15
(d) It is a good plan to perform the operation in the shade and out of the wind, because the
heat of the sun and the wind make the lymph dry on the arm before it has been rubbed in sufficient-
ly to be absorbed. Should it dry too quickly, all that is necessary is to add a drop of pure water
and go on rubbing.
(e) The after treatment of course is not to let the cloths get near the part till it is dry, nor to
wash the arm for a day or two, and to warn the parents to take care that when the vesicle rises it is not
broken ; but, besides these rules, which if not carefully carried out affect the results, of course there are
certain rules regarding the manufacture of lymph, which, if neglected, will impair the efficacy.
The rules are—
(1) Everything must be very clean, the calf properly shaved and washed.
(2) The scarification must not be too deep, or the oozing of blood will prevent the absorption of the
lymph.
(3) If any blood is oozing from a deep scarification it should be wiped off with a damp towel.
(4) The lymph, which should contain a proportion of humanized lymph after every two rounds,
must be well rubbed in and allowed to dry.
(5) The calves must be carefully housed and fed and kept clean and dry as there is a rise of
two to three degrees of temperature and they are very apt to develop pneumonia or
inflammation of the bowels while in this feverish state if exposed to cold or damp.
(6) The lymph should be taken from the inoculated calf from 100 to 120 hours after inocula-
tion. This depends on the weather and the rapidity with which the vesicles develop.
(7) In taking lymph, great care must be exercised that the vesicles have first been cleaned of all
dirt, crust, perspiration, &c., and then only the solid part of the vesicle should be carefully
scraped off with a blunt spoon. No blood or serum should be taken, otherwise the lymph
will not keep well.
(8) The lymph should at once be taken into the room where the tubes are loaded and put in
to a mortar to prevent dust getting into it. The room should have the windows covered
with paper to prevent the sunlight streaming in on the lymph prepared, as it takes
some hours pounding the lymph and loading the tubes The lymph should be pounded
with equal parts of glycerine and water till intimately mixed.
(9) The tubes must be carefully loaded, and care taken that the lymph is in the middle of the
tube, and the tube not too full.
(10) In sealing the ends of the tubes, see that a little air is exhausted by passing through the
flame before sealing, otherwise the end is expanded by the air and is sure to get broken
later on, and the lymph, being exposed to the air, goes bad or dries up altogether.
The reports received have been on the whole satisfactory :
(1) Surgeon-Captain Kanta Pershad, in medical charge, 10th Bengal Infantry, Barrackpur,
was twice supplied with lymph. Ho vaccinated 76 in the 10th Bengal Infantry, and
says all were successful. There were no bad symptoms in any case. The lymph was
excellent in every respect.
(2) Doctor Gillespie, Balipara, Tezpur, reports he has performed 1,350 primary vaccinations
with the best results. The lymph has been in every way excellent.
(3) Surgeon Lieutenant-Colonel A. B. Strahan, 44th G. R., Shillong, says in his annual regi-
mental report: "Including men, women, children, and followers, 240 were vaccinated, of
them 226 were successful and 14 unsuccessful, but the majority of latter number had
been previously inoculated in Nepal. The lymph (bovine) which was obtained from the
vaccine depôt, Shillong, was excellent.
This officer also informs me that he has noticed the difference- between cases vaccinated by
himself and by the Hospital Assistants has sometimes been very marked, his being great
successes and the Hospital Assistants not so good, or unsuccessful in some cases. This was
due to the great care in scarifying and in rubbing in the lymph.
(4) Doctor Bishop, Huntley, Golághát, writes: — " While thanking you for supply of lymph
already sent, I write to say I shall not require any more. It has been very good, and I
have hardly had any failures with it."
(5) Doctor A. Allen, Dullabcherra, Sylhet, writes—" In the Chargola valley I have had 1,020
children vaccinated and in the Longai valley about 150, all with your lymph, which is the
best ever I had. I cannot tell you the number of failures, but they are very very few. I
vaccinated 120 on two consecutive days without one failure, all from fresh lymph."
Lanoline lymph.
14. During the non-working season experiments were made with this preparation of lymph, and
a short report forwarded on the 4th October 1892. Copy of this
report is herewith attached.
General remarks.
15. The Hospital Assistant in charge, second-grade Hospital Assistant Pertab Chandra Bose, has
worked well. I am glad the Local Government has sanctioned his
extra allowance, though he only benefits but little by it, as the sanction
was received so near the end of the year. His time is so occupied that he cannot undertake practice
during the working season, and I have forbidden him to do so between the hours of 7 a.m. and 5 p.m ,
as he must be present, not only to inoculate the calves, take the lymph, see to the pounding the lymph,
loading and sealing the tubes, packing the tubes and distributing them, but also to see the calves taken
out to graze, to see them fed, their bedding put in, the houses cleaned out and washed, fires put on, their
food cooked and finally see them housed in the evening. In fact, the duties go on night and day,
for in the winter the fires must be replenished in the middle of night and early morning, and sick calves
treated as required. All this Pertab Chandra Bose has done, and done well.
A supernumerary Hospital Assistant, Chandra Kisor Sen (2nd), has been attached to the depôt
from 24th December 1892 to learn the duties, and is now qualified to carry on the depôt work.
R.NEIL CAMPBELL, Surgeon-Major,
Civil Surgeon.