irons : copper I prefer, as this metal is very good for wounds.
The effects of firing are slow ; I have seen animals in which
the effects of firing were not fully realized for six months ; it is an
imperceptible resolution ; time is required to produce the absorption
and reduction looked for .The effect of fire lasts twenty-
seven days, nine for its increase, nine for its developed condition
and nine for its subsidence ; the least time that ought to be given
for one to see the good effects is eighteen days Twenty-
five years ago, to speak of firing a horse or to send it to the skinner
were the same thing ; to-day it is different ; I have removed the
fear that people had of it ; experience had conquered."
In his '' Nouveau Par/ait MareschaV (1741)' Garsault reproduces
the same principles, and recommends firing, "following as closely
' CoUcctioH hippocratiqtte, trad, of Littr^, vol. iv., Aphorisms, p. 609.
CAUTERIZATION — FIRING. 79
as possible the direction of the hairs, so that when they grow out
again they may cover the marks." He advocates, also, firing as
a preventive, as practised in Oriental countries. "The only reason
preventive firing is not done in this country, as it is in others, is
because of the scars, which will lessen the value if the animal is
offered for sale ; but if one wishes to keep his horse, firing of the
legs will do it good. "
The hippiatres of recent times have abused firing. Having
but vague and incomplete notions about anatomy, they preferred it
as a means of hemostasis. Although its use has been greatly
restricted during this century, it remains yet in veterinary surgery
a therapeutic method well established and daily used with success
against numerous affections which have not yielded to other modes
of treatment. No doubt it is painful, it imposes long rest, and at
times leaves permanent marks ; but compared with the advantages
it offers, these objections are of little importance.
Among the uses of actual cauterization, the most common are for
chronic affections of tendinous sheaths, of bones and of joints ;
synovitis, hydarthrosis, sprains, luxations, exostosis, periostosis, ex-
tensive callosities, caries, and necrosis. It is the most generally used
curative agent for some tendinous lesions, amyotrophia, chronic in-
flammatory alterations of the connective tissue, and for various
kinds of cysts. It is used also ordinarily for treating the old lymph-
angitic and phlebitic indurations, fistulae, refractory ulcers, summer
and virulent wounds, anthrax tumors, septic swellings.
There are two kinds of cauterization, the superficial ^XiA the deep,
each of which is applied by various methods. Cauterization in sheet
is not practiced ; and the ignited substances, the moxas, are no
longer used. As much can be said oi cauterization by radiation, or of
the method with warm liquids and of mediate cauterization.
The only processes used to-day are :
1. Superficial cauterization, in points or in lines, in which the
instrument does not penetrate deeper than the dermis.
2. Catiterization with fine penetrating points, in which the skin is
perforated through and through with one or several strokes of the
cautery.
3. Needle cauterization, in which the instrument penetrates into
muscles, tendons, ligaments, bones and synovial sacs.
4. Subcutaneous Cauterization, done after incision of the skin.
CAUTERIZATION OF SOLIPEDS.
Yo\ firing in lines, instruments having the shape of a triangular
prism are used. (Fig- 37-) They are of small size for thin skinned
animals ; they are larger for those whose teguments are thick. The
8o
VETERINARY SURGICAL THERArEUTICS.
cauterizing; edge must be slightly convex, blunt throughout its
whole extent, rounded at its angles ; and its rod would better be
moderately rounded in. With such instruments the uneven parts
of the region can be well followed, and the heat evenly distributed.
The active part oi point cautery (fig. 37) is disposed in a conical form
more or less elongated ; it
varies in size. For penetrat-
ing or deep pointed firing, a
cautery more elongated than
the preceding is used. Abadie
has recommended an instru-
ment with which he could
run through the subcutaneous
connective tissue and deep
into the tissues. When one
does not wish to go beyond
the subcutaneous connective
tissue, ordinary cauteries
more or less elongated an-
swer all purposes. Needle
Cauterization requires very fine
needles which can penetrate
all tissues. At first iron need-
les, 2 millimeters in diameter,
and one or two decimeters
long, were used ; heated to
red heat, they were taken
hold of with nippers and implanted in the tissues. Bianchi, Lenck,
Foucher, have recommended cauteries having an olivary part,
terminated by a point of iron or platinum. The most of those in-
struments with a separate needle cool off too quickly and burn the
skin round the perforation. To protect the skin, Watrin had a
little disk of metal placed between the needle and the olivary part
of the cautery.
Bourguet (fig. 38), Vasselin, Hermann, andEhret have invented the
first cauteries with movable needles and independent heating.
That of Bourguet is superior to all others, and we use it often at
Alfort, with best results. A screw (A) regulates the penetration of
the needle, which is heated in the interior of the heat carrier, a
slight pressure from downwards upwards upon the branch F pushes
it out ; as soon as it is removed from the tissues, it is allowed to
return to the heating mass, which is fixed by a spring (INI). A
screen protects the skin. Notwithstanding its apparent complexity,
this instrument is remarkable for its solidity and the regularity of its
Working.
F'g. 37 — Lines firing iron. Dots firing iron.
Sharp pointed firing iron.
CAUTERIZATION — FIRING.
;i
The Paquelin cautery (fig. 39) is based upon the property that
platinum possesses, when once brought to a given temperature, of
becoming incandescent in contact
with a mixture of air and hydro-
carbon vapors ; and of remaining
in this condition as long as the
contact may last. The cauteriz-
ing part is screwed on a rod, and,
according to needs, may be a point,
a needle or a knife. The lighting
is simple. The cauterizing part
is heated Avith the alcoholic
lamp ; after a few minutes the
bellows is called into play. The
platinum reddens at once. The
ordinary Paquelin is rather weak
for large animals. Often, if the
animal reacts much, the point
bends, or becomes loose, or the
rods more or less deranged.
The Zoocatiiery (fig. 40) is more
solid and better adapted to our
uses. Its construction rests upon
the power of the platinum to
remain incandescent under the
action of the hydrocarbon aceous
vapors, and upon its remarkable
conductibility. The reservoir (A)
contains a sponge moist with a
small quantity of mineral essence;
at one extremity is fitted a
Richardson bellows ; on the other
is screwed a peculiar branch, car-
rying a cautery in point or in line,
whose base is perforated with lat-
eral holes, which permit it to act as
a siphon. A tube inside carries
the vapors of the essence to the
point of platinum ; a screw (H)
allows the essence to burn in the
siphon, or prevents its reaching
the siphon by the central tube.
To make the instrument work, a small quantity of essence is
poured upon the sponge, that which is in excess having been ex-
pelled, the cautery is screwed on the reservoir, and the bellows
6
Fig. 38 — Bourguet's cautery.
82
VETERINARY SURGICAL THERAPEUTICS.
adapted ; the screw H and the spigot B are now opened. The bellows
are worked, the vapors of essence which escape by the lateral open-
ings of the siphon are lighted, gradually the spigot B is closed until
Fig. 39 — Paquelin's cautery.
the flames do not come out any more. Soon the central tube red-
dens ; and the siphon being then closed by the screw H, the point
of the cautery is soon seen becoming red in its turn. As the
quantity of essence diminishes in the sponge, to keep up a sufficient
quantity of heat, the spigot B has to be opened gradually.
This cautery is very handy ; it permits rapid application of firing
in superficial deep points ; but though the needle is made of iridized
platinum, it bends just like that of the Paquelin cautery. This has
CAUTERIZATION — FIRING.
83
the more serious objection, however, that the assistant who has
charge of the bellows soon becomes tired working it.
In the cautery Paqiielin de Place (fig.
41) the heat is also furnished by the
combustion of hydrocarbon vapors.
For needle firing, one full needle is
made to pass through the heating
chamber, and when it is heated, is
brought out by pressure on the con-
ducting rod; when cooled off, the press-
ure is relieved and permits the needle
to return into the heating chamber.
Though not without advantages, this
instrument is less handy to work with
than the thermo or the zoocautery,
and the cauterizing action of the hollow
points of platinum is less active than
that of solid points of iron or steel.
To heat ordinary cauteries, a forge
or a heating furnace is used. Wood
coal or coke is preferable to other coal.
An assistant watches the process of
heating, and when the instrument
has sufficient amount of heat, he takes
hold of it, passes a file over its sharp
part and gives it to the surgeon.
Lagriffoul, Faugere, and Perrin
have had the idea of using eoli-
Lines cautery.
Fine point cautery.
\
Fig. 40 — Zoocautery ; A. tank ; B, cocfcj
G, hollow stem ; E, fire point ; H, regu^.
lating screw, .
piles like that of Paquelin. These instruments are useful and keep
the cauteries clean and free from clinkers. Some are dangerous.
That of Lagriffoul (fig. 42) is fixed on a table which carries a kind
84
VETERINARY SURGICAL THERAPEUTICS.
of chimney where the flames collect and where the cauteries are-
held to be heated. The heating of the cauteries is done by the-
burning- of some mineral essence poured into the lamp. The instru-
ment will do its work from half an hour to two hours without refilling.
Whatever is the mode of firing, some general rules are to be ob-
served. If possible, a favorable time should be selected. Spring-
and fall are favorable, and summer objectionable, as during that
season the inflammation is often exaggerated and the itching intense^
the animals scratch, rub, and bite themselves, so that, at times^
serious accidents are the result.
Fig_ 41— Paquelin de Place's cautery.
The preparation of the animal is important. It should have
fasted, if it is to be cast ; if very strong and plethoric, its rations-
should be reduced for several days, and a laxative should be given.
The region to be fired should be cleaned, all scabs brushed away, if
there are any ; the hair should be clipped with the machine or cut
short with the scissors. For superficial firing, the hair should be
left a little long ; so that the instrument may be kept from sliding
off the point or the line marked off, by a thin carbonized coat of
burnt hair. For the deep cauterization of synovials, some antisep-
tic measures may be useful. The cleaner the skin shall be, the less
the danger of infection after the operation. When firing is applied
CAUTERIZATION — FIRING.
85
lo regions where the skin is very loose, it is wise to mark the out-
lines of the surface to be cauterized before the animal is thrown.
Quiet, unirritable horses will endure the operation well, in the
standing position ; a twitch on the upper lip and the foot raised are
sufficient. Sometimes firing can be done in special regions, by
putting the horse in stocks.
But when firing is very painful, it is better to cast the animal. If
Ihe operation is to be on the external surface of a leg, he is thrown
cr::!^
Fi?. 1
Fiff 2
Fig. 42. — Eolipiles.
on the opposite side ; if the firing is to be applied all round the
joint, the inner surface should be operated upon first. When one
fires, at one sitting, the legs diagonally opposite, the external face of
one and the internal face of the other should be operated upon first ;
and when the animal is turned for the second part of the operation,
the cauterized surfaces must be protected from the bedding by cloth.
The fastening of the animal varies with each particular case. Gen~
erally the leg to be operated upon is kept in the hobble ; its con-
gener is fastened either forward or backward, as the case may be.
When the coronet or fetlock is to be fired, the best way is to secure
both legs together, above the knee or the hock, with a rope, passed
86 VETERINARY SURGICAL THERAPEUTICS.
in a figure 8 round both ; then to take the diseased leg out of the
hobble, pulling it forw^ard or backward to operate upon. The
hobble-stick is not necessary.
Let us consider the technic of line cauterization. (Fig. 43.)
When the subject is prepared and secured in good position, the
operator marks the firing. Renault recommended that the lines
should be parallel to the hair; Bouley, like Garsault, preferred
them oblique. The transverse lines of the English are as good and
Fig. 43. — Cauterization of the principal regions, where fire is generally applied. — Shank, fetlock, pastern
and coronet of the left hind-limb: superficial point firing; — pastern and coronet of the left fore-limb i
sharp point tiring ; — tendons and stifle of right limbs : stripe firing.
do not disfigure any more. The drawing of the firing is of little
importance. Fancy drawings have long been abandoned. What
is essential, is to make the lines straight, evenly distant, and ex-
tending somewhat beyond the diseased zone. Converging lines-
must not come together nor cross each other, as the cutaneous
portions of the angles would be exposed to too much heat and might
slough. When the firing is to envelop a section of the leg, a verti-
cal line should be drawn in front and behind, to indicate where the
lines of the lateral fans are not to extend on the opposite face.
The spaces to be left between the lines vary according to th&
CAUTERIZATION — FIRING. 8/
thickness of the skin and the extent of the region to be cauterized.
Closed and superficial lines are preferable to those made far apart and
deep. Generally they are separated by one to one and a half centi-
meters. Once marked, firing must be made with the proper degree
of heat. The cauteries, heated to a dark red or bright red heat —
ieniperatura maxima — should be slowly drawn over the lines, with-
out pressure in lowering or raising the hand, according to the
surface, — the instrument always held perpendicular to the skin. It
should be drawn towards the operator or pushed away from him,
but never contrary to the growth of the hair. It should not be passed
twice in succession over the same line ; the firing should be carried
the whole extent of the region, beginning at one end, passing suc-
cessively to the other, and returning to the starting point. In this
way, one may avoid the destroying effect of the heat. When the
surface is small, one should proceed slowly and leave a little time
between the applications of the instrument.
What are the signs which indicate that the firing is sufficient .-'
The aspect of the bottom of the lines, the exudation which takes
place, the state of infiltration of the skin and the more or less
marked rise of the epidermis, almost always tell exactly, providing
the operation has been performed according to the established rules.
There are three degrees of firing. According to the first, the lines,
not deep, have a few drops of serosity oozing from their borders ;
their bottom is slightly yellow ; the skin slightly infiltrated ; the
epidermis still adherent. According to the second, the lines are
deeper ; their bottom a clear yellow ; the oozing of serosity greater ;
the epidermis is easily raised. According to the third, the skin is
almost entirely cut through ; the edges of the lines have a tendency
to separate widely and may leave ugly cicatrices ; their bottom is
straw yellow, filled with abundant serosity ; often the skin is covered
with little blisters. The cautery, heated to a bright red color,
should be carried along each line five or six times for a light firing,
eight or ten for an ordinary, from twelve to fifteen for a strong
cauterization. These numbers, of course, will vary with the weight
and the temperature of the instrument, the dexterity of the operator,
and the condition of the skin.
Superficial point cauterization may be performed in many regions
standing. The points are placed in a quincunx. In general, points
and lines are separated by the same space. They can be made closer
at the places where the firing is to be more severe.
The application of the points is repeated according to the intended
strength of the firing. As in line-firing, the strength is recognized
by the color of the skin at the bottom of the points, by the quantity
of serosity thrown out, by the condition of the epidermis between
the points. To apply the pointed cauteries once or twice only and
88 VETERINARY SURGICAL THERAPEUTICS.
cover the parts with a blister, is a process very advantageous when
one desires to avoid disfigurement.
To U. Leblanc is due the introduction, into our surgery, of
catderizaiion in deep fine points, which he made known in 1836. The
characteristic of this method is the piercing of the skin through to
the subcutaneous connective tissue. The points are appHed in the'
same way, but somewhat closer than in superficial firing. The
instrument is slightly pressed upon, so that with one or two strokes
the skin is perforated.
The advantages of this mode of cauterization are facility and
rapidity of execution, and more intense and deeper action. Leblanc
used to run through the skin with two, three or four strokes of the
instrument, and complete the operation with a blistering application.
During summer, we apply the instrument only twice. When the
cautery is applied three or four times, especially during the hot
months of the year, it is prudent not to use the blistering process,
until a few days after — if the firing is not sufficiently strong.
For a long time, the absolute respect, in veterinary surgery, for
synovial membrane, was dogmatic. It was known that happy
results had been obtained by Basch, Boettger, Fischer, Robertson,
and Bruche, with fine punctures of synovial sacs with the red iron or
with the bistoury ; these practitioners were not imitated, their
advice remained a dead letter : so many unsuccessful attempts were
known, though they had not been published.
In 1847, Rey had already observed'the harmlessness of the intro-
duction of fine incandescent needles into the synovial membrane.
Twenty years later, Bianchi made known his experiments of the
Treatment of Synovial Dropsies with Heated Needles. The new method,
studied and discussed by Abadie, Bouley, Foucher, Peuch, and
Lenck, aroused much opposition at first. It has, however, resisted
all attacks ; and the number of its advocates is daily increasing.
When well performed, it is harmless, even for articular synovial
membranes ; and for intensity of action, and therapeutic value, it
surpasses all others. It is indispensable to use very fine points, the
diameter of which does not exceed one millimeter and a half. In
preference to the ordinary elongated cauteries, needles of uniform
diameter should be used ; such as that of the Bourguet cautery, or
the platinum point of the Zoocautery.
The dots are arranged in a quincunx, one centimeter apart. The
technic is somewhat important; the heated needle is implanted
in the tissues to the desired depth and immediately taken out. When
it is over the course of blood vessels and nerves, it should not go
deeper than the subcutaneous connective tissue. There is no harm
in insertins: the instrument several times in the same dot, when one
CAUTERIZATION — FIRING. 89
is operating on fibrous or bony tissues ; it is necessary to do so, if
â– one desires to produce a strong effect, though this is dangerous, even
with fine needles, for synovial membranes. We have seen carpal
synovitis follow an application made twice in the firing of a tendon.
Dots made with the red iron are aseptic, and such they remain as
deep as they go, when made small, fine, and with one stroke. It is
not necessary, however, for synovial dropsies, that all points shall
be perforating.
Give a single stroke for synovial membranes and two or three for
other tissues ; in some cases complete the operation with a blister ;
such are the rules of the needle cauterization.
Shall the cauterized regions be recovered with emollient applica-
tions.'' The observations of Renault, Favre, Gourdon, and Peuch
have shown that greasy substances assist suppuration, interfere with
cicatrization, and increase the size of wounds and of cicatrices.
Their immediate use after cauterization is condemned. When the
inflammatory reaction is too severe, antiseptics may be resorted to
(lotions or powders). If cauterization is not sufficient, a stimulating
friction (a blister, mercurial or red precipitate ointment) must be
made after the second or third day. Notwithstanding the absence
of exudation in too strong firing, practitioners know how to distin-
guish it from weak firing.
The consecutive phenomena of firing vary rnuch, according to the
method used. If the firing has been superficial, no matter in what
shape, during the days following, the region is swollen, and an
exudation more or less abundant is thrown out at the bottom of the
dots or of the lines, which soon dries up and forms yellow grayish
crusts, covering the entire region ; the resting of the leg is very
painful, the lameness is apparent and a severe itching exists. As
long as this lasts, the patient must be closely watched ; and to
prevent his biting and rubbing himself, he has to be tied up close to
his manger, with a cradle or a side bar fixed to his halter and
surcingle. The crusts become loose towards the eighth, tenth or
fifteenth day ; to accelerate their dropping, frequent lotions of warm
water may be applied, in preference to poplar ointment ; if the skin
has a tendency to crack, it may be covered with borated vaseline
or glycerine. Later on, the eschars produced by the cautery drop
off themselves ; when a great thickness of the dermis is involved,
they som.etimes adhere longer, and their sloughing takes place bv a
suppurative process, which leaves exuberant granulating surfaces,
followed by permanent scars, no longer concealed by the new
growth of hair.
While these phenomena take place on the surface of the skin, the
90 VETERINARY SURGICAL THERAPEUTICS.
subcutaneous tissues are inflamed, and in a state of hyperaemia ;
an abundant exudation infiltrates them, and an active cellular prolif-
eration takes place in them ; followed by resorption, induration
and compression, and ultimate and salutary effects of the caloric
action.
The effects of firing in deep points are more apparent than those
of superficial cauterization. The swelling of the leg is often greater,
although the serosity flows abundantly through the perforations
of the skin. Applied in this manner, says Leblanc, "firing leaves
as many cicatrices on the skin and in the cellular tissue as there
have been dots made. Those cicatrices, numerous and very close
together, produce a good effect ; they form a kind of permanent
compressive bandage, far superior to any other." Indeed, it is
certain that the retraction of these little islands of inodular tissue
have, through the medium of the skin, an active compressive effect
upon the diseased tissues, analogous to that which would be made
with a solid elastic band. The care afterwards is the same in this
as it is in superficial firing.
The phenomena following needle-firing vary according to the
depth of the punctures and the nature of the tissues involved. But
there is always a great inflammation of the cauterized region, the
leg becomes much swollen, at times very hot and painful, and the
animal is affected with a more or less marked reactive fever. When
the firing has been applied upon a synovial tumor, "besides the
serosity, synovia flows, sometimes in large quantities, which forms,
upon and below the cauterized surface, a grayish yellow albuminous
coat, running down the leg to the ground, and sometimes soiling
the bedding."
After two or three days, this serosity dries up, the holes become
obliterated, and the flow stops. The crusts fall off during the
second week, the eschars are eliminated towards the twentieth day,