Principles and practice of physical diagnosis / by John C. DaCosta ... ; with 225 original illustrations.

  • Da Costa, John C., jr., 1871-
Date:
1911
Catalogue details

Licence: Public Domain Mark

Credit: Principles and practice of physical diagnosis / by John C. DaCosta ... ; with 225 original illustrations. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    most of the air has been pumped out, the vacuum thus created being maintained by the closure of both stop-cocks. Suction is established by opening the needle stop-cock (the pump-cock remaining closed) Fig. 17.—Aspiration syringe and needles. just sufficiently to start a slow flow of liquid into the bottle. If it be necessary to interrupt the aspiration for the purpose of decanting the fluid and reexhausting the air within the bottle, the needle-cock must remain closed meanwhile. Failure to insert the needle to a sufficient depth commonly accounts for a dry tap, the remedy for which is obvious, while a sluggish, intermittent flow may be due to blocking of the needle's lumen by a flake of fibrin, to unusual thickness and viscidity of the exudate, or to feeble aspiration force. These last obstacles can generally be overcome by reinserting the needle in a different direction after having partly withdrawn it and cleared its bore with a sterile wire, by the use of a needle of larger caliber, or by exhausting more air from the bottle. Having finished the aspiration and measured the fluid withdrawn, a portion for subse- quent examination is poured into a sterile container, or the vacuum bottle itself is taken directly to the laboratory. The laboratory report should embody data relating to the following points: (a) The physical properties of the fluid—specific gravity, color, odor, transparency, consistence, coagulability, and amount of sediment; (b) chemic examination of the filtrate, including tests for albumin, serum-globulin, and mucin; for sugar and urea; and, occasionally, for sarcolactic acid, succinic acid, allantoin, and inosite; (c) microscopic examination, for the detection of blood-corpuscles, epithelial and endothelial cells, crystals, necrotic tissue, ray fungi, hydatid hooklets and membrane, trypanosomes, piroplasmas, ame- bas, and pathogenic bacteria, which, if not demonstrable by direct examination, may be identified by culture and by animal inocula-