. A practical treatise on medical diagnosis for students and physicians . )ray,by ice and salt, or in adults by the Sehleicli method of subcutaneousauiesthesia. Care must be taken, if the patient is aged or poorly nour-ished, or the skin cedematous, not to carry the freezing process too faron account of the danger of local gangrene. The Point of Puncture. The points selected for aspiration dependupon the cavity to 1)C explored or the situation of the cyst. The Pleura. To withdraw fluid Avithin the pleura, it is best to selecta point for asj^iration in one of the lower interspaces of the chest,
. A practical treatise on medical diagnosis for students and physicians . )ray,by ice and salt, or in adults by the Sehleicli method of subcutaneousauiesthesia. Care must be taken, if the patient is aged or poorly nour-ished, or the skin cedematous, not to carry the freezing process too faron account of the danger of local gangrene. The Point of Puncture. The points selected for aspiration dependupon the cavity to 1)C explored or the situation of the cyst. The Pleura. To withdraw fluid Avithin the pleura, it is best to selecta point for asj^iration in one of the lower interspaces of the chest, be-cause the fluid is more likely to accumulate in this position and becausecomplete aspiration can there be performed if necessary. The sixth or Fig. Aspiration of a pleural effusion. seventh in the anterior axillary line, or the eighth or ninthinterspace in the posterior axillary or scapular line, may be the right side the upper interspace of the two should be chosen onaccount of the position of the liver. If the contents tend to point orbreak out at any particular spot on the surface of the chest, the puncturemay be made in this area. In suspected loculated empyema or effusions, 684 EX PL ORA TORY P UNCT VRE. the point of puncture should be at the site of greatest dulness and leastfremitus. The Pericardium. For aspiration of the pericardium three points ofelection have been recommended : first, the usual position of the apex-beat, in the fifth inters[)ace, inside of the midclavicular line ; second, thespace between the ensiform cartilage and the left seventh cartilage, thepoint advised by Roberts ; third, liotch has tapped the fifth right inter-space a number of times on the cadaver, and thinks that this s
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