The hypodermic needle is then introduced after expulsion of all the contained air and the piston is drawn up until the blood enters. This assures the operator that the needle has entered the vein. The bandage is now loosened and the solution of the drug is introduced very slowly.
Intravenous infusion or transfusion is given in the same way. The fluid (normal saline?) must be running from the needle as it is introduced.
Hypodermoclysis is the introduction of normal saline solution, under the skin, or under the breasts. The solution may be transfused also into a vein.
By this operation, the quantity of fluid in the vessels is greatly increased and a circulatory stimulant is provided. Normal saline also promotes diuresis and aids in the removal of wastage.
The principal dangers arise from too great rapidity or too large a quantity of the flow.
The skin should be sterilized at the point of attack by a coating of tincture of iodine.
The instruments required are, a bath thermometer, a douche can (fountain syringe) with long tubes and an aspirating needle. A hypodermic needle will do, but the reservoir must be well elevated since the caliber is so small. Ordinarily the reservoir need be held only two or three feet above the point of discharge. The water should be flowing through the needle when it enters the tissues. If the fluid is to be introduced under the skin, the best place is in the loose region between the hips and the ribs in front. If under the mammary gland, the needle must go below and under the gland from the outside edge, not into the gland. If into a vein, such additional instruments will be needed as a rat-toothed tissue forceps, a pair of sharp-pointed scissors, a knife and some fine catgut. From four to sixteen ounces of fluid may be used at a temperature varying from 105° to 110° F.
The openings where the needles entered are closed by cotton and collodion.
Curettage of uterus is done for abortion or puerperal sepsis when foreign fragments are left in the uterus. The room is prepared as for delivery.
The instruments are: