The Cure of Rupture by Paraffin Injections — John Shaqi
The Cure of Rupture by Paraffin InjectionsMiller, Charles Conrad
Philosophy
The Cure of Rupture by Paraffin Injections
Miller, Charles Conrad
Hernia; Paraffin injections
If a vein is struck the needle should be withdrawn and the syringe
emptied of blood; then the needle should be reinserted, using the
syringe for suction. If a vein is struck a second time it will be well
to insert the needle through the abdominal wall at the site of the
internal ring and if no vein is struck at this point an injection may
be made. If this holds the hernia it may be well to make no injection
of canal for two weeks. During the interval even if the hernia does
not recur it will be well for patient to wear web bandage truss or a
spica bandage with a pad pressure over the inguinal canal. At the end
of two weeks inject canal moderately with paraffin or vaseline to
promote formation of connective tissue.
If the injection of the canal at the site of the internal ring does
not hold the hernia, reduce the same and make a puncture with a small
needle through the external wall of the canal just above the external
ring. If no vein is struck inject moderately and see if such injection
holds hernia. In such a case place pad of moderate size over the canal
and put on firm spica and have the patient stay off of feet as much as
possible for ten days or two weeks. In this case the permanence of the
cure will depend upon the amount of connective tissue formed.
Injection at Internal ring.
To inject through the abdominal wall at the internal ring select a
point midway between the anterior superior spine of the ilium and the
pubes and one-half an inch above the line of Poupart's ligament. This
represents the site of the internal ring. The needle should be pressed
through the fibrinous wall of the canal at this point and should be
directed towards the pubes. If the hernia is at all large remember
that the canal is shortened and select a point one-half or
three-quarters of an inch nearer the pubes as the site of the ring.
When through the outer wall of the inguinal canal the needle point
will have a considerable freedom in the loose cellular tissue and the
injection should be diffused in a circle of an inch or an inch and a
half in diameter. 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.
The advantage of the small hypodermic needle is that it may be passed
with very little discomfort to the patient and it throws a finer
string of paraffin and favors diffusion of the agent.
A hypodermic needle is lacking in length to inject the canal when
passed through the external ring along the canal.
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