ON A MODIFIED METHOD
OF USING
THE ASPIRATOR. By G. C. Roy, m.d., The tion.
has
aspirator First, by its
a
f.r.c.s.
Lond.
twofold virtue in its
ac-
suction power it draws in the
A MIRROR OF HOSPITAL PRACTICE.
June, 1883.]
second, by exclusion of air keeps the cavity aseptic. The evacuation of fluid from a cavity may be attained either by incision or tapping, but both have their disadvantages. Simple incision without fluid contents of
.
a
sac, and
163
the outer canula between which and the inner one
there
was
sufficient
interspace
for it to rush
in to fill up the vacuum. The canula was afterwards removed after having passed through it
a big-sized drainage tube into the cavity. The subsequent dressing was an easy one, and conthe spray will let in germs of putrefaction, sisted of similar aspiration under spray. Unwhilst a thick curdy fluid as the pus of liver der this treatment the cavity iapidly began to abscess, cannot be properly evacuated withcontract, and an abscess that was discharging I had lately out the suction power of a pump. 3 pints of matter on alternate days, could not under my care a case of this nature in which,
to
failing led
empty the
contrive
to
sac
of
a
liver abscess, I
which form the
measures
On each occasion
matter of this article.
hold
was
subjecta
thick-
sized trochar and canula of the size of the little
finger
introduced,
was
but
only
notwithstanding
of the fluid could be got out, that the opening of the canula
by
the introduction of the
two
an ounce or
was
probe.
kept patent The aspira-
tor, however, at once drew out from the same cavity no less than 3 pints of matter. Now if
had trusted to the trochar alone, that quanof matter would never have found an exit
we
tity
superiority of aspiration in such cases is proved beyond doubt. But towards the end of each operation as the cavity is emptied, the inThe
strument exercises its suction
power
over
the
wall of the sac, pain and rupture of the limiting membrane, and the discharge becomes blood-tinged. Besides, after the canula is withcauses
drawn, the opening closes,
a
re-accumulation of
pus takes place, and the same operation has to be repeated for an indefinite number of times till the
patient
succumbs under sheer exhaus-
tion.
To obviate this
evil,
some
other
that would combine the
measure
I
effects of both without their the following
I
was
tempted
to
disadvantages,
try and
recommend for general plan into the I thrust adoption. cavity next time a canula about the size of my little finger, introduced
the
can
aspiration
canula
through it,
and
evacuated the contents, whilst the spray continued to act at the mouth of the opening to render the air
aseptic.
the
thoroughly
cavity
was
By
traction could be exercised much
as
only
the
wall, inasbegan decline,
over
when the contents
the suction
this means, whilst emptied, no undue to
drew in the outside air through
than
more
2 ounces at
Under this modified tion without the and the constant in
a
a
week.
obtain
sucprocedure of the traction-power aspirator drainage soon places the cavity
condition to heal. in
the end of we
This step will not be abscesses, but in liver
necessary ordinary abscess and the like, where the contents mixed with
are
it is of essential service.
curdy flakes, big cavity where we cannot reach the lowest depth, a mere incision or even a drainage tube will not help the flow of matter against the law of gravitation. In empycema it is unsurgical to open at the most dependent part, because the arched roof of the diaphragm will obstruct the opening and interfere with free drainage ; whereas if the opening be made on a higher level, the residual pus at the bottom will collect and putrefy and threaten septicaeBesides,
mia.
in
a
Would it not be better in such
cases
to
plan above indicated, viz., put in a. big drainage tube and aspirate through it under follow the
spray ?
OF USING
THE ASPIRATOR. By G. C. Roy, m.d., The tion.
has
aspirator First, by its
a
f.r.c.s.
Lond.
twofold virtue in its
ac-
suction power it draws in the
A MIRROR OF HOSPITAL PRACTICE.
June, 1883.]
second, by exclusion of air keeps the cavity aseptic. The evacuation of fluid from a cavity may be attained either by incision or tapping, but both have their disadvantages. Simple incision without fluid contents of
.
a
sac, and
163
the outer canula between which and the inner one
there
was
sufficient
interspace
for it to rush
in to fill up the vacuum. The canula was afterwards removed after having passed through it
a big-sized drainage tube into the cavity. The subsequent dressing was an easy one, and conthe spray will let in germs of putrefaction, sisted of similar aspiration under spray. Unwhilst a thick curdy fluid as the pus of liver der this treatment the cavity iapidly began to abscess, cannot be properly evacuated withcontract, and an abscess that was discharging I had lately out the suction power of a pump. 3 pints of matter on alternate days, could not under my care a case of this nature in which,
to
failing led
empty the
contrive
to
sac
of
a
liver abscess, I
which form the
measures
On each occasion
matter of this article.
hold
was
subjecta
thick-
sized trochar and canula of the size of the little
finger
introduced,
was
but
only
notwithstanding
of the fluid could be got out, that the opening of the canula
by
the introduction of the
two
an ounce or
was
probe.
kept patent The aspira-
tor, however, at once drew out from the same cavity no less than 3 pints of matter. Now if
had trusted to the trochar alone, that quanof matter would never have found an exit
we
tity
superiority of aspiration in such cases is proved beyond doubt. But towards the end of each operation as the cavity is emptied, the inThe
strument exercises its suction
power
over
the
wall of the sac, pain and rupture of the limiting membrane, and the discharge becomes blood-tinged. Besides, after the canula is withcauses
drawn, the opening closes,
a
re-accumulation of
pus takes place, and the same operation has to be repeated for an indefinite number of times till the
patient
succumbs under sheer exhaus-
tion.
To obviate this
evil,
some
other
that would combine the
measure
I
effects of both without their the following
I
was
tempted
to
disadvantages,
try and
recommend for general plan into the I thrust adoption. cavity next time a canula about the size of my little finger, introduced
the
can
aspiration
canula
through it,
and
evacuated the contents, whilst the spray continued to act at the mouth of the opening to render the air
aseptic.
the
thoroughly
cavity
was
By
traction could be exercised much
as
only
the
wall, inasbegan decline,
over
when the contents
the suction
this means, whilst emptied, no undue to
drew in the outside air through
than
more
2 ounces at
Under this modified tion without the and the constant in
a
a
week.
obtain
sucprocedure of the traction-power aspirator drainage soon places the cavity
condition to heal. in
the end of we
This step will not be abscesses, but in liver
necessary ordinary abscess and the like, where the contents mixed with
are
it is of essential service.
curdy flakes, big cavity where we cannot reach the lowest depth, a mere incision or even a drainage tube will not help the flow of matter against the law of gravitation. In empycema it is unsurgical to open at the most dependent part, because the arched roof of the diaphragm will obstruct the opening and interfere with free drainage ; whereas if the opening be made on a higher level, the residual pus at the bottom will collect and putrefy and threaten septicaeBesides,
mia.
in
a
Would it not be better in such
cases
to
plan above indicated, viz., put in a. big drainage tube and aspirate through it under follow the
spray ?
