A handbook of local therapeutics / edited by Harrison Allen.

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of local therapeutics / edited by Harrison Allen. Source: Wellcome Collection.

    187/554 (page 175)
    either in a simple or complicated manner, as by the heating of any metallic or non- destructible substance to the required temperature by fire, or by the use of some of the more elaborate chemical or electrical apparatus. The common method of its application is by irons of various shapes heated to a red or white heat in a charcoal furnace. A eras cautery has been introduced, by which a jet of burning gas may be directed to the desired spot. The galvano-cautery, owing to the variety and delicacy of its means of application, offers to the surgeon a means of deaUng with many conditions which could not be attempted with the more primitive instrument. The electrical current may be ob- tained either from the chemical or storage battery. For the general use of the surgeon, Pacquelin has introduced a cautery in which the heat is maintained by throwing the vapor of some hydrocarbon (as benzin) upon spongy platinum which has been previously heated. This ingenious apparatus forms a compact, convenient, and easily regulated means of cauterizing, and has almost superseded the use of the galvanic cautery in aeneral surgery. The temperature at which a cautery should be used depends altogether upon the object in view. If used for its counter-irritant and destructive effect, it is best employed at a high temperature, as from a bright red to a white heat; if for its haemo- static action, the cautery should not exceed a dull, cherry-red. Otherwise, the blood- vessels will be seared through so rapidly that a very imperfect clot will be formed, and bleeding will re-occur. Care should be exercised in the use of the cautery, never to employ it when the temperature is below a dull red heat, as the tissues will adhere to the iron, and on its withdrawal a portion of the burned part will be removed, causing unne- cessary pain. General Surgery.—In Articular as well as Osseous Disease Mr. Barwell speaks highly of the use of the actual cautery, heated to white- ness, as a counier-irriiant. The agent is of especial value in that ob- stinate class of joint diseases which, if not corrected, will soon perma- nently impair the integrity of the parts. The effect produced by the actual cautery is apparently similar to that produced by blisters and other revulsives, although it is a more powerful method. As a rule, the pain caused by the cautery is momentary, less, indeed, than that following the application of a blister. The contact of the heated wire or rod should be for as brief a time as possible, as the object in view is to create a superficial ulcer which will rapidly heal. (See remarks on flying blister, p. 169.) It must be borne in mind that the cautery is not applicable to the early stages of inflammation, neither is it of any service in the sup- purative stage. It is best adapted to the long-standing, deep-seated in- flammations. Absolute rest of the part affected should always be enjoined after the use of the cautery. For its destructive effect the actual cautery is often employed by the surgeon when the parts involved are very vascular and the use of a cutting instrument is contra-indicated. In Cancer of the Uterus the entire surface of the growth may be altered and much temporary relief obtained by the careful employment of the .Pacquelin cautery. The electro-6craseur in action is similar to the ordinary instrument, the only difference being a series of mechanical devices, by which the loop