REPORT ON THE WORKING OF THE KING INSTITUTE, GUINDY
7
glycerine lymph in a cool climate. The best all round results are those obtained
by the Madras Corporation who in addition to a case success rate of 96.3 per cent
have also recorded an insertion success rate of 88.9. The order of priority of the
districts does not differ materially from that of the previous year. The majority
of the districts who returned bad results last year have done so again this year.
No definite reason such as higher temperature or length of time before receipt
of vaccine from the Institute can be assigned for the bad results received from
these districts. One is forced to the conclusion therefore that there is a consider-
able difference in the amount of skill and care displayed by the vaccination staff
belonging to different districts. Now that the vaccination operations have been
placed under the supervision of the new Health Officers who have themselves
received a special training in vaccination, it is to be hoped that those officers who
have been appointed to the bad districts will do their best to remove this slur
upon the district public health administration.
Revaccinations. —Statements Nos. 6 and 7 and charts Nos. I and II show the
results obtained with revaccinations. These statements have been included this
year for the first time in the Institute annual report. No comparison with the
results of previous years is therefore possible. The case and insertion success
rates must of necessity be much lower than those for primary vaccinations as it
must be presumed that many persons who present themselves for revaccination
have not yet lost the immunity conferred on them by their previous successful
vaccination. The same argument may also be applied to a certain extent to the
insertion success rate in these cases. The rates for the various districts vary
considerably, again giving an index of the skill of the vaccination staff of the
districts concerned.
The number of returns for revaccination is exceedingly small (only 198,262)
when it is remembered that the returns are drawn from the whole Presidency.
Every effort should be made to increase the number of revaccinations, for if we
take the case success rate with glycerine lymph (41.9 per cent) as an index of the
non-immune adult population of the Madras Presidency, then the actual number of
individuals who are not immune to smallpox must reach enormous proportions.
(e ) Work in the Saidapet range. —Through the kindness of the President of
the District Board, Chingleput, the Saidapet vaccination range was once more
placed at the disposal of the King Institute during the year under report. It was
thus possible for the members of the Institute staff to continue to observe the
results of different batches of vaccine lymph before issue and to carry out further
experiments in connexion with the best methods of manufacture. Such an
arrangement is so valuable from the Institute point of view that the permanent
allocation of the range to the King Institute as a "model vaccination range,"
where the effect of all measures taken to improve vaccination could be tested
before they were passed for general use, is a measure well worth consideration.
Meanwhile, the President of the District Board has again been approached with a
view to the extension of the period for another year.
The work which has been done in this range may be considered under two
headings :—
(1) The testing of different batches of stock lymph before issue to the
Presidency at large.
(2) Experiments as to the feasibility of purifying glycerinated lymph by
the chloroform process.
(1) The testing of different hatches of stock lymph before issue to the Presi-
dency at large.—A very large number of different batches of both lanoline and
glycerine lymph have been tested. Eight thousand one hundred and seventy-two
children have been vaccinated in this way, the majority being vaccinated on the
right arm with lanoline lymph and on the left arm with glycerine. The case and
insertion success rates in each case were as follows :—
Case
percentage.
Insertion
percentage.
Glycerine lymph
...
. . .
90.9
84.5
Lanoline lymph
...
. . .
68.5
53.3d