LIGATION OF THE CAROTID ARTERY. 79 



index finger in such a manner that it can only penetrate as 

 far as into the vein, and then push it in quickly just in 

 front of the compressing thumb through the skin, subcutem 

 and venous wall as deep as the fingers holding the lancet 

 will permit. 



Hold the blade perpendicular to the long axis of the 

 vein, and avoid directing the point dorsalwards, which would 

 endanger the superior wall of the vessel or cause the 

 lancet to glide over the wall and not enter the vein. When 

 the lancet has entered the vein, extend the wound somewhat 

 toward the head by flexing the hand dorsally. In cattle it 

 is necessary to compress the vein by means of a cord tightly 

 drawn around the neck, the operator taking the same posi- 

 tion as in the horse while an assistant holds the animal by 

 the horns or nose. Close the wound as in a. 



Phlebotomy with the spring lancet is carried out in a sim- 

 ilar manner, the jugular being compressed in the same way, 

 and the lancet, with the spring set, placed over the vein in 

 such a way that the opening will be made in the same direc- 

 tion and manner as with the fleams. The lancet blade is 

 then released and penetrates the vein. The compression be- 

 low is continued as in other cases. 



c. Phlebotomy, with the tiocar is performed in the same 

 manner as has been described for intravenous injection. So 

 long as the flow of blood continues the compression of the 

 vein must not be intermitted. The phlebotomy trocar 

 should be about 5 mm. in diameter. 



18. LIGATION OF THE CAROTID ARTERY. 

 Pl,ATE XIV. 



Objects. The control of hemorrhage from wounds or 

 the prevention of hemorrhage during the removal of tumors 

 or other operations in the parotid region. 



Instruments. Scissors, scalpel, tenacula, aneurism 



