Licence: Public Domain Mark
Credit: Hand-book of surgical operations / by Stephen Smith. Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![Median Basilic and Cephalic.—The cephalic vem may be selected on account of its isolation. The basilic is the largest, but the brachial artery passing- directly under it is in danger of being wounded. The position of the artery must first be determined. A band is then passed firmly around the arm, above the elbow, and with his hand the patient grasps a staff. The operator, stand- ing in front of the patient, grasps the arm with the left hand, placing the thumb on the distended vein, and^he fingers on the back of the elbow, and holding the lancet in tne right, opens the vessel. Internal Saphena.—The foot is first placed in a vessel of warm water to distend the veins; a band is then passed around the leg, just above the malleoli; the thumb being placed on the vein it is opened just above the inner ankle, with an oblique incision. Arteriotomy.—The temporal artery is that on which this opera- tion is practised. It may be opened just over the zygoma, in front of the tragus, before its division into the anterior and posterior brandies, but the anterior branch is generally selected. The posi- tion of the artery is determined by its pulsations; the skin being made tense a straight incision is made with a scalpel, involving a part of the calibre of the vessel; when a sufficient amount of blood has been withdrawn the artery should be completely divided, and compression made on either side of the incision with small gra- duated compresses, firmly retained with a bandage. Local Bleeding.—The local abstraction of blood is effected by leeching, cupping, scarification, and punctures. Leeching.—Leeches should not be applied to parts liable to infil- tration of blood, and discoloration, as the eyelids, scrotum, prepuce, or where a wound would disfigure, as their bites sometimes leave scars, nor over the track of a superficial vein. They are best applied by placing them in a small glass vessel, and inverting it over the inflamed part; blood, or sweetened milk, is pften put on the skin. A single leech can take about an ounce of blood. When removed, the parts may be fomented to increase the flow; if it is desired to stop the blood the bites may be sprinkled with flour, starch, or other absorbent material; if the flow of blood con- tinues astringents are used, of which the best is the persulphate of iron. Cupping.—Cupping requires a scarificator and cupping-glass. The scarificator is an instrument containing eight or twelve blades moved by a single spring, and so arranged as to be readily gra- duated as to the depth which they shall penetrate. They cover but the small space of an inch and a half or two inches Bquare, and make eight, twelve, or more parallel cuts. The cup] may be simple tin or glass, of the proper size and shape, and applied by exhausting the air within by burning a few drops of alcohol ; or it may have an exhausting pump attached to the top; or, finally, it](https://iiif.wellcomecollection.org/image/b21155434_0036.jp2/full/800%2C/0/default.jpg)
