A Surgical Kit containing all the Essen- 
tials for Aseptic Operations at 
Private Residences. 
BY 
Reuben Peterson, M. D., 
Grand Rapids, Mich., 
Gynaecologist to Butterworth Hospital; Fellow of 
the American Association of Obstetricians 
and Gynaecologists. 
Reprint from The American Gynaecological and 
Obstetrical Journal. [Reprinted from the American Journal of Gynecology and Obstetrics 
or October, 1894. 
A SURGICAL KIT CONTAINING ALL THE ESSENTIALS 
FOR ASEPTIC OPERATIONS AT PRIVATE RESIDENCES. 
By Reuben Peterson, M. D., Grand Rapids, Mich., 
Gynaecologist to Butterworth Hospital; Fellow of the American Association of 
Obstetricians and Gynaecologists. 
[with six illustrations.] 
Every surgeon who is called upon to operate frequently in private 
residences has, or ought to have, solved the problem of how an asep- 
tic operation can be secured. To attain this end with the least work, 
and consequently the least possible friction, requires considerable 
thought, experience, and close attention to details. 
Fig. i. —Surgical kit packed and ready for transportation. 
The writer’s apology for the present short paper is that when he 
was grappling with the problem of how to develop a technique which 2 
Reuben Peterson, M. D. 
would be applicable to a private house, he could find little or nothing 
published upon the subject. Many articles descriptive of hospital 
technique have appeared in the journals from time to time, but it is 
Fig. 2.—Cover removed, showing copper boiler. 
evident that many changes must be made in such a technique in order 
that it may be employed in operations at private residences. 
While the advantages of a well-equipped and well-managed hospi- 
Fig. 3.—Sponge basin and ligature pan inside of boiler. 
tal over a portion of a dwelling which has been temporarily trans- 
formed into a hospital are immense, there will always be a great deal A Surgical Kit for Aseptic Operations at Private Residences. 
3 
of surgical work performed in private houses. We are seeing more 
and more clearly the important part the mind plays in surgical shock, 
and the necessity in capital operations of eliminating anxiety and 
fear as much as possible if the best results are to be obtained. We, 
as surgeons, become accustomed to hospitals and their surroundings, 
and often fail to realize the dread and even horror some people have 
of these institutions. It has been the writer’s experience that patients 
operated upon at their own homes are far more tranquil and less 
apprehensive than when the work is done in a hospital ; this may 
prove an important factor in the case of weak and nervous patients, 
and may be the straw which will turn the scale in favor of a success- 
ful result. 
The writer is convinced, from what he has observed of operations 
performed in private residences, that an aseptic operation is of rare 
Fig. 4.—Basins and pans removed, showing Arnold steam sterilizer without hood. 
occurrence. A little carbolic acid or corrosive tablets and boiled 
water are often all that is employed by the surgeon, not because he 
does not know what is necessary for a clean operation, but because 
he has not taken the trouble to develop a system whereby this can be 
obtained. Certain articles which he supposes every family possesses 
are found missing on the morning of the operation, and therefore he 
gets along the best he can, oftentimes at a sacrifice of surgical clean- 
liness. For one who is doing much surgical work there is absolutely 
no excuse for this, even in emergency cases. It is his duty to over- 4 
Reuben Peterson, M. D. 
come all obstacles and to be prepared at all times. • If he has found 
that household utensils are far from suitable for operative work, 
and often in such a condition as to prevent asepsis being obtained, 
Fig. 5.—Contents of kit. 
he should see to it that his surgical kit contains all the necessary 
articles. 
The surgeon himself should either see to the details of the prepara- 
tion for the operation, or leave it in the hands of a trained assistant 
or nurse. The surgical kit should be at this field of operation, if pos- 
sible, the evening before, in order that there may be plenty of time 
for deliberate and painstaking preparation. 
The outfit should be simple and at the same time complete. It 
should be packed in a bag which is sufficiently light to be carried in 
a buggy and strong enough to be forwarded by express or baggage, 
where it is certain to receive hard usage. The trunk telescopes made 
by the Leatheroid Manufacturing Company, of Kennebunk, Maine, 
will be found to answer all the requirements. These cases are used 
by commercial travelers for samples, and are at once light and du- 
rable ; any size can be procured. The one from which the accom- 
panying photograph was taken is twenty-four inches long, twelve 
inches wide, and fourteen inches deep (Fig. i). 
Every house, to be sure, has a wash boiler, but this is not always 
kept surgically clean. Hence it is never safe, especially in abdominal 
operations, where la'rge quantities of sterilized water may be re- 
quired, to depend upon the house boiler, which may be rusty and un- A Surgical Kit for Aseptic Operations at Private Residences. 
5 
fit for surgical purposes. To overcome this difficulty a copper boiler 
can be made which will just fit inside the inner case. The tele- 
scopic arrangement of the cover allows the boiler to be made of any 
depth, according to what may be desired to be packed within it. The 
one shown in the photographs is eighteen inches deep. The cover 
of the boiler should be made flat so that it may not be jammed by 
the case cover. 
Operating gowns, towels, and dressings, which have been sterilized 
in some manner, are essential to an aseptic operation. The apparatus 
best adapted for making these articles sterile is some form of the 
Arnold Steam Sterilizer, made in Rochester, New York. By sending 
the inside measurements of the boiler to this firm any size of sterilizer 
can be secured. A sterilizer of this kind is of great convenience and 
can always be used, for even the dirtiest hovels have a stove. All 
the towels, gowns, etc., can be packed either inside the sterilizer or 
between it and the sides of the boiler. Inside the boiler and on top 
Fig. 6.—Pans, basins, and trays arranged for the operation. 
of the sterilizer there is also plenty of room to pack six granite 
iron basins ten inches and three quarters wide. These can always 
be kept perfectly clean, which can not be said of all basins in private 
houses. The number is none too large for an operation of any 6 
Reuben Peterson, M. D. 
magnitude, and if they are carried in a kit, the hurrying to the neigh- 
bors at the last moment for a basin can be dispensed with, and thus 
the wasting of valuable time can be avoided. 
A nest of instrument pans such as is figured in the photograph 
can be procured of any instrument maker and packed inside the 
sterilizer. Plenty of room will also be found for all the ordinary in- 
struments, although it is better to have a separate bag which will 
contain them and other smaller articles which may possibly be of use 
at the operation. They can be carried in a hand bag to the house on 
the morning of the operation, as it is only necessary to boil them ten 
minutes in a soda solution to make them perfectly aseptic if they 
have been properly cared for after the last operation. 
Equipped with the articles described, a trained surgical nurse can 
easily turn any well-lighted room into a very fair operating room, and 
the operation can be conducted under as good aseptic conditions as 
obtain in a hospital. Everything essential having come in the kit, the 
family are not inconvenienced or thrown into a flurry by demands for 
pans, pots, or kettles. The operation being completed, the kit can be 
repacked in a very short time, and the soiled linen and instruments 
quickly removed and taken care of elsewhere. This spares the feel- 
ings of the family and does away with a great deal of talk in the 
servants’ quarters. 
Pythian Temple Building.