214 MANUAL OF BACTERIOLOGY. 



should be treated for at least twenty-four hours before opera- 

 tion; preferably forty-eight hours should be given, with at 

 least two separate periods of " rubbing in " for about ten 

 minutes on each occasion. (3) On the operating table the 

 piece of gauze is removed, and the superfluous ointment 

 rubbed off with a piece of sterile gauze. 



To Prepare the Field of Operation. Wash with green 

 soap and water, scrubbing thoroughly and carefully, paying 

 particular attention not to scrub hard enough to render the 

 skin tender or to make abrasions. Shave parts with clean 

 razor. Wash with ether and alcohol, to remove debris and 

 epithelium, and cover with a sterile towel. If the skin of the 

 patient is thick a soap poultice may be left on, care being 

 taken to see that the skin does not become macerated. After 

 the patient is anesthetized the field is briskly scrubbed with 

 sterile brushes, soap, and water, washed with i-iooo 

 bichloride of mercury solution and covered with sterile 

 towels. 



It is important to remember that during an operation 

 patient, operator and assistants, may perspire and that in this 

 way fresh masses of bacteria from the deeper parts of the 

 glands may be brought to the surface of the skin. Careful 

 attention must be paid to maintaining cleanliness during an 

 operation. The patient's skin is kept covered with sterile 

 towels, changed as often as they become soiled. For the 

 surgeon's and assistant's hands rubber gloves do this per- 

 fectly. If an operator or assistant finds that the hands per- 

 spire during an operation the use of rubber gloves becomes 

 essential. Rubber gloves may be sterilized by boiling. 



Instruments are best sterilized by contact with super- 

 heated steam, or steam under pressure for ten minutes, or 

 by boiling in a I per cent, carbonate of soda solution. If 

 soda is unavailable use water that is actively boiling, as this 

 avoids spotting and rusting of the instruments. Imme- 



