APPENDIX.
Circular No. 4T., dated Darjeeling, the 29th September 1894.
From—W. H. GREGG, ESQ., M.B., DIP. PUB. HEALTH, CAMB., M.R.C.P., LOND.,
Sanitary Commissioner, for Bengal,
To—All Civil Surgeons (except the Civil Surgeons of the Districts in the Patna and
Bhagalpur Divisions).
IN paragraph 10 of the Government Resolution on the Annual Vaccination Report for
the year 1893-94, it was ordered that the experiment of vaccinating from local calves, which
was introduced too late last cold weather to admit of a full trial, should be continued
during the ensuing season with all the precautions needed to give it a fair chance of success.
The experiment should for the present be confined to those portions of a district where the
operations can be easily supervised either by yourself, or by one of your subordinates on
whom you can rely.
2. It must be distinctly understood, however, that the existing system of arm-to-arm
vaccination—which, when carefully performed from healthy children, is unobjectionable—must
not be interfered with when working satisfactorily. The object in introducing calf lymph is
not to supersede arm-to-arm vaccination, but to supplement human lymph (1) in localities
where such lymph is not easily available, (2) in places, such as jails and municipalities, where
large quantities are required, and (3) during outbreaks of small-pox, when a considerable
amount of lymph is suddenly wanted.
3. Instructions have already been issued which it is expected will result in the supply
of good lymph in future from the animal vaccine depôts at Calcutta and Darjeeling. This
lymph should be principally used in starting vaccination in the rural portions of your district.
4. In municipalities, jails, lunatic asylums, and selected rural areas containing compact
villages, locally raised calf lymph should be extensively used, the cost being borne by the local
authorities concerned. The necessary instruments, viz., forceps, lancets, small bottles for
storing lpmph, &c., will be provided by the Civil Suegeon from the Vaccination Department,
but the cost of the hire of the calves, which it is understood can be obtained from prices
varying from 8 annas to 1 rupee, and any other contingent expenditure in connection with
the operations, will have to be paid for by the authorities concerned. The calves should be
shaved and the operations performed by the paid vaccinator of the locality. The work should
be supervised and the subsequent inspection of results made by the Civil Surgeon as Superin-
tendent of Vaccination, or under his orders, if he has not the time, by an Assistant Surgeon
or a Civil Hospital Assistant, or by the District or a Sub-Inspector of Vaccination. In
villages the chaukidar and villagers may assist in holding down the calf or in any other way
that may be necessary.
5. The following are the details of operation which should be carefully explained to the
sudordinate vaccination staff:—
Rules for the guidance of vaccinators in vaccinating direct from village calves.
(1) Procure a calf under two years of age, preferably white in colour.
(2) The vaccinator should lay the calf on its back, and while it is held down he should
wash its abdomen and thighs with soap and water, and then shave the abdomen below the navel.
The inner side of the thighs should also be shaved.
(3) If lanoline vaccine paste is employed, a scarifier may be used, but if the calf is
inoculated with fresh lymph, a vaccine lancet will do.
(4) After inoculation, keep the calf tied up until the lymph has dried, and then give the
calf back to its owner, who may feed it as usual.
(5) On the fifth day (96th to 120th hours) the vaccinator should visit the calf, wash the
parts inoculated, pick off the crusts and squeeze the bases of the vesicles in order to obtain the
lymph.
(6) About every fifth rotation of calves, a fresh strain of lymph derived from a child
should be introduced.
(7) While the lymph is maturing on the calf, it should wear a bamboo collar in order to
prevent its turning round and licking the inoculations.
6. Extensive scarification, such as is carried on in the animal vaccine depôts, where the
object is to get as much lymph as possible from each calf, is not necessary in the case of local
calf inoculation, where only a few scarifications are required on each animal, enough to
vaccinate from 50 to 60 persons. It should also be impressed on the owners of the calves that
no harm is done to the animals by the operations, and that no particular care is necessary
during the period the lymph is ripening.
7. In addition to places specified in paragraph 4, where vaccination should in future
be performed with locally raised calf lymph, such lymph should as far as possible be used
whenever specially asked for by sections of village or other communities, especially during
outbreaks of small-pox.
8. There will probably be little difficulty in persuading Muhammadans to have their
children vaccinated with locally raised calf lymph, but there may perhaps be a little difficulty
with some Hindus until they see and are convinced of the advantage of such vaccination.
In all such cases the exercise of tact and patience will be necessary, but no compulsion should
be used. People in the selected areas who prefer the ordinary arm-to-arm method should be
vaccinated accordingly.
9. In conclusion, I have the honour to request that you will be so good as to report
specially on the working of the system of locally raised calf lymph in your quarterly vaccina-
tion and sanitary reports.
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