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No. 154-P.H., 29TH JaNUaRY 1923
would have to be purchased at whatever price the manufacturers might demand,
and for bacteriological and other clinical examinations any private institution
would have its regular tariff of charges. The Government recognize the economic
value of the Institute, and have under consideration the annual preparation. of
a p r o f o r m a
a c c o u n t
o f i t s w o r k i n g .
6. The comparative merits of lanoline and glycerine lymph have been
discussed in detail in a separate report, disposed of by Government in G.O.
No, 1421-P.H., dated 16th October 1922. Incidental to that investigation, Major
Cunningham touches on certain important innovations in method, among them being
(a ) the utilization of the Saidapet Vaccination Range for testing lymph, ( b) the
intensive testing of the results in mufassal and (c ) Dr. Nejland's method of
increasing the potency of seed lymph by passing it through three vaccinifers in
rotation. The Director's proposal to establish a Saidapet range appears feasible,
and should be made the subject of a separate reference.
7. Major Cunningham then discusses certain facts brought to light by an
exhaustive examination of the success rate month by month, an examination
which affords useful data in. appraising the relative qualities of lanoline and
glycerine lymph and the effect of discontinuing vaccination during the hot
weather. In this connexion it is interesting to note that the demand in various
towns and districts for vaccine lymph during the hot weather might be used as au
index to the local prevalence of smallpox.
8. In examining the success rates, Major Cunningham brings to light two
important facts:
—
(a) That the fall of temperature due to the advent of the south-west
monsoon has little, if any, beneficial. influence on the vaccination rates He
concludes from this that a stoppage of vaccination for two months in the districts
which are subject to this monsoon is insufficient, and that better results could be
obtained by a four months' cessation throughout the Presidency. The Surgeon-
General will be asked to submit specific recommendations on this point.
(b) That the standard for successful vaccination adopted by the King
Institute is higher than that generally accepted by the vaccination staff. In this
connexion Major Cunningham again emphasizes the importance of taking into
account the insertion success rate and the verification of vaccination operations
in the vesicle stage as far as possible. On this question also the views of the
Surgeon-General are requested.
9. The number of doses of bacterial vaccines issued was less than in 1920,
owing largely to the decline in the incidence of influenza. The increasing demand
for T.a.B. and cholera vaccine is significant. The value of the latter protection
against cholera at fairs and festivals for those who intend to visit places of
pilgrimage is a fact which deserves the widest publicity, and should enlist the
attention of all medical practitioners and all who are responsible for public health
administration.
10. The Surgeon-General's opinion is invited on the difficulty expressed by
the Director in ascertaining the results of treatment by autogenous vaccines issued
from the Institute.
11. an interesting feature in the clinical examinations conducted at the
Institute is the tendency for the simpler examinations such as the examination
of blood films to give place to tests such as the Wasserman reaction, the various
agglutination tests and the more complicated cultural operations. It is unfortu-
nate that investigations started on the nature of fevers of uncertain origin had
to be discontinued owing to the diversion of the staff engaged on it to duty at.
Bellary in connexion with the outbreak of disease among the Mappilla prisoners
there. Major Cunningham brings home the importance of repeated examinations
in cases where a positive result is not attained in the first instance, a fact of
which, it is hoped, all medical practitioners will take note. The timely detection
of a case of anthrax, due to shaving with an infected brush, is an interesting.
example of the value of bacteriological diagnosis, and it is satisfactory to learn
that the patient ultimately recovered from this deadly disease.