APPENDIX 335 



must be added. The additions of caustic soda or hydro- 

 chloric acid can best be controlled by taking them with 

 pipettes or droppers (D) from the medicine glasses (G). 

 The rubber tubing incorporating the transfusion thermom- 

 eter (T) and fitted with the platinum-iridium needle (P) or 

 the blunt infusion needle (N), rarely necessary, is adjusted to 

 the burette, which with the tubing is thoroughly rinsed out 

 and the tubing and needle filled with warm normal salt solution 

 (S), the tubing being freed of air by alternately elevating 

 and lowering the burette and needle, as shown in Fig. 64. 

 The weakly alkaline solution of salvarsan is then filtered 

 through sterile cotton contained in the funnel (F) into 

 the graduated burette (Fig. 65). Sufficient warm (110° 

 to 120° F.) sterile 0.5 per cent, saline solution made from 

 freshly distilled water is then passed through the cotton 

 filter, filling the burette to the 300 cubic centimetre mark.^ 

 This is the proper dilution for 0.6 gramme salvarsan. The 

 quantity is diminished by 50 cubic centimetres for each 0.1 

 gramme less of salvarsan. 



With the patient supine and the arm moderately abducted 

 and forearm supinated, the region of the elbow is antisepti- 

 cized with soap and water, alcohol and bichloride or a three 



* In view of the recommendation that the preferable diluting fluid 

 for salvarsan is 0.5 per cent, saline, while for neosalvarsan it is 0.4 per 

 cent, salt solution, the authors have found it practicable and con- 

 venient from the standpoint of preparation of solutions to utilize two 

 standard solutions — 0.9 per cent, chemically pure sodium chloride solu- 

 tion and freshly distilled water. From these any desired strength saline 

 solution can be readily prepared. For instance, in diluting the salvarsan 

 solution, distilled water is added until the quantity in the burette reaches 

 135 cubic centimetres, then 0.9 per cent, salt solution is added until the 

 amount equals 300 cubic centimetres. In the case of the full-sized dose 

 of neosalvarsan, the dilution is made first with distilled water to the 

 85 cubic centimetre level, then 0.9 per cent, salt solution is added imtil 

 the quantity in the burette stands at 150 cubic centimetres. 



