50 THE AMERICAN MONTHLY [Feb. 



regard to cliemico-mechanical disinfectiou, I must take 

 up the thread where I dropped it last year, as far as 

 thermic disinfection is concerned. It is quite natural 

 that surgeons who occupy tliemselves with operations in 

 private practice, not only are interested in portable 

 sterilizers, but also prefer such as are constructed for 

 combined boiling in water and its steam. Inventive gen- 

 iuses have also from time to time, at short intervals, en- 

 deavored to satisfy this popular demand, but they have 

 all, as far as I know, up to the present committed the 

 error of constructing their apparatus for under-steam, 

 which streams through the sterilizing chamber from be- 

 low upwards; that is, a stream, which neither expels the 

 air, nor penetrates the articles to perfection, and which 

 consequently results in deficient condensation, besides 

 leaving the articles moist. All sterilizers for streaming 

 steam must necessarily be constructed for over-steam; 

 the reasons being fully given in my article previously 

 referred to. Personally I am not particularly in favor 

 of combination sterilizers even when scientifically con- 

 structed, chiefly because boiling and steaming are differ- 

 ent processes requiring an unequal time, steaming at 

 least three times as long as boiling, not to speak of the 

 time required to dry the dressings after sterilization. 

 This entails the practical disadvantage, that instruments, , 

 for which boiling is our method of choice, suffer unneces- 

 sarily in the prolonged boiling, but, as this can be 

 avoided, as I will explain shortly, I have in deference to 

 the apparent popular demand revived the idea of a com- 

 bination apparatus, which I described in the Medical 

 Record a couple of years ago, and it is my improvement 

 upon that apparatus which I take the liberty to demon- 

 strate upon this occasion. 



My combination portable sterilizer consists, as you see, 

 of four parts: 1, the boiling plan; 2, the hood; 3, the in- 

 strument tray, and 4, the steam chamber. 



