“All gauze and bandages from ward dressings, amphitheater and out-patient department and operating rooms is collected in paper bags and taken to the laundry. It is transferred from these paper bags to open work bags made of cord, these bags being only half filled. The gauze is kept in these bags throughout the rest of the process of washing and the laundry sterilization.
“It is put in soak over night in cold water which is changed several times. The following morning it is put in an iron washer capable of resisting steam pressure up to ten pounds. It is then washed in cold water until the water runs perfectly clear. The gauze is then washed with warm water, soap,and sal soda. After this washing it is rinsed in hot water. After the rinsing, enough hot water is turned into the washer to cover the bags of gauze as they lie on the bottom of the washer. Steam is then turned on to a pressure of ten pounds. A self-registering thermometer placed in the gauze twice showed a temperature of 239° and 240°. The thermometer, which registers on the outside of the washer, showed a temperature of 236° at pressure of ten pounds. This temperature is maintained for one-half hour. During all this process, the washer is moving with a to-and-fro motion, which continually agitates the gauze and presents all parts of it to the action of the water and steam.
“The gauze is then put in the extractor and when dry is sent to the out-patient department, where it is overhauled under the direction of an intelligent maid. It is untangled and straightened, and the maid is instructed to throw out any piece of gauze which is stained or has anything adherent to it. The gauze is again handled by nurses or maids when it is cut and placed in packages for the last sterilization. These women, also, have instruction to look the gauze over carefully for any stained piece or any piece with foreign matter adherent. The final sterilization is then done at a temperature of 250° F., with a pressure of fifteen pounds in the sterilizing room.
“It is found that the washed gauze is softer and more absorbent than the new gauze. Repeated tests conducted in the pathological laboratory have shown the safety of the process. The overhauling and straightening of the washed gauze involves a very considerable amount of labor, and if it were necessary to hire additional people to do the work the saving would be much less. At the Massachusetts General Hospital we utilize labor that would otherwise go to waste. In our large out-patient department we must have a certain force of messenger boys and maids when the clinic is at its largest and at the busiest hours of the day. Much of the time all this force is not required for running the clinics or cleaning the buildings, and their time is utilized on the gauze.
“So much for the gauze which is recovered and utilized again as gauze. There is a part which is in too small pieces or is too badly tangled to be worth straightening. This material is run through a rag picker and becomes a very light and absorbent lint, which is sterilized and used in dressings where absorbent cotton or oakum is ordinarily used. It is also used in the boiler house in the place of waste for wiping around the engines. Another part of the gauze is thrown out because it is stained with chemicals. These pieces are utilized by the housecleaning force. This process, therefore, means not only less gauze bought, but less absorbent cotton, less oakum, less waste for the engine room. All pieces of compress cloth, many of which have been thrown away in the past, are washed and sterilized by this same process, used over again if large enough, run through the picker if small.
“Packages which are sent to the boiler house to be burned are overhauled and inspected at frequent and irregular intervals, and if it is found that material which should be saved is being wasted, the responsible head nurse is called to account. Safety pins, rubber dam, knives, forks and spoons are recovered from this inspection. I believe that it will pay to have a systematic inspection by a careful employee of everything brought from any part of the hospital to be destroyed or thrown away. Such a man cannot fail to more than earn his pay and board, nor would his inspection work take the whole of his time.
Soap Making
“About one year ago the Massachusetts General Hospital started to make its own soap. I have endeavored to make a comparison of the cost to the hospital of buying soap for the seven months, February to August, 1904, and making it for the seven months, February to August, 1905.
“We formerly used in the laundry a soap chip for which we paid about 4¾ cents a pound. We used a common yellow bar soap for which we paid 5 to 5½ cents per pound. Savogran for the floors, etc., at 6 cents a pound, and soft soap for ward use at 3½ cents. All these have been nearly or quite replaced by our homemade soft soap, which we find answers all these purposes in a satisfactory manner. We still use a small amount of Savogran on the white tile floors of our surgical building, and a little bar of yellow soap here and there. This latter we shall make ourselves as soon as our stock on hand is used up. But soft soap practically replaces everything except sand soap, toilet soap, soap polish, etc., which we buy as before.
“In the seven months of 1904 under consideration, we paid $535.26 more for Savogran than in the seven months of 1905; $108.48 more for yellow bar soap; $24.99 more for soft soap, and $300.65 more for soap chips, a total of $969.38 more paid for soap effected by our home soap making in seven months of 1904 than in the seven months of 1905.