SETON NEEDLES. 191 



uud the patient must be properly secured. Certain nervous ani- 

 mals may oblige the surgeon to place them in the recumbent posi- 

 tion, but our experience has taught us that the cases in which this 

 is necessary are very excej)tional, and that in the great majority 

 of operations, the simplest means of restraint, a twitch, with the 

 raising and securing of one or two of the extremities, is all that is 

 requii'ed. 



The appHcation of local anesthesia, so far as it may be practi- 

 cable, is also a measiu'e which is in all respects judicious and com- 

 mendable. With the spraying aj^paratus, any part of the body 

 can be reached with great facility. 



In introducing the needle, many veterinarians pass it du-ectly 

 tln'ough the skin, which is raised in a fold, and drawn away as far 

 as possible from the deeper tissues. This maybe readily practica- 

 ble in regions where the cellular tissue is very loose and abundant, 

 as under the chest ; but it is much less so, and more dangerous 

 where the skin is thick, and the subjacent connective tissue is de- 

 ficient or scant, and especially if the edges and point of the 

 needle are not perfectly sharp. 



For this reason the method preferred by many is more judi- 

 cious, of making an incision with the straight bistoury through 

 the skin at each of the two extremities of the proposed tract 

 through which it is intended to pass the seton. The manipulation 

 is sufficiently easy and simple, the operator holding the skin in a 

 fold with one hand, while with the other he guides the needle 

 under the skin and parallel with it, through the cellular tissue, 

 entering through one of the punctures made with the bistoury, 

 and emerging through the other. The point most important to 

 observe here is that of so guiding the needle in its motion that it 

 shall neither plunge into the deeper tissues nor emerge outwardly 

 at the wrong place. At this point the scissors may be utihzed by 

 laying blades flatwise over the place of exit, and pressing down 

 the svirface. Directions are sometimes given, as the next stejD, to 

 insert the tape into the eye of the needle, but it would seem that 

 the safer plan would be to have the tape already in place when 

 the needle is introduced. After the tape has been drawn through, 

 and the needle disengaged, the next and final step is either to 

 iinite the ends of the seton by a knot, or, without tying, to secure 

 them separately by the twisting or plaiting already described, and 

 leave them free. 



