Identifier: operatingroompat00fowl (find matches)
Title: The operating room and the patient; a manual of pre- and post-operative treatment
Year: 1913 (1910s)
Authors: Fowler, Russell Story, 1874-1959
Subjects: Operating Rooms Patients
Publisher: Philadelphia,: Saunders
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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g, which should always be in front, is first anesthetized bya hypodermic injection of a 4 per cent, solution of cocain or byfreezing with chlorid of ethyl. The needle of a hypodermicsyringe is first introduced until the fluid flows. This needleis left in situ. The hydrocele is now grasped behind with theleft hand^ the fluid contents forced forward and the trocar 526 OPERATING ROOM AND THE PATIENT introduced by a slight boring motion. The point of the index-finger of the hand grasping the instrument is placed firmlyagainst the trocar about an inch from its point, in order toprevent the latter from entering the cavity too suddenly andinjuring the testicle (Fig. 199). As a further precaution againstthe latter accident the point should be depressed as it entersthe cavity. An ordinary aspirator may be employed. Whenthe sac is emptied, 20 to 100 minims, according to the sizeof the hydrocele, of a 95 per cent, solution of pure liquidcarbolic acid is introduced through the previously inserted
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Fig. 199.—Tapping a hydrocele. TFoAvlers Surgery.) hypodermic needle. The cannula is now withdrawn and thesac manipulated so as to distribute the carbolic acid evenlyabout the interior. Some swelling follows, which subsides inthe course of a week or ten days, during which a suspensorybandage, padded with cotton, is worn. It is not usually neces-sary to confine the patient to the house after twenty-four hours.Should excessive reaction occur Avith eAidences of tension fromthe presence of fluid in the tunica vaginalis, secondary aspirationshould be performed and the patient kept in- bed for a few dayswith the scrotum supported. A permanent cure is usuallyeffected at one sitting. Exceptionally, a recurrence may takeplace, when a larger amount of carbolic acid should be used. OPERATIONS UPON THE FEMALE GENITALIA 527 Injection methods except in young children and in recent hydro-cele are unsafe and unreliable. The scrotum is supported. Theinjected agent, usually carbolic, may produce seve

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