30 



EXERCISE V 



clearly bare for 1 cm. The mid-finger of the left hand is then placed on the 

 skin at the top end of the wound, compressing the vein there. The right hand 

 holding the barrel of the syringe, as a fiddle-bow is held, between thumb and 

 forefinger, leaves the little finger free to press the handle of the piston 



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Text-fig. 14. Position of left-hand limb and mode of exposing the internal 

 saphena vein for intravenous injection by the needle-syringe. The position of 

 medial malleolus and the general course of the saphena indicated by dot ted lines. 



(text-fig. 15). The needle-point is introduced very obliquely into the dis- 

 tended vein near the lowest end of the wound and threads the vein with the 

 distal cm. of the needle, care being taken not to prick the vein from the inside. 



Text-fig. 15. Needle-syringe and mode of holding it for inserting 

 needle-point into vein and for delivering the injection. The stop on 

 the piston is screwed down as far as the mark on the piston-stem 

 limiting the quantity to be injected as desired. 



A branch of the internal saphenous nerve often crosses the vein in the 

 wound ; this, if touched, excites reflex movement and will disturb the manipu- 

 lation. It is best, when the nerve is seen, to snip it across with scissors at 

 the top end of the wound and thus prevent the reflex. If the introduction of 



