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vessel containing a sterilized solution for him to dip his instruments into while in use, or to use in cleansing his hands, from time to time, of blood.

Two assistants usually stand one on each side of the table, to aid the operator by holding the patient's limbs in any desired position, also in aiding with instruments, ligatures, sponging, etc. The nurse with her table for cleansing the sponges should stand back of the assistant on the operator's left, handing him sponges and receiving them from him for recleansing. Her stand should contain one basin filled with cold sterilized water for washing out the blood, and another basin with warm sterilized water for keeping them in until needed.*

A chair or stool should be placed at the side of the table to aid the patient in stepping up. The window should be screened from the outside gaze by a thin lace or muslin curtain, or a sheet of newspaper may be pinned across it. A waste bucket should stand under the table immediately in front of the operator. The operating pad may be placed at the lower edge of the table so that its flap rests over the waste bucket and thus conducts the water used in irrigation, etc., into it.

When the operator works without a pad it is well to have a folded sheet so placed over the

* When the operator attends to the sponging it is usually more convenient to have the sponges on the right.,

lower portion of the table as to extend from beneath the patient's hips over the lap of the operator. This serves to protect the operator's clothing, the floor at the foot of the table, etc., from soiling.

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The bed.

The bed for the reception of the patient after operation should be arranged beforehand. It should be so placed that access may be had to it on three sides. It should not face the light. A firm mattress, as of hair, is the most desirable. Care should be taken to see that the bed is in every way comfortable. A pad should protect the mattress, and a rubber protective should be so placed over this as to cover the portion of the bed, over which the parts operated upon shall rest. In pelvic operations this will be the middle of the bed, in a breast operation the upper part of the bed. A sheet is spread over these, and a draw-sheet, that is, a sheet folded upon itself twice in its length, is fastened over the portion of the bed beneath which the protective has been placed.

A heated soapstone or hot-water bag should be Warming placed, previous to the operation, between the upper and lower bedclothes, so that the bed may be warm for the reception of the patient.

The nurse should learn before the operation the Antiseptic kind of solutions to be used, if antiseptic solutions are to be employed. Should bichloride of mercury and carbolic acid be employed, which are the usual solutions desired by surgeons, a large bottle containing a solution of 1-500 or 1-1000 of the former and another containing 1-20 of the latter will enable the weaker solutions to be prepared with great rapidity. Thus, if a solution of 1-4000 of the bichloride be called for, the nurse taking one part of the 1-1000 (as one gill) can add three

the bed,

solutions.

rature of solutions.

Methods for quick

of solutions,

parts (or three gills) of warm sterilized water to

this, thus obtaining a warm solution of the required Regulating proportion. If a bath thermometer be kept in the the tempe

basin during the admixture of the solution and the water, the nurse may, by watching the column of mercury, determine whether to make the addition from the warm or cold water, until she obtains the quantity desired.

A solution of 1-1000 can be prepared by mixing preparation

in equal parts the solution 1-500 and warm sterilized water.

A solution of 1-40 carbolic acid (that usually employed for the immersion of instruments) may be made by adding the same quantity of warm sterilized water to a solution of 1–20.

Sometimes surgeons prefer the use of tablets of bichloride in making up solutions. The directions às to the strength of one of these will be found upon the vial in each case. As a rule, a tablet represents 772 grs., which, when added to a pint of water, gives a solution of 1-1000. A fountain syringe containing the solution to be used should be filled and hung behind and considerably above the operator, on a nail, that it may be ready when needed.

When the operator is obliged to use the edge of a bed in place of a table, the bed should be placed with one side sufficiently near the window to obtain

Arrangements when operation done on bed.

a good light. The sinking of the patient in the bed may be prevented by placing a board beneath the mattress and the springs, or between the mattress and pad. This portion of the bed should then be arranged for the operation in the same way that the table was arranged, as to the protective rubber and sheet.

A chair or stool of proper height with reference to the bed should be placed in front of this arrangement. The floor, for about one foot beneath the bed, on that side, and extending to at least two feet beyond it, should be protected by floor oilcloth or old carpeting.

The stands and other articles required should be Preparaarranged as before described. The preparation of sponges, sponges and instruments for the operation will be identical with those described in the chapter on the subject of their preparation for abdominal section. The dressings employed will vary somewhat as to their character, form, etc., with the choice of the operator.

For operations upon the floor of the pelvis, or T-bandage within the vagina, a T-bandage with an antiseptic septic pad. pad of some kind will be necessary. The T-bandage will consist of a straight abdominal bandage of firm muslin, to which a strip of muslin about four inches wide is fastened at right angles, so that it may serve as a perineal band passing between

etc.

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