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Show OF BLEEDING IN THE ARM. ' OF BLEEDING IN THE ARM- CHAPTER 1. 0] [lie Operation of Bleeding in the Arm-0f the bad Consc! quences which may follow-Offlie Operation for Ancurism in the Arm-0f the Operation for Ancurism in the Ham. 0F BLEEDING IN THE VEIN OF THE ARM. 'I‘nn ribbon or band being put about the arm twice, and drawn with a double running knot, we draw the band. 1 ture. MUM In choosing the vein, we take that which is most prominent, a. s and least apt to roll under the finger. In feeling it, we move the point of the fingers lightly across it. The choice lies in general betwixt the median basilic and the median cephalic vein; and although the humeral artery lies under the first, we generally prefer it. l.. .'. ....-. . , In: fig .P"'.T"' a; f‘ . - ..-,w'7~"‘~" ,_. .1,‘:~"-.i1-, JDUW- age as tight as possible without affecting the pulse. If the patient be timid and faint, he may be laid in a horizontal pos- As to the instrument, I think that in general the lancet is made too much spear-pointed, as it is called; and that the shoulders of it should be broad. But the form of the puncture depends less upon the lancet than 011 the motion of the fingers. It is not intended to [Hie/r the vein, but to open it; and at the same time to make such an incision in the skin as to make the blood tlow freely. The lancet enters the integuments at A. fig. 1. and pierces the vein B. The motion of the lancet and lingers revolveson bring the point D, so as to carry the lancet a little forward, and the point out in the line C. If a timid boy, after pricking the e vein and seeing the blood, withdraws the lancet, an obliqu opening, as in fig. 2. is made, which is the worst that can haps to pen in so trifling a matter. The arm is to beturned so as present the orifice to the bason for receiving the blood ; and little then the operator, grasping the arm, places his thumb a as to lower on the vein than where he intends to puncture, so a such in done be should distend and fix the vein. This skin to manner as to avoid changing the natural relation of the turn the vein. This would occasion what happens when we the arm round to the bason, after puncturing the vein, by pondwhich the orifice of the skin is shifted from a due corres ence with that of the vein. The blood begins to trickle, in- stead of flowing in a stream ; and immediately after the operation, there is around the orifice blackness and tumour, from ecchvmosisas. As soon as the lancet has entered the vein, the thumb of the left hand is raised from the vein. When the blood stops too soon, you make. the patient exert the muscles of the fore-arm, by clenching the hand; while you chafe or rub the forearm * Sometimes when there is a disease in which we foresee frequent occur sions for bleeding, we strike the vein high in the arm,loav1ng‘ good space for future p\mctures below. |