Hypodermic needle

“ The druggist handed him a new, long hypodermic needle, then the epinephrin.
“We hear a great deal nowadays about the glands, the endocrine glands,” said Kennedy, proceeding quickly with his sterilizing and antiseptic preparations. “One gland that has a striking influence on the chemical overturn in the body is the central, or medullary, portion of the adrenal. ”

“ Before taking off the suction syringe after the passage of the needle sweep the point slowly in a circle to make sure that no vein has been opened or is likely to be opened as the needle is swept about.
The hypodermic needle for injection.
A hypodermic needle may be used for an internal ring injection or an injection through the anterior wall of the canal, but in moving it about the operator should watch carefully and not break such needle. If a needle breaks it will be at the shoulder formed by the point of attachment of the shaft of the needle with the butt. ”

“ We consider it best to employ a short needle in aspiration, for fear that a delicate hypodermic needle might break. Flint states that he has known several instances of this accident. Aspiration can be performed with perfect safety, and, indeed, without any fears of unpleasant results even if we perforate an aneurism. The orifice made is so small that the tissues close the moment the needle is withdrawn after making the exploratory puncture. If care be taken to cleanse the instrument and to use Listerism that no deleterious germ be introduced, the operation is harmless. (See Purulent Pleurisy.) ”

“ Aspirating of blood may mean the puncture of this large vein and it may not be advisable to inject carelessly when this vein has been wounded owing to its size. The crural canal is only about a half inch in length. The injection of it may be accomplished with a hypodermic needle. It is not well to sweep the point of the needle externally with too [Pg 52] great freedom as the vein may be wounded. Inject slowly and move the point of the syringe carefully so that the injection may be diffused in the canal. ”

“ I want to add here that should you run out of sterilized gauze at any time you can make it from any soft cloth by boiling it for ten minutes in the bichloride solution and hanging in the air to dry.
The pain attendant upon any surgical manipulation can be prevented by the hypodermic injection of a solution of cocaine. When you get your hypodermic have the instrument man show you how it works. He can show you much better than I can tell it. Insert the needle half an inch from the wound and inject a few drops of the solution into the skin. ”

“ For the initial puncture in sensitive or inflamed tissue, it is proper to use a needle of the finest lumen so as to cause the least possible amount of pain. The ordinary needle, which comes with the usual hypodermic outfit, is about the proper length for the ordinary work already mentioned, but could be improved upon for anesthesia by being made a little finer in calibre. This length (three-quarters of an inch) will be frequently found insufficient to reach the deeper tissues and in the [Pg 239] removal of a more or less rounded growth, a longer needle must be selected at the start. ”

“ With some, the injection into external hemorrhoids is quite painful at the first contact of medicine, but immediately thereafter subsides. Where the tumor is very sensitive, external or internal, precede by a hypodermic of from three to five minims of a five per cent. solution of cocaine. Introduce the needle point barely underneath the covering of the growth and force out one drop. ”

“ A common glass barrel, metal bound, hypodermic syringe is all that is needed. It should be provided with side handles. Draw the medicine into the syringe before screwing on the needle, force out the air and gauge the nut on the piston for about as many minims as thought will be required. ”

“ Usually only medical men should administer hypodermic injections. Frequently it is not necessary to give a hypodermic injection, for the hypodermic tablet will be absorbed, and act almost as quickly if placed under the tongue. ”

“ The location of the hypodermic injection varied according to the amount of adipose tissues in the subject. In those who had but little adipose tissue the hypodermic injection remained immediately below the skin, while in those who had much, the injection diffused itself. It would be seen in the specimens presented that the hypodermically injected mass [100] lay close to the arteries and veins; sometimes it completely surrounded an artery or vein. This, together with some other experiments, proved that it was by the blood vessels and not by the lymphatics that absorption took place. ”

“ DR. NATHAN SMITH DAVIS, OF CHICAGO.
The name of Pravaz, the Lyons surgeon, has been perpetuated by the hypodermic syringe which he devised. The employment of suitable drugs in this instrument is the method par excellence for relieving pain. With it drugs can be injected into unconscious patients. Suicides who refuse to swallow emetics can have their stomachs emptied most effectually of their contents by a hypodermatic injection of apomorphine. ”

“ Many a physician who has used bread pills or other placebos to replace a drug that he did not want the patient to acquire a habit for, has thus been able to allow good effects to go on without interruption, where the stoppage of medicine had previously interfered with the continuance of the good habit that had been formed. Very few physicians have not seen the effect of a hypodermic of pure water when a hypodermic of morphine is demanded, and when the patient would not sleep without having the hypodermic injection. ”

“ The experience of Pasteur, Brown-Sequard, and our own specialists, in the use of extracts of nerve substance and of certain glands and organs by hypodermic or subcutaneous injection of these fluids, has, in a vast number of cases, been most gratifying to both physicians and patients. Many wonderful cures have thus been obtained. Injected subcutaneously these animal extracts are immediately assimilated and we are often able to stop, at once, the progress of disease and turn the tide towards recovery. Thus the cells receive the special stimulants upon which their life and activity depend. ”

“ Well, Monsieur le Préfet, I maintain that a man who practises medicine with great skill and who is accustomed to treating sick people, as Cosmo Mornington was, is incapable of giving himself a hypodermic injection without first taking every necessary antiseptic precaution. ”

“ For our purpose it can be injected into the arm, with a hypodermic syringe, or even dropped on any delicate mucous membrane. We have experimented on it in every way, and are more than satisfied with the result. ”

“ It is impossible not to admit the truth [Pg 73] of this statement, and it must be recognized that if it is true, a nurse is under too great a responsibility when she is in possession of a hypodermic kit, particularly if the patient knows that it is her kit, her hypodermic, her drug, and that she will not be called to account by the physician for such drugs as she may administer. ”

“ As it was quite weak, he decided not to wait for the doctor, and administered a hypodermic injection. The patient grew rapidly worse and died within a few hours. [Pg 198] There was something strange in the last symptoms, and on later attempting to replace the tube of hypodermic tablets into the case, he found to his consternation that he had taken out the wrong tube, and instead of a small dose of digitalis he had given a large dose of hyoscine.
“This case was related to me by the doctor after he read my paper on the Œdipus Complex. ”

“ No blood-vessel is ever found in the epidermis, and hence, when you cut it, it never bleeds. As long as you live it is always growing. The top scales are always being rubbed off. Whenever you wash your hands, especially with soap, you wash off some of the top scales; and you would soon wash your skin away, were it not that new round cells are always being formed at the bottom of the epidermis, along the line at d (Fig. 15) , and always moving up to the top, where they become dried into scales. Thus the skin, or more strictly the epidermis, is always being renewed. ”

“ The moment the hypodermic syringe is taken from the doctor’s or the nurse’s kit, the sufferer is made aware of the means which will be used to give him ease. He remembers it, forming a respect and admiration, almost an affection, for the mere instrument, and with the most intense interest gathers such information as he may find it possible to acquire about this wonder-working little tool and the material which is its ammunition of relief. He knows absolutely that the relief which he has found is not due to medical skill, but to the potency of a special drug administered in a special way. ”

“ The Dermis, or true skin, consists of an interlacing network of connective tissue, yellow elastic tissue corpuscles, vessels, and nerves. There are also small muscular fibres in connection with the hair follicles, and beneath the subcutaneous tissues contain an abundant supply of fat adipose tissue. Numerous ridges are seen on the surface, especially on the palm of the hand and sole of the foot, caused by rows of little elevations of the cutis vera, termed papillæ. ”

“ The Skin is the exterior investment of the body, which it serves to cover and protect. It is continuous at the aperture of the internal cavities with the lining membrane of those cavities, the internal skin or mucous membrane, and is composed essentially of two layers—derma and epidermis. The derma or cutis is chiefly composed of areola-fibrous tissues, besides which it has entering in its structure elastic tissues and smooth muscular fibre, together with blood vessels and nerves. The epidermis or cuticle (scarf-skin) is a product of the derma, which it serves to envelop and defend. ”

“ Formaldehyd catgut can be used if it is desirable; its fine strands withstand absorption to a greater degree than the ordinary.
Fig. 37.—5⁄8 Circle Haagedorn Needles.
Fig. 38.—Crescent Curve Haagedorn Needles.
Needles.—Very fine, flat, round-eye needles, such as Haagedorn’s, Nos. 12 to 15, 1⁄2 or 5⁄8 circle, are the most serviceable in skin work, as they incise the skin in penetrating and leave an elongated slit, which heals readily, rarely leaving a needle scar. The selection of needles, however, must be left to the operator, many preferring the one variety to the other. ”

“ The internal layer is the rete mucosum. It lies immediately upon the true skin, and consists solely and wholly of cells, being equally destitute of vessels and nerves. Here begin the first discrepancies in the opinion of writers. Some deny that it belongs to the epidermis, looking upon it as a separate substantive tissue, neither skin nor scarf-skin, but intermediate to the two. Others find it only in the coloured families of mankind. It occurs, however, universally; being of a yellowish-white colour in Europeans, and dark brown or black in negroes, Indians, and the so-called dark races. ”

“ The outer skin grows up from a limiting plane, or layer, a little distance below the surface—a place of predominant vital activity. Here perpetually arise new cells, which, as they develop, are thrust outwards and form the epidermis: flattening and drying up as they approach the surface, whence, having for a time served to shield the parts below, they finally scale off and leave younger ones to take their places. This still undifferentiated tissue forming the base of the epidermis, and existing also as a source of renewal in internal organs, is the essentially living substance ”

“ The human skin is capable of great extension. It may be distended to four times its size, yet is not endowed with much elasticity. On this account we may notice, in very fat persons, rolls of fat about the neck, back, buttocks, arms and pubis. The epidermis, which constitutes the external layer of the skin, is but slightly capable of extension. When distended beyond a certain point, it tears, and produces those white streaks which are to be seen on the abdomen of pregnant women, or of those who have borne children, and also of those who have laboured under severe dropsical ascites. ”

“ Describe the vesicular type of dermatitis herpetiformis.
This is the common clinical type of the disease, and is characterized by pin-head to pea-sized, rounded or irregularly-shaped, distended or flattened and stellate vesicles, occurring, for the most part, in irregular and segmental groups of three or more lesions, seated either upon apparently normal integument or upon hyperæmic or inflammatory skin. They exhibit no tendency to spontaneous rupture, but after remaining a shorter or longer time, are broken or disappear by absorption. The lesions tend to appear in crops. ”

“ All parts of the skin and subcutaneous connective-tissue are hypertrophied, the lymphatic glands are swollen, the lymph channels and bloodvessels enlarged, and there is more or less inflammation, with œdema. Secondarily, from pressure, atrophy and destruction of the skin-glands, and atrophic degeneration of the fat and muscles result. ”

“ But if, the skin being very dry, we suddenly sweat, as after drinking tea, then the little drops which escape from the whole cutaneous surface, not having had time to run together, but remaining separate, we see, by the places where they are, the orifice of the exhalants. Besides, if we examine against the light a considerable portion of epidermis, its transparency allows us to see many small pores separated from each other by interstices, and which pass through it in an oblique direction. ”

“ The Dose of Atropia for Subcutaneous Injection.—I wish to answer the query of Dr. Sisson in the Practitioner of last month with every caution, but I have formed a strong opinion on the subject in question. A “Country Practitioner,” who wrote to this journal in February, states that he used to give hypodermic injections of more than 1⁄5 grain of atropia daily, to the same patient, for years. ”