PHLEBOTOMY. 499 



and the fleam, and attends to the flow of the blood into the grad- 

 uated jar, or the pail provided to receive it. 



(e) Keeping the Stream.— Kb we have said, the pressure upon 

 the blood vessel must be sustained from the beginning to the end 

 of the operation. EeUeving it but for a moment is an error, 

 likely to be followed by the introduction of air through the wound 

 into the vein. Not only must it be kept up continuously, but it 

 must be steady. The habit which largely prevails of moving the 

 fingers or the vase up and down along the vein while the pressure 

 is applied, and with the idea of stimulating the flow of the blood, is 

 most dangerous. If the blood does not escape freely, though the 

 operation has been properly performed, an increased circulation 

 may be stimulated by making the animal move his jaws, or shak- 

 ing the bit in his mouth, or placing the bleeding-stick or a flnger 

 of the assistant, into the mouth over the bars, and quietly moving 

 them. 



if) When the bleeding is to be stopped, the operator applies 

 one of his fingers over the wound of the skin and gradually re- 

 moves the pressure made below it. When this has been done, he 

 proceeds to the appUcation of the suture, always introducing the 

 pin with the head turned upward, irrespective of the side on which 

 the operation has been performed. 



{g) Subsequent Care. — This is the same as in other cases, but 

 we may add that an animal that has been bled at the jugular is 

 unfit to work for three days, in order to give time for the woimd 

 to heal completely. 



Phlebotomy at the Cephalic Vein 



The cephalic is one of the terminal branches of the median 

 subcutaneous vein, and runs upward and forward to pass toward 

 the lower extremity of the coraco-radiaUs, where it crosses the 

 tendinous band which this muscle sends to the anterior extensor 

 of the metacarpus, running in the space which separates the sterno- 

 humeralis muscle from the levator-humeri, and emptying into the 

 jugular, a httle in front of the confluent of those two veins. In 

 this course, the most accessible portion is that which rests on the 

 inferior extremity of the levator-humeri. The fibrous band of the 

 coraco-radiaHs is the guide indicating its position, viz., a little in- 

 side the forearm, on a level with the anterior and oblique fold 

 ,which separates the arm from the forearm. 



