UNITED PROVINCES OF AGRA AND OUDH.                          7

(xvii) Vaccinators are required to sell quinine issued from the
Aligarh Jail, and to remit the sale proceeds to their District Superin-
tendent for transmission to the Superintendent, District Jail, Aligarh.
The following instructions should be observed carefully:—

(a) Do not vaccinate children suffering from dentition, persons who
are sick, or affected with skin disease.

(b) Take lymph from strong and healthy children only, born of
healthy parents.

(c) When practising arm-to-arm vaccination, always bring a healthy
infant with its mother to the village where operations are
to be performed. If a child is not procurable, then the lymph
must be brought on points or in tubes. Lymph must not be
taken from inflamed arms nor from the vesicles which show
areola. It is believed that care in this direction, together with
thorough cleansing of the infant's arms, will do much to diminish
the large amount of ulcerated arms that are now seen up and
down the country.

(d)  Vaccinators should be careful to explain to the parents at the
time of Vaccination, to protect the children's arms from sun,
dirt, flies, &c., by letting them wear loose sleeves to their coats,
and to inform them that they are not to apply anything what-
ever to the vesicle, but to leave it undisturbed to run its course.
For if the vesicle gets damaged, broken, rubbed or scratched,
and especially if it is not kept clean, it is liable to ulcerate, in
which case it becomes necessary to apply poultices and cold
lotions before the inflammation and irritation subside and the
parts return to their natural state.

(e)  Occasionally about the fifth, sixth, seventh, and again on the
tenth and eleventh days, slight fever and disordered bowels
may appear, rarely requiring any treatment, or, if anything, a
gentle purge. Sometimes a vesicular rash appears over the
whole body and remains a week, but seldom needs medicine.

(f) The vaccine instruments should always be kept scrupulously
clean and wiped after each operation. The needle should, if
possible, be dipped into boiling water before an operation.

(g) Children can be vaccinated when six weeks old, but may be
vaccinated even a few days after birth if exposed to variolous
infection.

(h) It is superfluous to vaccinate children badly scarred by small-pox.

(i) Each vaccinator should be provided with four needles, 50 points,
a box for keeping instruments, and a copy of the Manual on
Vaccination.

(j) The arms of the infant should be thoroughly cleansed, before
vaccinating, with pure water.

N.B.—Arm-to-arm vaccination is being gradually superseded by calf lymph vaccination
in the Provinces.

Duties of the Assistant Superintendent of Vaccination.

12. (i) The Assistant Superintendent of Vaccination must, during the
vaccination season, be continually moving about his district examining the
work of the vaccinators, testing the accuracy of the vaccinators' returns, and
satisfying himself that the work is progressing in a satisfactory manner.

(ii) He is held responsible for the veracity and correctness of the
vaccinator's diary and returns.

(iii) In the event of the work of any vaccinator not being satisfac-
tory—as, for instance, if the lymph be of bad quality—he will remain with