PREVENTIVE INOCULATION. 245 



were six cases, but no deaths. In Bangalore, among 80,285 of the in- 

 habitants not inoculated, there were 2,208 deaths from plague, while 

 among 23,537 inoculated there were only 108. The observations at 

 Lanowli, Kirkee, Daman, Hubli, Dharwar, Gadag, in the Bombay 

 Presidency, gave the same results. At Hubli over forty-two thousand 

 inhabitants out of some fifty thousand were inoculated. In Bombay 

 city, out of a population of 821,764, 157,256 have now undergone the 

 i n< 'dilation. The work proceeds here at present at the rate of one 

 thousand to eleven hundred inoculations a day. 



From plague hospitals the returns show that among those of the 

 attacked who were previously inoculated the mortality is reduced to less 

 than one half of that among patients who were not inoculated. The 

 property of reducing the case mortality thus appears to belong to the 

 plague prophylactic in an unmistakable degree. 



By the anti-cholera and anti-plague inoculation the methods of pre- 

 ventive treatment by means of cultivated bacteria and their products 

 have been rendered, so to say, a part of the daily policy in human 

 medicine. The usefulness and practicability of those methods have 

 become clearly apparent, and steps have been taken to extend further 

 the field of their application. On the ground of the experiments made 

 with the typhoid bacillus in the Pasteur Institute in 1889-'93, and of 

 the results obtained from the anticholera inoculation in India, I was 

 able to induce Professor Wright, of the Pathological Laboratory in 

 Net ley. whom I initiated in 1892 in the principles and technique 

 of anti-cholera inoculation, to start a campaign of similar operations 

 against typhoid among the British troops. The latter are stationed 

 at different times of their service very nearly in all parts of the world, 

 and yearly pay a very heavy tribute to that disease. The medical 

 officers in charge of these troops pass through a course of training at 

 Netley, and Professor Wright had rendered excellent services in con- 

 nection with the cholera inoculations, by disseminating the knowl- 

 edge of them among the probationers of the school. It seemed to 

 me expedient, therefore, to start the typhoid inoculation also through 

 the staff and pupils of that school. The following plan as to the pre- 

 paration of the vaccine, and the way of carrying out the inoculation, 

 was laid before Professor Wright. The typhoid bacillus was to be 

 brought to a fixed stage of virulence by the inoculation in the peritoneal 

 cavity of Guinea pigs, according to the exact rules prescribed for the 

 anti-cholera inoculation. Once the virus was fixed, it was to be cul- 

 tivated for twenty-four hours on a solid medium, and a first vaccine 

 prepared by carbolizing that virus. As, however, the durability of the 

 effect of carbolized vaccine alone was not known, this was to be followed 

 up by the injection of a dose of the fixed living virus. 



