SETON NEEDLES. - 191 



and 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 exceptional, 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 aU that is 

 required. 



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

 cable, is also a measure which is in aU respects judicious and com- 

 mendable. "With the spraying apparatus, any part of the body 

 can be reached with great facility. 



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

 through 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 verj' 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 holdiag the skia 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 ia 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 utilized by 

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

 the surface. Directions are sometimes given, as the next step, 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 

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

 them separately by the twisting or plaiting akeady described, and 

 leave tbem free. 



