NOTES ON THE STATISTICS OF VACCINATION IN BURMA FOR THE YEAR 1899-1900.
15
ture is put down to an outbreak of foot-and-mouth disease, and to an increase
under postage and packing charges owing to an increased demand for lymph.
(b) Taunggyi.—The vaccine depôt at Taunggyi was started as an experi-
mental measure in 1896-97, and whilst it remained in the experimental stage it
was considered that the work could be carried on in the Civil Surgeon's office by
the ordinary hospital staff; the addition of a clerk was made the following year,
and an attendant was added during the year under report.
The depôt is a mud-walled building in the hospital compound, but indiffer-
ently suited for its purpose. The appliances are insufficient and the methods are
rough.
In the earlier part of the year under report lanoline vaccine was manufactur-
ed, but this preparation was found to have a tendency to become mouldy in wet
weather and to decompose readily; consequently glycerine only was used as the
vehicle for mixing with the lymph, with the result that at first glycerinated vac-
cine kept pefectly sweet and free from smell for a longer period and was found to
retain its potency for upwards of six weeks; later on, however, the activity of the
virus failed and proved entirely unsuccessful in some stations to which it was sent.
The Civil Surgeon, Taunggyi, attributed this failure of infectiveness to deterior-
ation in the quality of lymph through exposure to air and contamination by the
bacilli of putrefaction, as well as to the ignorance of the vaccinators as to the pro-
per method of using the preparation.
The instrument in general use by the vaccinators is the vaccination lancet
with which the lymph is inserted by means of the ordinary puncture. This is a
simple and certain process if the process is performed with human lymph from
arm to arm, but when preserved lymph is used puncture by the lancet does not
give satisfactory results and should be avoided, as the successful results will be
disappointingly small. With any kind of preserved lymph scarifications should
alone be used to the exclusion of every other mode of introduction, and the lymph
should be rubbed in with moderate friction in order that it may penetrate well.
A very good scarificator is a modification of Weir's instrument consisting of
four No. 6 needles inserted into grooves in a plated handle with a small spatula
at the other end for rubbing the vaccine into the scarification. A small cap fits
over the needles and they can be removed at will and replaced by new ones when
they become blunt, tarnished, or tainted.
Three scarifications should be made on one arm, and, as the resulting cica-
trix is in each instance about quarter of a square inch, any two successful scars will
afford the maximum criterion of success, i.e., half a square inch.
In addition to the causes inducing to failure of Taunggyi vaccine as speci-
fied by the Civil Surgeon, a most potent, if not the main factor, is probably the
free use of perchloride of mercury both in the preparation of the calf and in the
collection of the vescicles, for this antiseptic is not only deterrent to the growth
of germs of putrefaction, but to the vitality of the vaccine germ itself. The use
of sterilized water without the admixture of any antiseptic, scrupulous cleanliness
of the hands of the operator, the belly of the calf, and the instruments by boiling,
will be found to answer all requirements.
The outturn of vaccine from the Taunggyi depôt during the three past years
is compared below:—
Year.
1897-98... ...
1898-99... ...
1899-1900... ...
Cost.
Rs.
603
841
1,179
Number of oper-
ations for which
a sufficiency of
lymph was sup-
plied.
25,000
34,000
48,990
Average cost of
vaccine suf-
ficient for one
case.
PIES.
4.5
4.7
4.7