4
better stabling and separation this difficulty should disappear to a great
extent.
The Institute supplied vaccine lymph to all the civil districts and to 26
Native States in the Punjab, to the North-West Frontier Province, Kashmir and
Jammu, Baluchistan, Sind, Kathiawar, Nepal, Tibet and Afghanistan, to Mili-
tary Medical Officers in the Punjab and North-West Frontier Province, and to
private individuals. The total number of tubes issued was 34,942, sufficient for
the vaccination of 1,747,100 persons (4 insertions each) as compared with 28,971
tubes (sufficient for 1,448,550 persons) in the previous year as detailed below : —
Civil Surgeons ... ... ...
Military Medical Officers ... ...
Native States
...
... ...
North-West Frontier Province ... ...
Special Staff ... ... ...
Out of the Punjab ... ... ...
Total ...
1911-12.
19,379
833
1,740
3,631
768
2,620
28,971
1912-13.
22,725
1,032
2,454
4,070
1,239
3,422
34,942
This shows an increase of 5,971 tubes.
Of the 34,942 tubes supplied, result statements were received in the
case of 31,189 ; these statements show that 920,358 primary and 319,600 re-
vaccination operations were performed with an average case success of 94.12
per cent. and an insertion success of 94.51 per cent. in primary operations and
a case success of 80.48 per cent. and insertion success of 69.10 in revaccination
as compared with 90.09 and 91.52 per cent. in the former and 71.76 and 66.87
per cent. in the latter in the year preceding ; this increase in the percentage
of successful results is very satisfactory and is doubtless a real one, for it is
confirmed by the results as reported by vaccinators and also by the inspection
of the Deputy Sanitary Commissioner, of Civil Surgeons and of Divisional
Inspectors and Superintendents of Vaccination. This happy result is almost
certainly due to the improved conditions in which the manufacture of the
lymph is carried on in the new Institute buildings.
The method of preparation and testing of chloroformed glycerinated
vaccine differed in no respect from that of the previous year. Virulence of
stock lymph was successfully maintained by alternate passage from buffalo to
cow calf and vice versâ. Vaccine was this year also supplied to the Bangalore
and Belgaum Vaccine Institutes with which potent strains were successfully
established in those places.
From Attook, Rohtak and Dera Ghazi Khan districts however com-
plaints were received that chloroformed glycerinated vaccine either did not give
good results or did not confer immunity from small-pox. Searching enquiries
were held on the spot in several places, but no sound evidence was forthcoming
against the potency of the lymph ; a few cases of mild small-pox with very
slight scarring were discovered in children of nine or ten years of age who had
been vaccinated in infancy ; when it is remembered that the age of election
for revaccination in temperate climates is twelve years (the age for compulsory
revaccination in Germany), it is evident that such cases must be expected in
the natural course of events, especially if the varying susceptibility of the
individual and the inevitable variation in efficiency of the actual operation is
considered; the subject is still under enquiry, and a general investigation
throughout the Province is proceeding. Such rumours are naturally prevalent
when small-pox is rife, for the people generally expect too much from vaccina-
tion and are inclined to discredit it when they see that it does not always confer
absolute and lifelong immunity from the disease ; they do not seem to realise
that only a relative and temporary protection is to be expected from the opera-
tion and generally do not recognise the necessity for revaccination. The Civil
Surgeons whom I consulted speak very highly of the lymph judged by the
actual results obtained by themselves.
I have the honour to be,
SIR,
Your most obedient Servant,
S. BROWNING SMITH, LIEUT.-COL., I.M.S.,
Offg. Sanitary Commissioner, Punjab.