. Even in England itself it was not able
to contend successfully with small-pox, until not only was inoculation
made a penal offence by Act of Parliament, but in addition, vaccination
was made compulsory ; and I am supported by the universal opinion of
all the experienced officers of this and the neighbouring districts whom
I have consulted on the matter, that similar measures (or at least the
prohibition of inoculation) will be found necessary before we can hope
for much success in making vaccination general. I earnestly hope,
therefore, that Government may think fit to take some action in the
matter.
19. Failing such authoritative prohibition, the only course likely
to succeed seems to be that advocated by Captain Money and
others, of enlisting on our side the hereditary Tekaits, to whose interests
otherwise vaccination would be opposed. Captain Money's own scheme
attempts this, but breaks down for want of supervision.
20. A similar difficulty will apply, I fear, to the Government scheme
recently proposed, of paying head-money for successful cases only, at
a rate not exceeding 2 annas per head to inoculators who take up
vaccination.
It is absolutely necessary to avoid imposition, that every case
should be seen and vouched for by a medical officer, as stated in Circular
Memo. No. A., dated 24th January last, of the Deputy Inspector-General
of Hospitals, Dinapore Circle.
To enable this supervision to be kept up, the men must be few
in number and must work, not according to their own fancy at whatever
times and places may suit them best, but as the Superintendent may
be able to arrange for them. Thus the amount of work done consis-
tently with due verification will probably be but small, and the men
would grumble greatly and with justice at losing the pay for successful
cases, because it happened to be out of the power of the Superintendent
or of the Civil Surgeon to inspect and certify to their success. There-
fore, I think the men will soon find it difficult to earn as much money
by vaccination as they could before by inoculation, when one man could
do a whole village at a time without any failures or any troublesome
inspections and verifications to enable him to get his fees.
Thus, as it is purely optional with them whether they forsake
inoculation for vaccination, or stick to their old practices, we can only
expect that they will do the latter.
OF VACCINATION.
9
21. Major Boddam, the Deputy Commissioner of Hazareebangh,
has proposed a third scheme, that the inoculators should be offered a
fixed minimum pay as subsistence allowance of Rs. 5 per month in any
case, and head-money besides for all the successful cases beyond a
certain number. This was to meet the objection made by some, that the
pay of even a good man, if dependent solely upon head-money, might
not be enough for him to live on, if he had bad luck in going to villages
where the people would not accept him ; and also to meet the opposite
objection that a fixed pay of Rs. 10 per month certain might
prove a premium to idleness. This scheme, too, has the same objection
of the difficulty of verifying the cases, otherwise it seems a happy
combination of the fixed-pay system and the head-money scheme, and
superior to either of them alone.
22. The success for a time (and since partially) of Captain Money's
system in Purulia is due, (both he and the Civil Surgeon, Dr. Wilson,
think) solely to the idea that had got about, that inoculation was
prohibited.
23. The same is the case with such success as was attained at
Hazareebaugh, where also the Deputy Commissioner and the Civil
Surgeon are of a similar opinion, and had taken determined action on the
matter. Inoculation had been forbidden, and some men caught inocu-
lating had been punished with imprisonment, and I can myself also
testify that it was this idea only, that induced several of the Sindooriahs
(from Khurrukdihee and elsewhere in the Hazareebaugh zillah), as they
themselves told me to offer to take to vaccination on the head-money
system. This was expressly reported in my letter No. 2, dated
February 10th, 1868, being reply to Circular Memo. No. A. of 24th
January, from Deputy Inspector-General of Hospitals, Dinapore, But
now this is all altered.
Recently, some of the men imprisoned have been released on
appeal to the Judicial Commissioner of Chota Nagore, who has decided
that the clause (against spreading an infectious disease) under which
they were convicted was not intended to apply to inoculation for
small-pox, which consequently is perfectly legal. The Police have now,
therefore, been directed by the Deputy Commissioner of Hazareebaugh,
not to interfere in any way with the inoculators who will now be able
to do just as they like.
24. The aggregate number vaccinated was very small compared
with the population of the zillah, and the people were decidedly averse
b
10
RANCHEE CIRCLE
to vaccination ; still the determined opposition of the Deputy Com-
missioner had done much good by deterring the inoculators so
effectually, that small-pox, after being very prevalent during several
previous seasons, was last season scarcely heard of. No disturbances
were excited, the inoculators were beginning from self-interest to
come round to vaccination, and, doubtless, in course of time, having the
ear of the people they would have gradually induced the latter to
do so too. But now there is not the slightest probability that these
inoculators will help us in the least.
25. With the mass of the people wedded to inoculation, and the
interests of the inoculators bound up with it too, (its performance not
being illegal,) the prospects of vaccination for next season are poor
indeed !
26. Experience, both in other places (Kumaon and Gurwhal for
instance) as well as here shows, I think, that the prohibition of
inoculation is not likely to cause any serious political consequences;
while it is essential for the general success of vaccination ; and I would
respectfully solicit that Government be moved to enquire from the
Commissioner of Chota Nagpore whether any special objection exists to
inoculation being forbidden by law throughout this circle, with a view
to some speedy action being taken on the subject.
OF VACCINATION.
11
First Annual Return of Persons Vaccinated by the Establishment attached to the Ranchee Circle of Vaccination for
the Season 1867-68.
DISTRICTS.
Ranchee...
Hazareebaugh...
Chyebassa...
Purulia...
Total...
Number of Vaccina-
tors attached.
5
9
4
1
19
NUMBER OF PERSONS VACCINATED.
October.
...
61
November.
34
5
December.
584
124
105 *
..
...
19
1,019
87
...
January.
539
502
756
400
2,197
February.
232
281
March.
200
384
2,134
...
...
3,231
Total.
1,589
1,357
2,995
506
6,447
NUMBER OF SUCCESSFUL CASES.
October.
...
36
November.
14
...
December.
341
120
27
...
16
71
625
January.
335
334
756
328
1,753
February.
131
162
March.
145
227
2,075
...
...
2,740
Total.
966
879
2,858
415
5,118
PERCENTAGE OF
Successful.
60.7
64.7
95.4
82.
75.7
Unsuccessful.
18.9
18.4
2.6
17.5
14.35
Doubtful
20.2
15.9
1.4
.3
9.45
Not ascertained.
...
.9
.5
...
.35
REMARKS.
Not" ascertained "—not
separated from the
"doubtful."
Not "ascertained"—not
separated from the
" doubtful."
* The returns for Chyebassa were found to be so mixed up, that it was impossible to give each month separately.
E. J. HOSKINS, M.D.,
RANCHEE:
The 30th June, 1868.
Superintendent of Vaccination,
Ranchee Circle.
REPORT
ON
VACCINATION OPERATIONS
IN THE
SONTHAL PERGUNNAHS
FOR 1867-68.
BY
NOCOOR CHUNDER BANERJEE,
SUB-ASSISTANT-SURGEON.
REPORT
ON
VACCINATION OPERATIONS
IN THE
SONTHAL PERGUNNAHS
FOR 1867-68.
From BABOO NOCOOR CHUNDER BANERJEE, Sub-Assistant-Surgeon, to the Deputy
Inspector-General of Hospitals, Dinapore Circle,—No. 157, dated Camp Patna,
the 14th June,1868.
I TOOK charge of the vaccine establishment of the Sonthal Per-
gunnahs, and commenced vaccine operations among the children of the
coolies in the Chord line at Deoghur in the latter end of December. I
had not been a month there, and scarcely had time to do justice to the
work, when I was called upon to begin operations among the Sonthals in
the Rajmahal district, on receipt of report of an epidemic of small-pox
having occurred in some of those parts. On the 29th January I joined my
present scene of operations, and, with the assistance of two vaccinators,
and another that preceded me and had already commenced work, I began
at once to surround the infected spots, with protected neighbourhood,
to arrest further dissemination of the disease, the panic among the
people aiding me in the operations. I allotted to each a circuit of five
miles in average length, myself superintending and inducing the heads
of villages and people in general to get their children vaccinated. In
a few days the epidemic disappeared, and contributed to establish a
faith among the Sonthals. For a time my work throve well, but in
March—probably on account of the growing heat and the wearing-out
of the hitherto existing panic—resistance began to show itself, and I
applied to the Assistant Commissioner, Mr. Wilmot, then on tour, for
interference. He at once proceeded to have the family and village of
a big Pergunnah, the head of a vast number of villages vaccinated, and
1 a