INTRODUCTION: ix 



success or failure as measured by modern surgical knowl- 

 edge. The operator's hands and, if need be, his arms 

 should be thoroughly scrubbed with a stiff brush in hot 

 water with soap for a period of fifteen, minutes, the finger 

 nails well trimmed and cleansed, and all dirt and old epider- 

 mal scales removed. The parts may then be disinfected by 

 immersing in a hot concentrated solution of permanganate 

 of potassium for ten minutes and then decolorized in a strong 

 solution of oxalic acid in sterile water. Or the hands may 

 be disinfected after the washing with soap and water by im- 

 mersing and scrubbing them for ten minutes in a i to looo 

 solution of corrosive sublimate, but in order to make this 

 thoroughly effective the solution needs be alcoholic, or the 

 hands should first be immersed in alcohol, ether, or other 

 substance capable of dissolving fats and permitting the dis- 

 infectant to penetrate the sebaceous glands. Great care 

 should be exercised by the student to not touch any object 

 after the hands have been disinfected for the operation unless 

 it also has been disinfected or sterilized, or in case it becomes 

 necessary to touch objects not sterile, the disinfecting process 

 should be repeated before proceeding further with the oper- 

 ation. This constitutes one of the most difficult of all de- 

 tails for the beginner to acquire, and each failure should be 

 remedied by repeating the disinfection over and over until 

 the habit of maintaining effectual sterilization is acquired 

 and fixed. 



The operation field should always be carefully shaved be- 

 fore beginning the operation, and the shaved area should 

 always be very ample, so as to insure against contamination 

 from adjacent hairs, as well as to give a clear view of the 

 field. The area should then be disinfected in a reliable 

 manner, that advised for the operator's hands serving as a 

 type. Whenever circumstances will permit the operation 

 field should be kept in an antiseptic bath or pack for twenty- 

 four hours prior to the operation in order that the deeper 

 parts of the skin, especially the hair follicles and sebaceous 



