12
MANUAL OF VACCINATION FOR THE
Description of a Regular Vaccine Vesicle.
17. The first sign of infection commonly appears on the third day: a
small red spot, rather elevated, may be seen at the place where the puncture
was made. On the fourth day this is increased in size, on the fifth day it has
become a small vesicle containing clear fluid. The vesicle goes on increas-
ing in size till the eighth day, when it appears like a pearl (if the skin isfair),
circular in form, with its margins elevated and its centre well depressed.
From the centre, bands radiate to the circumference, separating the vesicle
into partitions, each filled with a clear fluid. On the eighth day a slight
blush of redness is to be seen around the vesicle (this is called areola),
which begins to be extensive on the ninth day, and to decline about the
tenth or eleventh. At this period the vesicle begins to dry, the first sign of
which is a brown spot in the centre; in proportion as this brown spot
increases the surrounding areola decreases, until at length nothing remains
but a circular scab of a dark brown colour approaching to black. It often
retains the depression in the centre, which characterizes the vesicle before
exsiccation takes place. The crust falls off about the twenty-first day, and
leaves a depression behind usually visible throughout life: this, if carefully
examined, will be seen to be circular, somewhat depressed, foveated or
sometimes radiated.
Vaccine Virus:—Varieties in use.
18. The varieties used are:—Human lymph fresh from the arm; human
lymph dried on ivory points or preserved in capillary tubes; or fresh lymph
mixed with glycerine, lanoline or vaseline; or fresh bovine lymph from
the calf; bovine lymph dried on ivory points, or preserved in glass
tubes, or mixed with glycerine, lanoline or vaseline. The crusts and pulps
may be removed by a sterilized Volkman's spoon from arm or calf,
and after bruising in a mortar with glycerine, lanoline or vaseline be stored
as laid down in the report of the medical officer to the L. G. B. for 1897-
98 (see Appendix I). The admixture of vaccine lymph with glycerine,
vaseline or lanoline is now practised in preference to other media, and it is
due chiefly to the investigations of Dr. Monkto.. Copeman that glycerine has
been used for this purpose. He showed very conclusively in the Milroy
Lectures on Natural History of Vaccinia (British Medical Journal, 21st May
1898) the advantages of glycerinated calf lymph.
(i) "By employing the method or glycerination of lymph (pulp),
great increase in quantity can be obtained without any consequent deteriora-
tion in quality, the percentage of insertion success following its use being
equal to that obtained with perfectly active fresh lymph.
(ii) " Glycerinated lymph does not dry up rapidly as does unglycerin-
ated lymph, thus simplifying the process of vaccination.
(iii) "Glycerinated lymph does not coagulate, so that it never becomes
necessary to discard a tube on this account.
(iv) " Glycerinated lymph can be produced absolutely free from the
various streptococci and staphylococci which are usually to be found in
untreated calf lymph, and which are considered by Crookshank and others
as liable to occasional suppuration.
(v) " In like manner the streptococcus of erysipelas, in the event of its
having been originally present in the lymph material, is rapidly killed out
by the germicidal action of the glycerine.
(vi) " The tubercle bacillus is effectually destroyed by glycerine even
when large quantities of virulent cultures have been purposely added to
the lymph.