70 SYMPTOMS OF INFLAMMATION. 



of treatment that was in vogue twenty years ago, when repeated 

 and heavy blood-letting was the rule, and from my recollections 

 I cannot but severely censure such an irrational method. Where 

 local bleeding can be effected, it is preferable in all cases to 

 general blood-letting. 



General blood-letting is commonly performed by opening 

 the jugular vein in our patients. For this purpose a fleam is 

 preferable to a lancet, for reasons that need not be discussed 

 here. The operation is termed venesection, or phlebotomy. 

 If the blood is drawn from an artery, the operation is called 

 arteriotomy, and is best performed by a lancet. In some cases 

 of cerebral meningitis, the temporal artery has been opened 

 with good effect, and the wound in the skin closed by means 

 of a pin, retained in its position by a small quantity of tow or 

 thread. If the haemorrhage is not arrested by this method in 

 the case of arteriotomy, a pin or needle can be placed under- 

 neath the artery. By acupressure in this way, it will be most 

 effectually arrested, at the cost, however, of the vessel, which 

 will become obliterated at that spot. But this is of no moment, 

 as the collateral circulation will be sufficient to maintain the 

 integrity of the part. 



A cow requires a larger fleam than the horse. Of this fact 

 the instrument maker is well aware, and the intending phlebo- 

 tomist can get fleams suitable for all his patients. 



Local blood-letting is performed upon the inflamed part, or 

 as near to it as possible, and the object is speedily to unload 

 the engorged blood-vessels. It may be done by scarification, 

 incision, or puncture. In conjimctivitis, for example, it may be 

 drawn from the vessels of the inflamed part by scarifying the 

 inner surface of the eyelids, or by opening the angular vein. In 

 inflammatory disease of the foot, any quantity can be obtained 

 by puncturing the coronary plexus of veins. 



When general blood-letting from the jugular is practised, the 

 animal's head should be elevated, and a full gtream of blood 

 allowed to flow from a sufficiently large orifice in the vein. 

 If this be done, a smaller amount of blood drawn will make a 

 much gTeater impression on the pulse than when the orifice in 

 the vein is small, the blood flowing in a trickling stream, and 

 the head depressed. 



The question of a second blood-letting remains to be con- 



