New elements of operative surgery . ence by making pressure under thepoint to be punctured. This pressure may be effected in differentways. The machines invented for this purpose are entirely most simple mode is, to place a graduated compress of somethickness upon the lower part of the vessel in the supra-claviculardepression, and to cover it by the middle of the cravat, or a narrowband, whose extremities are attached by means of a knot underthe axilla of the opposite side, (Fig. 153 a) or held tight in thisdirection by an assistant. We obtain the same result by causingpressure to
New elements of operative surgery . ence by making pressure under thepoint to be punctured. This pressure may be effected in differentways. The machines invented for this purpose are entirely most simple mode is, to place a graduated compress of somethickness upon the lower part of the vessel in the supra-claviculardepression, and to cover it by the middle of the cravat, or a narrowband, whose extremities are attached by means of a knot underthe axilla of the opposite side, (Fig. 153 a) or held tight in thisdirection by an assistant. We obtain the same result by causingpressure to be made upon the vein by the thumb of another person,or by compressing it ourself below the point we wish to puncture, 256 NEW ELEMENTS OF OPERATIVE SURGERY. while the skin is made tense above by means of the index and middlefingers. M. Magistel, who has published a very good treatise uponbleeding, sometimes effects this compression by means of a porte-cachet supplied with a pelote ; but it is evident that the finger of (Fig. 153.). the operator, or a cravat, or the extremity of a band, or a riband,passed from the supra-clavicular region to the hollow of the oppo-site axilla, perfectly accomplish the object in view, v^hile theyinterfere as little as possible with the operation itself If the veinshould not be sufficiently swollen, we should cause the patient tomove his jaws as in mastication. C. Puncture of the Vein. There are, in fact, many reasons for opening the external jugularin its lower half, rather than in the neighborhood of the parotid re-gion. First, it is generally smaller above than below; again, it isat that part of it near the os hyoides where it is most surround-ed with nerves ; nevertheless, we should not puncture it at the ex- BLEEDING, OR SANGUINEOUS EMISSIONS. 257 treme lower part, as it might then be difficult to make pressurebelow, and the branches of the cervical plexus here again surroundit at this point. We make choice, moreover, of the right or leftside
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