SURGERY. 205 
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merve dividing principally about the median vein; ", aponeurotic strip, 
which, proceeding from the tendon of the biceps, overlies the brachial 
artery and vein, and median nerve, and passes into the radial side of the 
fascia of the forearm; ''*”, circumference of the opening in the aponeu- 
rosis, well defined internally, but externally confounded with the cellular 
tissue; ***, brachial artery; '‘, radial artery; “, ulnar artery; *, median 
nerve; ‘"’, brachial vein; "and *”*, outer muscles, and *.”, inner muscles 
of the forearm; “, internal condyle of the elbow; *, a hook by which the 
opening in the fascia is drawn inwards to show, above the tendinous strip 
of the biceps, the brachial artery and vein, the median nerve, the brachizeus 
internus' muscle, and the protractor teres; “, everted skin with adipose 
tissue; “4, skin of the forearm; *, skin of the arm. 
In inflammation of deep-seated parts, especially such as threaten suppu- 
ration, and even when this has already commenced, powerful counter- 
irritants are frequently necessary and advisable; these may consist in the 
introduction of setons, in the use of caustics, or the still more severe appli- 
cation of the actual cautery with red hot iron, and of moxas. The irons 
used in cauterization differ much in form. We shall here only mention the 
prismatic cautery of Larrey (pl. 140, fig. 38), whose prism has a narrow 
base in proportion to its height, and has the anterior corners cut off oblique- 
ly; also the prismatic cautery of Kust (jig. 89), which is 1 inch 4 lines long 
and has three equal surfaces 2 of an inch in breadth. 
3. ACUPUNCTURE is an operation which has for a long time been success- 
fully used in various ailments, as rheumatism, gout, &c. It consists in 
repeatedly piercing the part affected with a long needle, moving it back- 
wards and forwards in the wound. 
- Sarlaridere’s galvanic acupuncture needle (figs. 40, 41). 
2. SEWING UP OF WoUNDS, oR SuTURA CRUENTA. 
« Wounds are of various sorts: they are punctured, when produced by a 
pointed instrument; zncised, when made by a cutting instrument; lacerated, 
when the parts are lacerated or torn; povsoned, when some virulent sub- 
stance has been introduced; contused, when made by a blunt body, as a 
bullet. Incised and punctured wounds are of most frequent occurrence, 
and formerly were almost entirely treated by sewing up the edges; more 
modern surgery, however, rarely uses anything else than sticking-plaster 
and-proper bandages, by which the lips of the wound are more closely 
approximated and the reparative powers of the system less interfered with. 
The following sutures are those most employed at the present day, when at 
all necessary. 
1. THE INTERRUPTED SurureE, sutura nodosa (pl. 140, fig. 28). This 
requires as many ligature needles as there are ligatures, the needles 
being of various shapes to suit the emergency (jig. 25, the ligature needle 
‘of Assolini; jig. 26, do. of Blasius; jig. 27, do. of Savigny). Each needle 
is to be provided with one or more turns of thread, as the case may require. 
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