SALINE INFUSION 519 



proximal ligature is tied, with the first part of a surgeon's knot, about 

 the vein and canula, holding the latter in place and preventing leaking 

 of the salt solution from the vessel. When the injection is completed, 

 the tube is withdrawn and the proximal suture is tied on the heart side 

 of the incision, and thus the vessel is occluded on either side of the seat 

 of operation. A simpler method consists in connecting the tubing with a 

 sterile, hollow aspirating needle which is plunged into the vein through 

 the skin or, more certainly, after exposing the vein as above. The appa- 

 ratus is filled with salt solution — including the funnel, tubing, and canula 

 — at a temperature of 103° F. before its introduction into the vein, and 

 the funnel should be kept full during its use to prevent the entrance of 

 air into the vessel. Any pressure, previously employed between the in- 

 cision and the heart, should of course be removed before beginning the 

 injection. A little sterile absorbent cotton may be placed at the bottom 

 of the funnel before the salt solution is poured into it, if the so'ution has 

 not been previously filtered. In using the apparatus the funnel is raised 

 about two feet above the vein. The quantity of salt solution to be in- 

 j ected will vary from a few ounces to two pints in the case of dogs ; 

 from 2 to 6 quarts for horses. Considerable quantities of isotonic salt 

 solution may be introduced into the blood without harm, not exceeding 

 30 mils per kilo live weight (Crile), providing the inflow is not too rapid; 

 i.e., exceeding one fluid dram to the pound of live weight in fifteen min- 

 utes. When this amount is exceeded the heart and kidneys cannot take 

 care of the great quantity of fluid in the vessels and tissues. A return to 

 the normal volume, force, and rate of the pulse, and of color to the mucous 

 membranes, will lead us to stop the saline infusion. The use of intra- 

 venous saline injections is frequently followed by a reaction within half 

 an hour, characterized by a severe rigor, succeeded by sweating, labored 

 breathing, a strong pulse and increased urinary secretion. 



Hypodermoclysis. 



Injection of warm (103° to 105° F.) normal salt solution into the 

 subcutaneous tissue of the neck, abdomen or thigh, is done aseptically 

 with the same apparatus employed for intravenous saline infusions, using 

 a large hollow needle to thrust under the skin instead of the glass tube 

 for intravenous injection; or a fountain syringe filled with saline solution 

 and attached to a sterile aspirating needle may be used ; or a reversed 

 aspirator apparatus may be utilized: i.e., by filling the jar with salt solu- 

 tion and forcing the air into the jar, thus displacing the fluid. The foun- 

 tain syringe is the best apparatus. Hypodermoclysis may be employed 

 in the same cases as intravenous infusion, and is simpler but not so ef- 

 fective. We are guided as to the quantity of solution desirable by the 

 same indications noted above as referring to intravenous saline injections. 

 Hypodermoclysis may be done in several places, and absorption is assisted 

 by massage. Salt solutions are injected under the udder in females. 



Enteroclysis. 



Enteroclysis applies to slow, rectal injection of normal salt solution 

 (105° to 120° F.) to secure absorption. This method may be ajijil-ed 



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