. L3. Fig. 178.—Seat of operation for puncturing the pericardium by way of tlie ensiform cartilage. L B, AVhite line; H, line of the hypochondrium; , anterior mammary vein; P, point where the pericardium is punctured through the incision. pectoral muscles attached to the neck of the ensiform cartilage can then be divided with the bistoury. The area of operation is thus uncovered. Second stage. The second phase comprises incision of the tissues opposite the neck of the ensiform cartilage, about 8 inches in front of the base of the triangle and at equal distances from the points Nos. 1 and
. L3. Fig. 178.—Seat of operation for puncturing the pericardium by way of tlie ensiform cartilage. L B, AVhite line; H, line of the hypochondrium; , anterior mammary vein; P, point where the pericardium is punctured through the incision. pectoral muscles attached to the neck of the ensiform cartilage can then be divided with the bistoury. The area of operation is thus uncovered. Second stage. The second phase comprises incision of the tissues opposite the neck of the ensiform cartilage, about 8 inches in front of the base of the triangle and at equal distances from the points Nos. 1 and 2; incision through the skin for a distance of 8 inches, and dis- section of the muscles of the ensiform region exposed at the neck of the cartilage. By means of the index finger or the index and middle fingers of the right hand the mediastinal space is explored, and the fatty masses round the base of the heart broken through. If the pericardium is greatly distended, the point of the sac can be felt wdth the tip of the finger, or its position can be recognised, even from a little distance, on account of the fluid contents transmitting the impulse of the heart. The sensation conveyed to the finger is very clear. c c 2
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Keywords: ., bookcentury1900, bookdecade1900, bookpublishernewyorkwrjenkins
