Diseases of the nervous system .. . ch a height that the fluid column is in equilibrium, when its vertical position from the point of opening will show the existing pres-sure; after this has been noted (naturally taking into account the previously mentioned secondary in-fluences) the glass tube is lowered (10 to 20 mm.) below the height of pressure so that the fluid may slowly drop into a graduated cylinder. At the conclusion of the operation, the needle is withdrawn, and the fluid which is seen to exude from it is allowed to trickle into the vessel con-taining the rest of the fluid, and the p
Diseases of the nervous system .. . ch a height that the fluid column is in equilibrium, when its vertical position from the point of opening will show the existing pres-sure; after this has been noted (naturally taking into account the previously mentioned secondary in-fluences) the glass tube is lowered (10 to 20 mm.) below the height of pressure so that the fluid may slowly drop into a graduated cylinder. At the conclusion of the operation, the needle is withdrawn, and the fluid which is seen to exude from it is allowed to trickle into the vessel con-taining the rest of the fluid, and the point of puncture is closed. I shall now describe the hollow needle, 4 to 10 cm. long and to mm. in thickness, serves as the instrument for puncture; all of my needles except the smallest sizes have a steel mandrin which fits them exactly and extends to the point, being ground so as to match the slanting surface of the needle. I believe the mandrin very useful because, if the needle does not at once enter the dural. ( FiG. 129 6. LUMBAR PUNCTURE 237 sac and while we are moving its point about, particles of tissue may easilyslip into the opening and occlude it. After passing the interarcual spacethe mandrin may be removed, and the position of the needle may be shifteda little until fluid appears. The handle is attached to a well fitting conewith a rubber tube and a glass tube; both should be of narrow lumen () so that too much fluid shall not escape before the pressure is adjoining illustration shows the proper shape of the glass tube for theoutlet of the fluid; this should be from 10 to 15 cm. long, the length of therubber tube being 20 to 40 cm. Its length should correspond with the expectedpressure, and if insufficiently long it may be extended. To measure the pressure we use a metallic rule half a meter in length,this being held vertically with the zero figure at the point of puncture; or ametallic tape-measure may be used. To preven
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