ON
COMPULSORY VACCINATION. By Assistant Surgeon J. MacGkegoe, M.A., Superintendent of Vaccination, Benares Circle.
In the last returns of the
Sanitary Commissioner,
N. W.
P.,
the mortality from small-pox is recorded as over 35,000. Those who are aware how inadequately as yet mortuary statistics represent the actual mortality, will understand that this number is far short of the reality. Were this
frightful mortality not preventable we should acquiese in the course of events, or, as in the case of cholera, no expense would be spared in investigating the remedy. As the remedy, however, is known and easy of application, it is a question for grave consideration whether serious responsibility does not rest with those who, by legislative interference, could reduce this mortality to a minimum. Considering the prominence given to sanitation under our regime, it seems anomalous that compulsory vaccination, one of the most important of sanitary measures, should have been so long delayed. I have not the means of reference at hand, but I feel coneither have to
vinced that the mortuary statistics of the last ten years would support the assertion, that more people die of small-pox in than of cholera. So great is the scourge in some this
country
(Mynpoorie for example) that a child is not considered viable unless it has survived an attack of small-pox. In the prison records of that district among 8,000 prisoners who were admitted into jail within the last twelve years, only some 80 were without marks, more or less distinct., of that disease. districts
Cholera, it is true, attracts more attention inasmuch as its advent is sudden and violent; and?>a still more cogent reason? it attacks Europeans no less, in proportion, than it does natives ; while, thanks to the protective power of vaccination, smallunknown amongst the former. pox is almost There was a time when small-pox was, and with good cause, a greater source of dread even in Europe than cholera, but the fact is now only a matter of history. The progress of
not
vaccination,
as
it is conducted at present, is
encouraging.
In 1872 some 42,000 were vaccinated in the Benares Division. a paradox, but it is nevertheless true, that there
It may seem
remain more
people
unvaccinated
than there were at the end
THE INDIAN MEDICAL GAZETTE.
88 of the
previous year. The reason is obvious, the amount overtaken does not equal the natural increase of the population. The spread of vaccination must be co-extensive with the
enlightenment of the masses, and, in consequence, it will take a series of years before becoming universal, while in the mean " time, in Homeric phrase, the people perish." That it is not
accepted
to
greater extent is due to various
a
causes.
I should rank first the
small-pox in any Thannah I would under vaccine law, and would have compulsory vaccination enforced within the limits of that Thannah. All the vaccinators of that district, and, if necesssary, of the proclaimed
makes such small progress in towns,
ments.
it would be difficult indeed to surpass the Hindoo lunniah. Having only a pretence to rectitude he distrusts every one as a matter of rule, and the main reason why vaccination rural
is
districts,
to the
owing
element in the former.
Everything .
Oil the occurrence of
have it
neighbouring districts,
rule
as a
aversion, and enable them, regarding it.
is looked upon with distrust, if not with
new
the as
as compared with the preponderance of the bunniah
spirit of enquiry is not strong enough to its result, to exercise their own judgment
That vaccination is not more
The
expression family
another's
of much concern is
a
and discussed is
widely known
also due in great measure to the reticence matters observed amongst Eastern nations.
regarding family the welfare of
regarding
manifestation of goodwill that is
con-
sidered open to suspicion rather than to gratitude, and except case of near relations it is seldom or never resorted to.
in the
In consequence of this reserve it often number of children have been vaccinated in and the inhabitants of the next, not of the occurrence.
mile
a
happens a
that
a
distant,
are
deter the
having village,
husbands,
even
against
their children vaccinated. tlio
women "
their better
judgment,
Seldom leaving their
from own
that children whose
persuaded
use their own phrase) in the evil in consequence. The most obstinate case of refusal I have met with was that
arms
have been
cannot be
next, have suffered of
printed" (to
no
old
pensioner, who fought for us at Guznee Personally he had no objections to urge against an
and Cabul.
the vaccination of his child, but the tears of the child's mother prevailed against all my arguments and influence. The fnct of vacci-
nation being voluntary and gratuitous, of itself breeds distrust. It is the misfortune of the country to have been for so many ages misgoverned, that the traditional feelings of the people cause
them to
suspect some covert meaning. That Governsolely in the cause of humanity?only the
ment should act
enlightened few believe. A Zemindar of Sundowlic could only account for it on the principle, that from the greater saving of human life, there would be a corresponding increase of the Government revenue. Indeed a very prevalent opinion is?that vaccination is future taxation. A wide
spread belief
a
which
Jewish times "when Herod under an alien rule.
of census on which to base
kind
exists, reminds was
king"
one
of the old
and the Jews too
a child king to bo born, in whose veins milk flows instead of blood. He is to drivo the British from the country, and "to reign in their stead." To find out this child king, and to slay him, is the object of
were
There is
rulers in the institution of vaccination. The basis of their opposition and distrust is of the relation which exists between
our
a misconception small-pox and vaccination. Let the people be assured on the authority of law, that vaccination is intended as a prophylactic against smallpox with-
out any other
significance,
and
The to
posed
they
will
willingly
assent to it.
of the Benares
population
be about
9,000,000,
Division is sup-
gives a birth-rate of about 270,000. This amount could be effectually protected by a staff of 80 men. At present, under tho voluntary system, one man can vaccinate about 1,000. Were his time occupied in operating, and not, as now, in explaining and persuading the people to accept of its protection, he could easily quadruple tho number of cases. Indeed, did his subjects not require to be literally hunted out, tho clumsiest operator could vaccinate twenty within the hour.
which
Sucli a scheme at first must be to some extent a tentative measure, but carried out with discretion it could not fail of success. I should not advocate its adoption, to begin with, in large towns, but in smaller towns and in rural districts no need bo
contretemps Whenever
a
under vaccine nation a
Indian women, socially degraded as we may consider them to be, in numberless instances exercise sufficient influence to
could be concentrated in the infected
epidemic effectually stamped out. The prior outbreak of small-pox in any sub-division, and the enforcement of vaccination only therein would make its object manifest to the most obtuse of bucolic minds. Were this "vaccine law" adopted, a very slight increase of the existing establishment would meet all its requireand the
locality
certain
village, ignorant
1, 1873.
The law that I would suggest would make the bona fides of Government unmistakable?would introduce the enforcement of it by degrees, and prove at the same time the saving of many lives.
apathy and conservatism of the race. are unusually dormant as to intellect, and exhibit the dogged obstinacy which is the refuge of weakness, few will deny. For unehakeable, unreasoning obstinacy, That Hindoos
[April
eight
sum
annas
anticipated.
section of
town
or a
law, I would have according to their
tho
a
rural district is gazetted people pay for the vaccimeans, ranging from two to
for each child.
concert with the vaccine Superintendent, could undertako that the law was not enforced in such a way The
as
officials, in
to irritate the
feelings
of tho
people,
and
thereby
defeat, its
end ; a slight fine in case of repeated refusal would bo a sufficient deterrent against disobedience to tho law, and the masses would value tho protection in proportion to tho earnestown
ness
with which Government
pressed
it upon them.
division, tho responsibility regard rests with their respective municipal committees, inasmuch as, if I read it aright, tho local Government would support such a scheme were only a municipal committee found courageous enough to propose it. Had the same timid policy existed when our rule was less firmly established in the confidence of tho people, suttee fires would still be an every day occnrrcnce, while a more desWith
to tho towns in this
tructive agency is allowed in our time to have free course.
will, no doubt, apprehend they invariably do whenever any
Alarmists a3
some
mysterious danger,
measure is being Tho census and tho incomo-tax were, with them, sources of grave anxiety, which was only dispellod on seeing new
introduced.
the
quiet submission
with which both wero
received,
European countries where the liberty of tho subject is much more insisted upon than in India; and that the measure ha3 not been previously introduced hero is due, I believe, to a misapprehension as unfounded as it is indirectly destructive to human life. Compulsory
vaccination is the rule in
urged as an objection, that tho greatest amount small-pox occurs in the hot weather, when vaccination is impracticable. This is true, but mostly every epidemic has its nidus in tho cold weather, and when stamped out boforo tho end of March, and inoculation prohibited, the diseaso It has been
of
make little progress afterwards. Cahp GoiiUCKPOEE, 11 th February, 1873.
can
COMPULSORY VACCINATION. By Assistant Surgeon J. MacGkegoe, M.A., Superintendent of Vaccination, Benares Circle.
In the last returns of the
Sanitary Commissioner,
N. W.
P.,
the mortality from small-pox is recorded as over 35,000. Those who are aware how inadequately as yet mortuary statistics represent the actual mortality, will understand that this number is far short of the reality. Were this
frightful mortality not preventable we should acquiese in the course of events, or, as in the case of cholera, no expense would be spared in investigating the remedy. As the remedy, however, is known and easy of application, it is a question for grave consideration whether serious responsibility does not rest with those who, by legislative interference, could reduce this mortality to a minimum. Considering the prominence given to sanitation under our regime, it seems anomalous that compulsory vaccination, one of the most important of sanitary measures, should have been so long delayed. I have not the means of reference at hand, but I feel coneither have to
vinced that the mortuary statistics of the last ten years would support the assertion, that more people die of small-pox in than of cholera. So great is the scourge in some this
country
(Mynpoorie for example) that a child is not considered viable unless it has survived an attack of small-pox. In the prison records of that district among 8,000 prisoners who were admitted into jail within the last twelve years, only some 80 were without marks, more or less distinct., of that disease. districts
Cholera, it is true, attracts more attention inasmuch as its advent is sudden and violent; and?>a still more cogent reason? it attacks Europeans no less, in proportion, than it does natives ; while, thanks to the protective power of vaccination, smallunknown amongst the former. pox is almost There was a time when small-pox was, and with good cause, a greater source of dread even in Europe than cholera, but the fact is now only a matter of history. The progress of
not
vaccination,
as
it is conducted at present, is
encouraging.
In 1872 some 42,000 were vaccinated in the Benares Division. a paradox, but it is nevertheless true, that there
It may seem
remain more
people
unvaccinated
than there were at the end
THE INDIAN MEDICAL GAZETTE.
88 of the
previous year. The reason is obvious, the amount overtaken does not equal the natural increase of the population. The spread of vaccination must be co-extensive with the
enlightenment of the masses, and, in consequence, it will take a series of years before becoming universal, while in the mean " time, in Homeric phrase, the people perish." That it is not
accepted
to
greater extent is due to various
a
causes.
I should rank first the
small-pox in any Thannah I would under vaccine law, and would have compulsory vaccination enforced within the limits of that Thannah. All the vaccinators of that district, and, if necesssary, of the proclaimed
makes such small progress in towns,
ments.
it would be difficult indeed to surpass the Hindoo lunniah. Having only a pretence to rectitude he distrusts every one as a matter of rule, and the main reason why vaccination rural
is
districts,
to the
owing
element in the former.
Everything .
Oil the occurrence of
have it
neighbouring districts,
rule
as a
aversion, and enable them, regarding it.
is looked upon with distrust, if not with
new
the as
as compared with the preponderance of the bunniah
spirit of enquiry is not strong enough to its result, to exercise their own judgment
That vaccination is not more
The
expression family
another's
of much concern is
a
and discussed is
widely known
also due in great measure to the reticence matters observed amongst Eastern nations.
regarding family the welfare of
regarding
manifestation of goodwill that is
con-
sidered open to suspicion rather than to gratitude, and except case of near relations it is seldom or never resorted to.
in the
In consequence of this reserve it often number of children have been vaccinated in and the inhabitants of the next, not of the occurrence.
mile
a
happens a
that
a
distant,
are
deter the
having village,
husbands,
even
against
their children vaccinated. tlio
women "
their better
judgment,
Seldom leaving their
from own
that children whose
persuaded
use their own phrase) in the evil in consequence. The most obstinate case of refusal I have met with was that
arms
have been
cannot be
next, have suffered of
printed" (to
no
old
pensioner, who fought for us at Guznee Personally he had no objections to urge against an
and Cabul.
the vaccination of his child, but the tears of the child's mother prevailed against all my arguments and influence. The fnct of vacci-
nation being voluntary and gratuitous, of itself breeds distrust. It is the misfortune of the country to have been for so many ages misgoverned, that the traditional feelings of the people cause
them to
suspect some covert meaning. That Governsolely in the cause of humanity?only the
ment should act
enlightened few believe. A Zemindar of Sundowlic could only account for it on the principle, that from the greater saving of human life, there would be a corresponding increase of the Government revenue. Indeed a very prevalent opinion is?that vaccination is future taxation. A wide
spread belief
a
which
Jewish times "when Herod under an alien rule.
of census on which to base
kind
exists, reminds was
king"
one
of the old
and the Jews too
a child king to bo born, in whose veins milk flows instead of blood. He is to drivo the British from the country, and "to reign in their stead." To find out this child king, and to slay him, is the object of
were
There is
rulers in the institution of vaccination. The basis of their opposition and distrust is of the relation which exists between
our
a misconception small-pox and vaccination. Let the people be assured on the authority of law, that vaccination is intended as a prophylactic against smallpox with-
out any other
significance,
and
The to
posed
they
will
willingly
assent to it.
of the Benares
population
be about
9,000,000,
Division is sup-
gives a birth-rate of about 270,000. This amount could be effectually protected by a staff of 80 men. At present, under tho voluntary system, one man can vaccinate about 1,000. Were his time occupied in operating, and not, as now, in explaining and persuading the people to accept of its protection, he could easily quadruple tho number of cases. Indeed, did his subjects not require to be literally hunted out, tho clumsiest operator could vaccinate twenty within the hour.
which
Sucli a scheme at first must be to some extent a tentative measure, but carried out with discretion it could not fail of success. I should not advocate its adoption, to begin with, in large towns, but in smaller towns and in rural districts no need bo
contretemps Whenever
a
under vaccine nation a
Indian women, socially degraded as we may consider them to be, in numberless instances exercise sufficient influence to
could be concentrated in the infected
epidemic effectually stamped out. The prior outbreak of small-pox in any sub-division, and the enforcement of vaccination only therein would make its object manifest to the most obtuse of bucolic minds. Were this "vaccine law" adopted, a very slight increase of the existing establishment would meet all its requireand the
locality
certain
village, ignorant
1, 1873.
The law that I would suggest would make the bona fides of Government unmistakable?would introduce the enforcement of it by degrees, and prove at the same time the saving of many lives.
apathy and conservatism of the race. are unusually dormant as to intellect, and exhibit the dogged obstinacy which is the refuge of weakness, few will deny. For unehakeable, unreasoning obstinacy, That Hindoos
[April
eight
sum
annas
anticipated.
section of
town
or a
law, I would have according to their
tho
a
rural district is gazetted people pay for the vaccimeans, ranging from two to
for each child.
concert with the vaccine Superintendent, could undertako that the law was not enforced in such a way The
as
officials, in
to irritate the
feelings
of tho
people,
and
thereby
defeat, its
end ; a slight fine in case of repeated refusal would bo a sufficient deterrent against disobedience to tho law, and the masses would value tho protection in proportion to tho earnestown
ness
with which Government
pressed
it upon them.
division, tho responsibility regard rests with their respective municipal committees, inasmuch as, if I read it aright, tho local Government would support such a scheme were only a municipal committee found courageous enough to propose it. Had the same timid policy existed when our rule was less firmly established in the confidence of tho people, suttee fires would still be an every day occnrrcnce, while a more desWith
to tho towns in this
tructive agency is allowed in our time to have free course.
will, no doubt, apprehend they invariably do whenever any
Alarmists a3
some
mysterious danger,
measure is being Tho census and tho incomo-tax were, with them, sources of grave anxiety, which was only dispellod on seeing new
introduced.
the
quiet submission
with which both wero
received,
European countries where the liberty of tho subject is much more insisted upon than in India; and that the measure ha3 not been previously introduced hero is due, I believe, to a misapprehension as unfounded as it is indirectly destructive to human life. Compulsory
vaccination is the rule in
urged as an objection, that tho greatest amount small-pox occurs in the hot weather, when vaccination is impracticable. This is true, but mostly every epidemic has its nidus in tho cold weather, and when stamped out boforo tho end of March, and inoculation prohibited, the diseaso It has been
of
make little progress afterwards. Cahp GoiiUCKPOEE, 11 th February, 1873.
can
