TECHNIQUE AND COURSE OF VACCINATION. Virus for vaccination should be procured from well-developed typical vaccine pocks on the abdo men of a healthy young heifer. while they are still in the vesicular stage. The virus may he received upon ivory points or split quills. An other method consists in removing the whole vesicle entire by scraping it from the under lying corium with a and rubbing this mass with glycerin. The resulting emulsion of pulp i* much more active than the dried lymph upon quills. In making use of it, after the per son to be vaccinated has taken a bath, the arm or leg chosen for the place of inoculation is Nra.hed with carbolic or salicylated cotton. and then with sterile water. Two or three shallow searifications are made with as ninny crossing them, the surgeon cutting as deeply as the derma without necessarily drawing blood. After the lymphatic fluid begins to flow from these in-. visions the vaccine virus is worked into the in cisions with the point of the knife or with a very small sterile wooden spatula. After drying thoromily, the surface is covered with a layer of borated or salicylated cotton, which is to re main on for three days. in the course of 3 to 7 days elevated papules appear. oval or oblong, over the These papules are firm, hot, and tender. They are surrounded by a red halo or arcola. About the fifth clay after their appearance they become vesicles, containing clear fluid, which is vaccine lymph. When human ized virus was used. this was taken from the patient to lie used in inoculating another case.
These vesicles are called Jenner's vesicles, and somewhat resemble the vesicles of smallpox. Like them, also, they shrink and become umbilicated after the seventh or ninth day; the halo grows darker; pus takes the place of the lymph; pain, itching. swelling, and heat are troublesome. A general fever may be experienced on the fifth day with rapid pulse, rarely slight nausea, and very rarely general malaise. About the ninth or tenth day the pustule dries. and a crust forms. The areola fades. The axillary glands enlarge early at this time and are tender and pain ful on pressure. Children's symptoms are more pronounced than those of adults. They are fret ful, their sleep is broken and their appetite diminished. They have fever, headache, pains in the back, and rarely nausea. The temperature dnring vaccinia reaches 102.5° F., and rarely runs higher. The crust separates from the arm in 14 days. If the crust be detached by scratch ing or the chafing of the clothing a second one forms. In all cases scrupulous must be exercised lest the wound become infected with germs in dust or clothing, or under finger-nails. Serious consequences follow such infeetion. The wound may be infected with erysipelas, or gan grenous inflammation may set in, causing a very large ulcer. These are not the results of the vaccination, but of subsequent infection; and the same results are often seen following any scratch with a needle or an abrasion upon the hand.