08.07.2014 Views

BLOODLETTING INSTRUMENTS - Smithsonian Institution Libraries

BLOODLETTING INSTRUMENTS - Smithsonian Institution Libraries

BLOODLETTING INSTRUMENTS - Smithsonian Institution Libraries

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

NUMBER 41 11<br />

FIGURE 5.—18th-19th century lancets and lancet cases. The cases are made of mother-of-pearl,<br />

silver, shagreen, and tortoise shell. (NMHT 308730.10. SI photo 76-9116.)<br />

be Stopped by a bandage or compress applied to<br />

the incision.<br />

Teaching a medical student how to bleed has<br />

had a long tradition. Before approaching a patient,<br />

the student practiced opening a vein quickly and<br />

accurately on plants, especially the fruits and<br />

stems.^i The mark of a good venesector was his<br />

ability not to let even a drop of blood be seen after<br />

the bleeding basin was removed.^^<br />

It required some degree of skill to strike a vein<br />

properly. The most common vein tapped was in<br />

the elbow, although veins in the foot were also<br />

popular. The arm was first rubbed and the patient<br />

given a stick to grasp. Then a tourniquet would<br />

be applied above the elbow (or, if the blood was<br />

to be taken from the foot, above the ankle), in<br />

order to enlarge the veins and promote a continuous<br />

flow of blood. Holding the handle between<br />

the thumb and the first finger, the operator then<br />

jabbed the lancet into the vein. Sometimes, especially<br />

if the vein was not close to the surface of<br />

the skin, the instrument was given an extra impetus<br />

by striking it with a small mallet or the fingers to<br />

insure puncturing the vein.^^ xhe incisions were<br />

made diagonally or parallel to the veins in order<br />

to minimize the danger of cutting the vein in two.^*<br />

For superficial veins, the vein was sometimes<br />

transfixed, that is, the blade would be inserted underneath<br />

the vessel so that the vessel could not<br />

move or slip out of reach. The transfixing procedure<br />

ensured that the vein would remain semi-divided<br />

so that blood would continuously pass out of it,<br />

and that injury to other structures would be<br />

avoided. Deeplying veins of the scalp, for example,<br />

could not be transfixed. They were divided by cutting<br />

through everything overlying them since there<br />

were no important structures to injure.^^<br />

The consequences of puncturing certain veins<br />

incorrectly were discussed by many early writers<br />

including Galen, Celsus, Antyllus, and Paul of<br />

Aegina.^^ Injury to a nearby nerve, muscle, or artery<br />

resulted in convulsions, excessive bleeding, or paralysis.<br />

Bloodletting was at its most fashionable in the<br />

eighteenth and early nineteenth centuries. In this<br />

period it was considered an art to hold the lancet<br />

properly and to support the arm of the patient<br />

with delicacy and grace.^^ Many patients had by

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!