Modern Surgery

There are three locations, so to speak, the absolute cleanliness of which must be above snspicion before the operator is justifiei in proceeding to his work. These are the snrgeon's hands, his instruments and the integument covering the part of the patient'e body at which the operation is about to be perfonned. How is the requisite cleanliness in each case seciired? So far as the hands are concerned, by profuse scrubbing with a nailbrush in soap and hot water, followed by a thorongh drenching in some antiseptic solution, as that of 1 in 2, 000 of perchloride of mercury. So far as the instruments axe concerned, by sterilizing them - that is, by boiling them in water, or by passing them through the flame of a spirit lamp, or placing them in a steam sterilizer, and then, when the operator is ready to begin, by putting them into a receptacle containing an antiseptic solution - as, f or example, that of carbolic acid. Lastly, so far as the patient's integumont is concerned, by washing the part first thoroughly with soap and water, having previously shaved it, if necessary, and afterward with a perchloride of mercury solution, or, if the part be greasy, by removing all the greasy material by scrubbing it with ether. Without going into further details these are the cardinal precepts of the science of operating in the present day. Of course each wound which in this marmer is made under aseptic conditions, as it is called, is kept aseptic by the use oí' antiseptic dressings until healing has taken place. The results of i this method of treatment of wounds are nothing less than wonderful in comparison with those which the earlier surgeons were able to obtain. What happens after, say, the amputation of a limb nowadays? The rule is, nothing - nothing, that is to say, beyond the uneventful convalescence of the patiënt. The dressings are not touchtd unless the tempera ture and the pulse of the patiënt indicate, bysome distrorbance, that it would be expedient to examine the wound. The temperature and the pulse are the surgeon's guide. He takes his cue from them. Nothing eau be amiss in the wound if these remain normal, and thus it follows that a large wound, such as that following an amputation, heals soundly from first to last without any suppuration. What a contrast with that which obtained in former daysl Suppuration was then thought to be an indispensable part of the healthy process of healing. In the present time, on the contrary, a surgeon is held to have f ailed in his practice of the principies of eurgical cleanliness if, in wounds originally aseptic, suppuration occurs. -