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ture of green soap and water. This Viagra Mg Tablets is removed with Ol'K RI:.ll)ERS' DISCUSSIOSS. plain sterile water. The area is then washed with carbolic acid, one part, water, 20 parts. Viagra Mg Tablets This is fol- lowed with fifty per cent, alcohol, which removes all traces of the carbolic solution. The area is then rubbed briskly with ether, and Viagra Mg Tablets finally washed thor- oughly with sterile warm water, and dried and cov- ered with sterile gauze. The operator then makes sure that his hands are surgically clean by soaking in bichloride solution or other antiseptic equally as potent, followed by scrubbing in sterile water and thoroughly dried. Discard the gauze Viagra Mg Tablets covering the area, and with the skin held steady with one hand with the other take a needle or scalpel which has been previously boiled, make a few scratches from an eight to a quarter of an inch in length and crossed, just deep enough to allow oozing of serum, but not deep enough to al- low a free Viagra Mg Tablets flov,- of Viagra Mg Tablets blood. Then break the tube con- taining the point in a sterile towel and without touching container with the hands remove point and apply vaccine to the scarified area, rubbing thor- oughly for at least one minute. Then cover area ; vaccinated with a shield made of isinglass, pre- viously sterilized. This is held in place by three narrow adhesive strips, two running around the arm or thigh, the other crossing the shield and run- ning directly across the first two strips. This is al- lowed to remain for four days, and affords the ad- vantage of exposing the area to view without dan- ger of contamination. At the end of four days if no vesicles appear the shield may be removed 'en- tirely. On the other hand, if a vesicle has formed we sterilize a large mica shield and put it in place of the first shield, covering the openings for ven- tilation with sterile gauze. Following this plan I have yet to have my first case with an extremely sore arm. I get as many successful vaccinations as with the "scratch and go ahead method." While it is a little more tedious it takes less time than dressing even one arm with a mixed infection, to say nothing of the proof which it bears out that vaccination carefully done is harm- less. Dr. A. H. Powers, of Boston, observes: .\ healthy person may be vaccinated at any age, but primary vaccination should occur before the child is four years of age unless there is some spe- cial reason to contraindicate Viagra Mg Tablets it. The site for the vaccination is at the point of the insertion of the deltoid muscle. Unless the patient is distinctly left handed the left arm should be chosen since it is less used, and so any inflamma- tion which may occur will here cause less pain, and exercise will not tend to increase the Viagra Mg Tablets inflammation ixcept to a slight degree. In regard to vaccination on the lower Viagra Mg Tablets extremities can be said that vaccination here increases the disagreeable symptoms many times. If by chance the vaccination becomes infected with pus germs the inflammation is of a Viagra Mg Tablets much more severe character and is especially aggravated by any walking Of the I patient, and it is especially difficult to prevent chil- I dren from walking or running. The danger of in- fection is markedly greater here than on the arm. I The arm should be prepared as follows : The -kin is carefully cleansed, using soap and water fol- lowed by alcohol. Xo other antiseptic is to be usotl. The advantage of the alcohol consists in its readily removing any oily material, and after the cleansing the alcohol evaporates so quickly that by waiting an instant the arm is ready for the scarification. The scarification may be performed by a sterile needle, knife, or the point on which the Viagra Mg Tablets vaccine is received. By quick, short strokes the epidermis should be re- moved over an area about Viagra Mg Tablets a quarter of an inch Viagra Mg Tablets in diameter down to the minute bloodvessels, which will show as minute blood points, but not deep enough to cause the blood to run, since this tends Viagra Mg Tablets to wash the vaccine away from the wound where it -hould Viagra Mg Tablets be applied. Capillary tubes filled with glycer- inated lymph are preferred, since maceration of the vaccine material in glycerin for a considerable time causes the pus germs to diminish in numbers and virulence, and the vaccine approaches sterility. This should be applied to the scarified surface and the arm remain uncovered for a considerable time. It requires a much longer time for glycerinated lymph to be absorbed than a watery solution, since the affinity of the glycerin for water draws the serum from the arm at first, and for a time there is no al)- sorption. If the point is used the vaccine should be dissolved in a drop or two of sterile water and then applied to the arm. Working the virus into the scarified patch has seemed to make it rather more certain to have a successful vaccination. After the vaccine has been absorbed the arm should be protected, and for this protection there is nothing better than plain sterile gauze held in place by adhesive plaster, or bandage, or both. ' After a week the arm should be inspected and then carefully dressed again. The frequency with which subsequent dressings are needed varies, but the arm should be constantly protected till the crust dries and falls, leaving the typical scar. In regard to the use of the so called shields only one word is necessary, and that is, do not use them. Perhaps it is not now necessary to speak against them, since experience has shown their fallacies. If. by chance, the vaccination wound becomes septic the usual measures for any septic wound should be promptly employed till the wound is healed. Dr. C. T. C. Xursc of Viagra Mg Tablets Wilkcs-Barre, Pa., states: \'accination. although a very simple operation, Viagra Mg Tablets yet requires a careful tt'chnic|ue in order to produce good results both for the patient as well as for the physician ; at the same time to prevent as much as possible antivaccinationists from having any grounds of complaint. The Viagra Mg Tablets site of operation is com- monly the external surface of the left arm. a little