Syringe

“ INJECTIONS AND IRRIGATIONS
of simple water, or of some infusion or solution. The use of the syringe as an article of essential service in preserving the health of married women should never be overlooked. Even when they are aware of no tendency to weakness or unusual discharge, it should be employed once or twice a [Pg 380] week; and when there is debility or disease of the parts actually present, it is often of the greatest service.
There are many varieties of female syringes now manufactured and sold, some of which are quite worthless. ”

“ Connected with the syringe are full directions with reference to its use, and the advantages to be derived from it. The mass of people are but little aware of the great benefits derived from the frequent use of common water injections. This want of practical knowledge arises more from the want of a good instrument than any other cause. We can strongly recommend Lewis's Improved Syringe in this particular. Physicians themselves would always find it advantageous to recommend a good instrument of the kind to their patients. ”

“ Imagine to yourself a syringe, the tube of which gives rise to an infinity of branches, which afterwards give origin successively to a number of smaller ones; if, when you push the piston of the syringe, its body and all the branches and smaller branches arising from it, are already full of fluid, it is evident that at the very instant in which the piston shall push the fluid in the body, it will go out on all sides through the open branches. ”

“ It is decidedly the best construction of metalic syringe that we have ever seen. It has many important advantages over any other form of syringe. Its construction is such that the valvular apparatus seldom gets out of place. It is small and convenient, enclosed in a neat box, and may be conveniently carried in almost any way. The objections commonly urged against the metalic syringe, are in this improvement wholly obviated. Its long flexible tube allows a convenient self-application. Persons having the syringe need not the aid of an assistant. ”

“ This instrument may be soaked in the alcohol solution, the needle changed and the operator may continue until the syringe is empty.
Even though one have a syringe capable of holding enough for several operations it is well to have a second at hand ready for use as the instruments sometimes break or spring a leak when least expected. Never use a syringe which leaks, as one cannot tell how much is going into the tissues and how much is escaping. Leaks invariably occur at the side of the [Pg 14] needle base or at the point of juncture of the barrel of the instrument with its anterior portion. ”

“ The required necessities being to invent a syringe which would have a known capacity, a piston under control of the operator at all times, and metallic needles of proper lumen, to prevent the solidification of the liquid paraffin, screwed to the syringe to prevent loosening. ”

“ 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. ”

“ The tubing and the outlets are extra large, securing a rapid discharge of the water, which reduces the time required to less than one-half that usually taken, which is a very great advantage over other syringes. This new syringe will prove a most important help in the taking of "Internal Baths" in the "New Method" treatment as recommended by Dr. Forest and others, and will prove curative in many cases when all others fail. ”

“ The fluid should be aseptic, and at a temperature of 100° F. The patient’s head is inclined to the affected side, and the auricle is pulled upwards or backwards. The syringe is inserted a short distance within the meatus, and applied to the upper posterior wall so that the stream of lotion flows along the roof of the canal to the drum, and returns along the floor, thus washing out the contents. The best syringe is one with a metal plunger, as it can be easily sterilized. After syringing, the auditory canal should be dried and again inspected. ”

“ Portable Syringe.—Our attention was called a few days since to an improved Portable Syringe for domestic use, which is of great value. It is superior to any other which has yet been invented, and [Pg 48] must, we think, be preferred by physicians and others who are obliged to use such an instrument. While it is very simple in its construction, it is perfectly adapted for the purposes for which it is designed. Its size is such as to make it a very portable and convenient apparatus for traveller's use. ”

“ Three men had large syringes. A lad carried a pail of fluid from which they replenished them. The red-faced man watched. They went along the room in pairs, one holding the lantern while the other knelt by the sleeper and made the injection—two strokes of the piston with a pause between. One pair came to Mr. Raynor and another to me at the same time. I was too numb to feel pain when the great syringe dug deeply into my flesh, but it was well for me that I could not scream. As it was, I made a faint sound.
“Must have been near waking,” the injector said, putting the rug over my shoulders again. ”

“ I had next to deal with that portion of the drug which had already been absorbed and was exercising its poisonous effects. Taking my hypodermic case from my bag, I prepared in the syringe a full dose of atropine sulphate, which I injected forthwith into the unconscious man's arm. And that was all that I could do, so far as remedies were concerned, until the coffee arrived.
I cleaned and put away the syringe, washed the tube, and then, returning to the bedside, endeavored to rouse the patient from his profound lethargy. But great care was necessary. ”

“ When all is prepared, the syringe, with the stopcock attached, should be warmed, and then filled and emptied with the injecting fluid two or three times, care being taken that the end of the syringe be kept beneath any bubbles which form upon the surface. The syringe may then be filled, and closely attached to the pipe which is tied in the vessel. With a firm and steady pressure the piston must be forced downwards, when the substance will be perceived to swell, and the colour show itself in places where the covering is thin. ”

“ The injection of adrenalin and cocaine into the sac before its excision.
Fig. 165. Lachrymal Syringe.
Operation. The eye is cocainized and the patient made to look up. The punctum is everted by pulling down the lower lid. The canaliculus is then dilated. The nozzle of the lachrymal syringe (Fig. 165) should be passed until it is felt to impinge on the bony outer wall of the sac. Withdraw the syringe slightly and apply gentle pressure to the piston. The fluid will either regurgitate through the upper canaliculus or, if the duct be patent, pass down into the nose and so into the throat. ”

“ In all cases of suspicious connexion I recommend copious ablution as soon as possible. [1] The syringes I would advise to be used should have their points conically shelved off pear fashion; they fill up the urethra like a wedge, and prevent the immediate escape of the injection: all injections should be retained a few seconds, and then be allowed to flow out. It is seldom worth while to repeat the operation more than twice on an occasion; but that occasion may be resorted to two or three times a day.
When the nitrate of silver is used, the syringe had better be made of glass. ”

“ Carve. (Indicating syringe.) What is this device? Pascoe. This device? I'm going to get some strychnine into him by injection. Steady with that cup, now!
(Pascoe drops a tablet into the syringe and screws it up again, draws a little water up into the syringe and shakes the syringe. Then he goes to Shawn to make the injection, on the top side of the patient's forearm. Carve still holds the cup out mechanically.)
Pascoe. I've done with that cup.
Carve. (Putting the cup down.) Might I ask what's the matter with him?
Pascoe. Pneumonia is the matter. ”

“ The elevation of the skin is in the meantime partly kept up with the needle itself, while the syringe is grasped with the freed hand, the thumb and forefinger of the right hand being placed upon the handle of the screw or piston rod, which they must rotate to force the semisolid mass from the instrument.
Before beginning the injection an assistant is instructed to press with his fingers the tissue about the margin of the defect to prevent the filling from becoming misplaced or being forced into undesirable channels, especially if the skin over the defect is found to be thick and inelastic. ”

“ Top, from original Arabic manuscript (Ali 2854) , courtesy Süleymaniye Umumi Kütüphanesi Müdürlüğü. Bottom, from Argellata 1531, courtesy National Library of Medicine.
Of special interest in chapter 59 is the metallic "syringe" (fig. 15) used to inject medicinal solutions into the bladder: "The hollow passage [of the syringe] should be exactly equal to the plunger it contains and no more, so that when such fluids from an excess of humors are aspirated they will be drawn out, and likewise when the solutions are injected they will be pushed in easily." ”

“ Never to allow a nurse, until she be ordered by the doctor, to give either brandy, or wine, or porter, or ale to the patient. (2) I should recommend every respectable monthly nurse to carry about with her an india-rubber vaginal syringe. One of the best for the purpose is Higginson’s syringe, [84] which is one constructed to act either as an enema apparatus, or, by placing the vaginal pipe over the enema pipe, as a vaginal syringe. She will thus be armed at all points, and will be ready for any emergency. It is an admirable invention, and cannot be too well known. ”

“ It is not necessary to accumulate the evidence of physicians concerning their utility. Every practitioner of medicine can recall the cases, in which a perfect syringe would have saved hours of pain, and in which he could find only the most inefficient aid from a leaky barrel and a loose piston. ”

“ Preparation of the Inoculum.—Care must be taken in preparing the inoculum, as the injection of even small fragments may cause fatal embolism. To obviate this risk the fluid should, if possible, be filtered through sterile filter paper before filling into the syringe.
Air bubbles, when injected into a vein, frequently cause immediate death. To prevent this, the syringe after being filled should be held in the vertical position, needle uppermost. ”

“ He also states that: “As the absence of clotting depends upon the rapidity with which the syringes are filled and emptied, a series of syringes should be used in strict rotation, and all trace of blood must be washed out with saline before the syringes are used again. One or two additional assistants are necessary for this method.” The disadvantages are evident, and it is not suitable for general use.
A modification of the method has been described by Unger, in which only one syringe is used. The barrel of this is cooled by an ether spray so that clotting is discouraged or prevented. ”

“ Third, the valves were liable to malfunction. [130] Twenty-three years later Knox continued to disapprove of the syringe for the very same reasons. Of all the new inventions for cupping, he declared in 1836, “the worst is the syringe, as it makes that a most complicated and bungling operation that which, with common care and attention is one of the most simple in surgery.” [131]
Despite rejection by experienced cuppers, manufacturing of an air-tight syringe continued to challenge inventors throughout the nineteenth century. ”

“ Beginners should use a common bulb syringe, with water rather hot, varying in quantity as they become accustomed to the process, from a quart to a gallon or more, and a bulb-full squeezed out slowly, with intervals between, giving it time to pass out of the rectum into the colon. On regaining the erect posture, if the rectum be loaded with feces or distended with water, the desire to expel its contents may be irresistible, especially if air has passed through the syringe; although a little practice will enable any one to exert great control over his or herself in this respect. ”

“ For the edematization of large areas of loose tissue, where a considerable amount of a weak solution is intended, the use of a large barreled syringe will be found to save time and the annoyance of refilling. ”

“ You know that people who understand surgical instruments usually go in for a little chemistry, too. When I examined the cylinder of this syringe I noticed a small quantity of colorless liquid in it; so I took it out and analyzed it."
The doctor was now becoming interested again, and Nick continued:
"I found it was a terrible poison."
"What?" cried Dr. Lord.
"Yes, doctor. That little syringe contained enough poison to kill a dozen men."
"You astonish me!" said the doctor.
"I have a little vial of the same drug here," said Nick, producing the one which he had picked up in the snow. ”

“ He committed to his care, with expressions of the greatest solicitude, a strong box, brass bound and carefully locked, which he told him contained his god, a most potent and cruel deity, who would, however, when it pleased him, give back the life of a dead man for blood. This box contained a silver cup, with a thermometer fixed in its side; a glass syringe holding about a third of a pint; a large curved needle perforated in its length like a tube, sharp at one end, at the other expanded to fit accurately the nozzle of the syringe; a little strainer also fitting the syringe ”