The principles of surgery / [James Syme].

  • James Syme
Date:
1832
Catalogue details

Licence: Public Domain Mark

Credit: The principles of surgery / [James Syme]. Source: Wellcome Collection.

    52/752 (page 24)
    ed. Those at the bend of the arm, the external jugu- lar, and the veins of the hand and foot, are chosen for venesection. _Venesection.—The patient should be placed in a reclining posture, unless the peculiar circumstances of his case should render some other more conve- nient ; a bandage is then to be put twice round the arm about an inch above where it is proposed to open the vessel, and tied with sufficient force to obstruct the veins without impeding the current of the arteries. The surgeon now chooses the largest vein, which is generally the median basilic—puts the limb into such a position as may be preserved while the blood is flow- ing, and presses the thumb of one hand upon the ves- sel immediately below where he proposes to puncture it, in order to prevent it from rolling, and the blood from escaping, until he is ready to receive it; then holding the lancet with the other hand, he introduces it into the vein at an angle of 45, in respect both to the surface of the skin and longitudinal direction of the vessel. When the blood appears, he ceases to push the ‘instrument deeper, but carries it a little farther for- ward, in order to enlarge the opening of the vein ; and lastly, elevates the point, so as to make the external wound of sufficient size, which varies from a quarter to three-eighths of an inch, according to the thickness of the subcutaneous fat. The pressure of the thumb is then removed, and the blood is allowed to flow as long as seems proper. The surgeon, when a sufh- cient quantity has been abstracted, slackens the ban- dage,—places his thumb upon the orifice,—cleanses the arm from blood,—lays a small compress of folded