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If the pleural cavity full, the ordinary direction would suffice find the fluid.

On the other hand, an interlobar pleurisy or empyema, an abscess lung, or an abscess the liver pushing the diaphragm sharply, might demand exploration, but would require some especial selection the point puncture give any reliable The pericardial cavity may explored a finger breadth the left the sternum, in the fourth space, or slightly further the left in the fifth, in the left costoxiphoid angle, passing the needle upward, or the left the apex-beat, or in some thesis data analysis cases the right the sternum in the fourth space when the effusion gives dulness far the right.

Great care should used not injure the heart and especially since a thin-walled auricle, a coronary artery or Eronecker's coordination center might injured. In general, exploration the pericardial cavity should not undertaken without a very definite need and after a most best medical school essay editing service careful examination and study. 'I have seen blood aspirated from a much dilated heart with benefit, The peritoneal cavity commonly aspirated in the center line below the navel, after making sure that the bladder empty.

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If no fluid obtained the patient may placed upon the side toward which the fluid gravitates most readily and the puncture made between the navel and the anterior superior spine the ilium.

The liver often explored for abscess or hydatid cyst. If the, indications are clear, as when a large cyst or abscess gives a rounded area dulness, perhaps bulging, the aspiration may made in the center this region, otherwise the needle may entered in the center the hepatic dulness, either in the anterior essay writers needed or mid-axillary line, or in the back. If becomes necessary search for an abscess the liver not readily located, best use a general anesthetic. In several cases I have had the abdomen opened and the liver exposed before using the needle, since the condition serious enough demand any necessary means relief. The gall-bladder should probably never aspirated until The spinal cavity may entered at the region the third, fourth, or fifth lumbar vertebra, the needle being entered one or one and one-half the right or left the median line, and passed somewhat inward and upward for in children, or nearly twice as far in adults.

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The intervertebral spaces are widened and the operation made more easy bending the patient's body forward. The fluid escapes slowly drop drop if pressure normal, and faster, even in a stream when the pressure increased, as in meningitis or brain tumor.

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There commonly nothing gained manometric measurement the pressure justify the Puncture the spleen occasionally performed determine the presence or absence a cyst or abscess. It probably not justifiable obtain blood for examination in typhoid or malaria, and may dangerous also in leukemia. Aspiration the tumor in appendicitis mentioned in some works, but the procedure, like that upon the gall-bladder, antiquated, unsafe and useless. Cysts, abscesses, etc. are explored with the needle only SiiteX careful consideration their character, the danger infecting neighboring serous cavities with their contents, and their relationship important organs, especially the heart and large vessels. In general, customized essays they should punctured at the center the greatest area flatness, and with a fine needle only, since the escape fluid into the neighboring cavities may harm. The exploration the lung for echinococcus cyst should done EXAMINATION OF THE FLUIDS OBTAINED only after preparations have been made open the chest in case trouble for death, virtually drowning, has occurred through neglect this rule. In attempting demonstrate a lung cavity should explore when the presence flatness top writing service and the long abstinence from cough and expectoration lead believe that the cavity filled. I have obtained pus from a bronchiectasis which led diagnose lung abscess, and even with the greatest care may deceived. Careful microscopic examination for epithelial cells, pus cells, elastic fibers, bacteria, etc. should made. The presence elastic fibers practically excludes an empyema as the source the The harpoon occasionally used obtain muscular tissue for EXAMINATION OF THE FLUIDS OBTAINED Specific Gravity.

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