The enquirer. [volume] (Richmond, Va.) 1804-1815, 1811-04-19
s11Risrellaneoue.
FROM THE rLoapoN1 MEDICAL AND pnysI.
GAL JOURNAL.
NATTONAJ vzCCTNE ESTxay &c ~ M n Mt

cALJouRNAL.
NATIONAL VACCINE ESTABLISHMENT
Ordered by the Board that the following De-
stription of the Vaccine Vesicle, and Instruct
ons relative to Vaccination, which have been
presented b Tie Directors, DC strictly observed
by the fascinating Surgeons.
When vaccination succeeds, small red spot
is observable on the third day, the day the ope-
ration is performed being reckoned the first. IF
the spot IS touched, an elevation is felt /; and
1T examined with a. magnifying glass the little
tumor appears surrounded by very slight efilo-
rescence. - IS -
The spot gradually enlarges and between
pears. The edge of the vaccine vesicle is eleva-
ted, the centre depressed. The color is at first
of light pink, sometimes of blush tint and
changes by degrees to pearl color. The GEN.
tire is somewhat darker than the other parts.
The Vesicle is hard to the touch.
In its internal structure, it is celular the cells
being filled with Transparent, lymph.
The vesicle commonly augments till the 10th
or 11th day.
In the early stages, there is usually round
the base an inflamed ring or this takes place
on the seventh or eighth day towards the ninth
Stspreads rapidly, and near the tenth forms
an sreOla Of about al inch and halt in diane.
ter.
This areola is of the usual color Of inaamed
skin; it is hard, and accompanied with some de.
gree of tumefaction
1t continues out for day or two, and then be
gins to fade sometimes forming two or three
concentrick circles.
After the Areola is formed, the vesicle be.
gins to decline the centre first turns brown,
and the whole gradually changes into hard,
smooth scab, of very dark mahogany color.
This dry crust usually drops off about the
end ofthe third week, leaving permanent c,ca-
trix.
ayieties in the progress and appearance Of the
Vaccine Vesicie, nor preventing the success ofYac
cinafion.
The frs appearance is seldom earlier, but of
ten later than has been described. In some rare
instances the vescle commences even 4 fort
night, or three weeks after vaccination but
IL the process is then regular, it is equally efcs-
cious
When the vescie is slightly ruptured before
the sixth day, IT 1t resume its proper form, and
the process continue quite regular success is
not prevented is it, when the crust of a
regular yesicle is rubbed off in the decline of the
disease.
The Irregular ssd Imperfect Pesicle and P.s.ule,
which nor TO be depended Upon.
In these deyistions there is usually prema.
ture itching, irritation, inflammation, vescation,
or suppuration. Or the progress of the vesicle
rs 200 rapid, its texture soft, its edge not well
defined, its centre elevated, and the contents dis
coiored or purulent. Or instead Of q proper are
ola. premature efaorescence Of dusty purple
hue takes place, and the scab is of light brown
or amber color
The irregular yesicle or Pustule is more liable
70 be broken, than the other, both from its more
pointed form, and softer texture, and also from
its being usually so irritable as to provoke
scratching. When broken, or even without this
happening, liberation often ensues
A yesiole apparently regular at first, some.
times does not augment to the proper size, but
dies away without completing the regular pro-
cess. This usually leaves no cicatrix, or one
which is almost imperceptble.
When those, or any other considerable devia-
lions from the regular course of the disease
take place, no dependence can be placed upon
che operation. In such cases vaccination should
be repeated.
Hobab!e causes Of irregular Oesic!es and Pas'
rules
These accidents may be occasioned by matter
or lymph being taken from an irregular vesicle,
OR pustule, at any period, or from regular We
sicle, at too late period or by lymph, though
originally pure, which has been injured by long
keeping, by heat, or otherwise. Or they may
be caused by performing the operation with rus
tv or uncean lancets. or in q rude m amer, or BY
injuring the vesicle at early stage, and there
by exciting too much inflammation, or inter
cnpting the regular process of the disease
K1erpetick eruptions, and other cutaneous affec
tions, have also been supposed the cause of these
irregularities; and occasionally to prevent the
vaccine lymph having any effect.
aAe method Of taking vaecine lymph for Vaccina-
tio1.
The lymph of a regular vesicle is efficacious
from the time it is secreted, till the Areoa be.
gins 20 spread. 1t may therefore commonly be
takeh till the ninth day but not after the Are
ola IS formed
The lymph is to be taken by small superficial
punctures made in tho vesicle, with the point of
the lancet. Time should be allowed for the Ii.
quid to exude, which viii form small pellucid
drops. When requisite very slight pressure
may be cautiously applied with the fiat surface of
the lancet. Great delicacy is requisite in this
operation for if the vesicle is rudeiy treated,
or too much opened, inflammation and ulcera-
zion may ensue.
Lymph intended to be used Immediately, or
in q few days, may be received on a lancet but
Shis is an improper instrument for preserving it
longer for the lymph soon rusts the lancet and
1t is then liable 10 be ineficacous or INJURIOUS
Quilts and tootbpicks succeed but small bits of
ivory shaped like the tooth of comb, and pro-
perry pointed, are the most convenient instru-
Snents, and to render them more certain they
should be charged repeatedly
In order to preserve lymph for long period
the best method is by two bits of square glass
The lymph is to be received on the centre of
one Of them, by applying it to a punctured ve-
sicle. When fully charged ard dry, it is to be
covered with another bit of glass Of the same
size, and wrapped up in paper or in gold-bester's
skin.
In which ever way the lymph is taken, it
ry.o "a he Ill Ir,.