PRACTICAL DIRECTIONS FOR DISINFECTION. 217 



and a brush was even more important than the degree of potency of 

 the disinfecting wash subsequently applied. He recommends the 

 following procedure : 



1. Remove all visible dirt from beneath and around the nails. 



2. Brush the spaces beneath the nails with soap and hot water 

 for a minute. 



3. Wash for a minute in alcohol (not below eighty per cent), and, 

 before this evaporates, in the following solution : 



4. Wash thoroughly for a minute in a solution containing 1 : 500 

 of mercuric chloride or three per cent of carbolic acid. 



Roux and Reynes tested the above method of Fiirbringer, and 

 found that it gave better results than others previously proposed, al- 

 though not always entirely successful in securing complete steriliza- 

 tion. 



Boll has recently (1890) reported favorable results from the fol- 

 lowing method : 



1. Cleanse the finger nails from, visible dirt with knife or nail scissors. 



2. Brush the hands for three minutes with hot water and potash soap. 



3. Wash for half a minute in a three-per-cent solution of carbolic acid, 

 and subsequently in a 1 : 2,000 solution of mercuric chloride. 



4. Rub the spaces beneath the nails and around their margins with iodo- 

 form gauze wet in a five-per-ceiit solution of carbolic acid. 



Welch, as a result of extended experiments made at the Johns 

 Hopkins Hospital, recommends the following procedure : 



1. The nails are kept short and clean. 



2. The hands are washed thoroughly for several minutes with soap and 

 water, the water being as warm as can be comfortably borne, and being fre- 

 quently changed. A brush sterilized by steam is used. The excess of soap 

 is washed off with water. 



3. The hands are immersed for one or two minutes in a warm saturated 

 solution of permanganate of Dotash and are rubbed over thoroughly with a 

 sterilized swab. 



4. They are then placed in a warm saturated solution of oxalic acid, 

 where they remain until complete decolorization of the permanganate 

 occurs. 



5. They are then washed off with sterilized salt solution or water. 



6. They are immersed for two minutes in sublimate solution, 1 : 500. 

 The bacteriological examination of the skin thus treated yields almost 



uniformly negative results, the material for the cultures being taken from 

 underneath and around the nails. This is the procedure now employed in 

 the gynecological and surgical wards of the hospital. 



THE DISINFECTION OF EXCRETA. 



The contents of privy vaults and cesspools should never be allowed 

 to accumulate unduly or to become offensive. By frequent removal, 

 and by the liberal use of antiseptics, such necessary receptacles of 

 filth should be kept in a sanitary condition. The absorbent deodo- 



