8
in order to show the vaccinators that it can be done by any single vaccinator at
once in any village without special appliances. Calves of three or four months
are selected. One is laid on the ground on its side, and its legs tied or held.
The udder or belly is roughly shaved. The female calf is the best, as the udder
is more delicate and easier to puncture. About 20 to 30 punctures are made in
the usual way deep enough to draw a show of blood. The lymph from a baby's
arm is inserted in the usual way. The vesicles are ripe and can be used on
the 5th and 6th days. The amount of lymph in each vesicle is small, but it was
found that the slightest stain on the lancet was enough to ensure successful results.
By puncturing and waiting for some minutes enough lymph oozes out to be filled
into a tube. By squeezing the vesicle with a forceps the flow is promoted,
The vesicles produced in children were found to be very well developed.
There were no severer symptoms in any of the cases than in ordinary vaccina-
tion. It was known that Mohammedans were not likely to make any objection,
but we were astonished to find that many Hindus, especially the best educated
and of the highest castes, accepted it. The people had to come openly and of
their own accord and squatted down near the calf till the children were done.
There was not the slightest attempt to conceal the source of the lymph, and the
people were told that they could take it or not as they chose. It was only
towards the end of the epidemic that we succeeded with the calves. If we had
done so earlier, there would have been a ready supply of lymph. These results
prove, (1) that without any special skill or appliances calf vaccination may be
started by a vaccinator in any village at any time; (2) that in this way an amount
of lymph may be obtained in two or three weeks enough to cope with the require-
ments of an epidemic if the people will accept it; (3) that there is no special severity
in the vaccinations done in this way from the calf. It is to be remembered that
this is retro-vaccination, which has only the effect of re-vivifying the lymph. It
is not the same as inoculation of the calf with small-pox, the lymph resulting from
which may produce severer effect. It would seem to be indicated that there would
be little objection on the part of the Mohammedans to its use, and also apparently
on the part of the better class of Hindus. I am informed that in the Presidency
towns it is generally preferred by Hindus to 'arm-to-arm' vaccinations."
Dr. Doyle's arrange-
ments for procuring
lymph.
24. In regard to supply of lymph, Dr. Doyle followed the usual plan,
which he explains thus :—" At the beginning of the hot wea-
ther I settled with the vaccinators what ground should be
covered during each successive summer month, so as to
finish the work in the hills, by about the 10th October. I reserved a sufficient
tract of suitable ground to supply lymph in September. During the latter half
of September three pairs of vaccinators worked in three different places within
reach of Murree. From these sources I was able to send lymph to the districts,
without keeping a supply stored up. In the great majority of cases, I sent
off the lymph to the plains, on the day after it was gathered. In some
instances I was able to send it off on the day on which I filled the tubes.
In 1884, I enquired of Civil Surgeons when they would wish to have
lymph sent, and I was guided last year, by their replies. In most districts
vaccination was started between the 25th and end of September. At least three
supplies were sent to each district usually 3 tubes at a time. To many districts,
however, I sent a larger supply than this, as I had lymph to spare. The Eng-
lish lymph (human) was received in the latter part of August, and it was pro-
pagated and in good condition, by the 20th of September. No tubes of calf
lymph were received from England, but a number of points charged with calf
lymph were sent. These I did not try."
Dr. Center's experi-
ments exceedingly in-
teresting and commend-
able.
25. The experiments made by Dr. Center are exceedingly interesting,
and deserve special commendation. There is no difficulty,
as is now proved, to the same course being pursued in all large
cities.
Municipal Corporations should be informed of this
simple means of getting fresh lymph direct from the calf,
where "arm-to-arm" vaccination is impeded by the objection of parents to allow
lymph to be taken from their children who have been vaccinated.