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A constant-temperature apparatus for use during continuous intravenous administration of fluids
WATSOnT
:
A CONSTANT-TEMPERATURE
865
APFARATUS
CONCIJUSIONS
1. Sarcoma of the vulva is usually fatal, though early diagnosis and excision followed by intensive x-ray therapy offer the patient the best chance. 2. All growths about the vulva, particularly fibromas and hard tumors in the region of t,he Bartholin glands should be removed immediately to eliminate the danger of sarcomatous degeneration. REFERENCES (I) Bell: Jour. Obst. and Gynee. Brit. Emp., 1907, ii, 275, 282. (2) Torgler: (3) Rothschild: Die malignen Monatschr. f. Geburtsh. u. Gymik., xi, 382. Neubildungen der Vulva und ihre Prognose, Frankfurt a.M., 1912. (4) Netzer: Zentralbl. f. Gynlk., 1925, xli, 413. (5) GwrZU: Quoted by Netzer. (6) Beit: YIandbuch der Gyn?ik., iv, Part 2, 73. (7) E&y: Operative Gynecology, 1906, i, Am. Jour. Med. SC., 1911, cxli, 570. (9) Bland: Jour. Am. 241. (8) McFarZeluE: Med. Assn., 1912, lix, 509. (10) Jziti: Long Island Med. Jour., 1912, vi, 433. (11) McLean: Jour. Obst. and Gynec. Brit. Emp., 1909, xv, 245. (12) H’atiti: (13) Bhmberg: Zentralbl. f. Rev. de gyn& et de. chir. abd., 1913, xxi, 177. Obst. Trans. Edinburgh, 1912-13, xxxviii, Gynak., 1915, xxxix, 780. (14) Erewis: 136. (15) Lewers: Proc. Roy. Sot. Med., 4 (See. Obs. and Gyn.), 64-66-1910-11. (16) Rq@cht: Ztschr. f. Geburtsh. u. Gyn?ik., 1912, Ixxii, 664. (17) Hinselnun : Ztschr. f. Geburtsh. u. G-yn;ik., 1908, Ixii, 34. (18) S&gel, DeZvuZ, amd Mark : Bull. et mbm. Sot. Anat. de Paris, 1906, lxxxi, 405, 619. UNIVERSITY
HOSPITAL.
A CONSTANT-TEMPERATURE APPARATUS FOR USE DURING CONTINUOUS INTRAVENOUS ADMINISTRATION OF FLIJIDS BY (Pram
T
the Laboratory
E.
31.
WATSON,
M.D.,
LONDON,
of PathologicaE Chmaist~, Medica School)
CANADA
University
of Western
Ontario
HE intravenous administration of glucose solution is recognized as a rational therapeutic procedure in various medical and surgical conditions. It is in the fieltl of obstetrics that such injections have been most frequently employed. In order that the best results be derived from inkavenous glucose therapy, certain requisites must be observed. These have been adequately outlined by Titus and Dodc1s.l Not only is it necessary to use a properly prepared and properly sterilized solution, but the fluid must not enter the blood stream too rapidly and it must not be too cool or too warm. A method for ascertaining and controlling the rate of flow of intravenous infusion fluids has been devised by Freidell.2 A simple means for maintaining the temperature of the solution has been described by Titus and D0dds.l For this purpose, the rubber tube conducting the liquid from the container to the patient is coiled in a basin of hot water. The employment of this method necessarily entails considerable supervision
866
THE
AMERICAN
JOURNAL
OF
OBSTETRICS
AND
GYNECOLOGY
on the part of an attendant in keeping the water at the proper temperature and the correct length of tubing submerged. In an attempt to minimize the amount of attention required during these slow infusions, an automatic temperature-regulating mechanism has been constructed. The injection apparatus, as shown in Fig. 1, embodies the ratecontrolling device of FreidelL2 A is a reservoir containing the stock glucose solution. B is a salvarsan jar. C is a graduated burette. The rubber t,ubing has interposed in its course a piece of glass tubing in which a dilatation has been blown. These are immersed in the #
water-bath l?. The water in the bath is heated by means of the electric light bulb E. When the temperature of the water reaches the required degree, the light is automatically shut off by the key P, through the agency of the thermostat G. When the temperature of the water falls, the light goes on again. The thermostat can be made to operate at any desired temperature by adjusing the screw H. The temperature of the infusion fluid near the point of entrance into the vein, may be viewed on the thermometer I, situated within a short piece of glass tubing. REFERENCES xiv(ll)slTitw, > .
(2)
P., yd Freulell,
JOUR. Dodd-s, P.. * AN. Am. Med. H. F. : Jour.
OBST. Assn.,
AND GYNEC., August, March 12, 1921, Ixxvi,
1927, 724.
:
A CONSTANT-TEMPERATURE
865
APFARATUS
CONCIJUSIONS
1. Sarcoma of the vulva is usually fatal, though early diagnosis and excision followed by intensive x-ray therapy offer the patient the best chance. 2. All growths about the vulva, particularly fibromas and hard tumors in the region of t,he Bartholin glands should be removed immediately to eliminate the danger of sarcomatous degeneration. REFERENCES (I) Bell: Jour. Obst. and Gynee. Brit. Emp., 1907, ii, 275, 282. (2) Torgler: (3) Rothschild: Die malignen Monatschr. f. Geburtsh. u. Gymik., xi, 382. Neubildungen der Vulva und ihre Prognose, Frankfurt a.M., 1912. (4) Netzer: Zentralbl. f. Gynlk., 1925, xli, 413. (5) GwrZU: Quoted by Netzer. (6) Beit: YIandbuch der Gyn?ik., iv, Part 2, 73. (7) E&y: Operative Gynecology, 1906, i, Am. Jour. Med. SC., 1911, cxli, 570. (9) Bland: Jour. Am. 241. (8) McFarZeluE: Med. Assn., 1912, lix, 509. (10) Jziti: Long Island Med. Jour., 1912, vi, 433. (11) McLean: Jour. Obst. and Gynec. Brit. Emp., 1909, xv, 245. (12) H’atiti: (13) Bhmberg: Zentralbl. f. Rev. de gyn& et de. chir. abd., 1913, xxi, 177. Obst. Trans. Edinburgh, 1912-13, xxxviii, Gynak., 1915, xxxix, 780. (14) Erewis: 136. (15) Lewers: Proc. Roy. Sot. Med., 4 (See. Obs. and Gyn.), 64-66-1910-11. (16) Rq@cht: Ztschr. f. Geburtsh. u. Gyn?ik., 1912, Ixxii, 664. (17) Hinselnun : Ztschr. f. Geburtsh. u. G-yn;ik., 1908, Ixii, 34. (18) S&gel, DeZvuZ, amd Mark : Bull. et mbm. Sot. Anat. de Paris, 1906, lxxxi, 405, 619. UNIVERSITY
HOSPITAL.
A CONSTANT-TEMPERATURE APPARATUS FOR USE DURING CONTINUOUS INTRAVENOUS ADMINISTRATION OF FLIJIDS BY (Pram
T
the Laboratory
E.
31.
WATSON,
M.D.,
LONDON,
of PathologicaE Chmaist~, Medica School)
CANADA
University
of Western
Ontario
HE intravenous administration of glucose solution is recognized as a rational therapeutic procedure in various medical and surgical conditions. It is in the fieltl of obstetrics that such injections have been most frequently employed. In order that the best results be derived from inkavenous glucose therapy, certain requisites must be observed. These have been adequately outlined by Titus and Dodc1s.l Not only is it necessary to use a properly prepared and properly sterilized solution, but the fluid must not enter the blood stream too rapidly and it must not be too cool or too warm. A method for ascertaining and controlling the rate of flow of intravenous infusion fluids has been devised by Freidell.2 A simple means for maintaining the temperature of the solution has been described by Titus and D0dds.l For this purpose, the rubber tube conducting the liquid from the container to the patient is coiled in a basin of hot water. The employment of this method necessarily entails considerable supervision
866
THE
AMERICAN
JOURNAL
OF
OBSTETRICS
AND
GYNECOLOGY
on the part of an attendant in keeping the water at the proper temperature and the correct length of tubing submerged. In an attempt to minimize the amount of attention required during these slow infusions, an automatic temperature-regulating mechanism has been constructed. The injection apparatus, as shown in Fig. 1, embodies the ratecontrolling device of FreidelL2 A is a reservoir containing the stock glucose solution. B is a salvarsan jar. C is a graduated burette. The rubber t,ubing has interposed in its course a piece of glass tubing in which a dilatation has been blown. These are immersed in the #
water-bath l?. The water in the bath is heated by means of the electric light bulb E. When the temperature of the water reaches the required degree, the light is automatically shut off by the key P, through the agency of the thermostat G. When the temperature of the water falls, the light goes on again. The thermostat can be made to operate at any desired temperature by adjusing the screw H. The temperature of the infusion fluid near the point of entrance into the vein, may be viewed on the thermometer I, situated within a short piece of glass tubing. REFERENCES xiv(ll)slTitw, > .
(2)
P., yd Freulell,
JOUR. Dodd-s, P.. * AN. Am. Med. H. F. : Jour.
OBST. Assn.,
AND GYNEC., August, March 12, 1921, Ixxvi,
1927, 724.