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APPENDIX B.
Measures for obtaining efficient Vaccination.
Circular No. 5S., dated Shillong, the 11th September 1895.
From—The Principal Medical Officer and Sanitary Commissioner, Assam,
To—All Civil Surgeons in Assam.
In continuation of this office Circular No. 10S., dated the 21st September 1894, I have the
honour to request that, in order that the vaccine lymph supplied to you from the Shillong Depôt,
may be utilised as soon as practicable, and that you may at the same time be able to determine
whether the lymph supplied is active or not, you will arrange to vaccinate children in your sadr
station and its immediate neighbourhood with the first three supplies of lymph received by you
from the depôt in the beginning of the vaccinating season. I have also to request that as many
as possible of the operations done with these first three supplies of lymph be performed in your
own presence. If these supplies give good results, I beg to request that the supplies afterwards
received be distributed immediately after they reach your office to the vaccinators in your district
with instructions that the lymph be utilised by them as quickly as possible. I have, however,
to request that you will retain a few tubes of lymph taken from each supply, with which you
should do vaccination work in your sadr station soon after each supply reaches you, with a view
to your testing the quality of each supply received from Shillong. The results obtained from
the first three supplies received in the beginning of the season, should be reported to this office
as soon as they are known.
Circular No. 6S., dated Shillong, the 9th October 1895.
From—The Principal Medical Officer and Sanitary Commissioner, Assam,
To—All Civil Surgeons in Assam.
In connection with this office Circular No. 5S., dated the 11th September 1895, regarding
the measures to be taken for obtaining efficient vaccination, I have the honour to draw your
attention to the precautions which should be taken with a view to obtaining successful vaccination,
as given by Dr. Campbell in his Annual Report of the Bovine Vaccine Depôt at Shillong for the
year 1892-93, and contained in the 14th page of the Assam Annual Vaccination Report for that
year.
2. With a view to obtaining as efficient vaccination as possible during the ensuing season,
I beg to request that you will call the particular attention of your vaccinators to the following
points :
(a) Vaccinators should be requested never to expose the tubes containing vaccine lymph to
the direct rays of the sun, as it is well known that the sun's rays rapidly kill the active
principle of the lymph. Tubes should be kept in wooden boxes wrapped in cotton wool
and should never be removed from the boxes till they are required for use.
(b) Vaccinators should be directed to utilise each supply of lymph as soon after its receipt as
possible. It is well known that the vitality of vaccine lymph rapidly deteriorates by
keeping, specially in hot weather.
(c) Operations should, if possible, be done in the shade in places sheltered from the wind.
The sun's rays cause the lymph to dry rapidly, rendering absorption, even aided by
rubbing, difficult.
(d) If a child's arm is oily or dirty, it should be rubbed with a moist cloth before scarification
is performed.
(e) In scarifying, the skin of the child's arm should be stretched by the forefinger and thumb
of the left hand, and a slight scratch made with the right hand, either by a needle or
lancet. The scarification should be superficial, so slight that no oozing of blood should
occur till the lymph is being rubbed in. If by accident a deep scratch is made, the
vaccinator should wait till all oozing of blood has ceased, and should dry the arm with
a clean cloth before he applies the lymph, which in this case should be rubbed in gently.
(f) The scarification having been made, the lymph should be put on to an ivory point, and
should be well rubbed into the scratched surface.
(g) After the lymph is properly rubbed in, no article of clothing should be allowed to touch
the part till it is dry, the part should not be washed for a day or two afterwards, and,
when the vesicle rises, care should be taken to protect it from risk of rupture.
3. In order that the work of your vaccinators may be properly checked, I trust that you
will, during the ensuing season, do as much inspection work as practicable in the different
portions of your district, and that, in particular, you will scrutinise the work of licensed vaccin-
ators as closely as possible.
4. In order that the Civil Surgeon of Shillong may have as early information as possible if
any of the supplies of lymph forwarded to you from the Shillong depôt turn out to be inert, I beg
to request that, on finding, from operations done near your headquarters by means of the tubes
of lymph taken from each supply which you receive from Shillong, that a supply is inert, you will
at once inform the Civil Surgeon of Shillong, quoting at the same time the registered number of
the inert supply received, with the date of its receipt in your office.
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