PHLEBOTOMY. gi 



16. PHLEBOTOMY. 

 Fig. 6. 



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

 botomy trocar, spring lancet, pins, suture material. 



Technic. a. Phlebotomy zvith 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 cHp or shave 

 and disinfect the skin. Grasp the extended blade of the 

 fleam at the hinge 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 that the fleam 

 blade rests upon the shaved part. In fleshy-necked animals 

 the course of the vein may be clearly made out by causing 

 its repeated distension and relaxation. In some very heavy 

 necked horses, or in very restless animals, efficient distension 

 of the jugular is best obtained by cording the neck as 

 described under " Intravenous Injection." 



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. The instrument should be held perpen- 

 dicular to the surface and parallel to the long axis of the 

 vein. The most elevated point of the vessel should be 

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

 eous 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 small stick of heavy wood. The extension on the 

 fleam blade prevents its being driven too deeply. The size 



