South Bend news-times. (South Bend, Ind.) 1913-1938, 1916-08-18
By Donald McCaskey, NJ. D.

Immediately on top OF both hip bones Of
the pelvis. In front this line asses near
the umbilicus, and in the rear 1t crosses
the lumbar region of the spine. which is
ordinarily known as the small of the
back. The exact point where this lie
crosses the spine in the rear IS taken as
tue entrance point OF puncture for the
syringe needle.
The small OF the back consists OF the
five lumbar vertebrae out Of the thirty
two vertebrae which comprise the entire
spinal column. The line drawn as de-
scribed usually crosses the spine between
the third and the fourth lumbar vertebrae.
The child is placed upon its left side.
The surgeon has the youngster pull its
knees up close to the chin. The head is
made TO bend as far forward as possible.
This brings about q very marked curva-
ture OF the spine. It makes II convex, and
separates as widely as possible the va
rious vertebrae one from another. This
separation Of the vertebrae gives the
surgeon the best possible opportunity TO
puncture the spinal canal with his needle.
Every aseptic precaution is taken. The
skin over the child's spine is thoroughly
scrubbed with soap and water and then
vigorously rubbed with 90 per cent alco-
hol
With the needle in his right hand the
surgeon with the left hand determines
the space between the third and fourth
vertebrate and deliberately thrusts the
needle forward between the two verte-
brae. gently and firmly, until he feels tho
resistance OF the vertebra on the far side
OF the spinal canal.
In order for the spinal fluid to flow out
through the needle IT is necessary that
the surgeon withdraw the needle very
slightly so that its open end will not be
in direct contact with the bony portion
OF the spine.
Inside Of each spinal puncture needle
there is plug known as an obturator.
When the needle gets inside of the spine
this plug or obturator is withdrawn, and
II the needle is in proper position within
the spinal canal, the fluid within the
canal will begin to flow out through the
needle
II II flows drop by drop II indicates a
normal pressure of the spinal fluid. When.
however. the fluid spurts OF flows in a
stream, II indicates an excessive or dis
eased pressure within the spinal canal.
TIKI is the first valuable scientific iDdi-
cation to be obtained from the spinal
puncture. II the pressure within the
spine is normal, as the fluid makes its
way through the puncture needle. the
pressure is sufficient 10 force a thin col
umn OF water up through glass tube 10
the height OF so millimeters OF q trife
over two inches.
The spinal fluid is collected in a steril-
lied test tube. and is studied under the
microscope. and by chemical means. In
these ways its normal or diseased condi-
ton is determined.
The weight OF the spinal fluid contain
ing all OF its soluble substances in a nor
nal condition. is very nearly the same as
water but slightly heavier. Compared
bulk for bulk the ratio Of the spinal fluid
70 water is as 1908 is to 1000.
Every spinal fluid contains a small per
centage OF mineral salt of albumin and
glucose. or sugar
Where tubercular spinal meningitis has
developed. the spinal fluid contains a
delicate clot IN which is found the tuber-
cular bacilh. but il remains as yet for the
laboratory 10 discover any germ in the
spinal fluid OF infantile paralysis. We do
Copyright. 1915. 81 the Star Company