SURGICAL OPERATION S. 271 



and a left one. As each emerges from th 3 chest, it is found deep- 

 seated, and approaching the trachea. It then passes forward, in 

 company with the external carotid artery. Toward the middle 

 ~f the neck it becomes more superficial, and is now distinctly 

 seen progressing rather above and without the carotid artery and 

 trachea, or windpipe. The carotid, therefore, in the future course 

 of the jugular, is situated a little below and more deep-seated than 

 (he vein. The jugular is also separated from the carotid by a 

 slight muscular band, derived from the levator humeri. Its fur- 

 ther track is marked in the hollow formed by the inferior edge of 

 the levator humeri, where it is covered by the panniculus carnosus 

 and integuments only, when, having nearly reached the jaw, it 

 makes its well-known division into two portions. Bleeding by 

 the jugular is usually practiced with a lancet or with a fleam. The 

 proper spot for the puncture may be found anywhere between two 

 inches and six from the division of the vein. This latitude is her*, 

 mentioned, because it is prudent to avoid puncturing directly over 

 a former bleeding-place, known by the scar and enlargement. It 

 should also be avoided where a little knot in the course of the 

 vein will sometimes denote the existence of one of the venous 

 valves. But in all ordinary cases, where these hindrances do not 

 appear, operate at two or three inches from the division of the 

 vein, which will be sufficiently evident when it is pressed on below 

 the place punctured. Avoid operating low down in the neck, as 

 there the vessel is deeper-seated, and near to important parts. 



First moisten the hair and smooth it down ; then, steadying 

 and enlarging the vessel with one hand, with the other plunge the 

 point of the lancet into the integuments, so as just to puncture 

 them and the vein ; then, by a slight turn of the wrist, carry the 

 instrument obliquely forward to finish the cut. For opening the 

 smaller veins, the lancet should always be used. In all but the 

 practiced hand the fleam is the safest for bleeding from the jugu- 

 lar It is always prudent to have the eye of the horse covered. 

 Unless the eye be covered, the horse will be likely to flinch at the 

 moment of the stroke, and the puncture may be made in any place 

 but where we wish. The hair being first wetted and smoothed, 

 and the fleam being retained in the left hand, the unemployed 

 fingers pressing on the vein so as to fix and swell the vessel, let 

 the point rest exactly in the middle of the swelling. Strike the 

 fleam sufficiently hard to penetrate the skin and vein. A blood- 



