142 ELEMENTABY OPEEATIONS. 



withdraws the instrument by its pavilion, drawiag 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 small groove on one 

 side, are also used for making punctures, and then- adaptation as 



Fig. 177.— Exploring Needles. 



very small trocars, vnth aspirators (principally that of Dieulafoy) 

 find frequent use ia our surgery. These instruments have already 

 been considered ia the chapter upon surgical diagnosis. 



The Puncture with the Actual Cautery. — The conical cautery 

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

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

 perpendicularly upon the skin and pushed in until the sense of 

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

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

 apparently an act of great severity, the operation finds numerous 

 applications in our surgical practice, principally for the puncture 

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

 puncture with the bistoury, 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 ioflammation 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, wUl 

 remove from this mode of puncture the rough side of its apphcar 

 tion by rendering the operation entirely painless. 



EEUNION. 



This term signifies the readjustment and consolidation 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 



