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each case to medical practitioners carrying out the treatment and to
cover the cost of the necessary propaganda, and that the Medical Officer
of Health be authorised to take all necessary steps for circularising the
practitioners, informing the public and generally bringing the scheme
into operation as soon as possible.
The antigen used was T.A.M. in three doses of 1 c.c., spaced at onemonth
intervals. The immediate response was quite gratifying, though
further publicity in the autumn following a fall in the summer, achieved
little. 1,804 cases in all were treated under these arrangements. This
did not represent the total number of the treated because, especially
with the income limit, large numbers were treated privately. Some
7,548 units of T.A.M. were sold to medical practitioners, so that up to
some 2,500 cases were possibly treated. The next year only 315 were
immunised, and in 1937 only 226. In this year the one-shot A P T. was
marketed, though not used in this district.
On the general question of propaganda, it was felt that better results
would be obtained by concentrating on selected age groups, rather than
in carrying on a more diffuse propaganda directed to children of all ages.
As the immunity of infants passes off about one year of age, and the
toddler is reaching the stage in which he is more likely to be exposed to
risk, the age group chosen was 9 to 12 months. The practice was instituted,
which has since been continued, of sending to the parents of all
children of this age a letter pointing out the desirability of the child being
immunised, more particularly at this age. There was a welcome increase
in 1938 to a figure of 956 of those treated being largely infants of this
age. At the end of the year it was agreed that A.P.T. in two doses should
be accepted as a recognised method of immunising under the Council
scheme. Nevertheless, most of the 1,129 children treated in 1939 were
inoculated by T.A.M. and not A.P.T. The position was reversed though
in the next year, largely because of the difficulties of obtaining anything
other than A.P.T. 705 were treated in this year.
Up to this, the attitude of the central authority had advanced from
the earlier one of guarded hesitancy, through that of benign neutrality
to a mild encouragement. The position was completely altered at the
end of 1941, when the Ministry of Health apparently decided that the
immunising of children should be actively encouraged, and so, for the
first time, there were official broadcasts advocating this practice. This
meant that for the first time, the public appreciated that the scheme was
approved by the Ministry of Health and it also meant that use could be
made for the first time of broadcasting, so reaching the population not
getatable by the propaganda of local authorities. This propaganda in
the last weeks of 1940 brought in for treatment large numbers who
received their first dose before the end of the year, but whose returns are
classed in the next year, as it was not until then that their treatment
was completed.
Up to this, children were treated only under the scheme by which
they were dealt with by the family doctor. Early in 1941 arrangements
were made in addition for treating children at the infant welfare centres,
while the County school medical staff undertook inoculation of school