2
7. The diagram calls for no comment beyond that the death-rates of Cachar and
Sylhet were exceptionally high during 1902.
8. Appendix I is a statement showing the number of children available for
vaccination in towns, where the Vaccination Act is in force, and the number of opera-
tions actually performed. It shows that more than 80 per cent. of the children
available for vaccination were protected. The explanation furnished by the Civil
Surgeon of Dibrugarh for so small a proportion of protection is that some 88 were too
young for vaccination and others were sick. The large excess shown at Gauhati
in the number of operations actually performed over the number available is explained
by the District Civil Surgeon as due to the fact that among the children vaccinated
under one year of age are included those of coolies who passed through Gauhati during
the cold season on their way to the railway works at Lumding. The small excess at
Dhubri is similarly accounted for.
9. The Vaccine Depôt, Shillong, has been under the charge of Major E. R. W.
Carroll, I.M.S., Civil Surgeon, Shillong, from the 7th June 1902. The number of calves
inoculated was 621. Of these, 35 died without lymph being taken from them, and
from 93 others lymph was not taken either on account of illness or because the quality
of the vesicles was not up to the required standard. The number of calves, therefore,
which actually yielded lymph was 493, and the number of tubes loaded was 401,870,
or an average of 815 per calf, as compared with 395,317, or an average of 978 in the
previous year. The quality of the lymph was generally excellent throughout the year.
An unfavorable report was received from the Sylhet and Sibsagar districts regarding
lymph No. 129. The vesicles of this calf are stated to have appeared as good as usual,
and the reason why the lymph proved bad is quite obscure.
10. The total expenditure for the year was RS. 10,205-8, including Rs. 762-11
realized from the Manipur State, against Rs. 8,069-11-11 in the preceding year. The
increase of expenditure occurred almost entirely under the head " Purchase of calves,"
and was mainly due to an epidemic of rinderpest, which, from the mortality and sickness
it caused, necessitated the purchase of a much larger number of calves. There was also
a little increase in feeding expenses and in the expenditure on the establishment. The
cost per loaded tube works out to nearly 5 pies each.
11. Major Carroll, Superintendent, Vaccine Depôt, Shillong, furnishes the following
remark concerning the composition of the virus as issued by him :
Up to the month of September 1902 the strength of the lymph as made up was 50 per cent.,
during September and October 33 1/3per cent. Early in November the Principal Medical Officer,
while on tour, having found the lymph too potent, directed a reduction in its strength ; it was
thenceforth made 25 per cent., though in some cases where the vesicles were not of the very
finest quality, 33 1/3 per cent. were still made. Equal parts by weight of glycerine and water were
used in each case for mixing with the pulp. It was found that lymph of this strength produced
decidedly less irritation, while its quality was in no way impaired. I may remark that the lymph
made at the Local Government Board Vaccine Institution in London (which I visited while at
home) is composed of 1 part of pulp to 6 of mixed glycerine and water, but lymph of this strength
would probably soon lose its efficacy if exposed to any heat in the plains.
An unfavourable report was received from Sylhet on lymph No. 129, which was corroborated
from Sibsagar, where also this number had been sent. The vesicles on this calf were very good,
and the reason why the lymph was bad is quite obscure. Complaints regarding one or two other
numbers were also received from Sylhet, which were not corroborated from other districts. With
the exception of No. 129,I believe the lymph to have been of excellent quality throughout the
year.
12. Experiments were made with lymph preserved in lanoline : small pots were
filled, sealed down, and kept in my office for periods varying from one to three months;
these were then distributed amongst the Civil Surgeons. The results were very un-
satisfactory. The Civil Surgeon, Sylhet, reports 7 successes only out of 28 operations
with lymph three months old. The Civil Surgeon, Goalpara, did 14 cases, all unsuccess-
ful, with lymph of same age, and the Civil Surgeon, Tezpur, did 7 cases, all unsuccessful,
with similar virus. The Civil Surgeon, Nowgong, got 7 successes out of 13 trials
with lymph kept for two months only, while the. Civil Surgeon, Garo Hills, got 18 suc-
cesses out of 20 operations with lymph stored for a little over one month. It is evident,
therefore, that our lymph, as mixed with lanoline, will not keep for more than a month
or six weeks at the outside. I do not propose trying any further experiments, as
failures discontent the people and cause unnecessary dissatisfaction.
C. W. CARR-CALTHROP, M.D., Ch.D., Colonel, I.M.S.,
Principal Medical Officer and Sanitary Commissioner,
Assam.