140 I'HLEBUTOMY. 



days, the power of the operator's arms is insufficient, and Vogel 

 suggests the operator sitting on a stool and using the soles of the 

 feet. Counter-pressure must, of course, be exercised on the right 

 side. 



In dogs the abdomen can be massaged with the animal either 

 in the upright or prone position. The points of the fingers alone 

 may be used, or where over-distended portions of the bowel can be 

 felt the open hands may be employed. The coil of intestine is 

 grasped with the fingers and the contents broken down and forced 

 onwards. With the animal in the standing position one operates 

 in a similar way, the points of the fingers being slowly pressed from 

 either flank into the depths. Portions of bowel may be kneaded 

 and peristalsis aroused by suddenly releasing the parts after 

 subjecting them to steady pressure. In this way even severe con- 

 stipation may be cured and more serious operation often avoided. 



X.— PHLEBOTOMY. 



By phlebotomy is meant the surgical opening of a vein for the 

 purpose of removing blood. Although bleeding is almost invariably 

 practised on veins, arteries may be utilised for the same purpose, 

 and the old term blood-letting included venesection or phlebotomy 

 and arteriotomy. Bleeding from capillary vessels is usually effected 

 by scarification or the application of leeches. 



Bleeding may be divided into general and local. General bleeding 

 consists in removing a large volume of blood with the object of 

 lowering blood-pressure throughout the body ; local bleeding, on 

 the other hand, is undertaken to reduce the quantity of blood in 

 the part operated on or in its immediate vicinity, i.e., to improve 

 the conditions in a circumscribed area. 



In former times bleeding was popular in all acute and feverish 

 conditions, and was so excessively practised that a reaction naturally 

 set in. It has now almost fallen into desuetude, a result accelerated 

 and confirmed by the entirely different views now held as to the 

 value of general bleeding. In bacteriological laboratories, of course, 

 bleeding is a necessary preliminary to the preparation of protective 

 sera, and is also resorted to for obtaining blood for microscopical or 

 bacteriological experiments. The periodical bleeding of animals in 

 spring to keep them in good health is still practised in a few pails 

 of the country, but is rapidly dying out. The innate vitality of ancient 

 superstitions is well illustrated by its having survived so long. 



