Modern surgery, general and operative . / M \ What is known as a dry tap may be due to the entire absence of fluid, to encapsula-tion of fluid in a region not invaded by theneedle, to the lodgment of the point of theneedle in thickened pleura or in an adhesion, or to blocking of the lumenof the needle with coagula. Fowler^ points out that if a person has beenrecumbent for a long time the upper layer of fluid may be clear, while thelower layer is purulent. The fluid should be coUected in a sterfle glass tubeand subjected to a careful bacteriological study. Paracentesis Thoracis.—The operation o
Modern surgery, general and operative . / M \ What is known as a dry tap may be due to the entire absence of fluid, to encapsula-tion of fluid in a region not invaded by theneedle, to the lodgment of the point of theneedle in thickened pleura or in an adhesion, or to blocking of the lumenof the needle with coagula. Fowler^ points out that if a person has beenrecumbent for a long time the upper layer of fluid may be clear, while thelower layer is purulent. The fluid should be coUected in a sterfle glass tubeand subjected to a careful bacteriological study. Paracentesis Thoracis.—The operation of tapping with a trocar and al-lowing the fluid to flow out through the cannula is no longer practised exceptin an emergency, when an aspirator cannot be obtained, or in an early stageof non-traumatic pneumothorax. An aspirator is a much better consists in the introduction into the pleural sac of the tipof a hollow needle, the other end of which is attached by means of a rub-1 Annals of Surgery, November, Fig- 570.—^Diagram of Elsbergs apparatusshowing essential parts. The Operation for Creating Artificial Pneumothorax 907 ber tube to a bottle from which the air has been exhausted. The fluiddoes not run out, but is sucked out, air is excluded, and bacteria do notenter the pleural sac. Fig. 434 shows a pneumatic aspirator. No anes-thetic is required. The patients skin, the instruments, and the surgeonshands must be thoroughly asepticized. The patient is given a little whisky,and, unless he is very weak, he assumes a semi-erect attitude, with the armhanging by the side. The trocar is introduced in the fifth interspace, justin front of the angle of the scapula. The surgeon marks the upper bor-der of the sLxth rib with the index-finger, and plunges in the trocar just abovethe finger, thus avoiding the intercostal artery, which lies along the lowerborder of the rib above. He guards the needle with the index-finger to pre-vent its going in too far. T
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
