General Surgery 3 



tion of permanganate of potash until stained dark brown. Decolor- 

 ization can be effected by soaking them in a warm saturated solution 

 of oxalic acid, and the effect of the latter can be neutralized with 

 lime water. If it is desired to conduct an operation under un- 

 doubted absolute asepsis the only alternative is to wear thin rubber 

 gloves. 



Sterilization of Region of Operation. It is practically impos- 

 sible to completely disinfect the skin. Only the microorganisms 

 in the superficial layers can be destroyed by chemical agents. Those 

 existing in the deeper layers can not be reached by any agent 

 short of a gas, but it is known that they possess but feeble pyogenic 

 capacity which the living, healthy tissues have the power to over- 

 come. Welch proved that the white staphylococcus occurs in 

 wounds where every possible antiseptic precaution has been taken, 

 but it seldom exerts interference with the process of healing. Of 

 course, what has been written concerning the hands of the operator 

 applies equally as well to the cutis of the area of operation, but in 

 addition the hair should always be removed by means of clippers or 

 razor. , 



Antiseptics. There being such a variety of antiseptic agents, 

 I shall only briefly refer to a few which are specially adapted to the 

 particular purpose in view. Permanganate of potash is most valu- 

 able possessing as it does both microbicidal and deodorant proper- 

 ties and being at the same time free from toxicity. It owes its 

 power to its capacity to rapidly give up oxygen in the presence of 

 moisture. It is effectual for both dermal and mucosal surfaces. 

 It is used in the strerigth of i .•100 to 10:100. Corrosive sublimate is 

 very useful as an inhibitory agent, particularly in exposed joints, 

 but it is poisonous and corrodes metal. It is prepared by manu- 

 facturing pharmacists in tablets of definite strength and is used in 

 solutions of 1:2000, 1:1000, and 1:500. Carbolic acid is effective 

 in the strength of 2:100 to 5:100, but must be used with great cau- 

 tion as dogs are peculiarly susceptible to its, toxic effect. Creolin 

 is an. effective agent widely used. It is only slightly toxic and does 

 not corrode instruments. It is used in, strength of 1:100 to 5:100. 

 Boric acid is a mild antiseptic particularly useful for eye work in 

 saturated solution of 4:100. Peroxide of hydrogen is an unstable 

 oxidizing agent usually of uncertain strength, capable of setting free 

 ten or twenty times its volume of nascent hydrogen. Its sole use is 



