864 CHEMOTHERAPY 



This consists of a single cylinder to the narrow lower end of which about 

 five feet of rubber tubing are attached. A piece of glass tubing is in- 

 serted at the lower end to serve as a window, and at the end there is an 

 arrangement whereby it can easily be attached to the needle used for 

 making venipuncture. A clamp is placed on the tubing at some con- 

 venient place, where it may be operated by an assistant. 



Whatever apparatus is employed, it should be sterilized before use. 

 The cylinders and needle are boiled in an office sterilizer, and the tubing 

 is cleansed by running sterile salt solution or water through it. The 

 needle should have a sharp point with a short beveled edge, as a long- 

 pointed needle may pierce the vein through and through. Sufficient 

 sterile distilled water or normal salt solution is added to fill the rubber 

 tubing, while the cylinder should contain an additional 10 or 15 c.c. 

 If the double cylinders are used (Fig. 146), one should contain from 20 to 

 30 c.c. of salt solution or water and the second the solution of the drug. 

 The solution of drug is then filtered into the second cylinder, and the 

 pinch cock opened for a minute to be sure that all air has been expelled. 



2. The patient should lie on a bed or on an operating table. An arm 

 usually the patient's left in the case of right-handed operators is 

 prepared by placing a few towels around it and a firm tourniquet is ap- 

 plied above the elbow. Whatever material is used, whether rubber or a 

 broad muslin bandage, it should be fastened with a hemostat, for when 

 it becomes necessary to unfasten it, this may be done quickly and with 

 least disturbance by the operator, who simply unfastens the hemostat. 

 The skin over a prominent vein may be cleansed with green soap and 

 water, followed by alcohol and 1 : 100 bichlorid solution, or simply by 

 adding one or two coats of 10 per cent, tincture of iodin, which is washed 

 off with cotton and alcohol just before the needle is inserted. In fat 

 subjects a vein can frequently be felt when it cannot be seen. Occasion- 

 ally it may be necessary to infiltrate the skin with sterile eucain solution 

 and expose the vein by incision. In nervous subjects the routine opera- 

 tion of inserting the needle can be made practically painless by infil- 

 trating the skin over a vein with a few drops of a sterile 1 per cent, 

 solution of eucain. 



3. The operator now passes the needle into a vein. With experience, 

 considerable skill is gained in performing this little operation. A free 

 flow of blood indicates that the needle has been properly inserted, and 

 one can easily tell by the sense of touch whether the needle is free in the 

 lumen. The tourniquet is then quickly and deftly released by the oper- 

 ator, the clamp on the tube is opened, and while the blood is flowing from 



