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in mind the fact that a very sore arm is no proof of proper vaccinal effect. But it buy viagra works must be remembered that a very large per- centage of the vaccine in America buy viagra works is produced by men who, under the guise of some "vaccine com- pany" or " vaccine farm," look entirely to the com- mercial side of the matter, and, although utterly un- heard of in the scientific world, are keenly alive to an)' method of making more money. To these persons my method has these very serious objections, viz., that it takes constant care and skill, that it is expensive, and viagra 8 mg that the supply of virus from one animal is so limited. In other words, to supply a large number of vaccine points, a large number of calves must be employed. Now, it has long been known buy viagra works that the greater the age of the animals vaccinated, the more marked and severe are the symptoms produced ; and, further, it was found that by increasing the buy viagra works size of the vesicles a very much larger quantity of serum, " virus" by courtesy, could be obtained, although much thinner and more dilute. From these facts the brilliant theory was evolved that an ideal virus could be obtained by using full- grown cattle, three or four years old, and making deep scarifications two inches square or larger. These scarifications in no wise resemble a vesicle, but make a large angry sore, and when ruptured an enormous quantity of thin serum is poured out. But, argued these savans, by this means we can get a large amount of virus from one cow and the dilution of the lymph will be counteracted by the greater vigor obtained from the full-grown animals. This idea ap- pealed with great force to the buy viagra works commercial mind, and in accordance with it millions of vaccine points have been produced. The method is labor-saving and cheap, but the theory is utterly viagra 8 mg wrong, the fact being, it is true, that the larger the animal used the more vigorous the vaccine germ and the more violent the effects on the human subject, but the change from a small vesicle to a large angry sore only increases the flow of inflammatory serum, tending in no way to les- sen the vigor of the vaccine germ, but very much di- luting the amount of these germs in the so-called virus. In other words, the amount of true buy viagra works virus is not increased, but it is obtained adulterated with a large amount of serum. The practical results fre- quently obtained from such virus are either very sore and troublesome arms or no vaccinal effect whatever. Another labor-saving improvement which I must warn you against is the method of fixing the ivory points between two strips of rubber-covered wood, in rows of fifty to one hundred, so that they resemble a picket fence. The operator then ruptures the vesicle, dips a camel's-hair brush in it, and paints the pointed ends of the points over rapidly with the brush, leaving an almost invisible coating of vaccine on them. This can be done so rapidly that an ordinary buy viagra works clay's work by the proper method is nominally accomplished in fifteen or twenty minutes. Some of the points prepared in viagra 8 mg this viagra 8 mg way will take. A great many will fail. There is no possible excuse for viagra 8 mg this method of charging the points, nor for the method of large scarifications on full-grown animals, except that they are " labor-sav- ing" and "money-making." On all scientific grounds they are unqualifiedly bad and objectionable. During the past year I have investigated the reasons for the preference in Europe for tubes rather than for points. From conversations with the authorities there and a careful observation of their methods, I am convinced that the modern tube, prepared as' I have described above, is much more reliable than the old-fashioned tube of clear virus taken directly from the vesicle. Our method, however, of charging the ivory points is much more simple, economical, and reliable, and we certainly obtain a far purer virus at the start. The vesicle which they viagra 8 mg grind up and use is not the old- fashioned vaccine crust, with which many of you are familiar. That was the dried covering of the vesicle, which was allowed to remain undisturbed until it dropped off naturally at about the twentieth day. It was then cleaned thoroughly and scraped, and was perfectly dry and almost odorless. The European crust is taken at the height of the disease, when its reticulations and under surface abound with pus cells, and these are all included in the viagra 8 mg mass that is com- bined with the glycerin. I am not prepared viagra 8 mg to deny that this combination renders all the germs present, except the vaccine germ, inert and innocuous. I only say that, if true, it is an extraordinary fact, and that certainly the pure, clear virus that is collected on the points, after all the pus is removed, is a very much purer lymph, as viagra 8 mg it is taken from the animal. The real reason, as it seems to me, for the adoption of these tubes in Europe lies in the difficulty of pre- serving the points in a moist climate and of obtain- ing ice with which to keep them. We have no such difficulties here, and with us the ivory point will long keep its supremacy as the best form of preserving and using vaccine. I will only detain you, gentlemen, with a few words regarding the use of the vaccine points. Every one of you has his favorite way of vaccinat- ing. My way is to make two sets of scarifications viagra 8 mg about two inches apart. I cut with a dull bleeding- lancet about half a dozen short lines close together, just deeply enough through the skin to draw a tinge of serum and blood. These I cross with a similar set of cuts at right angles. I thoroughly dissolve the virus on the point with a little water, then wipe the cuts thoroughly, and immediately rub the virus into the cuts for about ten seconds with the flat side of the point. Then I expose the arm for one minute to the air. No plaster or subsequent dressing is necessary. The arm should be washed at bedtime. In three or four days the vesicle will begin to appear and will be at its height in about eight or nine days, after which it will decline. Unless the crust is broken there viagra 8 mg will be