. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. nsiderable pressureshould be brought to bear on the neck, since in cerebrospinal menin-gitis or in the basilar form of meningitis in which there is opisthotonos,serious injury to the neck may result. The spine is curved fromthe shoulders and pehis. The sterilized needle is introduced in themedian line between the spinous processes at right angles to a tangentto the spine (Plate II). When it is in the canal, it is perceived thatthere is a lack of resistance, and that the point of the instru
. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. nsiderable pressureshould be brought to bear on the neck, since in cerebrospinal menin-gitis or in the basilar form of meningitis in which there is opisthotonos,serious injury to the neck may result. The spine is curved fromthe shoulders and pehis. The sterilized needle is introduced in themedian line between the spinous processes at right angles to a tangentto the spine (Plate II). When it is in the canal, it is perceived thatthere is a lack of resistance, and that the point of the instrument isfree. The cannula is withdrawn and the first drops caught in a sterilizedtest-tube. A second test-tube is substituted for the first after a fewdrops of fluid have been allowed to flow out, and from 10 to 50 offluid are withdrawn, the amount varying with the pressure. If thefluid flows drop by drop, 20 are sufficient for diagnostic purposesand also to relieve the pressure. If there is opisthotonos and the fluiddoes not flow well at first, cautious straightening of the neck will <-J. facilitate the outflow. In infants the fontanelle is a good guide ingauging the pressure. As soon as a few cubic centimeters of the fluidhave been withdrawn, the fontanelle will be felt to be considerablyrelaxed or even depressed. If determination of pressure is desirable, the manometer tubingshould be immediately attached as soon as the obturator to the cannulais withdrawn, care being taken not to allow any of the fluid to escape,for this would invalidate the determination of pressure. The manom-eter is held at right angles to the spine in an upward direction as thepatient lies recumbent. The fluid from the spinal canal will rise in themanometer to the point where the glass is crooked; it must not beallowed to flow over the curve; the measurement is then taken of theheight of the column of liquid. After this is done the manometer tube islowered and the fluid is allowed to escape.
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Keywords: ., bookcentury1900, bookdecade1910, bookpublish, booksubjectchildren
