Lectures on obstetric operations : including the treatment of hæmorrhage : and forming a guide to the management of difficult labour / by Robert Barnes.

  • Barnes, Robert, 1817-1907.
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on obstetric operations : including the treatment of hæmorrhage : and forming a guide to the management of difficult labour / by Robert Barnes. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    by it from the human giver. But numerous experiments of Richardson and Ore answer this objection. Air may be got rid of by first pumping water through the instrument, or better still, a saline solution. But although avoiding contact with air retards coagulation it does not give security against it. Some form of injecting apparatus has been most generally used. The blood has been collected as it flows from the vein of the giver in a reservoir, generally a funnel communicating directly with the pipe of the syringe, so that the blood is propelled partly by gravitation. An excellent instrument of this kind is Mr. Higgin- son's, who by it saved ten lives out of fifteen, using whole blood (see Liverpool Med.-Chir. Joum., 1857, and Obst. Journ., 1873). In this apparatus there is no piston ; gravitation is aided by squeez- ing the barrel, which is made of vulcanized india-rubber. The apparatus of Dr. Little, figured and described in the London, Hospital Reports, 1866, has answered in practice. Dr. Richard- son, who prefers mediate transfusion, uses a glass syringe holding about eight ounces, to which is attached an elastic delivery-tube. The syringe has a piston with a jointed rod. Where the rod is united to the piston, this is perforated, so that on pulling up the rod fluid will run through, getting below. On pushing the rod down, this opening is closed, and the fluid is propelled. A little water is first put in the syringe. The blood is received direct from the giver into the syringe, the jointed rod and perforated piston admitting of this without any diffi- culty. Coagulation is prevented by adding about three drops of ammonia to every ounce of blood. This enables the operator to proceed leisurely and without fear of obstruction. 2. Defibrinatcd blood is by some preferred, on the grounds that it obviates the inconveniences and danger of coagulation; that the fibrin is really useless as a renovating ingredient; and that the use of defibrinatcd blood renders it unnecessary to bring the giver into the sick room. All the preparations can be made in an adjoining room. In using defibrinated blood, the blood is first received into a basin (not less than eight ounces should be collected); then it is stirred round rapidly with a clean silver fork or a glass rod, to let the fibrine cohere and be removed; it should then be filtered through fine muslin, to stop any small coagula or air-bubbles which might be dispersed in the fluid.