77
It will be seen from the statement, how the amount of clothing sterilized,
increased in the month of September 1900 due to the fact that orders
were issued making disinfection the measure of primary importance
just at that time. The registers kept at the other three sterilizers give
corresponding results. Every effort was made by persuasion and tact
to overcome the prejudices of the people with regard to the sterilizers
and besides to popularize disinfection as far as possible. They were
taught the necessity for prompt disinfection, their wishes were consulted,
their customs respected, and for any losses incurred they were fully
recompensed. It may be said that on the whole disinfection has been
carried out in strictest conformity with the orders, and that very
little room remains for improvement except in the direction of
European supervision ; the more there is of this, the greater the efficiency.
It is impossible to shut one's eyes to the fact that the subordinates
employed are open to temptations of all kinds, to bribery, to theft, etc.,
which they might find irresistible in the absence of supervising officers.
Mr. Hewett, Assistant Executive Engineer, Mechanical Branch,
reports upon the steam sterilizers as follows :—
So far as my observations go the process is carried out with a fair amount of
efficiency, but I am still of opinion that the operation, to make it absolutely reliable,
should be performed under the close personal supervision of a subordinate Medical
officer. This was my opinion at the beginning of operations, but it was objected
to on the score of expense. The whole question resolves itself into this—Has steam
at a temperature of not less than 230° F. enveloped every fibre of the articles placed
in the chamber ? A thermometer is reliable for ascertaining whether this has been
the case only when intelligently used. For instance, I have seen one placed with its
stem carefully embedded in the clothing, while the bulb was placed outwards with
scarcely any covering at all. A really intelligent supervisor would only require a
thermometer to occasionally check his powers of observation, for he would very soon
become acquainted with the time required to thoroughly sterilize different classes of
materials. Once that knowledge is gained, he would, by carefully noting what
was put into cradles and seeing that they were packed as loosely as possible, be
practically sure of the results.
With regard to the "Bowman" sterilizer as used at the Babula Tank
and Arthur Road Hospital Mr. Hewett goes on to point out, that " the
means adopted to ensure a thorough circulation of steam were defective
and that to obtain reliable results the articles to be sterilized must remain
in contact with the steam for a long period."
On the "Equifex" sterilizers, now in use at the Northbrook Gardens
and Modikhana, his opinion is that it is " undoubtedly a very reliable
apparatus when properly used."
Mr. Hewett concludes by saying that he thinks "a large measure
of success is obtained even with unskilled supervision." These sterilizers
as already stated were placed in charge of English Medical officers who
have given attention to essential points, but as they have to supervise all
disinfection work it was necessary to commit the working of the steriliz-
20