16G OPERATIONS ON THE SKIN AND CELLULAR TISSUE. 



are of a golden yellow tint, having only a few isolated drops of 

 serosity at their sides, the dermis not being extensible, and the 

 skin between the hnes free from infiltration, the epidermis can- 

 not yet be scraped with the finger nail. In the second degree or 

 ordinary firing, the hnes are of a lighter color, or bright yellow, 

 the drops of serosity are more abundant, the dermis is more ex- 

 tensible, the skin between the Unes is thickened with infiltration, 

 and the epidermis is easily scraped off. In the third degree, or 

 strong Jiring, the hnes have a hght yellow color, the dermis is so 

 thinned that the shghtest traction of the portions between the 

 Hnes, which then become wider, stretches it, the serosity is abund- 

 ant and overruns the edges of the hnes, and the skin between 

 them is infiltrated and possibly covered with small phlyctenases or 

 bhsters. To proceed further will be to produce a deep burn, 

 which may be followed with serious comphcations, or at the least, 

 leave large, unsightly cicatrices. 



The length of time required to produce these effects, and the 

 frequency of the apphcations upon a given region, are points by 

 no means easily determined. They are affected by many contin- 

 gencies, which cannot be anticipated. According to Fromage de 

 Feugrd, a cautery heated to a cherry color must be used in each 

 line from ten to twelve times for a hght firing, and from fifteen to 

 twenty for more serious cases ; but Gourdon considers these fig- 

 ures too high, and says that from five to six strokes will be suffi- 

 cient for a fii'ing of the first degree, from eight to nine for one of 

 the second, and from twelve to fifteen for the third, or strong fir- 

 ing. But these figures have no absolute value. The number of 

 strokes will depend upon many conditions, such as the heat of the 

 instrument, the state of the parts and the dexterity of the operator. 



The effects resulting from actual transcurrent cauterization 

 may be divided into primitive and secondary. 



(a) Primitive effects. — The inflammation which follows the 

 burning manifests itself by the appearance of a serous exudation, 

 the serosity being in the form of small drops, in greater or less 

 abundance, according to the degree of the cauterization. This 

 serosity collects between and at the bottom of the lines, and con- 

 tinues to flow for from twenty-four to forty hours, when it is re- 

 placed by the formation of crusts or scabs, dry, yellowish, and ir- 

 regular, and if the firing has been light, attached to the bottom or 

 the borders of the hnes ; but coveriner the entu'e cauterized sur- 



