242 bacteriolooy. 



Inoculation into the Great Seeous Cavities. 

 — Inoculation into the peritoneum presents no difficulties 

 if fluids are to be introduced. In this case one makes, 

 with a pair of sterilized scissorsj a small nick through 

 the skin down to the underlying fasciae, and, taking a 

 fold of the abdominal wall between the fingers, plunges 

 the hypodermic needle through the opening just made 

 directly into the peritoneal cavity. There is little or no 

 danger of penetrating the intestines or other internal 

 viscera if the puncture be made along the median line 

 at about midway between the end of the sternum and 

 the symphysis pubis. Though this may seem a rude 

 method, it is rare that the intestines are penetrated or 

 otherwise injured. The object of the primary incision 

 is to lessen the chances of contamination by bacteria 

 located in the skin, some of which might adhere to the 

 needle if it were plunged directly through the skin, and 

 thus complicate the results. 



If solid substances, bits of tissue, etc., are to be intro- 

 duced into the peritoneum, it becomes necessary to con- 

 duct the operation upon the lines of a laparotomy. 

 The hair should be shaved from a small area over the 

 median line, after which the skin is to be thoroughly 

 washed. A short longitudinal incision (about 2 cm. 

 long) is then to be made in the median line through the 

 skin and down to the fascise. Two subcutaneous 

 sutures, as employed by Halsted, are then to be intro- 

 duced transversely to the line of incision about 1 cm. 

 apart, and their ends left loose. This particular sort of 

 suture does not pass through the skin, but, instead, the 

 needle is introduced into the subcutaneous tissues along 

 the edge of the incision. In this case they are to pass 

 into the abdominal cavity and out again, entering at one 



