264 MANUAL OF BACTERIOLOGY. 



is comparatively easily disinfected, but the epidremis of the 

 hands is very difficult. The mucous membranes are dif- 

 ficult to disinfect for the reason of there delicate structure, the 

 interference of the secretions with the action of disinfectants 

 which precipitate them, and moreover because the disinfectants 

 have so little power of penetration below the surface. The 

 lack of penetration also interferes with the action of disinfec- 

 tants on the epidermis. The application of disinfectants to the 

 surface does little good unless it is preceded by thorough scrub- 

 bing with soap and water. The mechanical washing is of more 

 importance than the application of disinfectants in any case. 

 In fact some have advised the use of scrubbing with soap and 

 water alone, but it would seem rational to suppose that the ad- 

 ditional use of disinfectants would be of advantage. 



It follows from what has been said that it is very difficult for 

 the operator to sterilize his hands, or at least to be sure that the 

 hands are sterile. Many different methods have been recom- 

 mended for the purpose, all of them having this in common 

 that they recognize the importance of thorough scrubbing 

 with soap and water, with particular attention to the folds of 

 the epidermis around the nails and under the nails. All seem 

 to agree that the subsequent treatment of the hands with 

 alcohol as advised by Furbringer, no matter what subsequent 

 treatment is employed, is very efficacious. The strength of 

 alcohol recommended is at least 80 per cent., and the hands 

 should be washed in the alcohol for a few minutes. After the 

 scouring with soap and water and washing in alcohol, some 

 advise no further sterilization, others prefer to use various an- 

 tiseptics. The alcohol has not only germicidal value, but it 

 also frees the hands from grease and thus prepares the skin 

 for treatment with antiseptics. But it has been pointed out 

 that the adjuvant action of alcohol when used along with other 

 antiseptics cannot be attributed to its solvent action on the fat 

 alone, for ether is a better solvent for fat than alcohol is, and 



