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.

    188/554 (page 176)
    Of the 6crasenr is maintained at a low degree of temperature, so that the wire slowly burns its way through the part to be removed, if properly used, leaving a dry, seared stump. By this method the uterine neck and other vascular parts may be removed without hemorrhage. A similar method is applicable to Cancer of the Tongue. To obtain the best results, a low degree of heat must be maintained otherwise the vessels will be opened so rapidly that a satisfactory clot will not be formed and hemorrhage will ensue. As a hemostatic the value of the actual cautery has long been recog- nized. The ancients employed a large flat stone at a red heat to control bleeding from the stump in amputations. The cautery to-day, as a haemo- static, has a very extensive range of employment, especially in positions where the application of a ligature is impossible, as in bleeding from the internal maxillary artery in the removal of the upper jaw. The temperature must be relatively low and the contact with the bleeding part be longer than for other purposes, to insure the thorough closing of blood- vessels. In the treatment of Hemorrhoids the cautery is extensively employed, especially where Smith's clamp is used and the pile is removed with scissors. The base is thoroughly seared with a hot iron thereby controlling all bleeding. As a rule, the pain following the procedure is much less than in the use of the ligature so extensively employed in this country. The advocates of these procedures are so strongly arrayed on either side that the prudent surgeon will select for operation the method best suited to the individual case. In Prolapse of the Rec- tum, Van Buren recommends linear cauterization with the cautery, the resulting cicatrices serving to contract the bowel. The employment of nitric acid (^. v.) will, as a rule, be found a more satisfactory means of dealing with this troublesome condition. Diseases of the Skin.—The actual cautery is sometimes employed in the treatment of Lupus, Epithelioma, and N^vus. A convenient instrument is that figured in Piffard's Materia Medica and Therapeutics of the Skin (N. Y., 1881, p. 232). It consists in a small, curved rod of steel or iron, about the size of an awl, with a small globe of metal near the point, to retain the heat. This is inserted in a shank, and can be heated as desired, over a spirit lamp. Some caution is necessary in using this or any cautery in large nasvi, as bleeding may follow if the tissues are too rapidly destroyed. The Pacquelin thermo-cautery is employed for the same purpose. The construction of this cautery is based upon the property of platinum and some other metals of becoming immediately incandescent, when raised to a certain .degree of heat, in contact with a mixture of air and the vapor of some volatile hydrocarbons, and of maintaining this incan- descence so long as the contact of the mixture exists.