The most convenient antiseptic for general use is _Carbolic Acid_. This
is a clear, colourless liquid of rather oily consistence, which rapidly
becomes converted into solid crystals in cold weather. When required for
purposes of disinfection it should be mixed with 39 times its quantity of
water, or roughly one pint of water requires one tablespoonful of pure
Carbolic Acid to make a solution of 1 in 40.
This solution is required for soaking the hands after they have been
washed with soap and warm water, and the nails scrubbed with a nail
brush. This latter proceeding is one of _ordinary cleanliness_, the
soaking in the Carbolic Acid solution, which should be warm, is in order
to obtain _Surgical Cleanliness_. It will be readily understood, that if
the hands come in contact with any possible source of infection after
this soaking, then it must be repeated before beginning the operation.
The disinfection of the hands must be the last stage in all the
preparations for the circumcision. A similar solution of 1 in 40 Carbolic
Acid may be used for placing the instruments in before the operation.
They are to be taken directly out of the solution as required. A shallow
dish of a material easily cleaned, as metal, glass or porcelain should
be filled with 2½ ounces (5 tablespoons) of water which has been boiled,
and to this one half a teaspoonful of Carbolic Acid is added, taking care
that the acid is thoroughly well mixed up with the water and not allowed
to float about in droplets.
If the instruments are scrupulously clean, i.e., if they have been
washed thoroughly with soap and hot water, they require to remain for
_one hour_ in the Carbolic Acid solution to render them sufficiently
disinfected for operating purposes. It is therefore quicker, as it is
also more scientific, to _sterilize the instruments before using them_.
By sterilizing them we kill any micro-organisms that may be present on
them, and we are then confident that no living germs are carried to the
wound by means of the instruments. In other words they are _aseptic_.
Instruments are sterilized by boiling for about ten minutes in clean
water. It is useful to add washing soda in the proportion of 5 grains to
every two tablespoons of water. It is obvious that the instruments must
be of metal, as no other material will stand boiling. They must be made
in such a way as to prevent the accumulation of dust or dirt in joints or
crevices.
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