Disinfection of Sick-chambers, etc. 177 



until complete decolorization of the permanganate occurs, after which they are 

 washed free from the acid in clean warm water or salt solution. Finally, they 

 are soaked for two minutes in a i : 500 solution of bichlorid of mercury. 



Lockwood,* of St. Bartholomew's Hospital, recommends, after the use of the 

 scissors and penknife, scrubbing the hands and arms for three minutes in hot 

 water and soap to remove aU grease and dirt. The scrubbing brush ought to be 

 steamed or boiled before use, and kept in i : 1000 biniodid of mercury solution. 

 When the soapsuds have been thoroughly washed away with plenty of clean 

 water, the hands and arms are thoroughly washed and soaked for not less than 

 two minutes in a solution of biniodid of mercury in methylated spirit; i part of 

 the biniodid in 500 of the spirit. Hands that cannot bear i : 1000 bichlorid and 

 5 per cent, carbolic solutions bear frequent treatment with the biniodid. After 

 the spirit and biniodid have been used for not less than two minutes, the solution 

 is washed off in i : 2000 or i : 4000 biniodid of mercury solution. 



It is a mistake to insist upon the employment of disinfecting 

 solutions of a strength injurious to the skin. It must be obvious 

 to every one that rough skins with numerous hang-nails and fissures 

 offer greater difficulties to be overcome in disinfection, and more 

 readily convey micro-organisms into the wound than smooth, soft 

 skins. 



Sterilization of Ligatures, etc. — Catgut cannot be sterihzed by 

 boiling without deterioration. The present method of treatment is 

 to dry it in a hot-air chamber and then boil it in cumol, which is 

 afterward evaporated and the skeins preserved in sterile test-tubes 

 or special receptacles plugged with sterile cotton. Cumol was first 

 introduced for this purpose by Kronig, as its boiling-point is i68°- 

 i78°C., and thus sufficiently high to kill spores. The use of cumol 

 for the sterilization of catgut has been carefully investigated by 

 Clarke and Miller, f 



Catgut may also and equally well be sterihzed by the use of 

 chemical agents. This subject has been carefully reviewed by Ber- 

 tarelli and Bocchia,t who regard the method of Claudius and the 

 modification of it by Rogone as the best. The method of Claudius 

 is to roll the catgut into skeins and, without taking any precautions 

 to remove any fat it may contain, place it in a mixture of iodin i, 

 iodid of potassium i, and distilled water 100. After immersion for 

 eight days the catgut is removed, under aseptic precautions, to 

 alcohol or to 3 per cent, carbolic solution, in which it is indefinitely 

 preserved for use. 



Ligatures of silk and silkworm gut are boiled in water immediately 

 before using, or are steamed with the dressings, or placed in test- 

 tubes plugged with cotton and steamed in the sterihzer. 



Sterilization of Surgical Instruments, etc. — In most hospitals 

 instruments are boiled, before using, in a i to 2 per cent, soda (sodium 

 carbonate, sodium bicarbonate, or sodium biborate) solution, as 

 plam water has the disadvantage of rusting them. During the 

 operation they are either kept in the boiled water or in a carbolic 



* "Brit. Med. Jour.," July 11, 1896. 



t "Bull, of the Johns Hopkins Hospital," Feb. and March, 1896. 



t "Centralbl. ftir Bakt. u. Parasitenk.," Orig. l, 620. 



