A universal formulary : containing the methods of preparing and administering officinal and other medicines the whole adapted to physicians and pharmaceutists / by R. Eglesfeld Griffith.

  • Griffith, R. Eglesfeld (Robert Eglesfeld), 1798-1850.
Date:
[1854]
Catalogue details

Licence: Public Domain Mark

Credit: A universal formulary : containing the methods of preparing and administering officinal and other medicines the whole adapted to physicians and pharmaceutists / by R. Eglesfeld Griffith. Source: Wellcome Collection.

    554/696 (page 548)
    General Blood-letting. — Venexection is one of the most frequently employed of the different modes of detracting blood. It is u.sually practiced on one of the veins of the arm. A band or ligature is to be applied around the arm above the point at which the vein is to be opened, so as to obstruct the passage of the blood to the heart; this causes an enlargement and turgidity of the vessel below the ligature. This bandage should never be applied so tightly as to prevent the passage of blood in the arteries of the part. The vein is to be opebed by means of a common or thumb lancet, or a spring lancet. In using the first, the vein is to be kept from rolling by means of the thumb of the left hand placed a small distance below where the puncture is to be made; but care should be taken not to alter the relative posi- tion of the skin and vein, because, in resuming their position after the lancet is inserted, the aperture through the skin will no longer correspond with that in the vein, in consequence of which a thrombus or ecchymosis will form—ii very common accident in venesection. The lancet is to be pushed into the vein, and when its point is within the cavity of the vessel, it is to be carried forward a little, so as to enlarge sufficiently the opening. The arm is to be kept extended after the operation until the necessary quantity of blood is taken. If the blood should not flow as freely as is desired, the patient should exert the muscles of the arm by grasping a stick, or moving the fingers. The spring-lancet is much used in some parts of the United States, and is almost universally employed in Philadelphia. This has arisen, in great measure, from its being preferred to the common lancet by Dr. Physick, as well as by Dr. Dorsey, whose reasons for this preference are thus given in his “ Elements of Surgery.” “ In a country, situated like the United States, where every surgeon, except those residing in the large cities, is compelled to be his own cutler, at least so far as to keep his instruments in order, the spring-lancet has a decided preference over the lancet; the blade of this can with great ease be sharpened by any man of common dexterity, and if not very keen, it does no mischief, whereas a dull lancet is a most dangerous instrument; and no one can calculate with certainty the depth to which it will enter: to sharpen a lancet, is regarded by the cutler as one of his nicest and most difficult jobs; it is one to which few surgeons are competent. “ The safety of using the fleam is demonstrated by daily experience; there is no country in which venesection is more frequently performed than in the United States, and, perhaps, none where fewer accidents from the operation have occurred; of these few, I beg leave to state that all the aneurisms produced by bleeding, which I have seen, have been in cases where the lancet was used. I have since, however, met with an exception to this statement. I have seen the brachial artery opened by a spring-lancet, but it was by an old barber, half blind, and very clumsy.” “ The manner of using the spring-lancet differs in nothing from the operation with the common lancet, excepting that the surgeon must place the instrument in such a situation over the vein that, when the spring is touched, the orifice into the vein will have a proper size and direction. Dexterity in this is very readily and speedily acquired. In point of facility in its use, it has a great advantage over the lancet. “ Among the advantages of the spring-lancet, economy is not the least. A country practitioner who is constantly employing the English lancets, and who is particular in using none but the best, must necessarily consume half the emolument derived from the operation in the purchase of his instruments. One spring-lancet, with an occasional new blade, will serve him all his life.” After a sufficient quantity of blood has been drawn, the flow is to be stopped by removing the ligature and placing a finger on the orifice, when any blood that has soiled the arm is to be wiped off, and the edges of the orifice carefully brought together, that they may unite by the first intention. To accomplish this, let the bleeder, with the thumb of that hand which holds the arm, push the skin towards • the orifice, while he draws it on the other side to the same point with the compress; thus the skin will be thrown into folds at the wound, over which he is immediately