BAIRJD &TXTLOCK (LONDON) LTD. 



The needles should be sterilised in olive oil by heating them to 140 C. in one of the test tubes plugged 

 with wool. Before being heated in oil, the needles, if wet with water, must be rinsed in spirit, and great care 

 must be taken that the fine bore is not obstructed by blood or any other matter. 



The rubber pump requires no sterilisation. 



Remove the glass stopper of the bottle and shake in the contents of a capsule of Salvarsan (0.6 grammes). 

 Agitate the bottle so as to incorporate the powder with the glass beads. Fill the bottle with sterile saline 

 solution prepared from freshly distilled water and pure sodium chloride. Replace the cork and shake thoroughly. 

 Stand the bottle in hot water to hasten solution and to warm it. Shake occasionally. The solution should 

 feel luke warm to the hand at 'the time of injection. 



Boil the Rubber Cork and its appendages for 10 minutes and then, after draining, place it in the sterile 

 metal box. 



Having prepared the bottle of 15% Sodium Hydrate solution, and having sterilised the needles, the apparatus 

 may be packed for transport and use within a couple of hours. The needles may be carried with their wires 

 in situ in one of the test tubes, the points being directed towards the cork. 



At the bedside, remove the glass stopper from the bottle and add drops of Soda until the precipitate, which 

 immediately forms, is just re-dissolved. This will require about 23 drops of 15,, Soda Solution for 0.6 grammes 

 of Salvarsan. Care must be taken that the fluid is alkaline to litmus paper, since if too little soda is added, 

 solution of the precipitate will occur owing to the original acidity of the Salvarsan. 



Acid solutions are highly toxic. 



" Screw " the rubber stopper (c) firmly into the bottle containing the solution of " 606." Insert the two 

 filters (D and G), lightly plugged with wool, and attach the pump (F). Close the clip (E), and put a clip (N) en 

 the tube leading to the needle. Give two or three pumps, and by momentarily releasing the clip (N) expel the 

 air from the tubes. Attach the needle to the holder and again expel the air and oil by momentarily releasing 

 the clip (N). Next, keeping the clip (N) in position, open the clip (E) for a few moments to relieve pressure in 

 the bottle. Attach the bottle to the bedclothes by means of the collar and spike, so that it hangs on the side 

 of the bed at a lower level than the patient's arm. A tourniquet having been placed on the arm, so that the veins 

 stand out, sterilise the skin with Ether from the bottle and after again making certain that the needle is filled 

 with solution to the tip, push the needle into a vein with the bevel down. Release the clip (N) entirely. The 

 pressure in the vein will cause the blood to appear at the window (L). The needle must then lie in the vein. 

 Next fasten the needle in position by laying a strip of adhesive plaster across the wings of the holder (M), these 

 wings having been arranged to lie flat on the arm when the bevel of the needle is down. The strapping may 

 conveniently be applied to the skin on one side before the needle is inserted and afterwards carried across to 

 the other side. Release the tourniquet and give three or four pump?, and the blood will soon be seen to be 

 washed from the window (L). and the injection will proceed without any trouble other than four or five applica- 

 tions of the pump. Do not apply much pressure. Three hundred cc. are introduced in from six to nine minutes. 

 At the end, re-apply the clip (N), entirely remove the clip (E), and press the air out of the bulb of the pump. 

 Then release the clip (N) and the blood will syphon from the vein into the window (L). Re-apply (N) and with- 

 draw the needle. Press upon the puncture and hold the arm in a vertical position for a moment or two. No 

 dressing is applied, but the arm is wrapped in a clean towel and flexion of the forearm is not allowed for one hour. 



The success of a vene-puncture depends largely upon the condition of the vein and the position of the light 

 by which the operation is performed. This must be held at right angles to the line of the vein and low down 

 to give greater relief. It is also necessary to obtain a maximum prominence and distension of the vein to facilitate 

 entry and to force the blood to appear readily at the window. Engorgement of the veins cannot be obtained 

 readily by a circular application of a bandage. The best method is as follows : pass a piece of three inch bandage 

 behind the arm and bring the two ends to the front : then, pulling very tightly, cross and reverse the ends, and 

 carry them round again to meet on the outer side of the limb. Here tie a bow. In order to avoid pinching the 

 skin under the point of reversal, place a " swab " between the knot and the skin. The veins can be made still 

 more prominent by repeated clenching of the fist and by rubbing with Ether during the process of sterilisation. 



The state of the rubber tubing should be noted periodically. It is most apt to perish at the points at 

 which the retaining wires are applied. 



488 





489 



488 Mice Glasses, size about 8 by 6 in., with wire cover and bayonet joint 



489 Mice Glasses, of clear glass, with wire gauze cap, weighted with lead. 



Height 



Diameter 



Price 



8 in. 



4 in. 

 2/6 



each 066 



Sin. 

 6 in. 

 3/6 



CROSS STREET HATTCTM GARDETST, E- C 



lOfi 



