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mittees, suggested that the periods for such attend- CIRCULARS. ance should be fixed in the months of April or May, and September or October; and, assuming those periods to have been fixed by the Dispensary Committee, it would appear to be desirable to have the reports made up to the 30th of June and the 31st December in each year.

In regard to the period of payment, the Commissioners have, by the 3rd Article of the Regulations which they have issued in pursuance of the provisions of the Act, provided that payment shall be made by the Board of Guardians on the expiration of twenty-eight days after they shall have received the Report from the Committee of Management, to whom it is to be made by the Medical Officer."

No. 11.-VACCINATION-COMPULSORY VACCINA-
TION ACT, 26 & 27 Vic. c. 52.-CIRCULAR to
BOARDS of GUARDIANS, 10th August, 1863.

Poor Law Commission Office, Dublin,
10th August, 1863.

SIR, The Commissioners for administering the Laws for Relief of the Poor in Ireland transmit to you herewith, for the information of the Board of Guardians, a copy of an Act (26 & 27 Vic. c. 52) which received the Royal assent on the 13th ultimo, to further extend and make compulsory the practice of vaccination in Ireland.

It will be observed that the provisions of the Act do not come into operation until the 1st of January next, and that none of the provisions of the existing Vaccination Acts, excepting that which relates to the mode of remunerating the Dispensary Medical Officers for vaccinating, are superseded. The existing arrangements in regard to vaccination stations, and the returns to be made by the Dispensary Medical Officers, will,

a This provision is now included in the General Dispensary Regulations, Art. 26 (see p. 887).

CIRCULARS. therefore, remain in force, and the only new duties imposed upon the Dispensary Medical Officers in regard to vaccination, will be to give Certificates of successful vaccination (sec. 3); Certificates of children not being in a fit state for vaccination, when that is the case (sec. 4); or of their being insusceptible of vaccine disease (sec. 6).

The other duties to be performed under the Act are to be performed by the Registrars of births and deaths, and the Commissioners do not doubt that, before the Act comes into operation, all necessary instructions will be issued to them by the Registrar-General, who is empowered by the 11th section to cause to be provided all such books, Forms, and Regulations, as he may deem necessary for carrying into full effect the provisions of the Act.

The only additional points, therefore, to which the Commissioners think it necessary, at present, to direct the attention of the Board of Guardians, are the following:

1. Under section 1, the Master of the Workhouse is made responsible for taking all the steps in reference to the vaccination of children who are inmates of the workhouse, which are required to be taken in other cases by the father or mother of the child. It is part of the duty of the Medical Officer of the workhouse, under the Workhouse Rules, Art. 68, No. 6, to vaccinate all children in the workhouse who may require vaccination; and it will now be the special duty of the Master in regard to children in the workhouse, born after the 1st January next, to see that this is done, and that the child is brought to the Medical Officer, for inspection, on the eighth day after the vaccination, as required by sec. 2, and to obtain the necessary Certificate.

2. After the 1st January next, the Dispensary Medical Officers will, according to the 5th sec. of the Act, be entitled to receive, instead of the present rate of remuneration, one shilling for every person successfully vaccinated by him within his dispensary district, provided he shall have made.

the report to the Dispensary Committee, regard- CIRCULARS. ing such persons, which is required by the existing Vaccination Act, 21 & 22 Vic. c. 64.

3. The Guardians are empowered by sec. 13 to direct proceedings to be instituted for enforcing obedience to the provisions of the Act, and the expenses incurred in such proceedings, if certified and allowed by the Justices, are payable out of the rates of the union.

By order of the Commissioners,

B. BANKS, Chief Clerk.

To the Clerk of each Union.

No. 12.-VACCINATION-MODE of PRESERVING
VACCINE LYMPH. - CIRCULAR to BOARDS of
GUARDIANS, 28th October, 1863.

Poor Law Commission Office, Dublin,

28th October, 1863.

SIR, The Commissioners for administering the Laws for Relief of the Poor in Ireland forward, for the information of each Board of Guardians in Ireland, a copy of a circular letter, which is now in course of being issued by them to the Medical Officers of the dispensary districts, recommending them to adopt the use of Dr. Husband's capillary tubes as a means of supplying themselves with vaccine lymph from eligible cases within their own practice as public vaccinators, and of preserving the lymph in a fluid state.

The Guardians will observe that the cost of procuring the empty tubes is about 18. per hundred, and that the Commissioners consider the expense of a proper supply for each Medical Officer is a legal charge upon the poor rates, in the same way as the cost of medical or surgical appliances, under the Medical Charities Act.

The Commissioners recommend the Guardians not to hesitate to incur the small cost of furnishing these tubes for use by the Medical Officers, whenever a requisition is sent in to that effect by a Dispensary Committee.

CIRCULARS.

The Medical Officer of the workhouse will probably wish to be furnished occasionally with the same appliances for taking and preserving lymph for use in the workhouse, and a copy of the circular and a box of empty tubes is sent herewith for his use and information.

The tubes now forwarded were obtained from Mr. Robert Somerville, of No. 10, Spring Gardens, Stockbridge, Edinburgh, from whom a supply can be at any time obtained.

By order of the Commissioners,

B. BANKS, Chief Clerk.

To the Clerk of each Union.

No. 13.-VACCINATION-MODE of PRESERVING

VACCINE LYMPH.

- CIRCULAR to DISPENSARY

MEDICAL OFFICERS referred to in foregoing
Circular, 28th October, 1863.

Poor Law Commission Office, Dublin,

28th October, 1863.

SIR,-Adverting to their circular letter of the 10th August last, enclosing a copy of the recent Vaccination Act, the Commissioners for adminis tering the Laws for Relief of the Poor in Ireland desire to draw the attention of each Dispensary Medical Officer to certain considerations regarding the supply of vaccine lymph for the purpose of vaccination.

The success of vaccination in the individual case, when properly performed in all respects, and under the most favourable conditions, is still dependent on the quality of the lymph used in the operation.

Assuming the lymph to be intrinsically good, an additional security for its taking proper effect has been found in its freshness; and hence the prac tice of vaccinating from arm to arm is esteemed the best.

The practice, however, of vaccinating from arm to arm cannot always be adopted by the public vaccinator, nor can he always be sure of obtaining

fresh lymph of good quality from external sources; CIRCULARS. and any mode by which he can secure possession of it selected by himself from his own cases and kept in a good state of preservation cannot but be satisfactory to him as one of the means of insuring success in his operations.

The small glass capillary tubes invented by Dr. Husband, of Edinburgh, afford the means, if carefully used, of enabling the public vaccinator to keep himself supplied at all times with lymph selected by himself, and preserved in a fluid state.

These tubes are procurable, empty, at a cost of 18. per hundred, and are safely sent at that price by post in small wooden boxes. The cost of obtaining the supply of empty tubes the Commissioners consider to be a proper charge on the poor rates, when ordered by the Board of Guardians, as part of the ordinary dispensary requisites under the Medical Charities Act.

A box containing a few specimens of these capillary tubes is sent herewith, and if you should desire at any time to avail yourself of a further supply, the proper course will be to make a requisition through the Dispensary Committee to the Board of Guardians to that effect.

The annexed directions as to the proper mode of using the capillary tubes, both in preserving the lymph, and afterwards applying it to the purpose of vaccination, have been derived from Dr. Husband's own description of the methods which he recommends.

By order of the Commissioners,
B. BANKS, Chief Clerk.

To each Dispensary Medical Officer.

DIRECTIONS for filling Capillary Tubes with Vaccine Lymph, and afterwards using them for Vaccination.

Assuming that the operator has at hand a supply of Dr. Husband's capillary tubes, a healthy child with a well formed and mature vaccine vesicle just punctured in several places, the pure lymph exuding-and a lighted candle-he is to proceed as follows:-Let him dip one end of the tube, held slightly inclined to the horizontal plane, into the lymph. This will immediately ascend in the tube. As

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