A first ultrasonic medical instrument includes an ultrasound transducer, a medical ultrasonic blade, and a tube adapted to contain a liquid. A first tube end is adapted to have the liquid proximate the first tube end, when the tube contains the liquid, be ultrasonically vibrated to generate an ultrasonically-vibrating energy wave. The ultrasonic blade is acoustically connected to the liquid proximate a second tube end, when the tube contains the liquid. A second ultrasonic medical instrument includes a heat pulse initiator, a medical ultrasonic blade, and a tube adapted to contain a liquid. The heat pulse initiator is adapted to output heat pulses having an ultrasonic pulse frequency. A first tube end is adapted to receive the heat pulses outputted by the heat pulse initiator, wherein the heat pulses have an energy sufficient to create an ultrasonically-vibrating energy wave in the liquid, when the tube contains the liquid. The ultrasonic blade is acoustically connected to the liquid proximate the second tube end, when the tube contains the liquid.
