NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
12
VACCINATION PROCEEDINGS THROUGHOUT
augment the number of vaccinators. The municipalities have been
appealed to, with the view of their maintaining out of the town funds
one or more additional vaccinators, and of looking well after the steady
performance of their duties by the vaccinators. The municipalities have
met the Government in their views. These proceedings have been con-
firmed by the Government of India in Financial Resolution of January
1867. In Bombay and the North-West Provinces the municipalities
had already contributed their quota of vaccinators.
Bengal Zillah
vaccination un-
satisfactory.
32. Vaccination, as carried on in the several zillahs throughout
Bengal Proper (where not included in any recently-established vaccine
circle) being a part of the dispensary system, has always been most
unsatisfactory and unreliable, and is so still. It has run parallel with
the Madras system in operation, previously to its regeneration in 1865 ;
vaccinators from the dispensaries being sent out into the interior
of the district to vaccinate, and left to themselves to keep their
registers carefully or not, to work really, or not to work, and with
the greatest uncertainty prevailing as to whether they were dispersing
a genuine protective vaccination or not. No regular or systematic super-
vision has been exercised over them. In November 1867, the Govern-
ment of Bengal granted travelling and deputation allowance to Civil
Surgeons for visiting the interior during the vaccinating season, and
inspecting the works of the vaccinators.
Bengal Proper,
new circles of
vaccination.
33. During 1866 and 1867, large strides in vaccination in Bengal
were made towards bringing Bengal up to the level of the other
Governments of India. The Darjeeling circle of European superin-
tendence commenced operations at the cold season of 1866-67. The
Ranchee circle of European superintendence (within the Commis¬
sionership of Chota Nagpore) commenced operations with the cold
season of 1867-68; and so also did the small Sonthal Pergunnahs
superintendency, under the auspices of a Sub-Assistant-Surgeon. I
trust that we are gradually inclosing the whole of Bengal Proper within
the meshes of a sound vaccine system of close and reliable supervision
and inspection.
Character of
vaccine virus.
34. The hill depôt lymph and crusts from Kumaon and Simla,
now so generally distributed and in use throughout this Presidency, are
more successful, perhaps, than any other virus. I may add that herme-
tically-sealed liquid lymph is now in general use throughout India. It
was in use in Madras in 1855. It has been so since 1860 in Upper
India ; and in Calcutta since 1859. It is taken, and is readily and
THE GOVT. OF BENGAL PROPER.
13
safely transmissible, at the proper season. Throughout India, vaccina-
tion by crusts is largely practised also, and great care is now taken
as to the preservation, and proper time of removal from the arm, of
vaccine crusts. It has been observed at Madras that English tube
lymph lasts three months there, and that although the vaccinia produced
by it, in the first instance, may pass through its stages prematurely, yet
after the second or third transmission through individuals, a good and
sound vesicle results.
Instrument
used in vaccina¬
tion.
35. Vaccination by scratching the arm with needles, after laying
on the lymph, is very much superseding the perforation by the lancct
and insertion of the virus.
36. Considering the vast numbers of the population of this
country of India generally, the efforts of the Government to make vacci-
nation universal by paid vaccinators is a chimera almost; as Dr. Pearson
has observed, all that can be done under ordinary means, and such as
the finances will admit of, is merely like a shower to the ocean.
Converting
and employing
the native inocu¬
lators of small-
pox.
37. I am glad to observe that Dr. Pearson writes in his vaccine report
of 1866-67, that some plan must be devised whereby vaccination can be
brought to' the door of every family, and this can only be accomplished
by enlisting the services of all native practitioners, Brahmin tikadars,
bhaids, hakims, &c., in the cause. To this I would add and suggest the
attempt to engage the present inoculators of small-pox of all kinds in
the cause of vaccination. Dr. Pearson, in the same report regarding
the Benares circle, writes that attempts will be again made next year to
induce Brahmin inoculators to enrol themselves as vaccinators, for it is
by enlisting the sympathies of the inoculating class, and by providing
them with remunerative employment, that the bigoted attachment
of the Hindoos to inoculation can be best overcome. I have
already pointed out Dr. Shoolbred's successful efforts in this direc-
tion, as he has described them in his report on vaccination, so
long back as 1804. The same idea and recommendation is evident
in all the different vaccine reports from time to time ever since. At
Madras, Bombay, the Punjab and Oudh it is so. Indeed, many of our
present vaccinators in various parts of India originally practised inocula-
tion. The hakims of the King's Hospital at Lucknow have success-
fully exerted themselves, it is alleged, to overcome the prejudices
of the people against vaccination. I have already pressed this sub-
ject upon the notice of the Bengal Government, in my letter No. 237,
dated 7th July 1868.
14
VACCINATION PROCEEDINGS THROUGHOUT
Deteriotation
of lymph.
38. Dr. Charles, in his report above alluded to, makes some
interesting observations upon the superiority of the infecting power
of lymph obtained direct from England, over that closed up in the
same way in hermetically-sealed tubes from vaccination performed
in Calcutta. The Calcutta vaccinations from recent lymph taken
from the arm answered well in the early part of the season, but,
if removed and sealed in glass tubes thus early, and sent about for
use, it failed in its infecting power at and near to Calcutta; whilst
the same kind of lymph in sealed glasses, sent far up-country,
succeeded well. This seemed to show, Dr. Charles thinks, the greater
proclivity of certain parts of India to undergo the vaccine disease than
Calcutta at the same season of the year, and the unsuitability of
the climate of Calcutta in the early part of the vaccine season to favor
the propagation of the vaccinia. English lymph hermetically-sealed had
at the same time succeeded in Calcutta in the early part of the season.
This inferiority in the sealed Calcutta lymph to infect in Calcutta,
disappeared by degrees; and by the end of January its infecting power
became very great. The practical application which Dr. Charles made
of this recognised difference in the infecting power of the Calcutta
lymph, at different periods of the season, has been to induce him to
collect for store a large quantity of the lymph, at the time of the
season in which it exhibited its greatest infecting power, for distribution
at the commencement of the next vaccinating season.
Arm to arm
vaccination.
39. Arm to arm vaccinations are preferred and practised through-
out India where permitted. This proceeding is objected to by native
mothers in many parts. Presents are, however, provided for and given to
the people to allow of this, and to induce them to carry their children for
the purpose from place to place. This method is commonly in use
at Calcutta and its neighbourhood. It is with difficulty carried out
in many parts of the N. W. Provinces. It is permitted by the people
in some parts only of Madras, Bombay, and the Punjab.
1864.
Bengal Presidency including
Prince of Wales' Island and
Fort Marlborough
...
...
For Bengal Proper only ...
Total number
vaccinated.
8,140
2,37,748
1867-68.
Successful
cases.
7,213
1,01,487
Percentage of
successful cases.
......
80.54
THE GOVT. OF BENGAL PROPER.
15
1866-67.
40. For the whole of the Bengal Presidency, together with Madras
and Bombay:—
Bengal
...
...
...
North-Western Provinces...
Oude
...
...
...
...
Central Provinces ... ...
Punjab
...
...
...
Rajpootana & Central India
British Burmah
...
...
Bombay
...
...
...
Madras
...
...
...
TOTAL ...
Total
number
vaccinated.
2,06,230
2,03,916
3,704
22,367
2,48,094
57,623
7,870
3,79,497
1,94,509
13,23,810
Successful
cases.
1,74,386
1,61,711
2,330
19,584
2,12,979
39,183
6,171
3,51,935
1,68,057
11,36,336
Percentage of successful
cases.
Calcutta and environs...
Mofussil Stations ...
Darjeeilng ...
85.61
82.88
82.
80.53
62.90
87.56
94.74
68.4
78.41
92.7
86.38
85.83
Report of the
Superintendent
General of Vac-
cination at Cal-
cutta.
Quality and
preservation of
lymph.
41. Dr. Charles, in his report (3rd special report upon Calcutta
vaccination) for the past season, after giving an account of the pro-
ceedings of the vaccine establishment, working under him, as Super-
intendent General of Vaccination for Calcutta within the town and
suburbs, has entered fully into the consideration of the quality and
permanency of infecting power, and efficiency, of the vaccine lymph at
his disposal, derived from the several sources of England, the Himalaya,
and Calcutta. His investigation and inquiries, which he is still pursuing,
towards the discovery of some antiseptic agent which shall preserve the
virus in its soundness and integrity, and prevent putrefactive spoiling, are
very important and highly interesting. He invites the co-operation of
his professional brethren, and indicates the line of pursuit that may be
instituted by them. It is very satisfactory to know that good potent
lymph is generated in Calcutta during January and February of each
year. Dr. Charles' successful practice of keeping his sealed lymph in
porous earthen vessels (gurahs) of water is worthy of imitation. Efforts
will be made, to procure for the department more suitable tubes as
receptacles for the liquid lymph,
16
VACCINATION PROCEEDINGS THROUGHOUT
A large esta-
blishment re-
quired for Cal-
cutta.
42. With the full establishment of three Superintendents and the
staff of head vaccinators co-operating with, and guiding, and directing
the vaccinators, there is no doubt that vaccination in Calcutta is well
done, under the eye of the Superintendent General of Vaccination;
and in a large city like Calcutta, so multifariously and diversely
peopled with different races and creeds, nothing less than this establish-
ment will suffice. Throughout the long lines of native streets and
gullies the recusant population have to be spoken to, from house
to house, and their prejudices and denials overcome. Small-pox,
with a very small beginning, breaking out in one of these gullies
imperils all Calcutta. By this Calcutta system, much real work is
being done from year to year, and barriers of opposition are pro-
gressively being beaten down. Dr. Charles is now exerting himself in
superintending and organizing vaccination beyond his boundaries, which
comprise the city and suburbs only. He should receive extra remu-
neration for this.
Vaccination
without the
Suburbs of Cal¬
cutta.
43. I would also prominently bring to notice that the forty
additional vaccinators, whose permanent entertainment has received
the sanction of the Government of India by Resolution of 21st January,
1867, have been employed during the past year and season in the
new districts immediateiy around Calcutta, where inoculation has
been prohibited. There have been 72,936 vaccinated, and almost the
whole of these are recorded as successful; six-sevenths of the cases
have been individually inspected and verified. These vaccinations have
been conducted by the Calcutta Superintendents. The duties in
Calcutta have thus, in a measure, been in abeyance for a portion of the
vaccinating season.
Extra Super-
intendents re-
quired for vicini¬
ty of Calcutta.
44. It is now earnestly solicited that additional Superintendents,
Sub-Assistant-Surgeons, may be appointed to carry-out the work in
thannahs and villages around Calcutta, so that the very important
Calcutta vaccination may not be detrimentally interfered with. This has
become a necessary measure pending the decision as to the institu-
tion of the new vaccine circle, comprising the districts and zillahs
around Calcutta, under a distinct European Superintendent, which has
not yet been arrived at. To account for the disagreement between the
percentages of successful cases set down in Dr. Charles' Calcutta report,
and in the general table for Bengal Proper (to be found in the Appendix)
as far as relates to Calcutta, it is to be noted that Dr. Charles, in his
report, draws his percentage from the primary and ascertained vaccina-
THE GOVT. OF BENGAL PROPER.
17
tion results only. In the tables, the percentage is calculated upon the
whole vaccinations, including re-vaccinations and unascertaned ones.
Darjeeling
Circle of Vac¬
cination.
45. The Darjeeling circle of vaccination is under Assistant-Surgeon
Mathew, as Superintendent. The increase this last season numbers
12,673. The percentage of successful cases 89 this last year over 82 of
1866-67. These results have been verified by the Superintendent
by following up the work of his Deputy Superintendent and head
vaccinators, and inspecting severally the cases of vaccination, and
testing the accuracy of the vaccination registers. Dr. Mathew states
that his operations, this last season, were very materially aided and
furthered by the addition to his working party of three head vaccinators
(kindly supplied to him by Dr. Pearson) acting as Native-Superinten-
dents, who made themselves most useful in guiding his vaccinators,
verifying their work, and convincing the people, in many instances, of
the groundlessness of their objections to vaccination upon caste and
religious scruples. It is worthy of remark that out of twenty-six vacci-
nators, twelve are men previously inoculators, who have worked satis-
factorily. The work this year has been carried on at Rungpore, Dinage¬
pore, Rajshahye and Western Dooars.
46. Dr. Mathew's efforts in engaging the co-operation of the civil
authorities, and in publishing abroad in every possible way the advent
of vaccinators amongst the population, and the benign purpose that
brought them there, have been successful and praiseworthy. It is
a very encouraging fact that so little has been heard of the presence
and doings of small-pox inoculators. It may lead the Government to
hope that a complete and efficient system of vaccination, based upon
the closest and most rigid inspection and verification, and spreading
over the land with a view to meet the scourge of small-pox in a fair field
of opposition, will ultimately be crowned with success.
47. The whole system is amazingly promoted and advanced by the
addition of every new circle to the general scheme now carried on more
or less throughout the Bengal Presidency; another link is added to the
chain, and the whole strengthened. The community at large became
more and more familiar with the prophylactic, mutual assistance is more
feasible and easy; and from this general and combined good result the
vaccination proceedings in the sister and contiguous Presidencies of
Madras and Bombay cannot be excluded.
48. The season's work commenced in November.
49. The work throughout has been satisfactory on the whole, and
has met with much less opposition than it encountered last year. The
C
18
VACCINATION PROCEEDINGS THROUGHOUT
work has been found to be true and sound. A good vaccine vesicle has
been established and disseminated, and the prestige and character of
the inoculators of small-pox have been, I would hope, considerably
damaged in the eyes of the populace.
50. The proceedings of the Superintendent, of his Deputy, and his
head vaccinators and general staff of workers traversing the districts,
mixing with the people, enlightening them, disabusing them of ignorant
prejudices, doing them real good, and convincing them that to avert the
danger of small-pox is their sole object in dwelling amongst them, opens
a scene to the Government of Bengal which must well compensate for
the comparatively trifling outlay incurred.
51. There would seem to be no sufficient reason for detaining a
vaccinator during the whole season at Buxa, where the numbers to be
operated upon are so scanty; he should visit the place, but might
leave to it resort to some other station in the Dooars.
52. Dr. Mathew acted very judiciously in not spreading out his
work too much. Whatever number of districts may be included within the
circle, that is a matter of little consequence. His performances for any
one season must be so arranged and restricted, as to admit of his
thoroughly looking into the work of the whole of his party during the
working period.
53. Dr. Mathew has been working with his own lymph during the
season. Lymph originally supplied by Dr. Charles from Calcutta has pre-
served its efficacy during the two seasons. Hermetically-sealed lymph
supplied from England has proved excellent also.
Ranchee Cir-
cle of Vaccina-
tion.
54. Dr. Hoskins' first report on the Ranchee circle. The duties
in this new circle were first entered upon by Sub-Assistant-Surgeon
Neem Chand Goopto, as Deputy Superintendent for the time, at the
end of November 1867. Dr. Hoskins, the Superintendent, did not join
the circle and commence his work until very late in the season, viz.,
on the 3rd of February, when there were not much more than two
working months left.
55. The new circle comprised the extent of territory included within
the control of the Commissioner of Chota Nagpore.
56. At Hazareebaugh, where the work was commenced late in
November, the Deputy Superintendent was met and opposed by all
sorts of prejudices and childish superstitious fears. Dr. Hoskins enu-
merates the numerous objections raised by the people to his proceed-
ings, and to those of the Sub-Assistant-Surgeon,
THE GOVT. OF BENGAL PROPER.
19
57. The work was necessarily chiefly confined to Hazareebaugh.
58. Dr. Hoskins describes the Bengallee baids, the original inocu¬
lators of small-pox, as having relinquished their calling for ten years past,
and their work of inoculation having been taken up by vermilion sellers
"Sindooreahs," and with success, amongst the people. If the natives are
so impressible, and so open to change, as this testifies to, there is some hope
for the success of the more rational and protective system of vaccination
after a time, and so soon as the inhabitants become rightly informed
on the subject. Three of these Sindooreahs have already taken service
as Government vaccinators. At Ranchee, one of the districts of the
circle, some of the tikaits, Bengallee native inoculators, have been en-
listed in the Government service as vaccinators.
59. Dr. Hoskins, in his para. 13, does not evidently exactly under-
stand the system upon which he is to work his party ; this will be ex-
plained to him. The results of the cases at Hazareebaugh have been
veritably tested, and proved to be true. Captain Money's system, put in
operation in Pooroolie, will not answer, as has been shewn. If the inocu-
lators come to be employed as vaccinators, the closest supervision and'
inspection must be practised. With this close observation in force, with
an active Native Superintendent appointed to each district, the inocu-
lators (tekaits) might be enlisted as vaccinators, and might be allowed
to remain in the particular part of the district to which they belong,
and where they possess influence, and carry on vaccination according
to our method and system of registration, &c., &c. They might then,
under close inspection, be allowed to collect their legitimate gains as
before (oppression and over-reaching of the poor being prohibited, and
guarded against by the authorities), substituting vaccination for small¬
pox inoculation merely.
60. The presence of the new circle staff of vaccinators at Hazaree-
baugh has had a beneficial influence on the public mind, although the
number of vaccinations performed may have been small, and the exer-
tions and moral influence of the Deputy Commissioner have very much
furthered this good effect. The inoculators of small-pox, either through
persuasion or fear, have this year much relaxed their labours. Small-
pox did not break out as in previous years. The Superintendent,
Dr. Hoskins, expresses his opinion that the local inoculators of small-pox
are ready to come over to the side of Government, and to become
vaccinators, as soon as they see a decided opposition to inoculation
exhibited by the ruling authorities.
20
VACCINATION PROCEEDINGS THROUGHOUT
61. The number of vaccinators employed in the new circle has
been 20. The head vaccinators allowed have not been employed for
want of sufficiently good men.
Sonthal Per¬
gunnah vaccina¬
tion.
62. The Superintendent, Sub-Assistant-Surgeon Nocoor Chunder
Banerjee, took charge of his duties late in December 1867; he did not
do much until the middle of January; very little was done in May, and
during one month of the season he was unable to travel about for want
of carriage. The Sub-Assistant-Surgeon met with much opposition to,
vaccination from the traders of the Damen, after the panic, resulting
from a small-pox epidemic which had shewn itself, had in a measure
subsided. During the presence of the small-pox, the people applied for
vaccination to the Government vaccine party, which had proceeded to
the infected region. Vaccination continued until April. The Superin-
tendent carried on his duty of supervision for less than three months,
and it is to be feared that his inspection was not so close, and really
valuable, as it ought to have been. In fact, he seems to have displayed
indolence and apathy, and is not a fit man for the post. He has, in
consequence, been removed from this particular duty.
District and
Municipal vac-
cination.
63. Vaccination within districts by vaccinators attached to the
Government charitable dispensaries and by Municipal vaccinators.
64. The proceedings of this department of the Bengal vaccine
scheme are unreliable, except so far as the work lies within the range of
the Civil Surgeon's daily rounds and observation. It is a system obnoxi-
ous to caprice on the part of the inspecting officer, and, even when carried
on close to the beat of the medical officer, is more or less looked after,
according to the leisure of the surgeon from other urgent and more im-
mediate and pressing duties, and to his aptitude for labour, and to his
especial earnestness and desire to diffuse vaccination, and ward off
approaches of small-pox.
65. The system is, however, gradually undergoing supercession and
obliteration, by the setting up of special vaccine circles under medical
officers, whose sole duty it is to look after vaccination, and who are
responsible to the Government for the spread and maintenance of a
vaccine prophylactic against small-pox, which is one of the scourges of
India at present.
66. The district vaccination is not specially reported upon; allu-
sion is made in the various dispensary reports (which are now being
published) to the more or less successful working of it; to the reception
given to it by the people at large, and to the character of the vaccinia