16 
W. B. NILES. 
or allowing their instruments to come in contact with objects 
which are not sterile, for example, wiping the scalpel on a 
dirty cloth during the operation. 
You may ask if it is practicable and advisable to attempt 
to carry out asepsis in our operations. I would answer it is 
both practicable and advisable in many cases, but not in all. 
Many operations can be performed and the wounds made to 
heal by primary union, if we are sufficiently careful. In many 
instances incised wounds accidentally inflicted can be made to 
heal in the same way. Even if some pus does form, in many 
instances we have prevented worse complications by our 
aseptic methods. For example by disinfecting our instru¬ 
ments and hands, we may have eliminated septicaemia, 
pyemia and erysipelas, as possible sequelae. 
In the treatment of the second class of cases mentioned, 
disinfectants play an important role, i.e. y in the treatment of 
suppurating wounds. Here the disinfectant is applied in 
solution, or in the form of a powder. We wash the wound 
with a disinfecting solution for the purpose of destroying the 
pus organism, and thus lessen the suppurating process. The 
length of time which a wound should be irrigated with such 
a solution depends upon circumstances. The mistake is 
often made of not “washing" long enough. Merely keeping 
the surface wet long enough to remove accumulated pus, in 
many cases, does little good. I accomplish much in the way 
of disinfection. The wound should be irrigated at least ten 
minutes, and preferably longer. I have several times irrigated 
unhealthy looking wounds for several hours with the best of 
results. As a solution for this class of wounds, I can recom¬ 
mend very highly the per-manganate of potash solutions—it 
is effectual and cheap. Irrigating with the bi-chloride solu¬ 
tion has not in my hands given as good results. It combines 
with the albumen on the surface of the wound, which retards 
its disinfecting action, and also destroys a thin layer of tissue 
on the surface, which is unfavorable to rapid cicatrization. 
Carbolic acid or lysol can also be used. Pyoktanin, one 
part to three hundred of water, is an effectual disinfectant, and 
as it does not produce superficial necrosis, can be used to 
