THE CAUTERY AND THE SETON. 
301 
operator is never so certain with regard to the quantity of caloric 
which he introduces, as he is by the immediate transcurrent cau- 
terization* , 
DEEP FIRING. 
Under certain circumstances, it is necessary to have recourse 
to a deeper and severer mode of applying the cautery. In cases 
of synovial and osseous tumours, a conical firing-iron is used, 
heated to the same degree as the common cautery, or somewhat 
higher, because it more quickly gets cold. This is applied to 
different parts of the skin without piercing it. The points of the 
cautery are multiplied according to tlie circumstances of the case, 
and these points are often used in conjunction with the superficial 
firing in lines, in order to make the operation somewhat more 
severe and effectual. 
At other times, in order to penetrate into certain engorgements, 
cautery irons with sharper points are used, and which are freely 
carried through the skin. These are particularly used in indolent 
tumours in the neighbourhood of the jugular, and the conse- 
quence of inflammation of the vein. This mode of cautery is 
also used to penetrate certain indolent tumours, and to dilate 
fistulous openings. In the latter case, the point of the cautery 
should be of a white heat. 
Finally, when it is necessary to produce deep disorganization 
of any part, or to destroy more or less completely the organic 
tissue of it, the common cautery iron is raised to a far greater 
heat than when used for superficial firing. For this kind of cau- 
terization it is necessary to have several irons in successive readi- 
ness. Before they are applied, it is often advisable to protect 
the neighbouring parts from the too great action of the heat, by 
covering them with some thick compresses or bandages well wet- 
ted. The cautery iron acts more promptly and effectually, and 
with a less degree of pain, when it is brought to a white heat. 
The iron must not be kept in contact with the part more than 
* We are no advocates for this mediate cautery , and in no one instance 
have we had recourse to it ; but we must say that Professor Yatel does not 
do justice to it. He very properly orders the iron to be frequently and 
slowly passed over the pork-rind ; it will thus be brought to the melting 
point, and beyond which it cannot be raised. The temperature at which 
animal oil will boil has been clearly ascertained and above which it cannot 
be raised without deflagration ; therefore there is the clear and definite ap- 
plication of a certain degree of heat. It is another question, whether this 
degree of heat will produce the requisite irritation and engorgement of the 
part ; but Professor Vatel is quite wrong when he says, that the operator is 
uot so certain with regard to the quantity of caloric which he does intro- 
duce : it is far more certain than with the variable hue of thebeated iron. — Y. 
vol. x. r r 
