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Cauterization has been used to stop heavy bleeding since antiquity. The process was described in the Edwin Smith Papyrus[5] and Hippocratic Corpus.[6] It was primarily used to control hemorrhages, especially those resulting from surgery, in ancient Greece. Archigenes recommended cauterization in the event of hemorrhaging wounds, and Leonides of Alexandria described excising breast tumors and cauterizing the resulting wound in order to control bleeding.[7] The Chinese Su wen recommends cauterization as a treatment for various ailments, including dog bites.[8] Indigenous peoples of the Americas, ancient Arabs, and Persians also used the technique.[9] Tools used in the ancient cauterization process ranged from heated lances to cauterizing knives. The piece of metal was heated over fire and applied to the wound.[10] Cauterization continued to be used as a common treatment in medieval times. The Babylonian Talmud (redacted in 500 AD), alluding to the practice, states: "... and the effect of the hot iron comes and removes the traces of the stroke."[11] While mainly employed to stop blood loss, it was also used in cases of tooth extraction and as a treatment for mental illness. In the Muslim world, scholars Al-Zahrawi and Avicenna wrote about techniques and instruments used for cauterization.[12] As late as the 20th-century, Bedouins of the Negev in Palestine had it as their practice to take the root of the shaggy sparrow-wort (Thymelaea hirsuta), cut the root into splinters lengthwise, burn the splinter in fire, and then apply the red-hot tip of a splinter to the forehead of a person who was ill with ringworm (dermatophytosis).[13] The technique of ligature of the arteries as an alternative to cauterization was later improved and used more effectively by Ambroise Paré. Electrocautery[edit] "Electrocautery" redirects here. Not to be confused with Electrosurgery. Electrocauter Electrocauterization is the process of destroying tissue (or cutting through soft tissue) using heat conduction from a metal probe heated by electric current. The procedure stops bleeding from small vessels (larger vessels being ligated). Electrocautery applies high frequency alternating current by a unipolar or bipolar method. It can be a continuous waveform to cut tissue, or intermittent to coagulate tissue. The electrically produced heat in this process inherently can do numerous things to the tissue, depending on the waveform and power level, including cauterize, coagulate, cut, and dry (desiccate). Thus electrocautery, electrocoagulation, electrodesiccation, and electrocurettage are closely related and can co-occur in the same procedure when desired. Electrodesiccation and curettage is a common procedure. Unipolar[edit] In unipolar cauterization, the physician contacts the tissue with a single small electrode. The circuit's exit point is a large surface area, such as the buttocks, to prevent electrical burns. The amount of heat generated depends on the size of contact area, power setting or frequency of current, duration of application, and waveform. A constant waveform generates more heat than intermittent. The frequency used in cutting the tissue is higher than in coagulation mode. Bipolar[edit] Bipolar electrocautery passes the current between two tips of a forceps-like tool. It has the advantage of not disturbing other electrical body rhythms (such as the heart) and also coagulates tissue by pressure. Lateral thermal injury is greater in unipolar than bipolar devices.[14] Electrocauterization is preferable to chemical cauterization, because chemicals can leach into neighbouring tissue and cauterize outside of intended boundaries.[15] Concern has also been raised regarding toxicity of the surgical smoke electrocautery produces. This contains chemicals that, through inhalation, may harm patients or medical staff.[16] Ultrasonic coagulation and ablation systems are also available. Chemical cautery[edit] Many chemical reactions can destroy tissue, and some are used routinely in medicine, most commonly to remove small skin lesions such as warts or necrotized tissue, or for hemostasis.[17] Because chemicals can leach into areas not intended for cauterization, laser and electrical methods are preferable where practical.[18] Some cauterizing agents are: Silver nitrate is the active ingredient of the lunar caustic, a stick that traditionally looks like a large match. It is dipped in water and pressed onto the lesion for a few moments.[19] Trichloroacetic acid[20] Cantharidin is an extract of the blister beetle that causes epidermal necrosis and blistering.[21] It is used to treat warts.[22] Nasal cauterization[edit] Frequent nosebleeds are most likely caused by an exposed blood vessel in the nose, usually one in Kiesselbach's plexus. Even if the nose is not bleeding at the time, a physician may cauterize it to prevent future bleeding. Cauterization methods include burning the affected area with acid, hot metal, or lasers. Such a procedure is naturally quite painful. Sometimes, a physician uses liquid nitrogen as a less painful alternative, though it is less effective. A physician may apply cocaine in the few countries that allow it for medical use. Cocaine is the only local anesthetic that also produces vasoconstriction,[23] making it ideal for controlling nosebleeds. More modern treatment applies silver nitrate after a local anesthetic. The procedure is generally painless, but after the anesthetic wears off, there may be pain for several days, and the nose may run for up to a week after this treatment. Nasal cauterization can cause empty nose syndrome.[24][25][26] Infant circumcision[edit] Cauterization has been used for the circumcision of infants in the United States and Canada. The College of Physicians and Surgeons of Manitoba advises against its use in neonatal circumcision.[27] This method of circumcision resulted in several infants having their penises severely burned.[28][29][30][31][32][33] See also[edit] Cryosurgery Diathermy Singe References[edit] .mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman} ^ .mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}"Dictionary definition, retrieved: 2009-03-07". ^ Soballe, Peter W; Nimbkar, Narayan V; Hayward, Isaac; Nielsen, Thor B; Drucker, William R (1998). "Electric Cautery Lowers the Contamination Threshold for Infection of Laparotomies". The American Journal of Surgery. 175 (4): 263–6. doi:10.1016/S0002-9610(98)00020-8. PMID 9568648. ^ Robinson, Victor, ed. (1939). "Actual cautery". The Modern Home Physician, A New Encyclopedia of Medical Knowledge. WM. H. Wise & Company (New York)., page 16. ^ Agnus Stevenson, ed. (2010). "cauterize". Oxford Dictionary of English. OUP. p. 277. ISBN 978-0-19-957112-3. ^ Sullivan, Richard (August 1996). "The identity and work of the ancient Egyptian surgeon". Journal of the Royal Society of Medicine. 89 (8): 472. doi:10.1177/014107689608900813. PMC 1295891. PMID 8795503. ^ Colarusso, Chad (9 May 1995). "The Presocratic Influence upon Hippocratic Medicine". Tufts University. Archived from the original on 2001-11-04. Retrieved 2008-11-07. ^ Papavramidou, Niki; Papavramidis, Theodossis; Demetriou, Thespis (2010). "Ancient Greek and Greco–Roman Methods in Modern Surgical Treatment of Cancer". Annals of Surgical Oncology. 17 (3): 665–667. doi:10.1245/s10434-009-0886-6. PMC 2820670. PMID 20049643. ^ Unschuld, Paul U. (2003). "Survey of the contents of the Su wen". Huang Di Nei Jing Su Wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text. University of California Press. p. 314. ISBN 978-0-520-23322-5. ^ Selin, Helaine, ed. (2006-04-11). Medicine Across Cultures. Springer. pp. 212, 226. ISBN 978-0-306-48094-2. ^ "Surgical Instruments from Ancient Rome". Archived from the original on 2009-09-18. Retrieved 2008-11-07. ^ Babylonian Talmud (Hullin 8a) ^ Cosman, Madeleine Pelner; Jones, Linda Gale (2009). "Medicine, Science, and Technology". Handbook to Life in the Medieval World. Vol. 1–3. Infobase. p. 497. ISBN 978-1-4381-0907-7. ^ Ḳrispil, Nissim (1985). ילקוט הצמחים: צמחי הרפואה והתועלת של ארץ-ישראל [A Bag of Plants: The Useful Plants of Israel] (in Hebrew). Vol. 3 (T–M). Jerusalem: Cana. p. 738. ISBN
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