CALCUTTA AND ITS SUBURBS.
7
really serious evil. I am well aware that the maximum of work consistent with safe pro-
gress is a great desideratum, and that the establishment should be kept in full work; but in
making all the arrangements it has been kept in view, that the municipality pay for the
vaccinators, and if the residents of Calcutta fritter away the time of the men, it is they that
suffer the loss, and not the Government. Attempts are made to lessen the burden on the
municipality and to reduce the establishment from time to time; and the following table
(vide Appendix A.) will show that this matter has attracted yearly attention, and that the
same thing, which has been brought forward in the Resolution of Government, is being
steadily dealt with season by season as occasion offered.
Reductions.
The reductions which have, during this and during recent years, been made in the es-
tablishments, have been carried as far as is compatible with safety.
Any hope that still
further reductions to any great extent will be possible, is not warranted by past experience.
That ten years hence, in consequence of small further reduction being rendered possible by
the difficulties in the way of vaccination being diminished, the cost of vaccination will
be still further lessened to a slight extent, there is fair reason to believe. Any progress in
this direction will, however, be slow, and, reluctant as I am to confess it, no material dimi-
nution can be effected.
With the most complete data in my possession to enable me to form a judgment on
the subject, I feel myself in a position to state most distinctly, that the time will never
arrive in which a vaccination in Calcutta will come to cost such a small sum as one in
the country around, and that no operator will ever be able to overtake so many vaccinations
in Calcutta as he can readily do in the Mofussil.
Humanised animal
virus
8. Humanised animal virus.—In continuation of previous reports on the subject, I
have simply to mention that the stock of virus originally taken from the calf in Calcutta,
which had never previously been through the human system, had, on the 31st March 1873,
reached its 142nd transmission through man. It retains its efficacy unimpaired, but is
in no way superior to the old stock of lymph which is still in use in other parts of the
town.
Experiment
with
crust vaccination
9. Experiment with crust vaccination.—In compliance with instructions received from
the Inspector-General of the Medical Department, an experimental use of crusts has been
made to test: (1) the power of the crust to produce a genuine vaccine vesicle ; (2) as
to whether the vesicle so produced is simply a local disease, or produces constitutional effects
as well. I would guard against the supposition of the experiment being in any way an
original one, as when Bryce, in the beginning of the century, announced his discovery that
the crust could be used to vaccinate from, he had completely established both points.
Since his time other observers have fully corroborated his views. The assertion has
rashly been lately made in India that a spurious disease only resulted from the use of crusts,
and that the system was not thereby protected. It was deemed advisable to disprove the
assertion by bringing forward the results obtained by using crusts in a few cases rather
than to appeal solely to previously recorded facts.
Eighteen children were vaccinated from crusts. Of these in two, on a first vaccination
failing, a second attempt from crusts could not be made, so that sixteen only were success-
fully vaccinated from crusts. In all of them the vaccination ran a normal course. In
three of them Bryce's test was applied from crusts, and in two with lymph reared from
crusts. In whatever way that test was applied it gave similar results, the areola forming
round the later vaccinated points at the same time that it did round the first vesicles pro-
duced.
Besides these, four children were vaccinated with lymph reared from crusts. Bryce's
test was applied to these cases with virus belonging to a stock which had been propagated
from a calf inoculated with cow-pox which had not been through the human subject pre-
viously to its transference in Calcutta about two years ago; all of these cases also res-
ponded to the test, both the original and later vaccination being simultaneously surrounded
with an areola. Two of the cases vaccinated from crusts were vaccinated direct from the
arm after an interval of some three months. In one of the cases the vaccination failed
entirely, in the other it succeeded, but ran the modified course which it does after previous
protection has been afforded. The areola in this case formed after four days and sixteen
hours; two diminutive crusts falling off on the 10th day, and the two others being separated
on the 11th day. This last case, though opening up other large questions, proves conclu-
sively that the previous vaccination from a crust had not been merely a local disease, but
had influenced the constitution of the child.
In Appendix B six charts of the temperature of cases vaccinated from crusts are for-
warded. A glance at any of them will shew that febrile excitement attended the for-
mation of the areola. It should be noted, however, that the temperature was only taken