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(6) When the infection is widely distributed among the inhabit-
ants of a large place, it is then advisable to agitate the people as little
as possible, especially when there are among them a considerable
number of artisans and traders who may lose their occupation by being
removed from the town and are therefore likely to run away and infect
other places.
(5) Inoculation.
12. The exhaustive inquiries made by the Indian Plague Commission
have established the fact that inoculation with Haffkine's vaccine
lessens the liability to plague and greatly increases the chance of recovery
from an attack of the disease, and disproved the statement that serions
ill-consequences have resulted from such inoculation. The maximum
period for which protection is afforded by inoculation has not yet been
determined. For practical purposes, it has been fixed, for the present,
at four months, but it should be noted that inoculation does not confer
any great degree of protection within the first few days.
13. Inoculation should be encouraged wherever possible and in
particular among disinfecting staffs and the attendants of plague
hospitals. In places which, either owing to their nearness to plague-
infected places or to their having previously suffered from an attack of
plague, appear to be specially threatened with a visitation of the
disease, no effort should be spared to explain to the people the advantage
of being inoculated before the disease is among them and to secure the
co-operation of the more enlightened members of the communities. At
the same time, no compulsion of any sort, direct or indirect, should be
used. An awkward attempt at persuasion is liable to create opposition,
resistance, and occasionally, unfounded apprehension, and great circum-
spection is necessary in introducing inoculation in places where there
is no demand for it. The District Magistrate should be consulted
before starting inoculation at any place and the people should be
distinctly warned that inoculation is not a certain prophylactic, but
that it considerably reduces the chances of getting plague, that an
inoculated person when attacked has increased chances of recovery, and
that the process, if properly conducted, is harmless.
14. Only trained and reliable persons should be entrusted with the
actual operation of inoculation, and supervision should be exercised over
them to ensure that they use only sterilized implements. To remove
any possible ground for distrust as to the conveyance of disease from
one person to another, the inoculation syringe should be sterilized in
the presence of the person about to be inoculated. The sterilization
should be effected by immersion in carbolic acid, or preferably carbo-
lized oil kept hot by the flame of a spirit lamp underneath. After a
bottle has once been opened and only a portion of its contents used, the
remainder should invariably be thrown away.
15. Inoculated persons should be furnished with certificates in the
prescribed form [Appendix II-F]. The certificate should bear the
left thumb mark of the person inoculated and should be issued immedi-
ately after one full dose has been given, but the recipient should be
recommended to return for a second inoculation after ten days. The
full dose should always be given at one time, unless for medical reasons