NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
INSTITUTE OF PUBLIC HEALTH, RANGOON, FOR THE YEAR 1935.
At Christmas, the Institute received from Sir Spencer Harcourt
Butler, G.C.I.E., K.C.S.I., I.C.S., whose name the Institute bears, a
very fine portrait of himself and an encouraging letter conveying his
good wishes.
A tea party was arranged on the 22nd November 1935 on the
grounds of this Institute, by the Burma Branch of the Indian Red
Cr o s s S o c i e t y , i n h o n o u r o f Dr . Ru t h Yo u n g , Di r e c t o r o f t h e Ma t e r n i t y
and Child Welfare Bureau, Indian Red Cross Society. Dr. Young
visited Burma as external examiner for the Burma Health School
examination, and also did a tour of inspection of the Child Welfare
centres in the Province.
3. VISITORS.—The following distinguished persons visited the
Institute during the year :
—
The Hon'ble Minister for Education, Local Government and
Public Health and Mrs. Ba Maw.
Dr. De Sa, M.D., F.C.P.S.
Dr. R. N. Copper, M.S., F.R.C.S., F.C.P.S.
Lieutenant-Colonel G. T. Burke, M.D., F.R.C.P., I.M.S., Secretary
of the Indian Medical Council.
Professor D. B. Blacklock, M.D., D.P.H., D.T.M., Liverpool
School of Tropical Medicine and Mrs. Blacklock.
Dr. Ruth Young, M.B.E., W.M.S., Director of the Maternity
and Child Welfare Bureau, Indian Red Cross Society, New Delhi.
Dr. C. C. Turner, Dr. P.H., F.A.P.H.A., Chairman of the Health
Section of the World Federation of Education Associations.
Report of the Bacteriologist, Dr. K. P. Kundu, M.B.
(Cal.), D.B. (Lond.), on the Bacteriological section
for the year 1935.
4. This section consists of three sub-sections :
—
Bacteriological laboratory proper,
Media making room, and
Plague laboratory.
5. Bacteriological Section.—ROUTINE WORK.—Routine work princi
-pally consisted of—
Bacteriological examination of water for the determination of its
potability, and the examination of water for the presence of cholera
vibrio.
Examinations for the Customs Department of shaving brushes for
the presence of anthrax bacillus.
Finding the carbolic acid co-efficient of disinfectants.
Preparation of bacterial emulsions for agglutination tests.
Preparation of high titre agglutinating sera.
Maintenance of stock cultures of bacteria.
Preparation of cholera vaccine.
3
Maymyo.
Pyinmana.
Bassein.
Moulmein.
4
REPORT ON THE WORKING OF THE HARCOURT BUTLER
Examination of rats.
Stocking and looking after animals.
Bacteriological examination of water for the determination of its
potability consisted in (a) determining the total number of aerobic
bacteria per cubic centimetre of water, (b) th e l e a s t q u a n t i t y f e r m e n t i n g
McConkey bile salt lactose broth, (c) presence or absence of Cl. welchii
in 20 c.c. of water, (d) identification according to Clemesha's classifica
-tion of those lactose fermenting organisms found present. The last
test is done only in the case of a water showing the presence of lactose
fermenters in less than 50 c.c. The examination of the majority of the
samples of water according to the above requirements takes about eight
days for completion. The table below shows the number of water
samples examined during the year and their sources.
TABLE.
PUBLIC WATER SAMPLES.
Hlawga Lake, chlorinated (Rangoon Corporation) . . .
5 5
Hlawga Lake, unchlorinated (Rangoon Corporation) . . .
54
Samples of tube well water sent by the Water Officer . . .
33
Bassein . . .
25
Maymyo . . .
26
Moulmein . . .
17
Pyinmana . . .
12
Port Health Officer, Rangoon . . .
15
Insein . . .
11
Pyawbwè . . .
1 1
M a g w e . . .
10
Mandalay . . .
9
Pegu . . .
8
Rangoon Jail . . .
9
Port Blair . . .
9
Others . . .
58
Waters for Vibrio c h o l e r a .
Numbers of samples . . .
8
T o t a l . . .
370
Two samples of Hlawga Lake water are examined weekly, while
samples were sent monthly for examination from the following
places:—
Water samples from newly bored tube wells are bacteriologically
examined before a permanent licence can be granted under the
INSTITUTE OF PUBLIC HEALTH, RANGOON, FOR THE YEAR 1935.
5
provisions of the Burma Underground Water Act, and thirty-three such
samples were received during the year.
Eight samples of water were sent to be examined for the presence
of cholera vibrio. All were negative except one sample, from which
an organism simulating the cholera vibrio was isolated, but it did not
agglutinate with stock high titre serum.
Twenty-one samples of shaving brushes of different manufacture
were sent by the Customs Department to be examined for the presence
of anthrax bacillus ; on no occasion was this organism found.
Four samples of disinfectants were tested for their carbolic acid
coefficient. Out of these, three samples were received from the Police
Supplies Depôt, Rangoon. It must be noted here that this examination
gives only a comparative result, as it is not possible to maintain
standard requirements for the Rideal Walker test in this laboratory at
present.
Bacterial emulsions of the typhoid and paratyphoid group of
organisms were prepared in accordance with instructions detailed in
the Medical Council Research Series No. 51.
Preparation of high titre agglutinating sera was started for the first
time in this laboratory this year. In previous years, such sera had to
be purchased from the Pasteur Institute of Burma.
The following stock cultures were maintained in this laboratory
during the year :—
1. B. typhosus.
9. Vibrio choleræ (ten strains).
2. B. paratyphosus A.
10. Ratin virus.
3. B. paratyphosus B.
11. Ratin 116.
4. B.coli.
12. Ratin 688.
5. B. dysentery Flexner.
13. Liverpool virus.
6. B. dysentery Shiga.
14. Danyz's virus.
7. B. pestis.
15. Ps pyocyancus.
8. Staphylococcus.
16. Ch. prodigiosus.
6. PREPARATION OF CHOLERA VACCINE.—This has turned out t
o b e t h e h e a v i e s t i t e m i n t h e l i s t o f d u t i e s o f t h i s l a b o r a t o r y . A s t h i s
laboratory did not possess the necessary apparatus, preliminary experi
- m e n t s a n d t h e m a n u f a c t u r e o f t h e v a c c i n e o n a s m a l l s c a l e w e r e s t a r t e d
with the help of the Pasteur Institute of Burma, and the thanks of
the writer are due to the Director of that Institute for his co-operation.
Large scale preparation of the vaccine was started in the Harcourt
Butler Institute from the month of September when the laboratory
was equipped with the necessary apparatus.
During the year, about 80,000 doses of this vaccine were prepared,
out of which 20,000 doses, approximately, were filled in ampoules and
issued. The manufacture of this vaccine in the Institute means a
large saving to the Local Government.
REPORT ON THE WORKING OF THE HARCOURT BUTLER
METHOD OF PREPARATION. (Short synopsis).—Strains of cholera
vibrios used in the preparation of cholera vaccine are isolated from
acute cases of cholera. They are highly agglutinable against stock
" H "
a n d " O " h i g h t i t r e s e r a . T h e s e s t r a i n s a r e s t o c k e d i n a g a r
a m e d i ( p H 7 . 6 ) a n d a r e p a s s e d t h r o u g h g u i n e a - p i g s a t i n t e r v a l s o f 6 t o
8 weeks to maintain their virulence.
The seed cultures are always tested for Millon stability before
bottles are planted with them. The washing from each bottle is poured
in separate test tubes and is tested for bacterial purity by streaking agar
slopes with a trace of emulsion.
The purity tests are passed at the end of 48 hours and the washings
are collected in a flask after decanting the supernatant fluid. The
strength of the emulsion is estimated by the opacity method. The
vaccine is now carbolised. The sterility test is done both aerobically
and anaerobically 24 hours after the addition of carbolic acid. If found
sterile, about half a c.c. of the bulk vaccine is then injected
subcutaneously into a guinea-pig, which is examined every day for a
week for evidence of any necrosis. If there be no necrosis, the vaccine
is ready for dilution and storage in a cold room until required. The
date of manufacture of the vaccine starts from the date of dilution.
Each c.c. of the diluted vaccine contains approximately 8,000 millions
of the cholera vibrio per c.c. Soon after the dilution, a sterility test is
done again and, when passed, the vaccine is filled in 10 c.c. ampoules
with the help of a Geryk vacuumatic machine. When the ampoules
are sealed, a few of these are selected at random and tested for sterility
both aerobically and anaerobically.
7.Media Section—The work in this section increased considerably.
The i ncr eas e was mai nl y due t o t he addi t i onal r out i ne wor k of t he
manufacture of cholera vaccine. There have been a number of changes
in the method of preparation of media used in this laboratory, of which
the outstanding one is the preparation of papain digest broth. This
has taken the place of the ordinary meat infusion broth and the yield is
about four times greater than that obtained by the former method. It
was also found economical to replace agar powder with china grass in
the preparation of solid media.
Approximately 15 varieties of media are being prepared in this
section, of which Levinthal blood agar media is an addition worth
mentioning. Staining solutions and chemical reagents necessary for
routine bacteriological tests are also prepared by this section. It should,
however, be noted that the preparation of reagents that require high
technical skill, viz., nor mal sol ut i ons and Mi l l on' s r eagent , i s under t aken
by the Chemical Department of this Institute.
8.Plague Section.—As in previous years, the Port Health Department
continued sending trapped rats daily from the Port Area. Dead and
live rats were also sent to this section from steamships. Every one of
7
INSTITUTE OF PUBLIC HEALTH, RANGOON, FOR THE YEAR 1935.
these rats was identified, dissected, and smears made from spleens
were examined for the presence of Pr. pestis with negative results in
every instance.
The following table shows the numbers of the different species of
rats sent during the year under report:—
TABLE I.
LIVE RATS (PORT AREA) BY SPECIES EXAMINED.
N. bengalensis . . .
874
M . c o n c o l o r . . .
400
C. coerulea . . .
171
M . m u s c u l u s . . .
1 5 4
R. rattus . . .
132
R. norvegicus . . .
89
Total . . . 1,820
TABLE II.
LIVE RATS (STEAMSHIPS) BY SPECIES EXAMINED.
R . r a t t u s . . .
111
M . m u s c u l u s . . .
26
M. concolor . . .
2
R . n o r v e g i c u s . . .
1
N. bengalensis . . .
Nil
C. coerulea . . .
Nil
Total . . .
140
TABLE III.
DEAD RATS (STEAMSHIPS) BY SPECIES EXAMINED.
M. musculus . . .
285
R. rattus. . .
48
R. norvegicus . . .
8
M. concolor . . .
1
C. coerulea . . .
1
N. bengalensis . . .
Nil
Total . . .
343
9. Field Laboratory Work.— An investigation was undertaken in
connection with a sudden outbreak of a fatal infectious pneumonia at
Thinbangone Village in the Tharrawaddy District during October. The
bacteriologist of this Institute was called to the place and he reached it
just in time to examine a dying patient. Microscopical, cultural and
animal tests all showed the presence of Pr. pestis. Such outbreaks of
pneumonic plague are extremely rare in Burma.
10. Laboratory Animals.— An important part of the routine work was
that of looking after the animals which were stocked for use in
experiments, and also those that were actually under experiment. On
REPORT ON THE WORKING OF THE HARCOURT BUTLER
more than one occasion an epizootic started. Such outbreaks were
successfully stopped at the outset. During the year under review, 40
guinea-pigs and 3 rabbits were used for experimental purposes. Our
thanks are due to the Superintendent of the Victoria Memorial Park,
Zoological Gardens, Rangoon, and the Director, Vaccine Depôt,
M e i k t i l a , f o r k i n d l y s u p p l y i n g u s w i t h a n i m a l s a t a t i m e w h e n o u r s t o c k r a n
short.
11. Research. —(i) Experiments with rat killing viruses:—
The following strains were used:-
(a
)
R a t i n .
(
b )R
a t i n 6 8 8 .
(
c )R
a t i n 1 1 6 .
( d )
D a n y z ' s v i r u s .
( e ) L i v e r p o o l v i r u s .
With a view to finding out if any of the above strains could produce
an epizootic among rats, with a mortality high enough to recommend
such viruses as efficient rat exterminators, different sets of experiments
were carried out with each of the above strains.
The common Burmese house rat, Mus concolor, was used in every
experiment. The experiments were conducted on the following lines.
The strains were first passed through successive rats by intraperitoneal
injection to increase their virulence to the stage when the rats died
invariably within 24 hours. Feeding experiments were then carried
out. About one c.c. of 24 hours agar culture emulsion of this virulent
strain was mixed with a small quantity of cooked rice and put in the
cage of the rat under experiment. In most cases the infected food was
eaten within an hour. With a few exceptions, the fed rats died within
six days and the organism could be recovered from the abdominal
viscera. The next step in the experiment was to put a fed rat in
anot her cage cont ai ni ng 6 t o 8 heal t hy r at s, whi ch had been kept under
observation for about a week previously. In spite of such intimate
contact, we failed to start an epizootic in every experiment carried out.
All these experimental rats fed from the same container. The rats
were observed for about 5 weeks, and in some cases breeding took
place during the period under experiment. The fed rats were marked
by their ears being snipped. From these experiments it would appear
that Ratin virus is not superior to ordinary rat poisons as the fed rat
only dies and that also not within 4 days. If the viruses had started an
epizootic with a high mortality among rats they would have been
excel l ent r at ext er mi nat or s, t hough obj ect i ons t o t hei r use f or r at
destruction in public health activities inside domestic premises or food
warehouses would have been encountered, as it has not yet been
definitely proved that these viruses are not communicable to human
beings.
INSTITUTE OF PUBLIC HEALTH, RANGOON, FOR THE YEAR 1935.
9
(ii) During the course of the bacteriological examination o
f w a t e r s t h i s y e a r , B . 9 8 ( c i t r a t e + ; i n d o l — ; V . P . + ) w a s f o u n d i n 3 2
out of 362 samples of water. Out of these 32 samples, 20 samples
were collected from sources where the writer was able to assure him
- s e l f t h a t h u m a n f a e c a l c o n t a m i n a t i o n w a s s o r e m o t e a p o s s i b i l i t y a s t o
be negligible. It was also found that this organism, in the majority of
the cases, was associated with other organisms which were citrate
utilisers, non-producers of indol and V.P. positive. In only 12 cases
were faecal organisms (citrate—; indol +) found associated with this
organism. Clemesha in his book, " The Bacteriology of Surface Waters
in the Tropics " doubts its faecal origin and mentions that this
organism was isolated on some occasions from comparatively good
samples of water. He, however, put this organism into Class I, so
that its presence would make one suspicious of faecal pollution at the
source. From all the work done on water bacteriology, so far, the
conclusion that can be drawn is that true faecal organisms should be
citrate non-utilisers, indol producers and V.P. negative, whereas those
of the non-faecal origin are citrate utilisers, non-producers of indol
and V.P. positive.
An effort was made in this laboratory to find out the incidence of
B. 98 in human faeces. Twenty-five lactose fermenting colonies from
different samples of stools were examined and only on two occasions
was B. 98 encountered. In one case the stool was mixed with water.
It was interesting to note that, out of these 25 organisms examined,
21 were citrate non-utilisers, indol producers and V.P. negative.
Of the other two citrate utilisers, one was B. 7 and the other was
unclassified.
The next test that was done with B. 98 was to find its resistance to
sunlight. Clemesha's Class I organisms do not live in water for a long
time when exposed to sunlight. Two sets of flasks, one containing
sterilised distilled water and another containing sterilised pond water
were inoculated with saline emulsion of 24 hours agar culture of B. 98.
The mouths of the flasks were covered with pieces of gauze and the
flasks were exposed to sunlight for 37 days. The samples of water
were tested at frequent intervals and B. 98 was recovered on
every occasion. These experiments show that B. 98 is resistant to
sunlight. Lastly, it should be pointed out that B. 98 was found 19
times from March to May, while it was found 8 times only during the
months of July and August. This is not in keeping with the findings of
Clemesha who mentioned that it is never found in water supplies in dry
and hot weather.
12. Instruction .—Lectures and demonstrations were given to students
of the License in Hygiene Class, Health Visitors and to the students
of the Medical College and Medical School.
10
REPORT ON THE WORKING OF THE HARCOURT BUTLER
The following subjects were taught:
—
Public Health laboratory practice;
Plague and its preventive measures;
Identification of rats and rat fleas;
Demonstrations on the working of the cyanogas pump.
13. Miscellaneous Aclivities.—This section took part in the Annual
Public Health Exhibition, entirely supervising the sections on water
bacteriology and the prevention of plague.
In July, a test was carried out in this Institute as to the efficiency of
different types of cyanogas pumps. An elaborate experiment was done
under the supervision of Mr. V. W. Fenn, with whom the plague
section of this department fully co-operated.
Identification of snakes, whether poisonous or non-poisonous, is
another minor part of the duties undertaken by this department.
Report of the Malariologist, Lieutenant E. S. Feegrade,
I.M.D., on the Malaria Bureau for the year 1935.
13. During the year under review the following routine work
was carried out:
—
A. Educational Instruction.—(a) From the 19th July to 29th
October instruction in malariology was given to the members of the
License in Hygiene Class.
(b) A short course of instruction based on museum exhibits was
given to the Health Visitors' Class.
(c) Two demonstrations were given to the students of the Burma
Government Medical School.
(d) The Public Health Inspector of Lashio was given a compre
-hensive course on the identification of anophelines, and on methods
used in combating breeding.
B. Identification of Culicidae. —Specimens of adults and larvae
were received from the various districts in the province. They were
identified and a report submitted to the sender. Three hundred and
seventy-four adult anophelines and 2,510 anopheline larvae were thus
identified. Similarly, 39 adult culicines and 2,650 culicine larvae were
dealt with. Amongst the anophelines sent for identification, three
varieties hitherto not recognized were added to the list of anophelines
found in Burma, viz.—
Species.
Locality.
1. A.gigas var. simlensis—
James 1911 . . .
Lashio, Northern Shan States.
2. A. barbirostris var. ahomi
—
Chowdury 1929 . . . Maymyo, Mandalay District.
3. A. aitkeni var. bengalensis—
Puri 1929 . . . Maymyo, Mandalay District.
INSTITUTE OF PUBLIC HEALTH, RANGOON, FOR THE YEAR 1935.
11
C.
Spleen Census.—Findings were received from 57 towns and 147
villages located in 29 districts of the province. The records are card-
indexed so that they are readily available for reference. The rates
noted vary from nil per cent in certain places in the dry zone to 100
per cent in the foothills and irrigated tracts. Spleen rate records are
now being charted on sectional district maps, and on a large scale map
of Burma.
D.
Blood Smears. —One hundred and thirteen blood smears were
examined during the year. These were obtained from selected places
to ascertain the distribution of the species of parasites and to confirm
reports.
E.
Special Weekly Reports. —These are received from Kyaukpyu,
Maymyo and Lashio, as in these three areas anti-malarial measures are
carried out under special supervision.
KYAUKPYU.—Satisfactory progress continues to be made in dealing
with A. annularis, the chief carrier in the past. A. sundaicus, which in
previous years was confined to one area, now shows a tendency to
invade other parts of the town. It has not yet been definitely
incriminated as a carrier but investigation of this point is in hand ;
active steps are being taken to reduce breeding and, as well, a study
is being made on the salinity of its breeding places.
MAYMYO—Anti-malarial work here continues to be prosecuted
vigorously and, judging by the reduction in the number of larvae caught
in known breeding places, is being attended with a fair measure of
success.
During the year, A. annularis was observed to have changed its
breeding habits as it is now found in large numbers in hoof prints.
A. minimus and A. culicifacies continue to act as carriers in this town.
LASHIO.—The number of breeding places is being slowly but steadily
decreased. Stone filling is being practised and dense shading is being
attempted.
A. maculatus and A. minimus are the carriers of malaria in this
area.
F.
Preservation of Specimens. —(a) Specimens of all phases of the
common insects of medical interest are mounted both for teaching
purposes and for the museum. Specimens of larvivorous fish that are
used in Burma are also mounted.
(b) A new scheme for breeding these fish has been evolved and,
it is hoped, will be shortly put into use. It is anticipated that under
the new method it will be possible to supply malarious areas throughout
the Province with these fish in effective numbers.
The fish being bred are—
(1) Gambusia affinis.
(2) Panchax panchax.
(3) Esomus ahli.
12
REPORT ON THE WORKING OF THE HARCOURT BUTLER
Of these, the greatest success has attended the breeding of
Gambusia affinis. From 1,577 fish, 5,455 Were bred during the year;
casualties amounted to 1,863. They were distributed to
—
Pyapôn . . .
1 , 7 0 0
H l è g u . . .
1,000
Hanthawaddy . . .
800
Maymyo . . .
320
Rangoon . . .
195
S a h m a w . . .
150
Lashio . . .
107
Reports received from these places indicate that breeding appears
to be proceeding satisfactorily.
Specimens of fish were received for identification from the districts.
In cases of doubt they were forwarded to the Director, Zoological
Survey of India, Calcutta.
A new species of fish was discovered and sent to the Zoologica
Survey of India, Calcutta. It has been named Dermogenys
burmanicus.
15. Spi eci al I n v e s l i g a l i o n s . —(
1 ) A s p l e e n c e n s u s w a s c a r r i e d o u t i n
Maymyo and seven adjoining villages between the 7th and the 24th
August. The total rate was 0.74 as compared with 1.59 in 1933.
(2) In Rangoon, special inspections were made with a view to
ascertaining breeding places of mosquitoes at the Government Printing
Press, in Windermere Park area, and in 46th Street. In each
case, recommendations were made as to how to check breeding.
(3) Proprictary
Preparations.— Three of these were experi
-mented with during the year, namely, ( a ) Pearson's larvicide, a
product of Messrs. The Pearson Anti-Septic Co., Ltd., 172, Buckingham
Palace Road, London, ( b ) "Britway" Paris Green, samples of which
were obtained from Messrs. The Imperial Chemical Industries (India),
Ltd., No. 508, Merchant Street, Rangoon, and ( c ) Tic, a sample of
which was obtained from Messrs. The Havero Trading Co., Ltd.,
Ballard Estate, Bombay. The results are recorded in the Bureau.
16. Miscellaneous Activities
.—Health Week of the Indian Red
Cross Society, Burma Provincial Branch.
During the year two Health Exhibitions were held, one in January
and one in December. In this connection the Bureau undertook a large
amount of work in the way of turning out posters on health subjects
and manufacturing models. Supervision was exercised over the
manufacture of similar posters and models for the Rangoon Corporation,
who employed, under the direction of the Malaria Bureau, the necessary
artists and carpenters.
In this connection, it is gratifying to note that the January
Exhibition was awarded the Bostock Hill Memorial Shield by the
Royal Sanitary Institute, London.
17. Departmental Publications.— A note was written on how to
breed Gambusia affinis and another on the use of Paris green. These
were circulated to officers of the Public Health Department.