Diseases of the nervous system .. . Fig. 134 a. Fig. 134 6. 240 LUMBAR PUNCTURE 241 ness of the muscles. In following this rule the dural sac will not be pene-trated immediatel)^ but the needle will meet the bone or tough must then be withdrawn and carefull} inserted in another direction. Wecan often feel the needle enter the dural sac, and sometimes the patient isconscious of this by the pain he feels. To determine the location of the pointof the needle, we must notice the depth to which it has entered; if correctlyinserted, in adults it must penetrate from 4 to 6 cm. before flu
Diseases of the nervous system .. . Fig. 134 a. Fig. 134 6. 240 LUMBAR PUNCTURE 241 ness of the muscles. In following this rule the dural sac will not be pene-trated immediatel)^ but the needle will meet the bone or tough must then be withdrawn and carefull} inserted in another direction. Wecan often feel the needle enter the dural sac, and sometimes the patient isconscious of this by the pain he feels. To determine the location of the pointof the needle, we must notice the depth to which it has entered; if correctlyinserted, in adults it must penetrate from 4 to 6 cm. before fluid exudes, theslighter depth being in delicate, weak persons or women, the greater depth incases the reverse of these. In large, muscular men the depth to which theneedle penetrates ma}^ ]ye from ? to 8 cm., in a stout person even to 10 the rare cases in which there is cutaneous edema, this must be consideredand an effort made to remove it by pressure before the puncture. It is advisable always to note the depth to which the
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