PHLEBOTOMY. 69 



1 6. PHLEBOTOMY. 

 FIG. 3. 



Instruments. Razor or scissors, fleams, lancet, phle- 

 botomy trocar, spring lancet, pins, suture material. 



Technic. a. Phlebotomy ivith fleams may be performed 

 on either jugular vein. The operation is preferably carried 

 out on the standing animal, but is not difficult when the 

 patient is recumbent. The point of operation is at about the 

 boundary line between the upper and middle cervical regions, 

 because it is here that the subscapulo-hyoideus muscle which 

 separates the jugular vein from the carotid artery is most 

 voluminous and consequently affords the greatest protection 

 to the latter. At this point clip or shave and disinfect the 

 skin. Grasp the extended blade of the fleam at the joint 

 with the thumb and index finger of one hand, while the 

 third and fourth fingers compress the jugular vein at a point 

 far enough below the shaved part that the fleam blade rests 

 upon it. In fleshy-necked animals the course of the vein 

 may be clearly made out by causing its repeated distension 

 and relaxation. It is well to be careful that the point of the 

 fleam blade is not allowed to prick the skin prematurely and 

 render the animal restless, and that the fleam blade is held 

 perpendicular to the surface and parallel to the long axis of 

 the vein. The most elevated point of the vein should be 

 struck by the blade in such a way that the skin, subcutane- 

 ous muscle and jugular wall are penetrated parallel to the 

 long axis of the vessel. Drive the fleam blade into the vein 

 by a short, sharp blow with a light wooden stick. The ex- 

 tension on the fleam blade prevents its being driven too 

 deeply. The size of the blade to be used depends upon the 

 thickness of the skin and other tissues covering the vein. If 

 the vein is opened, dark red bloo^d escapes from the wound 

 in a large stream. If the operation does not succeed at the 



