The Inoculation Accident at Mulkowal

Abstract

I SHOULD like to Direct the attention of your readers to this matter. The evidence regarding the unfortunate Mulkowal accident, as given in the Lancet and the British Medical Journal for February 2, and in the Journal of Tropical Medicine for February 1, shows that on October 30, 1902, nineteen persons were inoculated from a single bottle of Haffkine's prophylactic labelled 53^N, while numerous other persons were inoculated from other bottles. A week later all the nineteen inoculated from bottle 53^N developed tetanus, and subsequently died, while none of the others suffered at all. This gives a strong argument in favour of the view that the poison was associated with the contents of that particular bottle; but the evidence is clearly not mathematically absolute even on this point, while it gives no indication whatever as to when the tetanus bacillus entered the bottle. It might possibly have entered during the processes of manufacture and bottling, or later through a loosened cork, or in several ways during the opening of the bottle and the inoculation of the contents. But the commission that was appointed to consider the subject seems to have somewhat hurriedly adopted the conclusion that it actually entered during preparation, and not later. Mr. Haffkine, as head of the laboratory, was blamed, especially because he had omitted, for good reasons, to add carbolic acid to the prophylactic. Great alarm was produced. The idea that the poisoning was due, not to local accident, but to carelessness at the laboratory, caused, I have been told, a sudden and wholesale rejection of the invaluable vaccine by the people, with the probable result that thousands of lives may have been lost from plague.