through the floor. The heat can thus be turned on or off with a key in the operating room and this regulating bar is neither higher nor lower than the floor surface.

Ventilation is arranged as follows: Under the entire operating room is a room for the purpose of heating the ventilating air. This arrangement also helps to warm the operating room as it prevents cold draughts through the floor; this air for ventilation comes into the hot air room through a glazed earthen pipe of 3 dm. diam. from a common large ventilating apparatus elsewhere, which first sifts the air and then forces it into the pipes with a revolving fan. This incoming air is already warm and is further heated in the hot air room by steam. The air can be heated at pleasure by another valve, bar and key arrangement from the operating room, as before mentioned. The air coming from the hot air room into the operating room passes through a short conduit close to the wall, a square box beginning at the ceiling of the hot air room and extending 0,8 meters above the floor of the operating room. This conduit is O, 4×O, 9 meters square and is finished with polished cement mosaic, and perfectly smooth. It is covered with a pane of plate glass. The side of this conduit facing the wall is rounded off and is not as high as the other sides. Through this opening under the plate glass cover the hot air for ventilation is poured out upon the wall and from there it extends over the whole room. It can be regulated with a plate glass valve in a nickel plated frame. This conduit can be cleaned whenever

desired by removing the glass top.

The air is not allowed to come in unfiltered, however. Under this conduit (in the hot air room) is an air filter in the shape of a number of pockets, one below the other, of thick, stout cotton cloth. These pockets are held expanded by pieces of tin plate and through the glass top in the operating room the whole arrangement can be examined, whether it is in good working order or not. The filter can easily be removed, cleaned or replaced. The air is evaporated through a ventilator near the ceiling, being an earthen pipe of 3 dm. diameter.

To prevent any objectionable gases entering the room from the waste pipes leading from the washstands or other places, every outlet pipe is well trapped and led into a large cast-iron tank coated with asphalt and located in one corner of the cellar. This large tank or receiver is provided with water lock and is surrounded with a brick and mortar wall and has a separate ventilating chimney reaching up over the top of the building. The receiver is connected through a large cast-iron pipe with asphalt coating with another large cistern in the yard, arranged about the same way as the tank in the cellar, and this is again connected with the sewer in the street.

The tank in the cellar and the cistern in the yard are always partly

full of water. The operating room is lighted with four large electric lights of 200 candle power each, situated in the four corners of the large plate glass window overhead. The two washing and disinfecting rooms are arranged upon the same principle as the operating room, except that the walls and the ceilings are here painted with oil paint, varnished and smoothly polished. Each room has a heater and an electric lamp like those before mentioned, and are ventilated in the same manner. They are provided with porcelain bath-tubs and washstands with hot and cold water. All waste pipes lead into the tank in the cellar, which we have before mentioned. There is also a hydrant,

THE OPERATING TABLE.

to which a rubber hose can be attached for the purpose of sprinkling the rooms previous to an operation.

Sterilizing apparatuses for instruments and dressings of the very latest patterns, are also found here. One of these sterilizing apparatuses is inserted into the iron door between the operating room and the next room. The apparatus can be opened from both rooms, so that instruments and bandages can be taken out when needed after they have been subjected to a moist heat at 150° C for 20 minutes and then allowed to cool. Disinfectants are not considered necessary with bandaging material sterilized in this manner.

The operating table deserves particular notice.

It is made as simple as

possible, in order to keep it thoroughly aseptic and allow blood and other fluids to run off without hindering the operator or his assistants. The frame is made of wrought iron pipes, so well united, that no space can be found for dirt to settle; it is painted white, varnished and polished, and is 960 mm. high, and 550 mm. wide.

The top of the table consists of four plate glass blocks 10 mm. thick (B), fastened to the frame by nickle plated hooks. These glass blocks form two separate planes, inclining towards the middle, where they are 15 mm. distant from each other. Under this space is a gutter loosely hung (D), of nickle plated copper sheeting, with drainage pipe and rubber hose (E), leading from it into the iron tank in the cellar.

These glass blocks which form the top of the table are 1,950 mm. long and 640 mm. wide, and are covered with two rubber mats, 5 mm. thick (A). A rubber pillow completes the outfit.

The preparation before an operation is worth mentioning.

The surgeon and his assistants attend to cleanliness with the most scrupulous care; hands, face, mustache and hair are thoroughly cleaned antiseptically. Thereupon the outer clothing is removed and sterilized coats and trousers are put on. Sterilized shoes (of tough sail cloth with wooden soles, very thick) must take the place of their own foot wear. No one can be present at the operation who has not prepared himself in this manner, or put on the aseptic outfit. The necessity of the thick wooden bottoms on the shoes was made quite manifest to me by the fact, that water stood half an inch high on the floor during the operation, from the previous thorough sprinkling of the operating room.

I can only see one point where a suggestion might come in to add to this otherwise most admirably arranged operating system, namely: that the surgeon and his assistants should wear neither mustache nor beard, and the hair should never be allowed to grow over half an inch in length, by running an American clipper over it as often as it exceeded this length, which could be distinctly set forth under the proper head in the hospital regulations.

HE KEPT GRAND MEDICINE.

In a Scotch village, where a young doctor had lately started practice, a workman had the misfortune to get his finger bruised badly in one of the mills. A doctor was sent for, and on properly dressing the finger the man nearly fainted. He was asked if he would take a little spirits to revive him. "Mon," he exclaimed with feeling, "that wud just be the very life o' me!" The doctor gave him a good glass, which he greedily swallowed, and on recovering his breath his first words were, "Well, doctor, I kin unco' little aboot yer skill; but, mon, ye keep grand medicine."-Detroit Free Press.

"So she married a man who lived in a distant city? How did she happen to become acquainted with him?" She saw his portrait in a medical advertisement in

a newspaper and fell in love with it."--Cape Cod Item.

HYGIENE.

INSTRUCTIONS FOR

COMPLETE DISINFEC

TION IN CHOLERA TIMES.

FORMULATED BY THE IMPERIAL CHOLERA COMMISSION IN GERMANY.

DR. E. LESSER,

Pawtucket, R. I.

I. DISINFECTANTS.

HE commission recommended as the best disinfectants the following preparations:

ΤΗ

I. Milk of lime.

Milk of lime, which is obtained in the following manner: One litre of water is poured into a vessel, and one litre of quicklime added to the water. When the lime has absorbed the water and has settled as a powder the whole bulk is mixed with three more litres of water. The milk of lime thus prepared should be kept in well stoppered vessels and should be shaken before using.

2. Chloride of lime.

This preparation possesses disinfecting properties only when it is freshly prepared and preserved in well stoppered vessels. Its good quality may be known by the strong odor peculiar to itself. It is used either as powder or in solution. The latter may be obtained by mixing two parts of chloride of lime with 100 parts of cold water; after having allowed the liquid to stand the clear solution is decanted.

3. Solution of potash soap,

black soap or soft soap.)

Three parts of

(so called green soap, the soap are dissolved in 100 parts of hot water; for example, 1-2 kgr. in 17 litres of water.

4. Solution of carbolic acid.

Crude carbolic acid is not very soluble in water and cannot therefore be used for the purpose of disinfection; but the crude carbolic acid is soluble in soap-water; one part of the carbolic acid is mixed with 20 parts of a soap solution prepared as described in §3. This solution keeps for a long time and is more effective than a solution of potash-soap alone.

Pure carbolic acid is very much more expensive and is not more effective than the crude acid. When pure carbolic acid is employed it is not necessary to dissolve it in soap solution, as pure acid is soluble in water.

5. Steam-generators.

Appropriate for the purpose in question is that apparatus, which is arranged for streaming water-steam at 100° C, as well as that in which steam is employed at pressure (not less than atmosphere).

6. Boiling water.

The objects to be disinfected are boiled in water at least half an hour. During this time the water should be kept continually boiling and should completely cover the objects to be disinfected.

The choice of the most convenient among the above mentioned disinfectants to be made according to the real nature of things. Especially, in default of crude carbolic acid, the disinfectants in §1 to §3 may be used. If it should be impossible to procure these, in case of necessity, carbolic acid of lower body of active substances may be employed. Of course a larger quantity of the latter must be employed in this case or another disinfectant may be used, which is to be considered as equivalent to the above mentioned.

II. THE APPLICATION OF DISINFECTANTS.

I. The liquid excrements (stool and vomit) are carefully collected in vessels and mixed with nearly the same quantity of milk of lime (I, § 1). This mixture should be allowed to stand at least one hour before it is done away as innoxious. In the same manner chloride of lime (I, § 2) may be employed, of which powder 3 table-spoonfuls are added to half a litre of the excrement. This liquid should be well mixed and may be done away with immediately after 15 minutes. Dirty water may be disinfected in similar way but it requires less milk of lime and chloride of lime.

2. Hands and other parts of the body should be disinfected by washing them thoroughly with chloride of lime solution (I, § 2), or with carbolic acid solution (I, § 4), when they have come in contact with in fected articles (excrements of the patient, dirty linen, etc.)

3. Bed-linen and linen worn on the body and similar articles, should be brought into a vessel filled with a disinfecting solution immediately after being soiled. The disinfecting solution may be soap solution (I, §3) or carbolic acid (I, § 4). The said articles should remain in the former solution at least 24 hours; in the latter at least 12 hours before they are cleaned in the common manner. The said articles, linen, etc., may be, disinfected also in steam-generators or by boiling water. But also in these cases the articles should first of all be moistened thoroughly with