ates the skin.
Cotton gloves may be worn by the surgeon when tying ligatures, or
between operations, and by the anaesthetist during operations on the
head, neck, and chest.

The first step in the disinfection of the hands is the mechanical
removal of gross surface dirt and loose epithelium by soap, a stream of
running water as hot as can be borne, and a loofah or nail-brush, that
has been previously sterilised by heat. The nails should be cut down
till there is no sulcus between the nail edge and the pulp of the finger
in which organisms may lodge. They are next washed for three minutes in
methylated spirit to dehydrate the skin, and then for two or three
minutes in 70 per cent. sublimate or biniodide alcohol (1 in 1000).
Finally, the hands are rubbed with dry sterilised gauze.

#Preparation of the Skin of the Patient.#--In the purification of the
skin of the patient before operation, reliance is to be placed chiefly
in the mechanical removal of dirt and grease by the same means as are
taken for the cleansing of the surgeon's hands. Hair-covered parts
should be shaved. The skin is then dehydrated by washing with methylated
spirit, followed by 70 per cent. sublimate or biniodide alcohol (1 in
1000). This is done some hours before the operation, and the part is
then covered with pads of dry sterilised gauze or a sterilised towel.
Immediately before the operation the skin is again purified in the same
way.

The _iodine method_ of disinfecting the skin introduced by Grossich is
simple, and equally efficient. The day before operation the skin, after
being washed with soap and water, is shaved, dehydrated by means of
methylated spirit, and then painted with a 5 per cent. solution of
iodine in rectified spirit. The painting with iodine is repeated just
before the operation commences, and again after it is completed. The
final application is omitted in the case of children. In emergency
operations the skin is shaved dry and dehydrated with spirit, after
which the iodine is applied as described above. The staining of the skin
is an advantage, as it enables the operator to recognise the area that
has been prepared.

If any acne pustules or infected sinuses are present, they should be
destroyed or purified by means of the thermo-cautery or pure carbolic
acid, after the patient is anaesthetised.

#Appliances used at Operation.#--_Instruments_ that are not damaged by
heat must be boiled in a fish-kettle or other suitable steri