Dharmapal (2000) has quoted British sources to prove that inoculation in India was
practiced before the British did.
In the seventeenth century, smallpox inoculation (tikah) was
practiced in India.
A particular sect of Brahmins employed a sharp iron needle to carry out these
practices. In 1731, Coult was in Bengal and he
observed it and wrote (Operation of inoculation of the smallpox as performed
in Bengall from Re. Coult to Dr. Oliver Coult in 'An account of the
diseases of Bengall' Calcutta,
dated February 10, 1731):
The operation of inoculation called by the natives tikah has been
known in the kingdom of Bengall as near as I can learn, about 150 years and
according to the Bhamanian records was first performed by one Dununtary, a
physician of Champanagar, a small town by the side of the Ganges about half way
to Cossimbazar whose memory in now holden in great esteem as being through the
another of this operation, which secret, say they, he had immediately of God in
a dream.
There method of performing this operation is by taking a little of the pus
(when the smallpox are come to maturity and are of a good kind) and dipping
these in the point of a pretty large sharp needle. Therewith make several
punctures in the hollow under the deltoid muscle or sometimes in the forehead,
after which they cover the part with a little paste made of boiled rice. When
they want the operation of the inoculated matter to be quick they give the
patient a small bolus made of a little of the pus, and boiled rice immediately
after the operation which is repeated the two following days at noon.
The place where the punctures were made commonly festures (sic) and comes to
a small suppuration, and if not the operation has no effect and the person is
still liable to have the smallpox but no contrary if the punctures do suppurate
and no fever or eruption ensues, then they are no longer subject to the
infection.
The puncture blacken and dry up with the other pustules.
The fever ensues later or sooner, according to the age and strength of the
person inoculated, but commonly the third or fourth days. They keep the patient
under the coolest regimen they can think off befor the fever comes on and
frequently use cold bathing.
If the eruption is suppressed they also use frequent cold bathing. At the
same time they give warm medicine inwardly, but if they prove of the confluent
kind, they use no cold bathing, but (keep) the patient very cool and give
cooling medicines.
I cannot say anything of the success of this operation or their method of
cure in this disease, but I intend to inform myself.
Dr. J.Z. Holwell writes the most detailed account for the college of
Physicians in London in 1767 (An account of the manner of inoculating for
the smallpox in the East Indies, by J. Z. Holwell, F.R.S. addressed to the
President and Members of the College of Physicians in London). He wrote:
Inoculation is performed in Indostan by a particular tribe of Bramins, who
are delegated annually for this service from the different Colleges of
Bindoobund, Eleabas, Benares, & c. over all the distant provinces: dividing
themselves into small parties, of three or four each, they plan their traveling
circuits in such wise as to arrive at the places of the operation consists only
in abstaining for a month from fish, milk, and ghee (a kind of butter made
generally of buffalo's milk); the prohibition of fish respects only the native
Portugese and Mahomedans, who abound in every province of the empire.
When the Bramins begin to inoculate, they pass from house to house and
operate at the door, refusing to inoculate any who have not, on a strict
scrutiny, duly observed the preparatory course enjoined them. It is no uncommon
thing for them to ask the parents how many pocks they choose their children
should have: Vanity, we should think, urged a question on a matter seemingly so
uncertain in the issue; but true it is, that they hardly ever exceed, or are
deficient, in the number required.
They inoculate indifferently on any part, but if left to their choice, they
prefer the outside of the arm, midway between the elbow and shoulder for the
females. Previous to the operation the Operator takes a piece of cloth in his
hand, (which becomes his perquisite if the family is opulent) and with it gives
a dry friction upon the part intended for inoculation, for the space of eight
or ten minutes, then with a small instrument he wounds, by many slight touches,
about the compass of a silver grout.
The instrument they make use of, is of iron, about four inches and a half
long, and of the size of a large crow quill, the middle is twisted, and the one
end is steeled and flatted about an inch from the extremity, and the eight of
an inch broad; this extremity is brought to a very keen edge, and two sharp
corners; the other end of the instrument is an earpicker, and the instrument is
precisely the same as the Barbers of Indostan use to cut the nails, and
depurate the ears of their customers. The operators of inoculation holds the
instrument as we hold a pen and with dexterous expedition gives about fifteen
or sixteen minute scarifications with one of the sharp corners of the
instrument, and to these various little wounds, I believe may be ascribed the
discharge which almost constantly flows form a part in the progress of the
disease. I cannot help thinking that too much has been said (pro and con) about
nothing, respecting the different methods preferred by different practitioners
of performing the operation; provided the matter is thrown into the blood, it
is certainly, a consideration of most trivial import by what means it is
effected; if any claims a preferences, I should conclude it should be that
method which bids fairest for securing a plentiful discharge from the ulcer.
Just making the smallest appearance of blood, then opening a linen double
rag (which he always keeps in a cloth round his waist) takes from thence a
small pledget of cotton charged with the variolous matter, which he moistens
with two or three drops of Ganges water, and applies it to the wound,
fixing it on with a slight bandage, and ordering it to remain on for six hours
without being moved, then the bandage to be taken off, and the pledget to
remain until it falls off itself; sometimes (but rarely) he squeezes a drop
from the pledget, upon the part, before it applies it; from the time he begins
the dry friction, to tying the knot of the bandage, he never ceases reciting
some portions of the worship appointed, by the Aughtorrah Bhade, to be
paid to the female divinity before mentioned, nor quits the most in a double
calico rag, is saturated with matter from the inoculated pustules of the
preceding year, for they never inoculate with natural way, however distinct and
mild the species. He than proceeds to give instructions for the treatment of
the patient through the course of the process, which are most religiously
observed; these are as follows:
He extends the prohibition of fish, milk and ghee, for one month from the
day of inoculation; early on the morning succeeding the operation, four collans
(an earthen pot containing about two gallons) of cold water are ordered to be
thrown over the patient, from the head downwards, and to be repeated every
morning and evening until the fever comes on, (which usually is about the close
of the sixth day from the inoculation) then to desist until the apperance of
the eruptions, (which commonly happens at the close of the third complete day
from the commencement of the fever) and then to pursue the cold bathing as before,
through the course of the disease, and until the scabs of with a fine sharp
pointed thorn, as soon as they begin to change their colour, and whilst the
matter continues in a fluid state. Confinement to the house is absolutely
forbid, and the inoculated are ordered to be exposed to every air that blows;
and the utmost indulgence they are allowed when the fever comes on, is to be
laid on a mat at the door; but, in fact, the eruptive fever is generally so
inconsiderable and trifling, as very seldom to require this indulgence. Their
regimen is ordered to consist of all the refrigerating things the climate and
season produces, as plantains, sugar-canes, water melons, rice, gruel made of
white poppy-seeds, and cold water, or thin rice gruel for their ordinary drink.
These instructions being given, and an injunction laid on the patients to make
a thanks giving Poojah, or offering, to the goddess is a pund of
cowries, equal to about a penny sterling, and goes on to another door, down
one side of the street and up on the other, and is thus employed from morning
until night, inoculating sometimes eight or ten in a house. The regimen they
order, when they are called to attend the disease taken in the natural way, is
uniformly the same. There usually begins to be a discharge from the
scarification a day before the eruption, which continues through the disease,
and sometimes after the scabs of the pock fall off, and a few pustules
generally appear round the edge of the wound; when these two circumstances
appear only, without a single eruption on any other part of the body, the
patient is deemed as secure from future infection, as if the eruption had been
general.
Thus far the system of practice pursued by the Bramins will, I imagine,
appear rational enough, and well founded; but they have other reasons for
particularly prohibiting the use of these three articles, which to some may
appear purely speculative, if not chimerical. They lay it down as a principle,
that the immediate (or instant) cause of the smallpox exists in the
mortal part of every human and animal form; that the mediate (or second)
acting cause, which stirs up the first, and throws it into a state of
fermentation, is multitudes of imperceptible animalculae floating in the
atmosphere; that these are the cause of all epidemical diseases, but more
particularly of the small pox.
That the great and obvious benefit accruing from it, consists in this, that
the fermentation being excited by the action of a small portion of matter
(similar to the immediate cause) which had already passed through
a state of fermentation the effects must be moderate and benign; whereas the
fermentation raised by the malignant juices of the animalculae received into
the blood with the ailment, gives necessarily additional force and strength to
the first efficient cause of the disease.
Holwell's detailed account, not only describes inoculation, but also shows
that the Indians knew that microbes caused such diseases.
In 1787 the Government erected a hospital for smallpox inoculation at Dum Dum
in Calcutta.
There were some restrictions included before and after inoculation, such as the
breastfeeding children were not inoculated, but children above one year of age
were considered old enough for the operation, no member of an inoculated
household was permitted to mix with the outside world, and no permission from
another village was permitted to enter a house having an inoculated person,
etc.
Smallpox in 18th and 19th Centuries:
During the 18th century smallpox was widely prevaialent in India, and
killed more people here than in other countries. At Calcutta in mid 18th centaury, the yearly
death rate from smallpox was, on an average, 12,000 per million.
In 1798, Edward Jenner discovered that the cowpox inoculation-vaccination
protected a person against the smallpox. Only four years after the discovery,
vaccination was introduced in India
under the guidance of Lord Clive. This was the time when British Government
banned this traditional inoculation practice.
In Calcutta,
around the 1802-03 inoculation was banned under the Bengal Presidency. At
first, in Bengall people rejected this vaccination because operation of
inoculation was very ancient and widespread. But in 1804, Dr. Shoolbred drew
attention to the determined opposition of the Brahmin inoculators. He tried to
convert the numerous ticcadars (inoculators) into vaccinators, and, to
an extent, he succeeded in his attempts. On April 23, 1805, after a visual demonstration
of the effect of vaccination, 26 Brahmin inoculators declaring their full faith
in the power of vaccination to prevent smallpox signed a statement.
Dr. T. P. Wright, civil surgeon of Bhagalpur
wrote in 1868 (Annual report of the Sanitary commissioner, India, Pp.
333.):
"There is a very strong prejudice against vaccination in almost all
parts of the district, and in five years, only 1519 operations have been
performed…."
In 1900, smallpox inoculation was still in practice in Bengal, Assam,
North-West Frontier Provinces,
Punjab and the Maratha state.
Conclusion
In olden times tikah (inoculation) against smallpox was very common
in Southern and Northern parts of India, chiefly at Calcutta. A special sect of the Brahmins
practiced this inoculation operation. It was a technical operation carried
through the sharp needle. Pollack asserts this operation was practiced in China from the
11th century and it definitely reached there from India. Around 17th Century it was
very common in India
but after the introduction of the smallpox vaccine in India by the
Britishers, this traditional inoculation practice was banned under the Bengal
Presidency.
Sources and Further Reading
Dharampal. 2000. Indian Science and Technology in the Eighteen Century.
An Account of the manner of inoculating for the Smallpox in the East Indies. Mapusa, Goa:
Other India
Press., Vol 1.
Dube, S. C. 1955. Indian
Village. London: Routlege and
Kegan Paul.
Leslie, Charles. 1998. Asian Medical systems: a comparative Study. Delhi: Motilal
Banarasidass.
Pollack, Kurt. 1968. The Healers, the Doctor, then and now. English
Edition. Pp. 37-8.
Sivin, Nathan. 2000. Science & Civilisation in China.
Vol.6. Part VI. Medicine. Cambridge:
Cambridge University press.
