10
4,055 grains lanolinated vaccine paste.
These figures show the necessity of an
adequate supply of lymph being kept in
reserve at the Bengal Vaccine Depôt.
The discovery by Dr. Blaxall of the
Government Lymph Establishment at
Hendon, London, that lymph could be
kept without losing its potency for a long
period of time, if stored at 10° Faren-
heit, will enable a reserve supply of
lymph to be maintained in sufficient
amount to meet the demand which would
arise should small-pox become epidemic.
Due to the failure of all efforts to in-
crease the local calf-supply for the cen-
tral depôt at Intally, a scheme is being
matured to open a branch depôt at
Ramna (Dacca) and it is hoped to com-
plete it in time for its inclusion in the
budget for the year 1929-30. Mean-
while, it may be necessary to supplement
the local production of lymph by pur-
chase from other provinces.
16. English Vaccination Committee.
—As an item of the greatest interest to
all engaged in the administration and
execution of vaccination, it appears use-
ful to report the appointment of a Com-
mittee in February 1926 by the Minister
of Health in England, in conjunction
with the Medical Research Council of
England, for the purpose of inquiring
and reporting from time to time—
(i) on matters relating to the prepara-
tion, testing and standardisation
of vaccine lymph;
(ii) on the practical methods which are
available in the light of modern
knowledge to diminish or remove
any risks which may result from
vaccination;
(iii) on the methods of vaccination
which are most appropriate to
give protection against risk of
small-pox infection in epidemic
and non-epidemic periods;
and to co-ordinate the work of investiga-
tion on these questions in England and
abroad, having regard to corresponding
work undertaken by international health
organisations.
17. The reasons which led to the
appointment of the above Committee may
briefly be stated. The vaccine lymph
used for public vaccinations in England
is prepared at the Government Lymph
Establishment in London, which also
supplies vaccine for the public services.
As a result, however, of the English
Therapeutic
Substances Act, 1925,
which will shortly come into operation,
responsibilities will also be imposed on
the British Government
Departments
concerned for the control of commercial
vaccines. Establishments in
which
vaccine lymph is prepared for sale and
use in this countny will in future need
to be licensed, and the control establish-
ed will be applicable also to the products
of institutes in foreign countries from
which lymph is imported. A principal
duty of the new Committee, therefore,
will be to advise on the standard require-
ments and tests which should be imposed
in consequence of the new legislation.
18. Since the Royal Commission on
Vaccination presented their final report
in 1896, considerable advancement has
taken place in general medical know-
ledge. The substitution of calf lymph
for humanised lymph has had beneficial
results, and the adoption of modern
methods has made the complication of
septic infection of the vaccinated arm a
relatively rare
occurrence. Neverthe-
less, examples of possible risk from vac-
cination occasionally arise, and in this
connection attention has been directed
on the Continent, as well as in England,
to cases in which symptoms of ence-
phalitis or other nervous conditions
have occurred shortly after vaccination.
19. Under the last heading of the
terms of reference, the Committee has
been asked to consider whether, in cer-
tain circumstances, advantage could be
secured by varying the methods of vacci-
nation, for example, in order to provide
temporary immunity during outbreaks
of small-pox.
20. Summary.—From
the
facts
stated in the preceding paragraphs, some
broad and simple conclusions may be
drawn. It is quite clear that the inci-
dence of small-pox has shown a notable
increase in Bengal since the year 1921,
and there appears to be no evidence that
the zenith of the present recrudescence
has been reached. I must again draw
attention to the grave risks incurred in
respect of small-pox as a result of
the
large proportion of the population which
is not vaccinated. Statistics
indicate
quite clearly the falling percentage of
primary vaccinations to births. In view
of the apprehended pandemic of small-
pox forecasted as likely to occur in or
about the year 1930, it becomes incum-
bent on all local authorities to put forth
all their efforts in preparing the popula-
tion to meet it whenever it comes. This