180 OPERATIONS ON THE SKIN AND CELLULAR TISSUE. 



In the first instance, it is indicated in superficial cutaneous ulcers, 

 in wounds indisposed to cicatrize ; in those following warts, in fun- 

 goid growths, in cancerous, melanotic or fibrous tumors, in gan- 

 grenous wounds and those following the opening of a cold abscess ; 

 in fistula due to caries or necrosis of bones, tendons or ligaments, 

 etc. The instruments used are of various shapes : round, 

 olivary, annular or culteUar. They are applied firmly upon the 

 tissues, and held in place for a few seconds, according to the density 

 of the parts If the surface is wider than the instruments, the 

 firing must be done by sections, applying the iron in detail upon 

 spots, until the entire surface has been touched. This is a better 

 method than that of rubbing the instrument over the surface, and 

 renders the eftect more regular and uniform. In the second 

 degree, or the cauterization into the depth of the tissues, a conical 

 instrument is used and held in its place of insertion until it has 

 lost most of its heat, thus reaching whatever depth may be neces- 

 sary. 



This cauterization is indicated against anthracoid, gangrenous, 

 farcinous and cancerous tumors ; in wounds of a virulent or veno- 

 mous nature; in purulent infiltrations of the skin or of the 

 ceUiilar tissue ; in caries of bones, tendons, cartilages and ligar- 

 ments, in dental caries, in indurated tumors, in fungoid growths, 

 polypoid granulations, etc. Renault has recommended them in 

 the treatment of the large sores so often occurring in granular 

 dermatitis. 



Subcutaneous Cautebization, 



Otherwise known as Neapolitan cauterization, or " a la Nan- 

 zio," consists in the appHcation of the cautery in points directly 

 upon the muscular structure, exi30se<i by an incision made through 

 the skin. The method was known and had been mentioned by 

 Ruini, Solleysel, Bourgelat, Rejnial and others in more or less 

 modified and varying terms, before Mr. de Nanzio called the at- 

 tention of the profession to the good results he had obtained by 

 it. 



Its application is principally efiicacious in the treatment of 

 chronic lameness of the shoulder or of the coxo-femoral joint. 

 The instruments required are two bistouries, one curved and one 

 straight, two flat tenaculums, a bull-dog forceps, scissors and an 

 ordinary oHvary cautery. De Nanzio thus describes the opera- 



