4
what the attitude of these people is towards all sanitary improvements, and in my
Sanitary Report for this year I have recommended that inoculation should be made
an illegal operation and the Ganaks performing it made punishable by law.
16. To try to convince the people of the benefits of vaccination, 170 copies of a
book called " Small-pox and Vaccination" by Dr. S. M. Das, M.B., were purchased and
distributed to all Hospital Assistants and all Inspectors who can read English, and
we are indebted as usual to Pandit Gunahash Goswami, Tahsildar of Roha in the Now-
gong district, for the very valuable help he gave to the vaccinators visiting his ilaqa.
Preservation of lymph.
17. Continued experiments have been made with regard to the keeping qualities
of our glycerinated lymph. I caused a certain quantity
of tubes from each batch of manufactured virus to be
kept for 4 months in my own office table during the last cold season and then distributed
to various selected officers with the following results: the Civil Surgeon, Goalpara,
reports that about two-thirds of the cases were successful; the Civil Surgeon, Nowgong,
found the contents of one box quite useless and that of the other one as fairly good,
but not fully equal to fresh lymph. The Civil Surgeon, Sibsagar, succeeded in 4 cases
out of 5 and could not do more, as he was detained in his sadr station by judicial duty.
The Civil Medical Officer, Garo Hills, found 17 cases, out of 21 primary vaccinations,
successful, but only 4 out of 18 revaccinations ; and the Civil Surgeon of Manipur,
Lieutenant C. Dykes, who gave the most extended trial, got 143 successes from 160
operations done by himself, i.e., 89.37, while his district average with the regular staff
and ordinary lymph was 97.58; he further reports that, although many of the cases were
correctly described as successes, the vesicles produced did not appear to be so large
and well-formed as usual. The Sanitary Commissioner of Bengal kindly had a trial
made in the 24 Parganahs. The Inspector of Vaccination reports that 20 children were
vaccinated with the Assam lymph and that the result proved unsuccessful, but he
does not state in what proportion. Finally the Inspector of Vaccination of Midnapur
reports that out of 24 cases, 10 were successful, 4 doubtful,and 10 failures.
18. I think it may therefore be concluded that the glycerinated lymph as stored
in hermetically sealed tubes will not keep for more than 4 months, even in a cool place,
and it begins to deteriorate after three months' storage. It has been further ascertained
that it will not keep for two months in the plains in the hot weather and probably
not for more than one. I presume the reason to be that the glycerine, which at first
rapidly destroys all extraneous germs, in time renders the vaccine virus itself sterile
and inert. For long keeping, it appears that storage in lanoline or vaseline must be
resorted to. As failures greatly annoy the parents of children operated on, I do not
propose to make any further experiments with glycerinated lymph, but next season
I will try how our virus keeps when preserved in lanoline.
19. The tubes supplied from England are not always of quite the same diameter,
and- in some cases the manufactured lymph was found too viscid to be easily
expelled from the tubes. In such cases the proportion of glycerine was lowered to 8
parts and the proportion of water raised to 10, that of the vesicular mass remaining at
18 as before. In order to prevent the vaccinators from having to blow out the contents
of the capillary tubes after having broken off their ends, a few of Montague's Patent
Vaccine Expellers were procured ; these articles are rather like small India-rubber teats,
but as their internal diameter varied a little, they did not prove a success and the old
oral method had to be reverted to.
C. W. CARR-CALTHROP, M.D., Ch.D.,
Colonel,I.M.S.,
Principal Medical Officer and Sanitary Commissioner,
Assam.