d in a
specially constructed steriliser, such as that of Schimmelbusch. This
apparatus is so arranged that the steam circulates under a pressure of
from two to three atmospheres, and permeates everything contained in it.
Objects so sterilised are dry when removed from the steriliser. This
method is specially suitable for appliances which are not damaged by
steam, such, for example, as gauze swabs, towels, aprons, gloves, and
metal instruments; it is essential that the efficiency of the steriliser
be tested from time to time by a self-registering thermometer or other
means.

The best substitute for circulating steam is _boiling_. The articles are
placed in a "fish-kettle steriliser" and boiled for fifteen minutes in a
1 per cent. solution of washing soda.

To prevent contamination of objects that have been sterilised they must
on no account be touched by any one whose hands have not been
disinfected and protected by sterilised gloves.

#Sterilisation by Chemical Agents.#--For the purification of the skin of
the patient, the hands of the surgeon, and knives and other instruments
that are damaged by heat, recourse must be had to chemical agents.
These, however, are less reliable than heat, and are open to certain
other objections.

#Disinfection of the Hands.#--It is now generally recognised that one of
the most likely sources of wound infection is the hands of the surgeon
and his assistants. It is only by carefully studying to avoid all
contact with infective matter that the hands can be kept surgically
pure, and that this source of wound infection can be reduced to a
minimum. The risk of infection from this source has further been greatly
reduced by the systematic use of rubber gloves by house-surgeons,
dressers, and nurses. The habitual use of gloves has also been adopted
by the great majority of surgeons; the minority, who find they are
handicapped by wearing gloves as a routine measure, are obliged to do so
when operating in infective cases or dressing infected wounds, and in
making rectal and vaginal examinations.

The gloves may be sterilised by steam, and are then put on dry, or by
boiling, in which case they are put on wet. The gauntlet of the glove
should overlap and confine the end of the sleeve of the sterilised
overall, and the gloved hands are rinsed in lotion before and at
frequent intervals during the operation. The hands are sterilised before
putting on the gloves, preferably by a method which dehydr