Syringes

SYRINGES (from German Spritze) are used for introducing various therapeutic and anesthetic substances into the organism, for diagnostic punctures, for aspirating accumulated fluids, and in anatomical work. Syringes are made of metal, glass, and rubber. The capacity of syringes ranges from ¹/₄ to 350 cm³. The capacity of syringes used in anatomical work reaches 1,000 cm³. The most widespread are the Record, Luer, and Pravaz syringes (Record, Luer, Pravaz). The Record syringe (Fig. 1) is made of metal and glass. The metal part is joined to the glass by a special metal alloy and forms a single entity, as it were. The glass cylinder is carefully ground and provided with precise graduations. The nickel piston is fitted very precisely, which ensures its smooth sliding and tight fit against the cylinder wall. The usual capacity of Record syringes ranges from 1 to 20 cm³, but for mercury-oil injections, as well as for other purposes, syringes with a capacity of ¹/₄ and ¹/₂ cm³ with fine graduations are manufactured, which ensures dosage accuracy (Fig. 2). The so-called universal Record syringe is adapted for injections, punctures, and aspiration (Fig. 3). The Luer syringe is distinguished by a very simple construction. It is made entirely of glass. A ground glass cylinder serves as the piston (Fig. 4). These syringes are produced with a capacity of from 1 to 20 cm³. The Barthelemy syringe to some extent resembles the Luer syringe, but differs in its small dimensions (Fig. 5). This syringe is used mainly for mercury-oil injections. Thanks to clearly visible graduations, it allows precise dosage. The Lieberg syringe (Fig. 6) is also distinguished by this property. The Pravaz syringe in its construction to some extent resembles the Record syringe, but its casing is manufactured

of metal or hard rubber, and the piston of rubber, leather, or asbestos. The capacity of this syringe can be changed depending on necessity thanks to the possibility of moving the piston (screw) (Fig. 7). The Roux syringe (Fig. 8) and Levyn syringe (Fig. 9) possess similar properties. Of the listed syringes, Record and Luer syringes enjoy the greatest distribution in daily practice. For introducing significant quantities of fluid, the Gabrichevsky syringe (Fig. 10), which has now gone out of use, was employed. Its capacity is from 5 to 100 cm³. For injecting thick substances, such as paraffin during the application of paraffin prostheses, Stein (Fig. 11) and Onodi (Fig. 12) syringes are used. Cannulas are fastened to these syringes by means of a screw. Special attention is deserved by the Broekaert syringe (Fig. 13), by means of which the injection of hard paraffin can be performed without applying great force and even with the help of one hand. For local anesthesia, Record and Luer syringes with a capacity of from 5 to 10 cm³ are considered the most common. Schleich proposed his syringe with an adjustable piston made of asbestos or rubber for infiltration anesthesia (Fig. 14). The Braun syringe, proposed for the same purpose, makes it possible, thanks to a screw included in the lock, to produce strong pressure, which facilitates the infiltration of dense tissues (Fig. 15). For the easier production of local anesthesia, Schwabe constructed his syringe (Fig. 16), which is connected by means of a special outlet to a vessel filled with the anesthetic liquid. The syringe is equipped with two valves, of which one is located at the exit and permits the movement of fluid only out of the syringe, and the other is located on the side and allows fluid to enter the inside of the syringe. For spinal anesthesia, Record and Luer syringes are usually used. Pochhammer proposes performing spinal anesthesia with the help of his syringe (Fig. 17). It is produced in the following manner: after aspirating cerebrospinal fluid through the side outlet, a corresponding amount of the anesthetic substance is introduced, and then the liquid contained in the large syringe pushes and spreads the previously introduced liquid. In otorhinolaryngology, for punctures of the maxillary sinus from the side of the inferior nasal meatus, the Schmidt-Schötz syringe (Fig. 18) is used. For introducing anesthetic substances into the submucosal layer of the nose, there exist the Heryng syringe (Fig. 19) and the laryngeal syringe according to Schmidt (Fig. 20). For the same purpose, the Brünings syringe (Fig. 21) was proposed. Anesthesia of the middle ear is conveniently carried out using the Neumann syringe (Fig. 22) and Hartmann syringe (Fig. 23). For nasal irrigation and insufflations, there are Weber-Lieel (Fig. 24), Fraenkel (Fig. 25), and Silberstein (Fig. 26) syringes. In urological practice, for irrigating the urinary bladder, the Leiter syringe (Fig. 27) is used. The casing of this syringe is made of hard rubber, the piston is rubber, and the syringe is easily dismantled. For the same purpose, as well as for irrigating the urethra, the Janet syringe (Fig. 28) is used. There is a modification of this syringe, the Janet-Record (Fig. 29). The capacity of these syringes is from 50 to 250 cm³. For douches and cauterization of the urethra, a glass syringe in a hard rubber casing was proposed by Pospelov (Fig. 30). The Tarnovsky syringe, with a soft rubber tip and a capacity of 8 cm³ (Fig. 31), is distinguished by an especially simple construction. For anesthesia of the urethra, the Kollmann (Fig. 32), Guyon (Fig. 33), and Lanz (Fig. 34) syringes were proposed. In gynecology, for uterine injections, aspirations, and irrigations, the following syringes are used: Braun (Fig. 35), Olshausen (Fig. 36), Record (Fig. 37), Spiegelberg (Fig. 38), and Courant (Fig. 39). The latter author proposed a special cannula for his syringe, which ends in a notch that facilitates the passage of a tampon. On the side is an opening for the outflow of fluid. With the help of this syringe, the introduced strip of gauze can be impregnated with a disinfectant solution in situ. For diagnostic punctures from the vagina, the Record syringe (Fig. 40) with a Flatau cannula (see Cannula) is very convenient.

F. Yanishchevsky.