14
REPORT ON THE WORKING OF THE KING INSTITUTE, GUINDY
B.— BACTERIOLOGICAL SECTION.
The Preparation and supply of Bacterial Vaccines.
The number of doses of autogenous and stock bacterial vaccines sent out
during the year was 61,562 as compared with 69,048 doses issued in the year 1920
(see statements VI and VII). The decrease in the total quantity issued is due to
the smaller demand for prophylactic influenza vaccine consequent upon the gradual
subsidence of the influenza epidemic. A satisfactory feature of the year's
working, however, is the greatly increased demands for the prophylactic cholera
and T.A.B. vaccines. The issues in both these cases were more than double those
of the previous year.
In spite of this increase, however, the amount of cholera vaccine used in the
Presidency is still very small when compared with the huge population almost
constantly at risk from this very fatal disease. Great opportunities for the use of
this prophylactic exist where great numbers of the people collect together, such as
at fairs and festivals. It is to be hoped that this very simple means of protection
will become still more popular as time goes on.
Autogenous vaccines were prepared for 261 cases. The type of case which
gave rise to the demand for these special vaccines did not differ to any extent
from that of previous years and included various affections of the skin such as
furunculosis, eczematous conditions, abscesses and carbuncles and certain
catarrhal affections of the respiratory tract. As the Institute sees only a very
small proportion of the actual cases for whom these vaccines are made, and those
only at the time of culture, it has been the custom to forward a form requesting
information as to the result of the treatment with these vaccines. The response
to this request has always been very unsatisfactory and the result during the
present year is no exception to the rule, only 11 per cent of the total number of
returns sent out having been received. It is useless to base conclusions on such
meagre data and no attempt has been made to do so this year. At the same
time it is to be regretted that statistics, which would be made available with
comparatively little effort, should be lost especially when the amount of labour and
trouble involved in the preparation of these autogenous vaccines is considered.
Examination of specimens.
The specimens sent for examination to the Institute during the year
show no falling off either in number or variety (statement VIII). There
is in fact an increase of 6 per cent over the number examined during the
previous year. Mere numbers in this case, however, afford little indication
of the amount of work actually performed, for the different examinations
vary very considerably in the amount of time and skill required for their
performance. Due consideration must be given to the more complicated tests
in making comparisons of this sort. A study of the tests carried out at the
Institute since its foundation shows that there has been a gradual change in
the type of examination which the Institute has been called upon to perform.
In its early years blood films for malaria and smears for plague formed the bulk
of the examination. These have been gradually replaced by tests such as the
Wasserman reaction, the various agglutination tests and the more complicated
cultural operations required for the separation and identification of the more
delicate organisms. The simpler examinations, such as the examination of blood
films for malarial parasites, are apparently being carried out to a greater extent
by the practitioner himself, This is as it should be and no exception can be
taken to a change of this sort.
There has been a steady increase in the number of Widal and Wasserman
reactions carried out at the Institute during the year. The number of speci-
mens sent for the former test reached 813. Each test really consists of four
separate operations for each serum is tested for the three organisms of the
typhoid group as well as for the micrococcus melitensis.
It is of interest to note that no less than 457 cases gave negative results
to all four organisms. It is presumed that blood slides for malarial parasites had