A Case of Tetanus Cured by the Hypodermic Injection of Cocaine, 87 American Educational Journalism, A Study of Longevity in New England. Atropine in Hemoptysis, Bloodless Excision of Nerves, Buffalo Lithia Water a Solvent for Uric Acid Calculi, Cardiac Failure in Diphtheria, Chlorosis and Heart Disease, Combined Chloroform and Cocaine Anasethesia, 471 244 435 435 237 238 Asphyxia Treated by Hypodermatic Injections of Ether, A Spray of Hydronapthol Papain and Hydrochloric Acid in Diphtheria, 434 477 332 37 477 184 330 32 Cigarette Smoking and Malignant Diseases of the Throat, Comparative Therapeutics of Uterine Fibroids, Copaiba in the Treatment of Croup, Corrosive Sublimate Internally in Puerpral and other Septicemias, 187 239 238 430 185 Electrolysis in the Treatment of Stricture of the Urethra, X Rectal Insufflation of Hydrogen Gas as an Infallable Test in the Diagnosis of Visceral Injury of the Gastro-Intestinal Tract in Penetrating Wounds of the Abdomen without Laparotomy, Removal of Wens, 81 32 430 431 477 34 191 238 Strophanthus, 37 Successful Treatment of Syphilis, 189 Surgical Shock, 477 Syrup of Hydriodic Acid, Its Manifold Uses, 85 The Calomel Treatment of Pneumonia, 236 The Combination of Sodium Chloride and Corrosive Sublimate as an The Proper Time for the Administration of Acids, Alkalies &c., The Usefullness of Terebene in Diseases of the Lungs, 434 The Value of Inhalations ir, the Treatment of Lung Diseases, 332 The Use of Subcutaneous Injections of Antipyrin and Cocaine during Use of Chloroform in Tracheotomy of Children Attacked with Croup, For Burns, 437 89 437 39 Forcible Currents of Water in Pruritis Ani, For Dyspepsia Accompanied with Flatulance and Palpitation, 487 437 For Freckles, 487 577 437 340 195 Iodoform in Carbuncle, Mastitis, Infantile Diarrhoea, Intubation, Iodine or Iodides, Lactic Acid in Nasal Lupus, Maternal Impressions, Medical Incomes in Kansas City, Mucous Patches, Napthol in Pyothorax, New Preserving Fluid, 485 483 133 484 487 487 484 103 391 483 339 Noma, 484 The Eliminations of Medicines by the Mammary Glands, The Knee Jerk in Diphtheria, 391 The Perfect Vaginal Tampon, 88 The Proper Time for the Administration of Acids, 146 The Relation of the Use of Coffee to Susceptibility to Tyhhoid Fever, 39 The Spare Bed 484 The Treatment of Violent Colic, 39 Traumatic Separation of the Superior Tibial Epiphysis 89 Treatment for Pneumonia, 146 Treatment of Xanthoma Palpebrarum, Unsavory Peptones, University of Pennsylvania, What He Wants in Iis, Where Ignorance is not Bliss, Publisher's Department, 41, 92, 146, 198, 247, 294, 341, 392, 440, 488, 539, 578 340 193 483 485 89 New England Medical Monthly. LIBRARY ASS DANBURY, CONN., OCTOBER 15, 1888. how to destroy infectious germs adher ORIGINAL TRANSLATION. HOW SHALL THE PHYSICIAN DISINFECT HIS INSTRUMENTS? ing to places difficult of access as well as the surfaces of instruments, with complete certainty, in not too long a time, and without complicated measures. Let us see what the means are at our A translation of Dr. Hugo Davidsohn's article in disposal for accomplishing these re the Berliner Kilnische Medicinische Wochen schrift, Aug. 27, 1888. BY D. C. BROWN, M. D,, DANBURY, CONN. [T has been proved past doubt by bacteriological observations, that wounds are less infected from germs floating in the air, than through contact with the skin of the patient himself, the hands of the physician, instruments, sponges, dressings, etc. Here throughout are found a very large number of germs and the endeavor must be made to find a method of disinfection suited to each of the sources of infection named. From this idea sprang those works on the questions, "How shall the physician disinfect his hands;" how the skin of the patient, and his dressings? It appeared to me, therefore, well worth the while to give the question of the disinfection of the physicians' instruments a closer examination, in order to produce a method, that in the first place should give complete assurance that instruments so treated shall under no circumstances act as a source of wound infection, and on the other hand that it should possess the advantage of being simple enough to be resorted to at any time without special preparations, at the office of the physician or the sick room of the patient. The question resolves itself into this: quirements. From the great number of known chemically active fluid disinfectants, only sublimate and carbolic acid are in general applied for this purpose to instruments; yet the sublimate is pretty generally given up, as it renders metalic instruments soon unfit for use and completely spoils them. Carbolic acid remains. It is far from us to decry the high disinfecting power and importance of this substance, and yet we cannot admit it to be sufficient in all cases for the physicians' instruments. After Koch's precedence we may claim absolute sufficiency for a method that is capable of destroying anthrax spores, for they are admitted to belong to the most resistant of all known pathologic organisms, and usually serve us therefore,as an indicator in our experiments in disinfection and they inform us in a given case if the means in hand are sufficient as a disinfectant, i. e., if they have the power to destroy the most resistant originator of infection yet known. Now a 5% sol. of carbolic acid, the sol. usually resorted to for disinfection of instruments, kills the anthrax spores surely, only after several days, demanding, therefore, so long a time for the fulfillment of its task that for our use it may scarcely enter the field. Should we admit that the ordinary pus bacteria |