92 DIVIDING TISSUES WITH THE ECRASEUR. 



rapidly than that made by the knife, owing to superficial cell necrosis. 

 The ecraseur consists of an articulated steel chain, the loop of 

 which is passed around the part to be divided and drawn tight until 

 the tissue is finally crushed through. Chassaignac's ecraseur (Figs. 

 102 and 103) acts by means of the two rods H H\ which are 

 provided with teeth controlled by the two spring pawls B B. By 

 slightly depressing the handle G G on either side, one of these rods 

 is drawn forward a tooth and immediately secured by its corre- 

 sponding pawl, when it becomes the fixed point through the medium 

 of which the opposite rod is drawn downwards. The lower ends 

 of the two rods thus act alternately as fixed points on which the 

 handle G G swings. Reference to the figures will show that move- 

 ment of this handle in the method described will cause the rods 

 gradually to descend, drawing the loop of the ecraseur K within 

 the tube C, and slowly dividing any tissue enclosed within the loop 

 K. In later ecraseurs, such as Fig. 104 the movement is effected 



g^Z2 FREE LOCKED 



#=€®lfe 



Fig. 104. — Professor Dewar's ecraseur. 



by a screw. At Professor Dewar's request Messrs. Arnold have 

 produced an ecraseur with a particularly neat and effective catch 

 by means of which the screw can be thrown into and out of action 

 very readily. When the catch is in the position marked " free " 

 the " slack " of the chain can be taken up so that the instrument 

 is ready to commence cutting as soon as put in operation. By 

 slipping back the catch the chain becomes locked to the screw, and 

 the apparatus is ready for use. The screw movement is certainly 

 preferable to the rack originally fitted in the Chassaignac instrument. 

 This instrument is now made long enough for the castration of mares 

 and cows, and as the chain is bevelled on one edge it crushes 

 through instead of cutting the tissues, thus avoiding a frequent cause 

 of post-operative haemorrhage. On the other hand it may be reversed 

 it very fibrous tissues require to be divided. 



Small and even medium-sized vessels may be divided in this way 

 without bleeding. The action depends to some extent on the rapidity 



