Report on preventive inoculation against plague in Hubli, from 11th May to 27th September 1898 / [H.F. Leumann].

  • Leumann, H. F.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Report on preventive inoculation against plague in Hubli, from 11th May to 27th September 1898 / [H.F. Leumann]. 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.

    1/100
    Fkom To Dhdricdr^ l9th October 1898* Sir I have the lionour to for’^arcl Snrgeon-Captaiii Leuraann’s report on plague inoculation at Huhli. E. L. CAT PEL, Esquire, Collector of Eliarwar; j^*>*** C, * 6 ? ■ 'O.X im ^ 5 J-'■ o The plague COAIMISSIONER, Bombay Presidency,' Bombay. 2. The results are shown in tho tables under'paragraphs XXIII to XXVII, and indicate a protection of 85^per cent, on the whole epidemic, with a figure of from 90 to nearly 100 per cent, for the greater part of the time. I\IorG than 2'P,000 persons were twice inoculated and nearly 10,000 once, of v/hom the majority liave received a second inoculation since tlie report w.as written. At the present moment the pbigue has practically died out at Ilubli, and tbcro can be no question as to the causal relation between this fact and the inoculation measures. In his paragraph XXXI, Dr. Loumann has sutheiently disposed of such ad- verse inferences as might have been drawn from certain general factors in the case. 3. The system of double dosage, which has also been adopted at Dh;irwalr, exhibits a 10 per cent, advantage over single inoculation. The results so far at Dharwar have been still more signilicant: 4,926 single inoculations giving 45 cases and 15 deaths, wdiile 3,387 double inoculations have given only 2 cases and 1 death. I concur Avith Dr. Leumann that the recorded advantage would appear con- siderably larger if it Avere possible to eliminate causes of error due to the in- oculation of persons in the incubation stage of the disease or with plague on them. This is a risk, howmver, common in some degree to both first and second inocula- tions. ft is very usual for persons to defer inoculation till plague has appeared in the house or has become virulent in their immediate neighl)Ourhood; they are then “ Contacts ” and the disease has already laid its hand on a considerable proportion. It is no matter of surprise that the common people should be un hie to distinguish between a preventive and a cure, and present experience at DhdrAvdr goes to show that inoculation is constantly sought by those who feel the approaches of the disease. On this point the Aledical Officers are collecting a record (dates of inoculation and of attack) Avhich will be of great interest. It seems impossible to prevent altogether the inoculation of infected persons. 4. In paragraph XXX of the report, Dr.’Leumann institutes a rather unfortunate comparison. He contrasts the advantages of inoculation with those of sanitati&n and hygiene, as if these wnre rival or opposing systems. There is of course no such rivalry or opposition, and the whole argument seems to be beside the mark. I assume, in any case, that Dr. Leumann intends the tabular statement of the effect of the contrasted systems (page 47) to be a comparison of merely abstract and hypothetical measures; because it is not the case, as might be otherwise inferred, that at Hubli the adoption of inoculation involved the exclusion of measures to destroy the bacilli or to remove the sick from the healthy. Exactly the same work Avas done to attain these objects as would have been done, had no inoculation been carried out. 5. It is now, I believe, recognized that, under the conditions which obtain in India, sanitary and hygienic measures in the ordinary sense of the words have no direct effect upon the course of a plague epidemic. A more effective comparison might be draAvm. between Inoculation and Evacuation, but even B 1555-1