The health of the inoculated / [W.M. Haffkine].

  • Haffkine, W. M. (Waldemar Mordecai), 1860-1930.
Date:
1901
Catalogue details

Licence: In copyright

Credit: The health of the inoculated / [W.M. Haffkine]. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    A lecture on the above subject was delivered, on the 29th June 1901, at a meeting presided over by his Excellency the Governor of Bombay, at the Native General Library, Budbwar Peth, Poona, by Mr. W. M. Haffkine, C.I.E., Director-in-Chief of the Plague Re- search Laboratory, Bombay. His Excellency was ac- companied by Captain Wood, A.-D.-C., and Lieutenant- Colonel Oroly, R.A.M.C. Those preeent included Sir Charles Ollivant, K.C.I.E., and the Hon. Mr. J. Monteath, C.S.I-, Executive Members of his Excel- lency’s Council ; Sir Andrew Wingate, K.O.I.E., Commissioner of Central Division, and Lady Wingate ; Surgeon-General Bainbridge, I.M.S. ; Mr. C. O. Quin, I.C.S, Secretary to Government ; Mr. E. L. Cappel, I.C.S., C.I.E., Collector of Poona ; Mr. M. Kennedy, Inspector General of Police ; Captain J. K. Condon, I.S.C., Under Secretary to Government ; Captain Collins, R.A.M.C. ; the President and members of the Poona Municipality ; a number of Medical officers, and a large gathering of European and native residents. The hall of the Library was crowded, a number of persons remaining standing. His Excellency, who was loudly cheered on rising, said that Mr. HaSkine required no introduction to the meeting. He hoped all those present would profit by his advice in connection with combating plague. He had been authorised by Mr. Haffkine to say that anyone desiring to ask questions at the conclusion of the lecture might do so, and Mr. Haffkine would be glad to give any further information in his power. Mr. Haffkine said : “ Your Excellency, Ladies and Gentlemen,—Iuooulation against plague has now been applied in India for four and-a-half years, and it may be assnmad that those here present are familiar with the fundamental points of the subject. It has been found that persons inoculated with the plague prophylactic have a greater chance of escaping the disease than uninoculated ones, and that when they are attacked notwithstanding in- oculation, they have a greater chance of recovery than non-inocnlated persons. When a large pro- portion of inhabitants get inoculated in a plague- stricken locality, the plague loses the character of an epidemic, and assumes that of a sporadic disease. It is also known that inoculation causes, for a time, pain at the seat of injection, and an attack of fever. None of us, however, is afraid of a temporary pain, or a rise of temperature for a day or two. What we want to know is whether the operation is likely to produce any injury to health or not. I may mention here in passing that the first stage in the formation of opinion on this matter was that some persons, who have never become known, spread a rumour that in three years1 time the inoculated would develope leprosy. The rumour was very persistent, and deterred a number of people from being inoculated. I hardly think there is anyone here who requires help to pass judgment upon that rumour and those who spread it. There was no ground for forming such a mon- strous conclusion ; and those persons, not having had the three years to observe actual facts, were spreading the rumour with interested, malicious intentions. INVESTIGATIONS IN PARIS. The inception of anti-plague inoculation is to be looked for not necessarily in Bombay in 1896, but rather, perhaps, in investigations which were carried out in 1889-1893 in Paris, on cholera and its preven- tion by inoculation. As the result of those studies a method was worked out, which, in many respects, served subsequently as a basis for the prophylaxis of plague. Inoculation against cholera is also done with a mate- rial in many ways analogous to the plague prophylactic. When it is injeoted under the skin a swelling is formed, which becomes painful as time proceeds. The temperature of the patient rises, and he developes a genuine attack of fever, accompanied by symptoms usual in that condition. The pain continues to increase for 10 to 15 hours, and the fever also. Then they subside. The general symptoms last for 24 to 36 hours, while the pain remains for 3 or 4 days, or even longer. Occasionally there is voznitting and in very exceptional instances momentary fainting. I describe these symptoms for a purpose which you will see presently. The studies on cholera were carried out in the famous Pasteur Bacteriological Institute. There is a large Btaff of experienced physicians and scientists attached to it. You are aware that one of the chief functions of a physician is to determine the disease from whioh a patient is suffering, and to tell whether it is dangerous or not. When a patient is brought into a hospital the doctor in charge examines his pulse, hiB heart, his breath- ing, occasionally takes and examines also sam- ples of his secretions, asks certain questions, and forms a conclusion. Sometimes the patient has slight, hardly perceptible symptoms, but the doctor, after examination, takes a serious view of the case. At others, the symptoms Beem severe, but the pbysioian is able to say at once that there is nothing very far wrong with him, and he will be hale and hearty in a day or two. Physicians are liable to make mistakes ; but the more experience they have the fewer mistakes they make. The first patients inoculated against cholera were taken to the Pasteur Institute, and kept there under observation while the symptoms lasted, and sometimes for a considerable time after they had subsided. ThiB was the easier, because gradually almost the entire staff of the Laboratory made up their minds to be inoculated, and became subjects for observation. At no moment was it considered that there was reason to apprehend ill consequences from the operation, not more than after a severe bruise, or a pricking of one's finger lead- ing to a swelling and temporary suppuration, or other such accidents, sometimes very uncomfortable, which we go through in our daily life. It was only after having satisfied a number of keen observers who pro- nounced the effects of inoculation as of a trifling nature, that steps were taken to apply the system to the general public. INOCULATIONS IN INDIA. < You may have heard that those inoculations against cholera were subsequently carried out in the North- Western Provinces of India, in the Punjab, Bengal, Behar,and in Upper and Lower Assam. A certain number of troops and civil people were also inoculated against cholera here, in Poona, at Kirkee, and at the Sassoon General Hospital, previous to the advent of the plague. At present anti-cholera inoculations are practised in a Government Laboratory in Purulia, for the bene- fit of people emigrating into the tea districts of Assam. During the first couple of years, from 1893 to 1895, the operation was performed on some 43,000 individuals in India. More than ten thousand of these were European and native soldiers, while a considerable pro- portion of the rest were coolies on the Assam tea estates, I mention theBe two groups of people because their health or liability to disease is watched over by competent persons. In no instance was there a sus- picion aroused in the minds of the regimental medical authorities or of the physicians on the tea plantations as to any permanent ill effects caused by inoculation. The proof of this is that inoculation against typhoid, which is done on the lines of the anti-cholera inocula- tion, is now largely applied, as you probably know, amongst the troops in India and elsewhere, with the difference that the operators use much larger doses than those which we injected against cholera, and much more severe symptoms are produced. On the Assam tea estates the managers have testified in a similar manner to their being gratified with the results. At my last visit to Calcutta the Hon. Mr. H. H. Risley, Secretary to the Government of Bengal, was good enough to inform me that the planters had offered to pay a fee for inoculation, sufficient for the maintenance of two additional anti-cholera ino- culation stations, iiz.t one in Calcutta and one in Dhubri, on the Brahmaputra. Certain planters insist on the new coolies engaged in India being inoculated against cholera before they agree to take them out to Assam. No such condition of affairs would exist had the health of the thousands of coolies who were inoculated inspired the least apprehension amongst those who take so much trouble to get and maintain them on their estates. When at the end of 1896 the plan of anti-plague inoculation was worked out in Bombay, the staff of the Laboratory were inoculated first, and we made minute observations on the symptoms produced in us. The first injection was done with a dose four times larger than that adopted aB a standard one in order to be certain that no danger would ensue to a person inoculated with a smaller dose. What struck us in those observations, and what you have possibly noticed already, was that the Bymptoms caused by the injection were in no way distinguish- able from those that I described above as consequent on anti-cholera inoculation, which bad been so minutely Btudied in Paris and afterwards observed and