Disinfection of the Hands 183 



filtration of large quantities of fluid is shown in the accom- 

 panying illustration (Fig. 32). 



III. The Disinfection of Instruments, Ligatures, 

 Sutures, the Hands, etc. There are certain objects used 

 by the surgeon that cannot well be rendered incandescent, 

 exposed to dry heat at 150 C., or steamed continuously, or 

 intermittently heated without injury. For these objects dis- 

 infection must be practised. Ever since Sir Joseph Lister 

 introduced antisepsis, or disinfection, into surgery there has 

 been a struggle for the supremacy of this or that highly rec- 

 ommended germicidal substance, with two results viz., that 

 a great number of feeble germicides have been discovered, 

 and that belief in the efficacy of all germicides has been 

 somewhat shaken; hence the aseptic surgery of the present 

 day, which strives to prevent the entrance of germs into the 

 wound rather than their destruction after admission to it. 



For a complete discussion of the subject of antiseptics 

 in relation to surgery the reader must be referred to text- 

 books of surgery. 



I The Disinfection of the Hands, etc. The disinfection of 

 the skin both the hands of the surgeon and the part about 

 to be incised is a matter of the utmost importance. Wash- 

 ing the hands with soap, which has marked germicidal 

 properties, will in many cases suffice to destroy or remove 

 bacteria from smooth skins. This method, which is regarded 

 by some surgeons as adequate, is not, however, commonly 

 regarded as sufficient protection to the patient who might 

 be infected by any remaining micro-organisms. To over- 

 come this, many surgeons prefer the use of sterilized gloves 

 of thin rubber to all other means of preventing manual in- 

 fections. Others prefer to use detergent and disinfectant 

 measures. The method at present generally employed, and 

 recommended by Welch and Hunter Robb, is as follows: 

 The nails must be trimmed short and perfectly cleansed. 

 The hands are washed thoroughly for ten minutes in water 

 of as high a temperature as can comfortably be borne, soap 

 and a previously sterilized brush being freely used, and 

 afterward the excess of soap washed off in clean hot water. 

 The hands are then immersed for from one to two minutes 

 in a warm saturated solution of permanganate of potassium, 

 then in a warm saturated solution of oxalic acid, until 

 complete decolorization of the permanganate occurs, after 

 which they are washed free from the acid in clean warm 



