A fleam, also flem, flew, flue, fleame, or phleam, was a handheld instrument used for bloodletting.
A fleam, also flem, flew, flue, fleame, or phleam, was a handheld instrument used for bloodletting.
This name for handheld venipuncture devices first appears in Anglo-Saxon manuscripts around 1000. [1] The name is most likely derived from phlebotome: phlebos, Greek for blood vessel and tome, meaning to cut. [2] These instruments are the progression from the early use of fish teeth, sharpened stones, and thorns used to penetrate blood vessels.
The earliest known examples are made of bronze with a myrtle-leaf shape to the blade. In the 17th and 18th centuries, the German Fliete and French flamettes were developed. These devices with their right-angle blades are the earliest forms of what collectors now refer to as the fleam. [3]
While there are reports of this type of instrument being used in humans, it is more likely that these were reserved for veterinary use, while the common thumb lancet was the instrument of choice for use in people. A survey of 100 fleams found thumb lancets in 6%. [4] These instruments with their triangular-shaped blades were designed to be placed over the vein (most commonly the jugular or saphenous) and struck with a fleam stick. This would ideally result in rapid penetration of the vein with minimal risk to the operator and minimal dissection of the subcutaneous tissues. The latter point was considered important in minimizing the formation of a dissecting hematoma.
Once the desired blood was drained from the patient, the operator would place a pin through the edges of the incision. A figure eight of tail hair or thread was then placed over the pin to retain closure. [5] Statements from Mayhew in his 1864 treatise indicate that the perceived benefits of these procedures were coming into great question in the latter half of the 19th century for all conditions except laminitis. [5]
Early craftsmen often varied the number of blades, the types of materials used for the bolsters, and the types of instruments included in the bolster for patient care. Pictured to the right is a three-blade fleam with a horn handle made in Scotland by the Sanderson craftsmen. This piece has a thumb lancet in one shield of the bolster and a thumb forceps in the other.
Controversy exists among collectors of antique surgical instruments that these types of fleams were made with the lancet so that rural families could bleed the animals and family members alike. Although there are descriptions of the use of thumb lancets in horses for opening the facial vein and for bleeding cats and dogs, the dimensions of the lancets fitted into fleams fit the dimensions of those described by Kirkup for human use. [4] [6]
Bloodletting is the withdrawal of blood from a patient to prevent or cure illness and disease. Bloodletting, whether by a physician or by leeches, was based on an ancient system of medicine in which blood and other bodily fluids were regarded as "humours" that had to remain in proper balance to maintain health. It is claimed to have been the most common medical practice performed by surgeons from antiquity until the late 19th century, a span of over 2,000 years. In Europe, the practice continued to be relatively common until the end of the 19th century. The practice has now been abandoned by modern-style medicine for all except a few very specific medical conditions. In the overwhelming majority of cases, the historical use of bloodletting was harmful to patients.
The kukri or khukuri is a type of short sword with a distinct recurve in its blade that originated in the Indian subcontinent. It serves multiple purposes as a melee weapon and also as a regular cutting tool throughout most of South Asia. The kukri, khukri, and kukkri spellings are of Indian English origin, with the original Nepalese English spelling being khukuri.
Bleeding time is a medical test done on someone to assess their platelets function. It involves making a patient bleed, then timing how long it takes for them to stop bleeding using a stopwatch or other suitable devices.
A scalpel, lancet, or bistoury is a small and extremely sharp bladed instrument used for surgery, anatomical dissection, podiatry and various handicrafts. A lancet is a double-edged scalpel.
A hemostat is a tool used to control bleeding during surgery. Similar in design to both pliers and scissors, it is used to clamp exposed blood vessels shut.
Interventional radiology (IR) is a medical specialty that performs various minimally-invasive procedures using medical imaging guidance, such as x-ray fluoroscopy, computed tomography, magnetic resonance imaging, or ultrasound. IR performs both diagnostic and therapeutic procedures through very small incisions or body orifices. Diagnostic IR procedures are those intended to help make a diagnosis or guide further medical treatment, and include image-guided biopsy of a tumor or injection of an imaging contrast agent into a hollow structure, such as a blood vessel or a duct. By contrast, therapeutic IR procedures provide direct treatment—they include catheter-based medicine delivery, medical device placement, and angioplasty of narrowed structures.
A stabbing is penetration or rough contact with a sharp or pointed object at close range. Stab connotes purposeful action, as by an assassin or murderer, but it is also possible to accidentally stab oneself or others. Stabbing differs from slashing or cutting in that the motion of the object used in a stabbing generally moves perpendicular to and directly into the victim's body, rather than being drawn across it.
Forceps are a handheld, hinged instrument used for grasping and holding objects. Forceps are used when fingers are too large to grasp small objects or when many objects need to be held at one time while the hands are used to perform a task. The term "forceps" is used almost exclusively in the fields of biology and medicine. Outside biology and medicine, people usually refer to forceps as tweezers, tongs, pliers, clips or clamps.
A drawing pin or [thumb] tack, also called a push-pin, is a short, small pin or nail with a flat, broad head that can be pressed into place with pressure from the thumb, often used for hanging light articles on a wall or noticeboard.
The Laguiole knife is a traditional Occitan pocketknife, originally produced in the "knife city" of Thiers, source of 70% of France's cutting tool production, as well as the small village of Laguiole, both located in the Massif central region of France. Laguiole in this instance does not refer to the French knife brand but to a generic type of traditional slipjoint knife associated with this region of France.
A surgical instrument is a medical device for performing specific actions or carrying out desired effects during a surgery or operation, such as modifying biological tissue, or to provide access for viewing it. Over time, many different kinds of surgical instruments and tools have been invented. Some surgical instruments are designed for general use in all sorts of surgeries, while others are designed for only certain specialties or specific procedures.
An antihemorrhagic agent is a substance that promotes hemostasis. It may also be known as a hemostatic agent.
A retractor is a surgical instrument used to separate the edges of a surgical incision/wound or to hold away certain organs and tissues so that body parts underneath may be accessed during surgical operations.
Veterinary dentistry is the field of dentistry applied to the care of animals. It is the art and science of prevention, diagnosis, and treatment of conditions, diseases, and disorders of the oral cavity, the maxillofacial region, and its associated structures as it relates to animals.
The Liston knife is a type of knife used in surgical amputation.
A trocar is a medical or veterinary device used in minimally invasive surgery. Trocars are typically made up of an awl, a cannula and often a seal. Some trocars also include a valve mechanism to allow for insufflation. Trocars are designed for placement through the chest and abdominal walls during thoracoscopic and laparoscopic surgery, and each trocar functions as a portal for the subsequent insertion of other endoscopic instruments such as grasper, scissors, stapler, electrocautery, suction tip, etc. — hence the more commonly used colloquial jargon "port". Trocars also allow passive evacuation of excess gas or fluid from organs within the body.
The navaja is a traditional Spanish folding-blade fighting and utility knife.
In dentistry, debridement refers to the removal by dental cleaning of accumulations of plaque and calculus (tartar) in order to maintain dental health. Debridement may be performed using ultrasonic instruments, which fracture the calculus, thereby facilitating its removal, as well as hand tools, including periodontal scaler and curettes, or through the use of chemicals such as hydrogen peroxide.
Mayo scissors are a type of surgical scissor, often used in the cutting of fascia.
Ancient Roman surgical practices developed from Greek techniques. Roman surgeons and doctors usually learned through apprenticeships or studying. Ancient Roman doctors such as Galen and Celsus described Roman surgical techniques in their medical literature, such as De Medicina. These methods encompassed modern oral surgery, cosmetic surgery, sutures, ligatures, amputations, tonsillectomies, mastectomies, cataract surgeries, lithotomies, hernia repair, gynecology, neurosurgery, and others. Surgery was a rare practice, as it was dangerous and often had fatal results. To perform these procedures, they used tools such as specula, catheters, enemas, bone levers, osteotomes, phlebotomes, probes, curettes, bone drills, bone forceps, cupping vessels, knives, scalpels, scissors, and spathas.
