SOME HINTS ON TROPICAL SURGERY 673 



Watch the rate and rhythm, a weak first sound at the apex and an 

 accentuated second sound in the aortic area. 



Exercises should be very gradual. The blood count must be over 

 3^- millions per c.mm. 



EMBALMING. 



In order to preserve bodies for autopsy inject 300 c.c. of 5 per cent, 

 solution of formalin. The fluid can be injected into the large arteries, 

 e.g., the femoral and brachial towards the extremities, the common 

 carotid in both directions and the cavities and organs by trocar and 

 cannula. 



A more elaborate method is as follows : — 



Prepare 10 litres of a 10 per cent, solution of mercuric chloride. 

 Expose the abdominal aorta and both iliac arteries. 

 Incise the aorta and tie a large cannula and syringe in the opening. 

 Inject 3 litres into the upper part, slowly and resting when the 



pressure is great. Ligature both sides of the opening. 

 Inject I litre into each leg through the common iliac artery. 

 Ligature the mesentery and intestines from the jejunum to the 

 sigmoid, divide and remove them. Open and wash them. Put 

 into them a i per cent, solution of mercuric perchloride, replace 

 them wrapped in sublimate wool,, or better, cremate the lot. 

 Wash the stomach, duodenum and rectum in the same way and 

 pack with sublimate wool. Treat in the same way the bladder, 

 vagina, external ear, nostrils, &c. Clean out the abdominal 

 cavity, dry it and sew up the incision. 

 Wipe the surface of the body with the same solution and dry it 



(the hair excepted). 

 Some also inject into the axillary and carotid arteries. 



SOME HINTS ON TROPICAL SURGERY. 



All surgical instruments and appliances must be of the best quality 

 obtainable. People at home sometimes send out those goods not readily 

 disposed of at home, much to the chagrin of the tropical surgeon abroad. 

 It is awkward indeed, if when attempting to remove a stone from the 

 bladder, one of the jaws of the instrument breaks off or bends consider- 

 ably. 



Vulcanite and gum-elastic goods should be avoided. Rubber rapidly 

 perishes, but if kept in water in a dark place it will last longer. Rubber 

 gloves can be kept in a glass jar, in powder, well stoppered. Catheters 

 should be rubber or metal, preferably the latter. Rubber tourniquets 

 are often useless when most urgently needed. Good metal ones are 

 now made. 



Syringes should be all metal or all glass. If they are made of two 

 or more kinds of material, the unequal alternate contraction and ex- 

 pansion will cause fracture of the instrument. All needles should be of 

 irido-platinum. They keep their points well and do not become oxidized. 



Microscopic slides should be of second-class quality, as the best 

 quickly "fog" and are useless. The cover-sHps should be of the best 

 quality. 



Take duplicates of fragile instruments likely to be used by native 



