IN BURMA FOR THE YEAR 1905-06.
3
whilst an unprotected population suffers chiefly in respect to children, unless
revaccination be resorted to in a population protected only by infantile vaccination,
adult lives are in danger. Hence, it is a healthy sign that the Municipality of
Rangoon is, at the present time, considering the advisability of asking for powers
to enforce re-vaccination.
Statement
No. I.
14. The success rate of re-vaccination varied from 100 per cent. to 1.92 in
a total of 52 cases. As to the first figure, it may be accepted, having regard to
the small number (2) treated; but there must be some error in respect to the
latter cases. The whole subject of success rate of re-vaccination depends upon
so many factors that it is not desirable that the matter should be expatiated upon;
but the chances are, judging from my own work, including vaccinations of persons
who have suffered from small-pox and who have been inoculated, that the rate
is low.
15. The vaccine lymph used was entirely bovine obtained from Meiktila
Vaccine Depôt, except in the case of Rangoon which, as already stated, is
supplied by its own depôt. All reports go to show that the supply was
trustworthy.* As, however, exhibited by the varying rates of success shown
in Statement No. I, it is but one stage in progress to place at the disposal of
the vaccinator trustworthy material; it still remains for the vaccinator to under-
stand how to use it with full advantage. It need hardly be said that with men of
the grade of education now available as vaccinators, all possible results are not
secured by them. Irrespective of careless exposure of the material to the sun,
there exist varying methods of performing the operation that go towards diminish-
ing the chances of success. Much in this respect can be done by Civil Surgeons
training the men to perform the operation on uniformly recognized principles ;
whilst during the next year, it is hoped to equip each vaccinator with "vaccine
carriers" that will protect the vaccine as far as feasible during transport from sun
influence, and at the same time provide for the requirements of asepticism. Three
forms of vaccine were used, namely, lanoline-vaccine, glycerinized-vaccine, and
quinated-vaccine. The latter form was excogitated by Major Entrican. It con-
sists of a proportion of bihydrochloride of quinine in sterile mucilage, stained with
cochineal. At the time of his original efforts, Major Entrican was unaware of the
fact that this form of quinine had been previously used by Dr. Alan Green in
experiments for the killing of extraneous micro-organisms, but the curious choice
of media had not been forestalled and these certainly serve their purpose. Quinine
was, however, put aside by Dr. Alan Green, in virtue of its effect in gradually
modifying the vesicle. That whilst recognizing its influence, however, up to a
certain period, this modifying influence may be disregarded and a vaccine less
loaded with organisms be produced, is testified to by Major Entrican. In com-
paring the various vaccines issued he shows, as experience in India already amply
testifies, that where duration of vitality is concerned lanoline easily leads as the
preferable medium, but he points out that in the unskilful vaccinator's hands the
more fluid glycerine forms are more readily manageable. This, of course, is a
mere matter of training men to certain procedures. The whole subject, however,
is being carefully worked out by Major Entrican, and as he takes a keen interest
in the subject of the cultivation and preservation of vaccine, I have no doubt
interesting results will be secured. But, in the meantime, his report goes to
support the opinion as to the necessity of more uniform methods and more skilled
training of vaccinators. An interesting matter in connection with Major Entri-
can's work in the Vaccine Depôt has been the production by him of two machines
for the filling of lanoline-vaccine in tubes, and of glycerinized and quinated lymph
in capillary tubes, respectively. He has produced, in both cases, decidedly
ingeniously contrived apparatus, which fulfil efficiently in a few minutes work
that, under other systems, would demand several hours tedious labour.
16. On the subject generally of organization of the Vaccination Department,
Government has directed me to furnish a report, and I trust that these and other
matters will, during the current year, be fully attended to.
W. G. KING, M.B., D.P.H., COL., I.M.S.,
Superintendent-General of Vaccination, Burma.
* FOOT-NOTE.—Although, in contrast with the history of previous years, Major Entrican was able to
produce vaccine continuously throughout the hot season at Meiktila, he shows that, as might be expected,
climatic conditions handicapped his efforts. On this subject, Government will be specially addressed.