Instructions for Vaccine Inoculation

Let the vaccine fluid be taken, for the purpose of Inoculation, from a pustule that is making its progress regularly, and which possesses the true vaccine character, on any day from the fifth to the eighth, or even a day or two later, provided the efflorescence be not then formed around it. When the efflorescence is formed, it is always most prudent to desist from taking any more of the virus from that pustule.

Let the vaccine fluid1 be taken, for the purpose of inoculation, from a pustule that is making its progress regularly, and which possesses the true vaccine character, on any day from the fifth to the eighth, or even a day or two later, provided the efflorescence2 be not then formed around it. When the efflorescence is formed, it is always most prudent to desist from taking any more of the virus3 from that pustule.

1. From Latin vacca, “cow”: of cowpox. In 1796 Jenner showed that a person given matter from a cowpox sore was protected from smallpox.
2. The red, inflamed ring that spreads around the pustule.
3. In 1801 “virus” meant any poisonous or infectious matter, here the fluid from the cowpox pustule. Viruses in the modern sense were discovered only in the 1890s.

To obtain the virus, let the edges of the pustule be gently punctured with a lancet in several points. It will gradually ooze out, and should be inserted upon the arm about midway between the shoulder and the elbow, either by means of a very slight scratch, not exceeding the eighth part of an inch, or a very small oblique puncture.

To obtain the virus, let the edges of the pustule be gently punctured with a lancet in several points. It will gradually ooze out, and should be inserted upon the arm about midway between the shoulder and the elbow, either by means of a very slight scratch, not exceeding the eighth part of an inch, or a very small oblique puncture.

A little red spot will appear on the punctured part on the third day, if the operation succeed, which on the fourth or fifth becomes perceptibly vesicated. It goes on increasing till the tenth day, when it is generally surrounded by a rose-coloured efflorescence; which remains nearly stationary for a day or two. The efflorescence then fades away, and the pustule is gradually converted into a hard glossy scab, of a dark mahogany colour. These progressive stages of the pustule are commonly completed in sixteen or seventeen days.

A little red spot will appear on the punctured part on the third day, if the operation succeed, which on the fourth or fifth becomes perceptibly vesicated.4 It goes on increasing till the tenth day, when it is generally surrounded by a rose-colored efflorescence, which remains nearly stationary for a day or two. The efflorescence then fades away, and the pustule is gradually converted into a hard glossy scab of a dark mahogany color. These progressive stages of the pustule are commonly completed in sixteen or seventeen days.

4. Blistered.

A single pustule is sufficient to secure the constitution from the small-pox; but as we are not always certain the puncture may take effect, it will be prudent to inoculate in both arms, or to make two punctures in the same arm, about an inch and a half asunder, except in very early infancy, when there is a great susceptibility of local irritation.

A single pustule is sufficient to secure the constitution from the smallpox; but as we are not always certain the puncture may take effect, it will be prudent to inoculate in both arms, or to make two punctures in the same arm about an inch and a half asunder, except in very early infancy, when there is a great susceptibility of local irritation.

Vaccine virus, taken from a pustule, and inserted immediately in its fluid state, is preferable to that which has been previously dried; but as it is not always practicable to obtain it in this state, we are compelled to seek for some mode of preserving it. Various means have been suggested, but from the test of long experience it may be asserted, that preserving it between two plates of glass is the most eligible. Let a piece of common window glass be cut into squares of about an inch each, so that they shall lie smooth when placed upon each other. Let the collected vaccine fluid be confined to a small spot (about the size of a split pea) upon the centre of one of these glasses; which should be suffered to dry in the common heat of the atmosphere, without exposure to the heat of fire or the sun. When dry, it should be immediately secured by placing over it the other piece of glass. Nothing more is necessary for its preservation than wrapping it in clean writing paper.

Vaccine virus taken from a pustule and inserted immediately in its fluid state is preferable to that which has been previously dried; but as it is not always practicable to obtain it in this state, we are compelled to seek for some mode of preserving it. Various means have been suggested, but from the test of long experience it may be asserted that preserving it between two plates of glass is the most eligible. Let a piece of common window glass be cut into squares of about an inch each, so that they shall lie smooth when placed upon each other. Let the collected vaccine fluid be confined to a small spot (about the size of a split pea) upon the center of one of these glasses, which should be suffered to dry in the common heat of the atmosphere, without exposure to the heat of fire or the sun. When dry, it should be immediately secured by placing over it the other piece of glass. Nothing more is necessary for its preservation than wrapping it in clean writing paper.

The virus, thus preserved, when wanted for the purpose of inoculation, may easily be restored to its fluid state by dissolving it in a small portion of cold water, taken up on the point of a lancet. It may then be used in the same manner as when just taken from a pustule.

The virus thus preserved, when wanted for the purpose of inoculation, may easily be restored to its fluid state by dissolving it in a small portion of cold water, taken up on the point of a lancet. It may then be used in the same manner as when just taken from a pustule.

A little practice in vaccine inoculation, attentively conducted, impresses on the mind the perfect character of the vaccine pustule; therefore, when a deviation arises, of whatever kind it may be, common prudence points out the necessity of re-inoculation, first, with vaccine virus of the most active kind, and secondly, should this be ineffectual, with variolous virus. But if the constitution shews an insusceptibility of one, it commonly does of the other.

A little practice in vaccine inoculation, attentively conducted, impresses on the mind the perfect character of the vaccine pustule; therefore, when a deviation arises, of whatever kind it may be, common prudence points out the necessity of reinoculation: first, with vaccine virus of the most active kind, and secondly, should this be ineffectual, with variolous virus.5 But if the constitution shows an insusceptibility of one, it commonly does of the other.

5. Matter from smallpox sores, as used in the older inoculation, now called variolation. Jenner adds that a person who will not take cowpox usually will not take smallpox either.

The lancet used for inoculation should always be perfectly clean. After each puncture, it is proper to dip it into water, and wipe it dry. The Practitioner should be particularly cautious in observing that its point be free from rust, either contracted by common means, or from the action of the vaccine virus, which, even when dry and in contact with it, has a tendency, in a little time, to produce it.

The lancet used for inoculation should always be perfectly clean. After each puncture, it is proper to dip it into water, and wipe it dry. The practitioner should be particularly cautious in observing that its point be free from rust, either contracted by common means, or from the action of the vaccine virus, which, even when dry and in contact with it, has a tendency, in a little time, to produce it.

EDWARD JENNER.

Edward Jenner