ANTISEPSIS AND ASEPSIS IN PRACTICE. 75 



Sterilised salt solution consists of boiled water containing 80 

 grains of pure chloride of sodium per pint, and is very useful in 

 washing out the abdominal cavity during or after operation. 



The number of antiseptics increases every day, but the more 

 recent have no marked superiority over those mentioned. Carbolic 

 acid, corrosive sublimate, chloride of zinc, iodine and iodoform still 

 maintain their position.. In selecting an antiseptic preference should 

 be given to one that does not irritate the tissues, that does not readily 

 poison, and that destroys all micro-organisms. Warm or hot solu- 

 tions of antiseptics are always more efficient than cold. 



Disinfection of the Hands. Fiirbringer's experiments have shown 

 how difficult it is to render the hands aseptic. The matter is, 

 however, of the highest importance, as the operator's hands are not 

 infrequently the means of infecting operation wounds, and the 

 surgeon who desires to avoid after-complications will take especial 

 care in this respect. The spaces beneath the nails, the folds of skin 

 at their base, the folds of the skin itself, and the orifices of skin- 

 glands are all refuges for microbes, to destroy which demands the 

 most minute precaution. In some cases it is impossible to render 

 the hands completely aseptic. Kummel and others have shown 

 that after soiling with pus or with putrid or septic liquids from 

 infected wounds or dead bodies, it is impossible to render the hands 

 absolutely sterile for forty-eight hours. The surgeon should bear 

 this in mind when arranging to perform laparotomy, ovariotomy, 

 or cryptorchid castration. He should either defer operation for 

 some days or redouble his precautions ; neglect in this respect 

 explains failure where apparently all the conditions for success have 

 been present. The nails should first be cut short, and all foreign 

 material mechanically removed from under and around them. The 

 hands and forearms should next be washed for some minutes with 

 soap and warm water, and scrubbed thoroughly with a brush or a 

 Turkish flesh glove. They are then washed with rectified spirit, 

 and lastly with 1 in 1000 solution of sublimate. The alcohol dissolves 

 fatty materials which would otherwise impede the action of the 

 antiseptic, and enables the latter to penetrate some distance into 

 skin ducts, etc. More complex methods have been suggested, 

 but the above is sufficient. In veterinary surgery the precautions 

 usually taken extend only to thoroughly cleansing nails, washing 

 the hands with hot water and soap, and thoroughly rubbing them 

 with 1 in 1000 sublimate solution or 5 per cent, solution of carbolic 

 acid. The hands must be rendered aseptic and kept aseptic 

 throughout the operation. For this reason the operator should 



