For a physician the choice among these three forms is governed by
considerations of efficiency, safety, and ease of use. All the forms
are under certain conditions efficient, but comparative tests show that
the emulsion of the pulp issued by different laboratories is much more
certainly efficient than the other forms, and the glycerinated emulsion
is at present in most general use both abroad and in this country.
It is also true that all forms may be perfectly safe. All forms
contain bacteria when prepared, and the majority of these bacteria
die within a few weeks or months after preparation. On account of the
mildly antiseptic quality of glycerin the bacteria in the glycerinated
emulsion usually die sooner than those in the other forms of virus,
and so far as bacteria are objectionable in the virus the glycerinated
form may therefore be said to be somewhat preferable. It should be
added, however, both that glycerinated virus is usually put in the
market before the bacteria have disappeared and that the bacteria
present in virus issued by well-conducted laboratories are not found
to be pathogenic to persons when inoculated by the customary method of
vaccination.
The ease of use of any form of virus depends largely upon the custom of
the physician. In vaccinating a large number at one time there can be
no question that the use of a liquid virus supplied in vials is more
rapid than the use of a dried virus, as the latter has to be thoroughly
moistened before it can be applied effectively.
*Methods of Vaccination.*--The usual method of vaccination is to
scarify a spot on the skin and to rub the virus on that spot. The
choice of place depends partly on æsthetic reasons and partly on
convenience. To avoid the formation of an unsightly scar on the arm,
the leg may be used instead. If the arm is chosen, the insertion of
the deltoid is the place of election on account of the small number of
lymphatics there. If the leg is chosen, the area just below the head of
the fibula presents the same anatomical advantage; but a spot a short
distance above the knee on the outside of the thigh is often thought
to offer less opportunity for injury and infection. Choice between the
sides depends in an adult on the use to which the vaccinated limb is to
be put, and in a baby on the advantage of vaccinating the side which is
carried away from the nurse.
Public-domain text, read in full here on John Shaqi.
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