On sub-cutaneous pneumatic aspiration, as a method of diagnosis and of treatment / by Georges Dieulafoy.

  • Dieulafoy, Georges, 1839-1911.
Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: On sub-cutaneous pneumatic aspiration, as a method of diagnosis and of treatment / by Georges Dieulafoy. 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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    powerful aspirator, ready to be used when the proper time arrives. Let it be sujsposed that we wish to examine an effusion into the cavity of the plem-a. The tubular needle No. 1 or No. 2 must first be introduced at an intercostal space, and, when it has penetrated the tissues for about a third of an inch (one centi- metre), it must be connected with the pump, in which the vacuum has been established, either directly or through the medium of a caoutchouc tube. This done,—and to this point I desire to call special attention,—the tap must be opened between the needle and the vacuum, and the needle pushed gently forwards. We may thus slowly traverse the tissues, so to speak, with the vacuum in hand, until we discover the effusion. The eyes of the operator should be directed to the glass body of the pump ; and, at the moment when the needle enters the liquid, the latter rushes forcibly into the instrument. The diagnosis is at once complete ; the manoeuvre is absolutely harmless; and the desired object is attained. I have supposed, for the purpose of demonstration, an effusion into the pleura; but the method of procedure is precisely the same for collections of fluid of all kinds and of every situation,— for effusions into the pericardium, the thorax, or the abdomen ; or for cysts of the kidney, the liver, or the ovary. Thanks to the manipulation that has been described, and to the command of the preliminary vacuum, it is impossible to pass beyond a layer of liquid. This is of importance when the collection is of small extent, or deeply seated. At the moment when the fluid is reached, the diagnosis will be written upon the instrument, sometimes even unknown to the operator.