142 ELEMENTARY OPERATIONS. 



withdraws the instrument by its pavilion, drawing it in a line 

 parallel to the division in which it was introduced. 



Exploring needles, or trocars, which are but small directors 

 with a lanceolate blade at one end, and a smaU groove on one 

 side, are also used for making punctures, and their adaj)tation as 



Fig. 177.— Exploring Needles. 



very small trocars, with aspirators (j)rincipally that of Dieulafoy) 

 find frequent use in our surgery. These instruments have ah'eady 

 been considered in the chaj)ter upon surgical diagnosis. 



The Puncture with the Actual Cautery. — The conical cautery 

 is the one used in this mode of operation. It varies in diameter 

 and in length. The instrument is heated to a white heat, apphed 

 perpendicularly ujDon the skin and pushed in until the sense of 

 resistance is no longer felt, when it is vdthdrawn. The condition 

 of white heat of the instrument is of great importance. Though 

 apparently an act of great severity, the oj^eration finds numerous 

 appUcations in our surgical practice, principally for the puncture 

 of deep-seated cold abscesses. It has great advantages over the 

 punctui-e with the bistoviry, inasmuch as there is no hemorrhage 

 to fear from its use ; because the opening made by the cautery 

 remains unclosed a longer time, and because the inflammation is 

 modified in its nature, and the process of resolution thus assisted 

 by the caloric thrown in. 



The use of local anesthesia, by the injections of cocaine, will 

 remove from this mode of puncture the rough side of its applica- 

 tion by rendering the operation entirely painless. 



EEUNION. 



This term signifies the readjustment and consoHdation of tis- 

 sues which had been disintegrated and divided — otherwise, simply 

 the reuniting of separated parts, and their restoration to a nor- 

 mal condition. This process is otherwise referred to as that of 

 cicatrization, a natural property of organic tissues, which, though 

 it may be aided and guided by the surgeon, can be controlled by 



