Further report on the treatment of phthisis by iodoform infusion / by Thomas W. Dewar.

  • Dewar, Thomas W.
Date:
[1905]
Catalogue details

Licence: In copyright

Credit: Further report on the treatment of phthisis by iodoform infusion / by Thomas W. Dewar. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    dissolved. Thereafter, a few minims of liquid paraffin may be drawn up and the wliole well shaken. To facilitate intro- duction, avoid haste, and prevent any escape, the point of the needle is sealed hy dqrping it in Hazeline Cream. Wlien work- ing with the Basilic veins the handkerchief tourniquet is placed immediately above the elbow, when with the forearm veins about its middle, and when with the veins on the knuckles or back of the hand at the wrist. The radial vein and the skin over it are thick and more difficult to puncture, and this is increased by its mobility. The fault of mobility for injection purposes applies to the ulnar also, but both are very serviceable. Prominence and tension of veins is assisted by giving the patient something to grip firmly in the hand. It is desirable when possible to inject in daylight, it is so much easier. The veins are generally fullest after 3 p.m. If these conditions are impracticable they may be temporarily dis- tended by placing the forearm in hot water, but if this is done the solution of iodoform in ether alone must not he used. With the 40 per cent, of liquid paraffin added, however, it is perfectly safe. Enter the needle vertically and try to pin the top of the curve of the vessel with the point of the needle, and tlien pushing it gently on and bringing it into line with the calibre of the tube, insert it half-way. The sensation of going into a space is felt at once, and can even be seen by an onlooker. The patients usually know when it is right. CASE No. 1. [Dll. Alexander Bruce and Dr. J. Craufurd Dunlop.] M., age 40; no tubercular history in near relatives; enjoyed ordinary health until 37, when he had a severe attack of dorsal myelitis, which left him, after a long illness, with partial paralysis of the right leg, stiff ankle, exaggerated reflexes, and imperfect control of his bowels and bladder. Wlien about 39 his health became indifferent, and three months before I saw him he had what he considered an attack of influenza. When I got him in the beginning of January the wliole of the right upper lobe was involved and breaking down.