734 GENERAL THEBAPEUTIC MEASURES 



an assistant, or by a bandage, applied proximally to the Bttx^j 

 of operation. The hair is shaved from the part, which is 

 cleansed, and an incision I5 to 2^ inches long is made hj 

 lifting a fold of the skin directly over the vein and snip- 

 ping off the top of the fold with scissors parallel to 

 its long axis. The sheath of the vein is exposed, raised by 

 dissecting forceps, and divided. The vein is then lifted from 

 its bed with an aneurism needle, and two silk or catgut liga- 

 tures are drawn under it about an inch apart. The vein is 

 now incised longitudinally, and, as the blood begins to spurt 

 out, the distal ligature is tied about the vessel. The canula 

 is next passed into the incision in the vein toward the heart 

 and the 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 with- 

 drawn 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. Tte apparatus is filled with salt 

 solution — including the funnel, tubing, and canula — at a 

 temperature of 103° to 110° 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 incision and the heart, 

 should of course be removed before beginning the injection. 

 A little clean absorbent cotton may be placed at the bottom 

 of the funnel before the salt solution is poured into it, if the 

 solution has not been previously filtered. In using the ap- 

 paratus the funnel is raised about two feet above the vein. 

 The quantity of salt solution to be injected will vary from a 

 few ounces to two pints in the case of dogs ; from one to 

 many quarts for horses. Enormous quantities of normal 

 salt, solution may be introduced into the blood without 

 harm, even an amount equal to four times that of the blood, 

 providing the inflow is not too rapid ; i. e., exceeding one 

 fluid drachm to the pound of live weight in fifteen minutes.. 

 When this amount is exceeded the heart and kidneys cannot 



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