DISINFECTION OF INSTEUMENTS AND APPLIANCES 415 



teeth of the snake, and injected into the tissues in the act of biting. 

 Except in the Common Adder (Pellaa herus) we have no venomous reptiles 

 in this country, and the poison from this creature is comparatively feeble 

 and harmless. In snake-bites, treatment, to be effective, must be prompt; 

 a ligature should be tied tightly round the part, above the wound, which 

 should be laid open and encouraged to bleed freely; excision of the bitten 

 part, and the application of lunar caustic, or the actual cautery may also be 

 resorted to. 



DISINFECTION OF INSTRUMENTS AND APPLIANCES 



As we have already pointed out, bacteria and their products are not 

 only obstacles to the healing process, but the active causes of the diseases 

 incidental to it. It is desirable, therefore, that everything brought into 

 contact with the wound in the way of treatment should be rendered free 

 from these oft'ending organisms. 



Sponges, cloths, and brushes, instruments, and sutures, as well as the 

 hands of the operator, should each and all be dealt with antiseptically 

 before being brought into use. 



Sponges in their ordinary condition teem with bacteria of various kinds, 

 and unless rendered thoroughly aseptic, may prove a fruitful source of 

 mischief. Before being employed for surgical purposes they should be 

 well washed out in soap and water, and then transferred to a fairly 

 strong solution of soda, and after soaking in this for a couple of hours 

 they should be wrung out in cold water, and kept immersed in a l-in-20 

 solution of carbolic acid for four or five days or until required. Imme- 

 diately before use they should be rinsed in a l-in-2000 sublimate solution, 

 or l-in-40 carbolic lotion. 



Where sponges so treated are not accessible, pads of absorbent wool 

 steeped in carbolic or sublimate solution may be substituted. By some 

 practitioners these are preferred, and generally employed, for the reason 

 that after use they can be thrown away, and thus the trouble and risk 

 of infection by sponges are averted. 



AA'^hether sponges or swabs of wool are used, the act of cleansing should 

 always be carried out by wiping the skin in the direction away from the 

 wound, and neither the one nor the other should be allowed to touch the 

 latter until again soaked in the disinfectant. 



Cloths and towels used for the hands and other purposes require to 

 be soaked for three or four hours in a solution of carbolic acid (l in 20), 

 and all instruments employed in the operation must be similarly dealt with. 



Ligatures and sutures of catgut should be soaked in carbolic solution 



