SUMMARY. 427 



patient seems to be developing alarming symptoms, it indicates 

 that an unusually large dose of venom has been injected. 



(5) For intravenous injection, a vein of the forearm should 

 be selected for preference. The vein should be made prominent 

 by pressure above. The syringe and needle should be held 

 almost parallel to the vein, keeping the oblique opening at the 

 point of the needle upwards. The operator steadies the vein with 

 his left hand and introduces the needle. When the needle is kept 

 parallel to the vein with the slant at the point upwards, steady 

 pressure carries it into the vein without difficulty, and avoids 

 puncturing both walls of the blood-vessel. As soon as the needle 

 is in the vein, remove the pressure above, and slowly inject the 

 serum. A local subcutaneous swelling appearing during the 

 operation of injection shows that the needle is not in the vein, 

 and a fresh attempt should be made to introduce it. 



(6) If there are any albuminous deposits or flocculi in the 

 bottle, the serum should be filtered through the corner of a clean 

 linen pocket-handkerchief or a piece of clean rag into a wine- 

 glass or other convenient receptacle, previous to using it. This 

 is not essential if injecting under the skin. 



If boiling water be at hand, dip the cloth into it and wash 

 out the vessel before straining. A one per cent, solution of per- 

 manganate of potash or boracic acid would do instead of boiling 

 water, for sterilizing the cloth and vessel. 



(7) The serum syringe should be perfectly clean. The best 

 plan is to boil it in water to which some borax has been added. 

 Then oil and put it away in its case, ready for use. Examine it 

 occasionally to see that the needle is not getting rusty. 



If any antiseptic such as strong alcohol or permanganate 

 in solution be at hand, wash the site of the proposed injection 

 with it. If no antiseptic is to be had, then rub the spot clean. 



(8) An albuminous precipitate in the bottle does not indicate 

 contamination, and would be quite harmless if given subcu- 

 taneously. 



For obvious reasons, it would not be safe to inject a preci- 

 pitate of any kind direct into a vein, hence the necessity for 

 filtering the serum through a clean cloth or muslin before in- 

 jection into a vein. 



{9) Be sure that your syringe is in good working order, so 

 that it will take up a charge of serum without any difficulty. 



