A manual of minor surgery and bandaging : for the use of house-surgeons, dressers and junior practitioners / by Christopher Heath.

  • Christopher Heath
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: A manual of minor surgery and bandaging : for the use of house-surgeons, dressers and junior practitioners / by Christopher Heath. Source: Wellcome Collection.

    131/400 (page 113)
    the canula will slope downwards, the best position for evacuati]ig the fluid, and when withdrawn it will leave a valvular opening in the skin. Should the fluid drawn off prove to be purulent, constituting an empyema, it will almost certainly re- accumulate, in which case it will be advisable to make a tree opening for its exit. The aspirator needle being withdrawn, a steel director maybe conveniently pushed through the puncture and between the ribs until pus appears along the groove of the instrument, when a blunt-pointed bistoury can be slipped along it and made to enlarge the opening sufficiently to introduce a flanged drainage-tube, or a loop of smaller tube. Any immediate washing out of the pleura is to be deprecated, as being not without danger, though later on antiseptic injections may be required. Aspiration.—The pneumatic aspirator of Dieulafoy and its various modiflcations are now in common use for the diagnosis and evacuation of collections of fluid in various pai-ts of the body. The exhausting syringe is a feature common to all the instruments, but the best form is that which admits of a reversal of the current so as to clear the needle of any accidental obstruction during the withdrawal of the fluid. This is of course impossible in the various forms of ' bottle aspirator.' In using the aspirator it is essential that the needle and tube employed should be perfectly clean, and this fact is best ascertained by pumping cai-bolised water through the entire apparatus on each occasion of its being employed. The tap communicating with the hollow needle being then reversed and a vacuum formed behind it, the needle, previously dipped in carbolic oil, is to be carefully thrust with a twisting motion into the part to be explored, care being taken to avoid the position of main vessels and nerves. Continuity being then restored by turning the tap, the fluid contained in any cavity which may have been reached will flow into the syringe or reservoir, and, if at a greater depth I