London's Pulse: Medical Officer of Health reports 1848-1972

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Kensington 1902

Annual report on the health, sanitary condition, etc., etc., of the Royal Borough of Kensington for the year1902

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72
Calf Lymph.—In the last four-weekly report for 1901 (December 31st, p. 198), reference was
made to the advantage that would accrue to the public were the Local Government Board to
supply medical practitioners generally, and not Public Vaccinators only, with lymph for revaccination
; or, in the alternative, to undertake supervision over the production of lymph at noofficial
establishments. The report was referred to the Public Health Committee who recommended—
" That the Local Government Board be requested to undertake the supply of lymph to any
registered practitioner who may apply for the same, instead of to public vaccinators only, as is
the case at present, and that the other Borough Councils be asked to make similar representations."
This recommendation having been adopted by the Council, a letter was addressed to the
Board, who replied—
" That glycerinated calf lymph supplied by the Board is only intended for use by Public
Vaccinators in the performance of primary vaccination under contract with the Guardians, aud
that under existing arrangements the Board are unable to extend the issue of such lymph to all
medical practitioners."
This letter, followed obviously on the lines of an old draft, as the Board have for some years
supplied to public vaccinators the lymph required for revaccination, and were doing so at the date of
the communication. The President of the Local Government Board stated in the House of Commons,
on the 10th February, that the establishment was producing 50,000 charges a week (=2,600,000 a
year); a quantity far in excess of the requirements of Public Vaccinators, if not sufficient to meet
the needs of all private practitioners. Arm-to-arm vaccination, in other words the use of humanized
lymph, is now discouraged, and has indeed become impracticable, owing to the abolition of public
vaccination stations since the passing of the Vaccination Act, 1898, which will expire, by effluxion
of time, at the end of 1903. This subject was again brought to the attention of the Board early in
the current year, by an important deputation to the President who stated that it would be impossible
to undertake the supply of lymph generally to the whole country; but, if the law of vaccination
could be strengthened, panics be avoided, and things brought into an everyday condition {i.e., by
the equalization of vaccination at all times), it might be practicable to attempt to deal with the
task ; and, certainly, if revaccination was to be made obligatory, as proposed, the lymph should be
of the very best quality.
During the small-pox epidemic, medical men frequently complained of the difficulty of
getting active lymph. Much of the supply then current, while being of sufficient strength to ensure
a satisfactory result in primary vaccinations, proved too feeble in cases of attempted revaccination.
Great public advantage would undoubtedly accrue if the Local Government Board could be induced
to supply doctors with lymph for revaccination, but hitherto the lymph cultivated upon calves at
Government establishments has been issued only to public vaccinators. Some of the private firms
engaged in the production of calf-lymph send out material to which no exception can be taken ;
but it appears desirable that, should the Board be indisposed or unable to supply Government
lymph to all applicants, they should, at least, be empowered to exercise such supervision over the
production of lymph for the use of private practitioners as may be necessary to secure that persons
upon whom it is used shall be " effectively revaccinated." Multitudes of persons, doubtless, during
the epidemic were made happy by the thought they were immune to small-pox, as their revaccination
did not "take"; the negative result of the operation being due, often, to the inertness of the lymph
employed.
The change of view as to the relative advantages of calf lymph and humanized lymph, during
the last few years, is truly remarkable. In Kensington the Guardians gave parents the option of
having their children vaccinated with calf lymph many years ago, and before the publication of the
report of the Royal Commission recommending the use of calf lymph. But the then existing
Order of the Local Goverment Board, required arm-to-arm vaccination, and calf lymph was
supplied to the public vaccinators solely for the purpose of starting a series of vaccinations. Calf
lymph for optional use in vaccination, in Kensington, was obtained from a private source; the
general use of such lymph was discouraged, not to say penalised; the special grant for successful
vaccination having been withheld from the public vaccinators who, acting upon the instructions of
the Guardians, gave parents the option of having their children vaccinated with it. Now, the use
of calf lymph, by public vaccinators at any rate, would appear to be universal.


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