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Show 466 REPOET OF SUPERINTENDENT OF INDIAN SCHOOLS, The mildest case shoild liot be allowed to mingle with other people within four weeks of the onslaught of the diseaae. SURGICANL ~ L ~ ~ANND GTEE CAREO F SURGICAGLA SE~. BY MFJ. P. C. PAAL. A augiesl nume is first taught how to wash her bnds. Thesurfcally clean hand is quite another thin from an ordhary clean hand. To sterilize t e hands they are first sembbedto theePbow witha brushand mpand water fortwenty minutes, making sure no part is slighted. Then they are treated with a com osition of equal part mustard and cornmeal, which is afterwards washed off with Jean water, nails again cleaned, and the hands are ready for the asce tic solutions, which are in four basins. In the first is thepermanganateof otash, in &second is a saturate solution of oxdic acid, in the third is bichloride, an2 the fourth contains sterile water. In all of these solutions the hands are subjected to treatment. The dressin (cheese cloth) are put in a strong 801ntion of bicarbonate of soda end boiled one anpa half hours, then boiled the same length of time in clear water, and afteruwds dried in an oven or hot-air compartment. Preparation of the patient: Begin three days before the date of operation by put-tin patient to bed on light diet, and for twenty-lour hours prevlous to operation nohng but liquids. Begin also to prepare alimentary tract by giving calomel in small broken doses, one-fourthgrainevery hour until 23 grains have been given; give this at night, and follow with a dessert spoonful of Epsom or Roohelle salts in the morning; calomel is preferred because of its antisepticvirtues. Let this be followed each day with a thorongh fiushin with water enemas and six hours previous to the operation let the fiushing be donbfy thorough by wing large quantities of water until it returns clear. This care is vitally essential if the operabon be abdominal, as with-out it there is danger of peritonitis and intestinal paralysis. Bathe the patient each A..*-., , . ,111 hair ahonld he removtxl irom 1110 part to be optatell upon and thc rt thor- 011gl1Iyw a s h 4 Br~itn ~oapandw ale? fortwenty lnil~utet~h,e n ndap rinsed o~wa s h e l l in l>iehlorideofm crrurv*ulutit,n. ?fr~nnthI- I0.N. ELllowin~,t lrisr.h eaoria-resh-ot~ lrl be washed first in ethe; to cut the oil 2 the &in. and then In absolute alcohol. and Drwa thr paticut iu a cltutl dr..% antl'bnlpical stocking< wl~icll reaelt to thr body. If the patirnt he 3 woman, part her hair irvm front ro havk and h i d in two braid*. Altiavd see thar tlir lrlstlrlrr is mode c~o~t,tr. If the patient's heart isiot stront g i i itrycbnia grains fa every four hours. This should have been begun wlththe ot erpreparations. Do notpernitany solid foodor milk within six hours of the operation, as with food in the stomach the ether might cause them to vomit. m e n the patient haa been put to sleep, the field of operation ma w i n be washed with ether and then with alcohol. Spread over the patients. ster%zed sheet wlth a hole in it just lalpc enough 10 expoa6thc work, aradill is M y . Re careIul that nothing nmrs in cunt:$rt witlt rlle furniruw ur anything whatever that is not sterilized. as all these tllinm are covered witlt hnrreria. Aftern onrient bas been operated 06, the h t th ine & to watch for a shock. The svmuto&s of a ~11oc.ka re Fold, rlaruGy Ilnnd~,r apid pul~ex, nll many t i~uwa -.en.icoinakre condi-tion. Placc pati~otb etween hlankeu. put her bottle^ ahnut i~inle, levate t b f~oot 01 the bed rn sunnlv blood tu the Imiu xnd to aieist tlrr hca.an. rrive Iwl c.offrt> fr~ur ounces, and wxiikv ounces one uer rectum. strvchnia erains 2x'<er hvuo. The 'symptoms hf internal Kemomhage a& rapidupnlse, "<eitIes&&m, dizziness, pinched exprwion, and pale lips and ears. Elevate the foot of the bed and give ergot drams one, and e hypodermic of atropia, grains &; apply cold ta the approxi-mate aurfaee and send for the doctor. In external bleeding, if. it is an arte the blood will be bright red and will come in spurts, or if a vein it will be dark r z a n d flow evenly. h t ap ly pressure, sev-eralfolds of cloth, and bind tightly. If this is not effectnal, apJy either heat or cold: if it is an artear where you can set at it. sterilize hands and instruments. and pick'it up with forceis and tie'a silk th&ad arbund it or apply some astringent 'such |