3

REPORT ON THE WORKING OF THE KING INSTITUTE, GUINDY

vaccinators instead of three times as formerly and these supplies have to be used
up by the vaccinator within four days of receipt. This change ensures the use of
the lymph in the fresh state only and is therefore a decided improvement over the
old system.

     The lymph is now issued in glass vials and, as a very large number of these are
used owing to the more frequent distribution, arrangements have been made for
their return to the Institute once a quarter. A considerable saving in material
has thus been effected. A rotary lancet suitable for use with glycerine lymph
has been introduced by the Institute and has been recommended to the Director
of Public Health for general use. More even results cannot fail to follow the
general introduction of this instrument. Complete instructions for the use of
glycerine lymph have been drawn up in the Institute. These instructions have
been issued by the Director of Public Health in his circular letter No. D. 66-P.H.,
dated 7th March 1924, and have been copied by him into his letter R. No. 534-3-
P.H., dated 27th March 1924, which has been issued by Government as G.O.
No. 1125-P.H., dated 6th August 1924. Attention has also been paid to the
returns of vaccinations performed. These forms were completely revised so as to
give all the information required during the year 1922-23. Once filled in by the
Health Inspectors, these are now sent through the District Health Officers who
scrutinize them before despatch to the Institute. In this way a more complete
check upon wastage and careless work on the part of the vaccinators has been
instituted. The habit of indenting for a certain percentage of lymph over and
above actual requirements to allow for wastage has been prohibited and the rules
dealing with extra indents and deviation from the vaccinators' fixed programme
have been made more stringent.

     As in 1922-23 routine vaccination was discontinued during the hottest months
of the year. In the present case, however, there was a uniform cessation for
four months in all districts. This was the original recommendation made by the
Director in putting forward this proposal in 1922 but the desire to interfere with
the vaccination work as little as possible led Government to cut the four months
period down to two months in the case of those districts receiving the south-west
monsoon. Last year's experience proved that the advent of the monsoon had no
beneficial effect on the success rate in those districts. The original proposal of a
universal four months' cessation was therefore agreed to this year.

     2,184,590 cases of vaccine lymph were despatched from the vaccine section
during the year (vide statement 1). This is the largest issue on record since
the Institute was founded and exceeds that of the previous year by over 104,000.
The fear that the hot weather cessation of operations would decrease the number
of operations performed has thus proved to be unfounded. The supplies to
District Boards again show the chief increase. Those to municipalities, jails,
private bodies and the Superintendent of Vaccination, Secunderabad, show a slight
decrease over the previous year's issues.

     Attention was drawn last year to the large amount of lymph issued which
was entirely unaccounted for in the returns received by the Institute. This
figure was no less than 38.9 per cent of all the lymph issued. The percentage of
lymph unaccounted for this year is 29.8 (see statement 2). Ten out of the 24
districts show a shortage of over 30 per cent and in the case of Anantapur
(62.5), Vizagapatam (55.1), South Kanara (52.6), South Arcot (49.7), Salem
(49.4), Rāmnād (44.8) and Cuddapah (43.2) the difference is over 40 per cent.
The shortage for the combined municipalities and the Madras Corporation is
14.9 and 12.7, respectively. Although there is a considerable improvement over
last year's figures, the amount of lymph unaccounted for is still far too high and,
as it was found out last year that the discrepancy could only be due to wastage
of lymph or inaccurate returns or to a combination of both these causes, the
present condition of affairs is one which calls for the serious consideration of all
District Health Officers, especially those in whose districts the discrepancy is
abnormally high. The number of returns made by the jails, military and private
bodies is as usual negligible.