. A practical treatise on medical diagnosis for students and physicians . Lumbar puncture—introducing the trocar. above the body of the first lumbar vertebra. (2) The method of Jacoby,which depends upon the fact that a line drawn through the crests of theilia across the back intersects the spinous process of the fourth lumbarvertebra. (3) The spinous process of the fifth lumbar vertebra is con-. Lumbar puncture—introducing the trocar. siderably more prominent than the spinous processes of the sacrum, andthis peculiarity may be utilized as a check upon the other two in all c
. A practical treatise on medical diagnosis for students and physicians . Lumbar puncture—introducing the trocar. above the body of the first lumbar vertebra. (2) The method of Jacoby,which depends upon the fact that a line drawn through the crests of theilia across the back intersects the spinous process of the fourth lumbarvertebra. (3) The spinous process of the fifth lumbar vertebra is con-. Lumbar puncture—introducing the trocar. siderably more prominent than the spinous processes of the sacrum, andthis peculiarity may be utilized as a check upon the other two in all cases all three methods should be employed. A markon the skin may be made with an indelible pencil or with a soft lead TECHNIC OF EXPLORATORY PUNCTURE. 687 pencil. As the former is soluble in the alcohol and ether used in pre-paring the skin, the latter is preferable. Technic. The technic is as follows : The patient may be eithersitting up or lying upon the side. The former position can only beused in patients who are conscious and not suffering from severe disease,as, for example, in cases of brain tumor and chronic patient sits preferably cross-wise upon a narrow operating-table ;the body is bent well forward, separating the spines of the vertebra asmuch as possible. The latter position should be used if the patient isseriously ill. The patient should lie upon the si
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