Smallpox in nineteenth-century India

Population and Development Review

Volumn 25, Issue 4, 1999, Pages 649-680

  Dyson, Jayant Banthia Tim ^a   Dyson, Tim ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

DISEASE PREVALENCE; HISTORICAL GEOGRAPHY; MEDICAL GEOGRAPHY; NINETEENTH CENTURY;

INDIA;

EID: 0033505952     PISSN: 00987921     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1728-4457.1999.00649.x     Document Type: Review

References (46)

1. "Is smallpox history?" The Lancet 353 (9164) 1999: 1539.
2. For such a suggestion see, for example, D. Arnold, "Smallpox and colonial medicine in nineteenth-century India," in D. Arnold (ed.), Imperial Mediane and Indigenous Societies (Manchester: Manchester University Press, 1988), p. 47.
3. Of course, age was usually recorded for registered deaths in India. However, except in the case of smallpox, it was not customary to publish deaths by both cause and age.
4. See, for example, D. Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India, (Berkeley: University of California Press, 1993).
5. I. Klein, "Population growth and mortality in British India," The Indian Economic and Social History Review 26(4) 1989 and 27(1) 1990; also
6. S. Guha, "Mortality decline in twentieth century India: A preliminary enquiry," The Indian Economic and Social History Review 28(4) 1991.
7. S. P. James, Smallpox and Vaccination in British India (Calcutta: Thacker, Spink, 1909).
8. See K. Davis, The Population of India and Pakistan (Princeton: Princeton University Press, 1951), pp. 33 and 47.
9. See T. Dyson, "The population history of Berar since 1881 and its potential wider significance," The Indian Economic and Social History Review 26(2) 1989: 182-186.
10. This article addresses the impact of primary vaccination. In India revaccination began only in the 1870s and remained at a low level for the rest of the nineteenth century.
11. Variola major and variola minor were the two types of smallpox virus. Clinically, however, there were five types of smallpox cases. In decreasing order of severity and case fatality they were hemorrhagic, confluent, semi-confluent, modified, and discrete. On the factors influencing case fatality see F. Fenner et al.. Smallpox and Its Eradication (Geneva: World Health Organization, 1988), pp. 175-178.
12. See Fenner et al., cited in note 10, p. 178.
13. By the early twentieth century a larger proportion of people who were unvaccinated contracted the disease at older ages, and at such ages case fatality rates were generally higher than at ages 1-10 years. This accounts for the higher case fatality of unvaccinated people shown in Table 2.
14. See Fenner et al., cited in note 10, p. 37.
15. See P. Sköld, The Two Faces of Smallpox: A Disease and Its Prevention in Eighteenth- and Nineteenth-Century Sweden (Umeâ: Demographic Data Base, Umeâ University, 1996), p. 72.
16. See W. J. Moore, "Marwar: The land of death," Indian Annals of Medical Science, Calcutta, 1866, Vol. XX, pp. 526-529.
17. See R. Pringle, "On smallpox and vaccination in India," The Lancet, January 1869, pp. 44-45.
18. Vaccination in the North-Western Provinces began to gain ground only in the 1860s.
19. There is evidence that smallpox was more prevalent in pans of Madras Presidency prior to 1850. An examination of 843 prisoners at Coimbatore in 1855 found that 596 (i.e., 71 percent) had distinct smallpox marks, while only 70 (8 percent) had vaccination marks. See Report on Vaccination in Madras Presidency 1855, p. 13.
20. For survey data on smallpox experience and vaccination status for a large rural child population in Bombay Presidency that show very similar results to these for the city of Bombay, see Report on Vaccination in Bombay Presidency 1865, p. 3. These survey data support our contention that the city census data are fairly representative of the experience of the wider presidency.
21. J. Banthia, "The practice of inoculation in nineteenth century India," Working Paper, Department of Social Policy, London School of Economics, 1999.
22. For example, registration was sometimes viewed as a way of controlling the practice of female infanticide indulged in by some higher castes.
23. See Government of India, Annual Report of the Sanitary Commissioner, 1868, Appendix to p. 98.
24. Most Sanitary Commissioners felt that registered smallpox mortality was understated rather than overstated. Thus the Sanitary Commissioner for Oudh observed in 1875, "Smallpox ought not [to] present any difficulty in recognition, its characteristic being well known, though the number may be understated through extreme laxity in reporting, especially as children are the greatest sufferers." See Annual Report of the Sanitary Commissioner, Oudh, 1875, p. 9.
25. In both Table 5 and Figure 3 the statistics for British India prior to 1870 are influenced by changes in territorial coverage; thus the data for the provinces of Bombay, Punjab, and North-Western Provinces (part of United Provinces) start from 1865; those for Madras from 1866; for Central Provinces from 1867; and for Berar (not shown separately in Table 5) from 1868.
26. D. Stewart, Report on Smallpox in Calcutta 1833-34. 1837-38, 1843-44 and Vaccination in Bengal from 1827 to 1844, Calcutta, 1844.
27. Data on registered deaths first appeared in Deaths in Bombay 1848.
28. Data on registered deaths first appeared in Deaths in Madras 1855.
29. See W. Seton-Karr (ed.). Selections from Calcutta Gazettes for the Year 1802, Calcutta, 1864. Vaccination first reached Bombay from Europe in June of 1802. It arrived in Madras in September via Colombo, finally reaching Calcutta in November.
30. Partly because of denominator problems and also for reasons of space Madras is not shown in Figure 6.
31. See Report of the Smallpox Commissioners, Calcutta, 1850. A committee was appointed by the Government of Bengal to inquire into the 1549-50 smallpox epidemic at Calcutta; it recommended a ban on inoculation, holding it responsible for epidemics.
32. By Act V of 1865, the government was authorized to ban inoculation in any part of Bengal provided that simultaneously it made vaccination available to the people.
33. A Compulsory Vaccination Act was first promulgated in India in Bombay in 1877. Children born within the city limits were required to be vaccinated within six months of birth, failing which their parents could be prosecuted.
34. See T. Dyson, "Infant and child mortality in the Indian subcontinent, 1881-1947," in A. Bideau, B. Desjardins, and A. Ferez Brignoli (eds.). Infant and Child Mortality in the Past (Oxford: Clarendon Press, 1997).
35. See Report of the Smallpox Commissioners, Calcutta, 1850, p. 13; and Annual Report of the Sanitary Commissioner, United Provinces, 1884.
36. First Sanitary Report for Oudh 1868-69, p. 5.
37. Report on the Scarcity and Relief Operations in the North-Westem Provinces and Oudh During the Years 1877-1878 and 1879, Allahabad, 1880.
38. The neighboring towns of Kanpur, Allahabad, Agra, and Bareilly practiced vaccination from the early nineteenth century.
39. See Sanitary and Vaccine Report for the Province of Oudh, 1869; Reporten Vaccination 1869-70, p. 2.
40. See Dyson, cited in note 8; also T. Dyson, "The historical demography of Berar, 1881-1980," in T. Dyson (ed.), India's Historical Demography: Studies in Famine, Disease and Society (London: Curzon, 1989).
41. See Reporten the Hyderabad Assigned Districts 1855-56, Appendix No. XVII, which states that "Two Brahmin vaccinators with 4 peons were appointed in 1854 to travel village to village for six months."
42. See Report on the Hyderabad Assigned Districts 1857-58, p. 79, which mentions the "difficulty of finding suitable persons as vaccinators and ... their lack in experience, [the] time required for their instructions .. . the frequency of their resignations of the department, [the] prejudice of the people and [the] difficulty in exercising any direct supervision over the vaccination."
43. Primary vaccinations conducted during 1856-67-as reported in the Annual Administration Reports-were 365, 304, 181, 577, 608, 544, 436, 582, 692, 678, 605, and 386 respectively.
44. Annual Report of the Sanitary Commissioner, Hyderabad Assigned Districts, 1890, p. 16.
45. In Berar the Compulsory Vaccination Act was introduced in 1893 in towns only.
46. Annual Report of the Sanitary Commissioner, Hyderabad Assigned Districts, 1896-97 pp. 8 and 9.