PHLEBOTOMY. 77 



vein has been properly punctured blood will flow from the 

 needle upon the removal of the thumb. If the vein is not 

 entered at the first attempt the needle should be partly with- 

 drawn and then pushed in again in a slightly different direc- 

 tion. The compression is then removed and the hypo- 

 dermic syringe in which no air is contained is connected 

 and the contents slowly discharged into the vein. In with- 

 drawing the needle be careful to press the skin firmly against 

 the underlying part. The omission of this precaution fre- 

 quently results in the formation of a subcutaneous hema- 

 tome. 



17. PHLEBOTOMY. 

 Fig. 3. 



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

 botomy trocar, spring lancet, pins, suture material. 



Technic. a. Phlebotomy with 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 confiiequently affords the 

 greatest protection to the latter. At this point clip or shave 

 and disinfect the skin. Grasp the extended blade of the 

 fleam at the joint 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 the shaved part 

 that the fleam blade rests upon it. In fleshy-necked 

 animals the cour.se of the vein may be clearly made out by 

 causing its repeated distension and relaxation. 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 rest- 



