The suppression of tuberculosis /

by Emil von Behring

The price of the complete outfit is 85 marks. By omitting the thermometers and syringes the price is reduced to 63.50 marks.

VIII. Method of Making the Intravenous Injection.—The injection is best made by means of a 5-c.c. glass syringe with an asbestos plunger (paragraph VII, k), which is cleaned by means of the lysol solution and rinsed in sterile salt solution. The canula attached to the syringe is cleaned in the same manner. One immunizing unit (1 I. E.) is then drawn up into the syringe and any air-bubbles are expelled, care being taken that any drops of fluid expelled in this manner do not fall on the floor but are caught up in the basin. The filled syringe, together with the canula, which is now detached, is then placed on the previously mentioned basin. The virus is injected into the left jugular vein. When possible the cattle should be inoculated, each in its own stall, so as to avoid exciting them. After washing the left side of the neck with 2% lysol solution, the operator, by pressing his thumb on the jugular vein, stops the circulation, causing a distinct, sausage-shaped, fluctuating swelling to appear. With his right hand he now takes the canula from the basin and thrusts it, just above the compressing thumb, upward into the vein at an angle of 45°. One recognizes that the vein has been entered, by the blood that at once flows through the canula. If no blood flows, the vein has not been entered. In that case the canula is withdrawn slightly but not completely, and again thrust into the fluctuating swelling. As soon as blood flows, the left hand ceases making pressure and grasps the canula, whilst the right hand fits the syringe thereto. Then the virus is slowly and uniformly injected into the vein. When the syringe is emptied, the skin at the site of injection is pressed together and the syringe and canula withdrawn. As a rule, bleeding ceases almost at once. The region is then rubbed over with 2% lysol solution and the inoculation is completed.[9]

CONDITIONS GOVERNING THE DISTRIBUTION OF THE VIRUS PROTECTIVE AGAINST TUBERCULOSIS.

1. The virus is supplied by the firm of Drs. Siebert & Ziegenbein in Marburg a. d. Lahn, Germany.

2. This firm supplies the virus in packages containing 5 I. E. and 20 I. E. The price for the former at present is 40 pf. per I. E. and for the latter 25 pf. per I. E. In ordering, the style of package is to be specified.

3. The recipients bind themselves to fill out and return the following records:

A. Temperature charts: The temperature is to be recorded as a curve.

B. Other data as per blank herewith enclosed (see next page) [(original illustration)].

A	Consecutive Marburg Number.
B	Consecutive Inoculation Number.
C	Breed, Herd and Designating Number.
D	Nationality.	I.	Owner.
		II.	Location.	A	At Birth.
				B	At Time of Inoculation.
		III.	Breed.
		IV.	Sex.
E	Manner of Raising.	I.	Natural (Suckling Calf).
		II.	Artificial.	a	With Nonsterilized Milk.
				b	With Sterilized Milk.
F	Protective Innoculation.	I.	Laboratory Number of the Virus.
		II.	Dose in Grammes or in c.c.
		III.	Date and Manner of Inoculation.
		IV.	Degree of Reaction.
G	Tuberculin Test.	Date.
		Degree of Reaction.
H	Weights.
I	Special Remarks.

Directions for filling this Blank.—Column A is to be left blank by the attending physician; column B contains the running number of the animal inoculated; C is to be recorded only in fitting cases; D, on the other hand, is never to be omitted; under E the fitting column is to be marked thus: “!”; in column F, IV, the degree of reaction following the inoculation is to be noted by signs, thus: O = Failure of any reaction whatsoever (R = O); I = short febrile reaction; II = 2-4 days of fever; III = 5-8 days of reaction associated with other disturbances of health (cough, loss of weight, diminution of appetite, diarrhœa, etc.).