ANTISEPTICS— PAST AND PRESENT 45 



is completed underneath. It is a common mode of repair 

 in wounds left to Ileal without any dressing. 



The Technic of Treatment 



"We now arrive at the practical application of the 

 principles, based on a consideration of the points we 

 have considered. Dealing first with operation wounds, 

 in the case of healthy tissues in the normal animal, 

 there are certain details which, if they do not result 

 in bringing about healing by first intention, will at any 

 rate assist in the process of repair, and prevent the 

 occurrerlce of serious sequels. 



I suppose every one will agree that instruments are 

 best sterilized by boiling for five minutes in water con- 

 taining a teaspoonful of carbonate of soda to each pint. 

 The addition of the soda raises the boiling point of water 

 to 104 degrees Centigrade, and also prevents the forma- 

 tion of rust if the instruments are left in the solution for 

 some time; when required for use they are placed in a 

 sterilized tray containing a solution of carbolic acid 

 (1 to 40) . The water should be boiling before the instru- 

 ments are placed therein, and the vessel in whicb they 

 are boiled should have a . closely fitting lid so that the 

 water wiU boil at a uniform temperature. As regards 

 sharp instruments, such as knives, scissors, and needles, 

 which become blunt from the effects of boiling, some 

 surgeons advise that the edges be protected with a piece 

 of gauze or lint, and state that blunting does not then 

 occur. . This is not my experience, and I prefer, to im- 

 merse such instruments in undiluted carbolic acid for 

 a short time, and then place them in a carbolic solution 

 (1, to 20). This method is advised by Sir Watson 

 Cheyne, and it is also valuable in case an instrument 

 happens to fall on the ground during an operation and 

 is immediately required, since boiling takes five min- 



