78 VETERINARY SURGICAL OPERATIONS 



Phlebotomy is also indicated when blood in any consid- 

 erable quantity is desired for experimental purposes. It is 

 also the method used in abstracting blood from the antitoxin- 

 producing animals. 



EQUIPMENT.— Phlebotomy is performed with the old 

 fashioned fleam (Fig. 36) or a sharp scalpel. If the former 

 is used a special mallet (Fig. 37) or a heavy stick is required 

 to drive the blade into the vein, and as surgical cleanliness 

 is essential, a curved scissors to clip the hair and antiseptics 

 to wash the seat of operation, must be included in the equip- 

 ment. A long pin and a long tuft of tail-hairs to close the in- 

 cision after the blood has been abstracted, answers every pur- 

 pose. 



RESTRAINT.— Phlebotomy is performed in th? stand- 

 ing position. The necessary restraint is accomplished with 

 the twitch and the hood-wink. The twitch may sometimes 

 be dispensed with, in fact it sometimes causes the horse to 

 curve the neck or "set" the cervical muscles so as to obliter- 

 ate the jugular groove, in which instance it is more of a detri- 

 ment than a benefit. The hood-wink is, however, essential 

 to prevent dodging as the fleam is struck with the mallet. A 

 thick handkerchief, or even the hand placed over the eye, may 

 be sufficient. The operation is best performed with the neck 

 in the normal position, that is, held leisurely in a slightly up- 

 ward direction. A high position, a low hanging position, or 

 any strained, cramped position of the neck, renders impossi- 

 ble the necessary palpation of the jugular groove to locate 

 and "raise" the vein. 



TECHNIQUE.— First Step.— Locating the Seat of In- 

 cision. — The left jugular furrow in the middle of the cervical 

 region, is the most advantageous position for the bleeding. 

 Here the vein is less incumbered with muscles, and the loca- 

 tion is in every way more accessible than either the upper or 

 the lower thirds of the region. 



Second Step. — Disinfecting the Field.— The hair is clipped 

 from the groove at the point determined, with the curved 

 scissors and then the field is well rinsed with mercuric chlo- 

 ride 1-500. If the abstracted blood is intended for experi- 

 mental purposes, or the manufacture of antitoxic serums a 

 much better disinfection of the field is advisable owing to the 

 importance of obtaining only strictly non-contaminated 

 blood. In therapeutic phlebotomy, nominal disinfection suf- 

 fices, but it must not be omitted. To thrust the fleam through 

 a hairy, unclean field may result in a serious infective phlebi- 

 tis which, in the ante-antiseptic days was one of the formid- 

 able sequelse of the operation. 



