NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
10
TABLE X.
N u m b e r .
Name of serum.
Stock on hand
on 1st January
1918.
Received
during the
year.
Sent out
during the
year.
Balance on
hand on 1st
January 1919.
1 Anti-streptococcus serum . . .
105
267
372
Nil.
2 Anti-tetanic serum . . .
1
403
352
52
3 Anti-diphtheritic serum . . .
37
237
159
115
4 Anti-dysenteric serum . . .
14
202
39
177
5 Anti-venomous serum . . .
10
3
10
3
6 Coley's fluid . . .
20
. . .
13
7
Total . . .
187
1,112
945
354
Table X gives details of the issues of the different sera, which in spite of the
shortage of supply, have exceeded those of last year.
Increasingly large quantities of veterinary sera and other products were
stocked in the cold room for the Veterinary Department and issued to touring
and other veterinary officers on indent.
Twenty-six medical men including assistant surgeons and sub-assistant
surgeons were given instruction in anti-plague inoculation. Of these seven sub
- a s s i s t a n t s u r g e o n s w e r e s e n t b y t h e H e a l t h O f f i c e r o f t h e M a d r a s C o r p o r a t i o n t o
undergo the training preparatory to starting an inoculation campaign in the city
consequent on the outbreak of indigenous plague in Triplicane.
Under G.O. Mis. No. 285, Medical, dated 18th June 1918, regular classes ex
- t e n d i n g o v e r a p e r i o d o f o n e w e e k w i l l b e h e l d f o r s u c h i n s t r u c t i o n t o b e g i v e n t o
medical men in the plague-infected districts, in batches of about a dozen at a time.
The first of the series was held in December 1918 and was attended by ten
assistant surgeons and sub-assistant surgeons.
Mr. V. Krisnamurthi, senior lecturer of the Madras Veterinary College, was
given laboratory instruction in the methods of making bacterial cultivations and
preparing autogenous vaccines, to enable him to do similar work in the veterinary
hospital.
In this, my last Annual Report on the working of the section, I desire to
call attention to and to express my satisfaction with the way in which the staff
and all concerned have dealt with the increased volume of work.
THE KING INSTITUTE OF
PREVENTIVE MEDICINE, GUINDY,
F. MAITLAND GIBSON, M.B., B.SC.,
3rd February 1919. Director.
11
APPENDIX.
NOTES ON VACCINE THERAPY.
By Dr. M. Kesava Pai, Acting Assistant Director.
Furunculosis.—All the ten cases for whom autogenous vaccines were made were staphy
-lococcal in origin. In one instance streptococci were present as well. It is not unlikely
that this was a secondary infection or else the complaint was pemphigoid in nature. The
results of treatment were good as usual. Of the six cases reported on, four were cured, and
two showed decided improvement.
TABLE I.
Furunculosis.
Serial
num-
ber.
Case
num-ber.
Medical Officer.
Disease.
Vaccine made.
Result.
1
43 Medical Officer, Fort Dispensary,
Madras.
Boils . . . Staphylococcus
aureus.
Not known.
2
45 Dr. S. Subbayya, Tanjore . . .
Do. . . .
Do.
Much im-
proved.
3
57 Superintendent, Government Maternity
Hospital, Egmore.
Do. . . .
Do.
Not reported.
4
81
. . .
Do. . . .
Do.
Vaccine
not
used.
5
89 Superintendent, Government Maternity
Hospital, Egmore.
Do. . . .
Do.
Do.
6
128
Do.
do.
Do. . . .
Do.
Improved.
7
133 Dr. H. R Sadasiva Rao, Vizagapatam. Do. . . .
Do.
Cured.
8
141 Dr. Scudder, Vellore . . . Do. . . .
Do.
Do.
9
152 District Medical and Sanitary Officer,
Ootacamund.
Do. . . .
Staphylococcus and
streptococci.
Do.
10
159 Major A. Chalmers, I.M.S. . . . Do. . . .
Staphylococcus
aureus.
Do.
Case 141 was that of a patient suffering from boils and abscesses in successive crops.
The complaint recurred every year in the months of August and September. She had 22 of
these boils and abscesses in 1917, some of them large and painful. In September 1918 a
small papule appeared under the left breast which developed into a large abscess and this
was opened under chloroform and a quantity of thick pus was removed from the deep tissue.
The condition yielded successfully to the autogenous staphylococcus vaccine prepared from
the culture made from this abscess and the patient has been free from the suppurative
troubles ever since.
Eczema, pemphigus and skin eruptions.— A variety of conditions are included in this class
of cases. The usual pemphigus streptococcus infection constituted a majority of them and
the vaccine was effective. Cases of sycosis and chronic eczema in which the staphylococcus
only was present did not give favourable results with the corresponding autogenous vaccines.
Two cases deserve a special mention.
TABLE II.
Eczema, pemphigus and skin eruptions.
Serial
num-
ber.
Case
num-
ber.
Medical Officer.
Disease.
Vaccine made.
Result.
1
12
. . .
Lupus Erythematosus Staphylococcus
aureus.
Partial cure.
2
16 Superintendent, Government Raya-
puram Hospital, Madras.
Chronic eczema
. . . Streptococcus . . .
No improve
-
ment.
3
26 Dr. K. D. Mugaseth, Calicut . . . Eczema . . . Staphylococcus . . .
Not much
improved.
4
44 Major F. F. Elwes, C.I.E., I.M.S.,
Egmore.
Pemphigus . . . Streptococcus . . .
Not im-
proved.
5
68 District Medical and Sanitary Officer,
Ootacamund.
Eczema . . . Staphylococcus . . .
Not reported.
Government
of Madras
LOCAL AND MUNICIPAL DEPARTMENT (LOCAL).
G.O. No. 290. L., 3rd March 1919
Report
Recording the — on the working of the Micro-Biological Section of the King Institute
Guindy, for the year 1918.
READ—the following paper:—
Letter—from Lieut,-Col. T. S. Ross, I.M.S., Officiating Sanitary Commissioner
for the Government of Madras.
To —the Secretary to Government, Local and Municipal Department.
Dated—M adras, the 18th February 1919.
No.—D. 522/S.
I have the honour to forward herewith two printed copies of the report on
the working of the Micro-Biological Section of the King Institute, Guindy, for the
year 1918.
Order—No. 290 L., dated 3rd March 1919.
Recorded.
( T r u e e x t r a c t )
H. G. STOKES,
Acting Secretary to Government.
To the Sanitary Commissioner.
„ Surgeon-General.
„ Sanitary Engineer.
„ Local and Municipal Department (Medical Section).
„ Assistant Quartermaster-General, 9th (Secunderabad) Division (with C.L.)
REPORT
ON THE
WORKING OF THE MICRO-BIOLOGICAL
SECTION OF THE KING INSTITUTE OFF
PREVENTIVE MEDICINE, GUINDY
FOR THE YEAR 1919
(WITH APPENDICES ) .
MADRAS:
PRINTED BY THE SUPERINTENDENT, GOVERNMENT PRESS
192
0
For official use only.
REPORT ON THE WORKING OF THE MICRO-BIOLOGICAL SECTION
OF THE KING INSTITUTE OF PREVENTIVE MEDICINE,
GUINDY, FOR THE YEAR 1919.
TABLE OF CONTENTS.
(1) Part I
...
...
...
...
...
PAGE
1
(2) Part II
...
...
...
...
...
6
(3) Appendices (I to III)
...
...
...
...
...
11 to 13
(4) Experiments (I to III)
...
...
...
...
...
14 to 19
REPORT ON THE WORKING OF THE MICRO-BIOLOGICAL SECTION
OF THE KING INSTITUTE OF PREVENTIVE MEDICINE, GUINDY,
FOR THE YEAR 1919.
Dr. F. Maitland Gibson, M.B., B.SC., was in charge of the Institute till the
31st March and Major J. Cunningham, I.M.S., from the 1st April to the end of
the year.
The report, this year, appears in a somewhat different form. The Micro
-Biological section, although officially only one section, fulfils two very different
functions—one in connection with the medical, the other in connection with the
sanitary side of the medical service.
This first of these deals with the diagnosis and treatment of disease from the
bacteriological point of view, the second with the examination of water-supplies
and all other subjects connected with the public health of the community.
Both of these functions will be dealt with separately, the first part of the report
being devoted to the medical side, the second part dealing with questions concern
-ing public health.
PART I.
The work of this part of the section consists of—
( 1 ) t h e p r e p a r a t i o n a n d s u p p l y o f b a c t e r i a l v a c c i n e s ,
( 2 ) t h e b a c t e r i o l o g i c a l e x a m i n a t i o n a n d d i a g n o s i s o f s p e c i m e n s ,
( 3 ) a s s i s t a n c e t o o t h e r d e p a r t m e n t s , a n d
( 4 ) r e s e a r c h w o r k .
(1) THE PREPARATION AND SUPPLY OF BACTERIAL VACCINES.
Table I shows the number of doses of bacterial vaccines prepared and issued
annually for the last five years. The total amount issued during the year under
report was nearly 100,000 doses, an increase of 92,209 over the output for the
year 1915.
TABLE I.
Statement showing the number of doses of bacterial vaccines prepared and issued during the
last five years.
Number of doses sent out.
1915.
1916.
1917.
1918.
1919.
Autogenous vaccines . . .
773
845
979
1,718
1,095
Other vaccines . . .
6,285
12,723
34,473
56,398
97,172
Total . . .
7,058
13,577
35,452
58,116
98,267
The year under report has been a considerable departure in this direction.
The widespread and serious epidemic of influenza which swept over the country
in the latter part of the previous year showed that energetic measures would have
to be taken in advance to meet any similar recurrence of the disease in the future.
Among the defensive measures projected by the Government of India was the
manufacture and storage of large quantities of prophylactic influenza vaccine
which would be ready for immediate issue should necessity arise. In order to
ensure a large enough supply, it was suggested that several laboratories should
prepare this vaccine and the King Institute was asked to undertake the manufac
- t u r e o f t h e q u a n t i t y r e q u i r e d f o r t h e M a d r a s P r e s i d e n c y w h i c h w a s e s t i m a t e d a t
450,000 c.cs. Neither staff nor equipment for the purpose existed in the Insti-
tute at the time but a scheme was prepared which involved the purchase of the
necessary apparatus amounting to Rs. 19,000 and the entertainment of 66 new
hands of all grades in addition to that part of the Institute staff already engaged
4
TABLE IV.
No.
Name of serum.
Stock on
hand on
1st Jan. 1919.
Received
during
the year.
Sent out
during
the year.
Balance on
hand on
1st Jan. 1920.
1 Anti-streptococcus serum . . .
. . .
483
275
208
2 Anti-tetanic serum . . .
52
868
679
241
3 Anti-diphtheritic serum . . .
115
90
138
67
4 Anti-dysenteric serum . . .
177
75
156
96
5 Anti-venomous serum . . .
3
9
6
6
6 Coley's flūid . . .
7
22
7
22
Total . . .
3 5 4
1 , 5 4 7
1,261
640
(2) BACTERIOLOGICAL EXAMINATION AND DIAGNOSIS OF SPECIMENS.
Table V gives a classification of specimens received for examinations and
the nature of the examination required.
TABLE V.
Details of specimens received for examination.
Serial
number.
Description of specimens.
Number of
positive
results.
Number of
negative
results.
Total
number
examined.
Remarks.
1
Blood for Widal's test* . . .
253
359
612 * See statement below.
2
Do. Malta fever . . .
. . .
6
6
3
Do Wasserman reaction.
658
978
1,636
4
Do. films for malarial
parasites.
51
394
445
5
Do. leucocytosis . . .
1
4
5
6
Do. differential count . . .
. . .
. . .
7
7
Do. Kala-Azar . . .
3
12
15
8
Do. relapsing fever . . .
N i l
6
6
9
Do. filaria . . .
. . .
3
3
10
Sputum for tubercle bacilli . . .
34
130
164
11
Do. pneumococci . . .
4
2
6
12
Do. influenza . . .
35
29
64
13
Smears for plague (human) . . .
31
32
63
14
" " (animal) . . .
39
105
144
15
" gonococci . . .
2
17
19
16
" spirochætes . . .
4
7
11
17
" bacillus lepræ . . .
. . .
1
1
18
" Negri bodies . . .
1
1
2
19
Culture for B. typhosus . . .
. . .
11
11
20
" diphtheria . . .
3
19
22
21
" bacillus xerosis.
6
3
9
22
" o f s p i n a l f l u i d ,
knee joint fluid.
. . .
. . .
4 Sterile.
23
Section for spirochætes . . .
11
43
54
24
Stools for cholera vibrios . . .
3
21
24
25
" dysentery, amoebæ,
etc.
14
75
89
26
" identification
of
parasites.
1
. . .
1
27
Urine for B. coli . . .
1
2
3
" B. typhosus . . .
28
. . .
2
2
29
" gonococci . . .
. . .
3
3
30
" chemical and bacte
-riological examinations.
. . .
. . .
16
31
" sugar and uric acid.
. . .
. . .
2
32
Milk for tubercle bacilli . . .
. . .
3
3
33
Catgut, dressings, gauze for
sterility.
1
3
4
34
Spittel's solution, saline solu
-tion for sterility.
1
. . .
2 Saline not sterile.
T o t a l . . .
1,157
2,271
3,458
* Statement referred to above.
Number
of
specimens.
Positive.
Negative.
Typhoid.
Para
- t y p h o i d
A .
Para-
typhoid B.
*Examined to B typhosus, B paratyphosus, A and B.
266
110
3
8
145
*Examined to B typhosus alone . . .
346
132
. . .
. . .
214
*Examined to B paratyphosus A alone . . .
Nil
. . .
. . .
. . .
. . .
*Examined to B paratyphosus B alone . . .
Nil
. . .
. . .
. . .
. . .
S
6
Results of examination of 54 macerated fœtera—cont.
N u m b e r .
Number
of
preg-
nancy.
History of former
pregnancies.
Result of
examination for
spirochætes.
Wasserman
reaction on
mother's blood.
Remarks.
13 Third . . .
First two born alive and the
second child died three years
ago in its second month.
Negative . . .
Positive (strong).
14 Seventh . . . Present premature labour—
Eighth month—fourth child
alive; all others still-born;
Do. . . .
Positive (weak).
15 Fourth . . . First two still-born; third
alive.
Do. . . .
Negative
16 First . . .
Natural . . .
Do. . . .
Do.
17 Third . . .
First two born alive; one died
on the seventh day and the
other after three months.
Do. . . .
Do.
18 Fifth . . .
Third still-born . . .
Do. . . .
Do.
19 Third . . .
First two born alive, but died
in three days.
Do. . . .
Do.
20 First
Premature labour; eighth
month.
Do. . . .
Do.
21 Fifth . . .
First four macerated fœtera;
present premature eighth
month.
Do. . . .
Do.
22 Third . . .
Second macerated fœtus—
present premature seventh
month.
Do. . . .
Do.
23 Third . . .
First two still-births . . .
Do. . . .
Do.
Note .—In the remaining 31 cases the examination for spirochætes was negative and the mother's blood was not
tested.
(3) ASSISTANCE TO OTHER DEPARTMENTS.
Veterinary sera and other products were, as usual, stocked in the cold room
for the Veterinary Department and issued as required.
Under G.O. Mis. No. 285, Medical, dated 18th June 1918, regular classes were
held for giving instruction in anti-plague inoculation and 106 medical men includ
- i n g A s s i s t a n t a n d S u b - A s s i s t a n t S u r g e o n s u n d e r w e n t t h e c o u r s e .
Three military pupils of the Madras Medical College and the Veterinary
Assistant in charge of the Veterinary Hospital, Saidapet, were given a course of
training in the laboratory work.
Further, at the instance of the Mysore Government, Assistant Surgeon
C. Krishnaswami Rao attended the Institute for a period of three months from
21st July to 20th October 1919 to learn the methods employed in clinical and
bacteriological diagnosis of disease.
( 4 ) R E S E A R C H W O R K .
No research work has been undertaken by the medical side during the year.
The time of the staff has been fully occupied in routine duties. Original research
into medical subjects is, however, a most important part of the duties of a
laboratory of this type and it is to be hoped that arrangements may be made to
take part in this most important branch of medical science. To make this
possible, the Director and his staff must have more time at their disposal to
enable them to consider and follow up profitable lines of research.
PART II.
PUBLIC HEALTH.
The work done on this subject may again be sub-divided into three sec
-tions:—
(1)
Examination of food, drugs, etc.
(2) Examination and reports on the Presidency water-supplies.
(3) Research work in connection with the experimental filter installation.
7
(1) Examination of food, drugs, etc.
Table I shows the nature and number of examinations made of milk, rice,
bleaching powder, etc. There has been an increase in the number of specimens of
this type examined.
The number is, however, still very small and a more extended use of the
services of the Institute in this direction could be made with advantage.
TABLE I.
N u m b e r .
Description of specimens.
Total
number
examined.
1
Analysis of milk . . .
2
2
Rice
.
.
.
2
3
Beer
.
.
.
4
4
Bleaching powder for percentage of available chlorine . . .
16
5
Preparation and supply of Spittel's solution . . .
16
6
Colossal antimony . . .
1
Total . . .
41
(2) Examination and reports on the Presidency water-supplies.
Table II shows the number of water analyses which have been carried out at
the Institute during the year under report. The table has been compiled in a
different way to those of previous years and therefore does not show, by compa
-rison, the great increase in the number of examinations which is a feature of the
year.
TABLE II.
Nature of examination.
Routine and
intermittent
samples.
Samples
from
experimental
filters.
Total.
Bacteriological and chemical . . .
424
63
487
Bacteriological only . . .
129
945
1,074
Chemical only . . .
7
123
130
As the result of G.O. No. 1006 L., dated 3rd August 1918, the systematic
(half-yearly) examination of all the water-supplies in the Presidency has been
recommenced at this Laboratory. This means that at least two single examin
-ations from each supply are carried out every year. It must be definitely
understood that these examinations merely reflect the condition of the water at
the time the samples are taken and it is of course impossible from this very
limited evidence to give anything like a complete report as to the potability of
the various supplies. It has been the custom, however, in each case to take
samples at various points along the distributary system so that information can
be obtained as to the value of the various processes of purification and the condi
-tion of the storage and distributing agencies.
A change in the method of reporting the results of the year's work has also
been introduced. A general survey of the condition of the various water-supplies,
as far as this can be deduced from the examination of the samples which have
been taken from each, is given and the details of the examinations which are, as
a rule, only of interest to those actually performing the analyses have been
omitted.
This part of the report is dealt with in three sections according to the origin
of samples:—
(a) Municipalities.
(b ) Jails.
( c) Railway stations.
3
10
filtration exerts a beneficial effect. Five days as a rule is sufficient to yield
good results.
It must be understood that the results of these experiments refer only to the
general decrease in the number of water bacteria. They do not necessarily bear
any relation to the length of time required to render a water infected with
pathogenic organisms safe for drinking purposes without the further process of
filtration. The storage for five days advocated in the foregoing paragraph must
be regarded merely as a preliminary to filtration.
( c) Mechanical filters .—The absence of sufficient storage arrangements has,
in the previous years, rendered it difficult to work the mechanical filters simultane-
ously so as to yield comparable results. This is now possible owing to the
provision of a third storage tank. After some preliminary experiments were
carried out in the laboratory to arrive at the optimum dose of alum, six series of
experiments with the Jewel and Paterson mechanical filters were carried out
towards the close of the year. The Mather and Platt filter was not worked
as this is now no longer on the market.
The first five series of experiments were carried out, leaving the alum to act
o n
t h e w a t e r o v e r n i g h t . T w o a n d a h a l f g r a i n s p e r g a l l o n w e r e u s e d i n t w o s e r i e s ,
and 3½ grains per gallon in the remaining three, and the filters were worked at
the rate of 100 gallons per square foot per hour. Both filters gave the same
results and succeeded in purifying the water 500 fold.
In the last series of experiments a continuous flow of water was maintained
through the coagulating tanks. In this way the conditions which obtain in a.
regular supply to a town were imitated. The filters were started at 8 a.m., on
11th December 1919 with water pumped on the same morning and were allowed
to run continuously for 3 working periods, the filters being cleaned between each
period. Four grains of alum per gallon were used. Samples were taken continu
¬ o u s l y t h r o u g h o u t t h e p r o c e s s a n d p a r t i c u l a r l y a t t h e c o m m e n c e m e n t a n d e n d o f
each period wherever possible. The results of these experiments did not show
any departure from those of the preceding series. (Vide Experiment III.)
Before closing the report the Director wishes to draw attention to the satis-
factory nature of the work done by all branches of the Institute Staff. Without
their loyal co-operation the increased volume of work could not have been
successfully dealt with.
THE KING INSTITUTE, GUINDY,
16th February 1920.
J. CUNNINGHAM, M.D., Major,I.M.S.,
Director.
13
Bezwada junction .—The two examinations both gave satisfactory results.
Erode junction .–—The water-supply to this station was unsatisfactory at each examination.
Guntakal junction .—Variable results were obtained at the three examinations. The water
at the source showed evidence of recent and undesirable pollution at the first, improved at
the second, and again deteriorated at the third examination.
Jālārpet junction .—This supply was examined four times during the year. The water
.showed signs of gross bacterial pollution on each occasion.
Kā
tpādi junction .—There are two wells at this station ; both were examined. The rail-
way station well was condemned on two successive occasions. The loco well which is liable
to fail during the hot weather gave fairly good results on two out of three examinations.
Madura junction —Municipal water is stored in reservoirs for supplying passengers.
The water supplied to the platform was worse than the municipal tap water in December 1918.
A sample submitted by the railway authorities after cleaning the reservoirs had improved.
In May 1919 the water was found to be in order.
Naupada junction .—At all the three examinations carried out with the water-supply of
this station, the water showed evidence of gross organic and bacterial pollution.
Pākāla junction.—The loco well was found at three consecutive examinations to be
heavily polluted. The twin wells yielded water of a much better quality.
Pōdanūr junction. —The water of the well supplying this station was typical of the
Coimbatore district. The bacteriological findings were not in favour of the supply.
Rēnigunta junction .—The water of the well was a moderately hard one, passable from the
bacteriological point of view but liable to variations at the different seasons.
Samalkōta junction .—A deep sub-artesian borehole supplies this station. The water has
been satisfactory but a deterioration due, it was reported, to flooding of the embankments,
was apparent in November.
Tanjore junction .—In April the water showed signs of recent and potentially dangerous
pollution but at the September examination there was a considerable improvement.
Trichinopoly junction .—This railway station was found to suffer from a water-supply,
initially good but spoiled by storage in dirty reservoirs.
Villupuram junction.—The May examination gave unsatisfactory results. That carried
out in August showed that conditions had improved.
Vizianagram.—This water-supply was found to be in good order at the first two exami-
nations but showed a deterioration in December 1919.
Waltair junction .—Two wells supply this station. The well situated 100 yards away
from the station was found to be the better of the two. The water supplied to the platform
showed signs of deterioration.