300 PROTECTIVE INOCULATIONS. 
“7, Never should the rubber stopper which closes the flask, or the cotton 
which plugs the short straight tube, be removed, because otherwise the 
germs of the external air might enter and contaminate the culture, and in 
this way give place to local and general accidents among the inoculated. 
Whenever, through the movements of transportation, the cotton plug in the 
short glass tube has become so wet as to impede the passage of the air which 
is to be forced into the flask in the act of expelling the vaccine from it, it 
may be removed with the point of a needle and rapidly substituted by an- 
other plug of surgical cotton which has been carbonized or salicylized. If 
this proceeds with cleanness and promptness, there is no danger in doing it. 
When the cotton, although wet, does not impede the injection of the air, it is. 
better not to change it. ' 
‘‘8. After terminating the vaccination, again the capillary extremity of 
the curved tubeis passed through the flame until the small quantity of liquid 
remaining in it is evaporated ; it is then stopped a second time with a small 
drop of wax; and from the other glass tube the rubber tube which has been 
employed for forcing in the air is removed and another thin layer of wax is 
placed over the cotton plug. 
‘*9, If in the smaller vessel or cup any of the vaccine fluid remains after 
the vaccination of all persons present, it is boiled, and in this manner the 
culture is killed, for it should not be used in another operation, because at- 
mospheric germs might become mixed with it. 
‘10. The technique for the practice of the inoculation is the same as for all 
hypodermic injections. The most convenient region is that of the brachial 
triceps. 
tT, The dose is one cubie centimetre—or the contents of a syringe—into- 
each arm, for individuals of all ages and conditions. 
‘12. Five days having elapsed, revaccinations may be performed by fol-. 
lowing the same instructions.” 
Shakespeare, who was sent by the United States Government to: 
Spain to investigate the results of these inoculations, reports as fol- 
lows: 
‘*And now with respect to the human inoculations: The most of these 
inoculations were performed in villages in the province of Valencia. The 
number of persons inoculated considerably exceeds thirty thousand. Much 
has been both said and written in Spain, France, and England concerning 
the results of these inoculations. The results which have been published 
have appeared to very strongly back up the claim of Dr. Ferran that chol- 
eraic inoculation has the power of protecting the individual against an at- 
tack of cholera, and that the extensive practice of this inoculation among 
villages already invaded by the epidemic is a powerful and at the same time 
harmless means of bringing the epidemic to an end. This being the case, 
for those who were unwilling to accept the deductions to be made from the 
published statistics the only way of escaping their force seemed to be by 
an attack upon their validity. 
‘‘The statistics of the anti-choleraic inoculations have been widely at- 
tacked. The first public onslaught upon these statistics of which the world, 
outside of Spain, had much knowledge was made in the report of the French 
Commission, with Dr. Brouardel at its head, which was presented to the 
Minister of Commerce after the return of that Commission from Spain in the 
summer of 1885. It is charged in that report that the results of the statistics 
therein reproduced are assailable on account of having been collected by 
physicians who were partisan supporters of Dr. Ferran, and that they neither 
possessed any adequate official character nor did they possess sufficient de- 
tails. As far as I can learn, the general impression entertained throughout. 
the world of the value of inoculation statistics is based, in the main, upon 
this report of the French Commission. 
