The phenomena following the insertion of the vaccine virus in an infant’s arm are as follows:—On the second day the puncture is slightly elevated; on the third it begins to grow red; on the fifth it is marked by a distinct vesicle with a depressed centre and red areola; on the eighth the vesicle is perfect, of pearl-like aspect, full of clear lymph; the areola, often little marked by the eighth day, rapidly increases on the ninth and tenth days, and reaches an inch or more in diameter. This bright-red inflammatory action in the skin is essential to show the system is properly infected with the vaccine disease; by the twelfth day the areola has lessened, the lymph is yellow, and often escapes by rupture of the vesicle; on the fourteenth day the vesicle has dried to a scab, that falls on the twenty-first day, leaving a dotted cicatrix, the vestige of the multilocular structure of the vesicle. The three important marks diagnostic of the vaccination being satisfactory, are—1, the pearly multilocular vesicle of the 8th-9th day; 2, the widely-spread areola on the 9th-12th day; 3, the well-marked foveated cicatrix after the scab has fallen. Observation shows that the number of people who take small-pox after vaccination is very small indeed, when more than three well-marked scars exist; and this number at least should be secured by making five insertions of lymph at the time of vaccination. FOOTNOTES: [1] Lister’s shell-lac plaster can be obtained of the Glasgow General Apothecaries’ Company, and the sheet tin of Messrs. Compton & Co., 148, Fenchurch Street, E.C. LIST OF THE INSTRUMENTS AND APPLIANCES REQUISITE, OR OCCASIONALLY USEFUL, IN MOST OF THE IMPORTANT AND ORDINARY OPERATIONS IN SURGERY. PREPARATIONS AND REQUISITES FOR OPERATIONS IN GENERAL. THE OPERATING ROOM. THE SICK BED AND BED-ROOM. SEDATIVES AND RESTORATIVES. THE ARREST OF HÆMORRHAGE. OPERATING ROOM. _Having a good Light and Windows that open readily, and a Fire in Winter._ 1. Firm table, 4 feet long, 2 feet wide, and 3½ feet high. 2. Pillows. 3. Blankets. 4. Towels. 5. Old linen. 6. Mackintosh sheets. 7. Old carpet, or old sheet to cover the floor. 8. Tray of sawdust or sand. 9. Bandages. 10. Strapping plaister. 11. Lint. 12. Oiled silk. 13. Cotton wool. 14. Tow. 15. Perchloride of iron. 16. Basins, large and small. 17. Hot and cold water, ice. 18. Bucket and slop-jar. 19. Sponges. 20. Chloroform and inhaler. 21. Oil. 22. Pins. 23. Scissors. 24. Brandy. 25. Ammonia. 26. Fire for heating cauteries. SICK ROOM AND BED. 1. Iron bedstead. 2. Wool and hair mattress. 3. Several pillows, soft and of different sizes. 4. Air and water cushions. 5. Blankets, small single ones. 6. Pieces of soft flannel. 7. Six sets of sheets and pillowcases. 8. Old soft linen. 9. Cotton-wool. 10. Towels. 11. Soft pocket-handkerchiefs. 12. Three pieces of Mackintosh, 2 feet 6 inches square.