Almost 300 were vaccinated in Sin lam, while some 200 more 
were made in other places chiefly Canton. Of those vaccinated 
Sin lam many were in direct contact with plague cases for a lon¬ 
ger or shorter period one or more times. Many more were vacci¬ 
nated in whose houses plague was existent and in ail cases plague 
was, in the immédiate neighborhood. Even this year none of them 
would hâve been willing to be vaccinated except under the spur 
of guat fear. Although plague was existent in Canton there was 
no such close a direct exposure of those vaccinated. 
Technique of vaccination. —■ The cleanest spot on arm or but- 
tocks was selected as the site for vaccinations. This was painted 
well with Tr. iodine. Washing the site was dirty sloppy, inef¬ 
fective worse than useless and consumed too much time, 1 cc. of 
the vaccins was injected and then the puncture was covered with 
a drop of flexile collodion. The syringe and needle were boiled 
from three to 5 minutes (dured three needles but do not remember 
that they were used in rotation). There was one helper to take 
name, résidence, âge, sex of the people vaccinated. Ile also 
usually applied the iodine. In this way about 10 could be done in 
one hour. Should greater speed be required 100 or more could be 
done in an hour by using three assistants and a larger number of 
needles, one assistant to keep the records, one to apply the iodine 
and collodion and one to boil the neadles and fill syringe. The 
needles should be used in rotation so as to give each one the lon- 
gest possible time to boil. The operator then would do nothing but 
inject the vaccine. With proper care both his hand and the sy¬ 
ringe could be kept reasonablv stérile. Care should also be taken 
in withdrawing needle that vaccine or other matter be not drawn 
back into syringe from the needle. 
Symptoms and effects of vaccination. — This was generally 
mild, slight fever average 99,5 a tired feeling, arm slightly pain- 
ful, some times red and swollen for 24,48 hours. Two painted du- 
ring injection, one had an axillary bubo, some few had headaches, 
some complained of thirst the night following. Fever, cough, 
malaria, or tuberculosis did not seem to be affected one way or the 
other by vaccination. Two women were prégnant, one 7 months 
and the other full terms. Both gave birth to their children a few 
days after the injection of the vaccine. Whither this was due to 
the vaccine or not is hard to say. Both children lived and seemed 
in no wise direetly injured by the vaccination. 
