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6. When a bottle has once been opened a clean glass or beaker should be
inverted over it to keep out dust and flies. Any contact between the mouth of the
bottle and any unsterilized object is to be carefully avoided. Should such contact
occur the mouth of the bottle is to be passed several times over the flame of the
spirit lamp and'thus sterilized,
7. When filling the syringe keep the bottle as horizontal as possible.
8. The needle of the syringe should be sterilized after each patient has been
inoculated. Particular care is to be taken in this matter. This may be done in
several ways. Some inoculators dip the needle into Carbolic Acid (strong solution)
and wipe the outside with a piece of cotton-wool soaked in strong Carbolic Lotion.
Others dip the needle into absolute alcohol. A 10% solution of Carbolic Acid in
spirit is suggested for this purpose. If preferred the needles may be boiled in
distilled water before use. Medical men carrying out inoculation should examine
each patient for any signs of scrofula, leprosy, tubercle, syphilis, or other disease. In
such cases he will, in addition to sterilizing the needle as above described, pass it a
few times through the flame of the spirit lamp, first disconnecting the needle from
the syringe to avoid any of the prophylactic remaining in the needle. Needles not in
use should be kept in a solution of Carbolic Acid (5%) until required.
9. The injection is a hypodermic injection. Care is to be taken to inject under
the skin : not into the muscle. If care be taken in this matter the patient will suffer
the minimum amount of pain. In cases where patients have been inoculated into
the muscular tissue the swelling and pain have been excessive.
10. The dose to be given to an adult man is noted on each bottle. For weak-
ly people the dose should be reduced. For women the dose is 4/5ths, the adult man's
dose. A child of 10 gets 2/3 ths of an adult dose ; a child of 3 years gets from 1/2 5 th
to 1/8th of the adult dose. The dosage on each bottle should in all cases be carefully
noted.
11. A bottle once opened, the contents should be used up at once or the rest
of the contents thrown away. It is never to be recorked for future use. Empty
bottles are to be collected and returned to the Laboratory.
Rules for the use of Hypodermic syringes in the Inoculations against
Cholera, Plague or Typhoid.
I.—Anew syringe, or one which has not been in use for some time, must be
kept soaked in a 5 per cent, solution of carbolic acid for 24 hours before using it for
inoculation purposes.
This is to be done in the following manner:—
Ascertain whether the needle is patent by passing a wire through it (a bundle
of wires is enclosed along with the syringe). Fix the needle firmly on
the nozzle of the syringe by means of pliers or strong dissecting forceps.
Fill the syringe up to about 1/4 with the disinfectant solution and draw
back the piston rod entirely, so as to have the syringe partly filled with
solution and partly with air. Shake the syringe briskly, so that the
solution may touch every part of the barrel and wash away any impurity
which may be sticking to the piston. Remove the needle by means of
the pliers, then squirt out the liquid, and fix the needle on again. Repeat