PROTECTIVE INOCULATIONS. 299 
‘‘1. The cholera vaccine is nothing more than a pure culture, in bouillon, 
of the comma bacillus. Its easy and long preservation (four to five days) 
allows of its transportability to great distances, taking care always to keep 
the flask which contains the material upright. 
‘*2. Heat and cold do not interfere with its preservation if the vaccine is 
to be used in a short time. It should not, however, be kept out of doors dur- 
ing the warm season. 
‘*3. The vaccine should be kept in flasks of the model of Ferran, with a 
flat bottom and a short neck. The stopper, which is of rubber, fits perfectly, 
and is penetrated by two glasstubes. One} straight and short, which does not 
extend below the inferior surface of the stopper, and which does not project 
above more than some two centimetres, is plugged with a small quantity of 
sterilized cotton and a superficial covering of wax. The other glass tube is 
longer, and extends on the lower side as far as the bottom of the flask, while 
its superior end is curved, and terminates in a capillary extremity, the tip of 
which is closed with wax. 
‘*4, When the vaccine is to be used 1t is necessary to make two principal 
preparations for the operation. A smallsyringe for the hypodermic injection, 
anda small vessel into which it is necessary to empty the fluid from the flask, 
are required. The syringe should have metallic pistons and mountings, 
without mastic of any kind and without rubber. Its capacity shou!d be one 
cubic centimetre, its needle thicker and shorter than that of ordinary use. 
Before beginning the vaccination the syringe must be filled two or three 
times with boiling water, which is aspirated and expelled through the needle. 
This is called sterilizing the instrument, and by this means the extraneous 
germs are destroyed which might be contained in it, in order to avoid the 
production of phlegmons and abscesses. The trouble in taking this precaution 
will be little. Acting thus, one may perform thousands of injections without 
fear of any accident. It is suggested that it is a bad custom to pass the nee- 
dle through a flame in order to sterilize it, because this mode of procedure 
draws the temper. Another precaution that must be taken relates to the 
examination of the syringe before using it, in order to be well assured that the 
piston acts perfectly and that not a single drop of the liquid escapes by a leak 
in thecannula. This latterdefect is sufficient to rejecttheinstrument. If the 
syringe aspires air because the leather washer, which is placed at the end of 
the glass tube in order to facilitate its adaptation, is dry, or the piston is in the 
same condition, it is necessary to delay a little while in order to take the 
syringe apart and soak it in warm water. It is convenient to keep several 
syringes for use, with a sufficient number of needles, when many inocula- 
tions are to be performed. 
“5. The small receptacle into which the vaccine is poured in order that 
the syringe may be filled readily is a capsule, a cup, or some similar vessel. 
Before use, it should be washed and dried with extreme care, and imme- 
diately before using passed through an alcohol or Bunsen flame, in order to 
sterilize it. 
‘6. All these preparations having been made, the drop of wax which 
closes the capillary extremity of the long tube of the flask is removed, and at 
the same time also the wax covering of the cotton stopper of the short tube, 
but by no means must this cotton stopper be removed ; a rubber tube, or the 
extremity of a small Richardson spray apparatus, is adjusted to the short 
tube. The capillary extremity of the long tube is now slightly warmed in 
order to soften somewhat the wax which may have been drawn into its 
lumen by capillarity, and air is forced into the flask, either by blowing into 
the rubber tube or by working the Richardson atomizer ; the air injected by 
pressure upon the vaccine fluid forces the latter out through the long tube 
with the capillary extremity, and it is collected in the cup or small sterilized 
vessel. This latter is then covered with white paper, which has been 
scorched in the flame, or with a sterilized glass plate ; as often as the syringe 
is filled this cover will be removed and again immediately afterward replaced. 
